EMDR therapy explained

You might follow the therapist’s moving finger or a light bar, listen to tones in each ear, or feel gentle taps on alternate hands. Each set lasts about 30 seconds, then you pause and say what you noticed.

The VA describes this as a way of staying grounded in the present while your mind works on the past.

You are fully conscious during EMDR and can stop at any moment, for example by raising a hand. Nothing is done “to” you without your agreement.

You think about the memory, but in most cases you don’t need to tell the story in detail. In EMDR, “processing” doesn’t mean talking it all through.

Unlike some other trauma therapies, EMDR does not require practice tasks between sessions. Your therapist will still teach calming skills to use in daily life.

Stuck memories can come with strong body feelings and harsh beliefs like “I’m not safe” or “It was my fault.” Reminders can set them off without warning.

EMDR doesn’t erase memories. The goal is that you can think about what happened without feeling flooded, and with a more balanced view of yourself.

Your therapist learns about your life, what is troubling you and which memories you may want to work on. Together you agree on goals.

You learn how EMDR works and practise ways to manage strong feelings, such as relaxation skills. This phase can take longer if life feels unsteady.

You pick a memory and notice the image, the negative belief, the feelings and body sensations linked to it. You also choose a positive belief you’d like to hold instead.

You hold the memory in mind during short sets of eye movements, tones or taps, then notice what comes up. Sets continue until the memory feels less disturbing.

You focus on the positive belief you chose, such as “I did the best I could,” while recalling the memory.

You notice whether any tension or discomfort is still linked to the memory. Work continues until it is gone or nearly gone.

Every session ends with steps to help you feel calm and safe before you leave, even if the memory isn’t finished yet.

At the start of the next session you review how things have been and decide what to work on next.

One disturbing event often takes around three to six sessions of EMDR, though everyone is different.

Complex or long-term trauma may take eight to twelve sessions or more, and the preparation phase may take longer. See “Complex PTSD” for more on this kind of hurt.

EMDR is offered in many VA specialist PTSD programs. Smaller VA sites may arrange sessions by video with a trained clinician elsewhere.

EMDR is also used for anxiety, phobias, low mood and other struggles. A large 2020 review found too few good-quality studies to recommend it for problems other than PTSD yet.

The VA calls EMDR one of the most effective treatments for PTSD. The World Health Organization advised in 2013 that CBT or EMDR should be considered for people with PTSD. The UK’s NHS lists it as a PTSD treatment too.

A federal (AHRQ) review summarised by the VA found moderate-quality evidence that EMDR reduces PTSD symptoms.

The same AHRQ review found the head-to-head evidence too limited to say EMDR beats other trauma-focused therapies. In a 2020 review, EMDR’s edge over other therapies disappeared in the best-quality studies.

So the choice between EMDR, Cognitive Processing Therapy or Prolonged Exposure often comes down to what feels right for you. See “Therapies for trauma” to compare.

A 2020 review of 76 trials found only 4 of 27 rated studies had a low risk of bias, and signs that positive results were more likely to be published. The authors said EMDR may help PTSD in the short term, but firmer conclusions need better studies.

Cleveland Clinic describes EMDR’s risks as very low. The most common side effect is distressing thoughts or feelings between sessions, which usually ease as treatment goes on.

The aim is for the memory to feel less distressing and for kinder beliefs about yourself to grow. The memory itself stays.

You are awake and aware throughout. A simple stop signal, like raising your hand, pauses the work.

Eye movements are only one part. EMDR includes history-taking, preparation and calming skills, memory work, and checking progress, all with a licensed therapist.

Many people notice changes after a few sessions, but a course often runs several weeks to a few months. Speed isn’t the goal.

EMDRIA says EMDR should only be offered by properly trained and licensed mental health clinicians. Working on trauma memories alone can stir up more than you can safely handle.

• “Do you want company or some quiet time?”
• “I’m proud of you for doing this.”
• “I’ve made tea, no need to talk.”
• “You don’t have to tell me anything.”

• “Shouldn’t you be over it by now?”
• “So what memory did you do today?”
• “That eye thing sounds weird.”
• “You seem worse, maybe stop.”

Feeling stirred up for a while is common. If you’re worried, gently encourage them to tell their therapist.

• Keep the evening low-key
• Offer a lift to or from sessions
• Respect their need for space
• Take on a chore that day

If you are thinking about suicide or are in emotional distress, call or text 988 to reach the 988 Suicide & Crisis Lifeline, 24/7. If you are in immediate danger, call 911.

Veterans, service members and their loved ones can dial 988 then press 1, or text 838255, for the Veterans Crisis Line.

FindTreatment.gov, run by SAMHSA, helps you find mental health services near you. Your primary care provider can also refer you.

To find an EMDR-trained therapist, see “EMDR: what a session is like & finding a provider.” For costs, see “Free & low-cost therapy.”

findahelpline.com lists free, confidential helplines in many countries. Your local health service can tell you how to reach trauma therapy, including EMDR, where you live.