How many EMDR sessions do I need?

For single-event trauma, 6-12 sessions is typical. Complex or developmental trauma may require more (20-40+ sessions with modified protocols). Some people experience significant relief after just 3-4 sessions, though completing the full course prevents relapse.

Does EMDR work for complex PTSD?

Yes, though it often requires modifications — longer stabilization phases, more sessions, and therapist expertise with dissociation and attachment issues. Phase-based treatment (stabilization first, then trauma processing) is the standard approach for complex PTSD.

Can EMDR make PTSD worse?

Temporary increases in distress during and between sessions are normal and expected. Actual worsening of PTSD from EMDR is rare when performed by trained clinicians. If you have significant dissociative symptoms, ensure your therapist is experienced with dissociation to prevent destabilization.

Is EMDR covered by insurance?

Most insurance plans cover EMDR when provided by a licensed mental health professional for a diagnosed condition. It's coded as psychotherapy. VA healthcare covers EMDR for veterans with PTSD. Check with your insurance provider for specific coverage details.

EMDR Therapy: How Eye Movement Helps Process Trauma

Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy that helps the brain process traumatic memories that have become "stuck" — stored in a way that preserves the original emotional intensity rather than filing them as past events. During EMDR, you focus on a traumatic memory while simultaneously engaging in bilateral stimulation (typically guided eye movements, but also tapping or auditory tones). The theory: this dual-attention process mimics the memory consolidation that occurs during REM sleep, allowing the brain to reprocess the trauma and reduce its emotional charge. EMDR is endorsed by the WHO, the VA, and the APA as a first-line PTSD treatment.

How EMDR Differs From Talk Therapy

Traditional trauma therapy asks you to narrate the traumatic event in detail, examine your thoughts about it, and gradually habituate to the distress. EMDR takes a different approach: you don't need to describe the trauma in detail or do homework between sessions. The processing happens through the bilateral stimulation while you hold the memory in mind. Many people find this less aversive than prolonged narrative exposure.

This doesn't mean EMDR is easier — sessions can be emotionally intense. But the mechanism is different, and for people who find verbal processing difficult or retraumatizing, EMDR offers an alternative pathway to the same destination: a traumatic memory that no longer hijacks your present.

The Eight Phases of EMDR

Phase 1-2: History and Preparation

Your therapist gathers history, identifies target memories, and teaches stabilization techniques (safe place visualization, grounding exercises) to ensure you can manage distress during processing. This phase typically takes 1-3 sessions.

Phase 3: Assessment

You identify the specific memory to target, the negative belief it holds ("I'm not safe," "It was my fault"), the positive belief you'd prefer ("I am safe now," "I did the best I could"), and rate the current distress level.

Phase 4: Desensitization

The core processing phase. You hold the traumatic memory in mind while following the therapist's fingers (or a light bar, or tapping) back and forth. After each set of bilateral stimulation (20-30 seconds), you report whatever comes up — new memories, thoughts, physical sensations, emotions. The therapist guides you through successive sets until the distress drops significantly.

What people commonly describe: the memory doesn't disappear, but it loses its visceral punch. "I can see it happened, but it feels like it's behind glass." "I remember it, but my body isn't reacting anymore." The emotional distance increases while the factual memory remains intact.

Phase 5-7: Installation, Body Scan, Closure

The positive belief is strengthened ("I survived, I'm resilient"), the body is scanned for residual tension, and the session is closed with stabilization. Incomplete processing can leave you feeling unsettled between sessions, which is why the stabilization skills from Phase 2 matter.

Phase 8: Reevaluation

The next session begins by reassessing the target memory. Often, distress has decreased further between sessions as the brain continues processing. New targets may emerge — associated memories that need their own processing.

What the Evidence Says

EMDR has a robust evidence base. A meta-analysis in the Journal of Clinical Psychology found EMDR produced large effect sizes for PTSD, comparable to other trauma-focused therapies. The VA/DoD clinical practice guidelines list EMDR alongside Prolonged Exposure and CPT as strongly recommended treatments.

EMDR typically works faster than some other approaches — many patients see significant improvement in 6-12 sessions. A randomized trial published in the Journal of EMDR Practice and Research found that 77% of combat veterans no longer met PTSD criteria after 12 sessions.

What EMDR Works For

EMDR was developed for PTSD but has evidence for other conditions: anxiety disorders, phobias, grief, and some depression presentations (particularly those rooted in specific adverse experiences). It's particularly useful for single-event trauma (assault, accident, disaster) and increasingly used for complex/developmental trauma with modified protocols.

Common Questions People Have Before Starting

"Will I lose my memory of the event?" No. EMDR doesn't erase memories — it changes how they're stored. You'll remember what happened, but the memory won't carry the same emotional weight.

"What if I can't do eye movements?" Bilateral stimulation can use tapping, auditory tones, or other modalities. Eye movements are most studied but not required.

"Is it safe?" When performed by a trained clinician, yes. The main risk is incomplete processing between sessions causing temporary distress. Your therapist's Phase 2 preparation addresses this. If you have a complex trauma history or dissociative symptoms, ensure your EMDR therapist is experienced with those presentations.

Finding a qualified EMDR provider through the EMDRIA directory ensures proper training and certification.