Eye Movement Desensitization and Reprocessing (EMDR) is one of three evidence-based psychotherapies for Post-Traumatic Stress Disorder recommended by the Departments of Veterans Affairs and Defense (VA/DoD) [1]. You may be asking what exactly is EMDR and how can it help? Read on to learn more.
What Is EMDR Therapy?
EMDR is a structured therapy designed to help individuals process and heal from traumatic memories and distressing experiences. It encourages the patient to focus briefly on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements or tapping).
This is associated with a reduction in the vividness and emotion associated with the trauma memories. EMDR helps you process upsetting memories, thoughts, and feelings related to the trauma and get relief from PTSD symptoms. EMDR therapy consists of eight phases, each playing an important role in the treatment process [2].
How Does EMDR Work?
After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps you process the trauma, which can allow you to start to heal. EMDR therapy works on changing the memory, unlike other behaviorally-oriented therapies.
In EMDR, you pay attention to a back-and-forth movement or sound while recalling the upsetting memory until shifts occur in the way that you experience that memory and more information from the past is processed [2].
Unlike Cognitive Behavioral Therapy (CBT) with a trauma focus, EMDR does not involve a) detailed descriptions of the event, b) direct challenging of beliefs, c) extended exposure, or d) homework [3].
Although EMDR is an effective treatment for PTSD, there is disagreement about how it works. Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite.
Is EMDR Evidence-Based?
Yes it is. Over 44 randomized controlled trials have investigated EMDR treatment of posttraumatic stress disorder (PTSD), early traumatic stress, and traumatized children. In addition, there are 28 randomized controlled trials which have evaluated its use with major depressive disorder, bipolar disorder, psychosis, anxiety disorders, obsessive-compulsive disorder, substance use disorder, and pain. [4] [5].
Who is a Good Candidate for EMDR?
EMDR can help people with a wide range of mental health conditions. Adolescents, teenagers, and adults of all ages can benefit from this treatment. Some healthcare providers also specialize in EMDR for children [5].
How Long Does EMDR Take?
The individuals’ needs, complexity of trauma, and their progress all determine the length of EMDR therapy.
1. Session Length
EMDR sessions typically last 60 to 90 minutes. Some intensive treatments may use longer sessions (90 to 120 minutes), especially for complex trauma.
2. Total Duration of Treatment
Single traumatic event (e.g., car accident, assault):
- 3–6 sessions (some clients see improvement in just 1–3 sessions).
Multiple traumas or complex PTSD (childhood abuse, chronic trauma):
- 8–12+ sessions (sometimes months to years for deep-rooted issues).
Phobias, anxiety, or recent distressing events:
- 1–4 sessions (faster processing due to less embedded trauma).
3. Factors Affecting EMDR Timeline
- Number of traumatic memories: More targets require more sessions.
- Client’s readiness and stability: Those with strong coping skills may progress faster.
- Session frequency: Weekly sessions are common, but some do biweekly or intensive formats (multiple sessions per week).
- Therapist’s approach: Some use EMDR as part of a broader therapy plan.
4. When Can You Expect Results?
- Some clients feel relief after the first few sessions.
- Full reprocessing of a single memory may take 1–3 sessions.
- Long-standing trauma may require ongoing work to reinforce positive beliefs and address new layers.
The 8 Stages of EMDR Therapy
The eight phases and three-pronged protocol facilitate a comprehensive evaluation of the clinical picture, client preparation, and processing of a) past events that set the foundation for pathology, b) current disturbing situations, and c) future challenges [3] [6].
Phase 1 – History Taking and Treatment Planning
- The therapist assesses the client’s history, identifies traumatic memories, and develops a treatment plan.
- Targets (past events, present triggers, and future goals) are selected for processing.
Phase 2 – Preparation
- The therapist explains EMDR, establishes trust, and ensures the client has coping skills for emotional regulation.
- Metaphors and techniques that foster stabilization and a sense of personal control.
- Techniques like the “Safe/Calm Place” exercise are taught to manage distress.
Phase 3 – Assessment
Primary aspects of the target memory are activated by identifying:
- Image: The worst visual moment of the memory.
- Negative Belief: A self-blaming thought (e.g., “I am powerless”).
- Positive Belief: A desired self-statement (e.g., “I am in control”).
- Emotions and Body Sensations: Physical and emotional responses.
- Subjective Units of Disturbance (SUD): 0-10 distress scale.
- Validity of Cognition (VOC): 1-7 scale for belief in the positive statement.
Phase 4 – Desensitization (Include info on bilateral stimulation)
- Process experiences toward an adaptive resolution (no distress)
- The client focuses on the memory while administered standardized protocols incorporating bilateral stimulation with eye movements (taps or tones) that allow the spontaneous emergence of insights, emotions, physical sensations, and other memories.
- Distress levels (SUD) are monitored until they decrease.
Phase 5 – Installation
- The positive belief is reinforced, increasing connections to positive cognitive networks until it feels more true (VOC increases to 6-7).
- Example: “I am strong” replaces “I am helpless.”
- Enhance the validity of the desired positive belief and fully integrate the positive effects within the memory network
Phase 6 – Body Scan
- The client checks for residual physical tension related to the memory.
- If present, further processing is done until the body feels neutral or calm.
Phase 7 – Closure
- Ensures the client leaves each session stable, using self-soothing (guided imagery or self-control) techniques if processing is incomplete.
- May involve journaling or relaxation exercises.
Phase 8 – Reevaluation
- The therapist checks progress on previously processed memories and adjusts treatment as needed.
- Ensures long-term effectiveness and addresses any new targets.
Why EMDR Is Especially Effective for Veterans
EMDR is particularly effective for veterans and active-duty military due to its unique ability to address combat trauma, PTSD, and military-related stressors in a structured yet flexible way [7]:
- Targets combat PTSD and moral injury.
- Bypasses the “Talk Therapy” barrier, an obstacle for many veterans.
- Reduces hyperarousal and nightmares.
- Addresses complex and multiple traumas.
- Works faster than many traditional therapies.
- Helps with transition and identity shifts.
- Supported by VA and military health systems.
Key Benefits for Veterans
- Non-invasive: No need to relive trauma in detail.
- Helps reprocess traumatic memories.
- Rapid symptom relief: Reduces PTSD symptoms quicker than some talk therapies.
- Strengthens adaptive beliefs.
- Holistic healing: Addresses body, mind, and emotions tied to trauma.
- Long-lasting results: Studies show sustained improvement even after treatment ends.
Addressing Military Trauma
Military trauma is complex, often involving combat exposure, loss of comrades, moral injury, and the unique stressors of service. EMDR therapy is particularly well-suited to help veterans and active-duty personnel heal from these wounds. EMDR addresses specific aspects of military trauma:
- Direct warfare experiences.
- Moral Injury.
- Military Sexual Trauma (MST).
- Loss and Grief.
- Transition Stressors.
Specialized EMDR Approaches for Veterans
EMDR has been extensively used for veterans and active-duty military, giving rise to a number of specific approaches used:
- Combat Trauma Protocol
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- Prioritizes most distressing memories first.
- Incorporates pre-deployment positive memories for resource building.
- Moral Injury Processing
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- Targets both the event and the self-judgment.
- Installs adaptive beliefs (“I made the best decision I could”).
- Transition Support
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- Processes feelings of abandonment after discharge.
- Reinforces civilian identity development.
- Couples EMDR
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- Addresses relationship strain from PTSD symptoms.
- Processes shared deployment experiences.
Expected Outcomes
- Reduced nightmares/flashbacks (often first to improve).
- Decreased emotional numbness.
- Improved sleep and anger management.
- Renewed sense of purpose.
- Better family relationships.
Getting the Most from EMDR
- Find a therapist versed in military culture.
- Combine with veteran support groups.
- Consider intensive EMDR formats (multiple sessions/week).
- Use veteran-specific resources (VA, Wounded Warrior Project).
EMDR Support for Veteran Families
EMDR can provide important support for veteran families dealing with secondary trauma, relationship strain, and their own emotional struggles. Many VA clinics and private therapists offer family-inclusive EMDR. Benefits include:
- Secondary Trauma Processing: Addresses the distress of witnessing a loved one’s PTSD symptoms (nightmares, anger, emotional withdrawal).
- Relationship Repair: Targets painful memories of conflict, emotional distance, or deployment-related struggles. Helps develop healthier communication patterns.
- Child and Teen Support: Processes anxiety, fear, or confusion about a parent’s trauma or absence. Uses EMDR-Adapted Family Therapy for shared healing.
- Caregiver Stress Relief: Reduces burnout, resentment, or helplessness in spouses/parents supporting veterans.
- Grief and Loss: Helps process the death of a service member or the “loss” of the pre-deployment family dynamic.
Key Benefits
- Reduces family-wide anxiety and tension.
- Improves emotional connection.
- Breaks cycles of trauma passed to children.
- Works in individual, couples, or family therapy formats.
Get the Help You Deserve at Miramar Health
Miramar Health is a veteran-owned and operated recovery program exclusively serving veterans. Our mission is to free veterans from America’s mental health and addiction crisis and to empower them to create a better future for themselves and their families.
We understand the complex nature of trauma and offer individualized treatment options that are specific to veterans. Take the first step to your recovery. You’re not alone. Reach out to our Admissions team today.
Sources
[1] Norman, S. et al. Overview of Psychotherapy for PTSD. US Department of Veterans Affairs. PTSD: National Center for PTSD.
[2] US Department of Veterans Affairs. PTSD: National Center for PTSD. Eye Movement Desensitization and Reprocessing (EMDR) for PTSD.
[3] Shapiro F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente journal, 18(1), 71–77.
[4] EMDRIA.org. Editorial: A Clinician’s Guide to the Efficacy of EMDR Therapy.
[5] Cleveland Clinic. 2022. EMDR Therapy.
[6] Maxfield, L. (2019). A clinician’s guide to the efficacy of EMDR therapy, Journal of EMDR Practice and Research [Editorial]13(4), 239-246.
[7] Leeds, A. 2020. The Scientific Status of EMDR Therapy for Combat-Related PTSD. Emdria.org