EMDR Worksheet*

Safe Place_______________________________________ Train Metaphor_____

Stop Signal_____

As we go through the EMDR process we will be doing brief sets of eye movements (EMs) (or bilateral stimulation). At the end of
each set I will ask you to blank it out (or let it go) and take a deep breath, and then ask you what do you notice now? This is a
simple check on what you are experiencing. I need to know from you what is going on with clear, concrete feedback. Sometimes
things will change and sometimes they wont. There are no supposed tos in this process. Just give as accurate feedback as you
can without judging whether it should be happening or not. And let whatever happens, happen. Well continue with the sets of eye
movements (or bilateral stimulation) until we complete the work or its time to bring the session to a close. I will be the guide through
this process.

Presenting memory:

Picture:
What picture represents the worst part of this incident? or
What picture represents this incident?
If no picture: When you think of the incident, what do you get?

Negative cognition (NC): What words go best with that picture that express your negative belief about yourself now?
Positive cognition (PC): When you bring up that picture or incident, what would you like to believe about yourself now?
VoC (Validity of Cognition): When you think about that picture or incident, how true do those words (repeat PC) feel to
you now on a scale from 1 to 7, where 1 is completely false and 7 is completely true?
(completely false) 1

7 (completely true)

Emotions/feelings: When you bring up that picture or incident and those words (repeat NC), what emotion(s) do you feel
now?
SUDS (Subjective Units of Disturbance Scale): On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the
highest you can imagine, how disturbing does it feel to you now?
(no disturbance) 0

10 (highest imaginable)

Location of body sensation: Where do you feel the disturbance in your body?

Desensitization: Id like you to bring up that picture, those words (repeat negative cognition), notice where you are feeling
it in your body-- and follow my fingers.
1) Begin the eye movements slowly and increase to the speed which the client can comfortably tolerate. First set of eye
movements is 24 passes. Occasional supportive comments can be helpful while guiding eye movements, like, thats it;
good.
2) After a set of eye movements, instruct the client to, Let it go (or blank it out) and take a deep breath. Pause and then
ask, What do you notice now?
3) Once client reports, say, Go with that (or notice that) and do another set of EMs. Sets of eye movements each
typically consist of 24-30 passes and can be increased or decreased as indicated by client feedback or non-verbal cues.

4) Continue with sets of EMs, reprocessing disturbance through all the associated channels. If you reach the end of a
channel and they have not spontaneously moved to the next channel, or if you are not certain where the client is in the
processing of the memory, bring their attention back to the target: I want you to bring your attention back to the original
incident and tell me what you notice now.

5) Continue with desensitization until no new channels of material come forward and the client reports a 0-1 SUDS.
To Check SUDS: When you bring up the original incident/experience, on a scale of 0 to 10 where 0 is no disturbance
and 10 is the highest you can imagine, how disturbing does it feel to you now? SUDS_______
6) If more than 0-1 then continue with desensitization. If 0 (or an ecological 1) then do at least one additional set of eye
movements. Then proceed to Installation Phase.

Installation:
1) Check the Positive Cognition: When you think about the original incident now, do the words (repeat the positive
cognition) still fit or is there another positive statement you feel would fit better? If the PC still fits proceed to the next
step; if it no longer fits, help them determine the current PC & then proceed.
New PC, if needed _______________________________________________.
2) Take a VoC measurement: Think about the incident and those words (PC). How true do they feel now, if 1 is
completely false and 7 is completely true? VoC ______
3) Installation: Think about the incident and hold that together with those words (repeat the PC). Do a short set of EMs,
15-18 passes. Then measure the VoC. Repeat, reminding them to think about the incident and to hold that with the PC
which you again state. Continue until they report a VOC of 6 or 7 and then do at least one more set of eye movements.
Then proceed to the Body Scan.

Body Scan: Close your eyes; concentrate on the incident and the positive cognition, and mentally scan your body. Tell
me where you feel anything. If any sensation is reported, do EM. If a positive/comfortable sensation is reported, do
short sets of EM to strengthen the positive feeling. If a sensation or discomfort is reported, reprocess until all discomfort
subsides. Then proceed to Closure.
Closure (debriefing the experience): The processing we have done today may continue after the session. You may or
may not notice new insights, thoughts, memories, or dreams. If you do, just notice what you are experiencing. Take a
snapshot of it (what you are seeing, feeling, thinking, and the trigger), and keep a log. We can work on this new material
next time. If you feel it is necessary, call me.

Closing down an incomplete session: If client is noticeably upset or SUDS is greater than 1 or if in Installation Phase
and the VoC less than 6:
1. Prepare client for ending the session: We are coming close to the end of the session and will need to stop soon (can
help to be even more specific [well do two more sets]. If there is any hesitation on their part check in with them about
their comfort stopping at this point (How comfortable are you stopping now?)
Once ending reprocessing, give encouragement and support for the work they have done today.
2. Skip Installation and Body Scan.
3. Use any needed stabilization tools (container exercise; Safe Place, Lightstream, or other tools previously used
successfully).
4. Read above closure statement to client.
5. Help client to fully orient to present time (e.g., Tell me 3 things you are going to see as you drive back to work; Tell
me three things you are looking forward to in the next week.)
Next session:
Reevaluation (checking your work): Whether the target was completed in the previous session or the session ended
with the target unfinished you want to check their current experience of the target.
If the last session ended with the target incomplete: I want you to turn your attention back to the incident we worked
on last session and tell me what you notice.
> If they report no disturbance, return to Desensitization Phase with the direction: I want you to turn your attention back
to the incident, and notice feeling neutral and begin sets of eye movements (more sets will likely bring forward
additional disturbance).
> If they find any disturbance return to Desensitization Phase by asking: Where do you notice that disturbance in your
body? With that information direct them with, I want you to turn your attention back to the incident, notice feeling it
in (repeat location(s) they identified in their body), and follow my fingers, and begin eye movements.
If completed the target (0-1 SUDS, VoC of 6-7 and clear Body Scan: I want you to turn your attention back to the
incident we worked on last session. When you think about the incident, how disturbing does it feel to you now, on a
scale of 0-10, where 0 is no disturbance or neutral and 10 is the highest you can imagine?
> If the SUDS is greater than 0-1 return to Desensitization Phase.
> If the SUDS has remained 0 and the VoC is less than 6-7, return to Installation Phase.
> If the VoC remained a 6-7, proceed to the Present and Future prongs of the approach.
Present: Check prior triggers, recent events and scan for any related recent event, present life circumstance or prior
trigger that still evoke a disturbing response. Target and reprocess and then install a future template on encountering
that again.
Future: Assist client to incorporate internal changes into anticipated or imagined life experiences in the future, targeting
any that carry disturbance and use future template to install imaginal rehearsal.

* adapted from Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing; Basic Principles, Protocols, and Procedures. New York: The Guilford Press.
pg. 431-432.