You've heard of EMDR. Maybe your therapist mentioned it, maybe you're on a waitlist, maybe you keep seeing it online and wondering whether it's actually legitimate or just another wellness trend with good branding.
This is the honest, real explanation you've been looking for.
In this episode, I break down what EMDR actually is, how it works, and what happens during a session — including why trauma memories get stuck in the first place, what the brain is doing during processing, and what it actually feels like when a memory resolves.
In this episode:
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Why EMDR looks weird but isn't
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The Adaptive Information Processing model — your brain's natural healing system
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The eight phases of EMDR and when the actual processing happens
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What a processed memory looks and feels like from the inside
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Why EMDR works when talk therapy hasn't
No finger-waggling mysticism. Just a clear, evidence-based explanation from someone who does this as a full-time job.
If you're considering EMDR, currently in it, or just tired of not understanding what people mean when they talk about trauma processing, start here.
Ep 1: WTF is EMDR?
Transcript
Welcome to the Trauma Nerd Podcast - What this show is about
Hello and welcome to the Trauma Nerd Podcast. This is the very first episode, so thank you so much for being here. I'm really glad you're listening.
I talk about EMDR all the time. Let's break down what it actually is. This episode is going to be: What the F is EMDR? You wave your fingers around and my trauma just goes away. Sounds fake? Okay.
It is weird, and you've probably heard EMDR described as the eye movement thing.
But first, let me introduce myself properly. I'm Helen Billows. I am a registered psychologist, a fully trained EMDR therapist, an EMDR supervisor -- which means I also help train other therapists in how to do this work -- and I also run a trauma-focused private practice in Adelaide, South Australia.
A big chunk of what I do with clients is EMDR. Not exclusively, but heavily, because it's a fabulous tool that I really love and that can really get to the root of what's keeping you stuck.
I'm going to be upfront: if you've done other therapy -- like CBT, talk therapy, counselling -- if you're used to other styles, EMDR is going to be very different. And when I say different, I mean like aliens visited the planet kind of different.
So today we're going to break down what exactly EMDR is, how it works, what trauma processing actually means -- because it's kind of an abstract concept, isn't it? What does it mean to process my trauma? What's going to happen? And how to tell if it's actually working.
What is EMDR therapy -- definition, history, and evidence base
EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed in the late 1980s by Dr. Francine Shapiro -- my idol, by the way. She noticed, and I think the story is she was walking through a park one day, that as she moved her eyes, the intensity linked to a distressing experience seemed to reduce. I love that for her. What a vibe.
Today, EMDR is a structured eight-phase psychotherapy. It is a full psychotherapeutic approach used to heal and treat trauma and other disturbing or distressing experiences. It's not just a strategy -- it's a full therapy.
EMDR is now recognised as an evidence-based treatment for PTSD and trauma by international organisations: the World Health Organization, the UK NICE Guidelines, the American Psychological Association, the Australian Psychological Association -- all the big dogs, really, worldwide. There is a very large body of research supporting EMDR. It has a significant evidence base.
That's not to say it didn't attract scepticism in the early days. To get an idea of that scepticism, all you need to do is look at the Wikipedia page. It is savage. It's also biased, has a lot of inaccuracies, and it's very outdated. I'm pretty up to date on the EMDR literature, and quite frankly, whoever did that Wikipedia entry has beef.
That's not to say I don't understand the scepticism, because EMDR is so weird. I was sceptical before I personally trained in it and before I did the therapy myself. I've done a lot of EMDR. But worldwide, it is considered a first-line trauma therapy. So take that, Wikipedia author.
Why EMDR therapy works -- the Adaptive Information Processing model
To understand why EMDR works, we need to address the foundation beneath it -- the Adaptive Information Processing model, or AIP for short.
The core idea is that your brain is naturally wired to process and integrate your experiences. When life events happen, your system usually files them away as memories you can think about without reliving them. Think of your healthy memory storage system as a nice, tidy filing cabinet -- alphabetised, colour-coordinated, working just fine and dandy.
But then something overwhelming, shocking, or traumatic happens that causes the processing system to break down. The memory can't be filed appropriately. It gets stuck -- locked in what we call its state-specific form, with all of the vivid sensory and emotional content from when it occurred. That includes images, body sensations, smells, emotional responses, and beliefs associated with the event.
These unprocessed memory contents can continue to trigger reactions in your life because your brain hasn't integrated the experience properly.
In EMDR, we intentionally and safely reactivate those unprocessed memories in a controlled context so your brain and nervous system can properly finish that process -- updating the memory, putting it in the filing cabinet, alphabetising, colour-coordinating. It no longer bothers you.
What to expect in an EMDR session -- the eight phases of EMDR therapy
The eye movements -- or whatever you end up doing, because it's not necessarily eye movements -- don't start until phase four. You are not going to walk into your first EMDR session and start eye-waggling.
The eight phases break down like this:
Phases one and two are history taking and preparation. We figure out what's going on, why you're in therapy, what your goals are, whether EMDR is right for you, and which memories to target and prioritise.
Phases three to seven are the active processing phases.
Phase three activates the memory. Phase four is the bilateral stimulation -- the eye movements or equivalent. Phases five, six, and seven are the closing phases of processing. If you completely process a memory in one session, you'll move through phases three to seven in that single session.
Phase eight is re-evaluation, which happens in the following session -- checking how that memory is sitting now and deciding where to go from there.
In an active processing session, we'll know which memory we're working on. We'll activate it, and you'll hold it in mind while engaging in a challenging task -- usually eye movements, but sometimes tapping or other things. Research now shows eye movements aren't actually necessary for EMDR to work. It's more about taxing the working memory. In the Netherlands, therapists might have clients walk in a square or spell words backwards.
After about 40 seconds of the task, we pause and I ask: what are you noticing now? You report whatever's coming up -- a feeling, a body sensation, a shift in perspective. A very common one is moving from being inside the memory to observing it from the outside. Then we keep going.
You have full control throughout. You can pause or stop at any point. The only time you might get gently pushed is if you're wanting to stop because you don't want to face the memory contents -- because that's avoidance, and avoidance maintains trauma. I don't think you want to pay your therapist to help you avoid things.
For EMDR to work, the memory needs to be activated. I use this analogy: you can't cook spaghetti if there's no spaghetti in the water. Everything can look as it should, but if the memory isn't activated, nothing's going to happen.
What to expect from EMDR therapy for complex trauma
EMDR works on one memory at a time. If you've got a complex trauma history, you're probably thinking that's going to take forever. This is where generalisation effects come in.
Think of your memory network like a Jenga stack. After we remove the right blocks strategically, suddenly the whole thing is looking precarious. Remove enough of the right ones and the whole stack will tumble. We target the right memories to create maximum impact with as few memories as possible.
That said -- I don't want to set unrealistic expectations. You're not going to do a few memories and have your complex trauma healed. You might need around 20 sessions or more. But you will be progressively feeling better and working towards a real outcome.
We also don't just pluck memories off the top. If there's a theme that runs all the way back to childhood, we need to start there -- pulling blocks from the bottom of the Jenga stack. That's when you'll really see things topple, and really notice change.
What is happening in the brain during an EMDR session
The prevailing explanation in the current literature is working memory taxation theory. When you hold a traumatic memory in working memory while simultaneously doing a demanding task, your working memory system gets taxed. That taxation appears to reduce the emotional vividness and intensity of the memory, which facilitates memory reconsolidation -- the memory is restored into long-term memory carrying less emotional charge.
Memories aren't fixed files. They're dynamic, and they can be updated when reactivated under the right conditions. This aligns well with cognitive science and memory theory.
This is the prevailing theory -- not the only mechanism, probably. There are other ideas such as orienting responses and procedural learning. There are likely numerous mechanisms occurring simultaneously. Still pretty interesting.
How to know if EMDR is working -- what a processed trauma memory feels like
First, the memory stays in the past. A stuck trauma memory can feel like it's happening right now -- you think it, you feel it, you see through the eyes of that experience. When it's processed, it no longer hijacks your system. No more overreactions, no more disproportionate responses, no more losing control of your thoughts and feelings.
Second, it's no longer distressing in the same way. You'll be able to recall the memory and might feel neutral, a bit sad, or annoyed that it happened -- but not distressed. Before EMDR, that memory will likely rate above a six on our distress scale of zero to ten. After EMDR, it's typically a zero or one.
Third, the negative beliefs no longer feel true. Trauma memories carry emotional beliefs about the self -- things like I'm not good enough, I did something wrong, I am powerless. These beliefs are essentially a verbalisation of the emotion stuck in the memory.
Post-processing, that belief will no longer feel true. EMDR brings the body into alignment with the mind. And often -- this is one of my favourite parts -- a healthy belief emerges spontaneously during processing. If your initial belief was I'm to blame, you might arrive at: it wasn't my fault. I've just realised it wasn't my fault. The healthy belief replaces the negative one.
Some things clients say after processing -- and these are not actual client reports, these are illustrative:
"It feels really far away now." "The volume of the memory's been turned down." "I know it happened, but I really know it's over now." "I feel calm. My body finally believes I'm safe." "I can think about it without going into the spiral I usually do."
There's a shift from it's happening to it happened.
How many EMDR sessions will you need -- timeline and what to expect
Best case scenario, a traumatic memory can be fully processed in a single 60 to 90-minute session. It doesn't always happen like that -- one to three sessions for most memories is more typical, sometimes longer. But when it does happen in one session, clients walk out going: what did you just do to me?
The distress can shift quickly too. If you start a processing session rating your memory a ten out of ten, it is entirely possible for that to drop to a five in ten to fifteen minutes. And the research shows these gains tend to hold -- at six and twelve month follow-ups, the improvements are maintained.
Does EMDR therapy work for everyone? Effectiveness rates and what the research shows
No. Nothing does. Anyone promising a hundred percent success rate for anything is selling snake oil.
The research suggests approximately a 70% effectiveness rate -- meaning 70% of people who do EMDR will experience a clinically significant benefit. That's not necessarily total resolution, but meaningful, significant improvement. The remaining 30% either won't benefit or won't benefit to a clinically significant degree.
In therapy terms, 70% is a strong effectiveness rate. If your difficulties are rooted in trauma, EMDR is likely to be a really good option for you.
The take-home message: trauma is healable. It is not a life sentence. Not only can you feel better -- the odds are in your favour.