What is EMDR Therapy? A Guide to Eye Movement Desensitization and Reprocessing

EMDR, or eye movement desensitization and reprocessing, is a structured psychotherapy designed to help people process distressing memories and reduce the emotional charge they carry. It was originally developed to treat post-traumatic stress disorder (PTSD), but its use has since expanded to a broader range of mental health conditions.

If you have heard about EMDR and wondered whether it might help you, or are simply trying to understand what it involves, this article explains how it works, what the research says, and who is most likely to benefit.

Key Takeaways

• EMDR is a recognized, evidence-based treatment: It is endorsed by the World Health Organization (WHO), the American Psychiatric Association, and the U.S. Department of Veterans Affairs as a treatment for PTSD. The APA places EMDR as a second-line treatment just after prolonged exposure (PE) and cognitive processing therapy (CPT).

• It works by helping the brain reprocess traumatic memories: EMDR uses bilateral stimulation, typically side-to-side eye movements, while a person focuses on a distressing memory, helping the brain reprocess and integrate the memory in a manner that reduces its intensity and associated emotions.

• EMDR can help beyond PTSD: Research seems to support EMDR’s potential usefulness for personality disorders, anxiety disorders, depression, phobias, and other conditions with trauma-related components, though the evidence outside PTSD is still developing..

What is EMDR Therapy?

EMDR was developed in the late 1980s by psychologist Dr. Francine Shapiro, who observed that moving her eyes back and forth while thinking about distressing memories seemed to reduce their emotional impact. This observation led to the development of a structured therapeutic protocol.

Adaptive information processing (AIP), the core idea behind EMDR, stipulates that traumatic memories are sometimes stored in a fragmented, emotionally raw form in the brain, not fully processed or integrated as other memories are. When certain sensations trigger one of these memories, the emotional response can feel as intense as when the original event happened. 

In a sense, people with traumatic memories, including those with PTSD, relive those experiences every time they encounter the sensations originally felt with the trauma. The purpose of EMDR is to process the traumatic memory along with the sensations tied to it so they don’t seem as distressing or painful anymore.

EMDR uses bilateral stimulation, typically following a therapist's fingers side to side, or through tapping or auditory tones, to activate both hemispheres of the brain while the person briefly focuses on a distressing memory. This stimulation helps the brain reprocess the memory and integrate it in a way that reduces its emotional intensity. 

Several meta-analyses have established EMDR therapy's efficacy for PTSD in children, teenagers, and adults, leading to its recognition by the WHO as a recommended psychotherapy for trauma.

The 8 Phases of EMDR

EMDR follows a structured protocol with eight phases. Understanding the process can help reduce anxiety about what to expect:

• History and treatment planning: The therapist gathers information about your history, current symptoms and triggers, and identifies specific memories or experiences to target. Your suitability for EMDR treatment is also evaluated at this stage.

• Preparation: You learn about EMDR, develop coping strategies, and build the skills needed to manage distress during processing and foster a sense of control.

• Assessment: The therapist helps you identify a specific target memory, the negative belief it carries, how distressing it feels right now, any physical sensations it brings, and the desired positive belief.

• Desensitization: You focus on the target memory while following the bilateral stimulation, noticing the emotions, sensations, and other memories that spontaneously come up without trying to control them.

• Installation: A positive belief is strengthened to replace the negative one associated with the memory.

• Body scan: You check for and process any remaining tension or physical discomfort connected to the memory.

• Closure: Each session ends with grounding and stabilization to ensure you feel safe and calm before leaving. You will be briefed on what to expect, self-control techniques, and asked for behavioral reports between sessions, in some cases.

• Reevaluation: At the start of the next session, the therapist reviews the previous work and assesses how much progress has been made. 

The number of sessions needed varies depending on the complexity of the trauma and how many memories need to be processed. Some people see significant improvement in as few as six to twelve sessions, particularly with single-incident trauma; others with complex or childhood trauma may benefit from longer treatment.

What Does the Research Say About EMDR?

EMDR has a substantial body of evidence supporting its effectiveness for PTSD, and growing evidence for other conditions.

EMDR and PTSD

EMDR is one of several trauma-focused psychotherapies with strong evidence for treating PTSD. A systematic review of studies published between 2000 and 2023 found that most studies showed EMDR was superior to control conditions in relieving PTSD symptoms, with eleven of sixteen studies demonstrating significant improvement.

The World Health Organization (WHO) recognizes EMDR as a recommended treatment for PTSD in children, adolescents, and adults. The U.S. Department of Veterans Affairs and the American Psychiatric Association also list EMDR among their recommended treatments for trauma. The 2025 APA Clinical Practice Guidelines place EMDR as a second-line treatment for PTSD behind other trauma-focused therapies.

EMDR for Other Conditions

Research has begun to explore EMDR's usefulness beyond PTSD. A systematic review on the effectiveness of EMDR beyond PTSD summarized evidence from randomized controlled trials on patients with psychosis, bipolar disorder, unipolar depression, anxiety disorders, and substance use disorders with a history of comorbid traumatic events. While the evidence base for these conditions is still growing, the review concluded that EMDR appears to improve trauma-associated symptoms and may have broader therapeutic effects.

EMDR is also being studied for phobias, grief, chronic pain, and eating disorders. In a randomized clinical trial involving patients with personality disorders, EMDR therapy was shown to produce a meaningful reduction in symptoms, with around 44% of patients on EMDR achieving remission.

As with any therapy, its appropriateness for conditions outside its primary evidence base should be evaluated on an individual basis with a qualified clinician.

Who is a Good Candidate for EMDR?

EMDR is most clearly indicated for people with PTSD or significant trauma histories that are affecting their current functioning. Beyond that, it may also be helpful for:

• People with anxiety disorders that have a specific traumatic or fear memory at their root

• People experiencing grief, particularly complicated grief with trauma elements

• People whose depression appears linked to unprocessed negative memories or stressful life events at the onset of depressive episodes

• People who have not responded adequately to other therapies

EMDR may not be appropriate as a standalone treatment for people with severe dissociation, active psychosis, or insufficient emotional stability to tolerate the processing phase. A qualified therapist will assess readiness before beginning trauma processing.

What is an EMDR Session Like?

Before processing begins, your therapist will spend a few sessions getting to know you, explaining the process, and making sure you have enough emotional coping tools to handle what comes up. This preparation phase is taken seriously in EMDR to ensure the therapy is appropriate for you.

During a processing session, you bring a specific memory to mind, usually just an image, a body sensation, or a negative belief, rather than retelling the full story in detail. You follow the therapist's fingers (or other bilateral stimuli) for a set of movements, then pause and notice what comes up. This process is repeated over several sessions until the memory becomes less distressing. Sessions typically last 60 to 90 minutes.

Many people describe EMDR as emotionally intense but manageable. Some people may experience strong emotions such as grief, anxiety, fear, or anger as they process the trauma. Some experience vivid dreams or feel tired after a session. 

However, as the treatment progresses and the negative beliefs or sensations are replaced with a desired way of thinking, people report that memories that once felt emotionally overwhelming begin to feel less so;  still real, but without the same raw emotional charge. 

EMDR vs. Other Trauma Therapies

EMDR is not the only effective trauma therapy. Cognitive processing therapy (CPT) and prolonged exposure (PE) are also well-established first-line treatments for PTSD. Research comparing EMDR to trauma-focused cognitive behavioral therapy (CBT) has generally found their effects to be comparable, suggesting the choice may come down to personal preference, therapist availability, and individual fit.

One advantage of EMDR compared to CBT is that it does not require the person to narrate the traumatic event in detail or complete written assignments between sessions. Some people find this preferable, particularly for trauma that is difficult to put into words.

Some studies even suggest EMDR may produce improvement in symptoms faster than trauma-focused CBT. 

Finding an EMDR Therapist

EMDR should be provided by a licensed mental health professional who has received formal EMDR training. The EMDR International Association (EMDRIA) maintains a directory of trained and certified therapists, which can be a helpful starting point.

Because EMDR therapists are not always widely available in every area, telehealth has opened up access for many people. Early research suggests that EMDR can be adapted for telehealth delivery in some cases, though the evidence base is still growing,  and it may require adaptations to how bilateral stimulation is delivered.

Medical Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. EMDR should be provided by a trained, licensed clinician. If you are in crisis, call or text 988.

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