EMDR Therapy – What Is It and Who Can It Help?

Introduction

EMDR therapy is a form of psychotherapy used primarily to treat post-traumatic stress disorder (PTSD). We explain what EMDR involves, how it helps people work through distressing memories, what research says about its effectiveness, and when it may be worth considering.

Some experiences stay with us for many years. Although we know they are in the past, the memories can still bring up fear, sadness, tension or a sense of danger.

Sometimes a particular sound, smell, place or situation that reminds us of what happened is enough to trigger a strong emotional response.

We may understand that the danger has passed, yet still feel anxious or react as though it were present.

This does not mean that every difficult experience constitutes trauma in the clinical sense, or that every traumatic event leads to a mental health condition.

Many people gradually regain their sense of balance without specialist treatment. Sometimes, however, the effects of an experience persist and begin to affect everyday life, relationships or a person’s sense of safety.

One form of psychotherapy used in these circumstances is EMDR – Eye Movement Desensitization and Reprocessing.

What is EMDR therapy?

EMDR stands for Eye Movement Desensitization and Reprocessing, a method in which eye movements are used as part of processing distressing memories.

The approach was developed by American psychologist Francine Shapiro in the late 1980s.

EMDR is a structured form of psychotherapy that focuses on distressing memories and the emotions, beliefs and physical sensations associated with them.

The aim is to reduce the distress connected with particular experiences and lessen their negative impact on life in the present.

The aim of EMDR is not to erase memories or make someone forget what happened.

Rather, it is to help a person recall the experience with less distress and respond less intensely when something reminds them of the past.

EMDR is one of the therapies recommended for post-traumatic stress disorder (PTSD). It is included in guidance from the World Health Organization (WHO), the UK’s National Institute for Health and Care Excellence (NICE), and the US Department of Veterans Affairs and Department of Defense (VA/DoD) [1–3].

Each organisation sets out specific circumstances in which the treatment is recommended. These recommendations do not mean that EMDR is appropriate for everyone who has had a difficult experience.

Why can traumatic memories continue to affect us?

Memory helps us learn from experience, recognise danger and respond to situations around us.

After a traumatic event, however, distressing reactions may continue long after the event itself has ended.

Someone who has been involved in a serious accident may feel intense fear when travelling by car. A person who has experienced violence may feel tense in situations that remind them of the earlier threat.

Some people experience intrusive memories, nightmares, avoidance of certain places or situations, heightened vigilance or difficulty regaining a sense of safety.

These symptoms can occur in PTSD, but not everyone who experiences them meets the diagnostic criteria for the disorder.

It is also important to remember that two people can respond very differently to similar events.

Factors may include the circumstances of the event, previous experiences, available support and individual ways of coping with stress.

That is why a psychological assessment considers not only what happened in the past, but also how someone is functioning now, what they are experiencing and what kind of support they need.

What does EMDR therapy involve?

One distinctive part of EMDR involves recalling a particular memory while paying attention to stimuli presented alternately on either side.

Eye movements are most commonly used. For example, the therapist may ask the person to follow the movement of the therapist’s hand with their eyes.

Depending on the person’s needs and the protocol being used, alternating tactile or auditory stimuli may also be used.

This is known as bilateral stimulation, meaning alternating stimulation on the two sides.

While working with a selected memory, the person notices the images, emotions, thoughts and bodily sensations associated with it.

The therapist follows a structured procedure, monitors emerging responses and helps adjust the pace of the work to the person’s needs.

The aim is to gradually reduce the distress associated with the memory and support a more adaptive way of processing the experience.

Do we know exactly how EMDR works?

Clinical studies support the effectiveness of EMDR for PTSD, but the precise mechanisms behind its effects are still being studied and debated.

One theoretical framework used to explain EMDR is the adaptive information processing (AIP) model.

It proposes that some difficult experiences may be processed in ways that make it harder to connect them with other information and experiences.

The AIP model provides a theoretical foundation for EMDR, but it should not be treated as a definitive explanation of all the mechanisms through which EMDR works.

Researchers are also examining the role of eye movements and the demands placed on working memory when difficult memories are recalled.

Some studies suggest that performing an additional task while recalling an unpleasant experience may influence the emotional intensity and vividness of the memory. This does not, however, fully explain all the effects of therapy [4].

It is worth remembering that EMDR involves much more than eye movements. It is a comprehensive form of psychotherapy that includes assessment, preparation, working with selected experiences and reviewing progress.

What happens during an EMDR session?

EMDR follows a structured process, but this does not mean that everyone moves through its stages at the same pace.

During the first appointments, the therapist gets to know your difficulties, discusses your goals and assesses whether EMDR is suitable for you. She also explains the process and helps you prepare for the work ahead.

When the time is right, you may begin working with selected memories and the emotions and responses linked to them. The therapist guides this process in line with EMDR procedures, monitoring your reactions and adapting the work to your individual needs.

In subsequent sessions, you review together how the intensity of distressing emotions is changing and how these changes are affecting your everyday life.

Do you have to describe a traumatic experience in detail during EMDR?

EMDR usually does not require you to describe every detail of a traumatic event aloud. However, the therapy does involve recalling particular memories and the responses associated with them, which can be emotionally demanding.

The therapist explains the process beforehand and monitors your responses throughout.

EMDR is not hypnosis, nor does it involve losing control of your behaviour.

Who can benefit from EMDR therapy?

The strongest evidence for EMDR concerns the treatment of post-traumatic stress disorder (PTSD).

PTSD can develop after experiencing or witnessing a traumatic event. Characteristic symptoms include recurring memories, avoiding reminders of the trauma, a persistent sense of threat, and changes in emotions or in how someone sees themselves or the world around them.

EMDR may be considered for PTSD following experiences such as violence, assault, a serious accident or other traumatic events.

The approach is also used in psychotherapy to address other distressing memories and the emotional responses associated with them.

However, it is important to distinguish between these uses.

The scientific evidence for EMDR is stronger for PTSD than for many other psychological difficulties.

We therefore cannot assume that it will be equally effective for every type of anxiety, depression, relationship difficulty or chronic stress.

The choice of treatment should be guided by the person’s circumstances, the nature of their difficulties and a professional assessment.

Not everyone who has experienced a painful event needs EMDR. Another form of psychotherapy or psychological support may sometimes be more appropriate.

Is EMDR therapy effective?

The effectiveness of EMDR for PTSD has been investigated in numerous clinical studies.

Their findings suggest that EMDR can lead to a meaningful reduction in post-traumatic stress symptoms.

EMDR is included in international treatment guidelines for PTSD alongside other recommended psychotherapies.

The 2023 US VA/DoD guidelines recommend EMDR, cognitive processing therapy (CPT) and prolonged exposure (PE) as trauma-focused psychotherapies [3].

The UK’s NICE guidelines recommend EMDR in certain circumstances for adults with PTSD or clinically significant PTSD symptoms following non-combat-related trauma. The specific recommendations take account of factors including the time since the event [1].

The World Health Organization also identifies EMDR as a psychological intervention to consider for adults with PTSD. Its 2023 guideline update gives a conditional recommendation based on moderate-certainty evidence [2].

A 2024 review published in the Journal of Traumatic Stress examines findings on the effectiveness of EMDR and the current understanding of how it may work [4].

However, studies vary in quality, and some have methodological limitations.

The available evidence also does not establish that EMDR is consistently more effective than all other recommended trauma-focused psychotherapies.

EMDR can be an effective treatment for PTSD, but it is not right for everyone and does not guarantee a particular outcome.

Treatment decisions should take account of the person’s needs, preferences and clinical circumstances.

How long does EMDR therapy take?

The length of therapy varies depending on factors such as the nature of the difficulties, the number of traumatic experiences, current functioning and progress in treatment.

For adults receiving treatment for PTSD, NICE guidelines indicate that EMDR usually involves 8–12 sessions, although more may be needed in certain clinical circumstances, such as when someone has experienced multiple traumatic events [1].

This is not a fixed number of sessions for everyone.

Different stages of therapy may also take different amounts of time.

Some people need more preparation before beginning to process traumatic memories, while others may be ready to start sooner.

At the beginning of therapy, it is therefore worth discussing your goals, the expected course of treatment and how progress will be reviewed with your therapist.

No one can guarantee that a particular difficulty will be resolved within a set number of sessions.

Is EMDR therapy safe?

EMDR is an established form of psychotherapy, but like other trauma-focused approaches, it can involve temporary emotional discomfort.

Recalling difficult memories can bring up sadness, fear, tension or other intense reactions.

For some people, difficult emotions may also arise between sessions [6].

This is why appropriate preparation, an assessment of current mental health and treatment by a professional with suitable EMDR training are important.

Starting to process traumatic memories immediately is not always the most appropriate approach.

In some circumstances, the priority may be to establish safety, improve stability in everyday life or consider another form of support.

Professional EMDR therapy is not about revisiting the most painful experiences as quickly as possible. Preparation, ongoing assessment and adapting the process to the person’s needs all matter.

When should you consider a consultation?

You do not need to diagnose yourself with PTSD before speaking to a psychologist about the effects of difficult experiences.

A consultation may be a helpful starting point if certain memories still trigger strong emotions, you avoid situations that remind you of the past, or you experience tension that interferes with everyday life.

It is also worth considering whether these difficulties affect your sleep, relationships, work or sense of safety.

Sometimes it is difficult to link the need for support to any one event. You may be more aware of your current difficulties without yet knowing which experiences or factors contribute to them.

During a consultation, you can explore these difficulties with a specialist and consider what type of support may be most appropriate.

This does not mean that EMDR therapy has to begin straight away.

Sometimes the most important first step is simply to understand the difficulties more clearly and identify a goal for further work.

EMDR therapy at Milevia – how can we help?

At Milevia Psychological Clinic in Warsaw, EMDR therapy is provided by Izabela Trojan.

During your first appointments, you can explore the difficulties that led you to seek support, discuss earlier experiences and consider together whether EMDR is a suitable approach.

You do not need a prior PTSD diagnosis or to know which experience to begin with.

What matters is understanding what you are finding difficult now, how it affects your life and what you would like to change.

If you feel that difficult experiences from your past are still affecting your emotions, relationships or everyday life, you can book an appointment with Izabela Trojan at Milevia.

The goal is not to forget the past, but to find ways of living with its effects that can help you feel safer and function better in the present.

Meet Izabela Trojan – a specialist at Milevia

References

[1] National Institute for Health and Care Excellence (NICE). Post-traumatic stress disorder. NICE guideline NG116 (2018). Recommendations on EMDR therapy for adults.

[2] World Health Organization (WHO). Posttraumatic stress disorder (PTSD): Psychological interventions – adults. Updated guidance on psychological interventions (2023).

[3] Department of Veterans Affairs / Department of Defense (VA/DoD). Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (2023).

[4] de Jongh A., de Roos C., El-Leithy S. (2024). State of the science: Eye movement desensitization and reprocessing (EMDR) therapy. Journal of Traumatic Stress, 37(2), 205–216. DOI: 10.1002/jts.23012.

[5] EMDR International Association (EMDRIA). Experiencing EMDR Therapy. Description of the standard EMDR therapy process.

[6] U.S. Department of Veterans Affairs – National Center for PTSD. Eye Movement Desensitization and Reprocessing (EMDR) for PTSD. Patient information on treatment, effectiveness and possible emotional discomfort.