EMDR Therapy: What It Is, How It Works, and What to Expect

You may have heard of EMDR.

Maybe a friend mentioned it.

Maybe you've seen it on social media.

Or perhaps you've been looking for a therapy that can help you work through an experience that still affects you today.

EMDR has become increasingly well known, but there are still many misconceptions about what it actually involves.

Some people imagine that EMDR is simply following a therapist's fingers with their eyes.

Others worry that they will have to tell their entire trauma story in detail.

And some wonder whether EMDR is actually supported by research.

The short answer is that EMDR is a structured form of psychotherapy with a substantial evidence base, particularly for post-traumatic stress disorder (PTSD). Current clinical guidelines recognize EMDR as one of the trauma-focused psychotherapies that can be used to treat PTSD.

But understanding EMDR involves more than knowing that eye movements are part of the process.

Let's take a closer look at what EMDR actually is, how it works, and what you might expect if you begin treatment.

What Does EMDR Stand For?

EMDR stands for Eye Movement Desensitization and Reprocessing.

It was developed by psychologist Francine Shapiro in the late 1980s and was initially developed as a treatment for PTSD. Today, EMDR is best established as a trauma-focused psychotherapy for PTSD, although clinicians may use EMDR-based approaches with other concerns depending on their training, the client's needs, and the clinical situation.

EMDR uses a structured treatment approach that helps people process distressing memories and the thoughts, emotions, and physical sensations connected to those experiences.

One component involves bilateral stimulation, which may include guided eye movements, alternating sounds, or alternating taps.

The eye movements are one of the most recognizable parts of EMDR, but they aren't the entire therapy.

EMDR involves a broader treatment process that includes history-taking, preparation, identifying treatment targets, processing, and evaluating progress.

Why Might a Difficult Memory Still Affect You?

Most people experience upsetting events at some point in their lives.

Over time, many memories become less emotionally intense.

You may still remember what happened, but thinking about it doesn't necessarily cause the same emotional or physical response that occurred at the time.

Traumatic or highly distressing experiences can sometimes feel different.

A memory may continue to feel extremely vivid.

Certain situations, sounds, places, smells, or interactions may trigger strong emotional or physical reactions.

You may understand logically that you're safe now while your body reacts as though the danger is still happening.

For someone experiencing PTSD, these reactions can include intrusive memories, nightmares, avoidance, negative changes in mood or thinking, and heightened arousal or reactivity.

EMDR is designed to help people process distressing memories so that the memories can become less emotionally overwhelming when they are recalled.

What Happens During EMDR?

One of the biggest misconceptions about EMDR is that you simply walk into a therapy session, think about a traumatic event, and immediately start moving your eyes back and forth.

That's not how a properly structured EMDR treatment begins.

EMDR follows an eight-phase approach that includes history-taking, preparation, identifying target memories, processing, and evaluating treatment progress.

Early sessions may focus on understanding your history, identifying what brings you to therapy, developing coping and grounding skills, and making sure you have the resources you need before beginning trauma processing.

This preparation is important.

Processing difficult memories can bring up emotions, body sensations, thoughts, or other reactions.

A therapist should work with you to determine whether EMDR is appropriate and how to approach treatment in a way that fits your individual needs.

What Is Bilateral Stimulation?

During the processing portion of EMDR, you may be asked to briefly focus on aspects of a distressing memory while simultaneously engaging in bilateral stimulation.

This might involve following the therapist's hand with your eyes as it moves from side to side.

Other forms of bilateral stimulation may include alternating sounds or taps.

The purpose is not simply to distract you from the memory.

Instead, bilateral stimulation is incorporated into EMDR's structured processing procedure.

Research supports EMDR as an effective treatment for PTSD, although there continues to be scientific discussion about exactly how its bilateral stimulation component contributes to treatment and whether eye movements themselves are necessary.

That distinction is important.

We know that EMDR can be an effective treatment for PTSD.

We don't necessarily have one simple explanation for exactly why every component of the treatment works.

Do You Have to Tell Your Therapist Everything That Happened?

This is a common concern.

The answer is not necessarily.

EMDR does not require the same type of extended trauma narration used in some other approaches.

According to the American Psychological Association, EMDR differs from some other trauma-focused treatments in that it does not require extended exposure to the distressing memory, detailed descriptions of the trauma, or trauma-related homework.

Your therapist will work with you to identify the memories, beliefs, emotions, or physical sensations that are relevant to treatment.

You remain an active participant in the process.

And your therapist should help you understand what to expect rather than asking you to enter the process without preparation.

Does EMDR Make You Relive the Trauma?

The goal of EMDR isn't to make you suffer through the experience again.

Instead, the treatment involves briefly focusing on aspects of a distressing memory while using the structured EMDR process to help reduce the distress associated with that memory.

That doesn't mean EMDR is always emotionally easy.

Processing difficult experiences can bring up strong emotions.

But the purpose of treatment is not to keep you stuck in the worst parts of what happened.

The goal is to help the memory become less overwhelming and less disruptive in the present.

What Might EMDR Feel Like?

Everyone experiences EMDR differently.

You might notice memories, emotions, thoughts, body sensations, or associations coming to mind.

You might remember details you hadn't thought about in a long time.

You might notice that your understanding of an experience begins to change.

Some people describe memories becoming less vivid or less emotionally intense.

Others notice changes in the beliefs they have carried about themselves since the experience occurred.

For example, someone may enter therapy carrying a belief such as:

"I'm not safe."

Through the therapeutic process, they may begin to develop a different understanding of the experience and of their present circumstances.

The experience is individual, which is one reason EMDR treatment should be tailored to the person rather than treated as a one-size-fits-all process.

How Long Does EMDR Take?

There isn't one universal number of sessions that works for everyone.

The length of treatment depends on factors such as the nature and number of experiences being addressed, current symptoms, treatment goals, and individual circumstances.

The APA describes EMDR as typically being delivered one to two times per week, with many treatment courses involving approximately 6–12 sessions, although some people benefit from fewer sessions.

For more complex situations, treatment may take longer.

Your therapist can discuss what a realistic treatment plan may look like based on your individual needs.

Does EMDR Really Work?

For PTSD, there is substantial research supporting EMDR.

The U.S. Department of Veterans Affairs' National Center for PTSD describes EMDR as one of the most studied treatments for PTSD and notes that multiple clinical practice guidelines recommend it.

The 2023 VA/DoD clinical practice guideline recommends individual, manualized trauma-focused psychotherapies including Cognitive Processing Therapy (CPT), EMDR, and Prolonged Exposure (PE) for PTSD.

The American Psychological Association's current guideline also includes EMDR as a recommended treatment option, although its recommendation is conditional and the guideline notes that the evidence was not sufficient to determine that EMDR is better or worse than other psychological treatments.

In other words, EMDR is not a miracle treatment, and it isn't the only effective approach to trauma.

But it is a legitimate, evidence-based treatment option that may be helpful for people experiencing PTSD and trauma-related difficulties.

Who Might Benefit From EMDR?

EMDR is most strongly supported as a treatment for PTSD and trauma-related symptoms.

Whether it is appropriate for you depends on your history, symptoms, treatment goals, and clinical needs.

A therapist can help determine whether EMDR makes sense as part of your treatment plan.

It's also important to remember that having experienced something traumatic doesn't automatically mean that EMDR—or any particular therapy—is the right choice.

Good therapy begins with understanding the person, not simply choosing a treatment based on a diagnosis or a trend.

What If I'm Nervous About Starting?

It's completely understandable to feel uncertain about trauma therapy.

You may wonder whether talking about difficult experiences will make things worse.

You may worry that you aren't ready.

You may not even know exactly what you need help with.

Those concerns are worth bringing into the therapy room.

A good therapeutic relationship gives you space to ask questions, understand your options, and work with your therapist to determine an appropriate pace.

You don't have to know exactly how therapy will work before your first appointment.

You can start with a conversation.

EMDR Is More Than Eye Movements

Perhaps the most important thing to understand about EMDR is that it is much more than moving your eyes from side to side.

It is a structured psychotherapy that includes preparation, assessment, trauma processing, and ongoing evaluation.

For people experiencing PTSD, EMDR is one of several evidence-based trauma-focused treatment options.

And while research continues to explore exactly how its different components contribute to change, there is meaningful evidence supporting its effectiveness for PTSD.

If you're carrying an experience that continues to affect how you feel, think, or respond in the present, you don't have to figure out on your own whether EMDR is right for you.

At Lakeside Counseling, our therapists can help you explore your concerns, understand your treatment options, and determine what type of support may best fit your needs.

You don't have to erase what happened to move forward. Sometimes healing begins with changing the way the past affects you in the present.