What Is EMDR Therapy and How Does It Work?

Nick Parker

3 hours ago

5 min read

EMDR (eye movement desensitization and reprocessing) is a structured therapy for trauma and PTSD. You briefly hold an upsetting memory in mind while following a back-and-forth movement or sound, such as your therapist's moving finger. The aim is for the memory to become less distressing. It follows eight phases and usually does not involve homework.

Key points

EMDR is a one-on-one therapy that helps people process upsetting memories of a traumatic event.
It pairs a memory with back-and-forth eye movements, sounds or taps, called bilateral stimulation.
Treatment follows eight phases, starting with history and preparation before any memory work.
The VA National Center for PTSD and the World Health Organization both list EMDR among well-supported treatments for PTSD.
In most cases you are not asked to describe the trauma in detail or to do homework.

What is EMDR therapy?

EMDR stands for eye movement desensitization and reprocessing. The VA National Center for PTSD describes it as an individual therapy for PTSD, meaning you meet one-on-one with a provider for each session.

The idea behind it is that trauma memories can be stored differently from other memories, which makes them hard to process or make sense of. EMDR is designed to help you process the memory so that, over time, you can see the trauma as a negative memory that is no longer so distressing.

The EMDR International Association (EMDRIA) notes that EMDR should only be offered by properly trained and licensed mental health clinicians.

How does bilateral stimulation work in EMDR?

Bilateral stimulation is the back-and-forth part of EMDR. While you call the upsetting memory to mind, you pay attention to something that moves or sounds from side to side.

The VA gives examples such as your provider's moving finger, a flashing light, or a tone that beeps in one ear at a time. EMDRIA describes sets of side-to-side eye movements, sounds or taps.

According to the VA, each set lasts about 30 seconds. Then you pause and talk about what the exercise was like for you. The sets are repeated until your distress about the memory goes down. The VA explains that the back-and-forth movement helps you stay in the present while your brain processes information from the past.

What are the eight phases of EMDR?

EMDRIA describes eight phases. The first two happen before any memory work begins, and the last one opens every later session.

1. History and treatment planning. Your therapist takes a thorough history and develops a treatment plan with you.
2. Preparation. You learn specific techniques for handling emotional disturbance, so you have ways to steady yourself.
3. Assessment. You and your therapist bring up each target memory in a controlled, standardized way.
4. Desensitization. Your therapist leads you through sets of eye movements, sounds or taps while you hold the memory in mind.
5. Installation. The focus shifts to strengthening a positive belief you would like to hold about yourself.
6. Body scan. Your therapist asks you to bring the original event to mind again.
7. Closure. Each session ends with closure, which is meant to help you leave feeling better at the end of the session.
8. Reevaluation. This opens every new session and guides your therapist through the next steps in the treatment plan.

What is EMDR used for, and what does the evidence say?

EMDR is used mainly for PTSD and other trauma-related distress. If you are not sure whether what you are living with fits, our guide to PTSD symptoms after a traumatic event covers the symptom groups and timing.

The VA National Center for PTSD says EMDR is one of the most effective types of treatment for PTSD, and it lists EMDR with two other trauma-focused talk therapies as having the most research support. The World Health Organization states that the psychological treatments with the most evidence for PTSD are cognitive behavioral therapy with a trauma focus and EMDR.

EMDRIA also says research supports EMDR for anxiety, depression, OCD, chronic pain and addiction. The VA and WHO pages we cite speak only to PTSD, so ask your therapist how well EMDR fits your situation.

No single treatment is right for everyone. For a side-by-side look at the other well-supported option, see EMDR vs CBT.

How long does EMDR take, and what does it feel like?

The VA describes a typical course as about 3 months of weekly sessions that run 50 to 90 minutes, and says many people start to notice improvement after a few sessions. EMDRIA says it could take one or several sessions to process a single traumatic experience.

You may feel uncomfortable while focusing on trauma-related memories or beliefs. The VA says these feelings are usually brief and that people tend to feel better as they continue.

In most cases you will not be asked to talk about the details of your trauma.
EMDR does not require homework or practice assignments between sessions.
Sessions are one-on-one with your provider.
Your therapist checks your symptoms toward the end of treatment to see whether other memories need attention.

How Balanced Life can help

Some clinicians at Balanced Life Counseling Services are trained or certified in EMDR. You can read how we approach it on our EMDR therapy page, or see our broader trauma therapy options if you are not sure EMDR is the right fit.

We see clients in Salisbury and Bethesda, in person and by telehealth. Whether a particular therapy can be done by telehealth depends on your situation and where you are located during the session, so ask when you call. Our new patients page explains how to get started, and insurance and fees lists the plans we accept.

If you are in crisis, call or text 988 or call 911. Our office does not provide emergency services.

Frequently asked questions

Do I have to talk about my trauma in detail during EMDR?

Usually not. The VA National Center for PTSD says that in most cases you will not be asked to talk about the details of your trauma. You hold the memory in mind during short sets of back-and-forth movement or sound, then briefly tell your therapist what came up. Your therapist needs enough information to plan treatment, but not a full retelling.

Who can provide EMDR therapy?

The EMDR International Association says EMDR should only be offered by properly trained and licensed mental health clinicians. When you call a practice, it is reasonable to ask whether the therapist you would see has EMDR training. The early phases are spent on history, planning and learning ways to steady yourself before any memory work starts.

How many EMDR sessions will I need?

It varies from person to person. The VA describes about 3 months of weekly sessions lasting 50 to 90 minutes, and notes that many people notice improvement after a few sessions. EMDRIA says one traumatic experience could take one or several sessions to process. Your therapist can give you a better sense after the history and planning phase.

Does EMDR have risks or side effects?

Focusing on a trauma memory can be uncomfortable. The VA says these feelings are usually brief, that people tend to feel better as they keep going, and that most people who complete EMDR find the benefits outweigh the initial discomfort. Tell your therapist if a session leaves you feeling unsettled so the plan can be adjusted.

Sources

If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline). In an emergency, call 911.