EMDR therapy
EMDR (Eye Movement Desensitisation and Reprocessing) is a structured psychotherapy for treating the effects of traumatic experiences. Here I explain what it involves, what a session is like, what clinical guidelines say and what it is used for, without overstating what it can do.
What is EMDR?
EMDR was developed by psychologist Francine Shapiro in the late 1980s. It combines recalling a disturbing memory with alternating bilateral stimulation (guided eye movements, or sounds or taps alternating on each side of the body), within an eight-phase protocol. Its aim is for the memory to lose its emotional charge and be integrated in a more adaptive way.
Key ideas
Unprocessed memories
According to the Adaptive Information Processing model, some experiences remain stored “undigested”, with the emotions and sensations of the moment.
Bilateral stimulation
While keeping the memory in mind, the person follows an alternating stimulus, which helps the memory to be reprocessed.
A structured protocol
It is not a stand-alone technique: it follows eight phases, with careful preparation before working on memories.
Why does it work? One of the explanations with the strongest experimental support is the working memory hypothesis: doing two tasks at once (remembering and following the stimulus) reduces the vividness and emotional intensity of the memory.
What is it used for?
The main indication for EMDR, supported by clinical guidelines, is post-traumatic stress disorder:
Post-traumatic stress in adults
WHO (2013) recommends it alongside trauma-focused CBT. NICE (2018) recommends offering it to adults with PTSD after non-combat-related trauma when more than three months have passed.
Traumatic experiences in general
Accidents, assaults, sudden losses, difficult medical experiences or other events that keep affecting the present.
Other difficulties
Its use is being studied for anxiety, phobias, grief and pain, among others, but the evidence is less solid than for PTSD. I always assess it case by case.
EMDR is not a universal treatment. When the difficulty is not linked to traumatic memories, other approaches are often more suitable.
The eight phases of the protocol
Prepare, reprocess and close
The standard EMDR protocol is organised into eight phases, which I group here into four stages:
History and planning
Assessment, choice of the memories to work on, and treatment plan.
Preparation
Explaining the method and strengthening stabilisation resources so the person feels safe.
Reprocessing
Assessment of the memory, desensitisation through bilateral stimulation, installation of a positive belief and body scan.
Closure and re-evaluation
Ending each session in a stable state and checking next time how the memory has changed.
During reprocessing, you don’t have to describe the event in detail: it is enough to keep in mind an image, the associated negative belief and the sensations, during short sets of stimulation.
What clinical guidelines say
The main international guidelines recognise EMDR for post-traumatic stress, with some nuances:
Recommended
It includes EMDR and trauma-focused CBT among the recommended treatments for post-traumatic stress.
Recommended for adults
Both recommend it for PTSD in adults, NICE with conditions related to the type of trauma and the time elapsed.
Conditional recommendation
The American Psychological Association gives it a conditional recommendation, behind the variants of trauma-focused CBT.
The differences between guidelines come from how studies are evaluated. The honest statement is that EMDR is a recognised treatment for PTSD, not that it is the best one for everyone.
How I work with EMDR
Assessing whether it is suitable
Not every person or every moment is right for it. We assess it together.
Stabilising first
Before touching difficult memories, we make sure you have resources to manage your emotions.
Reprocessing at your pace
We work on the chosen memories, with breaks and always with your agreement.
Integrating
We combine EMDR with CBT or ACT to work on the present: avoidance, beliefs, plans.
I am trained in EMDR (Standard Training accredited by EMDR Europe). Sessions can take place online, with adaptations to the protocol and close attention to safety.
What EMDR is not
It is not hypnosis
You stay aware and in control of the session from start to finish, and you can stop whenever you want.
It does not erase memories
The memory remains, but it loses its emotional charge and stops intruding on the present.
It is not an instant fix
It can be effective in a few sessions in some cases, but every journey has its own pace.
It is not just about the eyes
Eye movements are one form of bilateral stimulation, within a complete therapeutic protocol.
Gonzalo Garzo
Clinical psychologist · EMDR Europe
I have been a clinical psychologist since 2018, and I am also an anthropologist. For years I combined psychology with management positions (see my LinkedIn profile), before dedicating myself fully to clinical work.
I work with an integrative approach: CBT, third-wave or contextual therapies (especially ACT, DBT and mindfulness), EMDR and humanistic psychology, adapted to each person’s needs.
I have lived in several countries and I can support you in English, French or Spanish, online or in La Rochelle.
Frequently asked questions
How many sessions are needed?
It depends on the number and type of memories and on the person’s stability. A single trauma may need few sessions; repeated experiences, more time.
Do I have to describe what happened in detail?
No. A brief description is enough, plus keeping the memory in mind during reprocessing.
Can EMDR be done online?
Yes, with adaptations to the protocol (for example self-administered alternating taps) and a case-by-case safety assessment.
Can it make things worse?
During the process, intense emotions or memories may come up; that is why preparing and closing each session properly is essential.
Shall we talk?
Sources
- Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
- World Health Organization (2013). Guidelines for the management of conditions specifically related to stress.
- National Institute for Health and Care Excellence (2018). Post-traumatic stress disorder (NG116).
- American Psychological Association (2020). Clinical Practice Guideline for the Treatment of PTSD.
- International Society for Traumatic Stress Studies (2019). ISTSS PTSD Prevention and Treatment Guidelines.
- van den Hout, M. A. & Engelhard, I. M. (2012). How does EMDR work? Journal of Experimental Psychopathology, 3(5), 724-738.
This page is for information only and does not replace a professional assessment.