What is Eye Movement Desensitization and Reprocessing, or EMDR?
A structured, evidence-based way to help the past feel less present.
Sometimes a painful or frightening experience ends, but your mind and body continue to react as though the danger is still close.
You may logically know that you are safe while still experiencing intrusive memories, nightmares, avoidance, hypervigilance, shame, numbness, or intense physical reactions to reminders of what happened.
Eye Movement Desensitization and Reprocessing (EMDR) is a structured form of psychotherapy designed to help people process distressing experiences and reduce the symptoms connected to them. During parts of EMDR, you briefly focus on selected aspects of a memory while engaging in bilateral stimulation—a guided pattern of alternating left-to-right eye movements, taps, or sounds.
EMDR is not hypnosis, mind control, memory erasure, or a way of forcing you to relive every detail of an experience. You remain awake, aware, and able to pause or stop at any time.
What can EMDR help with?
The strongest and most consistent evidence for EMDR is for post-traumatic stress disorder (PTSD).
PTSD-related concerns may include:
Intrusive Memories • Nightmares • Distress at Reminders • Avoidance • Hypervigilance • Exaggerated Startle • Shame • Guilt • Negative Beliefs • Emotional Numbness • Trauma-Related Physical Reactions
EMDR is also used by some clinicians for other concerns, including anxiety, phobias, grief, pain, and distressing life experiences. However, the research for these uses is not equally strong or established.
What might that look like?
Reprocessing does not mean forgetting what happened or pretending it did not matter. It means helping the memory feel less emotionally intense and less likely to take over your thoughts, body, or behavior in the present.
You may still remember the experience, but it may begin to feel more like:
“That happened to me in the past.”
rather than:
“It feels like it is happening all over again.”
EMDR may also help painful beliefs connected to the experience—such as “I am powerless,” “It was my fault,” or “I am not safe”—shift toward beliefs that feel more accurate and helpful, such as:
“I survived.”
“I have choices now.”
“What happened was not my fault.”
For example, imagine you were involved in a serious car accident. Although the accident is over, brake lights, intersections, or sudden sounds may trigger panic, a vivid image of the crash, tightness in your chest, and the thought:
“I’m not safe.”
You may begin avoiding driving or feeling constantly on alert in a car.
During EMDR, you and your therapist might identify a specific moment or image, the belief connected to it, the emotions and body sensations you notice, and a more adaptive belief you would like to develop. You would then briefly focus on parts of the memory while engaging in short sets of bilateral stimulation. Between sets, your therapist may ask what you notice.
There is no correct response. You might notice an image, thought, emotion, physical sensation, new connection, or very little at all.
Over time, the memory may feel less vivid or overwhelming, and “I’m not safe” may begin to shift toward:
“The accident is over. I survived, and I can respond to what is happening now.”
Therapy is adjusted to your history, needs, reactions, and goals.
What happens during EMDR therapy?
EMDR follows a structured eight-phase process, but we will move through it together at your pace. Trauma processing does not begin until you feel ready.
1. Getting to know your goals
We begin by understanding what brings you to therapy, what you hope will change, and what support you already have. Together, we identify what may be helpful to address.
2. Building safety and preparation
Before processing difficult memories, we practice grounding and calming strategies. We also create a plan for pausing, slowing down, or stopping whenever needed.
3. Choosing a focus
When you are ready, you and your therapist select a memory, trigger, belief, or situation to work with. You do not have to share every detail.
4. Reprocessing
You briefly focus on part of the memory while using bilateral stimulation, such as guided eye movements or tapping. Your therapist will check in regularly and help you stay present.
You may be asked:
“What do you notice now?”
There is no right or wrong response. You simply notice what comes up, without forcing or analyzing it.
5. Strengthening helpful beliefs
As the memory becomes less distressing, you may focus on a belief that feels more accurate and supportive, such as:
“I am safe now.”
“I have choices.”
“It was not my fault.”
6. Checking in with your body
You will notice whether any tension or discomfort remains. If needed, you and your therapist will continue working with it.
7. Ending safely
Each session ends by helping you return to the present, feel grounded, and leave with a plan for the rest of your day. You never have to finish processing a memory in one session.
8. Reviewing your progress
At the beginning of future sessions, you and your therapist will check in about what has changed and decide together what to focus on next.
You are always in control. We will walk through each step together, at a pace that feels safe and manageable for you.
What is bilateral stimulation?
Bilateral stimulation means alternating stimulation from one side to the other.
Depending on your comfort and the format of therapy, this may include:
Following your therapist’s fingers or an on-screen object with your eyes
Alternately tapping your knees, hands, or shoulders
Eye movements are the best-known form, but they are not the only option.
EMDR combines memory recall, focused attention, emotional and cognitive processing, and bilateral stimulation. Researchers continue to study exactly how these components produce change.
What does virtual EMDR look like?
Virtual EMDR follows the same overall eight-phase structure as in-person EMDR. The therapist and client meet through a secure video platform, while bilateral stimulation is adapted for the online setting.
Virtual EMDR is still therapist-guided care. It is not simply watching a prerecorded video or attempting to process traumatic experiences by yourself.
Before reprocessing begins
You and your therapist will first make sure the virtual format is appropriate for you.
This may involve:
Confirming that you have a private, reasonably quiet space
Checking that your internet connection and device are reliable
Positioning your camera so your therapist can see you comfortably
Reviewing grounding and emotional-regulation strategies
Practicing the bilateral stimulation method before using it with a difficult memory
Establishing a plan in case the connection is interrupted
Confirming your physical location and the best way to reach you if needed
Discussing how you will care for yourself following the session
A laptop or tablet placed on a stable surface often works better than holding a phone. Headphones may improve privacy and are useful when alternating audio tones are used.
At the end of the session
Your therapist will help you shift your attention fully back to the present.
You may use grounding exercises, notice the room around you, stretch, breathe, or discuss what would help you transition into the rest of your day. You will also review what to do if additional emotions, memories, or dreams arise between sessions.
Does virtual EMDR work?
The evidence supporting in-person EMDR for post-traumatic stress disorder is well established. Research on virtual EMDR is newer and is still developing.
Virtual EMDR is a promising, evidence-informed option that may work well for appropriately assessed clients when provided by a trained clinician using thoughtful preparation and safety planning.
The VA/DoD guideline also supports secure video delivery of PTSD psychotherapy when the treatment has been validated for videoconferencing or when appropriate in-person options are unavailable.
Is virtual EMDR right for everyone?
Virtual EMDR may be a good fit when you:
Have a private and emotionally safe place to attend sessions
Have a stable internet connection
Feel comfortable meeting through video
Can use grounding strategies with therapist support
Prefer the accessibility or convenience of receiving care from home
Can remain reasonably connected to the present during difficult emotional work
An in-person setting, additional preparation, or another treatment approach may be preferable when someone is experiencing significant dissociation, acute safety concerns, ongoing immediate danger, frequent emotional destabilization, limited privacy, or technology problems that interfere with care.
This does not mean that someone is “too complicated” for EMDR. It may simply mean that the safest pace, setting, or starting point needs to be different.
The decision should be individualized rather than based on a diagnosis alone.
What makes EMDR evidence-based?
EMDR has been evaluated in randomized trials, systematic reviews, and clinical practice guidelines for PTSD.
Different guideline organizations grade the evidence somewhat differently:
The 2023 VA/DoD Clinical Practice Guideline gives a strong recommendation for EMDR, Cognitive Processing Therapy, and Prolonged Exposure as individual, manualized, trauma-focused treatments for PTSD.
The United Kingdom’s National Institute for Health and Care Excellence recommends offering EMDR to many adults with PTSD or clinically important PTSD symptoms.
The American Psychological Association’s 2025 guideline includes EMDR among its suggested, or conditionally recommended, interventions for adult PTSD.
These differences reflect how each organization evaluates and grades studies. They do not mean that EMDR lacks evidence. They do mean that responsible explanations should avoid describing any therapy as guaranteed, universally superior, or appropriate for every person.
What are the possible risks or discomforts?
EMDR can bring painful memories, emotions, beliefs, or physical sensations into awareness. Some people experience temporary discomfort during processing.
Your therapist should monitor your reactions, prepare you with grounding strategies, adjust the pace, and help you return to the present before the session ends. Most discomfort is brief, but your experience should never be dismissed or rushed.
You are encouraged to tell your therapist when:
The process feels too intense
You feel numb, disconnected, or far away
You are having difficulty staying present
A bilateral stimulation method feels uncomfortable
You need to slow down or stop
Something about the process does not feel right
Effective trauma therapy depends on safety, trust, collaboration, and honest communication—not on pushing through at all costs.
Want more?
Contact me through the button below or email me at anna@goldenhourcounselingnc.com
Read more here:
These resources include information relevant to depression and depressive disorders, anxiety and associated disorders, stress related disorders , trauma from sexual assault, domestic violence, childhood abuse or neglect, adverse childhood experiences, accidents, disasters, medical experiences, community violence, and other non-military events. If you are currently experiencing domestic or sexual violence, consider using a safer device or private browser when seeking help. In an immediate emergency, contact local emergency services.
These resources are for general educational purposes and are not a substitute for individualized mental health care.