EMDR Therapy (Eye Movement Desensitisation and Reprocessing)

What is EMDR?

EMDR is a structured therapy developed by Francine Shapiro in the late 1980s. It was originally designed for trauma and PTSD, but is now used for a range of conditions including anxiety, phobias, grief and chronic pain.

EMDR works differently from traditional talking therapies. Rather than analysing your experiences in detail, it helps your brain reprocess traumatic memories so they no longer trigger the same intense emotional and physical reactions.

How it works

When something traumatic happens, your brain can struggle to process the experience in the way it normally would. The memory gets stored with all its original intensity: the fear, the helplessness, the physical sensations. EMDR helps unblock this natural processing.

During EMDR, your therapist will ask you to recall a disturbing memory while simultaneously following a form of bilateral stimulation, most commonly their finger moving back and forth in front of your eyes. Other forms include tapping on alternate knees or holding buzzers that vibrate in each hand.

This bilateral stimulation appears to help your brain process the memory more fully, reducing its emotional charge. After successful EMDR, you can still remember what happened, but the memory no longer feels overwhelming.

What sessions look like

EMDR typically follows eight phases:

1. History taking -- your therapist learns about your background and identifies target memories
2. Preparation -- learning coping techniques and understanding the process
3. Assessment -- identifying the specific memory, the negative belief attached to it and the desired positive belief
4. Desensitisation -- processing the memory with bilateral stimulation
5. Installation -- strengthening the positive belief
6. Body scan -- checking for any remaining physical tension
7. Closure -- returning to a calm state
8. Re-evaluation -- reviewing progress at the start of the next session

A typical course of EMDR is 6 to 12 sessions, though complex trauma may require more. Sessions last 60 to 90 minutes, longer than standard therapy sessions.

Who is it best suited to?

EMDR is recommended by NICE (the National Institute for Health and Care Excellence) and the World Health Organisation for PTSD. It can be particularly helpful if you:

• Have experienced a traumatic event (accident, assault, witnessing violence)
• Suffer from flashbacks, nightmares or intrusive memories
• Have PTSD or complex PTSD
• Experience phobias or anxiety linked to specific events
• Have tried talking therapy but find it difficult to discuss the trauma in detail

One of EMDR's strengths is that you do not need to talk about the traumatic experience in great detail. This makes it more accessible for people who find verbal processing of trauma overwhelming.

How it differs from other approaches

Unlike CBT, which works on changing your thoughts about an experience, EMDR works on how the memory is stored in your brain. You are not asked to challenge your beliefs or complete homework. The processing happens during sessions through the bilateral stimulation.

Unlike psychodynamic therapy, EMDR does not explore the broader patterns of your life. It is focused and targeted: identify the memory, process it, move on to the next one.

The evidence

EMDR has one of the strongest evidence bases of any trauma therapy. Over 30 randomised controlled trials support its effectiveness for PTSD. NICE recommends it alongside trauma-focused CBT as a first-line treatment. Research by Maxfield and Hyer (2002) and others shows that EMDR can produce significant improvement in fewer sessions than many other approaches.