EMDR explained: how eye movement desensitisation and reprocessing works

Eye Movement Desensitisation and Reprocessing (EMDR) is a structured psychotherapy developed for the treatment of post-traumatic stress and other trauma-related presentations. It is endorsed by the World Health Organization and recommended in the Australian PTSD treatment guidelines as a first-line intervention for adults.

EMDR is based on the Adaptive Information Processing model. This model proposes that distressing experiences can be stored in the brain in a fragmented, unresolved form. When this happens, reminders of the event can trigger the same emotions, body sensations and beliefs that were present at the time. EMDR aims to help the brain reprocess these memories so that they are stored as ordinary autobiographical events rather than as intrusive, present-tense material.

Treatment follows an eight-phase protocol. The first phases focus on history-taking, stabilisation and skill-building. The counsellor gathers a treatment history, identifies target memories, and teaches grounding and self-regulation techniques. Reprocessing sessions then involve holding a specific memory in mind while engaging in bilateral stimulation — commonly guided eye movements, alternating tones or tapping. Sets of bilateral stimulation are alternated with brief check-ins, and the memory is followed until distress reduces and a more adaptive belief can be held alongside it.

In a telehealth setting, bilateral stimulation is delivered using purpose-built online tools that produce a moving visual target or alternating audio cues, or through self-administered tactile methods such as the butterfly hug. Research and clinical experience indicate that online EMDR can be delivered safely and effectively when preparation and stabilisation are adequate.

EMDR does not require the client to describe the traumatic event in detail, which some people find helpful when verbal disclosure is difficult. Sessions are typically 60 to 90 minutes. The number of sessions required varies with the complexity of the presentation, the number of target memories, and any co-occurring conditions.

Common indications for EMDR include post-traumatic stress disorder, complex trauma presentations, grief, and disturbances of self-concept following interpersonal harm. It is not appropriate in every case; the counsellor will assess suitability, consider stabilisation needs, and coordinate with treating medical practitioners when relevant.

If you have an approval for counselling under the NSW Victims Services Approved Counselling Scheme and would like to discuss whether EMDR is appropriate for your presentation, submit an enquiry through the contact form.