EMDR (eye movement desensitization and reprocessing)

EMDR stands for eye movement desensitization and reprocessing. It is a talk therapy for PTSD (posttraumatic stress disorder) and other effects of trauma. You bring an upsetting memory to mind for short periods. At the same time, you notice something that goes back and forth. This may be moving your eyes from side to side, hearing a sound in one ear and then the other, or feeling taps.^1,2,3

The goal is not to forget what happened. The goal is for the memory to feel like something from the past, not something that is still happening. This page explains what a session is like, the eight phases, what the research shows, and how to find a qualified therapist.

What EMDR is

Francine Shapiro, PhD, developed EMDR in the late 1980s. She noticed a link between eye movements and how upsetting a troubling memory felt. She then built the method into a structured therapy.³

The back-and-forth movement or sound is called bilateral stimulation (something that switches between your left and right sides). While you notice it, you hold the memory in mind for about 30 seconds at a time. Then you stop, take a breath, and say briefly what came up.¹

The idea is that this helps your brain store the memory in a new way. Over time, the picture often becomes less vivid and less charged with fear or shame.⁵ People often start to believe something kinder about themselves, such as "I survived" in place of "It was my fault."¹

What a session is like

EMDR is done one-on-one with a therapist. Sessions usually last 50 to 90 minutes.^1,2

• You stay in charge. You can stop the therapist at any point.²
• You don't have to tell the whole story. In most cases you do not need to describe the details out loud. You will think about the memory, though.¹
• There is no required homework. Some therapists may ask you to jot down notes between visits if something comes up.^1,2
• It can be done by video. The VA/DoD guideline supports trauma therapies like EMDR by secure video when that is the best option available.⁴

Each session ends with calming steps so you can leave feeling settled.² It can help to plan something gentle for afterward, like a walk or a quiet meal. A grounding practice is useful to have ready too.

The 8 phases of EMDR

EMDR follows a set order. Some phases take one visit. Others repeat over several visits.²

Source for the table: EMDR International Association.²

For one single traumatic event, the main memory work often finishes within about three sessions. People with many traumas, such as long childhood abuse, usually need more time, especially in the preparation phase.²

How many sessions does it take?

It depends on what you are working on. The American Psychological Association (APA) says EMDR is usually given once or twice a week, for a total of 6 to 12 sessions. Some people need fewer.⁵ The VA describes about 3 months of weekly sessions. Many people notice a change after a few visits.¹

What the research shows

For PTSD

Major U.S. guidelines support EMDR for PTSD, but they rate it differently.

• The 2023 VA/DoD guideline gives EMDR its highest rating, "strong for." It places EMDR alongside prolonged exposure and cognitive processing therapy. It also recommends these therapies over medicine.⁴
• The 2017 APA guideline gives EMDR a "conditional" recommendation. It lists EMDR as a second-line choice, a step below the therapies it recommends most strongly.⁵

So both guidelines include EMDR as a recommended option for PTSD, even though they rate it differently. Strong evidence

A 2020 review pooled 76 trials. About 6 in 10 were about PTSD. EMDR worked much better than control groups. But only 4 of 27 studies the authors checked closely had a low risk of bias (flaws that can tilt results). The reviewers also saw signs that studies with weak results may have gone unpublished.⁶

That same review found EMDR did somewhat better than other therapies overall. But that edge went away when the authors looked only at the best-quality studies.⁶ A 2024 study that pooled the raw data of individual patients from 8 trials found no clear difference between EMDR and other therapies. It looked at symptoms, recovery and dropping out.⁷

In plain terms: for PTSD, EMDR seems to work about as well as other proven trauma therapies. The best choice is often the one you feel ready to try, with a therapist you trust.

The debate about eye movements

Critics have long asked whether the eye movements do anything. Their view is that the main healing comes from facing the memory in a safe place, as in exposure therapy.

The research is mixed. An earlier review found no clear benefit from the eye movements. A 2013 review that pooled 15 clinical trials found that adding eye movements did give a moderate extra benefit. Lab studies in that review showed that eye movements made upsetting memories feel less vivid.⁸ Scientists still do not fully agree on how EMDR works.

For other problems

The EMDR International Association lists many uses beyond PTSD, including anxiety, depression, grief, pain and addiction.³ The research for these uses is much thinner.

The 2020 review found some benefit for phobias and test anxiety. But those results came from a few small studies with a high risk of bias. For most other conditions, there were too few studies to draw any conclusion.⁶ Limited research If anxiety or depression is your main concern, ask your therapist how EMDR compares with options such as CBT for your situation.

EMDR in later life

Most EMDR studies include younger and middle-aged adults. Research in older adults is growing but still small.

A European research team ran a small early study of EMDR in older adults with PTSD. Many also had other health or mental health conditions. About 8 in 10 no longer met the criteria for PTSD after treatment. Comorbid conditions (other illnesses at the same time) did not seem to block progress.⁹ This was a feasibility study, which means an early test of whether a treatment is practical. It was not a large trial comparing EMDR with another treatment.

Older adults sometimes carry trauma for decades, from war, loss, abuse or a medical crisis. It is never too late to seek help. Read more in PTSD in older adults and veterans.

Side effects and who should take care

EMDR is generally safe. The most common problem is feeling upset while you focus on hard memories. This discomfort is usually brief and tends to ease as treatment goes on.¹ Feelings or memories can also stir between sessions. Your therapist will tell you what to expect, and you can share anything that comes up at the next visit.²

Talk openly with your therapist before you begin if you:

• often "blank out" or feel unreal (dissociation)
• have many traumas, especially from childhood
• are using alcohol or drugs to cope
• have eye problems or pain that make eye movements hard (sounds or taps can be used instead)²

The preparation phase can take longer for people with many traumas or certain other conditions.² A good therapist will make sure you have coping skills first.

How to find an EMDR therapist

Trained versus certified

Finishing an EMDR training course is not the same as being certified. EMDRIA certification is a separate step with extra requirements.¹⁰ Two levels are worth knowing:

Source for this comparison: EMDR International Association.¹⁰

Where to look

1. EMDRIA's directory. The "Find an EMDR Therapist" search lists full members by distance from your location. EMDRIA does not vouch for any one therapist, so you still need to ask questions.¹¹
2. The VA. Many VA specialty PTSD programs offer EMDR. Smaller VA sites may connect you to an EMDR therapist by video.¹
3. Your insurance or doctor. Ask for a list of in-network therapists who offer EMDR or other trauma therapies.

For more general tips, see How to find a therapist.

Questions to ask

• Are you licensed in my state? What is your license?
• Did you finish EMDRIA-approved training? Are you certified?
• How much of your work is with trauma or PTSD?
• How will we prepare before working on memories?
• Have you worked with people my age or with my background?
• Do you offer video sessions?

Be careful with anyone who promises a cure in one session or pushes you to go faster than feels safe.

Paying for EMDR

EMDR is a form of psychotherapy. Medicare Part B covers individual psychotherapy from many types of providers. These include psychologists, clinical social workers, marriage and family therapists, and mental health counselors. After the Part B deductible, you usually pay 20% of the Medicare-approved amount.¹² Learn more in What Medicare covers for mental health and Paying for therapy.

Other trauma therapies to compare

EMDR is one good option among several. You can read about each one:

• Prolonged exposure therapy: you talk through the memory in detail and slowly face places you avoid.
• Cognitive processing therapy: you look at "stuck points," or beliefs about the trauma that keep you stuck.
• Trauma-focused therapies compared: a side-by-side look.
• Medicines for PTSD and coping with trauma symptoms.

Our evidence guide explains the badges used on this page.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.