How Does EMDR Work?
EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based psychotherapy approach originally discovered to treat trauma, PTSD, and distress. Now, research has found that it can be widely used to treat a variety of mental health concerns, including anxiety, depression, panic attacks, OCD, eating disorders, and more.
Originally developed by Dr. Francine Shapiro in the late 1980s, EMDR has since been widely researched and is recognized by leading mental health and medical organizations for its effectiveness in reducing the impact of traumatic experiences. This post outlines how EMDR works, the science behind it, and the types of symptoms and mental health concerns it can support.
*Please note that this blog is not a replacement for therapy, and intended for educational purposes only.
How is EMDR Scientific?
EMDR is based on the Adaptive Information Processing (AIP) model, which shows how psychological distress results when memories of adverse life experiences aren’t efficiently processed and become stored in a maladaptive form. When a traumatic or distressing event occurs, the brain may not fully integrate the memory due to its intensity or complexity. This can lead to persistent symptoms such as hypervigilance, intrusive thoughts, emotional reactivity, flashbacks, and avoidance.
Through the use of bilateral stimulation (typically eye movements, tapping, or auditory tones), EMDR facilitates the reprocessing of these memories. More specifically, bilateral stimulation activates both hemispheres of the brain. This dual attention stimulus is not just a technical tool; it mirrors the neurological activity that occurs during rapid eye movement (REM) sleep, the phase of sleep when the brain naturally processes and consolidates emotional memories.
During REM sleep, the eyes move rapidly from side to side as the brain sorts through experiences from the day, integrating new information and resolving emotional conflict. EMDR appears to parallel this same adaptive information processing system. The bilateral stimulation used in session helps facilitate the brain’s ability to reprocess distressing or traumatic memories in a more adaptive and integrated way—similar to the way the brain "digests" emotional content during dreaming.
How it all Connects:
As the Adaptive Information Processing (AIP) model suggests that trauma memories become “stuck” in the nervous system in a raw, unprocessed form, bilateral stimulation helps create the conditions for these memories to move, allowing clients to remain grounded in the present while safely accessing the past, promoting integration and resolution without becoming overwhelmed.
In this way, bilateral stimulation in EMDR supports the brain in doing what it was designed to do: make sense of painful experiences, reduce emotional intensity, and restore a sense of safety and coherence.
What parts of the brain Does EMDR help?
Functional neuroimaging studies suggest that EMDR impacts brain regions involved in memory, threat detection, and emotional regulation, particularly the amygdala, hippocampus, and prefrontal cortex.
The amygdala’s role is central to emotional processing, particularly fear detection and threat response. It works to detect potential danger and initiate a survival response (e.g., fight, flight, freeze, fawn). In trauma, it’s understandable that the amygdala may become hyperactive, leading to hypervigilance, emotional reactivity, and startle responses. It also helps tag emotional significance to memories, contributing to why traumatic memories often feel vivid or intrusive.
The hippocampus is essential for consolidating information from short-term to long-term memory and providing context to experiences. It encodes and organizes memory in a temporal and spatial framework (“this happened in the past,” “it’s not happening now”). Typically, it helps differentiate between past and present, helping individuals recognize when they are safe. In trauma, however, the hippocampus may become underactive, which can result in fragmented or disorganized memory encoding. This can contribute to flashbacks or intrusive memories that feel as though they are happening in the present.
The prefrontal cortex is responsible for executive functioning, including regulation, decision-making, and meaning-making. It inhibits the amygdala’s fear response, allowing for conscious reflection and regulation of emotional reactions. It supports impulse control, attention, rational thinking, and perspective-taking, and helps individuals assess risk and choose appropriate responses rather than reactive ones. In trauma, the prefrontal cortex can become less active during heightened emotional states, reducing a person’s ability to self-regulate or access internal resources.
These three structures in the brain work dynamically: the amygdala signals danger, the hippocampus places the experience in context, and the prefrontal cortex helps regulate the response and make meaning. In trauma, this system becomes dysregulated—often with an overactive amygdala, underactive hippocampus, and decreased prefrontal cortex activity—which is why individuals may feel flooded, on edge, and out of control. EMDR specifically works to rewire the brain to help these regions understand that there is no longer a threat. This is because the brain does not always know the difference between a trigger and the actual traumatic event(s). Through bilateral stimulation in EMDR, individuals become desensitized to the traumatic event(s) and install new neural networks.
What are the Phases of EMDR?
EMDR follows a structured eight-phase protocol, which includes:
History-taking
Preparation and resource-building (i.e. container, calm space, or safe space)
Assessment of target memory
Desensitization (using bilateral stimulation)
Installation of adaptive (positive) beliefs
Body scan
Closure
Re-evaluation
During the desensitization phase, clients are guided to bring to mind the target memory and associated thoughts, emotions, and body sensations while a therapist helps facilitate bilateral stimulation. This process helps activate the brain’s natural adaptive processing system. Reprocessing does not erase the memory, but rather reduces its emotional intensity and increases the client’s ability to engage with it from a more regulated state.
EMDR’s Empirical Support
EMDR is listed as a first-line treatment for post-traumatic stress disorder (PTSD) by the American Psychological Association, the Department of Veterans Affairs, and the World Health Organization (WHO). Numerous randomized controlled trials have demonstrated its efficacy in reducing PTSD symptoms, often in much fewer sessions than traditional talk therapy approaches.
Indications for EMDR
EMDR is most commonly used for trauma-related presentations but has also been applied to other conditions, including:
Anxiety disorders
Depression
Eating disorders
OCD
Grief
Phobias
Panic attacks
Chronic pain
Performance anxiety
Intrusive negative self-beliefs
It is often appropriate for individuals who have not gotten much out of traditional therapies, or for clients who prefer a modality that does not require in-depth verbal processing of their traumatic experiences.
Possible Risks of EMDR
Processing traumatic memories can temporarily increase emotional discomfort, distress, or anxiety. Some possible risks include:
Emergence of previously suppressed memories: EMDR can bring up new or suppressed memories or trauma, which may be distressing or destabilizing.
Dissociation: Some clients may experience dissociation, depersonalization, or a sense of detachment during or after processing.
Nightmares or disturbed sleep: There is a slight risk of nightmares following EMDR sessions.
Emotional flooding: Without adequate preparation or resourcing, some clients may feel overwhelmed by strong emotions that arise during processing.
Clients with severe dissociation, active substance use, or untreated psychosis may not be good candidates for EMDR without additional stabilization. It is important to consult a provider directly to assess for appropriateness of fit for EMDR.
Clinical Integration
EMDR can be used as a stand-alone treatment or integrated with other therapeutic modalities, such as Internal Family Systems (IFS), Somatic Attachment Therapy (SAT), Ketamine Assisted Therapy (KAP), or Polyvagal Theory to support clients in accessing and resolving trauma and distressing experiences. Integrative approaches may be especially effective for individuals with histories of complex trauma, and other mental health concerns that greatly impact daily functioning.
Therapists who are trained in EMDR have sought additional training for this specialized model. If you’re looking for an EMDR therapist, be sure to look for language that is “EMDR Trained” or “EMDR Certified” on their website, and verify their credentials to ensure ethical standards of care.
EMDR and IFS in Denver
As a Licensed Therapist in Denver, I believe EMDR is life-changing and am passionate about integrating this model into my practice. Over the years, I have developed a specific integration of EMDR and Internal Family Systems (IFS) for my clients. I also value bringing a flexible, collaborative approach to therapy. If you are interested in EMDR and live in Colorado, I would be honored to support you. Please reach out today to schedule a free phone consultation!
ABOUT THE AUTHOR
Gigi Woodall, LMFT
Trauma & Eating Disorder Therapist in Denver
Hi, I’m Gigi—a Denver-based trauma and eating disorder therapist and clinical supervisor passionate about helping people heal and reconnect with themselves. My work focuses on exploring how early experiences, relationships, and protective parts of the self shape our inner narratives. Through a compassionate and individualized approach, I help clients challenge limiting beliefs and step into a more authentic, intuitive way of living.
Prior to private practice, I worked at nonprofit organizations and eating disorder treatment centers. I'm also a proud Denver chapter member of the International Association of Eating Disorders Professionals (IAEDP), a clinical supervisor for pre-licensed therapists, and am on my way to becoming a Certified Eating Disorder Specialist (CEDS).
With training in Internal Family Systems (IFS), EMDR, and eating disorder treatment, I provide a safe, supportive space for those navigating recovery, trauma, and self-discovery.
Looking for support on your healing journey? Book a free consultation to see if we’re a good fit.