EMDR Therapy: How it Works, Benefits, Uses, and Side Effects (2022)

Developed by trauma therapists, EMDR helps your brain process and release traumatic memories in an unusual way — through your eye movements.

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If you’ve experienced trauma, you’ll know just how much hold it can have over you. Intense dreams, flashbacks, and anxiety-induced isolation can bring your daily life to a halt. Sometimes, it can be a challenge to leave your home at all.

While traditional talk therapy and medications are the main treatments for post-traumatic stress, you might be wondering what other options are out there.

Eye Movement Desensitization and Reprocessing (EMDR) therapy was developed by Dr. Francine Shapiro in 1987 to treat post-traumatic stress disorder (PTSD). This therapy uses eye movements (or sometimes rhythmic tapping) to change the way a memory is stored in the brain, allowing you to process it.

This therapy aims to help you work through painful memories with your body’s natural functions to recover from the effects of trauma.

EMDR therapy is considered a new, nontraditional form of psychotherapy. Therapists mostly use it to treat PTSD or trauma responses.

This therapy is based on the theory that traumatic events aren’t properly processed in the brain when they happen. This is why they continue to affect us — with nightmares, flashbacks, and feelings of the trauma happening again — long after the actual trauma is over.

When something reminds you of the trauma, your brain and body react as though it’s happening again. The brain isn’t able to tell the difference between the past and the present.

This is where EMDR comes in. The idea, known as the adaptive information processing model, is that you can “reprocess” a disturbing memory to help you move past it.

This therapy aims to change the way that the traumatic memories are stored in your brain. Once your brain properly processes the memory, you should be able to remember the traumatic events without experiencing the intense, emotional reactions that characterize post-traumatic stress.

During an EMDR therapy session, your therapist will ask you to briefly focus on a trauma memory. Then, they’ll instruct you to perform side-to-side eye movements while thinking of the memory. This engages both sides of your brain and is termed bilateral stimulation.

(Video) Eye Movement Desensitization and Reprocessing (EMDR) for PTSD

If you have visual processing issues, your therapist may use rhythmic tapping on both of your hands or play audio tones directed towards both ears.

One theory behind how EMDR works is that it helps the two sides of the brain to communicate with one another — the left side, which specializes in logic and reason, and the right side, which specializes in emotion.

Experts don’t know exactly how EMDR works. Ongoing investigations point out that it’s a complex form of therapy and likely has many mechanisms of action.

A review of 87 studies on EMDR found that two theories held the most promise: the working memory theory and the physiological changes theory.

Working memory theory

According to this theory, EMDR works through competition between where the brain stores information on sight and sound and where it processes working memory.

In this theory, recalling a memory at the same time your eyes are moving back and forth forces your brain to split its resources. You can’t dedicate all of your focus to memory recall because you’re also focusing on visual stimulation.

This split-focus can make any disturbing images you recall less vivid, and you may feel comfortably distanced from them. In this way, you might feel the emotional impact of the memories less strongly.

The bilateral brain stimulation might also help you feel more relaxed. As the memories grow less and less vivid, your brain might start to associate the memory recall with relaxation rather than emotional shock, which results in desensitization.

Physiological changes theory

Some researchers have found that performing eye movements in EMDR can invoke physiological changes in your body — a lowered heart rate, slower breathing, and decreased skin conductance — all of which are markers of relaxation.

This suggests that something about bilateral eye movements can alter how your nervous system is responding, allowing you to move away from an anxious fight, flight, or freeze response and toward nervous system regulation.

Other theories

Other theories about the way EMDR therapy works include:

  • Rapid eye movement (REM) sleep phase replication. Back-and-forth eye movements may help the brain consolidate memories in the same way it does during REM sleep.
  • Thalmo-cortical binding. Eye movements may directly impact a brain region called the thalamus, which may cause a cascade of cognitive processes that allow greater control over emotional distress.
  • Structural brain differences. Structural and functional brain differences may exist in people who respond well to EMDR therapy.

Much of the research involving EMDR therapy is on its use in working with trauma and treating PTSD.

(Video) Why EMDR Doesn't Always Work | Kati Morton

A mental health professional may also recommend this therapy for:

  • anxiety
  • panic attacks
  • depression
  • phobias
  • bipolar disorder
  • dissociative disorder
  • recovering from grief
  • eating disorders
  • pain management
  • personality disorders
  • stress
  • performance anxiety
  • sleep disturbances
  • substance use disorder or addiction

With EMDR, you’ll usually have one or two sessions per week, about 6 to 12 sessions in total. You may require more or fewer sessions depending on your individual response to therapy.

There are eight phases to EMDR therapy. Here’s what to expect:

Phase 1: History taking

First, you’ll work with your therapist to develop a treatment plan and treatment goals. This might include talking about your history, what emotional triggers and symptoms you experience, and what you’d like to achieve from therapy.

Your therapist might also determine whether you’d benefit from therapies or treatments alongside EMDR.

Phase 2: Preparation

Your therapist will then walk you through the therapeutic process, explain how EMDR works, and answer any questions.

EMDR therapy often takes multiple sessions to see progress. Your therapist can help you develop coping methods to help you manage your emotions both during and between sessions. This can include stress reduction techniques, such as breathing exercises and resourcing techniques.

Phase 3: Assessing the target memory

The goal of phase 3 is to identify and evaluate the memory causing your emotional distress.

Imagery, cognition, affect, and body sensation related to the memory are all assessed on diagnostic scales. Your therapist will use this as a starting point to track your progression through the EMDR treatments.

Phase 4–7: Treatment (desensitization, reaction, installation, closure)

Phase 4 marks the beginning of the memory desensitization process.

During your session, you’ll be asked to recall parts of a distressing memory. As you do this, your therapist will cue you to perform specific eye movements.

Once you’ve finished recalling the memory or feeling, you may be asked about the thoughts, feelings, and reactions you experienced during the recall.

(Video) What are the side effects of EMDR?

Noting these responses is another means of helping track the progress of your EMDR therapy. The goal is to “install” improved emotional responses and positive beliefs within each session.

Remember, your mental health team has your best interests in mind at all times during your therapy session. If you experience distress, your therapist can help you work through those feelings and come back to the present.

At the end of your session, your therapist will determine whether the memory was fully reprocessed based on your responses. If the reprocessing is incomplete, they’ll do a resource or stress-reduction exercise with you in order to ensure that you feel OK before ending the session.

They’ll also review which coping strategies you can use to manage your emotions and keep yourself safe until the next session. Not all memories can be processed in one session.

Phase 8: Re-evaluation

At the end of each therapy session, both you and your therapist will evaluate the effects of the treatments, what memories have been uncovered, and which memories to target next time.

At the end of your therapy program, after you’ve targeted all the memories you’ve wished to, your therapist will complete a Future Template. In this exercise, they’ll use the bilateral stimulation again as you walk through an imagined future scenario of handling any previously triggering situations.

While the exact mechanisms behind EMDR remain up for debate, this therapy is recognized as an effective treatment by a number of national and international organizations, including the World Health Organization (WHO) and the American Psychiatric Association (APA).

A 2018 review provides supportive evidence for the mechanisms behind EMDR, and other research continues to support this therapy’s effectiveness.

In 2019, a narrative review looked into the results of seven randomized controlled trials that involved early EMDR interventions. The researchers concluded that EMDR early interventions significantly reduced symptoms of traumatic stress and prevented symptoms from becoming worse.

Other review studies have also found positive results from EMDR therapy:

  • A 2018 review, conducted using eight databases of current studies, found that EMDR improved PTSD symptoms and was more effective compared to some traditional trauma therapies. However, they noted that much of the current evidence relies on small sample sizes.
  • A 2018 review focused on 15 studies involving the use of EMDR therapy for children with PTSD. Researchers found that all studies in the review showed reduced PTSD symptoms, as well as other trauma-related symptoms, in children.
  • A 2017 review looked at how EMDR therapy could impact conditions outside of PTSD. The results showed that EMDR therapy was a promising option for trauma-related symptoms in psychotic, affective, and chronic pain conditions.
  • A 2017 review suggested that, though the research is currently limited, EMDR could have potential as a treatment for depression.

Are there dangers or side effects?

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Most forms of therapy can have side effects. These secondary reactions can range from mild to severe, even with EMDR therapy.

Before you start an EMDR program, a mental health professional may warn you about potential side effects, such as:

  • strong emotional fluctuations
  • increased recall of traumatic or distressing memories
  • vivid, intense dreams
  • feelings of vulnerability
  • lightheadedness
  • physical stress responses (nausea, headache)

Part of your EMDR therapy plan will may include developing ways to manage these challenges if they arise.

Your healthcare team can recommend focus and relaxation methods or prescribe medications to help manage symptoms during treatment.

Past memories can do far more than just create feelings of sadness. If you’ve experienced trauma, these memories can impair your daily functioning.

Sometimes memories are so painful that they “freeze” you in that moment. You’re unable to get out, and it may feel easier to avoid those thoughts completely.

When this happens, people, places, and events, continue to bring out the emotions of trauma long after it’s passed.

EMDR therapy can help you break the freeze cycle by allowing your brain to process memories in a less painful way.

EMDR can be an emotional process, but you’re never alone. If you’re considering self-harm or suicide, help is available right now:

To learn more about EMDR or to access online support networks, publications, therapist finders, and other resources, visit The EMDR International Association (EMDRIA).

FAQs

What is EMDR and how does it work? ›

Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique. This method involves moving your eyes a specific way while you process traumatic memories. EMDR's goal is to help you heal from trauma or other distressing life experiences.

What are the benefits of EMDR? ›

Here are five of the most helpful benefits of EMDR therapy:
  • Effective for Trauma Recovery. Moving on after a traumatic event is one of the most difficult tasks imaginable, but EMDR therapy can make it possible. ...
  • Addresses Anxiety and Circular Thinking. ...
  • Improves Perspective on Self. ...
  • Doesn't Require Much Talking. ...
  • Fast Results.
23 Feb 2022

What happens when you have EMDR? ›

During these counseling sessions, the client and therapist together work through specific memories, negative beliefs, and emotional focus while engaging in sets of bilateral stimulation such as eye movements or repeated gentle taps.

How does EMDR therapy make you feel? ›

Generally, it's common to feel lighter and less weighed down after going through EMDR. The problem that brought you to therapy often feels less significant, and old triggers won't have their usual effect. You'll likely find that you are no longer scared or anxious about things that once bothered you.

How quickly does EMDR work? ›

How Fast Does EMDR Therapy Work? Generally, people with adult trauma from one event can be successfully treated in less than five hours. People experiencing multiple traumas may need longer treatment times. Long-lasting effects can be seen in only 5 to 8 weeks.

How long does EMDR take to help? ›

Each individual reacts differently to EMDR therapy, but as a general rule, a typical session will last anywhere between 60-90 minutes. Getting to the bottom of a traumatic memory and completely rewiring your brain can take anywhere between three to twelve sessions.

What symptoms does EMDR treat? ›

Research suggests that EMDR may also treat symptoms that accompany a traumatic experience, such as self-harm, stress, and anger.
...
Benefits
  • addiction.
  • anxiety.
  • attention deficit hyperactivity disorder (ADHD)
  • chronic pain and phantom pain.
  • depression.
  • eating disorders.
  • panic attacks.
  • psychotic symptoms.
11 Jul 2019

Why is EMDR so powerful? ›

EMDR helps build connections between the physical body and the psychological mind, improving cognition. As traumatic events are broken down with a therapist during sessions, individuals can take a step back and see another viewing angle of the incident or incidents and reshape what occurred.

Who would benefit from EMDR therapy? ›

Research continues to shed new light on ways EMDR can be used to help clients who are struggling with trauma and other mental health issues. Two recent articles in EMDRIA's Go With That magazine discuss how EMDR can be used to address racialized trauma and addiction.

Who should not do EMDR? ›

Because stability must come first, you don't use EMDR to process trauma when a patient is actively abusively using alcohol, drugs, or something to help them feel less. You can't effectively practice EMDR phases 3 – 8 with someone who has yet to experience a safe, trusting relationship.

Can EMDR bring up false memories? ›

Since EMDR deals with the reprocessing of memories, some may question whether this therapy can create false memories in people. However, EMDR does not have the ability to create a memory that was not already there – it only works with memories that exist within the person.

Why am I so tired after EMDR? ›

Tiredness after an EMDR session is completely normal. This does not only happen after an EMDR session, but can also happen after a deep conversation with your therapist.

What happens to your brain after EMDR? ›

EMDR temporarily slows your over-stimulated amygdala down and synchronises your brain waves helping you process the traumatic memory. This suggests that during EMDR therapy the traumatic memories are continuously “reactivated, replayed and encoded into existing memory networks”.

How many sessions of EMDR is needed? ›

EMDR is an individual therapy typically delivered one to two times per week for a total of 6-12 sessions, although some people benefit from fewer sessions. Sessions can be conducted on consecutive days.

How do I prepare for an EMDR session? ›

So what can you, the client, do to begin to prepare for EMDR?
  1. Know your support system. ...
  2. Engage in some kind of stress reducing body movement each day. ...
  3. Try to get into the habit of taking ten minutes each day to practice breathing exercises or meditation. ...
  4. Try to start a gratitude journal.
4 Feb 2020

Do you talk during EMDR? ›

EMDR is a form of psychotherapy, a specialized, brain-based method for healing trauma. But unlike conventional therapy, you're not talking back-and-forth with the therapist for the entire session.

How do I practice EMDR on myself? ›

“Hug” Method: Bring up the palm of each hand and cross them over the chest onto the forearm of the opposing arm. Close your eyes and be aware of your breathing. Gently tap the left, then right hands. When your mind drifts, bring it back to the tapping.

Is EMDR good for anxiety? ›

EMDR therapy is an effective treatment option for people suffering from anxiety, panic, PTSD, or trauma. It's a way to get past your past. EMDR is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma.

Does EMDR release emotions? ›

Treatment with EMDR

EMDR therapy uses bilateral stimulation, right/left eye movement, or tactile stimulation, or sound, which repeatedly activates the opposite sides of the brain releasing emotional experiences that are "trapped" in the nervous system.

Is EMDR a form of hypnosis? ›

EMDR allows you to maintain a dual focus by addressing your beliefs in a more positive manner while dealing with problematic memories. The most fundamental difference is that EMDR does not induce the trance-like state attributed to hypnosis.

Does EMDR work one session? ›

EMDR therapy can work for some issues, such as a specific anxiety or phobia, in just one session. More often, it takes place over a series of sessions based upon an eight phase system which has been tried and tested.

Why is EMDR so controversial? ›

EMDR therapy is a trauma therapy that is sometimes considered controversial. The reasons someone might think it is a controversial therapy option are the potential adverse side effects and the lack of long-term research. EMDR is safe and effective, but there are some risks associated with the therapy.

Who is not a good candidate for EMDR? ›

If you're emotions feel overwhelming or if you tend to shut down when you feel an emotion you may not be ready for EMDR treatment. EMDR therapy relies on your body and mind's ability to process through your thoughts and feelings. If you're unable to process in that way, EMDR therapy may not be effective.

What are the 8 stages of EMDR? ›

EMDR is an eight-phase treatment method. History taking, client preparation, assessment, desensitization, installation, body scan, closure and reevaluation of treatment effect are the eight phases of this treatment which are briefly described.

Does EMDR therapy really work? ›

Yes. Numerous controlled studies show that EMDR produces more improvement than absence of treatment, at least for alleviating the symptoms of civilian PTSD, such as those triggered by rape.

Can EMDR produce false memories? ›

Since EMDR deals with the reprocessing of memories, some may question whether this therapy can create false memories in people. However, EMDR does not have the ability to create a memory that was not already there – it only works with memories that exist within the person.

Can EMDR affect sleep? ›

Several of the sleep sessions incorporate bilateral stimulation, a treatment element of EMDR which has been found to stimulate delta brain wave activity (associated with deep restful sleep) and reduce insomnia in PTSD sufferers.

What are the pros and cons of EMDR? ›

Pros and Cons of EMDR

Shorter period of treatment than traditional therapies. Lower cost of treatment due to shortened treatment timeline. Ability to process traumatic experiences that may be difficult to talk about. Potential to improve both PTSD and substance abuse treatment outcomes.

How do I know if Im doing EMDR right? ›

The results of EMDR vary from person to person, but you may notice that you have less psychological distress, a better capacity to regulate your emotions, better sleeping habits, and increased self-esteem.

What happens after your first EMDR session? ›

After the First Session

The traumatic memory will start to be desensitized and will at the very least be less emotionally distressing. However, EMDR opens up the memory networks in the brain and many clients may notice new memories, additional details, or dreams after the first session.

Do you talk during EMDR? ›

EMDR is a form of psychotherapy, a specialized, brain-based method for healing trauma. But unlike conventional therapy, you're not talking back-and-forth with the therapist for the entire session.

How do I practice EMDR on myself? ›

“Hug” Method: Bring up the palm of each hand and cross them over the chest onto the forearm of the opposing arm. Close your eyes and be aware of your breathing. Gently tap the left, then right hands. When your mind drifts, bring it back to the tapping.

How does EMDR work in the brain? ›

EMDR works by stimulating the brain in ways that lead it to process unprocessed or unhealed memories, leading to a natural restoration and adaptive resolution, decreased emotional charge (desensitization, or the “D” of EMDR), and linkage to positive memory networks (reprocessing, or the “R” of EMDR).

How do I prepare for my first EMDR session? ›

Healthy habits such as exercising regularly, learning meditation, and practicing breathing exercises are all ways to effectively prepare yourself for EMDR. These are good tips in general that can also positively affect other areas of your life, too!

Videos

1. EMDR Therapy for First Responders
(EMDR Masterclass)
2. 7 Reasons Why EMDR Works
(Hawaii Island Recovery)
3. The Intersection of EMDR Therapy and Polyvagal Theory
(TCSPP Counselor Ed. Department)
4. remotEMDR's Full Demo (English)
(remotEMDR)
5. Bilateral Stimulation Music | EMDR | 🎧 Listen with headphones | Begin.
(Jorge Henderson Collazo)
6. How to Heal Trauma with EMDR Therapy in just 20 mins
(Cosmic Being 369)

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