EMDR: What is it and how does it work?

From medication to cognitive therapy, doctors have been attempting to treat PTSD for over 100 years. Prior to its official diagnosis in 1980, it has been referred to as “shell shock” or “soldier's heart” following the increasing numbers of cases after World War II and the Vietnam War. Initially, patients were being treated with antidepressants or anxiety management techniques, but these processes often did not have a long term effect on the patient. This changed in 1987.

Franice Shapiro was walking in the park when she noticed that eye movements helped her associate less negative emotion with traumatic events in her life. She decided to conduct a series of studies to investigate her hypothesis, which lead to her development of Eye Movement Desensitization and Reprocessing (EMDR) (1). 

EMDR therapy aims to target trauma in a more natural way than other therapies (2). Currently, the recommended interventions used to treat PTSD are psychotherapies such as Cognitive Behavioural Therapy (CBT), or if needed, medications (paroxetine or sertraline) (3). Cognitive psychotherapies include sessions with a mental health professional where the patient talks to their psychologist or counselor, aiming to understand their behaviours and learn new, healthy coping mechanisms to regulate their emotions (4). This might arise as an issue for people who are less likely to open up to a therapist, or find it extremely hard to talk about their trauma. The drugs used to treat PTSD are selective serotonin reuptake inhibitors (SSRIs), however studies show that they only work in short term trials as the patient continuously takes the medication (5).

EMDR focuses on addressing emotions associated with a traumatic memory and reprocessing them into new, stable feelings. By concentrating on certain traumatic memories, they were able to overcome their trauma in the long term (6). But how does it really work? 

EMDR consists of 8 phases (7):

Phase 1:

During the first phase, a therapist assesses the patient and their need for therapy or another intervention. This helps determine if EMDR is the right fit and if the patient is ready. 

Phase 2: 

The therapist will ensure that the patient has healthy ways of coping with stress that can be used in between sessions. These may be taught by the therapist or already implemented by the patient. 

Phases 3-6:

Once the therapist identifies a memory that the patient can focus on, the EMDR sessions begin. The patient is asked to identify a visual image associated with the memory and a negative emotion they feel when they think of said memory. The patient is instructed to focus on that memory as the therapist begins to move their fingers back and forth in front of the patient's eyes. After each session, the patient is asked to notice their feelings to do with the memory that is being assessed. Depending on the answer, the therapist will then change the subject of distressing memories. 

Phase 7:

The penultimate phase includes the patient keeping a log of related emotions or issues that may arise after the therapy. 

Phase 8: 

This phase examines the progress that the patient has made post-therapy. 

The bilateral eye movement can be used to stimulate both hemispheres of the brain, allowing for easier integration of the memory and reprocessing by the patient (8). This causes EMDR to be very effective, very quickly. One study showed that up to 90% of the patients were cured after just 3 90-minute sessions of EMDR (9). While others show that it can treat PTSD when administered over just a 3 month period (10).

EMDR is a very promising and efficient therapy for patients struggling with PTSD, but also other mental health disorders such as depression, anxiety, and many others. It opens up a new perspective in the world of psychotherapies which allows patients who struggle with speech or accessing trauma to heal. Hopefully in the near future, with further research on PTSD and EMDR the therapies can be developed to become even more successful. 

Bibliography

1. History of EMDR. EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (2024a, January 3). https://www.emdr.com/history-of-emdr/#timeline 

2. Cleveland Clinic medical. (2024, May 1). EMDR therapy: What it is, Procedure & Effectiveness. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy

3. Murray B. Stein, & Barbara O. Rothbaum. (2018, June 1). 175 years of progress in PTSD therapeutics: Learning from the past. American Journal of Psychiatry. https://psychiatryonline.org/doi/10.1176/appi.ajp.2017.17080955 

4. Cleveland Clinic medical. (2025, January 24). Cognitive behavioral therapy (CBT): What it is & techniques. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt 

5. Gregory M. Asnis, Shari R. Kohn, Margaret Henderson, & Nicole L. Brown. (2012, September 17). SSRIs versus non-ssris in post-traumatic stress disorder: An update with recommendations. https://pubmed.ncbi.nlm.nih.gov/14969574/#:~:text=These%20studies%20have%20demonstrated%20that,12%20months%20decrease%20relapse%20rates. 

6. van der Kolk, B. (2014). The body keeps the score . Penguin Random House Audio Publishing Group. 

7. What is EMDR?. EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (2024b, December 3). https://www.emdr.com/what-is-emdr/ 

8. How does emdr work?. PTSD UK. (2025). https://www.ptsduk.org/how-does-emdr-work/#:~:text=It%20is%20believed%20that%20EMDR,right%20side%20of%20the%20brain 

9. How effective is EMDR. PTSDUK. (2025)https://www.ptsduk.org/how-effective-is-emdr/#:~:text=Research%20has%20shown%20that%20EMDR,only%203%2090%2Dminute%20sessions.

10. Danielle Beauvais, PhD, Elissa McCarthy, PhD, Sonya Norman, PhD, & Jessica L. Hamblen, PhD. Eye Movement Desensitization and Reprocessing (EMDR) for PTSD. (2023, July 18) https://www.ptsd.va.gov/professional/treat/txessentials/emdr_pro.asp#:~:text=A%20large%20number%20of%20studies,for%20the%20treatment%20of%20PTSD.