EMDR

What is EMDR?

EMDR, or Eye Movement Desensitisation and Reprocessing, is a structured therapy that helps the brain process memories connected to a distressing or traumatic experience. It uses sets of bilateral stimulation, most often guided eye movements, alongside brief recall of the memory, so that the memory can settle into the past rather than continuing to intrude on the present.

EMDR was developed for post-traumatic stress and remains best known for that use. The idea behind it is that a disturbing event can get stored in memory in a raw, poorly processed way, so that sounds, images or situations linked to it keep triggering the same fear or distress years later. EMDR aims to help the brain finish processing the memory, so it stops firing the alarm every time it is touched.

How EMDR works

A trained practitioner asks you to briefly hold a specific image, thought or body sensation connected to the memory in mind, while following a back-and-forth stimulus, usually the practitioner’s finger or a moving light on screen, with your eyes. Short sets of this alternate with checking in on what has come up: a new thought, a shift in feeling, a different memory.

Nobody expects you to narrate the traumatic event in detail. You choose how much to describe out loud, and a session can move forward using very little verbal detail if that is what feels manageable. The practitioner tracks the process and adjusts pace, and stops if things become too much.

What EMDR looks like over video

Online EMDR follows the same structure as in-person work, adapted for the screen. Bilateral stimulation is usually delivered by asking you to follow the practitioner’s hand or a moving dot on the video call, or through a tapping pattern you do yourself, guided by the practitioner, such as alternating taps on your own knees. Some practitioners use a shared-screen visual tool instead.

You will need a private space, a stable internet connection and a device propped so both your hands are free. Many people also value having their own familiar surroundings during a session that touches on difficult material, rather than travelling to and from an unfamiliar room straight afterwards.

The eight phases of EMDR

EMDR follows a set structure, usually across several sessions rather than within one:

• History taking, to understand your background and identify target memories
• Preparation, including grounding and coping skills before any reprocessing begins
• Assessment, pinning down the specific image, belief and body sensation tied to the memory
• Desensitisation, the bilateral stimulation sets that reduce the memory’s emotional charge
• Installation, strengthening a more helpful belief in place of the old one
• Body scan, checking for any remaining physical tension linked to the memory
• Closure, bringing each session to a stable close
• Reevaluation, reviewing progress at the start of the next session

How many sessions will I need

This varies with the type and number of memories involved. A single, recent, clearly defined incident can sometimes be worked through in around six to eight sessions. Longer-standing or repeated trauma, including childhood experiences, usually needs more time, since there is more history to work through and more preparation needed before reprocessing starts. Sessions tend to run longer than a standard fifty-minute therapy hour, often sixty to ninety minutes, because interrupting reprocessing partway through is best avoided.

The evidence for EMDR

EMDR is recommended by the National Institute for Health and Care Excellence for post-traumatic stress disorder, alongside trauma-focused cognitive behavioural therapy. Both are considered first-line psychological treatments for PTSD in adults. The evidence base is strongest for single-incident and multiple-incident trauma, research into its use for complex, developmental trauma continues to grow, and a practitioner will assess whether it is the right fit for your particular history before starting.

Is EMDR effective and safe online

Online delivery of EMDR has become well established since services moved to video during the pandemic, and practitioners now routinely deliver it this way rather than treating it as a fallback. Reviews comparing remote and in-person psychological therapy generally find comparable outcomes, and EMDR practitioners have adapted bilateral stimulation methods specifically for screen-based delivery rather than simply improvising.

Safety online rests on the same foundations as any psychological therapy: a qualified practitioner, a clear plan for what happens if the connection drops or you become distressed between sessions, and agreement on what support is available outside session time. A good practitioner will talk through this with you before your first EMDR session, not after something goes wrong.

Who EMDR is for, and who it might not suit yet

EMDR is generally suitable for adults dealing with the aftermath of a specific distressing event or events, whether that is a single incident such as an accident or assault, or repeated experiences such as childhood adversity. It is also used for some anxiety, phobias and grief where a distressing memory sits underneath the current difficulty, although the evidence base here is less established than for PTSD.

EMDR is not usually the first choice if you are in the middle of an acute crisis, an unsafe living situation, or heavy substance use, since stabilisation needs to come first. It may also need adapting, or postponing, if you experience dissociation that makes it hard to stay grounded during sessions. A practitioner will talk this through with you at assessment rather than assuming EMDR is right from the outset.

This is not a crisis service. If you are thinking about suicide or self-harm, please contact Samaritans free, any time, day or night, on 116 123.

EMDR compared with CBT for trauma

Trauma-focused CBT and EMDR are both NICE-recommended for PTSD, and the choice between them often comes down to what suits you rather than one being clinically stronger than the other. Trauma-focused CBT typically involves more structured discussion of the traumatic memory, gradual exposure to reminders of it, and work on unhelpful beliefs that have grown up around the event. EMDR relies less on detailed verbal description and more on the bilateral stimulation process itself, which some people find easier to tolerate when talking about the event in depth feels too exposing.

Neither is inherently faster or more thorough. A practitioner can help you decide which approach fits your history, your current circumstances and how you prefer to work.

EMDR for adults in Greenwich and south east London

Clinical psychologists for Greenwich and south east London work online with adults, so EMDR sessions here are delivered by video rather than from a local practice base. That suits people across SE10 and the western edge of SE3, from the river at Cutty Sark up through Greenwich Park towards Blackheath, as well as those travelling in from Charlton, Deptford, Lewisham, New Cross and Maze Hill for work on the DLR or Southeastern services into central London. Online delivery means you are not tied to a commute either side of a session that may leave you needing quiet time afterwards. We will update this site as the practice develops.

Getting started

If you think EMDR might help with something you are dealing with, an initial conversation is the way to find out whether it fits your situation. That conversation covers your history, what you are hoping for, and whether EMDR or a different approach makes more sense to try first.