Eye Movement Desensitization and Reprocessing, commonly known as EMDR therapy, has emerged as one of the most effective and innovative treatments for trauma and post-traumatic stress disorder (PTSD).
Developed by psychologist Dr. Francine Shapiro in the late 1980s, this psychotherapy approach helps individuals process and recover from traumatic memories and other distressing life experiences. Unlike traditional talk therapy, EMDR therapy doesn’t require extensive discussion of the traumatic event, making it particularly valuable for those who find it difficult to talk about their experiences.
What is EMDR Therapy?
EMDR therapy is a structured psychotherapy that primarily focuses on treating trauma and post-traumatic stress disorder by processing distressing memories. The core premise of EMDR is that psychological trauma occurs when memories are improperly stored in the brain. These unprocessed memories retain their emotional charge and can be triggered by current situations, causing the individual to re-experience the original trauma.
The therapy uses bilateral stimulation—typically eye movements, but also tactile taps or auditory tones—to help the brain reprocess these stuck memories. According to the EMDR International Association, this process allows the brain to resume its natural healing abilities, enabling traumatic memories to be properly integrated and stored without their intense emotional charge. The World Health Organization recognizes EMDR as an effective treatment for PTSD, particularly for adults.
How EMDR Differs from Traditional Therapy
- Less verbal disclosure: Clients don’t need to extensively discuss traumatic details
- Focus on processing: Emphasis on neurological processing rather than insight
- Structured protocol: Follows a specific eight-phase approach
- Dual attention: Uses bilateral stimulation while recalling memories
- Rapid results: Often produces significant improvement in fewer sessions
The Science Behind EMDR: How It Works
The exact mechanisms of how EMDR therapy works are still being researched, but several theories explain its effectiveness. The most prominent is the Adaptive Information Processing (AIP) model, which suggests that trauma disrupts the brain’s natural information processing system. When this happens, memories get “stuck” with their original emotions, physical sensations, and beliefs.
During EMDR therapy, the bilateral stimulation appears to stimulate the brain’s information processing system, similar to what occurs during rapid eye movement (REM) sleep. Research published in PLOS One suggests that the eye movements in EMDR may working memory, reducing the vividness and emotional intensity of traumatic memories. Neuroimaging studies have shown that EMDR can produce changes in brain activity patterns, particularly in areas involved in memory and emotion processing.
Evidence Supporting EMDR Effectiveness
Multiple studies and meta-analyses have demonstrated the effectiveness of EMDR for trauma treatment:
- The World Health Organization recommends EMDR and trauma-focused CBT as first-line treatments for PTSD
- A meta-analysis in the Journal of Clinical Psychology found EMDR equally effective as trauma-focused CBT
- The American Psychological Association strongly recommends EMDR for treatment of PTSD
- Research shows EMDR can produce significant improvement in 80-90% of single-trauma victims within 3-5 sessions
The Eight Phases of EMDR Therapy
EMDR therapy follows a structured eight-phase approach that ensures comprehensive treatment and client safety. Each phase builds upon the previous one, creating a systematic process for identifying and processing traumatic memories.
1 History Taking and Treatment Planning
The therapist gathers information about the client’s history, identifies target memories for processing, and develops a treatment plan. This phase typically takes 1-2 sessions and helps establish a therapeutic relationship while identifying past events that contribute to current symptoms.
2 Preparation
The therapist explains the EMDR process, establishes expectations, and teaches coping skills and relaxation techniques. This phase ensures the client has the resources to handle emotional distress that might arise during processing. Techniques like the “safe/calm place” exercise are introduced.
3 Assessment
The therapist helps the client identify specific components of the target memory: the image, negative belief, desired positive belief, emotions, and body sensations. This phase activates the memory network and establishes baseline measurements for distress levels and belief validity.
4 Desensitization
This phase involves bilateral stimulation (eye movements, taps, or tones) while the client focuses on the target memory. The therapist guides the process until the memory no longer causes distress. Sets of bilateral stimulation continue until the Subjective Units of Disturbance (SUD) scale reaches zero.
5 Installation
The focus shifts to strengthening the positive belief identified in phase three. The therapist continues bilateral stimulation while the client holds the positive belief in mind, until it feels completely true on the Validity of Cognition (VOC) scale.
6 Body Scan
The client scans their body for any residual physical tension or sensation while thinking about the target memory and positive belief. If any discomfort is found, additional bilateral stimulation is applied until the body is clear of tension.
7 Closure
At the end of each session, the therapist ensures the client returns to a state of equilibrium. If processing is incomplete, specific techniques are used to provide containment. The client is reminded that processing may continue between sessions.
8 Reevaluation
At the beginning of subsequent sessions, the therapist checks the previously processed memory to ensure distress remains low and the positive belief remains strong. New targets are identified as needed, and progress is assessed throughout treatment.
Conditions Treated with EMDR Therapy
While originally developed for PTSD, EMDR therapy has been successfully applied to various psychological conditions. Research continues to expand the applications of this versatile therapeutic approach.
| Condition | Evidence Level | Notes |
|---|---|---|
| Post-Traumatic Stress Disorder (PTSD) | Strong evidence | Gold standard treatment; recommended by WHO and APA |
| Anxiety Disorders | Good evidence | Particularly effective for panic disorder and phobias |
| Depression | Growing evidence | Especially when linked to traumatic experiences |
| Complex Trauma | Good evidence | Multiple or prolonged traumatic experiences |
| Addiction | Promising evidence | Addressing underlying trauma that drives addiction |
| Chronic Pain | Emerging evidence | When pain has psychological components |
| Performance Anxiety | Clinical reports | Athletes, performers, public speakers |
What to Expect During EMDR Sessions
Understanding what happens during EMDR therapy sessions can help reduce anxiety about the process. A typical EMDR session lasts 60-90 minutes and follows the structured phases described earlier. The therapist will guide you through each step, ensuring you feel safe and supported throughout the process.
During the bilateral stimulation phase, you’ll be asked to recall the traumatic memory while simultaneously following the therapist’s fingers with your eyes, listening to alternating tones through headphones, or feeling alternating taps on your hands. Most people experience a range of sensations, emotions, and insights during this process. The therapist will periodically check in with you to assess your distress level and guide the direction of processing.
Example: Personal Experience with EMDR Therapy
My colleague, Sarah, sought EMDR therapy after a car accident left her with intense anxiety about driving. During her first sessions, she worked with her therapist to identify specific traumatic memories from the accident and developed coping resources. When they began the processing phases, Sarah was surprised by how the eye movements seemed to naturally reduce the intensity of her fear.
After six sessions of EMDR therapy, Sarah noticed significant changes. The mental images of the accident no longer triggered panic attacks, and she could think about driving without overwhelming anxiety. What impressed her most was that the therapy didn’t erase the memory but transformed it from a traumatic trigger into a neutral past event. She gradually resumed driving, starting with short trips and building up to highway driving, using the coping techniques she learned in therapy.
Benefits and Potential Side Effects
Like any therapeutic approach, EMDR therapy offers both benefits and potential temporary side effects. Understanding these can help you make an informed decision about whether EMDR is right for you.
Benefits of EMDR Therapy
- Rapid results: Often works faster than traditional talk therapy for trauma
- Minimal homework: Unlike some therapies, little between-session work is required
- Lasting effects: Changes tend to be permanent once processing is complete
- Less retraumatizing: Doesn’t require detailed discussion of traumatic events
- Comprehensive approach: Addresses thoughts, emotions, and physical sensations
Potential Temporary Side Effects
- Increased awareness: May notice other memories or issues needing attention
- Temporary distress: Processing between sessions can cause temporary emotional disturbance
- Vivid dreams: Some people experience more intense dreaming during treatment
- Emotional sensitivity: May feel more emotionally raw between sessions
- Physical sensations: Old physical sensations or memories might resurface temporarily
Important Considerations
EMDR therapy should only be performed by properly trained and licensed mental health professionals. While generally safe, it may not be appropriate for everyone. Individuals with certain medical conditions (like eye problems), severe dissociation, or certain psychiatric conditions may need modifications or alternative treatments. Always consult with a qualified healthcare provider to determine if EMDR is appropriate for your specific situation.
Finding a Qualified EMDR Therapist
Finding a properly trained EMDR therapist is crucial for effective and safe treatment. Look for licensed mental health professionals (psychologists, clinical social workers, licensed professional counselors) who have completed EMDRIA-approved training. The EMDR International Association maintains a directory of certified therapists.
When choosing a therapist, consider their experience with your specific issues, their overall therapeutic approach, and your personal comfort level with them. A good EMDR therapist will thoroughly assess your readiness for trauma processing, provide adequate preparation, and ensure you have coping resources before beginning memory work.
Frequently Asked Questions (FAQs)
How long does EMDR therapy take to work?
The duration of EMDR therapy varies depending on the individual and the complexity of their trauma. For single-incident trauma, significant improvement often occurs within 3-6 sessions. For complex trauma or multiple traumatic experiences, treatment may take several months with weekly sessions. Your therapist can provide a more specific timeline after the initial assessment phase.
Is EMDR therapy painful or scary?
While processing traumatic memories can be emotionally challenging, a properly trained EMDR therapist ensures you have adequate coping skills and resources before beginning memory work. The process is typically less distressing than repeatedly recounting traumatic events in detail, as required in some other trauma therapies. Most clients report that any temporary discomfort is manageable and worth the long-term benefits.
Can EMDR be done online or through telehealth?
Yes, EMDR therapy can be effectively conducted through telehealth with some adaptations. Therapists use alternative bilateral stimulation methods, such as auditory tones or tactile tapping that clients can self-administer. Research published in the European Journal of Psychotraumatology has shown telehealth EMDR to be effective, though in-person sessions may be preferable for some individuals or situations.
What if I can’t move my eyes or don’t want to use eye movements?
Eye movements are just one form of bilateral stimulation used in EMDR therapy. Alternatives include alternating tactile taps (using handheld pulsers or self-tapping) or auditory tones delivered through headphones. Research has shown these alternative methods to be equally effective, so your therapist can help you choose the method that works best for you.
How is EMDR different from hypnosis?
While both EMDR and hypnosis may involve altered states of awareness, they are fundamentally different approaches. In EMDR therapy, you remain fully conscious and in control throughout the process. There’s no suggestion or induction as in hypnosis. EMDR focuses on activating the brain’s natural information processing system rather than creating a hypnotic state.
Can children receive EMDR therapy?
Yes, EMDR therapy can be adapted for children and has been shown to be effective for treating childhood trauma. Therapists specializing in pediatric EMDR use age-appropriate techniques and may incorporate play therapy elements. The basic principles remain the same, but the implementation is modified to suit the child’s developmental level.
