What Is Tactile Bilateral Stimulation?

What Is Tactile Bilateral Stimulation?

Short Answer: Tactile bilateral stimulation is a form of stimulation used during Eye Movement Desensitization and Reprocessing (EMDR) that alternates a physical sensation between the left and right sides of the body. A common example is tapping the left side and then the right side in a repeating pattern. Other methods can include handheld devices that alternate gentle pulses between the hands. Tactile stimulation is an alternative to visual eye movements or alternating sounds and can be used while you briefly focus on a memory, thought, feeling, image, or body sensation.

Key Takeaways

• Tactile bilateral stimulation uses alternating physical sensations on the left and right sides of the body.
• Tapping is one of the most common examples.
• Tactile devices that alternate gentle pulses between the hands can also be used.
• It can be used instead of eye movements or alternating sounds.
• The taps or pulses do not need to be forceful.
• Tactile stimulation is one part of the larger EMDR process, not the whole treatment.
• Research does not establish that tactile stimulation and eye movements work in exactly the same way.

What Does “Tactile Bilateral Stimulation” Mean?

The term can be broken into two parts.

Tactile means related to the sense of touch.

Bilateral means involving two sides.

So tactile bilateral stimulation involves a physical sensation that alternates between the two sides of the body.

A simple pattern might be:

Left → right → left → right

The EMDR International Association includes alternating tactile stimulation in its definition of bilateral stimulation used during EMDR.

How Does Tapping Work?

With tapping, gentle taps alternate between the left and right sides of the body.

For example, you might tap:

• The left knee, then the right knee
• The left thigh, then the right thigh
• The left hand, then the right hand
• The left shoulder, then the right shoulder

The exact location can vary.

The important feature is the alternating pattern.

The taps do not need to be hard. The purpose is simply to create a noticeable physical rhythm that can be followed while you are also paying attention to the material being processed.

What Are Tactile Tappers or Buzzers?

Some EMDR sessions use small devices held in the hands.

These devices may produce gentle alternating pulses or vibrations, first in one hand and then the other.

This creates a tactile left-right pattern without requiring you to tap yourself.

EMDR International Association material describes tactile tappers or buzzers as one way bilateral stimulation can be delivered.

The experience is different from visual eye movements or auditory tones because the stimulation is felt physically rather than seen or heard.

How Is Tactile Bilateral Stimulation Used During EMDR?

Tactile stimulation is usually used while you also focus on something connected with the EMDR work.

That might be:

• A memory
• An image
• A thought
• An emotion
• A belief
• A body sensation

A simplified sequence might look like this:

1. Bring the memory or other focus to mind.
2. Begin alternating left-right tapping or pulses.
3. Continue for a brief set.
4. Pause.
5. Notice what thoughts, emotions, images, memories, or sensations are present.
6. Continue with another set.

The tactile stimulation acts as the second focus of attention while you remain connected to what you are processing.

Is Tactile Stimulation the Same as Eye Movements?

No.

Both can be used as bilateral stimulation during EMDR, but they are different sensory tasks.

Eye movements use vision.

Tactile stimulation uses touch.

They therefore do not feel the same and should not automatically be assumed to produce identical effects.

One experimental study found that alternating tactile stimulation and horizontal eye movements both affected memory retrieval under the conditions tested.

However, that kind of study does not prove that tactile stimulation and eye movements are completely interchangeable in every part of EMDR.

The more accurate conclusion is that both are recognized forms of bilateral stimulation.

Why Might Someone Use Tapping Instead of Eye Movements?

There are several practical reasons.

Someone may find tapping:

• Easier to follow
• More comfortable
• Less visually distracting
• More convenient during an online session
• Easier to use with the eyes closed

A practitioner may also change the type of bilateral stimulation during a session.

That does not automatically mean the previous method was not working. It can simply be an adjustment to how the stimulation is being delivered.

Some people exploring EMDR for anxiety may also prefer a tactile method if visual tracking feels distracting.

Can You Use Tactile Stimulation With Your Eyes Closed?

Yes.

Because tactile stimulation uses touch rather than vision, you do not need to visually track anything.

You can feel alternating taps or pulses whether your eyes are open or closed.

This makes tactile stimulation different from visual bilateral stimulation, where you need to see the moving target in order to follow it.

Does Tapping Have to Be Left and Right?

In the usual EMDR sense, tactile bilateral stimulation alternates between the two sides of the body.

For example:

Left hand → right hand → left hand → right hand

The alternating pattern is what makes it bilateral stimulation.

Tapping both sides at exactly the same time is a different sensory pattern.

How Fast Should Tactile Bilateral Stimulation Be?

There is no single tapping speed that everyone must use.

The pace can vary depending on the person, the part of the session, and how the stimulation is being used.

The tapping should generally be noticeable and easy enough to follow without becoming the only thing you can pay attention to.

The goal is not to tap as quickly as possible.

It is to create a usable alternating task while you remain engaged with the memory, thought, feeling, image, or sensation you are working on.

Does Tactile Stimulation Have to Be Strong?

No.

The stimulation only needs to be noticeable.

Tapping does not need to hurt or create a strong physical sensation.

A light, steady alternation can still provide the tactile left-right pattern.

The same applies to handheld devices: the pulses or vibrations can be gentle enough to notice without needing to feel intense.

What Is the Butterfly Hug?

One well-known form of self-administered tactile bilateral stimulation is sometimes called the Butterfly Hug.

The arms are crossed over the chest and the hands alternate tapping the upper chest or shoulder area.

It was originally developed as a self-soothing and bilateral stimulation technique and has been incorporated into some EMDR-related work.

The underlying tactile pattern is the same basic idea: alternating touch between the two sides of the body.

Is Tactile Bilateral Stimulation the Whole EMDR Process?

No.

Tapping by itself is not the same as completing EMDR.

EMDR is a structured process that includes more than bilateral stimulation. It can involve identifying what you want to work on, noticing thoughts and emotions, using sets of bilateral stimulation, pausing between sets, and noticing what changes.

The EMDR International Association defines EMDR as a structured treatment that combines dual attention with alternating visual, auditory, or tactile stimulation.

Tactile stimulation is therefore one component within that larger process. Tactile stimulation may also be used within EMDR when working with experiences related to PTSD.

Tactile Stimulation in Online and Self-Guided EMDR

Tactile bilateral stimulation can also be used outside a traditional in-office setting.

Online EMDR guidance describes physical tapping as one way bilateral stimulation can be used during remote sessions.

With Virtual EMDR, the self-guided program provides bilateral stimulation through its available online settings, while users manage their own pacing and session experience.

More broadly, self-guided EMDR can acknowledge tactile stimulation as one of the ways bilateral stimulation may be delivered without assuming that every session must rely on visual eye movements.

Conclusion

Tactile bilateral stimulation uses touch to create an alternating left-right pattern during EMDR.

It may involve self-tapping, tapping guided by another person, or devices that provide gentle alternating pulses or vibrations.

Like eye movements and alternating sounds, tactile stimulation gives your attention another task while you focus on a memory, thought, feeling, image, or body sensation.

It does not have to feel strong, and it does not require your eyes to be open.

The simplest way to understand it is this: instead of following bilateral stimulation with your eyes or hearing it through sound, you feel it through touch.