EMDR Therapy · In Depth
How EMDR therapy works.
The Adaptive Information Processing model, dual attention stimulation, and what actually happens in each of the eight phases of the EMDR protocol.
What EMDR is, in plain language
EMDR (Eye Movement Desensitization and Reprocessing) is a structured, evidence-based therapy that helps the brain process and resolve disturbing memories. It is delivered in eight phases by a licensed clinician trained in the protocol. You hold a memory in mind while your therapist guides you through bilateral stimulation, allowing unprocessed parts of the experience to move toward resolution.
EMDR was developed by Francine Shapiro in the late 1980s and has since accumulated more than three decades of research support, including conditional or strong recommendations from the American Psychological Association and the VA/DoD clinical practice guideline for the treatment of PTSD.
What follows is a closer look at the mechanism, the model behind it, and what each of the eight phases actually involves in session.
What happens in your brain during EMDR
When something overwhelming happens, the brain shifts its focus from making sense of the experience to simply surviving it. Instead of being filed away as something that happened in the past, the memory can stay "stuck," keeping the emotions, body sensations, and beliefs from that experience feeling as intense as they did when it first happened. That is why a sound, a smell, or a situation can suddenly bring everything flooding back as if it is happening right now.
EMDR helps the brain do what it naturally wants to do: process the experience and move it from feeling like a present-tense emergency to feeling like something that happened in the past. Something you can remember without being overwhelmed by it.
During EMDR, your therapist will guide you through dual attention stimulation (DAS), also called bilateral stimulation. This is a gentle, alternating right-to-left stimulus that can take a few different forms:
- Eye movements: following your therapist's fingers or a light bar back and forth
- Tapping: gentle alternating taps on your hands or knees, or holding small hand-held buzzers that pulse side to side
- Audio: gentle tones that move between your left and right ear through headphones (wired headphones usually work best)
You and your therapist decide together which form fits you and the situation. For telehealth sessions, on-screen visual stimulation, audio bilateral stimulation, or guided self-tapping all work.
Research has shown that DAS helps different parts of the brain work together in a way that allows difficult memories to be processed and integrated. The mechanism is still being studied, but the effect is consistent enough across decades of research that EMDR sits among the front-line, evidence-based treatments for trauma.
The Adaptive Information Processing model
EMDR is built on a theory called the Adaptive Information Processing model (AIP), created by Francine Shapiro. The core idea is that the brain naturally moves toward healing when the right conditions are in place, much like the body heals from a physical wound when nothing is blocking the process.
Think of a splinter. If a splinter is lodged in your hand, the body cannot fully heal the wound until the splinter is removed. Traumatic memories can work the same way. They can act as a kind of block, keeping the brain from processing what happened. EMDR helps access and remove that block so the brain's natural integration can resume.
You do not forget what happened. The memory is still there, but it no longer carries the same emotional intensity. You can think about it without being pulled back into the pain of it.
AIP is also why EMDR therapists pay attention to networks of related memories rather than just isolated incidents. A current-day pattern (a fear, a reaction, a belief about yourself) is often connected to a chain of earlier experiences that taught the nervous system to respond that way. Working at the level of the network, not just the symptom, is part of what gives EMDR its reach.
The protocol
The eight phases of EMDR
EMDR follows a structured, eight-phase approach, but it stays flexible. Each phase adapts to what you bring in, and different phases take different amounts of time depending on your history and what feels right for you.
History & getting to know you
Your therapist asks about what brought you to therapy and explores your strengths and resources. You will not be asked to detail all of your past traumas in this phase. That is by design. Talking about a painful event in detail can activate the memory network and bring up intense feelings before you are prepared to work with them.
Preparation
This is where your therapist helps you build the skills and resources you will need before any trauma processing begins. You will learn techniques to feel grounded and safe. Your therapist will introduce DAS for the first time so you know what it feels like. Don't be discouraged if you spend time here. The time invested in this phase directly supports everything that comes after.
Assessment
Together you and your therapist identify a specific memory to work on. You notice the image, the emotions, and the body sensations that come with it. You also identify a negative belief you hold about yourself connected to that memory (something like "I'm not safe" or "It was my fault") and a positive belief you would like to replace it with.
Desensitization
This is where DAS is used while you focus on the target memory. Your therapist guides you through sets of eye movements, taps, or sounds while you hold the memory in mind. You do not need to describe the memory in detail. You just hold it. Over the course of processing, the memory typically becomes less distressing. Many people describe it as the emotional charge gradually draining away.
Installation
Once the distress around the memory has decreased, your therapist helps strengthen the positive belief you identified earlier. The goal is for that new belief, something like "I am safe now" or "It wasn't my fault," to feel genuinely true, not just something you know intellectually.
Body scan
Your therapist asks you to notice what is happening in your body while you think about the memory and your new positive belief. If there is any remaining tension, tightness, or discomfort, it can be targeted for further processing. This matters because trauma doesn't just live in your thoughts. It lives in your body too.
Closure
At the end of each session, your therapist makes sure you feel grounded and stable. If processing on a particular memory is not complete yet, you will be guided through techniques to contain what is still unprocessed so you can go about your life between sessions. You should always leave a session feeling at least as good as when you arrived.
Reevaluation
At the beginning of the next session, your therapist checks in about how things have been and whether the positive results have held. From there, you continue processing or move on to the next target. Phases 3 through 8 repeat for each memory being processed.
After the core memories have been addressed, your therapist will also help you work through any present-day situations that still trigger you and help you feel prepared for challenges you might face in the future. The eight-phase structure is the scaffolding. The work itself remains yours.
Why the eight-phase structure works
The structure of EMDR is not bureaucratic. Each phase exists for a clinical reason that protects the work and the client.
Phases 1 and 2 exist because trauma processing without preparation is unsafe. The grounding skills, the trust between client and therapist, and the shared map of the work all need to be in place before the active processing begins. Trauma processing without these phases tends to backfire, often producing worse outcomes than no treatment at all.
Phase 3 (assessment) ties the body, the belief, and the image together. This isn't theoretical: research consistently shows that engaging multiple sensory and cognitive channels produces stronger memory reconsolidation than working with any one channel alone.
Phases 4 through 6 do the active work, but always with phase 7 (closure) holding the boundary. Closure is what makes it possible to engage difficult material in session and still leave the office regulated. It is also what makes EMDR sustainable across many sessions over time.
Phase 8 acknowledges that the brain continues processing between sessions. Reevaluating each session is how the therapist tracks what has actually shifted versus what still needs work. The work is iterative. The structure is what keeps it coherent.
Frequently asked questions
What is bilateral stimulation in EMDR?
Bilateral stimulation, also called dual attention stimulation (DAS), is a gentle, alternating right-to-left stimulus used during EMDR processing. It can take the form of eye movements (following the therapist's fingers or a light bar), tapping (alternating taps on hands or knees, or hand-held buzzers), or audio tones alternating between left and right ear. The therapist and client choose the form together, based on what fits the client and the situation.
Do I have to describe traumatic memories in detail?
No. EMDR does not require detailed verbal recounting. You hold the memory in mind while your therapist guides you through bilateral stimulation. You stay in control of what you share. For people who find narrating past experiences overwhelming, this is part of why EMDR can be more accessible than traditional talk therapy for trauma.
How many sessions does the 8-phase protocol take?
It varies. Phases 1 and 2 (history and preparation) might take 1 to 4 sessions depending on what you bring in and how much skill-building is useful. Phases 3 through 8 then repeat for each memory being processed. Some clients see significant change in 8 to 12 sessions of focused work on a specific issue. Clients with more complex histories often work in EMDR longer. Your therapist will share a clearer sense of pacing as the picture comes into focus.
Can EMDR be done over telehealth?
Yes. EMDR adapts well to telehealth using on-screen visual stimulation, audio bilateral stimulation, or guided self-tapping. Clinicians who deliver EMDR via video are trained in the adaptations. Many clients find video-based EMDR easier to maintain because there is no commute and they can do the work from a familiar setting. Our telehealth page covers the practical setup.
If you are in crisis right now
We are an outpatient practice and not a crisis service. If you or someone you love is in immediate danger or thinking about suicide, please call or text 988 for the Suicide and Crisis Lifeline, or go to your nearest emergency room. Help is available right now.
Curious whether EMDR fits you?
A consultation is the most direct way to talk through what's going on and figure out whether EMDR (or another modality we offer) is the right fit. There is no commitment to start care from a consultation.
Learn More
EMDR Therapy Overview
The full guide to EMDR: what it is, what it helps with, and what to expect.
What to Expect
A walkthrough of the first call, the first session, and what working with us looks like over time.
EMDR Intensives
Extended sessions (2x3hr or 3x2hr) that condense weeks of regular EMDR into a focused window.
Clinically reviewed by
Sarah Martin, LCPC, NCC
Clinical Director
Sarah is the Clinical Director at Trauma Specialists of Maryland, a Licensed Clinical Professional Counselor and Board Certified Counselor with over eight years in the field. She is trained in EMDR and reviews our clinical content for accuracy.
Read full bioPrimary reviewer
Mary Lockyer-Bratton, LGPC
Therapist, Frederick, MD