More than 30 randomized controlled trials have established EMDR as a first-line treatment for PTSD. The World Health Organization, the International Society for Traumatic Stress Studies, the National Institute for Health and Care Excellence, and the U.S. Department of Veterans Affairs all recommend it alongside trauma-focused cognitive behavioral therapy. A 2025 systematic review in the British Journal of Psychology, analyzing 29 clinical RCTs, found EMDR to be the most cost-effective intervention compared to 10 alternatives, including TF-CBT (Simpson et al., 2025).
Those are the credentials. What most people actually want to know is simpler: what will happen in the room, and why should I believe that following a therapist’s moving hand back and forth will change anything about the weight I carry?
That skepticism is reasonable. It is also addressable. The mechanism behind EMDR is better understood now than at any previous point in its 35-year history, and the answer involves how your brain stores traumatic memories differently from ordinary ones.
The Problem EMDR Solves: Memories That Got Stuck
Ordinary memories consolidate. Your brain processes the experience, files it with context (“that was then, this is now”), and stores it in a way that allows recall without reliving. You can remember a difficult conversation from last year without your heart rate spiking. The memory has been integrated.
Traumatic memories fail this process. The Adaptive Information Processing model, which provides EMDR’s theoretical foundation, proposes that overwhelming experiences get stored in an unprocessed state: the images, sounds, smells, physical sensations, and beliefs from the original event remain encoded in their raw form (Shapiro, 2018; Hase, 2021). When something in present life triggers that stored material, you do not just remember the event. Your nervous system reactivates as though it is happening now. The monitor beeps from an ICU stay become present-tense danger signals. The smell of a hospital corridor floods you with panic that has no rational proportion to walking past a clinic.
This is not a failure of willpower or emotional regulation. It is a memory storage problem. EMDR targets that storage.
The Eight Phases: What Actually Happens
Francine Shapiro developed EMDR’s eight-phase protocol in the late 1980s, and it has been refined through decades of clinical research and formalized by the EMDR International Association. The phases are not eight separate sessions. Some phases span multiple sessions; others may occur within a single meeting. The structure adapts to the individual.
Phase 1, History and Treatment Planning. Your therapist learns what brought you in, identifies the memories and experiences driving your current symptoms, and develops a treatment sequence. This is collaborative. You are not asked to narrate your trauma in detail at this stage.
Phase 2, Preparation. You learn how the process works, practice stabilization techniques, and develop a “safe place” visualization. For Atlanta patients, this often involves a specific location that carries calm associations: a bench in Piedmont Park on a quiet Tuesday, a particular stretch of the Chattahoochee trail in the early morning, or the view from a familiar spot in Decatur. The specificity matters. Your brain anchors more effectively to real sensory details than to abstract concepts of calm.
Phase 3, Assessment. You identify a target memory, the image that represents it, the negative belief it carries (“I am not safe,” “I am powerless”), the positive belief you want to hold instead, and the current level of disturbance. This is structured and contained, not a free-form exploration.
Phase 4, Desensitization. This is the core reprocessing phase. You hold the target memory in mind while engaging in bilateral stimulation, typically following the therapist’s hand movements, though some therapists use alternating taps or auditory tones. Recent neuroscience research supports the working memory hypothesis: bilateral stimulation taxes working memory capacity, which reduces the emotional vividness of the memory during processing (de Voogd et al., 2018). The amygdala’s activity suppresses, and the connection between the emotion center and the prefrontal cortex strengthens. A 2024 “state of the science” review in the Journal of Traumatic Stress confirmed that the more working memory is taxed, the stronger the inhibition effect on emotionally charged memories (de Jongh et al., 2024).
After each set of bilateral stimulation, lasting roughly 20 to 30 seconds, the therapist checks in: “What are you noticing now?” You report whatever comes up, whether thoughts, feelings, images, or physical sensations. The therapist does not interpret. Your brain’s own processing system directs where the associations lead.
Phase 5, Installation. Once disturbance around the target memory decreases, the positive belief identified in Phase 3 is strengthened and linked to the reprocessed memory.
Phase 6, Body Scan. You scan your body for any residual physical tension or sensation connected to the target memory. Trauma often stores somatically, so a memory can be cognitively resolved while the body still holds activation. This phase addresses that.
Phase 7, Closure. Every session ends with stabilization, regardless of where the processing stands. You leave the office grounded, not in an unfinished emotional state.
Phase 8, Reevaluation. Each subsequent session begins by checking the previous target. Has the disturbance stayed low? Have new associations or memories surfaced? This determines the next processing direction.
What the First Three Sessions Look Like
In a typical EMDR course at an Atlanta-area practice, patients spend the first two sessions in Phases 1 and 2: building the therapeutic relationship, mapping the trauma landscape, and practicing stabilization. Processing itself usually begins in session three.
This pacing is deliberate. Rushing into reprocessing without adequate preparation is like performing surgery without anesthesia. The groundwork makes the processing both safer and more effective. If you have complex trauma (multiple events, early childhood origins), the preparation phase may extend further. This is not a delay in treatment. It is treatment.
You will not be asked to describe your trauma in graphic detail. EMDR does not require the extended narrative exposure that some other trauma therapies use. The WHO’s 2013 guidelines specifically noted this distinction: unlike trauma-focused CBT, EMDR does not involve detailed descriptions of the event, direct challenging of beliefs, extended exposure, or homework.
What EMDR Is Not
It is not hypnosis. You remain fully conscious and in control throughout processing. You can stop at any point, and many patients open their eyes mid-set to orient themselves before continuing.
It is not a magic eraser. The traumatic memory does not disappear. What changes is its charge. Patients consistently report that after successful processing, they can recall the event without the emotional flooding, the physical sensations, or the intrusive quality that defined it before. The memory becomes a memory, not a reliving.
It is not one-size-fits-all. The standard protocol works powerfully for single-incident trauma. Complex trauma, developmental trauma, and intergenerational patterns require modified approaches and longer treatment courses. Your therapist assesses which protocol fits your presentation.
And it is not limited to PTSD. Research increasingly supports EMDR’s efficacy for depression (Hedges’ g = 0.75 in a 2024 meta-analysis of 25 RCTs), anxiety disorders, and chronic pain conditions. The underlying principle, that unprocessed disturbing experiences drive current symptoms, applies beyond the diagnostic boundaries of posttraumatic stress disorder.
Who Benefits Most
EMDR works across a wide range of trauma presentations. Research and clinical experience indicate that certain profiles tend to respond particularly well:
People with specific, identifiable traumatic events: a car accident on I-285, a medical emergency at Grady or Emory Midtown, a violent crime, a single devastating loss. When the target is clear, processing is focused and often efficient. Multiple RCTs show that single-trauma patients frequently see significant improvement within 3 to 6 sessions (de Jongh et al., 2024, Journal of Traumatic Stress).
People who have “tried talking about it” without resolution. If you have spent years in traditional talk therapy understanding your trauma intellectually but still experience the same emotional and physical activation, EMDR’s bottom-up processing approach (targeting the stored sensory material rather than the cognitive narrative) may reach what verbal processing could not.
People whose bodies carry the stress. Unexplained migraines, chronic tension, GI disturbance, sleep disruption. When medical workups return normal but symptoms persist, the body may be holding unprocessed material. Post 4.4 in this series explores this mind-body connection in depth.
Starting the Process
EMDR is available through qualified clinicians across the Atlanta metro area, both in-person and via secure telehealth for patients throughout Georgia. If you are unsure whether EMDR is appropriate for your situation, an initial consultation with an EMDR-trained therapist focuses entirely on that question.
No referral is necessary. You do not need a formal PTSD diagnosis to begin. What you need is a therapist trained in the protocol and a willingness to let your brain do what it already knows how to do: process, integrate, and resolve.
This content is for educational purposes and does not replace professional medical or psychological advice. EMDR therapy should be conducted by a trained, licensed clinician. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline or your local emergency services.