EMDR therapy

EMDR (eye movement desensitization and reprocessing) is a structured therapy for trauma and PTSD. While you briefly bring a painful memory to mind, the therapist guides you through back-and-forth eye movements, taps or tones. Over a series of sessions, the memory usually becomes less vivid and less upsetting, and the beliefs tied to it, like "I'm not safe" or "it was my fault," start to shift. Major PTSD treatment guidelines recommend it.

How does EMDR work?

Researchers are still studying exactly why EMDR works. One idea is that recalling a memory while paying attention to something else, like moving eyes, makes the memory less intense and easier for the brain to store as something in the past rather than something still happening. Unlike some trauma therapies, EMDR doesn't require you to describe the event in detail or do homework between sessions.

What does EMDR help with?

EMDR has the most evidence for PTSD and the effects of traumatic events such as assault, accidents, combat, disasters or sudden loss. It's also used for anxiety, panic and distressing memories that don't meet the full criteria for PTSD, though the evidence there is still growing.

If you've been through something frightening and it still affects you, the free PTSD self-check asks five questions and never asks what happened.

What happens in EMDR therapy?

EMDR follows eight phases. In practice it looks like this:

1. Getting ready (first sessions): your therapist learns your history, explains how EMDR works, and teaches you calming techniques you can use any time you feel overwhelmed.
2. Choosing a target: you pick a memory to work on and notice the image, the negative belief, the feelings and where you feel them in your body.
3. Processing: you hold the memory in mind while following the therapist's hand or a light bar with your eyes, or feeling alternating taps or tones, in short sets. After each set you briefly say what came up, and you continue until the memory feels much less distressing.
4. Strengthening a positive belief: you pair the memory with a more helpful belief, like "I survived" or "I'm safe now."
5. Closing: each session ends with you feeling settled, even if a memory isn't finished yet.

You stay in control the whole time and can stop whenever you need to.

How long does EMDR take?

For a single traumatic event, some people improve in 6 to 12 sessions. People who've had repeated or long-term trauma usually need more, including more time on preparation. Sessions are often 60 to 90 minutes.

How well does EMDR work?

Studies show EMDR reduces PTSD symptoms about as well as other leading trauma-focused therapies such as prolonged exposure and cognitive processing therapy. It's recommended for PTSD by the World Health Organization and by the U.S. Department of Veterans Affairs and Department of Defense guidelines. Some people feel more emotional or have vivid dreams between sessions early on; this usually settles as treatment goes on.

How do I find an EMDR therapist?

Look for a licensed therapist with formal EMDR training. Many have completed a training approved by the EMDR International Association (EMDRIA), and some are EMDRIA-certified, which means extra supervised experience. Ask:

• What EMDR training have you completed?
• How much of your work is with trauma, and with experiences like mine?
• How do you help clients feel safe and steady during processing?

EMDR can be done by video as well as in person. Veterans can get EMDR and other trauma therapies through the VA. Our guide on how to find a therapist who fits covers the search.

How much does EMDR cost?

Most insurance plans cover EMDR as psychotherapy, so you pay your usual therapy copay or coinsurance. Sessions may be billed as longer visits because they often run 60 to 90 minutes. Without insurance, expect prices similar to or a bit above standard therapy. See how much does therapy cost.