What Is Eye Movement Desensitization and Reprocessing (EMDR) Therapy?

In 1987, psychologist Francine Shapiro took a walk in the park. While walking, she happened to notice something — moving her eyes while remembering past traumatic events seemed to make them less upsetting. 

Shapiro began experimenting with this. She found that others had a similar experience — moving their eyes while thinking about past trauma made it a little easier. Shapiro eventually developed her discoveries into eye movement desensitization and reprocessing (EMDR) therapy. 

EMDR has become an important type of therapy, especially for people who have survived trauma. Let’s learn more about how this treatment works, who can benefit from it, and what to expect if you would like to try EMDR therapy.

What is EMDR used for?

EMDR was first developed to treat symptoms of trauma and post-traumatic stress disorder (PTSD). Currently, there is a lot of evidence that EMDR works for trauma, PTSD, and a number of other conditions. It is recognized worldwide as an effective, evidence-based treatment for PTSD.  

In addition to trauma and PTSD, we now know EMDR therapy can also be used to treat:

• Depression

• Anxiety disorders

• Eating disorders

• Addiction

• Grief

• Chronic pain/illness

• Complex PTSD (C-PTSD) and dissociation symptoms

How does EMDR work for trauma?

EMDR therapy works by helping your brain process traumatic memories. Our brains have a natural healing process after a traumatic event that is designed to occur on its own. This happens in the stress response and learning areas of the brain. 

Sometimes though, memories of the traumatic event get stuck instead. So when you come in contact with a reminder of past trauma, it triggers memories your brain hasn’t processed completely. You might experience these memories as: 

• Images

• Emotions

• Thoughts

• Physical sensations

To help your brain reprocess traumatic memories with EMDR, you will focus on one small piece of a traumatic memory at a time. At the same time, your therapist guides you to use bilateral stimulation while you think about the memory. 

Bilateral (side-to-side) stimulation helps your brain reprocess traumatic memories to reduce your symptoms. Eye movements are one type of bilateral stimulation. Your therapist may use other methods such as: 

• Watching their finger move back and forth

• Following a beam of light side to side

• Holding small paddles that vibrate between your left and right hands

• Listening to tones that alternate between your left and right ears

The phases of EMDR treatment

Once you begin EMDR, you’ll follow a structured treatment process done in eight phases. Each phase is designed to make sure you feel prepared, know what to expect, and to give you the best results.

Here are the steps you will go through during your EMDR sessions with your therapist:

1) History and treatment planning 

Your therapist will ask about your past so they can get to know you better. Your history also helps them develop an effective treatment plan. Part of creating a treatment plan includes deciding which traumatic events you want to work through. 

2) Preparation 

Your therapist will teach you techniques to cope with distress that might come up during therapy. They will also explain how EMDR works and what the process will be like.

3) Assessment 

During the assessment phase, you will decide which traumatic memory to focus on. You’ll identify the images, emotions, beliefs, and body sensations associated with that memory. Your therapist will also ask you to rate how much distress the memory causes. 

The purpose of this phase is to create a roadmap for you and your therapist to focus on in the next phases of treatment. You will repeat this process for each memory you work on in EMDR.

4) Desensitization

During this phase, you’ll use bilateral stimulation as you focus on the trauma memory. You’ll repeat this several times in a row. During each repetition, your therapist will ask how your images, beliefs, and feelings about the memory change. 

The goal is to desensitize you to the traumatic memory, or make it so the memory doesn’t cause much distress. Your therapist will keep checking in with your distress level as you go. 

5) Installation 

Next you will work to “install” a new, positive belief related to your trauma experience. During the assessment phase, you and your therapist will identify this belief. 

For example, the trauma may make you believe, “I am worthless.” Your positive belief might then be, “I am worthy.” Other examples may include, “I am lovable” or “I am now in control.” 

You will think about the traumatic memory and your positive belief at the same time while using bilateral stimulation. The goal is to strengthen your positive belief until it feels completely true.

6) Body Scan

Once you feel confident about your positive belief, your therapist will ask about physical sensations as you concentrate on the traumatic memory. Examples of body sensations might include:

• Tingling in your face

• Tension in your shoulders

• Butterflies in your stomach

Your therapist will work with you to process these body sensations while you use bilateral stimulation. This helps ensure you have reprocessed the entire traumatic memory.

7) Closure

At the end of each therapy session, your therapist will ensure you leave in a calm state. For example, they may guide you through relaxation or grounding exercises.

8) Reevaluation

At each EMDR session, your therapist will assess your progress from the previous session. You may need to go back to the same traumatic memory again. Or, you may decide it’s time to move on to the next memory. You and your therapist will work together to adjust your treatment plan as needed.

What to expect during EMDR therapy for PTSD

EMDR therapy is different for everyone. It can be short-term or long-term depending on your trauma. EMDR for a single event, like a car crash, may only require a few sessions. Complex trauma — such as having a history of childhood abuse or domestic violence — often takes longer. 

Some people will go for EMDR therapy more than once a week. Sessions may be 60 or 90 minutes long, depending on your situation. Your therapist will help you understand what to expect as you begin treatment.  

Since you think about trauma more during treatment, you might be reminded of it more day-to-day. Your therapist will teach you coping strategies to use between EMDR sessions for when memories come up.

Bilateral stimulation also imitates rapid eye movement (REM) sleep. You dream during the REM stage of sleep, so you may have dreams about the traumatic memory after an EMDR session. This is the brain’s way of further processing and healing from the trauma. 

How to find an EMDR therapist

If you think EMDR might be helpful for you, it’s important to find a qualified therapist. An EMDR therapist needs special training. You can search online for trained EMDR therapists in your area. Check out directories like: 

• EMDR International Association’s Find an EMDR Therapist directory

• Parnell Institute’s Find an EMDR Therapist database

• Therapy Den

• Psychology Today

• Gaylesta (LGBTQ therapists)

• InnoPsych (BIPOC therapists)

• Open Path Psychotherapy Collective (low-cost therapy)

If you have health insurance, you may be able to look for EMDR therapists through your health plan’s provider directory. Last, don’t be afraid to ask friends, family, and other trusted healthcare providers for a recommendation.

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Written by:

Shane Kavanaugh, PhD, LMHC

Shane Kavanaugh, PhD, LMHC, holds a doctorate in human development and family studies from Iowa State University and a master’s degree in clinical mental health counseling from Bellevue University. He has published research in leading academic journals, including the Journal of Family Psychology, Journal of GLBT Family Studies, and Journal of Homosexuality.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

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