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

Updated 06.24.2026

Written by Rachel De La Merced and reviewed by Board Certified Psychiatric Nurse Practitioner Kate Filippelli, PMHNP who specializes in evidence-based psychiatry practices with personalized treatment plans for all mental health challenges, including psychiatric medication management, research-based supplements and behavioral interventions for major depressive disorder, bipolar disorder, anxiety, panic, OCD, ADHD and eating disorders.

 

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 have been researching mental health treatment options, you may have come across Eye Movement Desensitization and Reprocessing, or EMDR.

What is 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.

If you are wondering how this therapy works, EMDR is designed to help the brain reprocess traumatic experiences so they become less emotionally disruptive. It is considered one of the leading PTSD therapies, and EMDR continues to be recommended in major treatment guidelines worldwide.

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

These are often referred to as the 8 phases of EMDR, or simply the EMDR phases.

During the assessment phase, therapists spend time identifying targets in standard EMDR therapy. These targets are specific memories, beliefs, emotions, or situations that continue to cause distress and become the focus of reprocessing work.

EMDR 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]. Similarly, when people ask how EMDR works in the brain, researchers point to changes involving memory processing, emotional regulation, and communication between brain regions associated with fear responses and cognitive control.

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]. 

In our clinical practice at Remedy Psychiatry, we often observe that patients who struggle with traditional talk therapy may respond well to EMDR because it does not rely as heavily on repeated verbal recounting of traumatic events. 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.

For those wondering what EMDR therapy is like, many patients describe it as different from traditional talk therapy because the focus is less on discussing details repeatedly and more on processing experiences through guided reprocessing exercises.

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. As a psychiatric nurse practitioner at Remedy Psychiatry, I often observe that proper stabilization, including sleep, anxiety management, and sometimes medication support can significantly improve a patient’s ability to engage safely and effectively in EMDR.

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]. 

Questions such as “does EMDR help with anxiety” or “how does EMDR work for anxiety” are becoming increasingly common as researchers continue to explore these applications. Although more studies are needed, some findings suggest that processing emotionally charged memories may help reduce anxiety symptoms in certain patients.

Researchers are also exploring whether EMDR therapy for anger and emotional regulation difficulties may have potential benefits when unresolved traumatic experiences contribute to these challenges.

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. In our clinical experience at Remedy, patients often benefit most from a combined approach: pairing trauma-focused therapies like EMDR with individualized psychiatric care when symptoms such as anxiety, insomnia, or mood instability are also present.

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.