EMDR Therapy for Trauma and PTSD: What to Expect in Treatment

If you've experienced trauma and are researching treatment options, you've likely come across EMDR—Eye Movement Desensitization and Reprocessing. Maybe you've heard it's effective, but you're wondering: What exactly is EMDR? Does it really work? What happens in a session?

This guide will walk you through everything you need to know about EMDR therapy, from how it works to what to expect in your first session.

What Is EMDR Therapy?

EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based psychotherapy approach developed by Dr. Francine Shapiro in 1987. It's specifically designed to help people heal from trauma and distressing life experiences.

How Is EMDR Different from Talk Therapy?

Traditional talk therapy for trauma involves:

• Discussing traumatic events in detail
• Working through emotions verbally
• Building coping skills over time
• Gradual exposure to trauma memories

EMDR takes a different approach:

• Less emphasis on talking through every detail
• Uses bilateral stimulation to help the brain reprocess memories
• Often produces results more quickly than traditional therapy
• Targets how traumatic memories are stored in the brain

The Science: How Does EMDR Work?

Trauma and Memory Storage

When you experience trauma, your brain's normal memory processing can get disrupted. Traumatic memories may get "stuck" in the brain in their raw, unprocessed form. This is why:

• Traumatic memories can feel as vivid and distressing as when they first happened
• Triggers can cause you to re-experience the trauma as if it's happening now
• Your body reacts to reminders with the same fear response
• The memory doesn't feel like it's "in the past"

EMDR's Approach

EMDR uses bilateral stimulation (typically eye movements, but also taps or sounds) while you think about a traumatic memory. This process:

1. Activates both sides of the brain through bilateral stimulation
2. Allows the brain to reprocess the stuck traumatic memory
3. Integrates the memory into your narrative as a past event
4. Reduces emotional charge associated with the memory
5. Strengthens adaptive information to replace negative beliefs

Think of it like this: Your brain has a natural healing process for memories (like how your body heals from a physical wound). Trauma interrupts this process. EMDR restarts and completes that natural healing.

What the Research Shows

EMDR is recognized as an effective treatment by:

• American Psychological Association
• American Psychiatric Association
• World Health Organization
• U.S. Department of Defense
• U.S. Department of Veterans Affairs

Multiple studies show that EMDR can produce significant improvement in PTSD symptoms in fewer sessions than many other trauma treatments.

What Conditions Can EMDR Treat?

Primary Uses

• Post-Traumatic Stress Disorder (PTSD)
• Complex PTSD (from ongoing or multiple traumas)
• Acute trauma (recent traumatic events)
• Birth trauma and difficult childbirth experiences

Also Effective For

• Anxiety disorders
• Panic attacks
• Phobias
• Depression with traumatic roots
• Grief and loss (especially traumatic or complicated grief)
• Childhood abuse or neglect
• Sexual assault and violence
• Attachment trauma
• Medical trauma
• Accident trauma

The 8 Phases of EMDR Therapy

Phase 1: History Taking & Treatment Planning

Your therapist will:

• Take a detailed history of your traumatic experiences
• Assess your current symptoms and distress levels
• Identify target memories to work on
• Create a treatment plan tailored to your needs
• Ensure you're ready for EMDR processing

This phase may take 1-3 sessions.

Phase 2: Preparation

Your therapist will:

• Explain how EMDR works
• Teach you coping skills and relaxation techniques
• Establish a "safe place" visualization
• Practice bilateral stimulation before processing trauma
• Ensure you feel stable enough to begin processing

Purpose: You need to feel safe and have tools to manage distress before working on traumatic memories.

Phase 3: Assessment

For each target memory, your therapist will identify:

• The image that represents the worst part of the memory
• A negative belief about yourself related to the trauma (e.g., "I'm not safe," "I'm powerless")
• A positive belief you'd like to have instead (e.g., "I'm safe now," "I can handle this")
• Emotions and body sensations associated with the memory
• Current distress level (0-10 scale)

Phase 4: Desensitization

This is where the active reprocessing happens:

• You think about the traumatic memory
• Your therapist guides bilateral stimulation (eye movements, taps, or sounds)
• You notice whatever comes up—thoughts, images, sensations, emotions
• The process continues in "sets" until distress decreases significantly

What you might experience:

• Memory becoming less vivid or detailed
• Emotions shifting or lessening
• New insights or perspectives emerging
• Physical sensations releasing
• Different aspects of the memory surfacing

Important: You remain in control. You can ask to stop at any time.

Phase 5: Installation

Once distress is reduced, you focus on strengthening the positive belief:

• You think about the memory and the positive belief simultaneously
• Bilateral stimulation helps "install" this adaptive belief
• The goal is to strengthen this new, healthier perspective

Phase 6: Body Scan

You scan your body for any remaining tension or discomfort:

• Think about the memory and the positive belief
• Notice any physical sensations
• Process any remaining distress until your body feels clear

Phase 7: Closure

At the end of each session:

• Your therapist ensures you feel stable and grounded
• You may use calming techniques learned in Phase 2
• You're prepared for what to notice between sessions
• You leave feeling contained and safe

Phase 8: Reevaluation

At the start of the next session:

• Review progress on previously processed memories
• Assess if additional processing is needed
• Identify new targets if appropriate

What Happens in an EMDR Session?

The Environment

EMDR can happen:

• In-person in a therapy office
• Via telehealth (yes, EMDR works effectively online!)

The Process

1. Check-In (5-10 minutes): How have you been since the last session?

2. Preparation (5-10 minutes): Review the target memory and establish baseline distress.

3. Processing (30-40 minutes):

   • Therapist guides bilateral stimulation (eye movements, tapping, audio)
   • You think about the memory and notice what comes up
   • Minimal talking during processing
   • Regular breaks to share what you're noticing

4. Closure (5-10 minutes): Ensure you feel stable and grounded before leaving.

Bilateral Stimulation Methods

Eye Movements: Following therapist's fingers or a light bar with your eyes

Tapping: Alternating taps on your hands, knees, or shoulders

Audio: Sounds alternating between left and right ears (great for telehealth!)

Self-administration: You can do bilateral stimulation on yourself (butterfly hug, alternate knee taps)

What Does EMDR Feel Like?

During Processing

People describe various experiences:

• "It felt like watching a movie of my memory that gradually faded"
• "I saw the memory but felt less emotional about it"
• "I noticed my body releasing tension I didn't know I was holding"
• "New memories or insights came up that helped things make sense"
• "I felt tired but also lighter"

After a Session

Common experiences include:

• Feeling emotionally or physically tired (processing is hard work!)
• Continued processing of the memory over the next few days
• Dreams related to the trauma (this is normal processing)
• Feeling lighter or experiencing relief
• Noticing triggers that used to bother you don't anymore

Between Sessions

Your brain continues processing:

• Keep a journal of any insights, dreams, or changes you notice
• Use coping skills if needed
• Reach out to your therapist if distress is high

How Many Sessions Will I Need?

This varies significantly based on:

• Single-incident trauma (car accident, assault): May show improvement in 3-6 sessions
• Complex or multiple traumas: May take 12+ sessions
• Childhood trauma: Often requires longer treatment
• Concurrent life stressors: May slow progress

Important: EMDR is not a "quick fix," but it often works faster than traditional trauma therapy.

Is EMDR Right for You?

EMDR May Be a Good Fit If:

✓ You have unprocessed traumatic memories causing distress ✓ Triggers continue to impact your daily life ✓ You experience flashbacks, nightmares, or intrusive memories ✓ You've tried talk therapy but still feel stuck ✓ You prefer less focus on talking through traumatic details ✓ You're willing to experience temporary discomfort for healing

When EMDR May Not Be Appropriate

✗ Active substance abuse (needs to be addressed first) ✗ Severe dissociation (requires preparation work first) ✗ Current crisis or unstable life situation ✗ Certain medical conditions affecting eye movement ✗ Not yet ready to engage with traumatic memories

Your therapist will assess if EMDR is right for you and ensure you're adequately prepared.

EMDR via Telehealth: Does It Work?

Yes! Research shows EMDR delivered via telehealth is just as effective as in-person EMDR.

How Telehealth EMDR Works

Instead of following eye movements:

• Audio bilateral stimulation: Sounds alternate between left and right ears through headphones
• Self-tapping: You tap alternating knees or shoulders
• Visual stimulation: Following a moving object on screen

Many clients actually prefer telehealth EMDR because:

• You're in your own safe, comfortable space
• No commute after emotionally heavy sessions
• Greater accessibility if you live far from specialized trauma therapists

Combining EMDR with Other Treatments

EMDR can be combined with:

• Medication for PTSD or depression
• Other therapy modalities like DBT skills or mindfulness
• Couples or family therapy to address relationship impacts
• Group therapy for connection and support

Common Concerns About EMDR

"Will I have to relive the trauma?"

You'll think about the trauma, but you won't have to describe every detail. The bilateral stimulation actually helps you process it more comfortably than traditional exposure therapy.

"What if I can't remember everything?"

You don't need to remember every detail. EMDR works with whatever memory you have, including fragmented or unclear memories.

"Will I forget the trauma completely?"

No. The goal isn't to erase memories, but to reduce their emotional charge so they feel like "a memory of something that happened" rather than something happening now.

"Is it safe?"

Yes, when conducted by a trained EMDR therapist. There are specific protocols to ensure safety throughout treatment.

Finding an EMDR Therapist

Look for:

• EMDR certification or training (ask about their training level)
• Experience with trauma similar to yours
• Good therapeutic fit (you feel comfortable and heard)
• Telehealth availability if you prefer virtual sessions

In Missouri, New Jersey, and other PSYPACT states, specialized EMDR trauma therapy is available via secure telehealth.

The Path Forward: Healing Is Possible

Living with unprocessed trauma can feel like carrying a heavy weight everywhere you go. EMDR offers a path to:

• Process traumatic memories so they no longer control you
• Reduce triggers and flashbacks
• Find relief from PTSD symptoms
• Reconnect with yourself and others
• Build a life not defined by past trauma

Healing from trauma takes courage. If you're considering EMDR, you've already taken an important step toward reclaiming your life.

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Ready to explore EMDR therapy? If you're in Missouri, New Jersey, or another PSYPACT state, book a free 15-minute consultation to discuss whether EMDR is right for your healing journey.

Learn more: Trauma Therapy & EMDR