What is EMDR Therapy?

EMDR Therapy. 6 min read · Trauma and PTSD

What is EMDR, and how does it actually work?

Eye Movement Desensitisation and Reprocessing is one of the most researched therapies for trauma. Here's a plain language guide to what it is, what a session looks like, the evidence behind it, and why it works just as well online.

When something overwhelming happens, the brain doesn't always file the memory away the way it files an ordinary day. EMDR is a structured therapy that helps the brain finish that filing, so a memory that still feels raw and present can finally settle into the past, where it belongs.

What EMDR is. EMDR stands for Eye Movement Desensitisation and Reprocessing. It was developed by psychologist Dr Francine Shapiro in the late 1980s, and has since become one of the most widely studied and recommended treatments for post traumatic stress. Unlike talking therapies that ask you to describe and analyse a difficult experience in detail, EMDR works with the memory while you focus on a gentle, rhythmic back and forth stimulation, usually side to side eye movements, but also taps or tones. You don't have to talk through every detail of what happened. For many people, that's an enormous relief.

How it works. The leading explanation is the Adaptive Information Processing model. The idea is that the brain has a natural system for processing experience. When an event is too distressing, that system can get stuck, and the memory is stored along with the original images, body sensations, emotions and beliefs (I'm not safe, it was my fault). Later, a sound, a smell or a situation can trigger the whole package as though it were happening now. The bilateral (left right) stimulation used in EMDR is thought to tax working memory and mimic some of the processing that happens during REM sleep, allowing the stuck memory to be reprocessed and stored more adaptively. The facts of what happened don't change, but the charge attached to them softens.

What a course of EMDR looks like. EMDR follows a structured eight phase protocol. In practice, your experience usually moves through these stages: History and preparation (we understand your story, build safety and trust, and learn grounding and self soothing skills before any processing begins) · Identifying a target (together we choose a specific memory, the image that represents it, the belief attached to it, and how it feels in your body right now) · Reprocessing (while you hold the memory in mind, you follow sets of bilateral stimulation; we pause often and let your brain do the work at its own pace) · Installation and closure (we strengthen a more helpful belief and make sure you leave each session settled and resourced).

What EMDR can help with. EMDR is best known for trauma and PTSD, but it's also used for anxiety, panic, phobias, grief, distressing childhood experiences, performance anxiety, and the lingering effects of single incident events such as accidents or medical trauma.

The evidence behind it. EMDR is not an alternative or fringe therapy, it is recommended in major international and Australian clinical guidelines as a frontline treatment for PTSD. The World Health Organization recommends EMDR and trauma focused CBT for PTSD in children, adolescents and adults. 30+ years of randomised controlled trials and meta analyses support its use for trauma. It is recommended in the American Psychological Association and Australian (Phoenix Australia) PTSD guidelines. Multiple meta analyses have found EMDR to be at least as effective as other trauma focused therapies, often with people needing fewer sessions and without homework between appointments. As with any therapy, results vary from person to person.

Telehealth and EMDR, does it work online? This is the question we're asked most often. The short answer: yes. Research conducted during and after the pandemic found that EMDR delivered via secure video can produce outcomes comparable to in person delivery, provided it's done with the right tools and a properly trained clinician. For online sessions we use purpose built bilateral stimulation tools, moving visual cues on your screen, or alternating tones through your headphones, so the core mechanism of EMDR works just as it would in the room. Many clients actually find online EMDR more comfortable, because they're processing difficult material from the safety of their own home. To get the most from online EMDR you'll want a private, uninterrupted space, a stable internet connection, a device with a camera, and headphones.

Is EMDR right for you? EMDR isn't the only path, and it isn't right for everyone or every moment. That's why we always begin with a thorough conversation about your history and what you need. If EMDR is a good fit, we'll prepare carefully before any processing begins. If it isn't, we'll draw on other evidence based approaches, because the plan should fit you, not the other way around.

References retained on the page (Shapiro 2018; WHO 2013; APA 2017; Phoenix Australia 2021; Perri et al 2021; Lenferink et al 2020). This page is general information, not a substitute for individual clinical advice. If you are in crisis, please call Lifeline on 13 11 14 or contact emergency services on 000.

Curious whether EMDR could help you? Start with a free 15 minute call. We'll talk about what's going on and whether EMDR, in person in Perth, or online anywhere in Australia, is the right fit.