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What Parts of EMDR Are Standardized and What Parts Are Flexible?
Short Answer: Eye Movement Desensitization and Reprocessing (EMDR) has a standardized overall framework, but it is not a rigid, identical procedure for every person. The eight phases of EMDR, the process of identifying and assessing targets, reprocessing distressing material, checking beliefs and body sensations, closing sessions, and reevaluating previous work are core parts of the approach. Within that framework, there can be flexibility in pacing, preparation, target order, wording, amount of discussion, type of bilateral stimulation, and how the process is adapted to the individual. EMDR guidance emphasizes fidelity to the eight phases while also recognizing that some procedures can be carried out in different ways as long as the purpose of each phase is maintained.
Key Takeaways
- EMDR has a standardized eight-phase treatment framework.
- The overall goals of each phase are core parts of EMDR.
- Standard EMDR also considers past experiences, present triggers, and future situations.
- The amount of time spent in each phase can vary considerably.
- Bilateral stimulation can be visual, auditory, or tactile.
- Pacing, wording, target order, preparation, and amount of discussion can be adapted.
- The eight phases do not have to fit neatly into one session or unfold in an identical way for every person.
- Flexibility means adapting how EMDR is delivered—not removing the core EMDR structure.
Why Is EMDR Both Standardized and Flexible?
At first, those ideas can sound contradictory.
If EMDR is standardized, how can it also be individualized?
The answer is that the framework is standardized, while many details of how someone moves through that framework are flexible.
The EMDR International Association describes the eight phases as a map for treatment. Each phase has a particular purpose, but not every phase has to occur during every session.
EMDR's formal definition goes a step further: treatment fidelity to the eight phases is associated with the best results, while some procedures can be implemented in more than one way as long as the broad goals of the phase are achieved.
That gives EMDR both consistency and room for individualization.
What Is Standardized: The Eight-Phase Framework
The most recognizable standardized feature of EMDR is its eight-phase framework:
- History-taking and treatment planning
- Preparation
- Assessment
- Desensitization
- Installation
- Body scan
- Closure
- Reevaluation
These phases organize EMDR from the initial understanding of the problem through preparation, active reprocessing, and review of the results.
This framework is one of the main reasons EMDR is considered a structured therapy.
However, the eight phases should not be interpreted as eight identical steps that must each take the same amount of time.
What Is Flexible: How Long Each Phase Takes
There is no rule that every person should spend the same amount of time in each phase.
One person may move through preparation relatively quickly.
Another may benefit from spending more time:
- Understanding the process
- Practicing grounding or coping strategies
- Getting comfortable with bilateral stimulation
- Clarifying targets
- Building familiarity with noticing thoughts, emotions, and body sensations
History-taking can also continue as new information becomes relevant.
The framework stays the same, but the time spent within it changes according to what is needed.
What Is Standardized: Identifying a Target
EMDR is normally organized around specific target material rather than processing distress in a completely unstructured way.
A target may involve:
- A memory
- An image
- A negative belief
- An emotion
- A body sensation
- A present trigger
- An anticipated future situation
During the assessment phase, several parts of the target are identified so there is a clear starting point for reprocessing.
Standard EMDR assessment commonly looks at the image, negative belief, preferred belief, emotion, level of disturbance, and associated body sensations.
What Is Flexible: Which Target Comes First
The fact that EMDR uses targets does not mean there is only one correct memory to begin with.
Treatment planning may involve deciding which experiences are most relevant and in what order they should be addressed.
One person may begin with an early experience connected to a current problem.
Another may first work with:
- A recent event
- A current trigger
- A particularly accessible memory
- A future situation that causes distress
The target sequence can therefore be individualized while the underlying target-processing framework remains recognizable.
When working with experiences connected to grief, the choice of target can reflect which memory or current reminder feels most relevant.
What Is Standardized: Past, Present, and Future
Standard EMDR uses what is often called a three-pronged approach.
It considers:
- Past experiences connected with the current problem
- Present triggers that continue to activate distress
- Future situations in which a different response is desired
EMDRIA describes this past-present-future approach as part of the standard protocol embedded within the larger eight-phase framework.
This does not mean every article, problem, or session must address all three at once.
It means EMDR treatment planning looks beyond a single isolated memory.
What Is Flexible: The Exact Route Through the Material
Even after a target is selected, no one can predict exactly where reprocessing will go.
A person may begin with one memory and then notice:
- Another memory
- A different image
- A body sensation
- Anger
- Sadness
- A new thought
- A realization
- A change in perspective
EMDR allows processing to follow these associations.
So the procedure is structured, but the content that emerges is individual.
This is an important form of flexibility built directly into the method.
What Is Standardized: Bilateral Stimulation During Reprocessing
Bilateral stimulation is a characteristic component of EMDR reprocessing.
During active processing, attention to the target is paired with stimulation such as:
- Side-to-side eye movements
- Alternating auditory stimulation
- Alternating tactile stimulation
The stimulation occurs in sets, followed by pauses in which the person notices what is present now.
That repeated rhythm of focus, stimulation, noticing, and continuing is part of standard EMDR reprocessing.
What Is Flexible: The Type of Bilateral Stimulation
EMDR does not require everyone to use the same form of bilateral stimulation.
Recognized options include:
- Visual stimulation
- Auditory stimulation
- Tactile stimulation
Someone might follow a visual target from side to side, hear alternating sounds, or use alternating taps.
The exact method may depend on the person, setting, and practical considerations.
However, flexibility in method does not mean research has shown every form of stimulation to be identical in its effects.
The methods are options within EMDR, not necessarily interchangeable in every scientific sense.
What Is Flexible: The Length of a Set
Even the length of bilateral-stimulation sets is not absolutely fixed.
EMDRIA defines a set as a period of bilateral stimulation that commonly lasts around 20 to 60 seconds but may vary.
That is a good example of how EMDR works:
There is a recognizable procedure, but not every detail is governed by one unchanging number.
What Is Standardized: Checking What Changed
EMDR does not simply begin bilateral stimulation and assume something happened.
The process includes repeated checks of the person's experience.
During assessment and reprocessing, EMDR may track:
- Distress
- Beliefs
- Emotions
- Images
- Body sensations
- New associations
Standard EMDR also uses formal ratings such as the Subjective Units of Disturbance scale and Validity of Cognition scale to establish reference points and monitor changes.
This systematic checking is one of the standardized features that distinguishes EMDR from simply using eye movements or tapping on their own.
What Is Flexible: What a Person Notices
The categories may be structured, but the response is not supposed to be manufactured.
One person may notice:
“The image looks farther away.”
Another may notice:
“My chest feels less tight.”
Another may remember something completely different.
Someone else may initially notice very little.
There is no requirement that every set produce the same kind of response.
EMDR provides a structure for noticing change without dictating exactly what that change should look like.
What Is Standardized: The Preferred Positive Belief
Standard EMDR assessment includes identifying both a negative belief associated with the target and a more adaptive or preferred belief.
For example:
Negative belief: “I am powerless.”
Preferred belief: “I can handle this now.”
Later in the process, the preferred belief is strengthened during the installation phase.
So EMDR does not focus only on reducing distress.
It also includes a structured process for checking what the experience means to the person now.
What Is Flexible: The Belief Itself
There is no universal positive statement everyone is supposed to use.
The preferred belief depends on the individual and the target.
Possible themes might involve:
- Safety
- Control
- Self-worth
- Responsibility
- Choice
- Capability
The structure asks for a preferred adaptive belief.
The exact belief comes from the person's experience.
What Is Standardized: The Body Scan
After reprocessing and installation, EMDR includes a body scan.
The person brings the target and preferred belief to mind and notices whether there is remaining physical disturbance.
If something remains, it may receive additional attention.
The body scan is therefore not simply an optional relaxation exercise.
It is one of the formal phases of the standard EMDR framework.
What Is Standardized: Closure
EMDR also has a defined closure phase.
The goal is to bring the session to an appropriate stopping point whether processing of the target is complete or still ongoing.
This means an EMDR session does not have to completely resolve a target every time.
The treatment has a structure for stopping and returning to the work later.
What Is Standardized: Reevaluation
Previous work is checked again rather than simply assumed to be finished.
During reevaluation, the person considers what happens now when they reconnect with previously processed material.
The process may examine whether:
- Distress remains low
- The preferred belief still feels accurate
- New material has emerged
- More processing is needed
- Another target should be addressed
EMDRIA describes reevaluation as the point where previous results and future treatment directions are reviewed.
What Is Flexible: The Amount of Talking
EMDR is not completely silent, but it also does not require continuous conversation.
There may be substantial discussion during:
- History-taking
- Preparation
- Assessment
- Closure
- Reevaluation
During active reprocessing, check-ins are often shorter.
Someone might simply say:
- “Another memory came up.”
- “It feels farther away.”
- “I notice anger.”
- “The tightness moved.”
- “Nothing changed.”
Some people naturally process more verbally than others.
The amount of talking can therefore vary while the broader EMDR procedure remains the same.
What Is Flexible: The Language Used
The exact wording used to explain EMDR or ask questions can also vary.
Some people may prefer:
- Short questions
- Concrete language
- Written prompts
- More explanation
- Less explanation
- More time before answering
Research on adapting EMDR for autistic people has found that therapists frequently adjusted language, communication style, structure, imagery, sensory input, and bilateral stimulation while retaining the core EMDR process.
This illustrates an important principle:
Standardization applies to the therapeutic framework, not to requiring identical wording for every person.
What Is Flexible: Sensory and Processing Preferences
Someone may prefer:
- Visual stimulation over sounds
- Sounds over visual stimulation
- Tactile stimulation
- A quieter setting
- More predictable instructions
- Additional time to notice body sensations
- Less emphasis on imagery
These practical accommodations can make EMDR easier to engage with.
Again, individualizing these details does not mean changing the therapy into an unrelated method.
What Is Flexible: Preparation
The preparation phase has standardized goals, but how those goals are achieved can vary.
Someone might use:
- Grounding exercises
- Safe/Calm Place imagery
- Breathing
- Mindfulness
- Other coping or resourcing strategies
EMDRIA describes these as resources that can support state change and preparation.
One person may need only limited preparation.
Another may use a larger set of resources before beginning reprocessing.
The goal of the phase is standardized; the exact route to that goal can differ.
Does EMDR Always Move Through the Phases in a Straight Line?
Not necessarily.
The phases provide the framework, but EMDR practice is not always perfectly linear.
For example, processing may reveal information that leads back to:
- Additional history-taking
- More preparation
- A different target
- Another period of assessment
Recent EMDRIA guidance explicitly describes the eight phases as foundational while noting that they are not always linear in actual practice.
So returning to an earlier phase does not automatically mean the protocol has been abandoned.
Can EMDR Be Adapted Without Stopping Being EMDR?
Yes—but there is a boundary.
EMDR's formal definition emphasizes that some procedures may be implemented differently as long as the broad goals of each phase are achieved.
That means flexibility can include:
- Different wording
- Different pacing
- Different bilateral stimulation methods
- Longer or shorter preparation
- Different target sequencing
- Adaptations to communication or sensory preferences
But simply using bilateral stimulation without the larger EMDR framework does not automatically make something EMDR.
The distinction is between adapting the protocol and removing the protocol.
What About Online EMDR?
Therapist-guided EMDR can be provided online while retaining the same overall framework.
The location changes, and some practical details may change, but the core process can still include:
- History-taking
- Preparation
- Assessment
- Reprocessing
- Installation
- Body scan
- Closure
- Reevaluation
The bilateral stimulation method may also be adapted for remote delivery.
This is another example of flexible delivery within a structured approach.
What About Self-Guided EMDR?
The distinction between structure and flexibility is also relevant to self-guided EMDR.
With Virtual EMDR, the user works independently through a structured online EMDR process rather than participating in a live therapist-led session. Users manage their own pacing, pauses, and available bilateral stimulation settings.
So some elements are user-controlled while the program still provides an organized framework.
This is different from simply choosing a memory and using bilateral stimulation with no surrounding process.
Conclusion
EMDR is neither completely rigid nor completely open-ended.
The standardized parts include its eight-phase framework, structured target assessment, reprocessing process, installation, body scan, closure, reevaluation, and broader attention to past experiences, present triggers, and future situations.
The flexible parts can include pacing, preparation length, target sequence, wording, amount of discussion, bilateral stimulation method, and adaptations for communication, sensory preferences, or processing style.
The most important distinction is:
EMDR standardizes the framework and goals of the process while allowing many details of how that process is delivered to be adapted to the individual.
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