What EMDR Is, and the Eight Phases of Treatment

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy for traumatic memories. The World Health Organization's 2013 guidelines on stress-related conditions recommend it, alongside trauma-focused cognitive behavioural therapy, for post-traumatic stress disorder.

What happens in a session

EMDR was introduced by the American psychologist Francine Shapiro in the late 1980s. The client briefly holds a distressing memory in mind while following a therapist-guided form of left-right stimulation. Side-to-side eye movements are the best known; alternating taps or tones are also used.

The aim is not to erase the memory. It is to reach a point where recalling it no longer brings the same physical reaction and the same negative belief about oneself.

The eight phases

1. History and treatment planning. Understanding the problem and choosing which memories to work on.
2. Preparation. Explaining the method and teaching ways to stay steady when emotions rise.
3. Assessment. Picking the image, the negative belief attached to it, the belief the client would rather hold, and rating the distress.
4. Desensitization. Holding the memory in mind during sets of left-right stimulation until the distress rating falls.
5. Installation. Strengthening the preferred belief.
6. Body scan. Checking for tension or discomfort that remains.
7. Closure. Making sure the client leaves the session stable.
8. Re-evaluation. Checking at the next session whether the change has held.

Where the evidence is strong, and where it is not

The best-supported use is post-traumatic stress disorder; the recommendation can be read in the WHO guideline itself. Uses beyond that, including the trauma-related side of addictive behaviour, are still being studied and should not be described as established treatment.

Who can provide it

EMDR is delivered by mental health professionals with specific training. It is not a self-help technique to copy from a video. The right first step is a licensed psychologist or psychiatrist.

This domain once belonged to the Norwegian EMDR association, which now lives at emdrnorge.no. This site has no connection to that association. It is an independent set of reading notes.