EMDR: An Evidence-Based Therapy for Trauma

You may have heard about EMDR as a popular therapy on social media lately. With all the attention it has been getting, it can be easy to think of EMDR as just another mental health trend.

But behind the hype, EMDR is a specific, evidence-based approach for treating trauma and other distressing experiences. Let’s talk about it in simple, real-world terms.

An Accidental Discovery in a Park

EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed in 1987 by psychologist Dr. Francine Shapiro.

The story of its discovery is quite famous. One day, Dr. Shapiro was walking in a park while thinking about something distressing. As she walked, she noticed her eyes moving rapidly back and forth. She also noticed that the thoughts seemed to become less distressing.

This observation eventually led to years of research and the development of EMDR therapy. During EMDR, a person briefly focuses on a distressing memory while using bilateral stimulation. Researchers are still studying exactly how it works, but the process seems to help the brain reprocess distressing memories so they can become less emotionally overwhelming.

What Is “Bilateral Stimulation”?

In simple words, EMDR uses Bilateral Stimulation (BLS), which means stimulation that alternates from one side of the body to the other.

In a session, this might look like:

• Following your therapist’s fingers with your eyes as they move left and right or following a moving light on an EMDR device.

• Listening to alternating tones through headphones.

• Holding small handheld devices that gently pulse in your left and right hands.

You may sometimes hear EMDR compared to REM (rapid eye movement) sleep because both involve eye movements. However, we still don’t know exactly how EMDR works or whether it works by “mimicking REM sleep.” What we do know is that EMDR can help many people process distressing memories, so those memories feel less intrusive or emotionally intense in the present.

The Myth: EMDR Will Make You Forget Your Story

A common fear about EMDR is that it will erase your memories or make you forget your past. This is a myth. EMDR does not delete your history. Instead, the goal is to change how strongly that history affects your body and mind today.

When you think about a past trauma, your body may react as if the danger is happening right now. Your heart may race, your stomach may tighten, or you may experience sudden anger, fear, sadness, or other intense emotions. The memory belongs to the past, but your nervous system may still respond to it in the present.

After successful reprocessing by EMDR, facts of your story remain the same, but the memory may feel less emotionally intense or disturbing. You can still remember what happened, but ideally, it no longer triggers the same level of distress or has the same power over your present life.

Of course, people respond differently to EMDR. Some people experience significant improvement, while others may respond more gradually or find that another therapeutic approach works better for them.

Why Reprocessing Does Not Usually Begin in the First Session

Many people come to therapy wanting to start reprocessing their deepest and most painful memories during the very first session. However, trauma work should not be rushed. Before beginning reprocessing, a therapist needs to understand your history, current situation, coping skills, and readiness.

There are a few important things your therapist may consider:

• Your current environment: Is your life relatively stable right now? If you are living in a highly volatile relationship, going through an ongoing crisis, or facing an unsafe environment, your therapist may recommend focusing first on safety, support, coping skills, or other therapeutic approaches.

• Your emotional regulation: Do you have tools to manage difficult emotions when they come up? If strong feelings easily become overwhelming, your therapist may spend more time developing coping and grounding skills first.

• Your overall mental health: EMDR can be helpful for many people, but it may not be the best approach for everyone at every point in treatment. Your therapist will consider your symptoms, history, current situation, and other mental health concerns when deciding how and when to use EMDR.

If EMDR isn't the right fit right now, that doesn't mean therapy cannot help. Depending on your needs, therapy may focus on stabilization, coping skills, cognitive or behavioral approaches, supportive therapy, safety planning, or other evidence-based treatments.

The Foundation: Preparation and Stabilization

Safety and readiness are important parts of trauma treatment. Before reprocessing difficult memories, your therapist may spend some time helping you build skills and resources to support you through the process. How much preparation you need varies from person to person.

During this phase, you and your therapist may work on grounding strategies and internal resources. For example, you might practice exercises such as a mental “container” to set difficult thoughts aside between sessions or develop a “safe or calm place” to help manage distress.

For some people, preparation may be relatively brief. Others may need more time, especially when there is complex trauma, ongoing stress, or difficulty managing intense emotions. You and your therapist can decide together when you are ready to move into reprocessing.

A Process That Takes the Time It Takes

Just as trauma may come from experiences that happened over time, reprocessing those experiences can also take time. Some memories may shift relatively quickly, while more complex experiences may need multiple sessions. There is no standard timeline, and everyone’s process can be different.

EMDR is an evidence-based therapy that can be very helpful for many people, especially those struggling with trauma-related distress. But it is not a magic eraser, and it is not the right approach for every person at every moment.

If you would like to explore this further, read about trauma therapy at Real Talk, or Request a Session.

Real Talk Clinical Psychology is a clinic in Houston, Texas. Our clinicians are in-network with Aetna, Blue Cross Blue Shield, Cigna, UHC/Optum, Tricare, Curative, and Oscar. Request a Session.