EMDR Explained

What EMDR is

EMDR is guided by the Adaptive Information Processing (AIP) model.¹ The model holds that distress can persist when a memory has not been fully processed. The aim is to process that memory further, so that recalling it no longer produces the same distress.

The left-right movements are called bilateral stimulation, and may take the form of eye movements, taps, or tones. You hold the memory in mind and follow them, and over repeated sets its vividness and the emotion attached to it are reduced.¹

What the evidence says

The clearest evidence for EMDR is in PTSD. In the UK, the National Institute for Health and Care Excellence (NICE) recommends offering EMDR to adults with PTSD more than three months after a non-combat trauma.²

In the United States, the American Psychological Association (APA) rates EMDR as a second-line option.¹ It places trauma-focused cognitive behavioural therapy (CBT) as the first-line choice. The NHS lists EMDR among the trauma therapies offered for PTSD.³

Some therapists also use EMDR for other difficulties, such as anxiety or grief, but the research there is more limited and still developing.

What happens in an EMDR session

EMDR follows a structured eight-phase approach.¹ A course of therapy moves through these stages:

• History and planning: the therapist learns your history and agrees with you which memories to work on.
• Preparation: the therapist explains the method and teaches a calming exercise, such as a Safe or Calm Place.¹
• Assessment: you name the target memory and the belief attached to it.
• Desensitisation: you focus on the memory during sets of bilateral stimulation, until it feels less distressing.
• Installation: a more helpful belief is strengthened in its place.
• Body scan: you notice any tension left in the body and work with it.
• Closure: the session is brought to a settled, safe end.
• Re-evaluation: the next session checks what has changed.

EMDR differs from some other trauma therapies in a practical way. It does not require extended exposure to the memory,¹ or a detailed description of what happened. For some people that makes it feel more manageable.

The therapist may also use two short rating scales during sessions. The first tracks how disturbing the memory feels, and the second tracks how true the new belief feels.¹

How long it takes

Processing a single memory is often completed within one to three sessions.¹ A fuller course is typically delivered over about 6 to 12 sessions, and NICE suggests around 8 to 12 sessions for adults.²

More may be needed where the trauma is complex; there is no fixed number, and the right length depends on the person and on what is being worked on.

How EMDR is thought to work

The AIP model is the theory behind EMDR: it holds that a poorly processed memory keeps its original distress, and EMDR aims to complete that processing so that the memory becomes less distressing to recall.

Researchers do not fully agree on how the eye movements contribute, and that question is still being studied. The method helps many people.

Who EMDR may suit, and when it may not be the first choice

EMDR is not the right first step for everyone. Working directly with painful memories requires a degree of emotional steadiness, which is why the preparation phase exists. A therapist should prepare you for that work and go at your pace.

Where trauma is long-standing or complex, EMDR may form part of a broader treatment plan. For some people, a therapist may suggest trying trauma-focused CBT first. EMDR should be delivered by a trained and supervised practitioner.²

PTSD often improves with treatment,³ though recovery differs from person to person. EMDR is one option among several, and the options are worth discussing with a qualified professional.

Finding a trained EMDR therapist

EMDR requires specific training. Our guide on how to find the right therapist covers the wider search. When you contact someone, ask what EMDR training they completed, whether they have supervision, and what experience they have with your kind of trauma.

Frequently asked questions

How often are EMDR sessions held?

Sessions are usually weekly. A therapist may space them differently to suit the work and your circumstances.

Is EMDR suitable for children?

It can be. NICE suggests considering EMDR for children and young people with PTSD who have not responded to trauma-focused CBT.² A therapist adapts the method to the child's age.

What if I do not remember the event clearly?

You do not need a detailed account. EMDR works with the feelings and body sensations attached to a memory, not with the factual record alone.

Is EMDR safe?

With a trained therapist, EMDR is considered safe. Reprocessing can feel intense, which is why preparation and pacing form part of the method.

This article is for general information and is not a substitute for professional assessment or care. If this is affecting your life, consider reaching out to a qualified mental health professional.

References

1. [1] American Psychological Association. Eye Movement Desensitization and Reprocessing (EMDR) Therapy (APA Clinical Practice Guideline for the Treatment of PTSD). apa.org.
2. [2] National Institute for Health and Care Excellence (2018). Post-traumatic stress disorder, NICE guideline NG116, Recommendations. nice.org.uk.
3. [3] UK National Health Service. Post-traumatic stress disorder (PTSD): Treatment. nhs.uk.