How Does EMDR Therapy Work?

How Does EMDR Work? Understanding the Science Behind EMDR Therapy

EMDR, or Eye Movement Desensitization and Reprocessing, is a psychotherapy approach that helps people process distressing experiences that continue to affect them in the present. Although EMDR was originally developed as a treatment for PTSD, it is now used with a range of concerns, including complex trauma, anxiety, panic, prolonged grief, phobias, chronic pain/illness linked to trauma, and other experiences that have become emotionally or physically “stuck.”

So, what actually happens during EMDR?

When something distressing happens, our brains don’t always process the experience in a way that allows it to become an ordinary memory. A traumatic or highly stressful experience can remain connected to the emotions, physical sensations, images, and beliefs that were present at the time. Later, something in the present can activate that network, and it can feel as though the past is happening again rather than simply being something that happened.

EMDR helps bring these different aspects of an experience into the processing system: the memory itself, the emotions and body sensations connected to it, and the beliefs we developed about ourselves because of what happened. These beliefs are often negative beliefs such as “I’m powerless,” “I’m not good enough,” “It’s my fault,” “I’m not safe,” or “I can’t trust anyone.” During EMDR, we work toward developing a more adaptive belief that feels true and appropriate in the present, such as “I have choices now,” “I did the best I could,” or “I am worthy.”

One of the leading scientific explanations for part of how EMDR works involves working memory. Working memory is the limited mental system we use to hold and work with information in our awareness. When you bring a distressing memory to mind while simultaneously following eye movements or engaging in another form of bilateral stimulation, both activities compete for some of the same limited mental resources. Research has found that this can reduce the vividness and emotional intensity of the memory. In simple terms, you are accessing the memory while your brain is also busy doing something else, which can make the memory easier to process and update.

How Does it Differ from Standard Talk Therapy?

While EMDR does help reprocess difficult memories, it is not only centred around making a memory less vivid. The goal is to help the brain reprocess what happened and update the meaning was tied to that event. As processing unfolds, the person may notice changes in emotions, body sensations, images, thoughts, and self-beliefs. A memory that once felt dangerous, shameful, overwhelming, or deeply personal can begin to feel more like something that happened in the past, and the individual often begins to think differently about themselves as well. Moreover, we know that trauma is not just stored in our thoughts, it is also stored internally in suppressed emotions and the body. Importantly, during EMDR, the body itself also begins to learn that the threat is no longer happening now, often releasing the tension stored there. This is one of the reasons EMDR can feel different from traditional talk therapy. You don’t necessarily have to spend a session repeatedly describing everything that happened. Instead, the therapist facilitates (through bilateral and working memory tasks) your brain/nervous system to access the parts of the experience that remain stuck and allows it to process through while staying connected to the present. There is no trance-like state or anything that you have to “believe in” in order for it to work. It is an evidence-based therapy that is supported by an overwhelming number of randomized control trials that have been carried out since the early 1990s.

Ultimately, EMDR is about helping the brain and nervous system integrate what happened rather than continuing to react as though it is still happening. The memory doesn’t need to disappear, and you don’t need to forget what happened. The goal is for the experience to become something you can remember without it continuing to control how you feel, think, or respond in the present.