EMDR

EMDR therapy

A trauma method using bilateral stimulation. It doesn't require narrating the event in detail — which is why it is bearable when talking isn't.

What it is

EMDR (Eye Movement Desensitization and Reprocessing) starts from the idea that a traumatic memory was never processed normally. Ordinary memories fade, lose their charge, integrate into the story of your life. A traumatic memory stays stuck in raw form: the same images, the same bodily sensations, the same intensity as on day one.

The method was developed by Francine Shapiro in the late 1980s, after she observed that spontaneous eye movements appeared to reduce the intensity of distressing thoughts. What followed is three decades of clinical trials — EMDR is today one of the few methods explicitly recommended for PTSD by the World Health Organization.

The practical difference from talk therapies matters enormously to many patients: you are not asked to describe the event in detail. You focus on the hardest image, the sensation in your body and the associated negative belief — but the full narrative is not required.

How it works

While you hold the memory in mind, the therapist asks you to track with your eyes a finger or a light moving left to right. Alternatively, alternating taps on the knees or sounds panning from one ear to the other are used. This is bilateral stimulation.

The explanation best supported by data is the working memory account: the dual task — hold the memory + track the movement — overloads the limited capacity of working memory. The memory reactivates in a paler, less vivid form, and when it is re-stored, it is re-stored in that weakened form. The process is called reconsolidation.

What patients notice is that the memory doesn't disappear — it stays accessible, but loses its physical charge. The typical shift is from "I'm reliving it" to "I remember it".

What a session looks like

EMDR follows an eight-phase protocol, and the reprocessing itself only begins in phase four. The first sessions are given to history-taking and, crucially, stabilisation: you learn regulation techniques (a "safe place", bodily grounding) to use if intensity rises too far. A therapist who skips this and starts processing at session two is not working correctly.

In a processing session, stimulation sets run 20-30 seconds, followed by "what do you notice now?". You aren't asked to analyse — only to report. This repeats until the memory, rated on a 0-10 scale, drops close to 0. Sessions often run 60-90 minutes, because processing isn't interrupted halfway.

What it works for

Post-traumatic stress disorder (PTSD)
Single-incident trauma — accident, assault, sudden loss
Childhood trauma (with extended stabilisation)
Complicated grief
Phobias originating in an identifiable event

How long it takes

For a single trauma in an otherwise stable adult (an accident, an isolated assault), 6-12 sessions are frequently enough, and some trials report results in 3-6. For complex or repeated childhood trauma, the horizon runs to months or years — the stabilisation phase alone can take months, and it is time well spent.

What the evidence says

EMDR is recommended for PTSD in the World Health Organization guidelines (2013) and by NICE. For single-incident adult trauma, several meta-analyses find it equivalent to trauma-focused CBT. The scientifically contested point is not whether it works, but why: dismantling studies testing whether eye movements add anything over exposure give mixed results. The clinical effect replicates; the mechanism remains debated.

When it is NOT the right choice

EMDR is not started in the middle of an active crisis — uncontrolled addiction, acute suicide risk, an abusive situation still ongoing. You don't process a trauma while it is still happening; safety first, then stabilisation, then processing. There are also relative contraindications (epilepsy, late pregnancy, severe dissociative disorders) that call for a specifically trained therapist rather than automatic exclusion. And if your problem is anxiety with no traumatic component, CBT is the shorter road.

Problems treated with this method

trauma anxiety grief

Frequently asked questions

Do I have to recount everything that happened to me?

No. That is the difference which makes EMDR bearable for many people who couldn't get through talk therapy. The therapist needs the hardest image, the bodily sensation and the negative belief ("I'm in danger", "it's my fault"). The narrative details stay with you.

Can EMDR be done online?

Yes, with adaptations. Bilateral stimulation is delivered by an animated dot on screen, alternating sounds through headphones, or by asking you to tap your shoulders alternately. The practice expanded considerably after 2020 and the evidence so far is encouraging. The requirement is a stable connection and a space where you won't be interrupted — processing cut off midway is unpleasant.

Is it normal to feel worse after a session?

In the first 24-48 hours, yes — vivid dreams, fatigue and surfacing emotions are common. Processing continues after you leave the session. What isn't normal is staying destabilised for days: tell your therapist, because it means the pace needs slowing or the stabilisation wasn't sufficient.

Other approaches

Cognitive behavioural therapyThe most heavily researched method in psychotherapy. It works on the link between thought, emotion and behaviour, with homework between sessions.Psychodynamic therapyThe modern descendant of psychoanalysis. It looks for the pattern repeating beneath the symptom, not just the symptom. Longer, deeper, no homework.Dialectical behaviour therapyFor emotions that arrive too fast and too hard. It teaches four concrete skill sets: distress tolerance, emotion regulation, mindfulness, relationships.Acceptance and commitment therapyIt doesn't try to change your thoughts, but your relationship to them. The goal isn't to feel good, it's to live by your values even when you don't.Systemic family therapyIt treats the family as a system, not one person as the fault. One member's symptom is often the solution the system found to a problem nobody names.Emotionally focused therapy for couplesThe best-evidenced couples method. It doesn't teach communication techniques — it untangles the cycle where one pursues and the other withdraws.Gestalt therapyIt works with what's happening now, in the room, not the story about the past. Experiential and direct — you'll do things, not just talk about them.Person-centred therapyNo techniques, no homework, no interpretations. It bets everything on the relationship — and research shows the relationship is the best predictor of outcome in all of psychotherapy.Mindfulness-based cognitive therapyA structured 8-week group programme. Built specifically to prevent relapse into depression — not to treat an episode in progress.Schema therapyFor lifelong patterns, not recent symptoms. It combines CBT, attachment and experiential techniques — built for the cases where classical CBT wasn't enough.Play therapyFor children who don't yet have the language of emotion. Play is the medium in which a six-year-old says what they can't explain — and parents are part of the process.

Not sure what fits you?

That's normal — most people don't know, and choosing the method is the therapist's job, not yours. A 15-minute call is enough to find out.

Book a free call Find a therapist working with EMDR therapy