What Is EMDR Therapy? How It Works and Who It Helps

EMDR stands for Eye Movement Desensitization and Reprocessing — a therapy developed in the late 1980s that has become one of the most effective treatments for trauma and PTSD. It's endorsed by the World Health Organization (WHO), the American Psychological Association (APA), and the US Department of Veterans Affairs as a first-line treatment for trauma.

If the name sounds strange — particularly the "eye movement" part — you're not alone. Let's break down what it actually is and why it works.

The Core Idea Behind EMDR

EMDR is based on a theory about how the brain processes distressing memories.

When you experience something traumatic, the memory can get "stuck" in the brain's nervous system in a way that prevents normal processing. Unlike regular memories that fade and integrate over time, traumatic memories can remain vivid, emotionally charged, and easily triggered — as if the event is still happening.

EMDR uses bilateral stimulation (typically guided eye movements, but also tapping or sounds) to activate both sides of the brain simultaneously while you hold the traumatic memory in mind. This bilateral activation appears to mimic what happens during REM sleep — when the brain naturally consolidates and processes emotional memories.

The result: the memory becomes less emotionally charged. It doesn't disappear, but it stops triggering the intense distress it once did.

What Happens in an EMDR Session?

EMDR follows a structured eight-phase protocol. Here's what the process looks like:

Phase 1–2: History and Preparation

Your therapist takes a thorough history of what brought you to therapy and teaches you stabilization techniques — grounding exercises and coping skills you'll use if you become distressed during processing. This phase can take several sessions.

Phase 3: Assessment

You and your therapist identify a specific memory to target, along with the negative belief associated with it (e.g., "I am powerless") and the positive belief you'd like to hold instead (e.g., "I am safe now").

Phase 4–6: Desensitization, Installation, and Body Scan

This is the core of EMDR. While holding the target memory in mind, you follow your therapist's finger (or another bilateral stimulus) with your eyes in a back-and-forth motion. After each set of eye movements, you report what came up — thoughts, feelings, images, body sensations.

You continue processing until the distress associated with the memory drops to near zero and the positive belief feels completely true.

Phase 7–8: Closure and Reevaluation

Each session ends with stabilization. At the start of the next session, your therapist checks what happened between sessions and reviews what was processed.

Does EMDR Actually Work?

Yes — the evidence is strong and wide-ranging.

A 2013 meta-analysis published in the Journal of EMDR Practice and Research found EMDR was more efficient than trauma-focused CBT in achieving PTSD remission. A WHO review of evidence-based trauma treatments identified EMDR as one of only two recommended therapies for PTSD in children and adults (the other being trauma-focused CBT).

The US Department of Veterans Affairs lists EMDR as a first-line treatment for PTSD. Multiple studies show that significant improvement can happen in as few as 3–6 sessions — faster than many other trauma treatments.

One notable 2004 study found that 84–90% of single-trauma PTSD sufferers no longer met the criteria for PTSD after just three 90-minute EMDR sessions.

What Can EMDR Treat?

EMDR was developed for PTSD but has since shown effectiveness for:

• PTSD and trauma (its primary and best-evidenced use)
• Complex PTSD (from repeated or childhood trauma)
• Grief and loss
• Panic disorder and phobias
• Anxiety disorders
• Depression (when connected to traumatic or adverse experiences)
• Chronic pain (pain with psychological components)
• Performance anxiety and blocks
• Body image and eating disorders
• Addiction (trauma often underlies addictive behaviors)

It's worth noting: EMDR is not only for severe or single-event trauma. Many people use it to process "small t" traumas — accumulated difficult experiences, childhood shame, relationship wounds, or ongoing stressors that have left an emotional imprint.

EMDR vs. CBT for Trauma

Both EMDR and Trauma-Focused CBT are first-line recommended treatments for PTSD. The key differences:

EMDR:

• Less talking and more processing
• Doesn't require detailed verbal recounting of the trauma narrative
• May work faster for some people
• Involves bilateral stimulation (eye movements or tapping)

Trauma-Focused CBT:

• More structured and verbal
• Includes education about trauma responses and coping skills
• Involves gradual exposure and processing of the trauma narrative

For many people, EMDR produces results with less explicit reliving of the event. Some trauma survivors find this easier to tolerate. Your therapist will help you determine which approach is a better fit.

Can EMDR Be Done Online?

Yes. What was once considered impossible has been validated by a growing body of evidence. Online EMDR uses screen-based bilateral stimulation tools — a dot or bar moving back and forth across your screen — in place of the therapist's hand movements.

Research during and after the COVID-19 pandemic found that online EMDR produced equivalent outcomes to in-person EMDR for most clients. The therapeutic relationship and proper protocol adherence matter more than the modality.

For online EMDR to work well, you'll need a private space where you can speak freely, a stable internet connection, and a screen large enough to follow the bilateral stimulation comfortably.

How Many EMDR Sessions Do You Need?

It depends significantly on what you're processing:

• Single-incident trauma (accident, assault, one-time event): 3–8 sessions
• Ongoing or repeated trauma (childhood abuse, domestic violence, complex PTSD): Often 20+ sessions
• Multiple targets (several different memories or issues): Varies widely

EMDR tends to work faster than many people expect for single-incident trauma. Complex trauma requires more time and careful preparation phases.

How to Find an EMDR Therapist

Look for therapists who are:

• Trained and certified in EMDR (ideally through the EMDR International Association)
• Licensed in their field (psychologist, social worker, counselor)
• Experienced specifically with trauma

Shemesh Wellness connects you with licensed practitioners offering trauma-informed therapy online — including EMDR-trained therapists. Free initial consultation, sessions from $79.

Frequently Asked Questions

Does EMDR work without trauma?

EMDR can address any distressing memory or emotionally charged experience — not just severe trauma. Many people use it for anxiety, relationship patterns, or persistent negative beliefs that don't stem from a single identifiable traumatic event.

Is EMDR a form of hypnosis?

No. You remain fully conscious and in control throughout an EMDR session. You're not in a trance and you can stop at any time. The bilateral stimulation activates natural brain processing mechanisms, but it's not hypnosis.

Can EMDR make things worse?

The preparation phase exists specifically to ensure you have the coping skills needed before processing begins. EMDR can temporarily increase distress as memories are being processed — this is normal and expected — but a skilled therapist manages this carefully.

Is EMDR covered by insurance?

In the US, EMDR is covered by most major insurers as a form of psychotherapy. The billing code is the same as standard therapy sessions.

---

Ready to Try EMDR or Trauma-Focused Therapy?

Shemesh Wellness offers trauma-informed therapy online with licensed professionals — from $79/session.

Book a Free Consultation →

---

Related guides:

• Online Therapy for PTSD and Trauma
• Types of Therapy Explained: CBT, DBT, EMDR and More
• What Is CBT Therapy?
• How to Start Therapy