If you’ve been exploring options for addressing trauma, anxiety, or distressing memories, you’ve likely come across EMDR therapy. Perhaps a friend mentioned it helped them, or your GP suggested it as part of a Mental Health Care Plan. You might be curious but uncertain—how can eye movements help heal psychological wounds?
Eye Movement Desensitisation and Reprocessing (EMDR) is one of the most extensively researched treatments for trauma and post-traumatic stress disorder (PTSD). It’s recommended by the World Health Organization, Australia’s National Health and Medical Research Council, and mental health organisations worldwide. Yet for many people, it remains somewhat mysterious.
This guide explores what EMDR therapy is, how it works, what the evidence shows, and what you might expect if you decide to try it. My aim is to provide you with accurate, balanced information so you can make informed decisions about your mental health care.
What is EMDR therapy?
EMDR stands for Eye Movement Desensitisation and Reprocessing. It’s a structured psychotherapy approach that helps people process and recover from distressing life experiences, particularly traumatic memories.
Developed by American psychologist Dr Francine Shapiro in 1987, EMDR emerged from an observation she made while walking through a park. She noticed that her own distressing thoughts seemed to lose their intensity when her eyes moved rapidly from side to side. This led her to investigate whether guided eye movements might help others process difficult memories.
What began as a simple observation evolved into a comprehensive, eight-phase treatment approach backed by decades of clinical research. Today, EMDR is practised by trained therapists in over 130 countries and has been used to help millions of people recover from trauma.
Unlike traditional talk therapy, EMDR doesn’t require you to discuss distressing events in detail or complete homework assignments between sessions. Instead, it uses a specific protocol that helps your brain process stuck memories in a safe, controlled environment.
The theory behind EMDR: Adaptive Information Processing
To understand how EMDR works, it helps to know about the theoretical framework that guides it: the Adaptive Information Processing (AIP) model.
The AIP model suggests that our brains have a natural ability to process and integrate information from our experiences—much like how our bodies naturally heal physical wounds. When we go through difficult experiences, our information processing system usually helps us make sense of what happened, store it appropriately in memory, and learn from it.
However, when an experience is particularly overwhelming or traumatic, this natural processing can become disrupted. The memory may get stored in a “raw,” unprocessed form, still containing the vivid images, sounds, emotions, and body sensations from the original event. According to research published in Frontiers in Psychology, these inadequately processed memories can continue to cause distress long after the event has passed.
Think of it like this: imagine your brain’s memory system as a filing cabinet. Normally, experiences get processed, organised, and filed away appropriately. But a traumatic memory might get jammed in the drawer—still active, still triggering strong reactions, never properly filed.
When these unprocessed memories are triggered by current situations—perhaps a sound, smell, or circumstance that resembles the original event—you might experience the same intense emotions, physical sensations, or beliefs you had at the time of the trauma. This can manifest as flashbacks, nightmares, anxiety, or a persistent sense that something is wrong.
EMDR therapy aims to help your brain’s natural processing system get “unstuck,” allowing these memories to be properly integrated. As described by the EMDR International Association, once reprocessed, you can still remember what happened, but without experiencing the overwhelming emotions and sensations that previously accompanied the memory.
How EMDR therapy works: The eight phases
EMDR follows a structured, eight-phase protocol developed by Dr Shapiro. This standardised approach helps ensure the therapy is delivered safely and effectively. Understanding these phases may help you know what to expect if you decide to try EMDR.
Phase 1: History and treatment planning
The first phase involves your therapist getting to know you, your history, and what you’re hoping to address. This includes discussing your background, current symptoms, and identifying specific memories or experiences that may be contributing to your difficulties.
Together, you’ll develop a treatment plan that identifies which memories to target and in what order. Your therapist will also assess your internal and external resources—the coping strategies and support systems you have available.
This phase typically takes one to two sessions, though for people with complex histories, it may take longer.
Phase 2: Preparation
Before processing any traumatic material, your therapist will ensure you’re properly prepared. This phase involves building a therapeutic relationship based on trust and safety, explaining exactly how EMDR works, and teaching you specific techniques to manage any emotional disturbance that might arise during or between sessions.
You’ll learn “resourcing” techniques—ways to calm yourself and return to a sense of safety if emotions become overwhelming. These might include visualisation exercises, breathing techniques, or other grounding strategies. The goal is ensuring you have the tools to stay within your “window of tolerance”—the zone where you can process difficult material without becoming overwhelmed.
This preparation phase is crucial. EMDR is designed to be a safe and controlled process, and your therapist will ensure you’re ready before moving to the processing phases.
Phase 3: Assessment
In this phase, you and your therapist identify a specific memory or “target” to work on. You’ll be asked to bring to mind the worst part of the memory as an image, along with:
- A negative belief about yourself connected to the memory (such as “I am not safe” or “I am powerless”)
- A positive belief you’d prefer to have (such as “I am safe now” or “I can handle difficult situations”)
- The emotions you feel when thinking about the memory
- Where you notice these feelings in your body
You’ll also rate how disturbing the memory feels on a scale of 0 to 10 (the Subjective Units of Disturbance, or SUD scale) and how true the positive belief feels on a scale of 1 to 7 (the Validity of Cognition, or VOC scale). These measurements help track your progress through the processing.
Phase 4: Desensitisation
This is the phase most people associate with EMDR—the actual reprocessing. While holding the target memory in mind, you’ll be guided through sets of bilateral stimulation. This typically involves following your therapist’s fingers with your eyes as they move back and forth across your field of vision, though it can also involve auditory tones or tactile taps.
Each set of bilateral stimulation lasts about 30 seconds. Afterward, your therapist will pause and ask what you’re noticing—any thoughts, images, emotions, or body sensations that have come up. You’ll briefly share these observations, then begin another set.
During this phase, you’re not required to speak about the memory in detail. The bilateral stimulation appears to help the brain process the memory naturally, with thoughts, images, and feelings often shifting spontaneously. You remain conscious and in control throughout—you’re not hypnotised, and you can stop at any time.
The desensitisation phase continues until the disturbance level associated with the memory drops to 0 or 1. This may happen within a single session or may require multiple sessions, depending on the complexity of the memory.
Phase 5: Installation
Once the disturbance level has decreased, the focus shifts to strengthening the positive belief you identified earlier. Using bilateral stimulation, you’ll pair the original memory with this positive cognition, helping to install a more adaptive way of thinking about the experience.
The goal is for the positive belief to feel genuinely true—not just intellectually, but at a gut level. You’ll continue until the belief feels completely or almost completely true (a VOC of 6 or 7).
Phase 6: Body scan
Trauma often leaves a residue in the body. In this phase, you’ll be asked to hold the target memory and the positive belief in mind while scanning through your body for any remaining tension, discomfort, or unusual sensations.
If any physical sensations emerge, these become targets for further processing with bilateral stimulation until they resolve. This phase helps ensure that the memory has been fully processed at both a cognitive and somatic level.
Phase 7: Closure
Every EMDR session ends with closure, regardless of whether the target memory has been fully processed. Your therapist will guide you back to a state of equilibrium, using the calming techniques you learned in the preparation phase if needed.
You’ll be briefed on what to expect between sessions—sometimes processing continues after the session ends, and you might notice new memories, dreams, or insights emerging. Your therapist will provide guidance on how to handle any disturbance that might arise and how to record your observations for the next session.
Phase 8: Reevaluation
Each subsequent session begins with reevaluation. Your therapist will check on the progress made with previous targets, assess any new material that has emerged, and determine the next steps in your treatment plan.
This phase ensures that processing has been thorough and that you’re continuing to move toward your treatment goals.
What conditions can EMDR treat?
EMDR was originally developed for treating PTSD and trauma, and this remains its most well-researched application. However, research and clinical experience have expanded its use to other conditions.
Trauma and PTSD
EMDR has the strongest evidence base for treating post-traumatic stress disorder. According to a comprehensive review in the Journal of Traumatic Stress, more than 30 randomised controlled trials have demonstrated its effectiveness for PTSD in both adults and children.
The Phoenix Australia Guidelines, endorsed by the National Health and Medical Research Council, recommend EMDR as a first-line treatment for adults with PTSD. The guidelines note that EMDR is equally effective as trauma-focused cognitive behavioural therapy (TF-CBT) for this condition.
This recommendation matters because PTSD is common in Australia. According to the Australian Institute of Health and Welfare, approximately 75% of Australian adults have experienced a traumatic event, and around 11% will experience PTSD in their lifetime. Women face nearly twice the risk of men. At any given time, over one million Australians are living with PTSD.
Complex PTSD
Complex PTSD (C-PTSD) is a condition recognised in the International Classification of Diseases (ICD-11) that can develop after prolonged or repeated trauma, particularly when it occurs in childhood or within relationships. In addition to the core symptoms of PTSD, C-PTSD includes difficulties with emotional regulation, negative self-concept, and relationships.
While research specifically on EMDR for complex PTSD is still developing, many clinicians use EMDR as part of a phased approach to treatment. This typically involves an extended preparation phase focusing on stabilisation and resource-building before processing traumatic memories.
Anxiety disorders
Research suggests EMDR may be helpful for various anxiety conditions beyond PTSD. A systematic review published in Frontiers in Psychology found evidence supporting EMDR’s use for panic disorder, specific phobias, and generalised anxiety.
The rationale is that anxiety often has roots in past experiences that shaped beliefs about danger, safety, and coping. By processing these foundational experiences, EMDR may help reduce current anxiety symptoms.
Other applications
Clinical experience and emerging research have explored EMDR for depression, grief and loss, chronic pain, performance anxiety, and various other conditions. The AIP model suggests that many psychological difficulties have their origins in unprocessed memories, which provides a theoretical basis for these broader applications.
However, it’s important to note that while these applications are promising, the evidence is generally stronger for PTSD than for other conditions. If you’re considering EMDR for a concern other than trauma, discussing the current evidence with your therapist can help you make an informed decision.
What does the evidence say?
EMDR is one of the most well-researched psychotherapies for trauma. Understanding this evidence base can help you evaluate whether it might be right for you.
International recognition
EMDR is recommended as an effective treatment for PTSD by numerous national and international bodies. According to Wikipedia’s summary of clinical guidelines, these include:
- The World Health Organization (2013, 2023)
- The UK’s National Institute for Health and Care Excellence (NICE)
- The International Society for Traumatic Stress Studies (ISTSS)
- The US Department of Veterans Affairs and Department of Defense
- Australia’s National Health and Medical Research Council (via Phoenix Australia Guidelines)
The Australian guidelines, developed by Phoenix Australia and approved by the NHMRC in 2020, give EMDR a “strong recommendation” for treating adults with PTSD—the highest level of endorsement.
How does it compare to other treatments?
Systematic reviews and meta-analyses have generally found EMDR to be equivalent in effectiveness to trauma-focused cognitive behavioural therapy (TF-CBT), including prolonged exposure therapy and cognitive processing therapy.
A 2024 paper in the Journal of Traumatic Stress summarised the state of the evidence: EMDR therapy has support from more than 30 published randomised controlled trials demonstrating its effectiveness in both adults and children, and most international clinical practice guidelines recommend it as a first-line treatment for PTSD.
This doesn’t mean one approach is definitively “better” than another. Different therapies may suit different people, and what matters most is finding an approach that works for you. Some people prefer EMDR because it doesn’t require detailed verbal recounting of traumatic events or homework assignments between sessions.
Ongoing scientific debate
In the interest of providing balanced information, it’s worth noting that some aspects of EMDR’s theoretical framework have been questioned by researchers.
Some critics have questioned whether the eye movements are necessary or whether the therapeutic effects come from other elements of the treatment, such as exposure to the traumatic memory or the therapeutic relationship. Meta-analyses examining this question have had mixed findings, though recent research increasingly supports that eye movements do contribute meaningfully to outcomes.
The 2013 World Health Organization guidelines observed that EMDR, unlike cognitive behavioural therapy, does not involve detailed descriptions of the event, direct challenging of beliefs, extended exposure, or homework—yet appears to achieve comparable outcomes. This has prompted ongoing investigation into exactly how and why EMDR works.
What this scientific debate means practically is that while we know EMDR works for many people, we don’t yet fully understand all the mechanisms involved. This is actually common in medicine and psychology—we often know that treatments are effective before we fully understand why.
What happens in an EMDR session?
Understanding what to expect can help reduce anxiety about starting therapy. Here’s what a typical EMDR session might look like.
The setting
EMDR sessions typically take place in a therapist’s office, though telehealth delivery has become more common and research supports its effectiveness. Sessions usually last between 60 and 90 minutes—longer than a standard therapy session—to allow time for processing.
Your first sessions
Initial sessions focus on the history-taking and preparation phases described above. You’ll discuss your background, current concerns, and treatment goals. Your therapist will explain EMDR in detail and teach you stabilisation techniques.
Many people feel relieved during these early sessions—it can be validating to have your experiences understood within a framework that makes sense, and to learn that there’s a structured approach that may help.
Processing sessions
Once you move into the processing phases, a typical session might flow like this:
- Check-in: Your therapist asks how you’ve been since the last session and whether anything new has emerged
- Target selection: Together, you identify which memory to work on
- Assessment: You bring the target memory to mind and identify the associated image, negative belief, positive belief, emotions, and body sensations
- Processing: You hold the memory in mind while following bilateral stimulation, then share what you notice. This cycle repeats
- Closure: The session ends with stabilisation exercises and a briefing on what to expect before the next session
What the bilateral stimulation feels like
During bilateral stimulation, you’ll be asked to follow a moving stimulus—most commonly your therapist’s fingers—while holding a disturbing memory or thought in mind. The therapist’s fingers move horizontally across your field of vision, and you follow them with your eyes while keeping your head still.
Some therapists use a light bar that you watch, auditory tones delivered through headphones that alternate between ears, or tactile stimulation through buzzers you hold in each hand or “tappers” that you place on your knees.
Each set typically lasts about 30 seconds. Many people report that the process feels somewhat meditative—you’re focused and aware, but in a gentle, observational way.
What you might experience
During processing, people often notice shifts in their thoughts, images, emotions, and body sensations. You might:
- See the memory change in some way—becoming less vivid, shifting in perspective, or connecting to other memories
- Notice emotions moving and shifting, sometimes intensifying briefly before diminishing
- Have insights or new thoughts arise spontaneously
- Feel sensations in your body—tension, warmth, movement
- Find that your perspective on the memory shifts
These experiences are your brain doing what it naturally does when processing is working. Your therapist is there to guide the process and ensure you stay within a manageable range of distress.
Between sessions
Processing often continues between sessions. You might notice:
- Vivid dreams or dreams about the content you’ve been working on
- Memories or thoughts that hadn’t previously come to mind
- Emotional shifts—feeling lighter, or sometimes temporarily unsettled as things process
- New insights or perspectives emerging
Your therapist will typically ask you to keep a log of anything significant that comes up, which can inform the next session.
EMDR side effects and safety considerations
Like any therapy, EMDR can involve some discomfort, particularly when working with traumatic material. Understanding potential side effects can help you prepare.
During sessions
During processing, you may experience temporary increases in distress as difficult memories are accessed. Emotions, images, and body sensations associated with the traumatic memory may become briefly more vivid before they diminish. This is a normal part of the process, not a sign that something is wrong.
Your therapist is trained to help you manage these experiences and to ensure processing stays within a tolerable range. The preparation phase specifically equips you with techniques to handle difficult emotions, and you can pause or stop at any time.
After sessions
Following an EMDR session, it’s common to experience:
- Fatigue: Processing can be mentally taxing, and many people feel tired afterward
- Vivid dreams: These often relate to the material being processed
- Emotional sensitivity: You may feel more emotional than usual for a day or two
- Physical sensations: Headaches or body sensations can occur as the body releases stored tension
- Continued processing: Thoughts, memories, or feelings related to the session may continue to emerge
These effects are typically temporary and often resolve within a few days. Many people find it helpful to schedule sessions when they can rest afterward and to avoid demanding activities immediately following a session.
Who might not be suitable for EMDR?
EMDR is generally considered safe, but it may not be appropriate for everyone or may require modifications. Situations that require careful consideration include:
- Severe dissociation: People who dissociate significantly may need extended stabilisation before trauma processing
- Active substance use disorders: Active addiction may need to be addressed alongside or before EMDR
- Current unsafe situations: If someone is in an ongoing dangerous situation, safety planning takes priority
- Certain medical conditions: Some physical health conditions may require consultation with medical providers
- Psychotic disorders: Active psychosis requires specialised consideration
A thorough assessment in the initial sessions helps identify any factors that might influence the treatment approach. A qualified EMDR therapist will discuss any concerns with you and modify the approach as needed.
The importance of a trained therapist
EMDR should only be conducted by properly trained mental health professionals. The structured protocol is designed to make processing safe, and modifications require clinical expertise.
In Australia, organisations like the EMDR Association of Australia (EMDRAA) provide accreditation for EMDR practitioners who have completed comprehensive training and demonstrated competence. Seeking an EMDRAA-accredited practitioner can help ensure you receive treatment from someone properly trained in the approach.
Finding an EMDR therapist in Australia
If you’re considering EMDR, finding the right therapist is an important step.
Qualifications to look for
In Australia, psychologists must be registered with the Australian Health Practitioner Regulation Agency (AHPRA) to practise. This ensures they have met national standards for education and competence.
For EMDR specifically, the EMDR Association of Australia (EMDRAA) offers different levels of accreditation:
- EMDR Trained: Has completed the first module of training (approximately 20 hours)
- EMDR Association Member: Has completed full Basic Training (approximately 50 hours)
- Accredited EMDR Practitioner: Has completed extensive supervised practice, submitted case consultations, and demonstrated competence through video assessment
- Accredited EMDR Consultant: Can supervise other practitioners
Seeking an Accredited EMDR Practitioner ensures you’re working with someone who has demonstrated competence across all eight phases of the protocol.
Questions to ask a potential therapist
When considering an EMDR therapist, you might ask:
- What is your EMDR training and accreditation level?
- How much experience do you have using EMDR?
- Have you worked with concerns similar to mine?
- How do you approach the preparation phase?
- What happens if I find processing overwhelming?
A good therapist will welcome these questions and provide clear, honest answers.
Accessing EMDR through Medicare
EMDR is covered under Medicare’s Better Access initiative when provided by a registered psychologist or clinical psychologist. To access Medicare rebates, you’ll need a Mental Health Care Plan from your GP.
Under a Mental Health Care Plan, you can receive up to 10 Medicare-subsidised sessions per calendar year with a psychologist. The rebate amount varies depending on whether you see a clinical psychologist or general psychologist. You’ll typically pay a gap fee (the difference between the therapist’s fee and the Medicare rebate).
Some private health insurance policies also provide rebates for psychology sessions, which can help reduce out-of-pocket costs.
Other funding options
Depending on your circumstances, EMDR may be available through:
- Department of Veterans’ Affairs (DVA): Veterans and their families may access funded mental health treatment
- WorkCover/workers’ compensation: If your condition is work-related
- NDIS: Participants with psychosocial disability may be able to access psychological support
- Employee Assistance Programs (EAP): Many workplaces offer funded counselling sessions
Frequently asked questions
How many EMDR sessions will I need?
The number of sessions varies depending on your individual circumstances. For single-incident trauma (such as a car accident), some people experience significant improvement in just a few sessions. Complex trauma or multiple traumatic experiences typically require longer treatment—often 12 to 20 sessions or more.
Your therapist can give you a better estimate after the assessment phase, but it’s important to remember that healing isn’t linear and everyone’s journey is different.
Is EMDR better than other trauma therapies?
Research generally shows EMDR and trauma-focused cognitive behavioural therapies (such as prolonged exposure and cognitive processing therapy) are similarly effective for PTSD. Neither is definitively “better”—what matters most is finding an approach that suits you.
Some people prefer EMDR because it doesn’t require detailed verbal recounting of traumatic events, involves no homework assignments, and may work more quickly for some presentations. Others prefer the structured cognitive work of CBT approaches. Discussing options with a mental health professional can help you decide.
Do I have to talk about my trauma in detail?
One aspect of EMDR that many people appreciate is that you don’t need to provide a detailed narrative of your traumatic experiences. You’ll need to identify a target memory and describe it briefly, but you won’t be asked to recount the event in detail as you might in some other therapies.
During processing, you internally hold the memory in mind while the therapist guides the bilateral stimulation. You share what you notice afterward, but this can be as brief as “the image changed” or “I feel calmer.”
Can EMDR work online?
Yes, EMDR can be delivered effectively via telehealth. The bilateral stimulation is typically achieved through guided eye movements on screen, or through apps that provide visual, auditory, or tactile stimulation.
Research supports the effectiveness of online EMDR, and many therapists developed expertise in telehealth delivery during the COVID-19 pandemic. If in-person sessions aren’t accessible for you, online EMDR is a valid option.
Will I lose my memories?
No, EMDR doesn’t erase memories. After successful processing, you’ll still remember what happened—but the memory typically loses its emotional charge. People often describe it as feeling like the memory is “in the past” rather than still happening now. The facts remain; the distress diminishes.
How quickly does EMDR work?
This varies significantly. Some people notice changes after just one or two processing sessions; others require many more. Single-incident traumas (like an accident) often resolve more quickly than complex or developmental trauma.
The preparation phase also takes time—ensuring you’re properly resourced before processing is crucial for safety and effectiveness. Rushing this phase can actually slow progress overall.
Can I do EMDR on myself?
EMDR should be conducted with a trained therapist. While there are self-help resources and apps that use bilateral stimulation, the full EMDR protocol requires clinical expertise to implement safely, particularly when working with traumatic material.
Attempting to process trauma alone can lead to becoming overwhelmed without adequate support. The therapeutic relationship itself is also an important component of the healing process.
Is EMDR covered by private health insurance?
Many private health insurance policies provide rebates for psychology sessions, which would include EMDR when provided by a registered psychologist. The amount varies by policy and level of cover. Check with your insurer for details about your specific coverage.
Taking the next step
If you’re considering EMDR therapy, I hope this guide has given you a clearer understanding of what it involves and what the evidence shows. While reading about a therapy is helpful, the real work happens in the relationship between you and a qualified therapist.
Healing from trauma takes courage. It requires being willing to turn toward difficult experiences rather than away from them—though always at a pace that feels manageable, with proper support. EMDR offers a structured, evidence-based path through this process, one that many people have found genuinely transformative.
If you have questions about whether EMDR might be right for you, speaking with a mental health professional can help you explore your options and make an informed decision about your care.
Supporting resources
If you’re experiencing distress, support is available:
- Lifeline Australia: 13 11 14 (24-hour crisis support)
- Beyond Blue: 1300 22 4636 (anxiety and depression support)
- 1800RESPECT: 1800 737 732 (sexual assault and domestic violence support)
- SANE Australia: 1800 187 263 (complex mental health support)
- 13YARN: 13 92 76 (Aboriginal and Torres Strait Islander crisis support)
To find an EMDR therapist:
- EMDR Association of Australia: Directory of accredited EMDR practitioners
- Australian Psychological Society: Find a Psychologist service
- AHPRA Register: Verify psychologist registration
This article is intended for educational purposes and does not constitute medical or psychological advice. If you are experiencing mental health difficulties, please consult a qualified health professional.