Also available in Portuguese: EMDR: o que é, como funciona e o que a ciência diz sobre essa terapia
Blog · Trauma and EMDREMDR Explained Simply: What Is EMDR Therapy? How It Works, Benefits, and What Research Says.
What EMDR therapy is, how a session works, and what research says about this treatment for trauma.
Have you ever wondered why a painful memory can still feel so fresh, even years later?
You may know that the experience is over. You may understand that you are safe now. Yet something as simple as a sound, a smell, a place, or a familiar situation can bring back the same fear, sadness, or physical sensations you felt when it happened.
Why does that happen? And is there a way to change how those memories affect you?
That's where EMDR therapy comes in.
EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured, evidence-based psychotherapy developed by psychologist Francine Shapiro in the late 1980s. EMDR is primarily used to treat posttraumatic stress disorder (PTSD) and trauma-related distress.
Unlike traditional talk therapy, EMDR does not require you to describe every detail of a painful experience. Instead, it uses a structured process to help you work through distressing memories and change how they affect you in the present.
In this article, I want to explain EMDR the same way I would explain it to someone sitting across from me in a therapy session: clearly, honestly, and without unnecessary jargon.
We'll explore how it works, what you can expect during a session, and what scientific research tells us about its effectiveness.
Why Do Some Memories Continue to Hurt?
Our brains are constantly processing experiences, making connections, and learning from what happens around us.
Most memories eventually become part of our past. We can remember them without feeling as though we are reliving the experience.
But sometimes, particularly after overwhelming or traumatic events, memories continue to trigger intense emotional and physical reactions.
Imagine someone who was involved in a serious car accident.
Even years later, that person might experience a racing heart, sweaty palms, or overwhelming anxiety whenever they drive past the location of the accident.
Logically, they know the accident is over. But their body still reacts as though danger is present.
EMDR is guided by something called the Adaptive Information Processing (AIP) model. This model proposes that some distressing experiences may not be fully integrated into our broader memory networks, allowing the emotions, beliefs, and physical sensations associated with those experiences to remain easily triggered.
EMDR is designed to help people process those memories in a way that reduces their emotional intensity.
The goal is not to erase your memories. It is to help you remember what happened without experiencing the same level of distress.
You can still remember the experience. But it may no longer have the same power over how you think, feel, or respond.
What Actually Happens During an EMDR Session?
EMDR follows a structured, eight-phase treatment approach. However, to make it easier to understand, let's break the process into four main parts.
1. Preparation: Building Safety and Stability
One of the most important things to understand about EMDR is that you don't have to jump straight into painful memories.
Before beginning memory reprocessing, your therapist takes time to understand your history, your current challenges, and what you hope to accomplish through therapy.
Together, you develop strategies to manage emotional distress and stay connected to the present.
This may include grounding exercises, relaxation techniques, and other emotional regulation skills.
If you experience frequent dissociation, feel unsafe in your current environment, or are going through an emotional crisis, your therapist may recommend spending additional time on stabilization before beginning trauma processing.
This stage is not simply a formality.
Feeling prepared and having the resources to manage distress are essential parts of responsible trauma treatment.
2. Identifying the Memory to Work On
Once you are ready, you and your therapist identify a specific memory or experience to target.
You will explore several aspects of that memory, including:
- The image or moment that feels most disturbing.
- The negative belief you associate with the experience.
- The emotions that come up when you think about it.
- Any physical sensations you notice in your body.
For example, someone who experienced abandonment during childhood might have developed the belief, "I'm not important" or "I'm not worthy of love.”
Even as an adult, that belief may influence relationships, self-esteem, and emotional responses.
Through EMDR, the goal is to help the person process the memory and develop a more adaptive perspective, such as, "I am worthy of love" or "What happened does not determine my worth.”
3. Processing the Memory Through Bilateral Stimulation
This is probably the part of EMDR you have heard the most about.
During processing, your therapist uses bilateral stimulation, which involves alternating stimulation from one side of the body to the other.
This may include:
- Eye movements: Following the therapist's fingers or another visual target from side to side.
- Alternating taps: Gentle stimulation alternating between the left and right sides.
- Alternating sounds: Audio tones presented from one ear to the other.
While engaging in bilateral stimulation, you briefly bring the targeted memory to mind and notice what comes up.
After each set, your therapist may ask a simple question:
"What are you noticing now?”
You might notice a new thought, an emotion, a physical sensation, or another memory.
There is no right or wrong response, and you do not need to force anything to happen.
Your therapist may simply say, "Go with that," before beginning another set.
As processing continues, some people notice that the memory becomes less emotionally intense. Others begin making connections or seeing the experience from a different perspective.
For example, someone who originally believed, "I was powerless," might begin to recognize, "I couldn't control what happened, but I have more choices and resources now.”
These changes don't always happen immediately, and everyone's experience with EMDR is different.
4. Closing the Session and Checking Your Progress
At the end of each session, your therapist checks in with you and uses grounding or stabilization techniques when needed.
Not every memory is fully processed in one session, and that's okay.
Some people notice new thoughts, dreams, emotions, or insights between appointments. Your therapist will check in about these experiences during your next session.
Throughout EMDR, you remain awake, aware, and involved in the process.
You are always allowed to ask questions, request a break, or stop the processing.
What EMDR Is Not
There are several misconceptions about EMDR, so let's clear up a few.
EMDR is not hypnosis.
You do not enter a trance or lose awareness of your surroundings. You remain conscious and actively participate in the process.
EMDR does not erase memories.
The goal is not to forget what happened. It is to reduce the emotional distress associated with the memory so that it becomes easier to remember without feeling overwhelmed.
EMDR is more than eye movements.
Bilateral stimulation is only one component of treatment. EMDR also involves assessment, preparation, identifying important memories and beliefs, processing, and evaluating progress.
EMDR can also be provided through telehealth when clinically appropriate and when the therapist can maintain the necessary treatment and safety procedures.
EMDR is not a quick fix.
Some people experience meaningful improvement after relatively few sessions, particularly when working through a single traumatic event.
Others may need more time, especially when dealing with repeated childhood trauma, complex experiences, or additional mental health concerns.
There is no universal timeline for healing, and no ethical therapist should guarantee results within a specific number of sessions.
What Does the Research Say About EMDR?
EMDR has been studied extensively, particularly for the treatment of PTSD.
Several major health organizations recognize it as an evidence-based treatment.
World Health Organization (WHO)
The World Health Organization's updated 2023 guidance includes EMDR among the psychological interventions that should be considered for adults with PTSD.
The recommendation is conditional, with moderate-quality evidence.
The WHO also includes EMDR among the recommended psychological interventions for children and adolescents with PTSD, with a strong recommendation and moderate certainty of evidence.
U.S. Department of Veterans Affairs and Department of Defense (VA/DoD)
The 2023 VA/DoD Clinical Practice Guideline strongly recommends EMDR as one of three leading trauma-focused psychotherapies for PTSD.
The other two are:
- Cognitive Processing Therapy (CPT).
- Prolonged Exposure Therapy (PE).
These treatments have substantial scientific support and are recommended as first-line psychotherapy options for PTSD.
American Psychological Association (APA)
The American Psychological Association's updated 2025 clinical practice guideline includes EMDR as a conditionally recommended treatment for adults with PTSD.
A conditional recommendation means that the treatment is a supported option, while the available evidence and individual circumstances should be considered when making treatment decisions.
Different professional organizations may assign different recommendation strengths because they use different methods to evaluate research.
What Have Clinical Studies Found?
In addition to these guidelines, several scientific reviews provide important information about EMDR.
Chen and colleagues (2014)
A meta-analysis of 26 randomized controlled trials found that EMDR significantly reduced PTSD symptoms, as well as depression, anxiety, and emotional distress among people with PTSD.
The findings showed moderate to large effects across these outcomes.
Yunitri and colleagues (2023)
A network meta-analysis involving 98 randomized controlled trials and 5,567 participants examined different psychological treatments for PTSD.
EMDR was among the therapies associated with significant reductions in PTSD symptoms, with evidence of benefits at follow-up.
Wright and colleagues (2024)
A systematic review and individual participant data meta-analysis examined EMDR compared with other psychological treatments for PTSD.
The researchers found no statistically significant differences between EMDR and the other treatments studied in reducing PTSD symptoms, achieving treatment response or remission, or reducing treatment dropout.
This suggests that EMDR can offer outcomes comparable to other established psychological treatments, although the study had limitations.
Fairbanks and colleagues (published online in 2025; journal issue in 2026)
A multisite retrospective study examined EMDR treatment among 279 veterans receiving either in-person or telehealth services.
Researchers found improvements in PTSD and depression symptoms in both groups.
Although the in-person group showed greater average improvement in PTSD symptoms, both formats produced encouraging results, and several measures of clinically meaningful change were similar.
Because this was an observational study rather than a randomized clinical trial, further research is needed.
What Does Science Still Not Know?
While EMDR has strong research support for PTSD, it is important to acknowledge that researchers are still studying several aspects of the treatment.
First, the strongest evidence is for PTSD.
EMDR is also being investigated for other conditions, including certain anxiety disorders and depression, but the evidence is not equally strong for every diagnosis.
Second, researchers continue to explore exactly how EMDR works.
Several theories have been proposed to explain the role of eye movements and bilateral stimulation, including their possible effects on working memory and emotional processing.
However, the precise mechanisms behind EMDR's therapeutic effects are still being investigated.
What we do know is that EMDR, as a complete treatment approach, can be effective for PTSD.
Understanding how a treatment works is important, but scientific progress often involves refining our understanding of why an established treatment helps.
Who Might Benefit From EMDR?
EMDR is most commonly used for individuals experiencing PTSD or trauma-related distress.
Some experiences that may be addressed in EMDR therapy include:
- Car accidents and other frightening events.
- Physical, emotional, or sexual violence.
- Childhood trauma and adverse experiences.
- Combat and military-related trauma.
- Distressing medical experiences.
- Traumatic loss and grief-related experiences.
- Other overwhelming events that continue to trigger emotional distress.
EMDR may also be considered when distressing past experiences contribute to current emotional difficulties, depending on the person's needs and the evidence supporting its use.
However, it is important to remember that not everyone who has experienced something painful needs EMDR, and not every emotional struggle is caused by trauma.
The most appropriate approach depends on your history, symptoms, preferences, and treatment goals.
Is EMDR Right for Everyone?
Not necessarily, and that's an important part of the conversation.
If you are currently in an unsafe situation, experiencing severe emotional instability, struggling with substance use that interferes with treatment, experiencing active psychotic symptoms, or frequently dissociating, your therapist may recommend additional assessment, stabilization, or coordinated care before beginning trauma processing.
These experiences do not automatically mean that EMDR is never an option.
They mean that treatment needs to be carefully planned around your individual circumstances.
Good trauma therapy is not about moving as quickly as possible. It is about moving at a pace that supports your safety and well-being.
What Should You Ask an EMDR Therapist?
If you are considering EMDR, finding a properly trained therapist is an important first step.
Here are a few questions you can ask during an introductory consultation:
- What EMDR training have you completed?
- Are you currently receiving EMDR consultation or supervision?
- How do you help clients prepare before processing difficult memories?
- How will we know whether treatment is helping?
- What should I do if I feel more distressed between sessions?
A therapist should be able to explain the process clearly, respect your boundaries, and discuss both the potential benefits and limitations of treatment.
Be cautious of anyone who guarantees a cure, promises results in a specific number of sessions, or discourages appropriate medical or mental health care.
Therapy is a collaborative process, and what works well for one person may not be the best fit for another.
Final Thoughts: Your Past Does Not Have to Define Your Present
Painful experiences can leave lasting emotional effects. Sometimes, those experiences continue to influence how we see ourselves, how we connect with others, and how we respond to the world around us.
EMDR offers a structured, research-supported way to work through traumatic memories and reduce their emotional impact.
It is not about changing your past or pretending that something painful never happened.
It is about helping you relate to those experiences differently, so they no longer have the same influence over your present.
You cannot change what happened to you, but you can work toward changing how it affects your life today.
If you are curious about EMDR or wondering whether it might be a good fit for you, I would be happy to talk with you.
At True Path Counseling, I believe therapy should be a space where you feel heard, respected, and supported as you work toward understanding yourself and moving forward.
You do not need to have everything figured out before reaching out.
Schedule a free introductory consultation to explore your options and take the next step toward emotional well-being.
Nathalia Freitas, MA
Registered Mental Health Counselor Intern
True Path Counseling, LLC
References
1. World Health Organization. (2023). Posttraumatic stress disorder (PTSD): Psychological interventions - Adults. WHO guidance
2. World Health Organization. (2023). Posttraumatic stress disorder (PTSD): Psychological interventions - Children and adolescents. WHO guidance
3. U.S. Department of Veterans Affairs & Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. Clinical practice guideline
4. American Psychological Association. (2025). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. APA guideline
5. Chen, Y. R., et al. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: A meta-analysis of randomized controlled trials. PLOS ONE, 9(8), e103676. https://doi.org/10.1371/journal.pone.0103676
6. Yunitri, N., et al. (2023). Comparative effectiveness of psychotherapies in adults with posttraumatic stress disorder: A network meta-analysis of randomised controlled trials. Psychological Medicine, 53(13), 6376–6388. https://doi.org/10.1017/S0033291722003737
7. Wright, S. L., et al. (2024). EMDR v. other psychological therapies for PTSD: A systematic review and individual participant data meta-analysis. Psychological Medicine, 54(8), 1580–1588. https://doi.org/10.1017/S0033291723003446
8. Fairbanks, C. L. D., et al. (2026). A multisite retrospective review exploring the delivery of eye movement desensitization and reprocessing (EMDR) therapy to veterans via telehealth (TH) versus in person (IP). Psychological Trauma: Theory, Research, Practice, and Policy, 18(3), 659–670. Published online May 26, 2025. https://doi.org/10.1037/tra0001917
If you are in immediate danger or experiencing a mental health emergency, call 911, go to the nearest emergency department, or call or text 988 in the United States.