What Is EMDR Therapy? A Plain-English Guide
If you have been searching for help with trauma, anxiety or memories that still feel raw, you have probably come across EMDR. It is one of the most researched therapies for trauma, yet the name puts a lot of people off before they get any further. So here is a plain-English guide to what it is and what it is actually like to do.
What does EMDR stand for?
EMDR stands for Eye Movement Desensitisation and Reprocessing. It was developed in the late 1980s by the American psychologist Francine Shapiro, and it is now recommended by NICE and the World Health Organization as a treatment for post-traumatic stress disorder, it is also now used within the NHS.
The name is a bit of a mouthful, and the eye movements are only one part of it. At its heart, EMDR is a structured way of helping your brain finish processing experiences that got stuck.
Why do some memories stay stuck?
Most of the time, your brain files experiences away without you noticing. Something difficult happens, you think about it, talk about it, sleep on it, and gradually it becomes part of your history rather than something you keep reliving.
When something is overwhelming, that filing process can stall. The memory gets stored with the original emotions, body sensations and beliefs still attached. That is why a smell, a tone of voice or a particular kind of argument can make you feel the way you felt back then, even years later. You know logically that you are safe, but your body has not caught up.
EMDR is designed to help the brain pick that processing back up, so the memory loses its charge and takes its place in the past.
What happens in an EMDR session?
EMDR follows eight phases. You do not need to remember them, but it helps to know there is a clear structure, and that you are never thrown in at the deep end.
History and planning: we talk about what has brought you to therapy, what you want to be different, and which memories or patterns are worth working on.
Preparation: before touching anything painful, we build ways for you to calm and steady yourself, such as a calm place exercise or grounding techniques you can also use between sessions.
Assessment: we choose a target memory and identify the image, the negative belief that goes with it (for example "I am not safe" or "it was my fault"), the emotions, and where you feel it in your body.
Processing: you briefly hold the memory in mind while following bilateral stimulation, which might be side-to-side eye movements, alternating taps or sounds. You then notice whatever comes up, and we repeat in short sets.
Installation, body scan and closure: once the distress has come down, we strengthen a more helpful belief, check for any leftover tension in the body, and make sure you leave the session feeling settled.
Re-evaluation: at the start of the next session we check what has shifted and what still needs attention.
Do I have to talk about everything in detail?
No, and this surprises a lot of people. Unlike some talking therapies, EMDR does not require you to describe a traumatic event in full detail, out loud, over and over. You stay in charge of how much you share, and many clients find this makes the work feel far more manageable.
What does it feel like?
People describe processing in different ways. Some notice images shifting or fading. Some find new memories or connections appearing. Some feel emotions or body sensations rise and then settle. Others notice very little during the session and only realise afterwards that a memory no longer bothers them in the same way.
It can be tiring, and it is normal to feel a bit wrung out afterwards. That is why preparation and closure are taken seriously.
How does EMDR actually work?
Researchers are still debating the exact mechanism. One leading idea is that holding a memory in mind while doing a demanding task, like following eye movements, taxes your working memory and makes the memory less vivid and less emotional. Another links EMDR to memory reconsolidation, where a memory becomes open to updating each time it is recalled. If you want to go deeper, I have written more about this in my post on the neuroscience of EMDR.
What does the research say?
EMDR has been tested in a large number of randomised controlled trials, particularly for post-traumatic stress. In the UK, NICE recommends it for adults with PTSD, and the World Health Organization recommends it internationally. Research into its use for other difficulties, such as anxiety, phobias and depression linked to painful experiences, is growing, although it is not yet as extensive as the evidence for trauma.
Who can EMDR help?
EMDR is best known as a treatment for PTSD, including after accidents, assaults, medical trauma or difficult births. It is also used for anxiety, phobias, panic, grief, low self-worth and the long shadow of difficult childhood experiences. I cover this in more detail in my post on what else EMDR can help with.
Can EMDR be done online?
Yes. I offer EMDR in person in Solihull and online, for clients across the UK and internationally. Online sessions use eye movements on screen or self-tapping, and many people find them just as effective, with the added comfort of being in their own space.
Frequently asked questions
Is EMDR safe?
EMDR is a well-established therapy with a good safety record when delivered by a properly trained therapist. Processing difficult memories can bring up strong feelings, and some people notice vivid dreams, tiredness or memories surfacing between sessions. This is usually temporary, and it is why preparation and grounding come first.
Can EMDR make things worse?
It is common to feel stirred up for a day or two after processing, but EMDR should not leave you worse off overall. A good therapist will pace the work, check in on how you have been between sessions, and slow down or return to stabilisation if needed. If you are in crisis or your life feels very unstable right now, processing may need to wait.
How is EMDR different from talking therapy?
Talking therapy works mainly through conversation, reflection and the relationship with your therapist. EMDR uses a structured protocol to target specific memories directly. As an integrative counsellor, I often combine the two: talking helps us understand the pattern, and EMDR helps shift the memories that drive it.
Do I need a diagnosis to have EMDR?
No. You do not need a PTSD diagnosis or a referral. Many people come simply because something from their past still affects how they feel, react or see themselves today.
What if I cannot remember the event clearly?
That is fine. EMDR works with whatever is stored, which might be an image, a feeling, a body sensation or a vague sense of something. You do not need a complete or detailed memory for processing to help.
Is EMDR right for me?
The best way to find out is to talk it through. A first conversation is a chance to ask questions, get a feel for how I work, and decide together whether EMDR, talking therapy or a mix of both is the best fit.
If you would like to find out more you can get in touch here.
