EMDR Note

Session Summary / EMDR Phase

The session moved from Phase 8 Re-evaluation through Phase 3 Target Assessment into Phase 4 Desensitisation of a previously selected road-traffic target, followed by Phase 5 Installation, Phase 6 Body Scan and Phase 7 Closure. The client reported less disturbance when driving past the accident location since the previous session, but continued activation when hearing sudden braking sounds. Bilateral tapping was used for further processing, and the session closed with grounding and containment because some residual disturbance remained.

Current Presentation and Re-evaluation

The client reported driving past the roundabout twice since the previous session with manageable anxiety, rated 4 out of 10. They also reported a sudden braking sound in a car park that brought back the image of the other vehicle approaching. The client used paced breathing afterwards and said it helped them continue with the journey.

Target Assessment and Baseline

The target was the memory of seeing the other car approaching before impact. The negative cognition related to being trapped, and the desired positive cognition related to being able to respond now. The client rated VOC for the positive cognition as 4 out of 7 at the start of the session. Emotions were fear and helplessness, SUD was 6 out of 10, and body sensation was pressure in the chest.

Preparation, Stabilisation, Consent and Readiness

The therapist reviewed the stop signal, dual-attention instructions, and the client’s grounding plan. The client confirmed they wanted to continue with the target and could ask to pause. The therapist and client agreed to use shorter tapping sets because the client had felt tired after the previous session.

Bilateral Stimulation and Processing Sequence

The therapist used shorter bilateral tapping sets while the client held the target image and negative cognition in mind because the client had reported fatigue after the previous session. When chest pressure intensified, the therapist slowed the tapping; the client reported that the intensity became manageable and asked to continue. After early sets, the chest pressure shifted into an image of sitting on the roadside. A later set brought an adaptive thought that help did arrive. The therapist used a brief cognitive interweave asking what the client knows now that they did not know in the moment of impact. The client then reported the image felt further away.

Installation, Body Scan and Closure

The positive cognition about being able to respond now remained unchanged. The client said it felt more believable after processing but that sudden braking sounds still brought some doubt; following a short installation set, VOC was 5 out of 7. During the body scan, the client held the target and positive cognition in mind and identified residual tightness in the chest at 2 out of 10. The therapist used a brief further tapping set for the residual sensation, followed by grounding through feet on the floor and container imagery for the remaining material. When asked, the client identified the current date and location, reported feeling back in the present, and said they felt ready to end the session.

Processing Shifts, Target Status and Client Meaning

SUD decreased from 6 out of 10 to 2 out of 10. The target was partially processed rather than described as resolved, with residual chest tightness and some activation around sudden braking sounds still present. The client said the strongest shift was remembering that help arrived and that the accident was over.

Therapeutic Process / Pacing Review

The client said shorter tapping sets felt easier to stay with than longer sets. The therapist and client agreed to continue using shorter sets and to pause if the client notices fatigue or difficulty staying dual-attentive.

Between-Session Guidance and Next Steps

• Aftercare or grounding: The client agreed to use paced breathing and the container image if activation occurs.

• Monitoring, journalling or noticing: The therapist suggested noting any dreams, driving triggers or body sensations that arise.

• Target or phase for next session: Re-evaluate the same target and decide whether to continue processing or focus on the sudden-braking trigger.

Risk Assessment and Management

The therapist checked for dissociation or feeling unable to return to the room during processing. The client denied losing time or feeling detached from the room.