WTF is EMDR?

This blog post is an adaptation of my podcast episode, WTF is EMDR?

If you've heard of EMDR, chances are someone described it as "the eye movement thing." Maybe you've wondered if it's legit, or whether waving fingers in front of someone's face is really a serious trauma treatment (no one would blame you for such thoughts).

EMDR is genuinely weird. I was skeptical before I trained in it — and I've now been doing this work for years as both a therapist and an EMDR supervisor who trains other clinicians. Basically, I'm now an EMDR fan-girl.

So let's break it down properly. What EMDR actually is, what's happening in your brain during a session, and how you know when it's working.

What Does EMDR Stand For?

EMDR stands for Eye Movement Desensitisation and Reprocessing. It was developed in the late 1980s by Dr Francine Shapiro — my idol, for the record — who noticed while walking through a park that moving her eyes seemed to reduce the intensity of a distressing thought. She ran with that observation and built a full therapeutic model around it.

Today, EMDR is a structured eight-phase psychotherapy. It's not a strategy you bolt onto another approach. It's a complete therapeutic system designed to heal trauma and other distressing experiences at the root.

It's also recognised as an evidence-based treatment for PTSD by the World Health Organisation, the American Psychological Association, the Australian Psychological Society, and the UK's NICE guidelines. All the major bodies worldwide.

Is EMDR Actually Evidence-Based?

Yes — and there's a large body of research to back that up.

About 70% of people who do EMDR experience clinically significant improvement. In therapy terms, that's a strong result. Nothing works for everyone — but the odds are genuinely in your favour.

How Does EMDR Work? The AIP Model

To understand why EMDR works, you need to understand what it's built on: the Adaptive Information Processing model, or AIP.

The core idea is that your brain is wired to process and integrate experiences naturally. Most of the time, when something happens to you, your system files it away as a memory — something you can think about without reliving it. The filing cabinet metaphor works well here: alphabetised, colour-coded, everything in its place.

But when something overwhelming or traumatic happens, the processing system can break down. The memory doesn't get filed properly. It gets stuck in its raw, unprocessed form — with all the images, body sensations, smells, emotions, and beliefs from the moment it occurred still attached. And because it hasn't been integrated, it keeps triggering reactions in the present, long after the event is over.

EMDR works by intentionally and safely reactivating those stuck memories in a controlled therapeutic context, so your brain and nervous system can finish the job.

The memory gets updated, properly integrated, filed away. And voila, it no longer bothers you (or bothers you much less, at the very least).

What Actually Happens in an EMDR Session?

Unfortunately, you are not going to walk into session one and start doing eye movements. While I would love to be able to help you that quickly, EMDR is a structured protocol and there are steps prior to the eye-waggling.

Phases one and two involve history taking and preparation. We're figuring out what's going on, what your goals are, whether EMDR is appropriate for you, and building the foundation for safe processing.

Phases three through seven are the processing phases (aka, eye-waggling begins). We identify the memory we're targeting, activate it, and then you hold it in mind while engaging in a challenging task — usually eye movements, but sometimes tapping, or other things. The eye movements are the most recognisable feature of EMDR, but research now shows they're not strictly necessary. What matters is taxing the working memory. In the Netherlands, EMDR therapists sometimes have clients walk in a square or spell words backwards.

After about 40 seconds of taxation, we pause. I ask: "What are you noticing now?" You report whatever comes up — a thought, a feeling, a body sensation, a shift in perspective. And we carry on our merry way. Eye-waggling proceeds.

Phase eight is re-evaluation, which happens at the start of the following session. That's where we check on all the fabulous work we did in the previous session, and pick up where we left off. Or, if we check in and the memory is filed away neatly in aforementioned filing cabinet, we pop some champagne before carrying on to our next memory.

What are the Eye Movements Actually Doing?

The prevailing explanation is working memory taxation theory. When you hold a traumatic memory in mind while simultaneously doing a cognitively demanding task, it taxes your working memory. This reduces the vividness and emotional intensity of the memory and files it away in that filing cabinet where all your other non-problematic memories live. This occurs via a process called memory reconsolidation.

Memories aren't fixed. They're dynamic. Under the right conditions, they can be updated. EMDR creates those conditions intentionally.

You Always Stay in Control

I want to be clear about this: you are in control throughout the whole process.

You can pause at any time. You can stop at any time. The only time I might gently challenge avoidance is if it's getting in the way of the work — because avoidance maintains trauma, and I'm not here to help you avoid things more efficiently.

But EMDR is never done to you. It's collaborative, and you set the pace.

How Do You Know When EMDR Is Working?

One of the most common shifts people notice is moving from being inside the memory — fully in it, like it's happening now — to observing it from the outside. The camera angle changes.

We track progress using a distress scale from 0 to 10. Before processing, most people rate the memory at a 6 or above. After EMDR, we're aiming for 0 or 1. That drop can happen faster than you'd expect — sometimes from a 10 to a 5 within 10 to 15 minutes.

A fully processed memory has a few recognisable features which we refer to as processing effects:

It stays in the past. It no longer feels like it's happening now. There's a shift from it's happening to it happened.

It's no longer distressing. You might feel sad, or a little annoyed, but not overwhelmed. The charge is gone.

Negative beliefs lose their grip. Things like "I'm not good enough," "It was my fault," or "I'm powerless" tend to lose their emotional weight. Often, a healthier belief emerges spontaneously.

Clients often describe it like this: "It feels far away now." "The volume is turned down." "I know it happened, but I know it's over."

How Many EMDR Sessions Will I Need?

Best-case scenario, a single memory can fully process in one 60–90 minute session. Often it takes one to three sessions per memory, but it's not abnormal for it to take longer (particularly for very complex and layered experiences).

With complex trauma — multiple events across a long history — it takes longer, and a few sessions isn't going to cut it. Most people in that situation need 20 or more sessions. But improvement is progressive. You don't finish memory 20 and suddenly everything is better, it's a gradual improvement.

We also approach complex trauma strategically. Your memory network is like a Jenga tower. We identify the key blocks — usually starting in childhood if there are longstanding themes — and pull from the bottom of the stack. The goal is maximum impact with minimum targets, but without rushing.

Does EMDR Work for Everyone?

Sadly, no. But nothing does! There is literally no medical or health treatment in the world that can promise a 100% success rate for anything. If they did, I'd be seriously thinking snake oil.

The research suggests around a 70% effectiveness rate for clinically significant improvement. That means roughly 30% of people won't benefit to that degree.

There are lots of reasons EMDR might not be the right fit, or might need to be adapted — and that's a whole other conversation (honestly, probably a future episode or post).

But if your difficulties are rooted in trauma or distressing past experiences, EMDR is likely worth exploring. The evidence is strong, the outcomes tend to be lasting, and the underlying premise — that trauma is healable — is one I believe wholeheartedly.

The Bottom Line

For most people, trauma is not a life sentence.

EMDR is weird, yes — but it's also evidence-based, internationally recognised, and genuinely effective for the majority of people who try it.

If you're interested in trying EMDR, get in touch. Or, if you'd like to hear more from me, sign up to my newsletter.

Helen Billows is a registered psychologist, EMDR therapist, and EMDR supervisor based in Adelaide, South Australia. She runs Billows Psychology and hosts The Trauma Nerd Podcast.