EMDR stands for Eye Movement Desensitization and Reprocessing. It's a trauma therapy that helps your brain finish processing experiences that got stuck, and it's one of the most studied trauma therapies there is.
It also looks a little strange from the outside (you're following a therapist's hand with your eyes, after all).
How EMDR Started
EMDR began in the late 1980s with a psychologist named Dr. Francine Shapiro. She noticed that moving her eyes back and forth while thinking about something upsetting made her feel less upset. After a lot of research, she developed it into a formal treatment.
It started out using only eye movements, which is how it got its name. Over time, therapists found that other kinds of side-to-side input could have the same effect. Today it's used for much more than PTSD (more on that in the research section below).
The Magic Ingredient: Bilateral Stimulation
EMDR processing sessions use bilateral stimulation, or BLS: some kind of side-to-side sensory input. BLS engages both sides of the brain while you hold a memory in mind, and that changes how the memory gets stored.
Four Types of Bilateral Stimulation
There are four common types of BLS. Each has its strengths, and some suit some people better than others.
Eye Movements
This is the original. You follow your therapist's hand, a wand, or a light bar with your eyes while your therapist guides you through specific mental exercises.
Eye movements have been used the longest and have the most research behind them for PTSD, so they're some therapists' default. Some clients prefer them.
They may suit you if you're visually oriented, or if certain images cause you the most distress. The downside: some people get dizzy or get headaches.
Tones Through Headphones
You wear headphones and hear tones that alternate from ear to ear while your therapist guides you. Some studies find tones help too, though eye movements have more research behind them.
Many clients like this option because it's easier on the eyes, with less dizziness and fewer headaches. It may suit you if you're sensitive to light or movement, or if sounds are part of what happened to you.
Self-Tapping and the Butterfly Hug
The butterfly hug comes from Lucina Artigas, who created it in 1998 while working with people affected by Hurricane Pauline in Mexico. You cross your arms and tap your shoulders, alternating sides. It took off when therapy moved online during the early COVID-19 lockdowns and therapists couldn't use their usual tools.
It worked. You take an active part in the process, and you don't need any equipment.
Many clients find it helpful. It may suit you if you're doing EMDR online, if what happened to you was physical, or if you tend to dissociate.
Alternating Vibrations with TheraTappers
TheraTappers are small handheld devices that vibrate in one hand, then the other. They're a good option if other kinds of BLS don't feel comfortable, and for people with visual impairments or who are hard of hearing.
What the Research Says
Eye movements have the most research behind them. Tones, tapping, and TheraTappers have been studied less, with more mixed results. The World Health Organization and the VA both recommend EMDR. Beyond PTSD, it's also used for anxiety, phobias, grief, attachment wounds, and a range of other issues.
If you like reading the research yourself, the EMDR International Association (EMDRIA) website is the place to start. EMDRIA has played a big role in advancing EMDR.
Why Some Memories Get Stuck
When something traumatic happens, your brain doesn't always file it away properly. It gets stored in pieces, unfinished, and never becomes a regular memory.
The emotions, body sensations, and negative beliefs attached to it stay raw and active, because your brain thinks you need them close at hand to stay safe. That's why something that happened years ago can still set you off today.
You don't need a PTSD diagnosis for EMDR to help. If your nervous system stored an experience as threatening, EMDR may be able to help, including years of criticism or relational stress that never felt like "real" trauma.
The Eight Phases of EMDR
EMDR helps your brain go back and finish that processing, and it happens in eight phases:
Phase 1, history: your therapist learns about your past and what you want to work on, and builds a plan.
Phase 2, preparation: you learn ways to manage strong feelings during and after sessions. More on this below.
Phases 3 through 6, processing (assessment, desensitization, installation, and body scan): your therapist guides you through BLS while you focus on an upsetting memory or thought. If you're not sure which memory to start with, the process helps you find it.
Phase 7, closure: your therapist helps you make a plan for any feelings or problems that are still there.
Phase 8, reevaluation: at your next session, you and your therapist check how things are going and what's left to work on.
A few situations need extra care before you start. Tell your therapist if you're pregnant, if you take certain medications, or if you have a history of seizures.
What the Eye Movements Do
Short answer: nobody knows for sure. The research is clear that EMDR works; it's less clear on exactly why.
The leading theory is that it mimics REM sleep. During REM sleep, your eyes move rapidly back and forth while your brain processes the day.
Many researchers believe the eye movements in EMDR switch on a similar process. Your brain loosens its grip on the emotional intensity of a memory, so the memory can be reprocessed and stored differently.
BLS also creates dual awareness: you're aware of the memory and the present moment at the same time. That keeps you in touch with the memory without getting flooded by it, which is part of what makes processing possible.
Most people find BLS repetitive and a little hypnotic, and they don't describe it as overwhelming. Since any side-to-side input works, the type can change to fit you.
What Happens in Your Brain
EMDR works with your brain's own ability to heal and rebalance, the same way the rest of your body does. Your brain keeps forming new connections throughout your life. That's called neuroplasticity.
Think of the smell of pine trees. Say you once had a great day hiking through a pine forest. Now that smell can bring back the trail, the view, and the feeling of reaching the top.
Your brain has linked them into a network, and every time the smell comes back, the link gets stronger.
Painful experiences build networks too. Trauma, whether it's one major event or a lot of smaller ones, can knock your brain off its normal healing course. You can end up stuck in stress, anxiety, or a loop where triggers seem to be everywhere.
EMDR uses neuroplasticity to help your brain get unstuck. It helps the memory link up with what you know now, so it can stop setting off the same intense response.
Think of your memories like computer files. You can open them and edit them, but you can't delete them. EMDR can help your brain make accurate edits, so the file is still there but doesn't hit the same way when you open it.
In EMDR, this is called the adaptive information processing model.
The Most Important Phase
Preparation. The processing phases get most of the attention because that's where the BLS happens, but we'd argue Phase 2 is the most important part of EMDR.
Processing can be intense. You think about, and sometimes talk about, the upsetting memory. Preparation is where you build the inner resources that let you do that without getting overwhelmed.
It looks different for everyone, but it can include:
A calm place, real or imagined, you can return to during processing
Nurturing, protective, or wise figures, drawn from real life or imagination
Comforting objects or memories that help you feel grounded
Mindfulness practices that keep you present
Getting to know different parts of yourself, sometimes using Internal Family Systems (IFS)
Wanting to feel better fast makes sense when you're hurting. In our experience, though, rushing preparation is one of the most common reasons EMDR doesn't work. Do not work with an EMDR therapist who skips the first two phases.
Mark, 45, wanted to move past his PTSD quickly and breezed through preparation. When processing started, memories flooded in and he felt overwhelmed and helpless.
With no resources to lean on, he started to doubt EMDR could work for him at all.
This story is a composite of experiences we see often.
Preparation can take weeks or longer. It's often the most personal and creative part of the work, because it centers on what specifically helps you feel grounded and steady.
Does EMDR Erase Memories?
No. EMDR reprocesses memories, and you keep the memory.
The myth may come from the idea that you have to forget something to heal from it. What happened to you stays part of your story, and healing means the memory can stop carrying the same charge.
People often describe it like looking at a picture from farther away: you feel safer, and you can see more of what was happening.
One client, after processing a childhood memory, said it was "like watching a movie that used to make me panic and realizing it's just a movie." The memory was still there, and thinking about it stopped wrecking the rest of the day.
This story is a composite of experiences we see often.
Learning More
If you want to go deeper, our page on EMDR and trauma therapy covers how we use it, and our page on EMDR intensives explains doing the work in concentrated blocks. We offer EMDR online for clients in California and Florida.
If you're wondering whether it fits what you're dealing with, schedule a free 20-minute consultation.
Yes, for many people. What named studies say about online EMDR, how bilateral stimulation works on video, and what happens if you get overwhelmed. (146 characters)