EMDR Therapy: How it Works and What to Expect
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured, eight-phase psychological therapy.
EMDR can help when things that have happened in the past are still affecting you now. This might be a single traumatic event, experiences from childhood, difficult relationships, or something that has happened more recently.
Rather than talking through what happened over and over, EMDR uses a structured process to help you work with the memories, emotions, thoughts and body sensations that are still causing distress.
This short animation from the EMDR Association of Australia gives an overview of EMDR and its eight phases. There is quite a bit more to EMDR than the bilateral stimulation used during processing. The preparation and assessment stages are an important part of the therapy too.
What does EMDR therapy involve?
You may already know that EMDR involves bilateral stimulation, such as eye movements, alternating sounds or tapping. But that is only one part of the therapy.
EMDR follows a structured eight-phase process. The early phases are about understanding what has brought you to therapy, what you would like to work on, and getting ready to begin processing. We might spend time building resources, practising ways to manage strong emotions, or getting a clearer picture of how past experiences are showing up in your life now.
When we begin processing, you will usually focus on a particular memory, thought, emotion or body sensation while using bilateral stimulation. The eight phases don't necessarily happen in a neat sequence across separate sessions. We may move between them depending on what you need.
If you want to understand the eight phases in more detail, you can read: The 8 phases of EMDR Therapy: What to Expect at Each Stage
Is EMDR evidence-based?
Yes. EMDR is an evidence-based psychological therapy, with particularly strong evidence for post-traumatic stress disorder (PTSD).
EMDR is recommended in Australian and international clinical guidelines as a treatment for PTSD, alongside other trauma-focused psychological therapies. Research has also looked at EMDR for other difficulties, including anxiety, phobias and depression, although the evidence is stronger for some conditions than others.
In Australia, EMDR is recognised as a focused psychological strategy that can be provided under the Medicare Better Access initiative with a mental health treatment plan.
EMDR is not a magic technique or simply a set of eye movements. It is a structured psychological therapy, and the preparation beforehand and the way the processing is managed are important parts of the work.
What issues can EMDR help with?
EMDR therapy is best known for treating post-traumatic stress disorder (PTSD), and it can be particularly helpful when distressing experiences from the past are still affecting how you feel, think or respond in the present.
EMDR may be helpful for:
complex trauma
single traumatic events
childhood trauma and difficult early experiences
relationship trauma and experiences that have affected your sense of safety or trust
fears and phobias
grief and loss
distressing memories that continue to feel emotionally or physically charged
negative beliefs about yourself, such as “I'm not good enough”, “I'm unsafe” or “I'm powerless”
difficulties with self-worth and confidence
Sometimes there isn't one obvious event that explains how you feel. There may instead be a pattern of experiences, including experiences in childhood or relationships, that has shaped the way you see yourself, other people or the world around you.
How many EMDR sessions will I need?
The answer is annoying: it depends.
EMDR can sometimes work relatively quickly, particularly when there is a single, clearly defined event to work on. Some people notice meaningful changes quite early. But EMDR isn't instant, and there isn't a set number of sessions that will work for everyone.
When there is a longer history of trauma, childhood experiences, relationship trauma or several things that have contributed to how you feel now, therapy can take more time. We may also need more time for preparation before we begin processing.
If you are using a Mental Health Treatment Plan, Medicare currently provides rebates for up to 10 individual mental health treatment sessions per calendar year for eligible clients. Ten sessions can be enough to make significant progress, but they don't necessarily represent the amount of therapy someone needs to address longstanding or complex difficulties.
How long we work together will depend on what you want help with, your history, what is happening in your life now, and how you respond to the therapy.
EMDR isn't magic, and it isn't instant. But it can be transformative.
Why don't we just start processing straight away?
You might have heard that EMDR involves following a light or another form of bilateral stimulation while thinking about something difficult. So you might expect that we start there.
EMDR is an eight-phase approach, and the early phases are important preparation for the processing work. Before we begin, we need to understand what has brought you to therapy, what you want to work on, and how difficult experiences are affecting you now.
We also spend time making sure we have a plan for what to do if things become difficult during processing.
For some people, this preparation may take a little while. For others, we may move through it more quickly. There isn't a set number of sessions before we begin processing.
The aim isn't to delay the work. It's to make sure we have a strong enough foundation to approach it safely and at a pace that works for you.
You can read more about me and my approach to therapy here.
What does being ready for EMDR mean?
Being ready doesn't mean that you will never feel distressed or that you need to be completely calm before we start.
It means having enough capacity and support in place to approach difficult memories while staying connected to the present.
Together, we might consider things like:
whether you can notice and describe emotions and body sensations
whether you have some ways of managing distress when emotions become intense
whether you can move between difficult experiences and the present moment
whether you're able to stay connected to what is happening around you while also noticing what is happening internally
whether there is enough stability and safety in your current circumstances to make processing manageable
whether you feel able to let me know if something feels too much, confusing or needs to slow down
whether there are factors such as dissociation that might mean we need to adapt the way we work
Readiness isn't a pass or fail test. It can change over time, and we can build these skills together.
Sometimes the most useful work at the beginning of therapy is helping you feel safer, more grounded and more able to stay with difficult experiences. That is still EMDR preparation, and it can be an important part of the treatment.
Do I have to tell you everything that happened?
No.
EMDR involves identifying the experiences, memories, beliefs and sensations that are relevant to the work, but you don't necessarily need to describe every detail of what happened.
We work with what is clinically useful and what you are ready to approach.
You remain involved in deciding what we work on and how quickly we move.
What might I notice during EMDR processing?
Everyone's experience is different.
You might notice memories, images, thoughts, emotions or physical sensations changing. Other memories or connections may come to mind too.
You don't need to force anything to happen or work out what everything means as it comes up.
My role is to help you stay oriented to the present, notice what is happening and adjust the process when needed.
Is EMDR suitable for everyone?
EMDR isn't automatically the right approach for everyone, or at every point in someone's life.
Current circumstances, significant instability, difficulties regulating emotions, dissociation or other factors may mean that we need to spend more time on preparation or use a different approach first.
This doesn't necessarily mean that EMDR won't be appropriate in the future.
The aim isn't simply to do EMDR. It's to use an approach that is safe, appropriate and useful for you.
EMDR therapy in Adelaide and online across Australia
I offer EMDR therapy in North Adelaide and online across Australia.
If you're considering EMDR and would like to talk about whether it might be appropriate for you, get in touch.