What Is EMDR Therapy and How Does It Work?
EMDR (Eye Movement Desensitisation and Reprocessing) is a structured psychotherapy for trauma. During processing, you briefly focus on a distressing memory while following a form of bilateral stimulation, usually side-to-side eye movements guided by the therapist. Over several sessions, the memory typically becomes less vivid and less emotionally charged, and the beliefs attached to it ("I'm powerless", "It was my fault") shift. EMDR is recommended for PTSD in the Australian PTSD Guidelines and by the World Health Organization.
Where EMDR came from
EMDR was developed by American psychologist Francine Shapiro in the late 1980s. It has since been studied in numerous randomised controlled trials, most of them for PTSD. Its evidence base for PTSD is comparable to that of trauma-focused CBT.
How is EMDR thought to work?
The honest answer is that the exact mechanism is still debated. The main explanations are:
Adaptive information processing. Shapiro's model proposes that traumatic memories are stored in an unprocessed form, with the original emotions, sensations and beliefs still attached. EMDR is thought to help the brain process these memories and link them with more adaptive information.
Working memory. Holding a memory in mind while doing a demanding task like tracking eye movements appears to tax working memory, making the memory less vivid and less emotional when it's recalled later.
What's well established is that it works for many people with PTSD, whatever the mechanism.
The eight phases of EMDR
EMDR follows a standard eight-phase protocol. Bilateral stimulation only features in some of them.
History taking and treatment planning. The therapist learns about your history, current difficulties and goals, and identifies target memories.
Preparation. You learn what to expect and develop skills to manage distress, such as a "calm place" exercise. Trust and stability are built here.
Assessment. For a target memory, you identify the image, the negative belief about yourself, the preferred positive belief, the emotions and where you feel them in your body. You rate how distressing the memory is and how true the positive belief feels.
Desensitisation. You hold the memory in mind while following sets of bilateral stimulation. After each set, you briefly report what you notice. This continues until distress drops.
Installation. The positive belief is strengthened and linked with the memory.
Body scan. You check for any remaining tension or disturbance in the body and process it.
Closure. Each session ends with you returning to a settled state, whether or not processing is complete.
Re-evaluation. At the start of the next session, the therapist checks progress and decides what to work on next.
Who EMDR suits
EMDR is best established for:
PTSD after single-incident trauma, such as an accident, assault or traumatic birth
PTSD after multiple traumatic events
It's also used, with a smaller evidence base, for:
complex trauma, usually after a longer stabilisation phase
anxiety, phobias and panic linked to specific distressing experiences
distressing memories that don't meet full PTSD criteria
Some people like that EMDR doesn't require detailed verbal retelling of the trauma. Others prefer a talking-based approach. Both are valid.
EMDR may need to be adapted or delayed for people who dissociate heavily, are in a current crisis, have unstable living circumstances, or have certain medical conditions. A trained clinician assesses this in the early phases.
What an EMDR session feels like
People often find processing sessions tiring but not as overwhelming as they feared. Memories and sensations can shift quickly, sometimes bringing up associated memories. It's normal to feel emotional or tired afterwards and to have more vivid dreams between sessions. The therapist keeps you grounded and ends each session with closure techniques.
How many sessions?
For single-incident trauma, some people see substantial change within a handful of processing sessions after preparation. Complex trauma usually takes considerably longer, with more time spent on preparation and stabilisation.
Training matters
EMDR should only be delivered by a registered health professional who has completed accredited EMDR training. In Australia, EMDR Association of Australia (EMDRAA) accreditation indicates a practitioner has completed training and supervised practice. It's reasonable to ask any therapist about their EMDR training before you begin.
EMDR and other trauma therapies
EMDR is one of several effective options. Trauma-focused CBT approaches, such as cognitive processing therapy and prolonged exposure, have equally strong evidence. Somatic, DBT-informed and attachment-based work can build the stability that makes trauma processing possible. The right choice depends on your history and preferences.
Our team at Satya Psychology works with trauma using CBT, ACT, DBT skills, somatic and attachment-based approaches. If you're specifically looking for EMDR, mention it when you get in touch so we can talk through whether our approach suits you or help you find an EMDR-trained practitioner.
Next steps
For an overview of trauma, PTSD and complex PTSD, and all the treatment options, read our trauma therapy guide. When you're ready, book a session.
This article is general information and isn't a substitute for professional advice. If you're in crisis, call 000 or Lifeline on 13 11 14.