By William Schroeder, LPC and clinically reviewed by Teri Schroeder, LCSW
I have to admit, the first time I heard about EMDR, I was skeptical. So you are telling me that wagging your finger back and forth causes trauma to go away?
Then I was in a dog bite incident, and that took me from skeptic to believer. I can honestly say that personally, I made more progress with EMDR in a year than I did in 20 years of therapy. So let’s break down how this works and why.
What EMDR Actually Is
EMDR stands for Eye Movement Desensitization and Reprocessing. You briefly bring a distressing memory to mind while following a back-and-forth stimulus, usually the therapist’s moving finger, a light bar, alternating tones, or taps.
The part that surprises most people, and the part that surprised me: you are not asked to describe the memory in detail, and there is no homework. That makes it a different proposition from talk therapy, and it is often why people who have stalled everywhere else are willing to try it.
How It Works
The working theory is that some memories never get filed properly. A memory stored while your nervous system was overwhelmed stays raw, and anything that resembles it pulls the whole thing back into the present with its original charge. That was my experience after the dog bite. My body reacted to dogs I had never met as though the incident were happening again.
EMDR aims to get that memory processed and filed, so it becomes something that happened rather than something happening. Francine Shapiro developed the approach in 1987. The mechanism is still debated. The leading explanation is that dual attention, holding the memory while tracking a stimulus, taxes working memory enough that the memory gets re-stored in a less vivid form. Research on the working memory account supports parts of this without settling the question.
Standard EMDR runs eight phases: history taking, preparation and resourcing, assessment of the target memory, desensitization, installation of a more useful belief, a body scan, closure at the end of each session, and re-evaluation at the start of the next. The reprocessing everyone associates with EMDR is phase four. The preparation before it is what makes phase four survivable.
What the Research Shows
EMDR is a first-line treatment for PTSD, and it sits alongside two others rather than above them. The VA and Department of Defense clinical practice guideline recommends three trauma-focused psychotherapies as most effective: Prolonged Exposure, Cognitive Processing Therapy, and EMDR. It deliberately declines to rank them and directs clinicians to choose with the patient.
That detail matters more than it sounds. When three treatments perform comparably, fit becomes the deciding factor: what you are willing to do every week, and what you can tolerate.
Where the field genuinely disagrees is on how strongly EMDR should be recommended relative to exposure-based therapy. Head-to-head trials have produced mixed results and the professional bodies have not landed in the same place. The Journal of EMDR Practice and Research published a critique of the American Psychological Association’s most recent PTSD guideline arguing it underrates EMDR. I am flagging the disagreement rather than pretending it is settled, because reading any single source would leave you thinking it is.
My honest summary: EMDR works for PTSD, the evidence for that is strong, and whether it beats Prolonged Exposure for any particular person is not something the research can tell you in advance. It worked for me. That is one case, not a study.
How It Compares to Other Trauma Therapies
- Prolonged Exposure asks you to approach the memory and the situations you avoid, repeatedly, including between sessions. Demanding, and well evidenced.
- Cognitive Processing Therapy works on the conclusions the trauma left behind, the beliefs about fault, safety, and trust, largely through writing and structured discussion.
- EMDR requires the least narration. You do not have to tell the story out loud in detail, which is the barrier that stops some people from starting at all.
If describing what happened is the thing you cannot face, that is a real argument for EMDR. If you would rather work on the beliefs than the memory, CPT may suit you better.
What a Session Is Actually Like
You and your therapist identify a target memory, the belief attached to it, and where you feel it in your body. You hold that in mind in short sets while following the bilateral stimulus, then pause and report whatever came up. There is no right answer to report. The material moves on its own and it often goes somewhere you did not expect. Mine did.
Sessions usually run longer than a standard hour, and most people need several before reprocessing begins. Feeling stirred up for a day or two afterward is common. So is being unusually tired.
Who Should Be Cautious
EMDR is not the right starting point for everyone. If you are in active crisis, currently unsafe, in heavy substance use, or dealing with dissociation, the preparation phase comes first and it may need to take a while. A therapist who moves to reprocessing before you can stay present for it is going too fast.
Complex trauma, meaning repeated harm over years rather than a single event, generally takes longer than the trial protocols suggest. That is not a failure of the method or of you.
Culture, Identity, and Fit
Trauma does not happen in a vacuum and neither does treatment. Racism, immigration experience, religious background, and community expectations all shape what registers as threatening, what feels safe to disclose, and what a person believes recovery should look like. A therapist who treats those as background detail will miss things. It is fair to ask how someone works with this before you book.
Finding an EMDR Therapist in Austin
Look for someone trained through an EMDRIA-approved program, and ask how many phases of preparation they typically do before reprocessing. The answer tells you a lot. Cleveland Clinic’s overview is a solid plain-language primer if you want more background first.
Several of our clinicians at Just Mind are EMDR trained. If you are not sure whether EMDR or another trauma therapy fits your situation, that is worth working out in a first conversation rather than deciding alone.
