SUD, VOC and cognitions in EMDR: a clear guide
The EMDR assessment phase includes terms such as SUD and VOC and questions about negative and positive cognitions. These are subjective reference points for organising work, not objective brain tests or exams that require a particular score.
SUD usually means subjective units of disturbance, while VOC rates the felt validity of a positive cognition. Together with an image, emotion and body sensation, they describe how a target is experienced now and help observe change. Scores do not diagnose, verify memories or justify forcing a session to look “complete”.
Negative and positive cognitions
A negative cognition expresses a current interpretation linked to the memory, involving safety, responsibility or worth. A positive cognition describes a more adaptive perspective the person would like to feel is true.
This is not simply replacing a “bad” sentence with positive thinking. Wording should fit the experience and may change during processing; repeating an affirmation is not the same as reprocessing.
What the SUD scale records
SUD asks for an estimate of target-related distress at that moment, commonly from 0 to 10. It supports discussion of change, blockage, closure and reevaluation.
A number depends on context, interpretation and access to internal states. Comparing people or demanding zero can distort its use; a low rating also does not prove the absence of risk or dissociation.
What VOC records
VOC commonly rates how true or available a positive cognition feels, often from 1 to 7. It is particularly relevant during assessment and installation.
Validity is not a detector of historical truth. A belief may be rationally plausible without feeling available, and its wording may change as the work develops.
Responsible use
The practitioner integrates numbers with language, body, behaviour, functioning and safety. They should accept “I don’t know”, explain the scale and check whether it makes sense for the person.
Ask what target completion means, how it will be reevaluated next time and what happens when a rating falls but symptoms remain. Scales support clinical judgement; they do not replace it.
Frequently asked questions
What does SUD mean in EMDR?
It is a subjective estimate of how disturbing a target feels at that moment, commonly from 0 to 10.
What does VOC mean?
It rates how true or available a positive cognition feels, often from 1 to 7.
Must I reach SUD 0 and VOC 7?
A number should not be imposed without context. Safety, ecological validity, functioning and later reevaluation also matter.
Sources and scope
Informational content based on guidelines and professional bodies. It does not diagnose, recommend individual treatment or replace clinical assessment.