EMDR therapy

EMDR was developed in the late 1980s by psychologist Francine Shapiro and has since been studied extensively. It is based on the idea that traumatic or very upsetting experiences can be stored in the brain in a "stuck" way, with the original images, emotions, beliefs and body sensations still feeling raw. Reminders can trigger these memories as if they were happening now.

EMDR aims to help the brain reprocess these memories so they become less vivid and distressing and more like ordinary memories of the past. The goal isn't to forget what happened, but to remember it without being overwhelmed.

Unlike some talking therapies, EMDR doesn't require describing traumatic events in detail or doing extensive homework. Many people find this appealing, especially if speaking about the trauma feels too difficult. EMDR is an integrative therapy and is usually delivered by a licensed mental health professional, such as a psychologist or psychotherapist, with specific EMDR training.

EMDR therapy follows a structured, eight-phase protocol:

• History and treatment planning: the therapist learns about your history, current difficulties and goals, and identifies target memories.
• Preparation: you learn what to expect and practice coping and calming techniques, so you have tools if emotions become intense.
• Assessment: you identify a target memory, including an image, a negative belief about yourself (such as "I'm powerless"), a positive belief you'd prefer, and related emotions and body sensations.
• Desensitization: you hold the memory in mind while following the therapist's hand or a light bar with your eyes, or while experiencing tapping or alternating sounds. After each set, you notice what comes up.
• Installation: strengthening the positive belief.
• Body scan: checking for remaining tension.
• Closure: returning to calm at the end of each session.
• Reevaluation: reviewing progress at the next session.

Exactly how bilateral stimulation contributes is still debated among researchers, but the overall approach has strong evidence for trauma.

EMDR for PTSD is where the evidence is strongest. International clinical guidelines recommend it, alongside trauma-focused cognitive behavioral therapies, as a first-line treatment for post-traumatic stress disorder in adults, and it is also used with children and adolescents.

EMDR may also help with:

• Complex PTSD and the effects of repeated trauma, often as part of a phased approach
• Anxiety and phobias linked to specific frightening experiences
• Distressing memories that aren't formally traumatic but still affect daily life
• Grief, especially after sudden or traumatic loss
• Nightmares related to trauma

Research is growing for conditions such as depression, chronic pain and panic disorder, but the evidence is less established than for PTSD. A therapist can discuss whether EMDR is a good fit for your particular situation, or whether another approach might be better suited.

Many studies have found that EMDR reduces PTSD symptoms, and it is considered an evidence-based treatment by major health organizations. Some people notice improvements after relatively few sessions, especially for single-incident trauma. Complex or multiple traumas usually require more time and preparation.

During and after sessions, it's common to feel tired or emotional, and memories, dreams or feelings may surface. These effects are usually temporary. Your therapist will help you prepare for them and use calming strategies at the end of each session.

EMDR isn't right for everyone at every moment. If you're in an unstable situation, are experiencing severe dissociation, or have certain health conditions, your therapist may recommend stabilization work first or a different approach. That's not a failure; it's careful, safe treatment.

You may come across brainspotting, a related approach that uses fixed eye positions to access distressing material. It is sometimes discussed alongside EMDR, but its research base is much smaller.

Look for a licensed mental health professional, such as a clinical psychologist, psychologist or psychotherapist, who has completed recognized EMDR training. It's reasonable to ask about their training, experience with your type of difficulty, and how they adapt EMDR for complex trauma.

Your first sessions will focus on history-taking and preparation rather than processing memories. The therapist will ask about your symptoms, history, current life and support, and teach you techniques to manage distress. Processing begins only when you both feel you're ready.

Sessions typically last around an hour, sometimes longer for processing sessions. EMDR can also be delivered online by therapists trained to do so.

If you are currently in crisis, EMDR isn't the first step. Seek urgent help: call 911 in the US or your local emergency number, call or text 988 (Suicide & Crisis Lifeline, US), or call Samaritans at 116 123 (UK and Ireland).