What is EMDR?

EMDR stands for Eye Movement Desensitisation and Reprocessing. It is an evidence-based psychological therapy, best known for treating PTSD and the effects of traumatic or distressing experiences.

EMDR helps the brain process memories and experiences that continue to feel distressing or influence how you think, feel and respond in the present.

Although originally developed for trauma and PTSD, EMDR is now used to work with a broader range of psychological difficulties where past experiences may be contributing to current distress.

Most experiences, even difficult ones, gradually become part of our wider memory. We can remember what happened, and may still feel sad, angry or upset about it, but we know that it happened in the past.

Sometimes, particularly when an experience has been overwhelming, frightening or traumatic, it doesn't seem to settle in the same way. Memories can remain vivid, emotionally charged or easily triggered, and reminders of what happened can bring back some of the thoughts, feelings and physical sensations you experienced at the time. It can sometimes feel less like remembering something from the past and more like your mind and body are responding as though the threat is happening again.

These experiences can continue to influence how you feel and respond in the present. You might avoid particular situations, feel constantly on alert, experience flashbacks or intrusive memories, or develop beliefs about yourself, other people or the world based on what happened.

EMDR is based on the idea that helping these experiences to become more fully processed and integrated can reduce their emotional intensity. The aim isn't to erase the memory or make you forget what happened, but to help it feel more like something that happened then, rather than something you are still experiencing now.

EMDR aims to help distressing memories become more fully processed and integrated, so that they feel less vivid, emotionally intense or present in your everyday life. The aim isn't to remove the memory — you'll still know what happened — but to reduce the distress attached to it and help your mind recognise that the experience is in the past.

During EMDR, you'll briefly bring aspects of the experience to mind while also engaging in bilateral stimulation, usually through guided eye movements or alternating taps. You'll be encouraged to notice whatever thoughts, feelings, images, memories or physical sensations arise, without needing to deliberately analyse or change them.

Exactly how EMDR produces its effects is still being researched. One explanation is that holding a distressing memory in mind while your attention is also engaged places demands on working memory. This may reduce the vividness and emotional intensity of the memory, allowing it to be processed differently and making space for new associations, perspectives and more helpful beliefs to emerge.

Over time, the memory can begin to feel more like something that happened then, rather than something your mind and body need to continue responding to now.

EMDR is an 8-phase model that goes through the following steps:  

1. History taking: 

We explore the difficulties you would like to work on, relevant experiences from your history, what is happening in your life currently and any factors that may affect how we approach the work. We may also develop a timeline to help us understand how different experiences connect.

2. Preparation: 

We spend time making sure you understand the EMDR process, building our therapeutic relationship and developing any grounding, self-regulation or other resources that may help you manage difficult emotions during the work.

3. Assessment: 

This is where we select the specific target memory we want to work on. We will look at aspects of this target such as the picture, negative cognitions associated with it, what you would rather believe about the event, the emotions and bodily sensations associated with it, and we will use ratings to assess how distressing these are. 

4. Desensitisation: 

Here we will introduce bilateral stimulation to help process the event. You will be asked to notice whatever comes up, without deliberately discarding any information. 

5. Installation: 

When a target memories distress is reduced, we then introduce your preferred positive belief to that memory. 

6. Body scan: 

Sometimes even after a memory begins to feel better, our bodies can sometimes hang on to distress and tension. So, during this stage, we focus explicitly on what the body is experiencing. 

7. Closure: 

The processing part of the session will then be safely ended. 

Re-evaluation: 

At this stage we'll review the target we've been working on, notice what has changed and consider whether anything further needs attention.

During all of these stages you will retain full control of your session and can pause or slow the process as needed. 

Good EMDR is much more than the processing phase itself. Assessment, formulation, preparation, pacing and the therapeutic relationship are all important parts of the work.

EMDR feels different for everyone. For some people it can feel quite emotional, particularly when working with a painful or distressing memory. You might notice sadness, anxiety, anger or other emotions, or become aware of physical sensations such as tension, heaviness or a feeling in your stomach or chest.

At other times, the experience can be surprisingly subtle. You might notice that a memory starts to feel further away, that something which previously felt very upsetting has less emotional charge, or that you begin to think about what happened differently. Sometimes people notice new memories, thoughts or connections emerging that they hadn't expected.

You might feel tired afterwards or find yourself continuing to reflect on the work between sessions. Equally, you might simply carry on with your day and notice changes more gradually.

There is no "right" way to experience EMDR. You don't need to become extremely distressed, remember something new or have a dramatic breakthrough for the therapy to be meaningful. Whatever comes up, we'll work with it together and at a pace that feels manageable for you.

EMDR is best established as a treatment for PTSD and trauma-related difficulties. It may also be used where distressing past experiences contribute to other current difficulties, including:

• Trauma and PTSD
• Distressing or intrusive memories
• Phobias and fears
• Anxiety linked to previous experiences
• Traumatic bereavement
• Experiences of abuse or bullying
• Occupational trauma
• Difficulties linked to multiple or cumulative experiences

EMDR isn't automatically appropriate simply because one of these difficulties is present. Assessment helps us understand what is maintaining your difficulties and whether EMDR is a suitable approach.

EMDR can be very effective, but no psychological therapy is right for everybody. Whether it is appropriate will depend on what you're experiencing, your history, current circumstances, stability, safety and what you hope to achieve from therapy.

Sometimes additional preparation or stabilisation is helpful before beginning trauma processing; in other circumstances I may recommend a different therapeutic approach.

You don't need to decide for yourself whether EMDR is right for you. That's part of the assessment process, and something we'll consider together.

There isn't a set number of EMDR sessions, and how long therapy takes will vary considerably from person to person.

If you are working on a single traumatic event and were otherwise functioning well before it happened, the work may be relatively focused. Where there have been multiple difficult experiences, longstanding difficulties or earlier trauma, there may be more to understand and work through, and therapy is likely to take longer.

The amount of preparation needed can also vary. Some people feel ready to begin processing relatively quickly, while others benefit from spending more time developing resources, strengthening their ability to manage difficult emotions and making sure they feel sufficiently safe and prepared before beginning trauma processing. This preparation is an important part of EMDR therapy rather than something that happens before the "real" therapy starts.

During your assessment, we'll begin to develop an understanding of what you might need, and I can give you an initial idea of the likely scope of the work. We'll continue to review this together as therapy progresses.

If you would prefer to work in longer, more concentrated blocks rather than traditional weekly sessions, you may also want to explore my EMDR Intensives.

EMDR is an evidence-based treatment for PTSD and is recommended within national and international clinical guidelines.

NICE (the National Institute for Health and Care Excellence), which produces evidence-based guidance for health and care in England, recommends EMDR as a treatment for PTSD in adults. EMDR is also recommended in international guidance, including by the World Health Organization.

Research into EMDR continues, including its use with difficulties beyond PTSD and different ways of delivering treatment.

EMDR Association Research

Chartered Clinical Psychologist • HCPC Registered • EMDR Therapist • 20+ years’ experience in psychological services 

I bring extensive experience in trauma-focused psychological therapy alongside a warm, collaborative and individualised approach to EMDR. 

If the idea of having longer, protected periods of therapeutic time appeals to you, you can find out more about my one-day EMDR Intensive programme, including what happens before, during and after your intensive.