The word target can make a clinical decision sound simpler than it is. A client says, “I want to stop panicking,” and the therapist begins looking for the event that explains the panic. Yet the first useful question is not always which memory to process. It may be what the client means by panic, when it occurs, what is happening around them, and what they hope to do differently. A target becomes useful when it connects a particular experience with a carefully understood treatment goal.
This book treats target selection as a collaborative clinical judgment, not a search for a hidden answer. Its primary audience is clinicians with appropriate professional preparation and EMDR training, including trainees working within their supervision arrangements. The assessment dialogues are original teaching examples, not validated questionnaires, official protocol wording, or a substitute for training. All case examples are fictional. Their purpose is to make the reasoning visible before a clinician begins memory reprocessing.
How to use EMDR: from a target to a changed response
The practical purpose of this book is to help a trained clinician use EMDR, not merely decide whether to avoid it. EMDR has been investigated beyond PTSD, including depression and several anxiety presentations. That literature warrants a differentiated account of what clinicians can work on; it does not require every client to have PTSD before a distressing experience can become a relevant target. Research strength, population, comparison treatment, and the specific protocol still matter. A systematic review documents this wider field while also identifying substantial variation in study quality and design. Scelles and Bulnes, 2021.
A practical EMDR sequence follows the eight phases rather than treating target identification as the end of the work:
- History and treatment planning: Identify what happens in daily life, the experiences that may maintain it, the client's goals, and the order of work. Include past events, current triggers, and anticipated situations.
- Preparation: Explain how the work will proceed, establish a usable stop signal, and practice the supports this particular client will need to remain engaged and recover between appointments. Preparation makes processing possible; it is not a demand that the client feel no distress.
- Assessment: Bring up the agreed target and identify its currently disturbing image or sensory aspect, negative self-belief, preferred positive belief, the felt validity of that belief, emotions, disturbance, and body location. Use the client's meaning rather than a diagnostic stock phrase.
- Desensitization: Facilitate reprocessing with the bilateral stimulation and clinical procedures in the clinician's training. Following each set, briefly invite what the client notices and follow the emerging material. Do not require a detailed retelling, supply an explanation, or insist on a particular emotional trajectory.
- Installation: When appropriate within the protocol, strengthen the positive cognition that fits the processed material now. It may differ from the initial wording. It should be believable and adaptive, not a promise that nothing bad will happen.
- Body scan: Invite attention to the target and the positive cognition while noticing the body; address relevant residual disturbance according to the protocol rather than assuming a lower verbal rating tells the whole story.
- Closure: End every session with an appropriate return to the present and an agreed between-session plan, whether processing is complete or incomplete. Do not rush to label a target finished to fit the clock.
- Reevaluation: Review the target and what happened in life since the session. Decide whether to return to unfinished material, address another target or present trigger, develop the future template, or change the formulation.
Assessment Script: “When you bring up that moment now, what image or part of it is most disturbing? What does it seem to say about you? What would you prefer to believe about yourself when you remember it?” Follow with the emotion, disturbance, felt validity, and body assessment used in the trained protocol.
Processing Script: “What do you notice now?” The usefulness of this brief prompt lies in allowing the client's own processing to lead. A cognitive interweave is a brief, purposeful intervention when processing is blocked, not a lecture inserted into every set.
Reevaluation Script: “How does the meeting memory feel now—and what happened when you spoke in the meeting this week?” The first question checks the target; the second checks whether treatment is doing the job the client asked it to do.
Throughout the condition chapters, the proposed targets are hypotheses to assess, not presumed causes. The example wording illustrates clinical reasoning within EMDR training; it is not a new standardized protocol.
A target belongs to a larger treatment
Francine Shapiro developed EMDR therapy and the adaptive information processing framework associated with it. Her foundational text, Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures, provides the formal treatment framework on which this discussion builds. [1]
EMDR is more than the use of eye movements or another form of bilateral stimulation. Its eight phases encompass history and treatment planning, preparation, target assessment, desensitization, installation, body scan, closure, and reevaluation. Target identification begins within a treatment plan rather than appearing as an isolated technique. [2] Keeping that frame in view prevents a common error: treating a vivid memory as sufficient evidence that reprocessing it is the best next intervention.
For the purposes of this book, a candidate target is an experience being considered for focused therapeutic work because of its possible relevance to an agreed problem. A selected target is a candidate the clinician and client have agreed to address within an appropriate plan. These are working distinctions used here for clarity, not additional official EMDR phases. A candidate can remain on the map without being processed, and a selected target can be reconsidered when new information changes the plan.
From complaint to specific experience
Consider Maya, a fictional project manager who seeks help because she freezes when asked to speak in meetings. “Work anxiety” describes the broad complaint. “Being judged” describes a theme. Neither yet tells the clinician what particular experience Maya might hold in mind during assessment. When the therapist asks about a recent example, Maya describes Tuesday's meeting: a colleague looked toward her, her prepared answer disappeared, and she noticed the thought, “Everyone can see I am useless.”
The therapist now has a concrete episode to explore. That does not establish its cause. Maya might connect the meeting with a prior public humiliation, a recent workplace incident, or no earlier event at all. It might also matter that her manager has been openly threatening employees. The clinician should not decide that Maya's alarm is a distorted memory response before understanding the present environment.
Assessment Script
“You have described freezing in meetings. Could we look at one recent occasion, without going into more detail than feels useful today? What was happening just before you noticed the change?”
“As you describe that moment, what stands out to you? It may be an image, words, a feeling, or something else.”
“What would you most want to be different when a similar situation happens again?”
These questions move from a general complaint toward a bounded experience and a functional aim. They do not tell Maya what she ought to remember or imply that her reaction proves a particular history.
The event and the experience of the event
A factual event label is not the whole target assessment. “The meeting” identifies an episode; it does not capture what currently makes that episode disturbing. EMDRIA's definition describes assessment of a representative image or other sensory experience, a related negative self-appraisal, a preferred adaptive belief, emotions, subjective disturbance, and bodily sensations. [3] These components help describe the client's present response to the material. They are not tests of whether an event happened exactly as recalled.
Two people can remember similar events and experience them differently. One may feel trapped; another ashamed; another grief-stricken. Even one person may notice different meanings on different days. Asking what is present now is therefore more useful than assigning a standard negative belief to a category of experience. A clinician can help with language without replacing the client's meaning with the clinician's preferred formulation.
Clinical focus
Distinguish the event label, the currently disturbing aspect, and the reason for treating it. For Maya these might be “Tuesday's meeting,” “the moment my mind went blank,” and “being able to contribute at work.” The three descriptions belong together but are not interchangeable.
A model is not proof of a mechanism
The adaptive information processing model offers a way to conceptualize links between disturbing experiences and current responses. It should be presented as a clinical model rather than as a scan of the client's brain or proof that every symptom is an unprocessed memory. The VA describes the theoretical account while noting continuing uncertainty about EMDR's mechanisms. [4] A responsible explanation can be understandable without claiming more than the evidence establishes.
For example: “One way we understand this treatment is that experiences can continue to affect how a person responds now. We will explore whether working with particular experiences might help with the difficulties you want to change.” This explanation leaves room for uncertainty, other maintaining factors, and other treatments. It also avoids telling a client that their nervous system contains a buried event the therapist must uncover.
What makes a target clinically useful
A useful target is not necessarily the oldest, most dramatic, or highest-rated memory. It is sufficiently identified to work with, relevant to the formulation, acceptable to the client, and appropriate to the clinician's competence and the treatment setting. These considerations are questions to reason through, not a numerical scoring system. A beautifully organized target list can still be a poor plan if it overlooks current danger, the client's priorities, or what happens after the appointment.
Maya's therapist might retain Tuesday's meeting as a candidate while learning more about the workplace and Maya's history. The therapist can write, “Client identifies this episode as relevant to freezing; earlier links not yet established.” That note is more accurate than “Core trauma located.” It preserves both what has been learned and what remains unknown.
The practical aim of target selection is not to discover the one memory that explains a life. It is to make the next treatment decision understandable, collaborative, and open to correction. The following chapters begin with the person whose life gives that decision its meaning.