How EMDR Therapy Works: 8 Phases, Sessions & Evidence

The idea behind EMDR

EMDR was developed in 1987 for post-traumatic stress disorder. It is built on what its developer called the Adaptive Information Processing model: the idea that some distressing memories are stored without being fully processed, so the emotions, beliefs and body sensations from the original moment come flooding back when something triggers them. EMDR aims to change how that memory is stored, so that it can be remembered without the same intensity.

Unlike some other trauma therapies, EMDR does not involve long, detailed retelling of what happened, challenging your thoughts in writing, or homework between sessions, according to the American Psychological Association.

The eight phases

History and treatment planning You and your clinician talk through your history and agree on targets: past memories, present-day triggers and future goals.
Preparation You learn what to expect and practise skills for calming yourself, such as a “calm place” exercise, before any processing begins.
Assessment You identify one target memory: an image, the negative belief tied to it, the emotion, and where you feel it in your body. You rate how disturbing it feels.
Desensitization While you briefly hold the memory in mind, you follow short sets of bilateral stimulation and notice whatever comes up, repeating until the memory feels less distressing.
Installation A more helpful belief about yourself (“I survived”, “I did what I could”) is strengthened.
Body scan You check for leftover tension or discomfort linked to the memory, and process it if needed.
Closure Each session ends with steps to help you leave feeling settled, even if a memory isn’t finished.
Re-evaluation The next session starts by checking what has changed and what to work on next.

What “bilateral stimulation” means

Bilateral stimulation is rhythmic left-right input. In an office it is often a clinician’s moving hand or a light bar; it can also be alternating tones in headphones or alternating taps. The VA describes each set as lasting about 30 seconds, followed by a short check-in about what you noticed.

By telehealth, clinicians typically adapt this with on-screen eye-movement cues, audio tones or self-tapping. Achieve Growth Therapy’s EMDR page says EMDR adapts well to secure telehealth and that the practice walks clients through the setup first.

How long it usually takes

The APA notes that EMDR is typically delivered once or twice a week for about 6-12 sessions, with some people needing fewer. The VA describes roughly three months of weekly 50- to 90-minute sessions. People with several traumatic experiences, or long-standing trauma from childhood, often need longer, including more time in the preparation phase.

A realistic expectation: many people notice some change within a few sessions, but timelines vary widely. Be cautious of anyone who promises a fixed number of sessions or a guaranteed result.

What the evidence says

The American Psychological Association’s Clinical Practice Guideline for PTSD suggests EMDR for the treatment of PTSD.
The VA National Center for PTSD lists EMDR among trauma-focused therapies and calls it one of the most effective treatments for PTSD.
The World Health Organization’s 2013 stress-related conditions guideline recommends EMDR, alongside trauma-focused CBT, for PTSD in adults, adolescents and children.
NICE (the UK’s national guideline body) recommends EMDR for adults with PTSD related to non-combat trauma in certain circumstances.

The strongest evidence is for PTSD. EMDR is also used for anxiety, grief and other distress connected to specific experiences, but the research base for those uses is smaller. A good clinician will be straightforward about that.

Is it uncomfortable?

It can be, briefly. The VA notes that focusing on trauma memories may bring up uncomfortable feelings, that these are usually short-lived, and that most people who complete EMDR find the benefits outweigh the initial discomfort. You stay awake and in control throughout. EMDR is not hypnosis, and you can pause at any time.

Wondering whether it suits your situation? Read Is EMDR right for me? or go straight to getting started.

Ask whether EMDR fits what you're carrying

Book a free 15-minute consultation through Achieve Growth Therapy's own contact page. You'll talk about what's going on, whether EMDR by telehealth is a good fit, and what next steps could look like.

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How EMDR therapy works