Eye Movement Desensitization and Reprocessing (EMDR)

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Published September 16, 2026•Updated September 16, 2026

Indications

Primary Indications

Post Traumatic Stress DisorderGeneralized Anxiety DisorderMajor Depressive DisorderPhobiasGrief

Mechanism

The mechanism of EMDR is thought to involve dual-attention stimulation that facilitates adaptive information processing. By recalling traumatic memories while engaging in bilateral stimulation (such as eye movements, taps, or sounds), the brain may reprocess distressing material, reducing its emotional intensity and allowing new, healthier associations to form.

Protocol

Preparation

Initial assessment, history-taking, and stabilization of coping resources.

Procedure

Identify target traumatic memory.
Patient focuses on the memory while simultaneously engaging in bilateral stimulation.
Therapist guides the patient through processing until the distress decreases.
Positive beliefs are installed to replace negative cognitions.
Body scan and closure conclude each session.

Frequency: Typically once or twice per week.

Duration: 6–12 sessions for single-incident trauma; longer for complex trauma.

Total Treatment Time: Variable, often 2–4 months.

Session Structure

Pre-Session

Review symptoms and establish target memory.

Treatment Phase

Guided recall of traumatic event with bilateral stimulation.

Post-Session

Debriefing, coping strategy reinforcement, planning next target.

Expected Outcomes

Immediate

Reduction in distress related to trauma recall

Short Term

Decreased PTSD symptoms
Improved emotional regulation

Long Term

Sustained reduction in trauma symptoms
Improved functioning and quality of life

Side Effects

common

Temporary emotional distress
Fatigue
Vivid dreams

uncommon

Increased anxiety between sessions

rare

Dissociation if unprepared or unsupported

Contraindications

absolute

Active psychosis
Uncontrolled dissociation

relative

Unstable mood or medical condition

Patient Selection

ideal candidates

Individuals with PTSD or unresolved trauma
Patients who struggle with trauma recall in traditional talk therapy

screening required

Psychiatric evaluation
Assessment of stability and coping resources

Training Requirements

practitioner

Licensed therapists with EMDRIA-approved EMDR training

facility

Outpatient clinic, private practice, telehealth-adapted settings

Research Evidence

Key Studies

Shapiro F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry.
Bisson JI, et al. (2007). Psychological treatments for chronic post-traumatic stress disorder: systematic review and meta-analysis. British Journal of Psychiatry.
Watts BV, et al. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry.

Limitations

May not be suitable for patients with unstable psychiatric conditions or high dissociation without stabilization.

Cost Considerations

typical session cost: $100–$200

total treatment cost: Typically $1,200–$2,500 depending on duration

insurance coverage: Often covered under mental health benefits for PTSD

cost effectiveness: Considered cost-effective compared to long-term supportive therapy for trauma

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Integration Support

Concurrent Therapies

Pharmacotherapy for PTSD or anxiety
Mindfulness-based stress reduction
Cognitive-behavioral therapy

Special Populations

Clinical Notes

Requires specialized training and supervision for safe delivery.
Bilateral stimulation can be adapted (eye movement, tapping, auditory tones).
EMDR is often faster than traditional trauma-focused CBT for some patients.

This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

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