EMDR can sound surprising at first. A therapy that involves following a therapist’s hand movements with your eyes, or listening to alternating tones, while thinking about a distressing memory does not sound like ordinary talking therapy. Yet EMDR — Eye Movement Desensitization and Reprocessing — is one of the most studied treatments for trauma and post-traumatic stress disorder (PTSD). This article explains, in plain words, what EMDR is, what the research and guidelines say, and what actually happens in sessions.
First, an important point: EMDR should be delivered by a properly trained therapist. It is not a self-help technique, and it should not be tried alone at home by following a video or app. Trauma work can bring up strong feelings, and a trained therapist helps you prepare, stay safe and process memories at a pace you can manage.
What is EMDR?
EMDR is a structured psychotherapy developed for people whose distress is linked to difficult or traumatic experiences. It is based on the idea that some memories remain stored in a way that keeps them feeling present and overwhelming, rather than settled in the past. A sound, smell, place or anniversary can trigger the memory, along with the emotions and body sensations that went with it.
In EMDR, the therapist helps you bring a specific memory to mind in a controlled way, while also paying attention to bilateral stimulation — most commonly eye movements from side to side, but sometimes alternating sounds or taps. Between sets of stimulation, you pause, notice what comes up, and report it briefly. The therapist then guides the next set. Over time, many people find the memory becomes less vivid and less distressing, and they can think about it with a clearer, more balanced perspective.
EMDR does not erase memories, and it does not require you to describe every detail of what happened in the way some other therapies do. That can be a relief for people who find detailed retelling very difficult.
What the research says
The World Health Organization’s 2013 guidelines for stress-related conditions recommend EMDR, alongside trauma-focused cognitive behavioural therapy (CBT), for PTSD in adults and children. That recommendation matters because it reflects a careful review of the evidence, not a single study or a passing trend.
International trauma guidelines, such as those from the International Society for Traumatic Stress Studies (ISTSS), also list EMDR among the recommended trauma treatments. When different guideline groups, working independently, reach similar conclusions, it strengthens confidence that a treatment has a solid evidence base.
Laboratory research associated with van den Hout and Engelhard offers one possible explanation for how EMDR might work. Their work suggests that the eye movements tax working memory — the mental workspace we use to hold information in mind — which may reduce the vividness and emotional intensity of distressing memories. It is important to be honest here: the exact mechanism is still being studied, and researchers continue to debate how much of the benefit comes from the eye movements themselves, the structured recall, or the combination of both. What is clearer is that EMDR, delivered properly, helps many people with trauma-related difficulties.
What happens in EMDR sessions?
EMDR is not a single technique applied in one session. It follows a structured process, usually over several sessions, and the early work is about safety and preparation.
- Assessment and preparation. Your therapist will take a careful history, explain EMDR, and help you build coping and grounding skills. You will agree together on which memories to work on and in what order.
- Identifying a target memory. For each memory, you and your therapist identify the image that represents the worst part, the negative belief connected to it (for example, “I am not safe”), and a more balanced belief you would prefer to hold.
- Desensitisation. You hold the memory in mind while following the therapist’s bilateral stimulation in sets. After each set, you briefly report what you noticed — an image, a thought, a feeling or a body sensation — and the therapist guides the next set.
- Installing a positive belief. As distress reduces, the therapist helps strengthen the more adaptive belief, so the memory is linked to a steadier sense of yourself.
- Body scan and closing. Each session ends with a check of any remaining tension in the body and a clear closing routine, so you leave feeling as settled as possible.
- Re-evaluation. At the start of the next session, you review what has changed since last time and decide what to work on next.
Sessions can sometimes feel tiring or emotional, and memories may continue to be processed between sessions. A good therapist will explain this and make sure you have grounding strategies to use at home.
EMDR compared with trauma-focused CBT
Both EMDR and trauma-focused CBT are recommended treatments for PTSD, and both involve working with traumatic memories in a structured way. Trauma-focused CBT usually involves more detailed discussion of thoughts and beliefs and gradual exposure to avoided situations or memories. EMDR tends to involve less detailed verbal retelling, with more focus on the memory and the bilateral stimulation.
Neither approach is right for everyone. The best choice depends on your symptoms, your preferences, any other difficulties you have, and the judgement of a trained therapist after a proper assessment. If you are unsure, an assessment session can help you understand the options without committing to a particular approach straight away.
For background on trauma and its effects, you may find our pages on trauma and PTSD and trauma-focused therapy helpful.
Is EMDR suitable for everyone?
EMDR is not suitable for every person or every situation. It requires a degree of stability and safety in daily life, and a therapist will assess whether you are ready, or whether stabilisation and support need to come first. People with certain medical conditions, dissociation, or complex difficulties may need a longer preparation phase or a different approach.
It is also important to have realistic expectations. EMDR can reduce the distress linked to a memory, but it does not change what happened, and it does not solve every problem at once. Progress is often gradual, and some memories take longer than others.
When to seek professional help
Seek professional help if you experience flashbacks, nightmares, strong avoidance, feeling constantly on edge, or difficulty sleeping or concentrating after a traumatic event, especially if these persist for more than a month or interfere with daily life. Help is also important if you feel numb, detached, or unable to enjoy things you used to, or if trauma is affecting relationships or work.
If you are in immediate danger, or feel you may act on thoughts of harming yourself, seek emergency help right away and, if possible, stay with someone you trust until help arrives.
Therapy with Anjum — by Anjum Mehmood Siddiqui, Consultant Clinical Psychologist, Personality Analyst and Psychotherapist. Therapy in Islamabad, Rawalpindi and online.
If you would like support, you can book an appointment with Therapy with Anjum.
This article provides general information only. It is not a diagnosis and is not a substitute for professional care. If you are in immediate danger, please seek emergency help right away.