What is EMDR?
EMDR is a structured therapy developed by Francine Shapiro in the late 1980s. It was originally designed for trauma and PTSD, but is now used for a range of conditions including anxiety, phobias, grief and chronic pain.
EMDR works differently from traditional talking therapies. Rather than analysing your experiences in detail, it helps your brain reprocess traumatic memories so they no longer trigger the same intense emotional and physical reactions.
How it works
When something traumatic happens, your brain can struggle to process the experience in the way it normally would. The memory gets stored with all its original intensity: the fear, the helplessness, the physical sensations. EMDR helps unblock this natural processing.
During EMDR, your therapist will ask you to recall a disturbing memory while simultaneously following a form of bilateral stimulation, most commonly their finger moving back and forth in front of your eyes. Other forms include tapping on alternate knees or holding buzzers that vibrate in each hand.
This bilateral stimulation appears to help your brain process the memory more fully, reducing its emotional charge. After successful EMDR, you can still remember what happened, but the memory no longer feels overwhelming.
What sessions look like
- History and planning The therapist learns about the client and agrees a treatment plan.
- Preparation The therapist explains the work and helps the client develop ways to manage distress.
- Assessment They identify a memory, its associated beliefs, emotions and body sensations.
- Desensitisation The therapist guides memory work with sets of eye movements, taps or sounds.
- Installation The work focuses on a preferred positive belief linked to the memory.
- Body scan The client notices any remaining physical discomfort linked to the memory.
- Closure The therapist supports the client before the session ends and discusses what may arise between sessions.
- Re-evaluation The therapist reviews progress and what needs further work.
The therapist can revisit earlier work. These are phases of treatment, not a fixed number of sessions.
Eye movements are only one part of EMDR. Assessment, preparation and review also form part of the therapy.
A typical course of EMDR is 6 to 12 sessions, though complex trauma may require more. Sessions last 60 to 90 minutes, longer than standard therapy sessions.
Source: EMDR Institute: overview
Who is it best suited to?
EMDR is recommended by NICE (the National Institute for Health and Care Excellence) and the World Health Organisation for PTSD. It can be particularly helpful if you:
- Have experienced a traumatic event (accident, assault, witnessing violence)
- Suffer from flashbacks, nightmares or intrusive memories
- Have PTSD or complex PTSD
- Experience phobias or anxiety linked to specific events
- Have tried talking therapy but find it difficult to discuss the trauma in detail
One of EMDR's strengths is that you do not need to talk about the traumatic experience in great detail. This makes it more accessible for people who find verbal processing of trauma overwhelming.
How it differs from other approaches
EMDR is sometimes confused with emotionally focused therapy, shortened to EFT, because the initials look alike. That is a couples and family therapy, not a trauma treatment.
Unlike CBT, which works on changing your thoughts about an experience, EMDR works on how the memory is stored in your brain. You are not asked to challenge your beliefs or complete homework. The processing happens during sessions through the bilateral stimulation.
Unlike psychodynamic therapy, EMDR does not explore the broader patterns of your life. It is focused and targeted: identify the memory, process it, move on to the next one.
The evidence
EMDR has a large evidence base for PTSD. Chen and colleagues (2014) pooled the randomised controlled trials and reported reduced PTSD symptoms. NICE recommends it for adults with PTSD after a non-combat-related trauma, alongside trauma-focused CBT. If you are starting from what happened rather than from a therapy name, our trauma and PTSD page is the place to begin. Maxfield and Hyer (2002) reviewed the EMDR trials and found that the more rigorous studies reported the larger effects.
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References
- Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures. Guilford Press.
- Maxfield, L. & Hyer, L. (2002). The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD. Journal of Clinical Psychology. doi:10.1002/jclp.1127
- Chen, Y. R., Hung, K. W., Tsai, J. C., Chu, H., Chung, M. H., Chen, S. R., Liao, Y. M., Ou, K. L., Chang, Y. C. & Chou, K. R. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic stress disorder: A meta-analysis of randomized controlled trials. PLOS ONE. doi:10.1371/journal.pone.0103676
- NICE (2018). Post-traumatic stress disorder (NG116). nice.org.uk
- EMDR Institute (2026). What is EMDR?. emdr.com
