EMDR for PTSD

EMDR for PTSD

Short Answer: EMDR is a well-established treatment for post-traumatic stress disorder (PTSD). It helps people work with distressing memories and the thoughts, feelings, and reactions connected to them by combining focused attention with bilateral stimulation, such as guided eye movements, alternating sounds, or tapping. EMDR has been extensively studied for PTSD and is recommended in major treatment guidelines.

Key Takeaways

• PTSD is the condition for which EMDR has been most extensively studied.
• EMDR focuses on distressing memories and the thoughts, feelings, beliefs, or body sensations connected to them.
• You do not necessarily need to describe a traumatic experience in extensive detail during EMDR.
• Major organizations and clinical guidelines recognize EMDR as a treatment for PTSD.
• EMDR may be used to work with one specific event or multiple experiences connected to PTSD.
• The goal is for distressing memories and triggers to carry less emotional intensity and interfere less with everyday life.

What Is PTSD?

PTSD stands for post-traumatic stress disorder. It can develop after experiencing or witnessing an event that felt frightening, threatening, or deeply distressing.

Not everyone who goes through a difficult experience develops PTSD. For those who do, reactions connected to the experience can continue long after the event itself has ended.

Someone with PTSD might notice:

• Unwanted or upsetting memories
• Nightmares
• Feeling anxious or on alert
• Avoiding certain places, situations, or reminders
• Strong reactions to particular sounds, sights, people, or situations
• Negative thoughts or beliefs connected to what happened
• Difficulty feeling relaxed or comfortable in situations that are actually safe

The exact experience varies from person to person.

For some people, one particular memory stands out. For others, PTSD may be connected to several experiences or a longer period of difficult events.

How Does EMDR Work With PTSD?

EMDR stands for Eye Movement Desensitization and Reprocessing.

During EMDR, you briefly bring a distressing memory or another focus to mind while engaging in bilateral stimulation.

Bilateral stimulation alternates attention from one side to the other and may involve:

• Guided side-to-side eye movements
• Alternating sounds
• Alternating tapping

You then pause and notice what comes to mind before continuing.

The process may involve the memory itself as well as thoughts, feelings, images, beliefs, or physical sensations connected to it.

The goal is not to erase the memory or convince yourself that the event did not matter.

Instead, EMDR is intended to help the memory become less emotionally charged so that remembering what happened does not produce the same reaction it once did.

Why Is EMDR Used for PTSD?

PTSD often involves memories that continue to produce strong reactions even though the event happened in the past.

A reminder can sometimes make the experience feel unusually immediate.

For example, someone involved in a serious car accident might later feel a strong reaction when approaching the same intersection, hearing tires screech, or riding in a car under similar conditions.

Someone who experienced bullying might react strongly to criticism or situations that remind them of being humiliated.

EMDR provides a structured way to focus on the memories and associations connected to those reactions.

Over time, the aim is for the event to feel more clearly like something that happened in the past, rather than something that continues to produce the same level of emotional response in the present.

What Might You Focus on During EMDR for PTSD?

A common starting point is a specific memory connected to the traumatic experience.

You might focus on:

• A particular moment from the event
• An image that stands out
• A thought about yourself connected to what happened
• An emotion associated with the memory
• A physical sensation you notice when thinking about it
• A situation that triggers a reaction now
• A future situation you would like to approach differently

You do not necessarily need to work with everything at once.

If several memories are connected to the PTSD, you can work with them individually.

Sometimes one memory also brings another related memory to mind. That can become part of the process naturally rather than something you need to plan in advance.

Do You Have to Talk About the Trauma in Detail?

Not necessarily.

This is one of the ways EMDR differs from some other approaches.

Traditional talk therapy may involve describing experiences and discussing thoughts and feelings with another person.

EMDR uses a more structured process and does not necessarily require you to describe every detail of the traumatic experience out loud.

The American Psychological Association notes that EMDR differs from some other trauma-focused treatments because it does not require extended exposure to the distressing memory or detailed descriptions of the trauma.

You still bring the memory or another relevant focus to mind, but much of what you notice during the process can remain private.

For people who do not want to repeatedly explain every detail of a difficult experience, this can be an important distinction.

Is EMDR Effective for PTSD?

PTSD has the strongest research base of any condition for which EMDR is used.

EMDR has been studied for decades, including in randomized controlled trials and systematic reviews.

Major clinical guidelines recognize it as a treatment for PTSD.

The 2023 U.S. Department of Veterans Affairs and Department of Defense PTSD guideline strongly recommends EMDR alongside Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) as individual trauma-focused psychotherapies for PTSD.

The World Health Organization also includes EMDR among the psychological interventions that can be considered for adults with PTSD.

This substantial evidence base is one reason EMDR has become widely associated with PTSD treatment.

Research continues into exactly why EMDR works. There are different theories about the role of bilateral stimulation, attention, memory, and working memory during the process.

We do not need a complete explanation of the mechanism, however, to know that EMDR has demonstrated benefits for PTSD in clinical research.

What Does Progress With EMDR for PTSD Look Like?

Progress does not necessarily mean forgetting what happened.

You may still remember the event clearly.

What can change is how strongly you react to the memory and the things associated with it.

For example, you might notice that:

• Thinking about the event feels less upsetting.
• A memory seems less vivid or immediate.
• A trigger produces a smaller reaction.
• A negative belief about yourself feels less convincing.
• You feel more comfortable in situations you previously avoided.
• You can remember what happened without feeling as though you are back in the experience.

Changes may happen gradually rather than all at once.

Different memories may also change at different rates.

Can EMDR Help With PTSD From Different Types of Experiences?

EMDR is not limited to one particular type of traumatic experience.

PTSD can be connected to many different events, including:

• Accidents
• Assault
• Abuse
• Combat or military experiences
• Natural disasters
• Medical experiences
• Sudden loss
• Violence
• Childhood experiences
• Repeated exposure to frightening or distressing events

What matters during EMDR is not fitting the experience into a particular category. The focus is on the memories, beliefs, feelings, and present-day reactions connected to what happened.

What If There Are Several Traumatic Memories?

PTSD is not always connected to one event.

Some people can identify a single experience that continues to bother them. Others have several memories or a series of related experiences.

You do not need to address every memory during one EMDR session.

Instead, you can choose a specific focus and work with it individually.

As one memory becomes less distressing, you may decide to work with another.

This allows EMDR to be approached as a process rather than something you need to complete all at once.

Can EMDR Work With Current PTSD Triggers?

Yes. EMDR does not only focus on the past.

A current trigger may help you identify what you want to work on.

For example, you might notice that:

• Driving past a certain location makes you anxious.
• A particular sound brings back a memory.
• Conflict makes you feel as though an earlier experience is happening again.
• A medical appointment reminds you of a previous difficult experience.
• Being around certain people or situations produces an unexpectedly strong reaction.

You can begin with the current reaction and notice what memory, image, thought, or feeling seems connected to it.

EMDR may also include thinking about future situations you want to approach differently.

How Many EMDR Sessions Are Needed for PTSD?

There is no single number that applies to everyone.

The American Psychological Association describes therapist-guided EMDR as commonly being delivered over approximately 6 to 12 sessions, while also noting that some people benefit from fewer.

That does not mean everyone with PTSD needs the same amount of EMDR.

The amount of work involved can depend on factors such as:

• Whether you are focusing on one event or several
• How many memories or triggers you want to address
• How you respond from one session to another
• The length and pace of individual sessions

It can be more useful to pay attention to how particular memories and triggers are changing than to aim for a predetermined number of sessions.

Using Virtual EMDR for PTSD

Virtual EMDR is a specific self-guided online EMDR program.

This is different from the general phrase “virtual EMDR,” which is also sometimes used to describe traditional therapist-led EMDR conducted remotely through video.

With the Virtual EMDR program, you work independently through a structured online EMDR process rather than participating in a live therapist-led session.

You can choose what you want to focus on, use the available bilateral stimulation options, and move through the process at your own pace.

Because it is self-guided, you also control the timing of your sessions and can pause or stop whenever you choose.

This can provide an alternative for people who prefer doing EMDR privately, independently, and on their own schedule.

Conclusion

EMDR is one of the most extensively studied treatments for PTSD.

It uses focused attention together with bilateral stimulation to work with distressing memories and the thoughts, feelings, beliefs, and reactions connected to them.

The aim is not to erase what happened. Instead, EMDR can help a difficult experience feel more firmly located in the past and reduce how strongly memories and triggers affect you in the present.

You also do not necessarily need to describe every detail of an experience or work with every difficult memory at once. EMDR provides a structured way to focus on one memory, trigger, belief, or reaction at a time and notice how it changes.