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EMDR Therapy Explained: How It Works and Who It Helps
What EMDR therapy is, how its eight phases work, what NICE says, what sessions feel like and how to find an accredited EMDR therapist in the UK.
Key takeaways
- EMDR is a structured therapy for trauma that pairs recalling memories with side-to-side eye movements, taps or tones.
- NICE and the World Health Organization recommend it for PTSD; it’s also offered through NHS Talking Therapies in many areas.
- Choose a therapist with recognised EMDR training who is also registered with a professional body.
On this page
EMDR stands for eye movement desensitisation and reprocessing. It’s a structured therapy that helps people process distressing memories, most often after trauma. During parts of a session, you briefly bring a memory to mind while following your therapist’s hand moving from side to side, or while hearing alternating tones or feeling alternating taps. Over time, the memory tends to feel less vivid and less upsetting. In the UK, NICE recommends EMDR as a treatment for post-traumatic stress disorder (PTSD), and it’s available on the NHS in many areas.
Where EMDR came from
EMDR was developed in the late 1980s by the American psychologist Francine Shapiro. It has since been studied in many clinical trials, mainly for PTSD, and is recommended in guidelines from NICE and the World Health Organization.
How EMDR is thought to work
When something overwhelming happens, the memory can be stored in a raw, unprocessed way. Reminders can then trigger the same fear, images and body sensations as if it were happening again. EMDR aims to help the brain process the memory so it becomes an ordinary, if painful, part of your past.
Exactly why it works is still debated. Researchers have suggested that holding a memory in mind while doing a task that takes up attention, such as eye movements, makes the memory less vivid and emotional. Some studies question how much the eye movements themselves add. What’s clearer is that the structured approach helps many people with PTSD.
The eight phases
| Phase | What happens |
|---|---|
| 1. History and planning | Your therapist learns about you and what you want help with, and you agree which memories to work on |
| 2. Preparation | You learn about EMDR and practise calming and grounding techniques |
| 3. Assessment | You identify a target memory, the image, the negative belief (such as “I’m not safe”), emotions and body sensations linked to it |
| 4. Desensitisation | You hold the memory in mind during short sets of eye movements or taps, noticing whatever comes up |
| 5. Installation | You strengthen a more helpful belief, such as “It’s over, I’m safe now” |
| 6. Body scan | You check for any remaining tension linked to the memory |
| 7. Closure | You return to a calm state before the session ends |
| 8. Re-evaluation | At the next session, you review progress and decide what to work on next |
What a session feels like
Sessions usually last 60 to 90 minutes. During the processing phases, you don’t need to describe the memory in detail; you simply notice thoughts, feelings or images and give brief updates. Many people say memories become blurrier, more distant or less charged as sessions go on.
Between sessions, you may notice vivid dreams, new memories surfacing, tiredness or stronger emotions for a while. This is common, and your therapist will help you plan how to look after yourself.
Who EMDR can help
- PTSD after single events such as accidents, assaults or disasters. NICE recommends EMDR for adults with PTSD after non-combat trauma, alongside trauma-focused CBT.
- Complex trauma, usually with a longer preparation phase and a skilled, experienced therapist.
- Other difficulties, such as phobias or distressing memories that aren’t PTSD, where research is more limited.
EMDR may need adapting or delaying if you’re currently unsafe, in crisis, misusing substances heavily or experiencing some dissociative conditions. A careful assessment will look at this.
How many sessions?
It depends on the person and the trauma. A single-incident trauma may need relatively few sessions, while complex or multiple traumas usually take longer. NICE suggests EMDR for PTSD is typically delivered over 8 to 12 sessions, with more if clinically needed.
EMDR compared with trauma-focused CBT
| EMDR | Trauma-focused CBT | |
|---|---|---|
| Focus | Processing memories with bilateral stimulation | Understanding the trauma, changing beliefs and facing memories and reminders |
| Talking about details | Less detailed talking needed | Usually more discussion of the trauma |
| Homework | Little or none | Usually some, such as practice or reading |
| NICE status for PTSD | Recommended | Recommended |
Both are effective for many people. Your preference matters. Our overview of therapy options after trauma compares approaches in more detail, and our guide to CBT explains the principles behind it.
Getting EMDR in the UK
- NHS Talking Therapies (England): you can refer yourself, and many services offer EMDR for PTSD.
- Your GP: can refer you to local or specialist services.
- Privately: look for a therapist with recognised EMDR training. The EMDR Association UK accredits practitioners and lists them on its website.
Check that your therapist is also registered with a professional body, such as BACP, UKCP or the HCPC for psychologists. Our guides to finding a counsellor in the UK and counselling costs will help you compare options.
Questions to ask an EMDR therapist
- What EMDR training have you completed, and are you accredited?
- How much experience do you have with problems like mine?
- How will we prepare before working on memories?
- What should I do if I feel unsettled between sessions?
If you need help now
If you feel unable to keep yourself safe, call 999 or go to A&E. You can call Samaritans free on 116 123, any time, or text SHOUT to 85258. In England, call NHS 111 and choose the mental health option.
Frequently asked questions
Is EMDR hypnosis?
No. You’re awake, aware and in control throughout, and you can stop at any time.
Do I have to talk about my trauma in detail?
Not in detail. You identify the memory and give short updates during processing, which some people find easier than detailed talking therapies.
Can EMDR be done online?
Many therapists offer EMDR online using on-screen movements or self-administered taps. Discuss with your therapist whether it suits you.
Sources
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