Eye Movement Desensitisation and Reprocessing, often called EMDR therapy, is a structured trauma therapy used to help people process trauma, PTSD and other distressing life experiences. It is best known as a treatment for posttraumatic stress disorder, but trained clinicians may also use EMDR for anxiety, grief, phobias, disturbing memories, nightmares, shame-based memories and experiences that continue to cause emotional distress. EMDR was developed by psychologist Francine Shapiro in the late 1980s and has since become one of the more widely recognised trauma-focused psychological treatments for PTSD.[1]
EMDR does not require a person to describe every detail of a traumatic event in the same way some exposure-based therapies do. Instead, the client briefly brings aspects of the memory to mind while also paying attention to an external stimulus, such as guided eye movements, hand-tapping or audio stimulation. These are forms of bilateral sensory stimulation, meaning attention alternates from one side of the body or sensory field to the other.[2] The aim is not to erase the memory. The aim is to reduce the emotional charge, body distress and negative beliefs attached to it, so the memory feels more like something that happened in the past rather than something still happening now.
What Is EMDR and How Does It Work?
EMDR therapy is based on the idea that some traumatic memories are not fully processed at the time they occur. During overwhelming experiences, the nervous system can prioritise survival over normal memory integration. As a result, images, sounds, emotions, body sensations and negative beliefs may remain highly reactive. A person might logically know they are safe, but a reminder, flashback, smell, facial expression or tone of voice can still trigger fear, shame, anger, numbness or panic.
The main theory behind EMDR is called Adaptive Information Processing. This model suggests that the brain usually has a natural capacity to process experiences and integrate them with existing memory networks. When something is overwhelming, this processing can become blocked. The memory may then remain “stuck” with the emotions, sensations and beliefs that were present at the time. EMDR aims to help the brain reprocess the memory so it can be stored in a more adaptive way.[3]
In EMDR, the therapist helps the client identify a target memory and the meaning attached to it. A client might notice a negative belief such as “I am powerless”, “I am unsafe” or “It was my fault”. Therapy then works toward a more adaptive belief, such as “I survived”, “I am safe now” or “I did the best I could”. This can overlap with cognitive reappraisal, where a person develops a more balanced understanding of what happened, but EMDR does not rely only on rational thinking. It also works with emotion, body sensation, memory and nervous system activation.
Bilateral stimulation is the most recognisable feature of EMDR. This may involve side-to-side eye movements, alternating tones through headphones, handheld buzzers or gentle hand-tapping. Some theories suggest bilateral stimulation reduces the vividness and emotional intensity of traumatic memories by taxing working memory. Others suggest it supports dual attention, allowing the person to stay anchored in the present while briefly activating the past. EMDR is sometimes compared with REM sleep because both involve eye movements and memory processing, but this is best understood as a theory rather than a settled explanation. Researchers continue to study exactly how EMDR works.[4]
The Eight Phases of EMDR Therapy
EMDR therapy follows an eight-phase model. The first phase is history taking and treatment planning. The therapist learns about the client’s current symptoms, past experiences, strengths, risks and goals. This phase is especially important for people with complex trauma, dissociation, self-harm risk, unstable living conditions or multiple traumatic events. A skilled EMDR therapist does not rush into reprocessing before the person has enough stability, trust and support.
The second phase is preparation. This includes psychoeducation about trauma, PTSD, emotional distress and how EMDR works. The therapist explains what may happen during and after sessions, answers questions and teaches grounding or emotional regulation strategies. This helps the client manage strong emotions during and between appointments. Preparation may involve breathing exercises, imagery, body-based grounding, identifying support people and planning how to settle after sessions.
The third phase is assessment. The therapist identifies the target memory, the worst image, the negative belief, the desired positive belief, the emotions, the level of distress and any body sensations connected to the memory. This gives the session a clear focus. It also helps the therapist track change as the memory becomes less disturbing and the positive belief becomes more believable.
The fourth phase is desensitisation. The client briefly focuses on the memory while following bilateral sensory stimulation. After each set, the therapist asks what the client notices. New thoughts, images, emotions, body sensations or associations may arise. The person does not need to analyse everything or tell the therapist every detail. The therapist helps the process continue until the memory becomes less distressing.
The fifth phase is installation, where the positive belief is strengthened. The sixth phase is the body scan, where the client checks whether any tension, discomfort or unease remains when they bring the memory and positive belief to mind. The seventh phase is closure. The therapist helps the client return to a grounded state, even if the memory has not been fully processed in that session. The eighth phase is re-evaluation, which happens at the next appointment. The therapist checks whether the gains have held, whether new material has emerged and whether the treatment plan needs adjusting.[5]
What Conditions EMDR Effectively Treats
EMDR has its strongest evidence base for PTSD. PTSD can involve intrusive memories, nightmares, flashbacks, avoidance, emotional numbing, hypervigilance, sleep problems, irritability, guilt and difficulties with concentration. Major clinical guidelines include EMDR as a treatment option for PTSD, alongside trauma-focused cognitive behavioural therapy and other evidence-based interventions.[6]
EMDR may also be used when a person does not meet full criteria for PTSD but still experiences disturbing memories that affect daily life. Examples include medical trauma, accidents, bullying, grief, panic linked to a past event, painful relationship experiences, childhood emotional neglect or shame-based memories. Some clinicians also integrate EMDR into broader treatment for anxiety, depression, chronic pain, addiction or personality-related difficulties. However, the research base for these areas is generally less established than it is for PTSD, so suitability should be assessed carefully.
It is useful to compare EMDR with other trauma therapies. Prolonged Exposure, for example, helps people gradually approach trauma memories and avoided situations so the brain learns they are no longer dangerous. Cognitive Processing Therapy focuses more directly on trauma-related beliefs and meanings. Trauma-focused cognitive behavioural therapy often includes psychoeducation, emotional regulation, exposure, cognitive reappraisal and relapse prevention. EMDR overlaps with some of these goals but uses a different structure, especially through bilateral stimulation and memory reprocessing.
For some people, EMDR feels less verbally demanding than traditional talk therapy because they do not have to give a long, detailed account of the trauma. For others, it can still be emotionally intense because the therapy deliberately activates painful memory networks. The number of sessions varies. A single-incident trauma may require fewer sessions than complex trauma, childhood abuse, repeated interpersonal trauma or long-standing mental health concerns. Some people notice meaningful change within a short block of therapy. Others need a longer, staged approach that includes stabilisation, skills development and careful pacing before reprocessing begins.
Risks, Limits and When EMDR May Not Be Appropriate
EMDR is generally considered safe when delivered by a trained clinician, but it is not risk-free. During or after sessions, some people experience strong emotions, vivid dreams, fatigue, temporary increases in memories, body sensations or unexpected links to other experiences. Nightmares may initially become more noticeable for some people as memory networks are activated. This does not necessarily mean therapy is going wrong, but it does mean the therapist should prepare the client, monitor distress and adjust the pace when needed.
EMDR may not be appropriate as a first step if someone is currently unsafe, in crisis, heavily dissociative, actively suicidal, experiencing untreated psychosis, affected by severe substance dependence or living in an ongoing traumatic situation where safety has not been addressed. In these situations, the priority may be stabilisation, crisis support, medical care, risk management, practical safety planning or other forms of therapy before trauma processing begins.
What can go wrong during EMDR? The most common problem is moving too quickly. If reprocessing begins before a person has enough grounding skills, support and emotional tolerance, they may feel overwhelmed. Another issue is using EMDR as a technique rather than a full therapy. Good EMDR requires clinical judgement, not just a protocol. The therapist needs to know when to pause, when to return to preparation, when to explore dissociation, and when another treatment approach may be more suitable.
There is also no single “success rate” that applies to everyone. Outcomes depend on the type of trauma, the person’s current safety, co-occurring mental health conditions, therapeutic relationship, treatment fidelity and number of sessions. While EMDR is supported by major PTSD guidelines, responsible clinicians should avoid promising quick or guaranteed results. The evidence is strongest when EMDR is delivered as a structured trauma-focused therapy by a trained professional.
Finding a Qualified EMDR Therapist in Australia
If you are considering EMDR, look for a therapist who is qualified in their core mental health profession and has completed recognised EMDR training. In Australia, EMDR may be provided by psychologists and other eligible mental health professionals with appropriate training. A Clinical Psychologist may be especially well placed to assess complex trauma, PTSD, dissociation, anxiety, depression and other mental health conditions that may affect treatment planning.
A useful first appointment should include careful assessment rather than immediate reprocessing. You can ask the therapist about their EMDR training, experience with PTSD or complex trauma, how they manage dissociation or high distress, and how they decide whether EMDR is appropriate. You might also ask what preparation looks like, what happens between sessions, and how they would adapt the work if you became overwhelmed.
The EMDR Association of Australia provides a therapist directory and notes that listed members have completed EMDR training that meets international guidelines.[7] This can be a helpful starting point, but it is still important to check whether the therapist’s qualifications, registration, experience and style fit your needs.
For cost and access, Medicare rebates in Australia are not usually for “EMDR” as a separate item. Instead, eligible patients may be able to access Medicare-subsidised psychological therapy under the Better Access initiative with a valid referral and mental health treatment plan. The Australian Government states that eligible patients can claim Medicare benefits for up to 10 individual and 10 group mental health treatment services per calendar year, although clinicians set their own fees and Medicare may only cover part of the cost.[8]
EMDR therapy can be a powerful treatment for trauma, but it works best when it is thoughtful, paced and collaborative. The goal is not to forget the past or convince yourself it did not matter. The goal is to help the brain and body process what happened, reduce the grip of traumatic memories, and make room for a stronger sense of safety, choice and emotional freedom in the present.
References
[1] EMDR Institute. “What is EMDR Therapy?” Describes EMDR as a psychotherapy originally designed to alleviate distress associated with traumatic memories.
[2] American Psychological Association. “Eye Movement Desensitization and Reprocessing.” Describes EMDR as a structured therapy involving brief focus on a trauma memory while experiencing bilateral stimulation.
[3] Hase, M. “The AIP Model of EMDR Therapy and Pathogenic Memories.” Frontiers in Psychology / PMC. Discusses the Adaptive Information Processing model and its role in EMDR theory.
[4] Wadji, D. L., et al. “Can working memory account for EMDR efficacy in PTSD?” European Journal of Psychotraumatology / PMC. Reviews evidence that eye movements and similar tasks may reduce memory vividness and emotionality.
[5] EMDR International Association. “The Eight Phases of EMDR Therapy.” Lists the standard eight phases: history taking and treatment planning, preparation, assessment, desensitisation, installation, body scan, closure and re-evaluation.
[6] National Institute for Health and Care Excellence. “Post-traumatic stress disorder: NICE guideline NG116”; World Health Organization PTSD psychological intervention guidance; American Psychological Association PTSD treatment guideline. These sources include EMDR among recommended or conditionally recommended psychological interventions for PTSD.
[7] EMDR Association of Australia. “Find an EMDRAA Therapist.” Provides an Australian directory of EMDR-trained therapists.
[8] Australian Government Department of Health, Disability and Ageing. “Better Access initiative.” States that eligible patients can claim Medicare benefits for up to 10 individual and 10 group mental health treatment services per calendar year.
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