EMDR Therapy: Definition & Examples

Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy that has gained popularity in recent years. It was developed in 1987 by a psychologist named Dr. Francine Shapiro who observed that certain eye movements could have an effect on disturbing memories (Oren & Solomon, 2012).  Dr. Shapiro hypothesized that these eye movements when performed while awake, can mimic the benefits of Rapid Eye Movement (REM) which happens when we sleep. She developed a protocol for EMDR and this new therapy modality spread like wildfire in the mental health community during the early 1990s. 

Early research on EMDR focused on treating war veterans and sexual assault victims and as a result, it has become a widely used treatment for different types of trauma. EMDR has also proven to be an effective treatment for other types of mental and physical conditions (Oren & Solomon, 2012). A core belief in EMDR is that dysfunctionally stored memories can often lead to outward physical and mental symptom manifestations. EMDR helps individuals reprocess these memories in such a way that they are not stored dysfunctionally but are rather fully processed and integrated back into the person’s psyche in a helpful manner.

Since it has been in use for over 30 years, there is a wealth of evidence on the effectiveness of EMDR. It can be used to treat several mental health disorders as well as physical health conditions. It is an effective, well-tolerated treatment modality for both clinicians and clients. It is also the most cost-efficient form of therapy for people with PTSD compared to eleven other types of treatment (Mavranezouli et al., 2020).

EMDR can be an effective treatment for:

• Post-traumatic stress disorder
• Phobias
• Panic disorder
• Generalized anxiety disorder
• Body dysmorphic disorder
• Chronic pain
• Migraine headaches
• Phantom limb pain (Oren & Solomon, 2012)

In addition to the proven effectiveness of EMDR versus other therapy modalities, there are other benefits as well. Namely, EMDR is much less burdensome to the person receiving treatment than traditional forms of therapy. As an example, Cognitive Behavioral Therapy typically requires 30-100 hours of homework in addition to sessions with the therapist, potentially re-exposing the client to trauma numerous times. In contrast, EMDR therapy is completed in the session and no homework is required. This leads to EMDR being a more tolerated therapy for both clients and clinicians (Arabia et al., 2011).

Eye Movement Desensitization and Reprocessing (EMDR) is most likely unlike any other type of therapy that you’ve been exposed to in the past. While there are some components of traditional psychotherapy, such as having a conversation with your therapist, many things will be completely new—like learning the physical movements required in this therapy. In a nutshell, EMDR incorporates physical actions such as eye movements and hand taps which are designed to help people reprocess what are often painful memories (Shapiro, 2001). 

The thought is that these painful memories can often underlie current psychological difficulties and that by reprocessing the memories in a healthy way, the difficulties could be alleviated. This is based on a psychological concept called the adaptive information processing model. This model states that “memory networks of stored experiences are the basis of both human health and human pathology”(Oren & Solomon, 2012). 

Are you still having trouble picturing what this type of therapy might look like? The next section will outline the eight phases of an EMDR therapy session.

In EMDR therapy, eight distinct phases occur during each session. These are described in brief detail below (Oren & Solomon, 2012). 

EMDR Phase 1 – Client History​
During this phase, the clinician will obtain a psychological history of the client. This can include current problems, future goals, and/or present difficulties. It is important to be open and honest with about what is bothering you in this phase.

EMDR Phase 2 – Preparation
The trust between clinician and client is an essential part of EMDR. During the preparation phase, the clinician will establish a relationship with the client by getting to know them better and explaining the EMDR process in detail. 

EMDR Phase 3 – Assessment
Each session focuses on a specific memory and the details of that memory are identified during this stage. The client is asked to relive details such as sounds, smells, and sights. The client should identify negative emotions associated with this memory as well as what positive emotions they want to replace these feelings with. 

EMDR Phase 4 – Desensitization
The client processes the painful or disturbing memory during this phase with guidance from the clinician. Processing includes changes in “sensory, cognitive, emotional, and somatic information. The goal of this phase is to bring the disturbance associated with the memory to the lowest possible level and enhance personal growth through the development of insight and new perspectives resulting in a new sense of self and world view” (Oren & Solomon, 2012). This is the phase that utilizes physical movements such as hand tapping or eye movements.

EMDR Phase 5 – Installation
After processing the negative emotions, this phase focuses on the new, positive beliefs around the memory. This facilitates integrating the memory into adaptive memory networks. 

EMDR Phase 6 – Body Scan
The clinician guides the client in a body scan to help identify and resolve any residual feelings in the body. The goal is to resolve all bodily sensations before the end of the session.

EMDR Phase 7 – Closure
During this phase, the clinician will tell the client what to expect after the EMDR session is completed. If the client still feels unstable, the clinician will help them relax before the session concludes. Clients may be asked to keep a diary between sessions to log how they feel.

EMDR Phase 8 – Reevaluation
Reevaluation occurs at the beginning of the next session. The clinician will assess how the treatment worked and talk about anything that might have happened between sessions.

• ​Terry is a US Army veteran who served two tours in Afghanistan and Iraq. Due to his combat experience, he is medically retired from the military with post-traumatic stress disorder. He does not respond to traditional therapy and his mental health starts to decline. A friend recommends EMDR to him as a way to re-process and reintegrate his painful memories from the war. After going to EMDR consistently for a while, Terry notices that his mental health has improved and that he can cope with life much better than before.

​​

• Yesenia is a college student who is away from home for the first time when she starts to struggle with her classes. She had some traumatic events happen in her childhood and these memories often cause her emotional pain. Her college counseling center offers EMDR therapy and she utilizes this service. The EMDR helps her reprocess her painful childhood memories, her mental health improves, and she can move forward and get her degree.

As with almost all mental health treatment, there is usually a cost involved. If you have health insurance, you may be able to get some of the cost covered through that. Otherwise, you will need to plan on paying out of pocket. The good news is that one study found that EMDR is the most cost-effective treatment for PTSD out of the eleven types of treatments analyzed, meaning if you struggle with PTSD and are looking for therapy, trying EMDR may be where you want to start to get the most value (Mavranezouli et al., 2020). 

The cost of EMDR can vary widely depending on how you receive the therapy. Traditional in-person EMDR sessions with a trained therapist can cost $100-$300 per session, online EMDR therapy costs $60-$90 per session, and self-administered online EMDR can cost $199 per month with access to unlimited sessions (Zolik, 2022). When deciding how to receive EMDR therapy, consider which option would be easiest to incorporate into your lifestyle and which one fits into your budget.

• Arabia, E., Manca, M. L., & Solomon, R. M. (2011). EMDR for survivors of life-threatening cardiac events: Results of a pilot study. Journal of EMDR Practice and Research, 5(1), 2–13. https://doi.org/10.1891/1933-3196.5.1.2 
• Barker, R. T., & Barker, S. B. (2007). The use of EMDR in reducing presentation anxiety: A case study. Journal of EMDR Practice and Research, 1(2), 100–108. https://doi.org/10.1891/1933-3196.1.2.100 
• Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd003388.pub4 
• EMDR Basic Training. EMDR International Association. (2022, December 13). Retrieved April 25, 2023, from https://www.emdria.org/emdr-training/ 
• Mavranezouli, I., Megnin-Viggars, O., Grey, N., Bhutani, G., Leach, J., Daly, C., Dias, S., Welton, N. J., Katona, C., El-Leithy, S., Greenberg, N., Stockton, S., & Pilling, S. (2020). Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults. PLOS ONE, 15(4). https://doi.org/10.1371/journal.pone.0232245 
• Oren, E., & Solomon, R. (2012). EMDR therapy: An overview of its development and mechanisms of action. European Review of Applied Psychology, 62(4), 197–203. https://doi.org/10.1016/j.erap.2012.08.005 
• Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. Guilford Press.
• Zolik, M.-B. (2022, July 1). What is the cost of an EMDR session? EMDR Healing. Retrieved April 25, 2023, from https://emdrhealing.com/cost-emdr-session/