Originally developed by Francine Shapiro in 1987, Eye Movement Desensitisation and Reprocessing (EMDR) has become a clinically recognised therapy for psychological trauma.
How does EMDR work?
EMDR interrupts the recall of distressing or traumatic memories and works to reduce the level of intensity of those memories as they become blended with new positive thoughts and emotions.
EMDR does not rely on talk therapy or medication. Instead, it works firstly by building practical resources where we can begin to experience feelings of safety and relaxation. In doing so, resilience begins rebuilding, allowing us to increase our tolerance so we may start the processing of traumatic memories.
The stages of EMDR
There are 8 stages to EMDR: history and planning, preparation, assessment, desensitisation, installation, body scan, closure and revaluation.
1. History and therapy planning
This phase will include some discussion of the problem and its impact on you. There is no requirement to discuss the issue in detail; it is more of a general overview of your concerns.
One of the main goals of this phase is building trust between you and your therapist. Here, your therapist will thoroughly explain the whole EMDR process. You will develop various relaxation techniques that can be used either in sessions or at home. One goal of EMDR is that you learn to take care of yourself.
In this phase, you will identify an event or a snapshot of an upsetting event (target event) to ensure you do not become overwhelmed. From that memory, your therapist will ask you to determine the negative belief you have surrounding the event, i.e. “I did not act; therefore, I am wrong”. You would then pick a positive statement; for example, “I am a good person”.
Your therapist will then ask you to score your belief applied to each statement. Both these numbers will form part of processing each targeted event.
This phase focuses on your disturbing emotions and physical responses resulting from the traumatic memory (not the traumatic event itself). Your therapist will introduce bilateral stimulation (BLS) here. The original form of BLS was eye movement, hence the name. Eye movement is still the most commonly practised form of BLS.
The essential element here is that you notice what happens in your body and mind after each round of BLS. The goal in this phase is for you to work towards reducing your distress.
After completion of phase 4, you will begin to work on increasing the strength of your positive statement as it replaces your previously held negative belief. Your therapist will use BLS as you accept your positive statement as true.
6. Body scan
Once your positive belief is accepted and installed, your therapist will ask you to revisit the earlier disturbing sensations and emotions to see if you notice any residual distress in your body. If found, your therapist will focus on reprocessing your discomfort until you no longer have tension in your body.
If the processing of the event is incomplete, your therapist will explain what you might expect and how to handle any issues arising. They will remind you of the skills and tools you learned in phase 2 and recommend you use them until your next session. Some processing might continue in between your sessions, which could lead to new sensations or emotions. Your therapist will ask you to make a note of these experiences and, if necessary, reprocessing them until resolved.
This step is where you will review progress and performed at the beginning of each session. This stage is vital to establish the ongoing success of therapy.
How many sessions are required?
For a single traumatic event, NICE recommends that 8-12 sessions of EMDR might be sufficient. However, in the case of complex or multiple issues, therapy could take longer. By following the 8 phased approach, your therapist will ensure that they are working safely and ethically with you.
How long is each sessions?
We generally book 90–minute sessions for EMDR. These longer sessions are required to complete to work in session and to deal with any issues that might arise.
The next steps
if you would like to know more about EMDR and how it might be helpful for you, or if you have any other questions, we would love to hear from you. Please email firstname.lastname@example.org or complete the contact form.
Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1, 68–87.
Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols and procedures. (3rd ed.). New York, NY: Guilford Press
EMDR Institute (2020). Research overview.