VOC scale: Validity of Cognition in EMDR, explained
The VOC scale (Validity of Cognition) is a 1-to-7 self-rating scale used in EMDR. It measures how true a positive belief feels, not just how true it sounds. One means completely false; seven means completely true. Psychologist Francine Shapiro introduced it in 1989, alongside the SUDS scale, EMDR’s distress measure.
Where does the VOC scale come from?
Francine Shapiro introduced the VOC scale in a 1989 study. It’s titled Efficacy of the Eye Movement Desensitization Procedure in the Treatment of Traumatic Memories, published in the Journal of Traumatic Stress. She asked participants to rate a positive belief using their “gut feelings,” not their intellect. That’s the whole point of the scale: people often already know a healthier belief is true well before they feel it.
How does EMDR use the VOC scale?
Per EMDRIA, the EMDR International Association, VOC shows up across three of the 8 phases of EMDR. In the assessment phase, the client chooses a positive cognition: a healthier belief to replace the negative cognition tied to a target memory, then rates its starting VOC as a baseline. In the installation phase, sets of bilateral stimulation continue while the client holds the memory and the new belief together. The therapist checks the client’s VOC after each set, working toward a 7. The next session’s reevaluation phase checks whether that higher number held.
How is VOC different from SUDS?
They’re companion measures of the same target memory. But they move in opposite directions during a session.
| SUDS | VOC | |
|---|---|---|
| Measures | Distress intensity | Belief strength |
| Range | 0 (calm) to 10 (worst distress imaginable) | 1 (completely false) to 7 (completely true) |
| Goal during processing | Bring the number down | Bring the number up |
See SUDS scale: subjective units of distress, explained for the full picture of its sibling measure.
Can you check your own VOC without a therapist?
Informally, yes. Before a calming practice, name a belief you’d rather hold about yourself. Rate how true it feels, 1 to 7. Try a round of self-guided EMDR or another calming technique, then rate again. Picking which memory and which belief pairing is safe to work through, though, is a therapist’s judgment call, not a do-it-yourself step.
You can run the same gut-check with EmEase, a self-guided EMDR app, at app.emease.com. Rate a wanted belief before and after a practice session. It’s an honest, personal way to notice whether it’s landing.
Frequently asked questions
What does VOC stand for in EMDR?
Validity of Cognition: a 1-to-7 scale measuring how true a positive belief feels, not how logical it sounds. One means completely false, seven means completely true. It's the companion measure to SUDS, which tracks distress instead of belief.
Who created the VOC scale?
Psychologist Francine Shapiro introduced it in a 1989 study on eye movement desensitization, alongside the SUDS scale. She had participants rate belief using their gut feelings rather than their intellect, which is still the scale's key distinction.
What counts as a good VOC score?
In EMDR's installation phase, a therapist works toward a 7, meaning the positive belief feels completely true. Progress toward 7 signals the belief is settling in, though a session can end on a lower, more honest number too.
How is VOC different from SUDS?
SUDS rates distress from 0 to 10, and the goal is bringing it down. VOC rates belief from 1 to 7, and the goal is bringing it up. Therapists track both around the same target memory.
Can you rate your own VOC without a therapist?
You can informally gut-check a belief you want to hold, 1 to 7, before and after a calming practice. Picking which memory and belief to pair safely is a therapist's judgment call, not a do-it-yourself step.
Sources
- Efficacy of the Eye Movement Desensitization Procedure in the Treatment of Traumatic Memories — Journal of Traumatic Stress (1989)
- The Eight Phases of EMDR Therapy — EMDR International Association (2021)