EMDR

What is EMDR?

EMDR, Eye Movement Desensitisation and Reprocessing, is a structured talking therapy that helps the brain process distressing memories that have become stuck. It was developed specifically for trauma and is now one of the two therapies NICE recommends for post-traumatic stress disorder, alongside trauma-focused cognitive behavioural therapy.

Most people come to EMDR because a memory still feels present rather than past. A car accident, a difficult birth, a bereavement or a period of abuse can leave the nervous system on alert long after the event has ended. EMDR does not ask you to relive the event in detail or talk it through session after session. Instead, it works with how the memory is stored, using structured attention and bilateral stimulation, typically eye movements, to help the brain file the memory as something that happened rather than something that is still happening.

How EMDR works

The theory behind EMDR is called adaptive information processing. In simple terms, the brain usually processes difficult experiences over time, so they lose their emotional charge and settle into ordinary memory. Trauma can interrupt that process. The memory stays raw, along with the images, body sensations, beliefs and emotions attached to it, and can be triggered by reminders that have nothing directly to do with the original event.

During EMDR, you bring a specific memory to mind while following a side-to-side stimulus, usually a moving light or sound delivered through headphones on a video call, or in some cases guided eye movements on screen. This dual attention, holding the memory while also tracking something in the present, appears to support the brain’s own reprocessing system. Over a series of short sets, the memory typically becomes less vivid and less distressing, and unhelpful beliefs that grew up around it, such as ‘it was my fault’ or ‘I am not safe’, tend to shift towards something more accurate.

What EMDR sessions look like online

Sessions take place over video call at a time you have arranged in advance, from wherever you have a private, stable connection. In the early sessions, your psychologist will take a full history, explain the approach and help you build some grounding and stabilisation skills before any reprocessing work begins. This groundwork matters. EMDR is not started on a first session.

For the eye movement or tapping element, most people use headphones for bilateral sound, or watch a moving point on screen, and your psychologist will check what works best for you. Some sessions focus entirely on stabilisation and coping strategies, particularly if daily life feels unsettled at the moment. Reprocessing sessions are usually a little longer than a standard fifty-minute hour, to allow enough time to reach a stable point before ending.

The phases of an EMDR session

EMDR follows an eight-phase structure, developed by its originator, Francine Shapiro. The early phases cover history-taking and preparation, including agreeing which memories to target and building resources such as a calm place and grounding techniques. The middle phases are where reprocessing happens: identifying the image, belief, emotion and body sensation connected to the memory, then working through sets of bilateral stimulation until the distress has reduced. Later phases install a more helpful belief in place of the old one, check the body for any remaining tension connected to the memory, and close each session so you leave in a settled state. A final phase, usually revisited briefly at the start of later sessions, checks that progress has held.

How many sessions people typically need

This varies with the type of memory involved. A single, well-defined traumatic event, such as one accident or one assault, might be worked through in six to twelve sessions. Complex or repeated trauma, such as childhood experiences that unfolded over years, generally takes longer, because there is more material to work through and more groundwork needed before reprocessing begins. Your psychologist will give you a clearer estimate once they understand your history, rather than a generic number applied to everyone.

The evidence for EMDR

EMDR has a substantial evidence base for post-traumatic stress disorder and is recommended by NICE for adults with PTSD, alongside trauma-focused CBT. The World Health Organization has also recognised it as an effective trauma treatment. Its evidence base for other presentations, such as specific phobias or the aftermath of a single distressing medical event, is less established but growing, and it is sometimes used as part of a wider treatment plan for these.

Is online EMDR safe and effective?

Delivering EMDR by video call is now well established. Research comparing online and in-person EMDR has generally found similar outcomes, and many clinicians moved their EMDR practice online during and after the pandemic without a drop in effectiveness. The key safety consideration is less about the video link itself and more about pacing: a psychologist trained in EMDR will build in enough stabilisation and will check in carefully during and after reprocessing, so that sessions end with you feeling settled rather than activated. You will usually be asked to plan something low-key after a reprocessing session, since some emotional processing can continue quietly for a day or two afterwards.

Who EMDR helps

EMDR is used most often for post-traumatic stress disorder, but it can also help with distressing memories that fall short of a full PTSD diagnosis, including difficult birth experiences, road traffic accidents, workplace incidents, bereavement complicated by trauma, and some forms of childhood adversity. You do not need a formal diagnosis to benefit from it. If a specific memory or set of memories still feels raw or intrusive, that is usually enough reason to explore whether EMDR is a reasonable option.

Who EMDR may not suit, or not suit yet

EMDR is not usually the first approach offered where someone is in the middle of a crisis, is misusing substances in a way that is not yet stable, or has significant dissociation that has not been assessed. In these situations, a period of stabilisation work, sometimes with a different approach, tends to come first. EMDR also asks you to bring memories to mind, even briefly, so it requires a degree of readiness. Your psychologist will assess this with you rather than assuming EMDR is right from the outset.

EMDR compared with trauma-focused CBT

Both EMDR and trauma-focused CBT are recommended by NICE for PTSD, and the choice between them often comes down to personal fit rather than one being stronger than the other. Trauma-focused CBT typically involves more direct discussion of the traumatic memory and structured written or verbal work on the thoughts connected to it. EMDR relies less on verbal description and more on the bilateral stimulation process, which some people find easier when talking about the event in detail feels too much. Neither is a lesser option. A psychologist can talk through which might suit your situation better.

Getting started with EMDR

We are clinical psychologists for Brighton and East Sussex, working online with adults, covering the city from the seafront and the Lanes up through BN1 and BN2, and out to Hove, Kemptown, Preston Park, Hanover, Withdean and Portslade. If you are unsure whether EMDR is the right approach for what you are carrying, an initial conversation with a psychologist is the way to find out, rather than trying to work it out alone in advance. We will update this site as the practice develops.

If you are having thoughts of suicide or self-harm, or need support right now, contact the Samaritans free, any time, on 116 123. This is not a crisis service and cannot respond immediately in an emergency.