How Does EMDR Therapy Work?
When trauma memories won't let you move forward, you need more than time to heal; you need the right approach. Eye Movement Desensitization and Reprocessing (EMDR) offers hope for those who feel stuck in the past. It provides a path to process difficult experiences without reliving every painful detail.
This evidence-based therapy is a widely recognized and utilized approach that has been effective for many individuals in overcoming trauma. Whether you're considering this approach for yourself or a loved one, understanding how it works can guide you toward the healing you deserve.
Table of Contents
How Does the Eight-Phase Process Work?
How Your Brain Heals From Trauma
How Long Does It Take for EMDR Therapy to Work?
What Are the Benefits of This Approach?
Who Can Benefit From EMDR?
What Should You Expect During Treatment?
How Do You Find the Right Therapist?
When Is Someone Ready for This Treatment?
Frequently Asked Questions
Ready to Begin Your Healing Journey With Expert Trauma Care?
What Is EMDR Therapy and How Does It Work?
Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy designed to help people heal from trauma. It was developed in 1989 by Dr. Francine Shapiro, who noticed during a walk that moving her eyes back and forth seemed to reduce the intensity of upsetting thoughts (1).
Unlike traditional talk therapy, EMDR treatment doesn't require you to go into painful detail about past trauma. Instead, it uses gentle techniques like guided eye movements, tapping, or sounds to activate both sides of the brain. This process helps your brain "unstick" troubling memories and reprocess them in a healthier way.
The science behind it is based on the Adaptive Information Processing model. Simply put, when something highly stressful or traumatic happens, your brain may not store the memory properly. Instead of being filed away like a normal memory, it can get "stuck" in the part of the brain that controls emotions. EMDR helps refile these memories, so they feel less overwhelming and lose their grip on your present life.
The Science Behind the Healing
Major health organizations around the world recognize EMDR as an effective treatment. The World Health Organization included EMDR in its 2013 guidelines for stress-related conditions, recommending it alongside trauma-focused cognitive behavioral therapy (CBT) for PTSD (post-traumatic stress disorder) (2). The U.S. Department of Veterans Affairs also lists EMDR as having "strong" evidence for treating PTSD (3).
Research supports these recommendations. More than 30 high-quality studies show that EMDR is effective across different populations, making it one of the most well-studied trauma treatments available today (4). The American Psychological Association (APA) also recognizes EMDR as a recommended option for treating PTSD in adults (5).
How Does the Eight-Phase Process Work?
This structured approach ensures your safety while maximizing healing potential through carefully designed phases that build upon each other.
Foundation Building (Phases 1-2)
History and Planning: Your therapist gathers background information and develops your personalized treatment plan for healing. You won't need to share graphic details—simply identifying "something that happened" provides enough information to begin.
Preparation and Trust: Building a strong therapeutic relationship forms the foundation for successful healing. Your therapist explains what to expect and teaches you tools for managing any emotions that arise. Most people need 1-4 sessions for this phase, though those with complex histories may need more time.
Active Healing (Phases 3-6)
Assessment: Together, you'll identify specific memory components, including mental images, negative beliefs, preferred positive cognition, and any physical sensations connected to the experience.
Processing: This is where transformation happens. You'll follow bilateral stimulation while focusing on the targeted memory until emotional distress significantly decreases. For single trauma, reprocessing generally takes three sessions.
Strengthening: Positive, adaptive beliefs become deeply integrated, replacing old negative patterns with healthier, genuinely true perspectives.
Body Integration: Physical tension or discomfort related to the memory receives attention through a body scan, ensuring healing occurs throughout your entire system.
Completion and Integration (Phases 7-8)
Closure: Every EMDR session ends with techniques to ensure you feel stable and grounded, regardless of whether processing is complete.
Ongoing Assessment: Future sessions begin by checking previous work and identifying any new material needing attention.
This systematic approach allows you and your therapist to track progress while maintaining safety throughout your healing journey.
How Your Brain Heals From Trauma
Understanding trauma's impact on your brain helps explain why this approach proves effective for lasting healing.
When Trauma Gets "Stuck"
During overwhelming experiences, your brain's normal processing system can become disrupted. Instead of filing memories away properly, traumatic experiences often become fragmented and stored in emotional centers like the amygdala. These fragments retain their original intensity, explaining why certain triggers can make past events feel like they're happening right now.
How Bilateral Stimulation Unlocks Healing
Bilateral stimulation works through several mechanisms:
Working Memory Relief: The dual attention required, focusing on memories while following movements, reduces the memory's emotional intensity by giving your working memory more than it can handle.
Present Moment Awareness: The stimulation helps your brain distinguish between past memories and present reality, reducing the memory's emotional grip.
Natural Processing Activation: The eye movements appear to activate the same neural pathways used during REM sleep, when your brain naturally processes daily experiences.
Brain imaging studies show successful treatment produces measurable changes: fear centers become less reactive while rational thinking areas become more active (6).
How Long Does It Take for EMDR Therapy to Work?
Every healing journey is unique, but research provides helpful guidelines for setting realistic expectations about your recovery process.
What Influences Your Timeline?
Trauma Type: Single incidents (like accidents) typically heal faster than repeated trauma or childhood experiences. Individuals can no longer meet PTSD diagnostic criteria in as few as five treatment sessions following single-incident trauma (7).
Your Current Stability: Strong support systems and healthy coping skills often lead to faster healing progress.
Treatment Goals: Processing one specific memory requires less time than addressing multiple experiences or broader life patterns.
Realistic Timeframes
Single Trauma: 3-6 sessions for significant improvement
Multiple Experiences: 8-12 sessions commonly needed
Complex Childhood Trauma: Several months to a year or more
Preparation Phase: 1-4 sessions for most people
Many people notice positive changes after their first processing session, though complete integration usually develops over multiple appointments. Remember that healing often continues between sessions as your brain naturally processes the work accomplished during therapy.
How Long Does EMDR Therapy Take to Work Compared to Other Approaches?
A comprehensive meta-analysis found EMDR to be as effective as trauma-focused cognitive behavioral therapies, often requiring fewer sessions while achieving comparable outcomes (8). For veterans with combat-related PTSD, approximately 77% no longer meet PTSD criteria after 12 sessions, as documented in controlled trials (9).
What Are the Benefits of This Approach?
The positive changes from this approach extend far beyond symptom relief, often transforming how you experience life itself.
Freedom from Trauma Symptoms
PTSD Relief: Studies show significant reductions in PTSD symptoms, with effect sizes indicating large therapeutic benefits (10).
Emotional Regulation: Rather than being overwhelmed by triggers, you develop the ability to experience emotions as manageable and temporary.
Physical Healing: Many people experience relief from trauma-related physical symptoms like chronic tension, headaches, and sleep disturbances.
Personal Transformation
Self-Worth Recovery: As negative self-beliefs heal, many people experience profound improvements in self-esteem and confidence.
Relationship Improvements: Relationships often become more satisfying and authentic with reduced symptoms and better emotional regulation.
Life Engagement: People frequently report feeling more present and able to fully participate in work, family, and activities they enjoy.
Treatment Advantages
This approach often works faster than traditional therapy, typically requiring fewer sessions while producing lasting results. Because it doesn't require detailed trauma discussion, many people find it less re-traumatizing than other approaches.
Who Can Benefit From EMDR?
This versatile approach helps diverse populations heal from various trauma-related conditions and life challenges.
Primary Applications
PTSD and Trauma: Whether from combat, accidents, assault, or other overwhelming experiences, EMDR has the strongest recommendation across most clinical practice guidelines for trauma recovery.
Childhood Trauma: Those with difficult childhood experiences, including abuse or neglect, often experience significant healing through this gentle approach.
Recent Trauma: Early intervention can prevent chronic symptoms from developing and promote natural resilience.
Additional Conditions
Anxiety and Depression: When these conditions stem from difficult life experiences, this approach often provides relief by addressing underlying trauma. EMDR had significant effects on reducing depression symptoms (11).
Grief and Loss: Complex grief responses and traumatic loss can heal through targeted memory processing.
Phobias: Specific fears, especially those rooted in frightening experiences, often respond well to this approach.
Special Populations
Veterans and First Responders: These populations face unique trauma exposures and show particularly strong responses to evidence-based trauma treatment.
Healthcare Workers: Medical professionals experiencing secondary trauma benefit from processing difficult patient care experiences.
Children and Adolescents: It is effective in treating traumatized youth, with adapted protocols ensuring age-appropriate healing (12).
What Should You Expect During Treatment?
Understanding what happens during sessions can help reduce anxiety and prepare you for this unique healing experience.
Your First Session
Your initial appointment focuses on understanding your background and goals rather than trauma processing. This meeting provides space to ask questions and understand what healing involves. A qualified therapist will assess your current stability, trauma history, and treatment goals to develop your personalized plan.
During Processing Sessions
Each session typically lasts 60-90 minutes, providing adequate time for processing while maintaining safety protocols. During active processing, you'll focus on selected aspects of the target memory while following bilateral stimulation. Many clients describe this as surprisingly manageable, often less distressing than anticipated.
Between Sessions
Processing often continues between sessions as your brain naturally integrates the work accomplished during therapy. Some people experience vivid dreams, emotional shifts, or new insights as healing progresses.
How Do You Find the Right Therapist?
Finding a qualified therapist is crucial for successful treatment outcomes.
Training Requirements
Ensure your therapist has completed approved training from organizations like EMDRIA (EMDR International Association) (13). Proper training ensures both safety and effectiveness.
Experience Matters
Look for therapists with specific experience treating your type of concerns and working with your population.
What to Look For
Specialized Knowledge: Therapists who understand trauma's complex impacts and have experience with various trauma presentations.
Comprehensive Approach: Practitioners who view healing holistically and can integrate multiple therapeutic approaches when beneficial.
Safety First: Professionals who prioritize your emotional safety and work at your pace throughout the healing process.
When Is Someone Ready for This Treatment?
Several factors help determine whether this approach aligns with your needs and readiness for healing.
Emotional Readiness: While you don't need to be symptom-free, basic emotional regulation skills or willingness to develop them support successful outcomes.
Support Systems: Having adequate support outside therapy enhances your healing process and provides stability during recovery.
Commitment to Healing: Treatment requires a willingness to experience temporary emotional discomfort during memory processing.
Current crises or severe instability typically require stabilization before beginning intensive trauma processing. Your therapist will help determine the right timing for beginning this work.
Frequently Asked Questions
Will I have to talk about what happened in detail?
No, EMDR minimizes the need for detailed verbal recounting of traumatic events, but some emotional processing is inherent to the therapy. You'll identify target memories and associated feelings, but detailed narration isn't required for healing to occur.
What if I become overwhelmed during a session?
You maintain complete control throughout every session. You can pause, take breaks, or stop the process anytime you need to. Your therapist will teach you grounding techniques and ensure you feel stable before leaving each session. The bilateral stimulation actually helps prevent overwhelming feelings during processing.
How will I know if it's working?
Most people notice some positive changes after their first processing session. You might experience reduced emotional reactivity to triggers, better sleep, decreased anxiety, or simply feeling more hopeful about recovery. Your therapist will regularly check in about your progress and use standardized measures to track improvement.
Are there any side effects?
The most common side effects include temporary emotional intensity, vivid dreams, or fatigue as your brain continues processing between sessions. These typically indicate that healing is occurring and usually decrease as treatment progresses. Serious side effects are rare when properly trained therapists conduct treatment.
Will I forget what happened to me?
No, you won't forget your experiences. Instead, memories remain intact but are processed to reduce their emotional charge, allowing healthier integration. You'll remember what happened, but the intense emotional pain associated with the memory usually diminishes significantly.
Ready to Begin Your Healing Journey With Expert Trauma Care?
At Resolve Counseling Group in Murfreesboro, Tennessee, our experienced trauma specialists understand the courage it takes to seek healing. Led by Missy Loftis, LMFT, who has dedicated over a decade to helping individuals break free from trauma's impact, we offer comprehensive evidence-based approaches, including specialized training in trauma treatment.
Our compassionate team recognizes that healing happens in many ways. Beyond traditional therapy, we offer innovative approaches like trauma-sensitive yoga and group therapy options that complement your recovery journey. We believe in your innate ability to heal and are honored to guide you toward the freedom and peace you deserve.
Take the first step toward reclaiming your life from trauma's grip. Call us now at 615.900.4008 to schedule your complimentary 15-minute consultation.
References
Shapiro, F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 20(3), 211-217. https://doi.org/10.1016/0005-7916(89)90025-6
World Health Organization. (2013). Guidelines for the management of conditions specifically related to stress. https://www.who.int/publications/i/item/9789241505406
U.S. Department of Veterans Affairs & Department of Defense. (2017). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. https://www.healthquality.va.gov/guidelines/MH/ptsd/
Chen, L., Zhang, G., Hu, M., & Liang, X. (2015). Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: Systematic review and meta-analysis. Journal of Nervous and Mental Disease, 203(6), 443-451. https://doi.org/10.1097/NMD.0000000000000306
American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. https://www.apa.org/ptsd-guideline/ptsd.pdf
Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Monaco, L., Lauretti, G., Russo, R., Niolu, C., Siracusano, A., Vermigli, P., & Ammaniti, M. (2012). Neurobiological correlates of EMDR monitoring–an EEG study. PLoS ONE, 7(9), e45753. https://doi.org/10.1371/journal.pone.0045753
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227. https://doi.org/10.1176/appi.ajp.162.2.214
Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews, (12). https://doi.org/10.1002/14651858.CD003388.pub4
Boudewyns, P. A., & Hyer, L. A. (1996). Eye movement desensitization and reprocessing (EMDR) as treatment for post‐traumatic stress disorder (PTSD). Clinical Psychology & Psychotherapy, 3(3), 185-195. https://doi.org/10.1002/(SICI)1099-0879(199609)3:3<185::AID-CPP103>3.0.CO;2-4
van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder. Journal of Clinical Psychiatry, 68(1), 37-46. https://doi.org/10.4088/jcp.v68n0105
Dombo, E. A., & Gray, C. (2013). Engaging spirituality in addressing vicarious trauma in clinical social workers: A self-care model. Social Work and Christianity, 40(1), 89-104. https://doi.org/10.1093/hsw/hls055
Adler-Tapia, R., & Settle, C. (2017). Evidence for the efficacy of EMDR with children and adolescents. In EMDR therapy and adjunct approaches with children (pp. 23-58). Springer. https://doi.org/10.1007/978-3-319-48526-2_2
EMDR International Association. (2020). EMDR training standards. https://www.emdria.org/about-emdr-therapy/emdr-training/
