EMDR Therapy

If you’ve ever wondered what’s involved in EMDR therapy, this article describes EMDR therapy—or eye movement desensitization and reprocessing therapy. 

Additionally, we share insights from a leading EMDR expert and bust a myth about EMDR that is often misrepresented in the media. 

What is EMDR (eye movement desensitization and reprocessing) therapy?

EMDR therapy is a psychotherapeutic modality often used to treat unresolved trauma. 

You might be wondering “What does EMDR stand for?” 

EMDR stands for eye movement desensitization and reprocessing, and EMDR therapy is a treatment process founded by psychologist Dr. Francine Shapiro in 1987. 

In a nutshell, EMDR therapy is one of the most researched and used methods of treating trauma. EMDR involves an adaptive information processing model that utilizes the body’s natural information-handling system to treat trauma and adverse life experiences. 

I recently completed an EMDRIA-approved training and am amazed by its healing effects compared to other therapies.

“EMDR is a powerful treatment that can get to the heart of what distresses a person and can allow them to shift how memories are stored in their brain and thus their body,” says Jamie Marich, Ph.D., LPCC-S, EMDRIA-certified trainer and established EMDR therapy author. 

Marich started offering EMDR therapy after going through treatment herself. “I’ve experienced its power in my own life, which is why I decided to offer this to my clients,” she says. “And I see powerful shifts happen every week in my practice.”

EMDR therapy in more detail

EMDR therapy uses the brain’s natural processing system, which manages and stores new information. This process occurs during REM (rapid eye movement) sleep. 

However, information processing is interrupted when a person experiences a traumatic event, such as a car accident, assault, abuse, natural disaster, or other distressing event. 

When trauma occurs, the brain becomes overloaded, and it cannot process the trauma. 

As a result, the trauma remains unprocessed and stored in isolation in the limbic system (the emotional center of the brain or mammalian brain). 

As the limbic system is separated from the brain’s neocortex, where executive functioning happens, these unhealed memories may cause maladaptive processes. 

When a person experiences a high level of disturbance with a traumatic event, new experiences may trigger these dysfunctional memory networks, causing a negative affect and/or sensations and reinforcing the original memory. 

I won’t get too in-depth with the theory, but I will say this explanation helps us understand how EMDR therapy differs from cognitive therapies. Talk therapies work primarily on the neocortex, whereas EMDR—or other action-oriented interventions, like somatic awareness—uses the whole brain, thus facilitating the connections needed for healing. 

How EMDR works

EMDR therapy involves processing emotionally disturbing material through dual attention (or bilateral stimulation). Dual attention consists of the client engaging in an external stimulus, such as following the therapist’s hand movements or a moving light, listening to audio stimulation, or tapping on their shoulders or legs. 

This reprocessing phase mimics the natural information processing that occurs during REM sleep. 

To bust a myth here, as an EMDR therapist—just like any other type of therapy—you don’t jump right into treatment, unlike what you may see on television. 

EMDR therapy scenes in the media often depict a distressed client, with a close-up of their eyes darting back and forth following flashing lights or a therapist’s hand movements. 

The reality, however, is that EMDR therapy has a specific protocol. 

What is the 8-phase EMDR therapy process?

The EMDR (eye movement desensitization and reprocessing) sequence contains eight phases.

Phase 1: Client history and treatment planning

This stage includes thematic history taking, case conceptualization, and treatment planning through an adaptive information processing (AIP) lens. Clinicians will also assess the client’s suitability for EMDR therapy.

Phase 2: Preparation

This phase focuses on resource building, stabilization, EMDR process orientation, answering questions, and explaining different types of bilateral stimulation. This stage also includes assessing the appropriateness of continuing with EMDR therapy.

Phase 3: Assessment

This phase involves conceptualizing the target sequence—the negative memory or event and thoughts and emotions experienced—for reprocessing.

Phase 4: Desensitization

This is the reprocessing stage in which the clinician applies bilateral stimulation to the target sequence to move the disturbance to an adaptive resolution.

Phase 5: Installation

Once a client has arrived at a positive cognition and other appropriate measures, the clinician uses bilateral stimulation to install or link the positive beliefs to the traumatic event or memory.

Phase 6: Body scan

This involves checking in with the client’s body to see if any shifts have occurred due to phases 4 and 5. If the client reports adaptive responses, the therapist continues to phase 7. If not, you may need to repeat the process.

Phase 7: Closure

This involves grounding procedures to close a session or targeting sequence.

Phase 8: Reevaluation

The goal of this phase is to ensure that the target memories, current triggers, and future templates are fully processed. If this stage reveals unprocessed memories, specific guidelines are provided to re-engage the targets for continued processing. Reevaluation of the targeting sequence also occurs at the conclusion of EMDR therapy treatment.

EMDR therapy benefits and conditions it can help treat

In addition to treating PTSD, EMDR (eye movement desensitization and reprocessing) can be used to treat:

• Anxiety and panic attacks
• Anger
• Depression
• Grief and loss
• Phobias
• Sleep problems
• Substance use disorders
• Trauma, including PTSD and complex trauma
• Chronic pain
• Performance anxiety
• Low self-esteem and feelings of worthlessness

“EMDR therapy can be appropriate for any client if they are well-prepared to handle the affect, the body sensations, and the emotions that can come up once we target the trauma,” Marich says.

In addition to resolving the unprocessed memory, there are other benefits of EMDR. For example, EMDR therapy does not require clients to get into the details of traumatic events. 

“While EMDR therapy does not require that people get into a lot of the verbal narrative around the trauma, powerful emotional releases can occur when a person taps into what they’ve been holding onto for a long time,” Marich explains.

However, that said, Marich also cautions that EMDR is not a quick fix. “EMDR is not a magic bullet—Iit requires good preparation and it is hard work, she says. “Yet hopefully, clients will continue to experience how valuable this work can be to their healing.”

EMDR therapy side effects

While I wouldn’t say there are specific dangers of EMDR therapy, clients may experience side effects or have a negative experience. However, that is where competence comes in. 

“Fortunately, there are procedures in the EMDR protocol and with the use of some other therapeutic procedures that can prepare people,” says Marich. 

Clinicians should prepare clients for the possibility of experiencing residual distress, highlighting the resources they have used in earlier phases. It’s also important to provide debriefing and closure to sessions. 

There may also be times when reviewing a safety plan is necessary. 

However, there are still instances of clients reporting adverse experiences of EMDR. According to Marich, this, too, is an issue of preparation. “Most folks I’ve talked to who have had negative experiences with EMDR therapy were not well-prepared by their therapist,” she says. 

According to Marich, there can be another explanation for negative experiences. “The person themselves was wanting a quick fix and didn’t take the preparations seriously,” she says.. 

Steps to take for EMDR therapy training

For those who are interested in taking EMDR therapy training, it may be advisable to find a training accredited by the EMDR International Association (EMDRIA). 

EMDRIA is a nonprofit organization that advances the education, practice, and science of EMDR therapy. 

One of the ways they do this is through accrediting EMDR training organizations to demonstrate they have met the highest standards of excellence and integrity. 

Once trained, clinicians may be eligible to join EMDRIA as members and be featured in their directory of EMDR therapists. 

Sources

1. Marich, J. (September 2, 2024). Personal interview.
2. Marich, J. (2015). Eye movement desensitization and reprocessing (EMDR) therapy training course. The Institute of Creative Mindfulness.
3. Menon, S. B., & Jayan, C. Indian journal of psychological medicine. (2010). Eye movement desensitization and reprocessing: a conceptual framework. 
4. Shapiro, F. (2017). Guilford Press. Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). 
5. Shapiro F. (2014). The Permanente journal. The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences.
6. Shapiro, F. (2024). What is EMDR therapy? EMDR Institute. 
7. Shapiro, F. (2024). Research overview. EMDR Institute. 

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