About EMDR Therapy

By Olivia Guy-Evans, published May 09, 2022 | Fact Checked by Saul Mcleod, PhD


Eye Movement Desensitization and Reprocessing (EMDR) therapy is a type of psychotherapy which helps people to process and recover from past experiences that are affecting their mental health and well-being. It is an effective treatment for those who may be suffering from posttraumatic stress disorder (PTSD), anxiety, panic, or trauma.

Psychotherapy and psychology. Emdr therapy help with psychological problems. Sadness, longing, despondency, depression. Eye movement to the right and left.

As evident from the name, EMDR can involve eye movements during the therapy, where the eyes focus on a stimulus which moves from side to side. However, it does not have to involve eye movements, but a variety of bilateral stimulation.

EMDR helps people to process the negative images, emotions, beliefs, and body sensations associated with traumatic memories that seem to be stuck. The therapy involves reconnecting the traumatised person to their memories in a safe and measured way.

EMDR is an individual therapy typically delivered one or two times per week for around 6-12 sessions, although some people may benefit from more or fewer sessions depending on their progress.

How was EMDR developed?

EMDR was initially developed by Francine Shapiro in 1987.

She found that when she was thinking about her own trauma, she would move her eyes from side to side and found that this helped reduce the occurrence of distressing memories.

Although being a relatively new type of psychotherapy, EMDR has become widely used and has been shown to be an effective treatment for many conditions, especially those relating to trauma.

EMDR is guided by the Adaptive Information Processing model. The model proposes that the symptoms of PTSD and other disorders (unless physically or chemically caused) result from past disturbing experiences that continue to cause distress because the memory was not processed.

The unprocessed memories are understood to contain the emotions, thoughts, beliefs, and physical sensations which occurred at the time of the traumatic event.

Essentially, the traumatic and painful memories can cause distressing emotions when they are unprocessed.

How does EMDR work?

With EMDR, the client will typically have one or two sessions per week for around 6-12 sessions. There are eight phases to EMDR which will be detailed below:

Phase 1: History taking

The first step in EMDR is to review the symptoms and health history of the client, to gain a better understanding of where they are in the treatment process.

In addition to getting a full health history and conducting appropriate assessments, the therapist and client work together to identify targets for treatment. These targets can include looking at past memories, current triggers, and future goals.

These evaluation phases also include briefly talking about the trauma and identifying potential memories which can be addressed. 

Phase 2: Client preparation

To prepare the client for the therapy, the therapist will teach a few different techniques to help the client to manage and cope with their emotional distress or uncomfortable feelings that may come up during treatment.

This is known as resourcing. It can take some time to find the right stress management technique that works for the client. They may be asked to try several techniques and find that perhaps only one or two work for them. 

The therapist will explain the reasons for the treatment and introduce the client to the procedures, practicing eye movements and/or other bilateral stimulation components, to ensure they are able to carry this out. 

Phase 3: Assessment

The therapist will then guide the client through the process of selecting a specific memory to target, along with any relevant aspects of the memory such as any painful emotions, physical sensations, intrusive thoughts, or images, and distressing self-beliefs. This will all help to activate the memory that is being targeted in the session. 

Two measures are used to evaluate changes in emotion and cognition: the Subjective Units of Disturbance (SUD) scale, and the Validity of Cognition (VOC) scale. Both measures are used again during the treatment process, in accordance with the standardised procedures. 

For the VOC scale, the therapist may pose the following question to the client: ‘When you think of the incident, how true do those words feel to you now on a scale of 1-7, where 1 feels completely false, and 7 feels totally true?’ 

After the client has named the emotions they are experiencing, the therapist may use the SUD scale to ask: ‘On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the highest disturbance you can imagine, how disturbing does it feel now?’

The therapist will then begin using EMDR techniques to address the targeted memories in four stages (Phases 4-7). 

Phase 4: Desensitization 

During the desensitization phase, the client will be encouraged to focus on the memory, thought, or image while engaging in eye movements or other bilateral stimulation.

The bilateral stimulation may involve tapping, audio tones, blinking lights, or anything that involves left-to-right activation. 

The client will then be asked to let their mind go blank and to notice any thoughts and feelings that spontaneously come up. After each set of bilateral stimulation, the therapist will likely ask the client to share any thoughts, sensations, or images that came up during the set. 

After these thoughts have been identified, the therapist may have the client refocus on that traumatic memory or move on to another one if that memory no longer triggers unwanted emotions. 

The process will continue until the client reports that the memory is no longer distressing.  

Phase 5: Installation

This phase will involve the client ‘installing’ a positive self-belief or image to replace the unwanted belief they identified in phase 3.

The focus of this phase is to strengthen the preferred positive cognition. The client will do this by focusing on this new belief through another repetition of bilateral stimulation. 

Phase 6: Body scan

The client will be asked to ‘scan’ their body while thinking of the memory and the positive cognition. They will be encouraged to identify any somatic distress that may still be residing in their body.

If there is still some disturbance, standardised procedures involving bilateral stimulation will be used to process this. 

Phase 7: Closure

At the end of each session, the therapist will explore the client’s progress and will suggest relaxation techniques and other coping strategies they can use between sessions to help maintain improvements.

If the targeted memory was not fully processed in the session, specific instructions are given to provide containment and ensure safety until the next session. 

Phase 8: Re-evaluation 

The next therapy session will start at phase 8, during which the therapist evaluates the client’s current psychological state and observes whether the effects from the previous session have lasted.

The therapist and the client will also go through what memories may have emerged since the last session and they will identify targets for the current session.

What coping strategies are taught to clients?

Stress reduction techniques can be used to help manage the emotions of the client during and between sessions, including breathing exercises and resourcing techniques.

Resourcing refers to identifying and instilling coping skills to help deal with difficult reactions. Resourcing can be used anytime disturbing emotions, thoughts, images, and/or physical sensations are experienced.

Some techniques may work better than others, but clients have the choice to choose their go-to resource during EMDR sessions or between sessions. Some example of resourcing include:

Butterfly hug

This technique involves having the arms crossed over the chest, with hands and fingers being as vertical as possible, possibly interlocking the thumbs if this helps.

Next, alternate the movement of the hands, which signify the flapping wings of a butterfly.

While doing this, breathe slowly and deeply while observing what is going through the mind and body such as thoughts, images, sounds, smells, and feelings, without pushing the thoughts away or judging them. 

Safe/calm/healing place

While having eyes closed and using imagination, go to a place which feels safe or calm.

While concentrating on the pleasant sensations in the body, the therapist will use bilateral stimulation to strengthen the association of the positive experience with the place. 

Container

This technique works by imagining a container to store upsetting thoughts, feelings, and images. The container needs to have a way to add and remove memories, thoughts, and images, as well as being able to regulate how much comes out at any one time.

To test if this resource is helpful, think about a slightly disturbing experience, then bring up the contained and notice any shifts in the body. Then, picture putting this experience and any feelings associated with it into the container. 

Coherent breathing

When inhaling and exhaling, engage the diaphragm, rather than breathing from the chest and shoulders. Think about the diaphragm as a balloon that can be expanded on the inhale and decompress on the exhale.

The ideal breath rate is about 6 breath cycles per minute. At this breath rate, the heart and brain should be more balanced and calm. 

Mindfulness

Mindfulness is a type of meditation in which focus is given on being intensely aware of what is being sensed and felt at the present moment.

Mindfulness also involves acceptance, meaning that attention is paid to thoughts and feelings without judging them or without believing that there is a right or wrong way to think or feel in a given moment.

There are many reasons why someone may consider EMDR therapy. There are many benefits to the treatment including:

Reducing negative thinking

EMDR therapy can help to identify and challenge any negative thoughts associated with the distressing memory.

For instance, someone may look back on their traumatic memory and believe that they were fully at fault for what happened, even if this was not true.

EMDR can help declutter the mind of these negative thoughts and replace them with more helpful and positive ones. 

Rapid results

The main selling point of EMDR therapy is that it tends to yield fast results compared to other psychotherapies.

While it is not helpful to expect to complete the therapy as quickly as possible- since some clients may need extra sessions- many people who undergo EMDR report positive results within as little as 3 sessions. 

Unlike other treatments that focus on altering the emotions, thoughts, and responses resulting from the traumatic experiences, EMDR focuses directly on the memory which causes distressing feelings.

This may be the reason why EMDR can be a quicker treatment than other therapies as it helps with the root cause of the distress. 

Minimal talking

In EMDR therapy, there is no pressure to discuss all the details of a traumatic experience. Other types of talk therapies may involve needing to go into the details in order to make the therapy effective.

Since there is little talking involved, EMDR may be useful for people who have difficulty talking about their trauma.

Increase self-worth

As EMDR targets distressing memories and negative thoughts about the client, such as thoughts that they are weak, powerless, or useless, these thoughts can be changed.

Changing these negative thoughts about the self into something more positive can have a great impact on the client’s self-esteem and confidence in themself. 

How effective is EMDR?

EMDR has proven to be an effective therapeutic treatment method. According to the EMDR Research Foundation, EMDR therapy has been clinically validated by more than 30 randomised controlled studies, which is the gold standard for clinical studies. 

What does the research say?

  • According to the EMDR Institute, some of the studies for EMDR effectiveness show that 84%-90% of single-trauma victims no longer have PTSD symptoms after only 3 sessions. 

  • A study compared the effectiveness of EMDR to cognitive behavioural therapy (CBT) in treating the symptoms of panic disorder and improving patient’s quality of life. The results determined that EMDR is just as effective as CBT (Horst et al., 2017). 

  • The effectiveness of EMDR and trauma focused CBT (TF-CBT) for posttraumatic stress symptoms was explored through met analyses. The results indicated that both therapies are effective in treating these symptoms, but TF-CBT was marginally more effective (Lewey et al., 2018). 

  • A study compared EMDR with CBT on children with behavioural problems. Both therapies were found to have significant positive effects on behavioural and self-esteem problems. Although the differences between the effectiveness were small, children who received EMDR therapy showed significantly larger changes in target behaviours than those in the CBT group (Wanders et al., 2008). 

  • A 2014 study looked at 24 randomised controlled trials that support the effectiveness of EMDR for the treatment of trauma. The results of some of these studies suggested that EMDR therapy is more effective than CBT for trauma (Shapiro, 2014). 

  • A small pilot study found that EMDR was safe and effective in treating PTSD in people with a psychotic disorder (van den Berg & van der Gaag, 2012). 

  • A small 2015 study reported that people who underwent EMDR treatment for depression were less likely than those in the control group to experience relapse or problems relating to depression in the year following treatment (Hase et al., 2015). 

  • A review of studies on the effectiveness of EMDR found evidence that it may even help improve other, non-traumatic symptoms found in mood disorders, as well as showing potential as an additional treatment for those with chronic pain (Valiente-Gómez et al., 2017)

  • A 2021 study surveyed data from 33 EMDR therapists who gave therapy online. The results showed that EMDR provided over the internet was shown to still help relieve mental health symptoms as it does in person (McGowan et al., 2021). 

How to seek treatment

To seek EMDR therapy, you could either be referred through your healthcare provider, or you can search for a suitable therapist yourself. 

Determine your personal preferences when choosing a therapist such as considering the age or gender of therapist and whether you prefer in-person or online therapy. It is important to find someone you work well with. Likewise, if you find that the therapist you have is not suited to your needs then it is perfectly fine to find another therapist. 

It may be beneficial to find a therapist who treats your specific symptoms as some EMDR therapists may only work with people who have PTSD.

If you want EMDR for another condition such as panic disorder, it is worth asking potential therapists what experience they have treating your concerns. 

How to get the most out of EMDR

Attend all the sessions – as difficult as you may find some of the sessions and thinking about traumatic memories, try to engage in, and complete the full course of the treatment to ensure you are getting the most out of it. 

Keep an open mind – while the idea of engaging in bilateral stimulation such as following the therapist’s fingers or repeatedly tapping both sides of your body may seem like an unusual approach to treatment, try to keep an open mind.

There is plenty of research to support the effectiveness of EMDR and the bilateral stimulation is an essential part of the treatment plan. 

Engage in the coping strategies – ensure that you take the therapist’s advice onboard and use the coping strategies between sessions. Practicing these whenever distressing feelings arise can help in the overall recovery of traumatic memories, rather than solely relying on the work in the sessions.

Be honest with the therapist – the therapist will ask you to rate your distress levels and to notice any unpleasant thoughts, emotions, and images which are causing discomfort.

Be honest if you are still struggling with certain aspects of the distressing memory so that these can be worked through. 

Things to consider

EMDR is generally recognised as a safe treatment, typically causing fewer adverse reactions than medications for trauma symptoms.

Unlike some medications, EMDR may maintain its effectiveness after treatment ends since it is dealing with the root cause of distress. 

Even so, EMDR, like other psychotherapies, may come with some side effects:

  • An increase in distressing memories.

  • It can feel very exhausting after the first session while you are bringing up traumatic memories that may have been pushed down for a long time.

  • Heightened emotions or physical sensations during sessions which may last beyond the session.

  • Light-headedness.

  • Some more report unpleasant or vivid dreams while they begin to reprocess traumatic events.

  • The surfacing of new traumatic memories if EMDR is not used appropriately. 

Despite this, symptoms of new emotions or physical sensations typically resolve as the treatment continues. Ensure you work with the therapist to find ways to cope with your feelings as you go forward with therapy.

If you become distressed during therapy, your therapist will help you to return to the present before shifting to another traumatic memory. 

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

Fact Checking

Content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication.

This article has been fact checked by Saul Mcleod, PhD, a qualified psychology teacher with over 17 years' experience of working in further and higher education. He has been published in psychology journals including Clinical Psychology, Social and Personal Relationships, and Social Psychology.

Cite this Article (APA Style)

Guy-Evans, O. (2022, May 09). About EMDR Therapy. Simply Psychology. www.simplypsychology.org/about-emdr-therapy.html

APA Style References

Gotter, A. & Raypole, C. (2022, January 11). Considering EMDR Therapy? What to Expect. Healthline. https://www.healthline.com/health/emdr-therapy 

Hase, M., Balmaceda, U. M., Hase, A., Lehnung, M., Tumani, V., Huchzermeier, C., & Hofmann, A. (2015). Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting. Brain and Behavior, 5(6), e00342.

Havens, J. (n.d.). What is EMDR? bacp. Retrieved 2022, April 1, from:

Horst, F., Den Oudsten, B., Zijlstra, W., de Jongh, A., Lobbestael, J., & De Vries, J. (2017). Cognitive behavioral therapy vs. eye movement desensitization and reprocessing for treating panic disorder: a randomized controlled trial. Frontiers in Psychology, 8, 1409.

Juby, B. (2021, August 3). What Is EMDR Therapy? PsychCentral. https://psychcentral.com/health/emdr-therapy#8-phases

Leonard, J. (2019, July 11). EMDR therapy: Everything you need to know. Medical News Today. https://www.medicalnewstoday.com/articles/325717 

Lewey, J. H., Smith, C. L., Burcham, B., Saunders, N. L., Elfallal, D., & O’Toole, S. K. (2018). Comparing the effectiveness of EMDR and TF-CBT for children and adolescents: A meta-analysis. Journal of Child & Adolescent Trauma, 11(4), 457-472.

Mazzei, R. (2021, January 27). What is Resourcing in EMDR Therapy? Evolutions Behavioral Health Services. https://www.evolutionsbh.com/articles/what-is-resourcing-in-emdr-therapy/  

McGowan, I. W., Fisher, N., Havens, J., & Proudlock, S. (2021). An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid–19 pandemic. BMC psychiatry, 21(1), 1-8.

Riddle, J. (2022, March 29). EMDR Therapy for Anxiety, Panic, PTSD and Trauma. Psycom. https://www.psycom.net/emdr-therapy-anxiety-panic-ptsd-trauma/ 

Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal, 18(1), 71.

Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.

Shapiro, F., & Maxfield, L. (2002). Eye movement desensitization and reprocessing (EMDR): Information processing in the treatment of trauma. Journal of clinical psychology58(8), 933-946.

Star, K. (2021, July 22). What Is EMDR Therapy? Very Well Mind. https://www.verywellmind.com/emdr-for-panic-disorder-2584292 

Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Perez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in psychology, 8, 1668.

van den Berg, D. P., & van der Gaag, M. (2012). Treating trauma in psychosis with EMDR: a pilot study. Journal of behavior therapy and experimental psychiatry, 43(1), 664-671.

Wanders, F., Serra, M., & De Jongh, A. D. (2008). EMDR versus CBT for children with self-esteem and behavioral problems: A randomized controlled trial. Journal of EMDR Practice and Research, 2(3), 180-189.