EMDR Therapy FAQ: Your Questions, Answered
EMDR (eye movement desensitization and reprocessing) is a structured, eight-phase psychotherapy that helps the brain process distressing memories so they lose their intensity. It is one of the most widely studied treatments for trauma and PTSD, recognized by the American Psychological Association (APA) and the Department of Veterans Affairs (VA).
This page answers the most common questions about EMDR: what it is, how it works, what it treats, what sessions feel like, and how to get started.
At-a-glance: EMDR
What EMDR is
What is EMDR therapy?
EMDR, or eye movement desensitization and reprocessing, is a structured, eight-phase psychotherapy that helps the brain process distressing memories so they lose their intensity and stop intruding as much. It is widely used for trauma and PTSD and is recognized by organizations like the APA and the VA. Unlike traditional talk therapy, it does not require you to describe the event in detail.
What does EMDR stand for?
EMDR stands for eye movement desensitization and reprocessing.
Is EMDR talk therapy?
No. You will talk during treatment, especially at the start when you explain your background to the therapist. But during the reprocessing phase, the focus shifts away from detailed discussion of the trauma. Instead, you notice what comes up internally while engaging in bilateral stimulation and recalling the memory.
EMDR relies more on reprocessing and bilateral stimulation than on extensive conversation about the event.
What is bilateral stimulation?
Bilateral stimulation means rhythmic, side-to-side sensory input. The most common form is back-and-forth eye movements, often guided by your therapist's hand. Some therapists use alternating taps on your shoulders or knees, headphones with tones that alternate between ears, or handheld buzzers that pulse in each hand.
All of these methods activate both sides of the brain in a rhythmic pattern, which helps the brain reprocess a distressing memory and store it differently.
How it works
How does EMDR work?
EMDR works by having you recall a distressing memory while engaging in bilateral stimulation. According to the APA's clinical practice guideline, this dual focus helps the brain change how the memory is stored and reduce its emotional charge.
Over time, the memory becomes less intense. It may feel more distant rather than something you relive. You may also notice that emotions and physical sensations tied to the trauma stop surfacing as often, and negative beliefs you associated with the experience begin to loosen.
What are the eight phases of EMDR?
The eight phases of EMDR are:
- History-taking
- Preparation
- Assessment
- Desensitization
- Installation
- Body scan
- Closure
- Reevaluation
Reprocessing (phases three through six) only begins after preparation. Your therapist uses the first two phases to build stability and make sure you have coping tools in place before working directly with distressing material.
Why does EMDR make some people tired?
Revisiting traumatic memories and processing difficult emotions takes real effort. Feeling drained after a session is common and usually brief. If the fatigue feels unusual or lingers, mention it to your therapist so they can adjust the pace.
What it treats
What is EMDR used for?
EMDR is primarily used to treat post-traumatic stress disorder (PTSD) and trauma. It may also be used as an adjunctive treatment for anxiety, phobias, and grief, but the strongest body of evidence is for trauma.
Does EMDR help with anxiety?
EMDR may help with anxiety, especially when the anxiety is linked to a traumatic experience. If a past event is one of the root causes of your anxiety, reprocessing that memory can sometimes relieve anxiety symptoms as well. There is less research on EMDR for anxiety disorders specifically than for trauma.
Does EMDR help with depression?
EMDR may help when depression is connected to trauma. A 2024 meta-analysis of randomized controlled trials published in the Journal of Clinical Medicine found that EMDR can significantly reduce depressive symptoms, with effects maintained up to 18 months after treatment. That said, the strongest evidence for EMDR remains in the treatment of PTSD and trauma.
Is EMDR effective for PTSD?
Yes. EMDR is a recommended, evidence-based treatment for PTSD. The APA conditionally recommends it, and the VA includes it in its clinical practice guidelines. A 2024 individual participant data meta-analysis published in Psychological Medicine found EMDR comparable in effectiveness to other evidence-based trauma-focused therapies, including trauma-focused cognitive behavioral therapy.
Effectiveness
Does EMDR really work?
Yes, for many people. EMDR is an evidence-based treatment recommended by the APA and the VA for PTSD, with dozens of controlled studies behind it. Some people experience meaningful relief in relatively few sessions for a single memory, while complex trauma usually takes longer. As with any therapy, results vary, and a trained clinician will track your progress.
Is EMDR controversial?
The debate about EMDR is mostly academic and centers on why it works (the role of eye movements), not whether it works. Major bodies, including the APA and the VA, recognize it as an effective trauma treatment. In practice, the question for most people is fit and readiness, not legitimacy.
How long does EMDR take to work?
The duration varies. According to the APA's clinical practice guideline, EMDR is typically delivered one to two times per week for a total of six to 12 sessions, which works out to roughly two to four months. A single traumatic memory may take fewer sessions to process, while complex or ongoing trauma can take longer.
How many EMDR sessions are needed?
A general range is six to 12 sessions total. It could take as few as three to six for a single distressing memory, or eight to 12 or more for complex trauma. Sessions typically run 60 to 90 minutes. Once reprocessing begins, your therapist will track your progress and give you a clearer picture of the timeline for your situation.
What to expect
What does EMDR feel like?
EMDR can feel emotionally challenging because you are revisiting difficult memories, but you stay aware and in control throughout. You may feel strong emotions or notice physical sensations like tightness in your chest or stomach as you process. Your therapist paces the work and checks in with you between sets of bilateral stimulation.
At the end of each session, you do a body scan to notice whether any tension or sensation remains. Your therapist then helps you feel grounded and stable before you leave.
What happens in an EMDR session?
Your therapist asks you to recall a distressing memory while engaging in bilateral stimulation. Most often, this means following their hand or a light bar with your eyes as it moves side to side. Some therapists use alternating taps, handheld buzzers, or headphones instead.
During the session, your therapist leads you through short sets of bilateral stimulation and pauses between them to check in on what you are noticing, whether that is a new emotion, a thought, or a physical sensation. Over time, this process helps the brain reprocess the memory so it feels less intense.
At the end of the session, your therapist helps you feel grounded and stable.
Is it normal to cry during EMDR?
Yes. EMDR can bring up intense emotions you may have been holding back, and tears are a natural part of that process. Your therapist is trained to support you through these moments and will not rush you.
What should I avoid after an EMDR session?
Give yourself some gentle time after a session. You may feel emotionally drained, so it helps to avoid high-stakes conversations, major decisions, or tasks that require intense focus right afterward.
Processing can continue between sessions. Vivid dreams, unexpected emotions, or new memories surfacing in the days that follow are all normal. Keep a note of what comes up so you can share it with your therapist at your next appointment.
Safety and side effects
What are the side effects of EMDR?
Some people notice temporary effects between sessions, such as vivid dreams, fatigue, or heightened emotion. These are usually part of processing and settle with time and your therapist's support. If they feel intense or persistent, tell your therapist, who can slow the pace. Serious adverse effects are uncommon when EMDR is done by a trained clinician with proper preparation.
Are there dangers or risks of EMDR?
EMDR is considered safe when delivered by a trained therapist who builds stabilization first. The main risk is becoming overwhelmed if difficult material is processed before you are ready, which is why preparation and pacing matter. A skilled clinician keeps the work within a range you can tolerate and will pause or slow down if needed.
Can EMDR create false memories?
EMDR does not aim to recover hidden memories or implant new ones. The therapy focuses on reprocessing memories you already have so they feel less distressing. Some people notice that details or feelings connected to a memory shift during processing, but this reflects the brain integrating the experience rather than creating something new. If this is a concern for you, raise it with your therapist before starting.
When is EMDR not recommended?
EMDR is not recommended when you are in active crisis, such as having thoughts of harming yourself or others. In those situations, stabilization and safety planning come first.
EMDR may also not be the right fit if you are experiencing severe dissociation, since the reprocessing phase requires you to stay present with the memory. Your therapist will assess your readiness during the preparation phases and may recommend building coping skills before beginning reprocessing. For more on recognizing when to adjust course, see our guide on signs to pause or reassess EMDR.
Who it's for
Who is a good candidate for EMDR?
Someone with unresolved trauma or distressing memories who has (or can build) enough emotional stability to tolerate the reprocessing process. EMDR is not appropriate during active crisis, but many people who feel "stuck" or find that a past experience still affects their daily life are good candidates.
Your therapist will assess your readiness during the preparation phase and help you build coping tools if needed before beginning reprocessing.
Can EMDR be done online?
Yes. EMDR can be done online with a trained therapist and a safe, private space. For bilateral stimulation, your therapist may ask you to follow their hand back and forth on the screen, or guide you through alternating taps on your knees or shoulders. Some therapists use audio tones through headphones.
Cost and access
Does insurance cover EMDR?
In most cases, yes. EMDR is a form of psychotherapy, so it is typically covered like other therapy under mental health parity laws. At Octave, most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Exact costs vary by plan and are always confirmed before care begins.
How do I find an EMDR therapist?
Look for a therapist with specific training in EMDR and experience treating trauma. You can browse therapist directories and filter by trauma specialty and EMDR training.
If you are looking for an EMDR therapist through Octave, our Care Navigation team can match you with a qualified, EMDR-trained clinician.
Find an EMDR-trained therapist at Octave
How Octave supports you
Octave's therapists are fully licensed, average 10+ years of experience, and include clinicians trained in EMDR who build stabilization first and pace the work to your readiness. Octave does not work with trainees or pre-licensed associates.
Most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Forty million Americans are in-network, FSA and HSA are accepted, and matching typically happens within one to three business days. Virtual, in-person, and hybrid care is available. Octave is therapy only; if you need a prescriber or a higher level of care, our Care Navigation team can help point you toward the right resources. Exact costs vary by plan and are always confirmed before care begins.
A note on crisis support
EMDR is not crisis care. If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline) or go to the nearest emergency room.
Find an EMDR-trained therapist at Octave
Sources
- American Psychological Association. "Eye Movement Desensitization and Reprocessing (EMDR) Therapy." PTSD Clinical Practice Guideline. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing/
- Brouzos, A., et al. (2024). "The Efficacy of Eye Movement Desensitization and Reprocessing Treatment for Depression: A Meta-Analysis and Meta-Regression of Randomized Controlled Trials." Journal of Clinical Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC11433385/
- Bisson, J.I., et al. (2024). "EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis." Psychological Medicine. https://pubmed.ncbi.nlm.nih.gov/38173121/
- Shapiro, F. (2014). "The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences." The Permanente Journal, 18(1), 71-77. https://pmc.ncbi.nlm.nih.gov/articles/PMC3951033/
