A Comprehensive Guide for EMDR Therapy

EMDR Therapy

Eye Movement Desensitization and Reprocessing (EMDR) is an extensively researched treatment modality for trauma and PTSD developed in the 1980s by Dr. Francine Shapiro. EMDR has also been known to treat symptoms of anxiety, depression, OCD, addictions, or phobias. EMDR is different from other therapy forms due to its unique and structured approach. It works with the brain's neurophysiology of memory to bring our present awareness to past experiences. It is important for individuals interested in EMDR treatment to foster curiosity, open-mindedness, and hope for positive change. EMDR must be offered by properly trained and licensed mental health clinicians. This blog will explore the origins, mechanisms, benefits, applications, and misconceptions of EMDR therapy.

An attentive, highly trained therapist will guide you through your journey to wellness in EMDR treatment.

Origins

In 1987, Dr. Francine Shapiro was walking through a park when she unexpectedly noticed that while she thought of a distressing event, her eyes began to move back and forth. Intrigued, she began to research the movements. She discovered that the movements of her eyes made the distressing experience more tolerable as her negative thoughts disappeared and were no longer upsetting. She took this newfound knowledge to her research and soon discovered that this could be an effective treatment for those diagnosed with PTSD. This sparked interest and ongoing research in the psychological community (Shapiro, 2017). 

EMDR Model

As a whole, EMDR is now seen as an effective treatment for individuals to reprocess traumatic memories and reframe negative beliefs associated. The therapy follows an eight-phase protocol to ensure safety, structure, and efficacy:

1. History-Taking and Treatment Planning: The therapist gathers information about the client’s history and identifies target memories for processing. In this phase, the client and therapist understand how past experiences have influenced present-day behaviors, emotions, or thoughts. Here, the therapist explores the client's needs and existing resources.

2. Preparation: The client learns coping strategies and relaxation techniques to manage emotional distress. The therapist is responsible for setting the client up for the most success in managing uncomfortable emotions that may arise. 

3. Assessment: The therapist identifies specific aspects of the traumatic memory, including images, beliefs, emotions, and physical sensations. The therapist will then take baseline measures that will help them later understand how the therapy was effective. 

4. Desensitization/Reprocessing: Using bilateral stimulation such as eye movements, tactile tapping, or auditory tones, the client focuses on the memory while the therapist guides them through the process. Imagine it like having one foot in the past and one foot in the present. This phase aims to reduce the emotional charge associated with the memory. While the research is based on eye movements, other forms of stimulation are found to be just as effective. 

5. Installation: In this phase, the therapist guides the client through replacing negative beliefs with positive beliefs, helping the client develop a healthier perspective.

6. Body Scan: The therapist checks for residual physical tension linked to the memory and processes it as needed. This is done to ensure that the client has fully reprocessed the memory. The body will tell the client and therapist what remains. 

7. Closure: The session ends with techniques to ensure the client feels stable and grounded. While reprocessing cannot always be completed within one session, the therapist will use closure at the end of each session to ensure the client has the most success once leaving the therapy office, as processing will likely continue. Some forms of coping might include guided imagery, debriefing, or other useful relaxation techniques.

8. Reevaluation: At the start of subsequent sessions, the therapist assesses progress and addresses remaining issues. If the memory reprocessing is not complete, the therapist will begin at step 3 in each session until the memory is complete.

This process may be completed for more than one memory, but each memory is targeted individually. The therapist can teach skills to help the client differentiate between memories being worked on. The process may be paused at any time based on client discretion. However, it is important to continue memory work as soon as possible to maintain effectiveness. 

The Science

EMDR follows the Adaptive Information Processing (AIP) model – a theory about how the brain processes and links memories. This model helps us understand how the past can inform the present. It has been found that when an individual undergoes a stressful or traumatic event without proper regulation, the memory is considered to be “frozen in time,” causing the brain to store the event maladaptively. This model functions similarly to how a physical injury is healed: the brain and body work together to close and heal a wound after a cut. However, if a foreign object blocks the healing process, the pain continues, and the cut cannot fully heal. Once the block is removed, the natural process may take over again (EMDRIA, n.d.). With memories and emotions, the body is healing you from the inside out, as if your nervous system has cuts in it that are blocked by negative beliefs and distress.

EMDR allows your body to do now what couldn't be done during the time of the event. Through the process, the client focuses on memory while simultaneously applying bilateral stimulation. Bilateral stimulation activates both sides of the brain and nervous system using eye movements, or tactile or auditory stimulation. It is hypothesized that the deliberate eye movements used in EMDR mimic the brain's natural processing during Rapid Eye Movement (REM) sleep, which is the stage of sleep in which dreams occur (Shapiro, 2014). 

Example

Carly, a 17-year-old girl, is driving home from school in January. Unexpectedly, she notices a car swerving into her lane of traffic only a ¼ mile from her driveway. With little time to react, Carly decides to move out of the way as much as possible by driving into the right embankment. Carly’s car crashes into the snowbank when suddenly the oncoming car flies at her with impact and bounces back into the highway. Carly examined herself for injuries and then went to help others involved in the accident. Carly calls emergency responders and then decides to call her father. 

Carly’s father meets her at the scene and puts her in his warm truck. He assures her that he is only concerned about her safety and does not care about the damage to the car. After hearing how the events occurred from the police, her father understands that Carly did not cause this. Carly hesitantly approaches driving after this experience, but ultimately can drive again with more caution toward other drivers. 

Now, if we pretend that Carly’s father had responded with blame and shame. He blames Carly for the accident and insists that she is a bad driver. Carly likely might not be able to drive again due to the way her nervous system responds to the lack of support from her father. The memory becomes stored in the brain as a traumatic memory, and Carly might adopt negative beliefs about herself, such as “I am not safe” or “I am a bad person.” Carly might experience somatic symptoms when in a vehicle, such as shaking, sweating, a racing heart, or racing thoughts. The experience of being shamed overwhelms the information processing system. 

Years later, through EMDR, Carly and her therapist hope to create a more adaptive understanding of this incident. Carly can understand that her father’s reaction caused her to adopt negative beliefs about herself and develop a worse fear of driving. Carly understands that two things can be true at the same time. Her father responded out of fear because he worried so deeply for his daughter's safety, but he also caused her significant distress. With this understanding, Carly can reprocess the event in a safe and supportive environment as an adult.

As Carly works through her trauma as an adult, her childhood self finally gets to heal and grow to her full inner potential.

Misconceptions about EMDR

Due to its unique approach, EMDR is often misunderstood, and clients may have many questions regarding the process. The following are some common misconceptions that tend to surround Eye Movement Desensitization and Reprocessing: 

1. EMDR is like hypnosis

EMDR and hypnosis work entirely differently. Hypnosis is a type of mind-body medicine that puts the client in a deeply relaxed and focused state (Hypnosis: What It Is, Why It's Done, Benefits & Risks, 2022). During EMDR, you are aware of your surroundings and in control of when the process begins or ends. While bilateral stimulation may remind you of hypnosis, they are not the same. Extensive research proves bilateral simulation to be effective. 

2. EMDR only works for PTSD

Traumatic events don't always result in a PTSD diagnosis, and everyone perceives trauma differently based on how it affects the person individually. EMDR allows your brain to store those memories functionally (Guy, 2023). EMDR is an effective treatment for a broad range of diagnoses, including anxiety, depression, OCD, phobias, etc. 

3. EMDR will make me remember things I do not want to face

EMDR only works with memories that exist in your mind now. Your brain can not create memories that are not already there. 

4. I won't be able to control my emotions 

Through EMDR therapy, the client is in control of when the treatment begins or ends. Proper protocols will be established with each client individually. 

The clinician is trained to adequately prepare you with coping skills to manage any discomfort that may arise. While our body's sole purpose is to protect us from discomfort, it is important to learn how to trust ourselves, the therapist, and the ability to cope appropriately. 

Often with EMDR, it is found that individuals who have experienced immense adverse experiences seldom had the support or resources necessary to store the memories adaptively. Hence why they tend to remain an issue for some. While it may be a new and difficult experience for the client to express their emotions with someone, it is the healthiest avenue toward healing. 

Dr. Jill Taylor, a neuroscientist, explains that “When a person reacts to something in their environment, there’s a 90-second chemical process that happens in the body; after that, any remaining emotional response is the person choosing to stay in that emotional loop (Stone, 2019).” Through that 90-second reaction, the client will be there with you the whole time to help support and regulate the body back to baseline. 

5. EMDR will make me lose my personality

Sometimes, clients fear that the changes happening through EMDR will make them lose aspects of their personality. Often, through EMDR, clients begin to understand the natural defenses that have helped them cope with potentially negative emotions in the past. This can present as humor/laughter, shutting down, etc. Eye Movement Desensitization and Reprocessing therapy can only take away what was not meant to be within you in the first place. Again, two things can be true at the same time. Individuals can heal and still be unique. 

6. EMDR shouldn't be used on pregnant women 

A blog from emdria.org by Bethany Warren, LCSW, PMH-C, highlights that there is no evidence to support concerns for pregnant women engaging in EMDR therapy. Research has shown that pregnant clients receive many of the same benefits as any other client, including decreased PTSD symptoms, decreased fears of childbirth, less intrusive thoughts, and increased confidence. During pregnancy, a woman is most susceptible to miscarriage during the first trimester, but EMDR has no direct link to this occurrence. To reduce any doubts that EMDR may have contributed to their loss, if a loss occurs, it could be best to wait until later in the pregnancy to begin EMDR intervention (Warren, 2022). 

While these are only a few misconceptions that individuals may have regarding this structured therapy, your therapist will be able to answer any further questions that arise.

Benefits of EMDR Therapy

Eye Movement Desensitization and Reprocessing Therapy has a variety of benefits to your physical and mental health:

Non-Invasive: A study comparing EMDR to the medication fluoxetine used to treat anxiety and depressive symptoms found that EMDR was associated with greater symptom reduction than medication (Van der Kolk et al., 2007).

Broad Applicability: Extensive research has proven EMDR to be an effective treatment for a broad range of diagnoses. The therapy works to treat a variety of issues including depression, anxiety, PTSD, childhood experiences, obsessive-compulsive disorder (OCD), chronic pain, phobias, etc. EMDR works deeper to find the root cause of diagnosis such as anxiety and depression rather than simply managing symptoms. 

Empowerment: Through EMDR’s reevaluation phase mentioned above, we take time to notice the changes occurring week to week. This includes a specific form of bilateral tapping called butterfly tapping to instill positive feelings in the body. The positive installation allows the client to become familiar with potentially newfound emotions.

Minimal details necessary: Unlike talk therapy, EMDR does not require the client to explain details about their experiences. Sometimes, the less talking and more feeling, the better the outcome. The process of EMDR requires trust and curiosity within the body to heal itself from the inside out. 

Reduces Negative Thoughts: As mentioned earlier, EMDR helps the brain store memories, emotions, and thoughts adaptively. This means that if an individual has adopted negative beliefs about themselves from an adverse experience (like in the example with Carly) they can see that it is not their fault. While we are not necessarily blaming anyone else for the event, remember that two things can be true at the same time.

Fast results: There is no specific timeline to state how long it will take each person to complete EMDR, however, extensive research has found EMDR to be more effective than most other therapy models (Shapiro, 2014). Using the past, present, and future AIP model allows the client to use present-day problems, trace them back to the past, and dissolve the root cause, resulting in lasting impacts in the present and future. 

Increased self-esteem: Often, clients arrive in therapy with preconceived opinions about themselves, such as “I am not good enough” or “I am a bad person.” Once the body begins healing and those thoughts become less intense or frequent, the individual is able to experience positive self-talk and positive beliefs. 

Stress Reduction: Through EMDR, the client accesses memories that have been stored dysfunctionally in the body. When those experiences begin to cause emotion, the body is physically releasing the stress hormone cortisol through their tears (Tiret, 2018). 

During the phase called metamorphosis, a caterpillar's body breaks down and reorganizes to form the adult butterfly. Similarly, through the healing process, sometimes we have to completely break down in order to reach our full potential.

What kind of training is required for an EMDR therapist?

It may bring peace of mind to understand that an EMDR therapist undergoes extensive training to provide clients with this transformative therapy. While there are many different training programs, our therapists at Life Restoration and Wellness have found The Center for Excellence in EMDR Therapy to be profound. The center's founder, Deany Laliotis, has practiced since 1992 and worked closely with the founder of EMDR, Dr. Francine Shapiro. Lalitois’ trainings are approved by the EMDR International Association (EMDRIA). She offers training that varies from basic knowledge to masterclass practice. 

The Center’s mission to provide excellence to therapists and clients is so deep that it is required for the therapist to do their own level of healing through the training. This allows your therapist to understand on a personal level what it feels like to be in your chair. The basic training alone requires numerous hours of training for the clinician. The Center even exceeds EMDRIA’s expectations through supervised practice and case consultation. This allows the therapist to have full confidence to begin practicing EMDR right away. 

Having the right support can make all the difference.

Conclusion

Eye Movement Desensitization and Reprocessing (EMDR) therapy stands as a transformative and evidence-based approach to healing emotional trauma and associated conditions. Rooted in rigorous research and clinical application, EMDR offers a unique, structured method for processing distressing memories and reframing negative beliefs. It is an eight-phase protocol that ensures safety and effectiveness while addressing the underlying causes of emotional pain rather than just managing symptoms. EDMR is an all-encompassing therapy often combined with a variety of other therapy models, including Mindfulness-Based Interventions (MBIs), Cognitive Behavioral Therapy (CBT), Attachment Theory, etc.

From its origins with Dr. Francine Shapiro to its widespread application for PTSD, anxiety, depression, phobias, and beyond, EMDR has proven to be a versatile and adaptive therapeutic modality. The process empowers individuals to reclaim their sense of self, fostering positive self-beliefs and emotional resilience.

While misconceptions about EMDR exist, it is neither invasive nor dependent on extensive verbal recounting of traumatic experiences, making it accessible to a wide range of individuals. With its ability to integrate seamlessly with other therapeutic models and its adaptability to virtual settings, EMDR continues to evolve, offering hope and healing to those seeking relief from emotional wounds.

In summary, EMDR therapy is a powerful tool for unlocking the brain's natural healing potential, enabling individuals to process past pain, transform present struggles, and build a brighter, healthier future.

References

(2025). emdrtherapy.com. Retrieved Jan 20, 2025, from https://emdrtherapy.com/emdr-trainings/basic-emdr-training

The Eight Phases of EMDR Therapy. (2021, August 13). EMDR International Association. Retrieved January 13, 2025, from https://www.emdria.org/blog/the-eight-phases-of-emdr-therapy/

EMDRIA. (n.d.). What is the Adaptive Information Processing (AIP)? EMDRIA.org. Retrieved January 13, 2025, from https://www.emdria.org/about-emdr-therapy/aip-model/

Guy, O. (2023, September 18). Dangers of EMDR Therapy: Side Effects & Misconceptions. Simply Psychology. Retrieved January 14, 2025, from https://www.simplypsychology.org/dangers-of-emdr-therapy.html#Myths-Misconceptions

Hypnosis: What It Is, Why It's Done, Benefits & Risks. (2022). Cleveland Clinic. Retrieved January 14, 2025, from https://my.clevelandclinic.org/health/treatments/22676-hypnosis

Shapiro, F. (2014). The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences. Retrieved January 13, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC3951033/

Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

Stone, A. M. (2019, November 19). 90 Seconds to Emotional Resilience. Alyson M. Stone, PhD, CGP. Retrieved January 14, 2025, from https://www.alysonmstone.com/90-seconds-to-emotional-resilience/

Tiret, H. (2018, December 4). Benefits of crying - Healthy Relationships. MSU College of Agriculture and Natural Resources. Retrieved January 14, 2025, from https://www.canr.msu.edu/news/benefits-of-crying

Van der Kolk, B. A., Spinazzola, J., Blaustein, M., Hopper, J., Hopper, E., Korn, D., & Simpson, W. (2007, Jan). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. National Library of Medicine. Retrieved Jan 13, 2025, from https://pubmed.ncbi.nlm.nih.gov/17284128/

Warren, B. (2022, May 13). EMDR Therapy and Pregnancy. EMDR International Association. Retrieved February 5, 2025, from https://www.emdria.org/blog/emdr-therapy-and-pregnancy/