EMDR (eye movement desensitisation and reprocessing)

EMDR, or eye movement desensitisation and reprocessing, is a structured psychological therapy that helps the brain process distressing memories so they stop intruding on daily life. Instead of talking through an event in detail, you focus on it briefly while your therapist guides a form of bilateral stimulation, usually side to side eye movements or alternating taps.

EMDR was developed in the late 1980s by the American psychologist Francine Shapiro, who noticed that side to side eye movements seemed to reduce the intensity of her own distressing thoughts. Decades of research since then have refined the approach into an eight phase protocol used by trained therapists across the NHS and private practice. The theory behind EMDR is that when something traumatic happens, the memory can get stuck in the nervous system in a raw, unprocessed form, prone to being triggered by reminders. Bilateral stimulation appears to help the brain file that memory away properly, so it becomes a memory like any other rather than something that resurfaces with the same intensity.

How does EMDR work?

A trained EMDR therapist asks you to briefly bring a target memory to mind, along with the image, belief and body sensation attached to it, while following a set of eye movements, taps or tones. Short sets of this bilateral stimulation are followed by a pause, where you report what came up: a thought, an image, a physical sensation, sometimes nothing obvious at all. The therapist does not interpret or direct what emerges. Instead, they let the process unfold and periodically steer it back towards the target memory. Over a series of these sets, the emotional charge attached to the memory typically reduces, and it starts to feel more like something that happened in the past rather than something happening now.

What does EMDR look like over video?

Online EMDR follows the same eight phase structure as in-person work, adapted for video. Bilateral stimulation is usually delivered by asking you to move your eyes side to side following your own hand or a moving object on screen, or by using alternating tapping on your own knees or shoulders, sometimes guided by audio tones through headphones. Your therapist talks you through the technique before you start, so you are comfortable with it before any trauma processing begins. You will need a private, quiet space, a reasonably stable internet connection and somewhere comfortable to sit where you will not be interrupted.

The eight phases of EMDR

EMDR is delivered across eight distinct phases, though these do not always map neatly onto individual sessions. The first two phases cover history taking and preparation: your therapist asks about your background and current difficulties, explains the approach and teaches you calming techniques you can use if a memory feels too intense. Phase three identifies the target memory in detail, along with the negative belief attached to it and the more helpful belief you would rather hold. Phases four to seven are the reprocessing phases themselves, known as desensitisation, installation, body scan and closure, where bilateral stimulation is used to work through the memory, strengthen the more helpful belief and check for any residual physical tension. The eighth phase, re-evaluation, happens at the start of the next session, checking how the work has settled since you last met.

How many sessions will I need?

This varies with what you are processing. A single, well defined traumatic incident, such as a road accident, might be worked through in a handful of sessions once preparation is complete. Trauma that built up over years, or several linked memories, generally needs longer. Your therapist will give you a realistic sense of this once they understand what you are bringing, rather than a fixed number set in advance.

The evidence for EMDR

EMDR has a substantial evidence base for post-traumatic stress disorder. The National Institute for Health and Care Excellence recommends it as a treatment option for PTSD in adults, alongside trauma-focused cognitive behavioural therapy. Trials have found it reduces PTSD symptoms with outcomes broadly comparable to trauma-focused CBT, and some people find the lower reliance on detailed verbal recounting makes it more manageable. It is also used, with a smaller evidence base, for other difficulties where distressing memories play a part, including some anxiety disorders and complicated grief.

Does online EMDR work as well as face-to-face EMDR?

Research on remote-delivered EMDR, much of it published since 2020, has generally found outcomes comparable to in-person delivery for PTSD symptoms. The mechanism, bilateral stimulation paired with a target memory, translates well to video because the eye movements or tapping can be self-directed with the therapist’s guidance rather than requiring hands-on contact. Screen size and a stable connection matter more than they would in talking therapy, since you need to see the movement clearly, but most adults adapt to this within the first session.

Who EMDR suits

EMDR is most established for adults dealing with a specific traumatic memory or a small number of related memories, such as an assault, an accident, a frightening medical event or a bereavement that has left intrusive images or flashbacks. It can also help with some phobias and anxiety where a memory sits behind the fear. If you find it hard to put what happened into words, or find repeated verbal recounting of an event unhelpful, EMDR offers a different route into processing it.

Who EMDR is not right for, or not right for yet

EMDR is not usually the first approach for someone in an acute crisis, actively self-harming, or without any current stability in daily life, since reprocessing work needs a baseline of safety to draw on. It also is not typically used during the early weeks after a traumatic event, when natural recovery is still likely, or for people with significant dissociative symptoms without additional preparation first. If you are currently thinking about suicide or self-harm, this website is not a crisis service. Samaritans are available free, any time, on 116 123.

EMDR compared with CBT for trauma

Trauma-focused CBT and EMDR are both NICE-recommended for PTSD, and the choice between them often comes down to personal preference and what a particular memory needs. CBT tends to involve more structured discussion of the event, written work between sessions and gradual exposure to reminders of it. EMDR asks less verbal detail of you moment to moment and relies more on bilateral stimulation to do the processing work. Neither approach is more legitimate than the other, and some people benefit from a combination over time.

EMDR with us

We are clinical psychologists for Maidstone and Kent, working online with adults, and EMDR is one of the approaches available within that work. Sessions run by video with a psychologist trained in EMDR, following the same eight phase structure used in person. Because the practice is online, you can reach us from anywhere in Maidstone, including Bearsted, Barming, Loose, Tovil, Allington and Penenden Heath, and from further afield across Kent. At the moment all our sessions are online.