What Is EMDR Therapy? A Plain-English Guide to the Evidence, the Sessions and What to Expect

Few therapies attract as much curiosity, and as much scepticism, as EMDR. From the outside it looks improbable: you think of a distressing memory while your eyes follow a moving target, and over a course of sessions the memory loses its charge. Yet EMDR (Eye Movement Desensitisation and Reprocessing) is recommended for post-traumatic stress disorder in Australia’s national trauma guidelines, by the World Health Organization and by NICE in the UK.

This guide explains what EMDR is, what actually happens in a session, how many sessions the guidelines describe, and what the research genuinely shows: where the evidence is strong, and where it is still emerging.

Looking for EMDR sessions rather than an explainer? For the practical details (your psychologist, fees, Medicare and booking), see our EMDR therapy on the Central Coast page.

What Is EMDR?

EMDR was developed in the late 1980s by American psychologist Francine Shapiro, and has since grown into a standardised, eight-phase therapy used worldwide. It rests on a theory called the adaptive information processing model: the idea that trauma symptoms arise when a distressing experience wasn’t fully processed at the time, so the memory stays stored in raw form, with the original images, sensations, emotions and beliefs still attached. That’s why a reminder can make an event from years ago feel like it’s happening now.

Rather than working mainly through conversation, EMDR works directly with the memory itself. The American Psychological Association describes it as a structured therapy in which you briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation, typically eye movements, with the aim of changing how the memory is stored in the brain.

Two practical features surprise people. First, the bilateral stimulation doesn’t have to be eye movements: the UK’s NICE guideline notes that taps or tones can be used instead if you prefer. Second, EMDR asks less talking of you than most people expect. The World Health Organization’s 2013 guidelines point out that, unlike trauma-focused CBT, EMDR doesn’t involve detailed descriptions of the event, direct challenging of beliefs, extended exposure, or homework.

How Does EMDR Work? The Honest Answer

The honest answer is that researchers are still working it out.

The best-supported explanation is the working-memory account. Holding a memory in mind while also tracking a moving target taxes your limited working-memory capacity, and a memory recalled under that load becomes less vivid and less emotionally intense. Repeated in short sets, the memory appears to be re-stored in that milder form. A 2013 meta-analysis by Lee and Cuijpers found that eye movements added a significant benefit when processing emotional memories, although an earlier meta-analysis (Davidson and Parker, 2001) found no incremental effect, so the debate isn’t settled. You may also read that eye movements mimic REM sleep; that remains a hypothesis, not an established finding. And “EMDR rewires the brain” is marketing, not neuroscience.

What matters clinically is a different question, and it has a clearer answer: whatever the mechanism turns out to be, the overall EMDR protocol has repeatedly reduced PTSD symptoms in randomised controlled trials. The “why” is debated; the “whether” is much less so.

What Happens in an EMDR Session?

EMDR follows a standard eight-phase structure:

1. History taking. Understanding your background, what you’re carrying, and what you want to change.
2. Preparation. Learning how EMDR works, building grounding and coping skills, practising the mechanics of bilateral stimulation, and agreeing a stop signal. This phase varies greatly in length from person to person, and reprocessing doesn’t begin here.
3. Assessment. Choosing a target memory and identifying the image, belief, emotions and body sensations attached to it.
4. Desensitisation. Holding the memory briefly in mind during short sets of eye movements, taps or tones, with a check-in after each set, until the distress reduces.
5. Installation. Strengthening a more balanced belief to sit with the memory (for example, moving from “I’m in danger” towards “it’s over; I survived”).
6. Body scan. Checking whether the body still reacts when the memory is recalled, and processing any leftover tension.
7. Closure. Ending every session in a settled state, whether or not the memory finished processing. You’re not left mid-process.
8. Re-evaluation. Re-checking the memory at the next session and deciding together what to work on next.

Throughout, you remain awake, alert and in control. The process is interactive, you can stop at any point with the agreed signal, and you only ever share as much as you choose to.

How Many Sessions Does EMDR Take?

NICE recommends that EMDR for adults with PTSD typically be provided over 8 to 12 sessions, with more if clinically indicated, which is the same range it gives for trauma-focused CBT. So claims that EMDR is dramatically faster than other trauma therapies should be treated with caution. The American Psychological Association describes courses of roughly 6 to 12 sessions, once or twice weekly, noting that some people benefit from fewer, and that reprocessing an individual memory is generally completed within one to three sessions. The EMDR International Association describes typical sessions of 60 to 90 minutes; in Australia, standard psychology appointments are typically 50 minutes, so your psychologist will plan how reprocessing work fits that structure. Complex or repeated trauma usually needs a longer course, with more time spent in preparation, and that time is part of the treatment, not a delay to it.

Is EMDR Evidence Based? What the Research Shows

For PTSD in adults, yes, and by the standards that matter:

• Australia: the NHMRC-approved Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD, developed by Phoenix Australia, strongly recommend EMDR for adults with PTSD, alongside trauma-focused CBT, trauma-focused cognitive therapy and prolonged exposure.
• World Health Organization: its 2013 guidelines state that CBT with a trauma focus or EMDR should be considered for adults with PTSD.
• NICE (UK): recommends offering EMDR to adults with PTSD who present more than three months after a non-combat-related trauma.
• Australian Psychological Society: its evidence review lists EMDR at Level I, the highest evidence rating, for PTSD in adults; the only other Level I treatment is trauma-focused CBT.
• The research base: a 2024 state-of-the-science review by de Jongh and colleagues counts more than 30 published randomised controlled trials and notes that most international clinical guidelines recommend EMDR as a first-line PTSD treatment.

For balance: the American Psychological Association is the outlier, listing EMDR as conditionally recommended rather than first-line, a designation that has been contested in the literature. And a 2020 meta-analysis led by Pim Cuijpers concluded that EMDR may be effective for PTSD in the short term, while criticising the quality of many of the underlying trials.

A reasonable verdict: for adult PTSD, EMDR is a legitimate, guideline-recommended treatment on par with trauma-focused CBT. It isn’t a miracle cure, it isn’t clearly better or faster than its alternatives, and figures like “90 per cent recover in three sessions”, which trace back to small studies from the 1990s, are not endorsed by any clinical guideline and shouldn’t be treated as expected outcomes.

EMDR for PTSD

PTSD is where EMDR earns its place. When flashbacks, nightmares, hypervigilance and avoidance persist months after a traumatic event, the problem is rarely willpower; it’s that the memory can behave like a live threat. EMDR works directly with that memory, and guidelines list it as a first-choice option for adults because of its trial evidence. It’s also often considered when talking through the event in detail feels impossible: EMDR doesn’t require it.

Two honest caveats. For children and adolescents, the evidence is weaker: Australia’s guidelines make their strong child recommendation for trauma-focused CBT, and NICE suggests EMDR for young people mainly when trauma-focused CBT hasn’t helped or hasn’t engaged them. And NICE’s “offer EMDR” recommendation for adults applies to non-combat-related trauma; for combat-related PTSD the evidence picture is less clear-cut, which matters for veterans weighing up options. None of this rules EMDR out; it’s the kind of detail a careful assessment works through with you. For the broader territory, see our guide to trauma and PTSD.

Can EMDR Help With Burnout?

Honestly: the research on EMDR for burnout specifically is limited, and I won’t tell you otherwise. Burnout isn’t a formal diagnosis, and no clinical guideline recommends EMDR for it.

But burnout often isn’t just exhaustion. For nurses, paramedics, teachers, and others in demanding roles, it can sit on top of distressing workplace events or accumulated vicarious trauma, and that’s where EMDR’s strong PTSD evidence becomes relevant. I’d first assess what’s actually driving your burnout, and might use EMDR for any trauma component alongside approaches with better direct support for stress and burnout itself. If your exhaustion has a particular incident, or a pile of them, sitting underneath it, that’s worth naming in an assessment rather than treating as “just stress”.

EMDR for Anxiety, Depression and Phobias: What We Know So Far

Beyond PTSD, the picture is promising but genuinely unfinished, and it deserves to be graded honestly:

• Depression. The Australian Psychological Society’s review rates EMDR at Level II for adult depression, a rung below its PTSD rating. More recent meta-analyses of randomised trials report positive short-term effects, but the trials are small and varied in quality.
• Anxiety and panic. A 2020 meta-analysis of 17 randomised trials found EMDR reduced anxiety and phobic symptoms; findings for panic disorder are mixed, with severity improving in some studies but panic attack frequency not.
• Specific phobias. Individual randomised trials support EMDR for phobias such as flying and dental phobia, though the overall research base remains described as promising but limited.

No major guideline (WHO, NICE, or the Australian guidelines) currently recommends EMDR for depression or anxiety disorders as such; their EMDR recommendations are PTSD-specific. In practice, that means EMDR may still be worth considering for a distressing memory that sits underneath anxiety or low mood, but it shouldn’t be sold to you as a proven treatment for those conditions in themselves.

Common Misconceptions About EMDR

• “EMDR is hypnosis.” No. There’s no trance and no suggestion. You stay fully awake and in control, the protocol is interactive with constant check-ins, and you can stop at any time with an agreed signal.
• “EMDR erases memories.” No. Reprocessing reduces a memory’s vividness and emotional intensity; the factual memory remains and you can still recall it. The memory stays; the distress fades.
• “You have to talk through everything that happened.” No. The WHO’s own description notes EMDR doesn’t involve detailed descriptions of the event. You hold the memory in mind privately and share only what you choose.
• “The eye movements are pseudoscience, so EMDR is bunk.” The fair version: whether eye movements add benefit beyond structured recall is still debated in the research. What isn’t debated to nearly the same degree is the outcome evidence for the protocol as a whole, which is why bodies as cautious as the WHO, NICE and Australia’s NHMRC-approved guidelines recommend it for PTSD.
• “EMDR fixes trauma in one session.” Guidelines describe courses of roughly 8 to 12 sessions, more for complex trauma. The often-quoted idea that one memory can settle in one to three sessions refers to a single memory, not a completed treatment.
• “EMDR is better and faster than CBT.” Guidelines list EMDR and trauma-focused CBT as parallel first-line options with the same typical session range. Which suits you better is a matter of fit, preference and assessment, not a league table.

Thinking About Starting EMDR?

At MindSure Psychology, EMDR is provided by James Wightman, a registered psychologist who has completed accredited training in Eye Movement Desensitisation and Reprocessing (EMDR) to support clients processing trauma. Sessions are available in person in Gosford, with Medicare rebates available under a GP Mental Health Treatment Plan (details on fees and rebates).

If you’re weighing up whether EMDR is right for you, you can book an EMDR session in Gosford through our service page, which covers the practical side: what the first session involves, how the work is paced, and common concerns answered directly. When you’re ready, you can book an appointment online or contact the practice with any questions. The first session is a conversation, not memory work, and you don’t need to have anything figured out before you come in.

Frequently Asked Questions

What is EMDR therapy in simple terms?

EMDR (Eye Movement Desensitisation and Reprocessing) is a structured psychological therapy in which you briefly hold a distressing memory in mind while following side-to-side eye movements, taps or tones guided by your therapist. Done in short sets over a course of sessions, this helps the memory become less vivid and less emotionally intense, so it starts to feel like something that happened rather than something still happening.

Is EMDR evidence based?

For PTSD in adults, yes. EMDR is recommended in Australia’s NHMRC-approved PTSD guidelines, by the World Health Organization and by NICE in the UK, with support from more than 30 randomised controlled trials. For conditions other than PTSD, the research is promising but not yet strong enough for guideline recommendations.

How many sessions does EMDR therapy take?

Clinical guidelines describe a typical course of around 8 to 12 sessions for PTSD, with more when trauma is complex or repeated. The first sessions are history-taking and preparation rather than memory work, and reprocessing a single memory often takes more than one session.

Is EMDR the same as hypnosis?

No. There is no trance and no suggestion. You remain fully awake, alert and in control throughout, the process is interactive with frequent check-ins, and you can stop at any point using an agreed signal.

Do you have to talk about the trauma in detail during EMDR?

No. EMDR doesn’t require you to describe what happened in detail. You bring a small piece of the memory to mind while your attention stays anchored in the present, in short sets with breaks, and you share as much or as little as you choose. For some people, this is what makes EMDR possible when talking about it felt like too much.

Does EMDR erase memories?

No. EMDR changes how a memory feels, not the facts of what happened. After successful reprocessing the memory remains and you can still recall it, but it is typically less vivid and carries far less emotional charge.

Can EMDR help with anxiety, depression or burnout?

The honest answer is that the evidence is emerging rather than established. EMDR’s strong evidence is for PTSD. Small trials suggest possible benefits for depression, anxiety and phobias, but no major clinical guideline currently recommends EMDR for these conditions, and a careful assessment should decide whether it is appropriate for your situation.

About the Author

James Wightman is the Principal Psychologist & Clinical Psychology Registrar and founder of MindSure Psychology in Gosford, on the NSW Central Coast. He works with adults experiencing trauma, PTSD, anxiety, OCD, burnout and perfectionism, and has completed accredited training in Eye Movement Desensitisation and Reprocessing (EMDR) to support clients processing trauma.