TIRCIA · General public
EMDR: what happens in therapy, and what the research says
A recognised trauma therapy: how it works, its stages, its limits, and how to choose the right therapist
By Marie-Agnès Thulliez · Author · Publishing Director7-minute read
Perhaps you have heard about EMDR from someone close to you or from a doctor, and you are wondering what it really involves. This therapy, which uses eye movements among other things, often arouses curiosity.
It is in fact one of the most thoroughly studied treatments for trauma. Here is how it works, what sessions are like, and what is worth knowing before you begin.
What is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. This psychotherapy was developed in the late 1980s by the American psychologist Francine Shapiro.
It rests on a simple idea: the brain naturally knows how to "digest" most difficult experiences. A traumatic memory, however, can remain stuck, together with the images, emotions and sensations of the moment, as if it had never truly passed. To find out more: What is trauma?.
During the session, the person briefly brings the memory to mind while the therapist offers bilateral stimulation: following the movement of the therapist's hand with the eyes, or receiving light taps or sounds alternating left and right. Most often, the memory gradually loses its emotional charge and settles into place as an event that belongs to the past. The precise mechanisms behind this effect are still being researched.
What happens in therapy
EMDR therapy follows several stages, at a pace suited to each person (the official protocol has eight phases, summarised here as five):
- Getting to know each other. The therapist goes over your history, your current difficulties and your resources, then builds a treatment plan with you.
- Preparing. You learn tools to calm yourself and feel safe. This stage can be short or longer, depending on your history.
- Reprocessing memories. You focus on a specific memory, with the images, thoughts and sensations that go with it, during sets of bilateral stimulation. Between sets, you simply say what comes up.
- Strengthening the positive. A more accurate belief about yourself, for example "I am safe now", is reinforced.
- Checking and closing. Each session ends in a calm state, and the next session begins by taking stock.
In France, the Haute Autorité de santé (the national health authority) stated that a structured trauma-focused psychotherapy generally involves 15 to 20 sessions, once or twice a week (HAS, 2007). To our knowledge, this remains its most recent text on the treatment of post-traumatic stress disorder: guidelines on psychological trauma have been in preparation since 2020 (HAS, 2020). After a single event, fewer sessions are sometimes needed; after repeated trauma, often more.
Between sessions, it is normal for memories, dreams or tiredness to surface: the work is continuing. Talk to your therapist about it.
What the guidelines and studies say
| Source | What it says |
|---|---|
| Haute Autorité de santé (France), 2007 | For post-traumatic stress disorder, trauma-focused cognitive behavioural therapies and EMDR are the psychotherapies of choice. |
| VA/DoD 2023 guideline (Schnurr et al., 2024) | EMDR is one of the three first-line recommended psychotherapies, alongside prolonged exposure therapy and cognitive processing therapy. |
| Wright et al., 2024 | Reanalysing individual data from 346 patients across 8 trials, the researchers found no significant difference between EMDR and the other psychotherapies it was compared with (including trauma-focused cognitive behavioural therapies, but also relaxation), either for improvement or for dropout. The sample remains modest. |
| American Psychological Association, 2025 | Trauma-focused cognitive behavioural therapies are recommended first; EMDR receives a "conditional" recommendation, as a second choice. |
In short, EMDR is one of the best-supported trauma therapies. Most guidelines rank it alongside trauma-focused cognitive behavioural therapies; the American Psychological Association places it as a second choice ("conditional" recommendation), a position it already held in 2017 and maintained in its 2025 update. The choice can therefore often be made according to your preferences and the availability of therapists.
Some common misconceptions
- It is different from hypnosis: you remain awake, aware and in control of the session. You can stop at any time.
- You do not need to recount everything in detail: the therapist needs a few landmarks rather than a complete account.
- It is a full psychotherapy rather than a miracle method: it calls for preparation and support.
- It suits some people and some moments better than others: in 2007, the HAS considered it contraindicated in psychotic disorders. A Dutch randomised trial has since shown that EMDR could reduce post-traumatic stress in people with a psychotic disorder, without notable worsening, within ongoing psychiatric care (van den Berg et al., 2015). In that case, the decision is made with the team looking after you. Where dissociation is marked, a longer preparation phase is needed.
Choosing the right therapist
EMDR should be practised by a mental health professional (psychiatrist, psychologist or psychotherapist) who has completed full training in the method. Before you start, you can ask them:
- What is your core professional training, and where did you train in EMDR?
- Are you accredited or supervised in your EMDR practice?
- Do you have experience of working with situations like mine?
- How will we prepare for working on difficult memories?
A good therapist takes the time to explain the method and waits until you feel ready before starting reprocessing.
Need help now?
If you are in immediate danger, call your local emergency number (999 in the UK, 911 in North America, 112 in the EU).
If you are having suicidal thoughts, contact a crisis line: 988 (US/Canada), Samaritans 116 123 (UK and Ireland), or find a local helpline at findahelpline.com. In France: 3114.
If you have experienced violence or a crime, local victim support services can help (in France: 116 006, free, every day).
Key points
- EMDR is a trauma psychotherapy that combines briefly recalling a memory with bilateral stimulation.
- It is recommended in France and internationally for post-traumatic stress disorder.
- It is one of the best-supported trauma therapies, ranked alongside trauma-focused CBT in most guidelines.
- It is a structured psychotherapy, distinct from hypnosis, in which preparation is essential.
- Choose a mental health professional who is trained and accredited in EMDR.
References
- American Psychological Association (2025) Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD). 2025 update (first edition: 2017). Available at: https://www.apa.org/ptsd-guideline/treatments (accessed 16 October 2026).
- Haute Autorité de santé (2007) Affections psychiatriques de longue durée. Troubles anxieux graves [Long-term psychiatric conditions. Severe anxiety disorders]. Guide médecin ALD 23. Saint-Denis: HAS. Available at: https://www.has-sante.fr/portail/upload/docs/application/pdf/guide_medecin_troubles_anxieux.pdf (accessed 16 October 2026).
- Haute Autorité de santé (2020) Évaluation et prise en charge des syndromes psychotraumatiques : enfants et adultes [Assessment and management of psychotraumatic syndromes: children and adults]. Note de cadrage [scoping document], 14 October. Available at: https://www.has-sante.fr/jcms/p_3215922/fr/evaluation-et-prise-en-charge-des-syndromes-psychotraumatiques-enfants-et-adultes-note-de-cadrage (accessed 16 October 2026).
- Schnurr, P.P. et al. (2024) 'The management of posttraumatic stress disorder and acute stress disorder: synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline', Annals of Internal Medicine, 177(3), pp. 363–374. Available at: https://doi.org/10.7326/M23-2757.
- van den Berg, D.P.G., de Bont, P.A.J.M., van der Vleugel, B.M., de Roos, C., de Jongh, A., van Minnen, A. and van der Gaag, M. (2015) 'Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial', JAMA Psychiatry, 72(3), pp. 259–267. Available at: https://doi.org/10.1001/jamapsychiatry.2014.2637.
- Wright, S.L. et al. (2024) 'EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis', Psychological Medicine, 54(8), pp. 1580–1588. Available at: https://doi.org/10.1017/S0033291723003446.
This article offers general guidance, up to date at the date of publication. It is no substitute for the advice of a doctor, who alone can make a diagnosis, or for support from a psychologist or psychotherapist.
