What Is 'EMDR' Therapy & How Does It Work?

Eye Movement Desensitization and Reprocessing (EMDR) therapy is a therapeutic method that has gained increasing popularity over the past several years, especially among men and women suffering from post-traumatic stress disorder (PTSD).

What is EMDR therapy?

EMDR therapy is a fairly new form of psychotherapy originated by Francine Shapiro, PhD in 1987, when she "made the chance observation that moving her eyes from side to side appeared to reduce the disturbance of negative thoughts and memories."

Following decades of research, trials, studies and refinements, EMDR therapy is now recommended as an effective treatment for trauma in international practice guidelines, including the International Society for Traumatic Stress Studies.[fn]Differences in International Guidelines Regarding EMDR for Posttraumatic Stress Disorder: Why They Diverge and Suggestions for Future Research. (2019). Journal of EMDR Practice and Research. https://connect.springerpub.com/content/sgremdr/13/4/247.abstract[/fn]

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And while this powerfully effective technique is extremely beneficial for treating symptoms of PTSD, the uses of EMDR aren't limited to recovery from trauma. It can also be effective in the treatment of mental health issues such as anxiety, depression, eating disorders, phobias, chronic pain and more.

Since I began integrating EMDR therapy into my own work as a therapist, it has transformed my clinical practice.

I primarily work with women who struggle with emotional eating, eating disorders, anxiety and poor body image, and I have been amazed and inspired by the power of EMDR therapy as I observe the positive changes in women undergoing this process, such as their development of a deeper sense of emotional freedom, heightened awareness and increased self-acceptance.

How does EMDR therapy work?

It's thought that eye movements[fn]Bacon, I., McKay, E., Reynolds, F. et al. The Lived Experience of Codependency: an Interpretative Phenomenological Analysis. Int J Ment Health Addiction 18, 754–771 (2020). https://doi.org/10.1007/s11469-018-9983-8[/fn], which create bilateral stimulation of the brain, are similar to what occurs during REM (rapid eye movement) sleep, essentially allowing your brain to “dump out” non-useful content. This is where the Adaptive Information Processing (AIP) model comes into play, which involves what is believed to be the way the mind stores disturbing events that continue to cause us pain because they have not been emotionally processed.

The technique involves an eight-phase protocol designed to reduce emotional and physical distress caused, usually by a specific traumatic event or adverse life experience, that has occurred at any time throughout one's life.

Phase One

As explained by the EMDR Institute:

"The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past. Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations."

Phase Two

As one goal of EMDR therapy is to "produce rapid and effective change while the client maintains equilibrium during and between sessions," the therapist "may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions."[fn]What is EMDR? - EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (n.d.-b). EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. https://www.emdr.com/what-is-emdr/[/fn]

Phases Three, Four and Five

During the reprocessing phase, you are asked to focus on a specific distressing memory (phase three), consider how the memory makes you feel about yourself (phase four), and take notice of any physical sensations and emotions the memory brings up for you (phase five).

For example, if the memory still causing your pain is of your experiences being berated by a parent as a child for not losing weight despite their efforts to put you on a diet, you may feel an ongoing need to be perfect, that you're not good enough, or as though you are not in control of yourself.

These are all examples of negative cognitions.

The memory connected to your negative cognitions has become an unconscious trigger which is essentially stuck in your mind, creating a negative feedback loop in your brain that makes it difficult for you to move forward in your life.

The bilateral stimulation caused by eye movements (or, sometimes, auditory stimulation alternating between left and right speakers or headphones, or physical stimulation from the tapping of the therapist’s hands) allows the brain to begin reprocessing the memory and become desensitized to it.

Over time, the brain lets go of the emotional and physical distress related to that memory.

Phase Six

Once you work through a memory and no longer experience emotional or physical distress related to it, a positive statement or positive cognition is "installed" in order to establish a healthier, more realistic outlook on the memory.

Using the same example mentioned above, you would now be asked to think of the same distressing memory. While doing so, you would be directed to tune into any uncomfortable emotions surrounding it, such as feeling embarrassed, sad and/or angry, as well as any uncomfortable sensations in your body, such as nausea or tightness in your chest, and to simultaneously recall the previously associated negative cognitions.

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You would then be asked how distressing this memory feels on a 0-10 scale.

While sitting with the discomfort, you would next be asked to follow the therapist's fingers as they move back and forth for about 30 seconds, during which time you should pay attention to whatever comes up for you.

When the therapist stops moving their fingers, they will ask what you noticed, then instruct you to “go with that,” meaning you should now focus on whatever arose in you.

For example, you might remember your parent calling you fat or putting a lock on the refrigerator. As you sit with that memory, the therapist administers the eye movements again.

This process may be repeated several times over the course of one session.

After several sets of focusing in on the mental, physical, and emotional discomfort that arises, most people begin feeling less and less uncomfortable.

As they reprocess their memory through these eye movements, their brain “dumps out” distressing baggage. Positive thoughts may even begin breaking through, along with feelings of acceptance.

While it is rare for the distress to go away entirely in one session, most people recognize an immediate impact in some form.

Phases Seven and Eight

After working through several memories in this way, a new template for how you would like to view yourself is then created. You may be asked to keep a journal logging your feelings throughout the week, and reminding you of self-soothing techniques you can practice on your own.

The therapist will evaluate your progress and determine next steps.

Most people find that after they work through several past memories and specific negative cognitions, their old baggage from those traumas no longer shows up or causes them distress.

To be clear, the information above details only a small sampling of everything encompassed by the EMDR process.

You cannot jump right into the reprocessing phase without first ensuring there are additional positive resourcing and grounding elements in place.

My intention here is to provide a glimpse into the process and acknowledge the powerful healing it can provide as an integrative therapy approach, which should only ever be administered by an experienced and certified practitioner.

EMDR therapy has improved the lives of so many who have struggled with difficult and traumatic memories and experiences.

If you feel it may benefit you, reach out today. Healing is possible.

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Sarah Thacker is a licensed professional counselor and certified EMDR therapy practitioner who helps women overcome emotional attachments to food and correct their issues with diets, body images, and healthy eating. As the author of "Wholistic Food Therapy: A Mindful Approach to Making Peace with Food", she is dedicated to helping her clients create positive lifestyle changes.