What is EMDR Therapy?
Developed by psychologist Francine Shapiro in 1987, Eye Movement Desensitisation and Reprocessing Therapy (EMDR Therapy) is a structured psychotherapy approach that uses bilateral stimulation, typically in the form of guided eye movements, to help the brain process and integrate disturbing memories that have become ‘stuck’.
Why Do Certain Memories Get ‘Stuck’?
It’s your brain doing its best to ensure your survival. When we experience something traumatic, the brain’s alarm centre, the amygdala, hijacks the cognitive processing centres, preventing the event from moving to the hippocampus where a story of what happened is created followed by the long-term memory.
There are a number of reasons why this happens:
1. The Survival Mechanism
The brain views the trauma as a potential future threat. To keep you safe, it maintains a state of high alert (or hypervigilance) by constantly reminding you of danger through intrusive thoughts, nightmares or flashbacks.
2. Memory Processing Shuts Down
During a traumatic incident, the brain shuts down normal organised memory processing. As a result, the memory is stored in a fragmented, sensory way rather than a cohesive story. This means the memory hasn’t been effectively dated as a ‘past’ event and the brain is likely to interpret sights, sounds, smells or reminders as a current, ongoing threat.
3. The Role of the Amygdala
Following trauma, the brains threat detector, the amygdala, becomes hypersensitive. It acts like a malfunctioning smoke alarm, going off at the slightest hint of danger. It can be particularly sensitive to anything similar to the original trauma.
4. Unprocessed Information
If the brain wasn’t able to process the experience at the time, it can get stuck trying to understand it, replaying the trauma on a loop, hoping to make sense of what happened and file it away.
How Does EMDR Therapy Work?
It can be helpful to think of unprocessed trauma as an infected wound. Usually, when we have an open wound, the body immediately sets to work repairing it. However, if there is an infection, it will be unable to heal itself. EMDR Therapy facilitates the mind’s own natural ability to heal by ‘cleaning’ the wound and curing the infection rather than leaving it as a raw, exposed injury.
During EMDR sessions, you focus on a traumatic memory while simultaneously experiencing bilateral stimulation. This dual attention seems to reduce the vividness and emotional intensity of the memory, allowing your brain to reprocess it more adaptively.
The bilateral stimulation most commonly involves following the therapist’s fingers as they move back and forth across your field of vision or following a moving light bar. However, alternatives include tactile stimulation (such as tapping alternately on your hands or knees) or auditory stimulation (sounds alternating between your left and right ears through headphones). These alternatives are particularly useful for remote therapy sessions or for people who find eye movements uncomfortable.
While researchers continue to study the exact mechanisms, EMDR appears to work by helping the brain reprocess traumatic memories in a similar way to REM sleep, when our eyes move rapidly and the brain consolidates memories and experiences.
How Is EMDR Therapy Delivered?
EMDR follows a structured eight-phase approach:
Phase 1: History and Treatment Planning – Your therapist gathers information about your history and identifies specific memories to target.
Phase 2: Preparation – You learn about EMDR and develop coping strategies to handle emotional distress between sessions.
Phase 3: Assessment – The therapist helps you identify the specific components of the target memory, including the image, negative belief, emotions, and physical sensations associated with it.
Phase 4: Desensitisation – This is where the bilateral stimulation occurs. You focus on the memory while following the therapist’s hand movements with your eyes (or experiencing other forms of bilateral stimulation). You’ll process whatever thoughts, feelings, or sensations arise.
Phase 5: Installation – Positive beliefs are strengthened and ‘installed’ to replace the negative beliefs associated with the memory.
Phase 6: Body Scan – You’re asked to notice any residual physical tension or discomfort related to the memory.
Phase 7: Closure – Each session ends with techniques to help you return to a state of equilibrium, even if the processing isn’t complete.
Phase 8: Re-evaluation – At the beginning of subsequent sessions, your therapist assesses your progress and determines next steps.
EMDR sessions typically last 60 – 90 minutes and occur once or twice weekly. The number of sessions needed varies widely depending on the complexity of your trauma history. A single traumatic incident might be processed in three to six sessions, while more complex trauma may require months or longer. EMDR Therapy can be conducted in person or online.
Is EMDR Therapy Like Being Hypnotised?
No, during EMDR Therapy you are not being hypnotised. You are fully conscious and aware, and you can stop at any time.
It does involve having one foot in the present and one in the past simultaneously. An analogy I often share with clients is that you need to imagine you are boarding a train and embarking on a journey. You are safely sat at the window seat, observing distressing memories pass by outside.
Every 30-60 seconds, I will check in by asking ‘what do you notice now’ or something similar. You don’t need to describe everything that has happened – a headline will do. Equally, if there are things you don’t want to say out loud that’s fine too. The processing will still work.
What Are the Benefits of EMDR Therapy?
Many people report that EMDR feels less overwhelming than repeatedly recounting traumatic experiences in traditional therapy. The bilateral stimulation seems to create a sense of safety and distance that makes the processing more tolerable.
The memories you reprocess don’t disappear. The way they’re stored in the mind changes. They become less distressing and lose their power to trigger overwhelming reactions.
Another crucial change we are seeking in EMDR is that any negative beliefs associated with the trauma shift to something much more adaptive and accurate that you believe wholeheartedly. For example. ‘I’m in danger’ becomes ‘I am safe now’, ‘It was my fault’ becomes ‘I didn’t do anything wrong’, and ‘I am shameful’ becomes ‘I am worthy’.
What Conditions Can EMDR Therapy Be Used to Treat?
EMDR is primarily used to treat post-traumatic stress disorder (PTSD). It’s effective for single-incident trauma like accidents or assaults and complex trauma from repeated experiences.
There is also growing evidence that it can be used as part of the treatment for other difficulties such as panic disorder, generalised anxiety disorder, phobias and depression – particularly when these issues are linked to traumatic or adverse life experiences.
Does EMDR Therapy Work for Everyone?
No. Although I have witnessed the profound shifts that can occur with EMDR multiple times, it doesn’t work for everyone. For example, it can be less effective when someone has experienced relational trauma that feels like ‘death by a thousand cuts’. For these clients, a combined approach is often more effective. For example, I might recommend Schema Therapy or Compassion Focused Therapy (CFT) alongside using EMDR for some of the more specific distressing memories.
Therapy to Help You Heal
With more than 18 years’ experience in the field of mental health, I help clients understand the patterns of thinking and behaving that have been driving their actions for decades. By connecting past experiences to your present struggles, we create lasting transformation.
I regularly support people experiencing specific psychological difficulties such as PTSD, OCD, panic attacks, and depression. I also help clients struggling with low confidence, excessive worry, burnout, and the sense that the same painful patterns keep repeating. If these things sound familar, please get in touch. I also share mental health education via Instagram.
