​Eye Movement Desensitization and Reprocessing (EMDR) therapy is a structured psychotherapy approach used to address psychological distress associated with traumatic or highly stressful life experiences. EMDR was developed by Francine Shapiro in the late 1980s, and the first scientific study evaluating the approach was published in 1989 (Shapiro, 1989).

Today, EMDR is recognised as one of several evidence-based psychotherapies for the treatment of Post-Traumatic Stress Disorder (PTSD).

EMDR is not simply a technique involving eye movements. It is a comprehensive psychotherapy model that includes assessment of the person’s history, current symptoms, psychological resources, safety and readiness for treatment.

Standard EMDR therapy consists of eight phases:

1. History taking and treatment planning

2. Preparation

3. Assessment

4. Desensitisation

5. Installation

6. Body scan

7. Closure

8. Re-evaluation

The duration and pace of each phase may vary depending on the individual’s needs, age, trauma history, current circumstances and clinical presentation.

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What Happens During EMDR Therapy?

During the reprocessing phases of EMDR therapy, the client is invited to briefly focus on selected aspects of a distressing memory while simultaneously engaging in bilateral stimulation.

Bilateral stimulation commonly involves therapist-guided side-to-side eye movements. In some cases, alternating tactile stimulation or auditory tones may also be used.

The client may be asked to notice different elements connected to the memory, including:

• Images or sensory impressions

• Negative beliefs about the self

• Emotions

• Physical sensations

• Changes that arise during the processing

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The therapist carefully monitors the client’s responses, structures the process and supports the client in noticing changes between each set of bilateral stimulation.

The aim of EMDR therapy is not to erase memories or make the person forget what happened. Rather, it aims to reduce the intense emotional and physical distress associated with the memory, support the development of more adaptive perspectives and decrease the disruptive influence of past experiences on the person’s present life.

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The Adaptive Information Processing Model

EMDR therapy is guided by the Adaptive Information Processing model (AIP).

According to the AIP model, human beings have a natural capacity to process experiences, make meaning from them and integrate them into existing memory networks. However, some traumatic or overwhelming experiences may not be fully processed at the time they occur.

As a result, elements of the experience—including images, thoughts, emotions and physical sensations—may remain stored in a distressing and insufficiently integrated form.

Although the event occurred in the past, present-day situations may activate these memory networks. When this happens, the person may feel as though they are once again in danger, helpless, powerless, responsible or unworthy.

EMDR therapy aims to facilitate the processing of these memories and help them connect with more adaptive information and experiences.

The AIP model is a theoretical framework that guides EMDR case formulation and treatment. However, its assumptions should not be presented as fully established neurological facts. The model and the neurobiological processes associated with EMDR continue to be investigated through scientific research (Solomon & Shapiro, 2008).

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How Does EMDR Therapy Work?

The mechanisms through which EMDR produces therapeutic change are not yet fully explained by one single neurological or psychological process.

Several possible mechanisms have been investigated, including:

• Working memory processes

• Dual attention

• The orienting response

• Emotional regulation

• Memory reconsolidation

• Changes in the vividness and emotional intensity of distressing memories

 

One of the most extensively studied explanations is the working memory hypothesis.

Holding a distressing memory in mind while simultaneously performing another task, such as following side-to-side eye movements, places demands on the limited capacity of working memory. This may reduce the vividness and emotional intensity of the memory.

Research and meta-analyses suggest that eye movements can contribute to reductions in the emotional intensity and vividness of distressing memories (Lee & Cuijpers, 2013).

However, the effectiveness of EMDR therapy cannot be attributed solely to eye movements. The therapeutic relationship, structured treatment protocol, controlled attention to traumatic memories, preparation, emotional regulation and meaning-making processes are also important components of the therapy.

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What Conditions Is EMDR Used For?

The strongest scientific evidence for EMDR therapy relates to the treatment of Post-Traumatic Stress Disorder and trauma-related symptoms.

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The World Health Organization identifies EMDR as one of the psychological interventions that may be considered for adults with PTSD. In its 2023 guidelines, the recommendation was classified as conditional and supported by moderate-certainty evidence.

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The United Kingdom’s National Institute for Health and Care Excellence recommends offering EMDR to adults with a diagnosis of PTSD, or clinically important symptoms of PTSD, following non-combat-related trauma that occurred more than three months earlier.

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Recommendations for children and adolescents are more cautious and depend on factors such as the child’s age, the nature of the trauma, the time that has passed since the event and the response to trauma-focused cognitive behavioural therapy.

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The NICE guideline was originally published in 2018 and reviewed again in April 2025.

The American Psychological Association’s 2025 clinical practice guideline for adults with PTSD also includes EMDR among the recommended psychological treatments.

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A 2024 systematic review and individual participant data meta-analysis found no statistically significant differences between EMDR and other structured psychological treatments in relation to reductions in PTSD symptoms, treatment response, remission or treatment dropout.

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These findings indicate that EMDR is an effective psychotherapy option for PTSD. However, the available evidence does not establish that EMDR is superior to all other evidence-based trauma-focused therapies in every situation (Wright et al., 2024).

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EMDR has also been studied in relation to other psychological and physical health difficulties, including:

• Anxiety disorders

• Depression

• Grief-related difficulties

• Phobias

• Chronic pain

• Other trauma-related psychological symptoms

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However, the quality, quantity and consistency of evidence are not the same across all these areas.

It would therefore be scientifically inaccurate to describe EMDR as an established first-line treatment for every psychological disorder. At present, the strongest evidence and the clearest international guideline support relate to PTSD and trauma-related symptoms.

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Is EMDR Therapy Safe?

EMDR should be provided by a qualified mental health professional who has completed appropriate EMDR training and who practises within their professional scope of competence.

Before beginning trauma reprocessing, the therapist should conduct a comprehensive clinical assessment and consider factors such as:

• Current safety and stability

• Emotional regulation capacity

• Trauma and attachment history

• Dissociative symptoms

• Psychological and interpersonal resources

• Current life circumstances

• Readiness for trauma-focused work

 

Not every client begins memory reprocessing immediately.

For individuals with prolonged, repeated, developmental or interpersonal trauma histories, the preparation and stabilisation phases may need to be longer. The pace of therapy and the protocols used should be adapted to the individual’s needs and clinical presentation.

During or following an EMDR session, some memories, emotions, dreams or physical sensations may temporarily become more noticeable. For this reason, EMDR should not be reduced to the use of eye movements alone.

It should be understood as a comprehensive psychotherapy process that includes clinical assessment, treatment planning, preparation, reprocessing, closure and ongoing evaluation.

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Important Information

The information provided on this page is intended for general educational purposes only. It is not a substitute for an individual psychological assessment, diagnosis or treatment.

Whether EMDR therapy is appropriate for a particular person should be determined following a comprehensive assessment conducted by a qualified mental health professional who has received recognised EMDR training.

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References

American Psychological Association. (2025). Clinical practice guideline for the treatment of posttraumatic stress disorder in adults.

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Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, 1395. https://doi.org/10.3389/fpsyg.2018.01395

 

Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry, 44(2), 231-239. https://doi.org/10.1016/j.jbtep.2012.11.001

 

National Institute for Health and Care Excellence. (2018; reviewed 2025). Post-traumatic stress disorder: NICE guideline NG116.

 

Shapiro, F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 20(3), 211–217. https://doi.org/10.1016/0005-7916(89)90025-6

 

Solomon, R. M., & Shapiro, F. (2008). EMDR and the Adaptive Information Processing Model: Potential mechanisms of change. Journal of EMDR Practice and Research, 2(4), 315–325. https://doi.org/10.1891/1933-3196.2.4.315

 

World Health Organization. (2023). Mental Health Gap Action Programme – mhGAP guideline for mental, neurological and substance use disorders.

 

Wright, S. L., Karyotaki, E., Cuijpers, P., et al. (2024). EMDR v. other psychological therapies for PTSD: A systematic review and individual participant data meta-analysis. Psychological Medicine, 54(8), 1580–1588. https://doi.org/10.1017/S0033291723003446