EMDR

What is EMDR?

EMDR (eye movement desensitisation and reprocessing) is a structured psychological therapy for distressing memories, most often trauma. It uses guided eye movements, taps or sounds alongside brief recall of a difficult memory, helping the brain reprocess an experience that has become stuck.

The approach was developed in the late 1980s by the psychologist Francine Shapiro, initially for post-traumatic stress disorder. It has since been used for a wider range of memories that continue to carry strong emotional weight long after the event itself, including road accidents, medical trauma, bereavement and some phobias.

How EMDR works

EMDR rests on the idea that a traumatic or highly distressing memory can get stored in the brain without being fully processed. Ordinary memories tend to settle over time and lose their emotional charge. A stuck memory does not. It can resurface with the same intensity as the original event, triggered by sounds, images or situations that resemble it.

During EMDR, a psychologist asks you to briefly hold the memory in mind while following a form of bilateral stimulation, commonly side to side eye movements, alternating taps, or alternating tones through headphones. Sets of stimulation are followed by a short pause to notice what has come up. Over a course of sessions, the memory typically becomes less vivid and less distressing to think about. You do not need to describe the event in detail for this to work; brief contact with the memory is usually enough. You stay in control throughout. A psychologist will agree a stop signal with you before starting, so you can pause the process at any point.

The eight phases

EMDR follows a structured protocol with eight phases: taking a history and agreeing a treatment plan, preparation and stabilisation, assessing the target memory and the beliefs attached to it, desensitisation using bilateral stimulation, installing a more helpful belief, a body scan to check for remaining tension, closure at the end of each session, and re-evaluation at the start of the next one. Not every phase needs a full session; several can run together once you are familiar with the process.

EMDR by video

Online EMDR follows the same phases as in-person work, delivered over a secure video call. Bilateral stimulation is usually done by following the psychologist’s hand or a moving point on screen, using alternating tapping on your own knees or shoulders, sometimes called self-tapping or the butterfly hug, or listening to alternating tones through headphones. You will need a private, quiet space where you will not be interrupted, and a stable enough connection to see and hear your psychologist clearly throughout. A laptop or tablet with a working camera and a pair of headphones is normally all the equipment needed; nothing beyond what you would already use for a video call.

How many sessions EMDR takes

There is no set number of sessions. A single, well-defined incident, such as one accident or one frightening medical procedure, may need only a handful of sessions once preparation is complete. Trauma that built up over months or years, or several linked memories, usually takes longer. Your psychologist will agree a pace with you rather than working to a fixed schedule, and will check in regularly on how you are finding the process.

The evidence for EMDR

EMDR has a substantial evidence base for post-traumatic stress disorder. NICE guideline NG116 recommends EMDR as a treatment option for adults with PTSD, alongside trauma-focused CBT. The World Health Organization also lists EMDR among the trauma-focused approaches it recommends for PTSD in adults. Evidence for other uses, such as some anxiety and phobia-related difficulties, is more limited but growing, and a psychologist will discuss what the evidence supports for your particular difficulty before starting.

Does EMDR work as well online as in person?

Research comparing remote and in-person EMDR generally finds comparable outcomes when the session is well prepared, with a private space, a reliable connection and enough time for the closure phase at the end. Some people find video sessions easier to attend consistently, since there is no travel involved, though a small number prefer to be in the same room as their psychologist for this kind of work and should say so during assessment.

Who EMDR is for, and when it may not be right yet

EMDR is generally suitable for adults with a clear traumatic memory or a small number of linked memories, including single-incident trauma, some phobias, and grief that has become complicated by how someone died. It is also used for work-related incidents, witnessing an accident or assault, and medical experiences that have left a lasting sense of threat. It may not be the right starting point if you are currently in crisis, at immediate risk of harm to yourself or others, managing severe dissociation that has not yet been stabilised, or dealing with untreated substance dependency; a full assessment will look at this before any trauma-focused work begins.

If you are in crisis right now, this is not a crisis service and cannot offer immediate support. Samaritans can be contacted free, at any time of day or night, on 116 123.

EMDR compared with trauma-focused CBT

EMDR and trauma-focused CBT are both recommended by NICE for PTSD, and the choice between them often comes down to what suits you personally. Trauma-focused CBT typically involves more structured discussion of the traumatic event, written or spoken accounts, and tasks to complete between sessions. EMDR asks for less verbal detail and less between-session work, relying instead on bilateral stimulation during the session itself. Some people find one approach sits more comfortably than the other; a psychologist can talk through both at assessment.

Getting started

Sessions are held online with adults across Bromley and south east London, including Beckenham, Chislehurst, Shortlands, Bickley, Hayes and Petts Wood, as well as further afield. No GP referral is needed to arrange an assessment. An initial assessment looks at your history, current difficulties and what you want from therapy, and will help decide whether EMDR is a good fit or whether another approach would serve you better. We will update this site as the practice develops.