Eye Movement Desensitization and Reprocessing Therapy, commonly referred to as EDMR, was founded by Francine Shapiro with the intention of helping individuals who were struggling with traumatic memories. Since its creation, EMDR has successfully helped individuals living with a variety of mental health concerns. Explore 10 EMDR exercises to help your clients process trauma, reduce distress, and develop coping strategies.
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For many, seeking help for a mental health concern can be overwhelming. Those who experience significant impairment from their mental health concerns are often worried about the time it takes to see the benefits of counseling. Eye Movement Desensitization and Reprocessing Therapy can be an effective tool to improve the quality of life for some clients in a timely manner.
EMDR is designed to help counselors access and process traumatic memories or events so that they can work with their Client’s to reach a new resolution (EMDR, n.d.). This can help decrease negative symptoms including psychological arousal and distress, and assist in reformulating core beliefs (EMDR, n.d.). Overall, having a positive impact on the Client’s quality of life. Keep reading to learn 10 EMDR Therapy Exercises and Activities you can do with your clients.
EMDR 8 Step Approach
Eye Movement Desensitization and Reprocessing Therapy follows an eight-phase approach. The eight phases are outlined as the following, by the EMDR Institute, Inc.:
Step 1: Information Gathering
Initially, it is important to focus on information gathering, which should include the client’s history and relevant experiences. At this time, the client’s treatment plan will be developed during this phase.
Step 2: Preparing to Cope with Emotional Distress
The Clinician then begins to focus on preparing the client to cope with the emotional distress that the Client will experience in later phases.
Steps 3 – 6: Identify and Process Painful Events
3-6. The target memory or event is identified and processed using EDMR procedures. During this phase, the client will work to identify a vivid visual of the event, any negative beliefs they have of themselves, and identify related emotions and body sensations. Clients are also asked to identify positive self-beliefs they have. The Clinician will guide and support the client through these phases.
Step 7: Logging Experiences
The Client is asked to keep track of their experience for one week in a written log. This log is designed to show the client’s use of what they have learned in session, including self-calming activities.
Step 8: Review Experience
The final phase examines the Client’s experience with EMDR therapy. This can include exploring what they have achieved and identifying future goals.
Mental Health Concerns That Can Benefit from EMDR Exercises
Research has found that EDMR can effectively reduce symptoms associated with Posttraumatic Stress Disorder, Panic Disorder, and some phobias (Cahill, S.P., Carrigan, M.H., & Frueh, B.C., 1999).
The EMDR Institute, Inc. reported that 84-90% of individuals who experienced a single traumatic event found that they no longer struggled with their Post Traumatic Stress Disorder symptoms after three 1.5 hour EMDR sessions. Additionally, promising results have been found for individuals who have multiple traumas and combat veterans with as few as 12 EMDR sessions (EMDR, n.d.). These results are encouraging for Clients who may be hesitant or concerned about the length of time that would be needed to see the positive effects of EMDR Therapy.
Eye Movement Desensitization and Reprocessing therapy is supported by the American Psychological Association, the World Health Organization, and the U.S. Department of Defense.
EMDR Exercises to do With Clients
Eye Movement Desensitization and Reprocessing exercises can be used to enhance the client’s experience in session. EMDR exercises can reinforce information discussed in the session, and help Clients utilize the skills they learn in their sessions. Here is an example list of EMDR activities that can be used during EMDR sessions:
1. Subjective Units of Disturbance (SUD) Rating Exercise
Teaching your client about the Subjective Unit of Disturbance, or SUD, can help clients rate the amount of distress they experience regarding challenging memories. Providing clients with a SUD worksheet, like the one available at TherapyByPro, can help them track their level of distress over time. Clients can use this worksheet to track their experience outside of the session and use it as a tool to reflect on their progress. Tracking their SUD can also provide them with an opportunity to reflect on the progress they have made in therapy.
What It Is: A rating scale that allows clients to track the intensity of distress related to challenging memories.
How It Helps Clients: Provides insight into changes in distress over time and reflects progress in therapy.
How to Do It: Teach clients to rate distress on a scale (0–10) using a SUD worksheet, track ratings over time, and reflect on progress in session.
2. Butterfly Hug Exercise
Introduce your client to the Butterfly Hug method to self-soothe. Take time to demonstrate this skill and answer any questions that they may have. Talk your client through the steps of a Butterfly Hug and follow up by asking about how they felt after practicing this skill. Encourage your client to use this self-soothing skill outside of the session, and follow up about their ability to do so.
What It Is: A bilateral stimulation exercise where clients cross their arms over their chest and tap alternately on their shoulders.
How It Helps Clients: Promotes emotional regulation and calming during moments of distress.
How to Do It: Demonstrate the steps, have the client practice, ask them to note their feelings before and after, and encourage use outside of sessions.
3. Challenging Cognitions Exercise
The Challenging Cognitions Worksheet offered by TherapyByPro can help clients develop positive cognitions to replace negative cognitions. Experiencing negative cognitions is a common experience after experiencing a challenging or negative event. Clients can use the worksheet to track negative thoughts that they were able to challenge and replace outside of therapy sessions, which can help them see their progress.
What It Is: A structured worksheet for tracking and challenging negative thoughts.
How It Helps Clients: Reinforces cognitive restructuring and tracks progress outside of therapy.
How to Do It: Have clients identify negative thoughts, develop positive alternatives, and record experiences using the worksheet.
4. Grounding Skills Exercise
Introduce your client to grounding skills. Grounding skills can be used to keep our minds in the present moment, rather than being wrapped up in the past or the future. You can discuss the use of our five senses in grounding skills, and encourage them to practice various grounding skills that they can utilize outside of sessions in moments of distress.
What It Is: Mindfulness-based exercises using the five senses to maintain present-moment awareness.
How It Helps Clients: Reduces dissociation and distress during EMDR or everyday stress.
How to Do It: Teach clients different grounding techniques (sight, sound, touch, smell, taste) and encourage regular practice.
5. Window of Tolerance Exercise
Introduce your client to the concept of the Window of Tolerance. Understanding physical symptoms associated with hyperarousal, optimal arousal, and hypoarousal can help your client recognize when they fall into a hyperarousal or hypoarousal state so that they can use skills to work towards feeling calm and safe within the optimal arousal state. TherapyByPro offers a Window of Tolerance Worksheet that can be used to track their experience outside of therapy sessions.
What It Is: A framework to identify hypoarousal, hyperarousal, and optimal arousal states.
How It Helps Clients: Encourages self-awareness and the ability to regulate emotions before distress escalates.
How to Do It: Discuss physical and emotional signs of each state, use the Window of Tolerance worksheet, and track experiences outside of session.
6. Deep Breathing Exercise
Introduce your client to the practice of deep breathing. Explain the process of breathing in through their nose and expanding their diaphragm rather than their chest. Some may benefit from visually seeing a demonstration where the Clinician breathes int through their nose, to their belly, and exhales through their mouth. Encourage your client to take several deep breaths in a row, and explore how they feel after this exercise compared to before the practice. Encourage your client to utilize deep breathing as a self-soothing skill.
What It Is: A diaphragmatic breathing exercise to reduce physiological stress responses.
How It Helps Clients: Lowers anxiety, promotes relaxation, and supports self-regulation.
How to Do It: Demonstrate breathing in through the nose to the diaphragm and exhaling through the mouth; have clients practice multiple cycles and reflect on sensations.
7. Safe Place / Calm Place Visualization Exercise
Another relaxation technique that clients can benefit from is using a Safe Place or a Calm Place. This can include thinking of a place that makes them feel calm and safe, how they feel when they think about this place, and using their senses within their safe place. They can then identify a word that represents their safe place for them so that when they think of that word, they can think of the positive associations they have with their safe place. TherapyByPro EDMR Safe Place Worksheet can be completed in a session and kept by the client to serve as a reminder of their safe place.
What It Is: Visualization of a calming or safe location using all senses.
How It Helps Clients: Provides emotional refuge and enhances coping with distressing memories.
How to Do It: Guide clients through imagining a safe place, note sensory details, choose a word to anchor the memory, and document with a Safe Place worksheet.
8. Eye Movement Practice Exercise
A helpful EMDR exercise for sessions would be to practice the eye movements that the client will be using during their EMDR Therapy sessions. This can help your client feel confident in their ability to engage in their therapy sessions and provide the Clinician with an opportunity to address any concerns that the client may have.
What It Is: A rehearsal of bilateral eye movements used in EMDR processing.
How It Helps Clients: Reduces anxiety about EMDR and increases engagement during sessions.
How to Do It: Guide clients through side-to-side eye movements while focusing on neutral stimuli and address questions or concerns.
9. EMDR Container Exercise
Clients who find themselves struggling to manage their distressing symptoms can benefit from using an EMDR Container Worksheet. The Container exercise can help Clients visualize a strong container that can carry their distressing feelings. The container should allow for the client to take out a single concern at a time, and they would have control regarding how much of a concern they take out at a time. During this exercise, clients are asked to describe the jar and explore how they would feel if they could put some of their concerns in their container. TherapyByPro offers an EMDR Container Worksheet that can serve as a template for an in-session EMDR activity.
What It Is: Visualization of a container to hold distressing thoughts temporarily.
How It Helps Clients: Gives clients control over when and how to engage with distressing content.
How to Do It: Have clients imagine a container, describe it in detail, and “store” concerns one at a time; use the EMDR Container Worksheet as a guide.
10. TICES Worksheet Exercise
Clients will likely experience distress outside of the session. Our EMDR TICES worksheet can help clients track the triggers, images, cognitions, emotions, and sensations they experience when they feel distressed. Encourage your client to notice the trigger, and take a snapshot of it that they can record on the worksheet and bring to the session. Once clients have completed the worksheet, they can put it in a safe place until their session when they can revisit the worksheet in session.
What It Is: A structured worksheet for recording Triggers, Images, Cognitions, Emotions, and Sensations (TICES).
How It Helps Clients: Promotes awareness of emotional responses and prepares for EMDR processing.
How to Do It: Instruct clients to record experiences when distressed, keep the worksheet in a safe place, and review during sessions.
Frequently Asked Questions About EMDR Therapy Activities
Below are the practical questions clinicians ask when facilitating Eye Movement Desensitization and Reprocessing (EMDR) exercises and resourcing activities to build emotional stabilization, track distress levels, and safely prepare clients for trauma reprocessing.
How can a clinician effectively sequence the EMDR Container and Safe Place exercises during the preparation phase?
During Phase 2 (Preparation), the clinician should introduce and establish the Safe Place or Calm Place visualization before building the EMDR Container exercise. The Safe Place activity provides a positive sensory anchor and active emotional refuge to lower autonomic arousal. Once this positive baseline is installed, the Container exercise should be established as a complementary, structural visualization designed to store distressing thoughts or incomplete targets between sessions. This sequencing ensures the client has both a functional mechanism to hold distress and a comforting internal retreat to return to, preserving psychological safety.
What clinical adjustments should a therapist make if a client experiences abreaction or a severe spike in distress during the Butterfly Hug exercise?
If a client experiences a severe emotional wave or hyperarousal while using the Butterfly Hug for self-soothing, the therapist should temporarily halt the bilateral tapping and shift to external grounding skills. While the Butterfly Hug is an effective bilateral stimulation method for home-based emotional regulation, manual tapping can occasionally accelerate internal processing and inadvertently deepen access to a trauma pocket. The clinician should direct the client to lower their hands and utilize their five senses or diaphragmatic deep breathing to stabilize their physical state before evaluating whether to return to active processing.
How does utilizing the TICES exercise outside of sessions improve the efficiency of Phase 3 target identification?
The TICES exercise functions as a structured tracking tool for clients to forensically document real-world triggers, images, cognitions, emotions, and sensations as they happen. Clients recovering from traumatic stress frequently struggle to recall specific components of their distress accurately due to cognitive avoidance or emotional overwhelm. Reviewing a completed TICES log during checking-in sessions provides the clinician with precise, empirical snapshots of real-time activation, making it significantly easier to isolate clean targets and map out treatment plans without getting bogged down in narrative sorting.
Why is introducing a Window of Tolerance framework critical before starting active eye movement processing?
Introducing the Window of Tolerance exercise helps clients cultivate the necessary somatic self-awareness to identify when they shift into hyperarousal or hypoarousal states. Active trauma reprocessing requires the client to remain within their optimal arousal zone to effectively digest the target material. Teaching clients to track their physical warning signs through a dedicated framework ensures they can collaboratively notify the practitioner when they are reaching their tolerance limits, allowing the therapist to modulate the bilateral stimulation pacing before dissociation or panic stalls the session.
How can a therapist utilize the Subjective Units of Disturbance (SUD) scale to objectively measure processing progress over time?
Clinicians utilize the SUD scale to quantify the immediate intensity of target-related distress on an objective 0 to 10 scale during and across reprocessing sessions. Progress is explicitly evidenced when the client’s baseline SUD rating for a specific traumatic memory consistently drops toward zero when re-accessed in consecutive Phase 8 check-ins. Tracking these quantitative data parameters on a visual log provides clear empirical proof of cognitive restructuring and successful desensitization, helping both the managed care reviewer and the client observe clear milestones in recovery.
Final Thoughts on EMDR Exercises and Activities for your Clients
Thanks for reading this resource on EMDR Therapy Exercises and Activities you can do with your clients. Eye Movement Desensitization and Reprocessing Therapy is a great tool for Clinicians who are working with clients who are struggling with Post Traumatic Stress Disorder and other mental health concerns. Research has supported the reliability that EDMR can help various populations who are significantly impacted by their mental health concerns. EDMR can provide relief for clients sooner than other forms of psychotherapy, including talk therapy.
Clinicians who work with clients who struggle with traumatic memories could benefit from learning more about the uses of Eye Movement Desensitization and Reprocessing Therapy. This can be done through specialized training sessions, courses, or continuing education opportunities. Your supervisor can be a valuable resource if you are looking to expand your knowledge of EMDR.
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Resources:
- Cahill, S. P., Carrigan, M. H., & Frueh, B. C. (1999). Does EMDR work? And if so, why?: a critical review of controlled outcome and dismantling research. Journal of anxiety disorders, 13(1-2), 5–33. https://doi.org/10.1016/s0887-6185(98)00039-5
- EMDR Institute, Inc. (n.d.). What is EMDR? EMDR. Retrieved March 2, 2023, from https://www.emdr.com/what-is-emdr/