What is EMDR?

by | Oct 4, 2025 | anxiety, Depression, EMDR, trauma

what is EMDR

Although it’s been around for over 30 years (1) and was embraced by the world of hypnotherapy almost immediately, it has taken some time for eye movement desensitisation and reprocessing (EMDR) to enter the mainstream, but is now commonly used by institutions like the NHS. Recently EMDR has entered the public consciousness through references in popular TV shows, such as the critically acclaimed Russian Doll and famous people, such as Prince Harry, speaking of their experience with it. But what is EMDR?

What is EMDR?

 

EMDR is a psychotherapy technique used for trauma and anxiety. EMDR creates a bilateral movement of attention whilst simultaneously the patient engages with  anxiety provoking thoughts. This is repeated with occasional checks by the therapist to see how the patient is feeling or if any particular thoughts of memories have arisen. The bilateral movement is created in a number of ways;

  • Simulated REM – The most common forms of EMDR is to get the patients eyes to replicate rapid eye movement (REM) by directing the patient to focus their vision on something which moves left to right and then right to left. Usually this is done by the therapist holding their fingers up level with the patients eyes and then instructing them to keep their head still whist the move them on a level with the eyes.
  • Butterfly taps – Often used when eye movement is impractical in some way. The patient is instructed to cross their arms across the body with the right hand on the left shoulder and vice versa. They then create the bilateral movement by tapping the should, alternating between left and right. Variations on the tapping approach exist, with some therapists tapping the back of patients hands.
  • Auditory simulation – occasionally a therapist will initiate the cross lateral stimulation by making sound on either side of the head. This can be very hard on a therapists joints so some have special machines for it.
  • EMDR machine – a number of devices exist which stimulate bilaterial movement. These could be a simple led set up which moves a light from left to right and back again, or programme for a set of headphones to create alternating sounds, or a more integrated device which does both of these synchronously and possibly more.

So we’ve looked at the mechanics of what EMDR is, but this tells us nothing about how it works?

How does EMDR Work?

No one can currently say for certain how EMDR works but a two of the commonly given explanation are

  • Bilateral processing – the idea here is that bilateral activities, such as REM, cause information in the brain to be processed in both left and right hemispheres of the brain. Because the left and right hemispheres of the brain fulfil different roles (Left =logic/reason, right = creation/emotion) the bilaterial stimulation encourages integration of the thoughts/memories which are currently active whilst the stimulation is active. In real terms this means that by accessing a traumatic memory, essentially a right brain memory (emotional memory), and then initiating bilateral stimulation the left brain is activated simultaneously to the left brain, ultimately resulting in the previously solely right brain memory now being integrated into the left brain, where the lefts brains distinct function (logic/reason) acts to moderate and process it. (2)
  • Neurological rewrite – there is a brief period after every memory is accessed where it is open to being altered (3). One theory goes that by applying immersive stimulation, the bilateral movement, during this brief window the memory is changed and by repeating this many times in a therapeutic context with an explicit goal the memory is adjusted with that goal in mind.

These are but two of a number of possible explanations for why EMDR works, now let’s look at how and what it works for

 

What does EMDR help with?

Originally developed as an intervention to help with trauma(2), there is evidence for EMDR’s effectiveness in treating;

  • Trauma (4, 5)
  • Depression (5, 6)
  • Anxiety and related conditions (7)

Further, evidence exists that it can be effective at reducing the experience of cravings in recovering addicts (8), and perhaps most importantly it has been seen to have a low risk for side adverse reactions (9).

Is EMDR a sort of a psychotherapy ‘wonder drug’?

Like most psychological intervention EMDR sometimes has miraculous effects. As a practitioner myself it certainly feels like miraculous change happens with more frequency than with a lot of other interventions, but not always and not for everyone. As with most techniques there is a skill in when and where to apply it. This means that EMDR often works best as part of a larger therapeutic intervention where techniques are introduced to prepare the patient for change before the EMDR is applied, and then other techniques are used to ensure that the changes are effectively embedded into ongoing life.

EMDR is however a highly versatile therapeutic tool. I have applied it successfully in all the evidence based areas (trauma, anxiety, depression) and also with issues like relationship breakup, weight loss, pornography addiction, functional dyspepsia, erectile dysfunction, driving anxiety, bereavement and many more.

References
  1. Shapiro F. EMDR 12 years after its introduction: Past and future research. Journal of clinical psychology. 2002;58(1):1-22.
  2. Shapiro F. Eye movement desensitization and reprocessing. 1995.
  3. Shaw J. The memory illusion: Remembering, forgetting, and the science of false memory: Random House; 2016.
  4. Torres-Giménez A, Garcia-Gibert C, Gelabert E, Mallorquí A, Segu X, Roca-Lecumberri A, et al. Efficacy of EMDR for early intervention after a traumatic event: A systematic review and meta-analysis. Journal of Psychiatric Research. 2024;174:73-83.
  5. Villegas-Ortega J, Galvez-Arevalo R, Castilla-Encinas AM, Gutiérrez-González B, Apolitano-Cárdenas CI, Alvarez-Arias PM, et al. Effects of EMDR vs. waiting list for adults with post-traumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders. 2025:120134.
  6. Sepehry AA, Lam K, Sheppard M, Guirguis-Younger M, Maglio A-S. EMDR for depression: A meta-analysis and systematic review. Journal of EMDR Practice and Research. 2021;15(1):2-17.
  7. Yunitri N, Kao C-C, Chu H, Voss J, Chiu H-L, Liu D, et al. The effectiveness of eye movement desensitization and reprocessing toward anxiety disorder: A meta-analysis of randomized controlled trials. Journal of psychiatric research. 2020;123:102-13.
  8. Martínez-Fernández DE, Fernández-Quezada D, Garzón-Partida AP, Aguilar-García IG, García-Estrada J, Luquin S. The effect of eye movement desensitization and reprocessing (EMDR) therapy on reducing craving in populations with substance use disorder: a meta-analysis. Brain Sciences. 2024;14(11):1110.
  9. Wright SL, Karyotaki E, Cuijpers P, Bisson J, Papola D, Witteveen A, et al. EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis. Psychological medicine. 2024;54(8):1580-8.