Eye Movement Desensitization and Reprocessing (EMDR): What Is It?

Trauma can leave a lasting imprint on the brain. For some people, memories of a distressing event feel stuck – replaying as flashbacks, nightmares, or intense emotional reactions long after the danger has passed. If you’ve been researching mental health treatment options, you may have come across Eye Movement Desensitization and Reprocessing, or EMDR.

EMDR is an evidence-based psychotherapy most commonly used to treat posttraumatic stress disorder (PTSD). Major clinical guidelines recommend it as a first-line treatment for PTSD, supported by more than 30 randomized controlled trials demonstrating effectiveness in both adults and children [3]. But what exactly happens during EMDR, and how does it work?

What Is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a structured psychotherapy that helps people process and reduce the distress associated with traumatic memories.

During EMDR, a patient briefly focuses on a traumatic memory while simultaneously engaging in bilateral stimulation. This typically involves following the therapist’s fingers with their eyes as they move side to side, though tapping or auditory tones can also be used. At the same time, the therapist guides the patient in identifying negative beliefs connected to the trauma (such as “I’m not safe” or “It was my fault”) and replacing them with more adaptive, accurate beliefs.

EMDR follows a standardized eight-phase treatment model [2]. These phases include:

• History Taking & Treatment Planning
• Preparation
• Assessment
• Desensitization
• Installation
• Body Scan
• Closure
• Reevaluation

It integrates elements of cognitive-behavioral, psychodynamic, and experiential therapies, but it has a distinct structure and protocol of its own [2].

The therapy is grounded in the Adaptive Information Processing (AIP) model. This model proposes that PTSD symptoms arise when traumatic memories are inadequately processed and stored in isolation from more adaptive information. EMDR aims to help the brain reprocess those memories so they become less emotionally charged and more integrated [2].

How Does EMDR Work?

Researchers continue to study exactly how EMDR works, but several well-supported theories exist.

One leading explanation involves working memory. When you recall a traumatic memory while simultaneously performing a task that requires attention – like tracking moving fingers – the brain’s working memory becomes taxed. This may reduce the vividness and emotional intensity of the memory over time [4].

Other theories suggest that bilateral stimulation enhances communication between brain hemispheres or activates processes similar to those that occur during REM sleep, when the brain naturally processes emotional experiences [4][5].

A 2023 experimental study found that bilateral eye movements reduced both the perceptual vividness and emotional distress associated with trauma-related memories [6]. In simple terms, the memory may still exist, but it feels less overwhelming.

How Effective Is EMDR?

EMDR is widely recognized as an effective treatment for PTSD. A 2024 state-of-the-science review concluded that EMDR has strong empirical support and is recommended in international PTSD treatment guidelines [3]. Meta-analyses show large treatment effects that are comparable to other trauma-focused therapies such as cognitive processing therapy and prolonged exposure [3]. A review of randomized clinical trials also found that trauma-focused psychotherapies – including EMDR – significantly reduce PTSD symptoms [1]. 

Importantly, EMDR does not always require detailed, repeated verbal descriptions of the traumatic event in the same way that some exposure-based therapies do. For some individuals, that structure feels more manageable.

The choice between EMDR and other trauma-focused therapies often depends on patient preference, clinical history, and therapist training.

What Happens During an EMDR Session?

EMDR sessions are structured and intentional. Early sessions focus on preparation – building coping skills and ensuring the patient has strategies for managing distress. This phase is important for emotional safety.

When reprocessing begins, the therapist asks the patient to focus briefly on a target memory while engaging in bilateral stimulation. After a short set of eye movements or taps, the therapist checks in and asks what the patient noticed – thoughts, feelings, images, or body sensations. This process repeats in sets until the memory becomes less distressing.

EMDR also includes identifying and strengthening a positive belief to replace the negative belief associated with the trauma. Over time, the goal is that recalling the memory no longer triggers intense emotional or physical reactions.

The number of sessions varies. Single-incident trauma may require fewer sessions, while complex or repeated trauma may require a longer course of treatment.

Is EMDR Safe?

When provided by a trained mental health professional, EMDR is considered safe and well-tolerated.

Because it involves accessing traumatic memories, some temporary increases in emotional distress can occur during sessions. However, structured preparation phases are designed to ensure patients have coping tools before reprocessing begins [2].

EMDR may not be appropriate for everyone without stabilization first. Individuals experiencing active crisis, severe dissociation, or lack of safety support may require additional preparation.

A psychiatric provider can help assess overall mental health symptoms and determine whether additional support, including medication, may be helpful alongside therapy.

Does EMDR Help Conditions Other Than PTSD?

Although EMDR was originally developed for PTSD, research is exploring its potential role in other conditions. A 2021 systematic review suggests emerging evidence for anxiety disorders, addiction-related conditions, and chronic pain [7]. However, the strongest and most consistent evidence remains in the treatment of PTSD.

When to Seek Professional Care

Consider speaking with a mental health professional if you experience:

• Intrusive memories or flashbacks
• Persistent nightmares
• Avoidance of trauma reminders
• Ongoing anxiety or panic
• Irritability or emotional numbness
• Difficulty functioning at work or home

If you are experiencing thoughts of harming yourself or are in crisis, seek emergency care or contact the 988 Suicide & Crisis Lifeline.

Remedy Psychiatry provides telepsychiatry medication management. An online psychiatric provider can evaluate symptoms and prescribe medication when appropriate.

If you are exploring treatment options, you can learn more about our telepsychiatry services here. We also provide information about insurance coverage here. If you’re considering a psychiatry appointment, our FAQs may answer common questions about virtual visits and how online care works.

Disclaimer: This article is for educational purposes only and does not constitute medical advice. It does not replace individualized evaluation by a qualified psychiatric provider. Please seek professional care for personal treatment decisions.