How Does EMDR Work: Understanding the Brain's Natural Healing Process
Have you ever wondered how does EMDR work to heal trauma? It's a fascinating process that taps into your brain's natural healing abilities. EMDR therapy (Eye Movement Desensitization and Reprocessing) harnesses bilateral stimulation—whether that's following a therapist's fingers from side to side, feeling alternating taps, or listening to tones that shift between ears—while you briefly focus on traumatic memories. This allows your brain to process experiences that have become "stuck" in your nervous system. A crucial element of EMDR therapy is eye movement desensitization, which facilitates emotional healing through specific eye movements believed to enhance the processing of traumatic memories.
Think of it this way: when you cut your finger, your body naturally knows how to heal the wound if nothing blocks the process. Your brain works similarly with emotional wounds. At Pittsburgh Center for Integrative Therapy, our EMDR therapy simply removes the obstacles that prevent natural healing from occurring.
What You'll Learn in This Guide
In this comprehensive guide, we'll explore everything you need to know about how does EMDR work to heal trauma. You'll discover:
The fascinating science behind bilateral stimulation and eye movements
What happens in each phase of the structured eight-phase approach
Who benefits most from EMDR therapy, including those with post-traumatic stress disorder
What to expect before, during, and after EMDR sessions
How our team at Pittsburgh Center for Integrative Therapy tailors EMDR treatment to meet your unique needs
EMDR therapy is backed by substantial research, including randomized controlled trials, and endorsed by major health organizations including the World Health Organization, the American Psychiatric Association, and the U.S. Department of Veterans Affairs. At our group practice in Murrysville, PA, we've seen remarkable results with clients struggling with posttraumatic stress disorder, anxiety, depression, and various trauma-related conditions.
How Does EMDR Work? Understanding the Science
When traumatic events occur, our brains sometimes can't process the experience normally. Instead of filing it away as a past memory, the brain holds onto it in its raw, unprocessed form—complete with the original images, feelings, all the physical sensations, and negative beliefs. It's like having a splinter that your body can't push out on its own.
"The brain, among other things, is always trying to solve problems," explains Dr. Steven Silver, a leading EMDR researcher. "EMDR therapy has shown us that our brains are a lot more powerful than we originally thought they were."
How does EMDR therapy work to help the brain finally process these stuck traumatic memories? The secret lies in bilateral stimulation—alternating attention between the right and left sides of your body while focusing on traumatic memories. This bilateral stimulation might take several forms during your session at Pittsburgh Center for Integrative Therapy:
Following a light bar or therapist's finger with your eyes from side to side (eye movements)
Feeling gentle, alternating taps on your knees, hands, or shoulders (bilateral movements)
Listening to tones that alternate between your left and right ears
This side-to-side stimulation resembles what happens naturally during REM sleep—that deep sleep phase when your eyes dart back and forth beneath closed eyelids. During REM sleep, your brain processes daily experiences and emotions. EMDR therapy seems to tap into this same natural healing mechanism to help unstick those traumatic memories that have been frozen in time.
The Neuroscience Behind How EMDR Works
When we look deeper at the brain, how EMDR works becomes even more fascinating. Several key brain regions play important roles in this healing process:
Your hippocampus helps process memories and distinguish between past and present, but traumatic stress can affect this vital structure. Meanwhile, your amygdala—the brain's alarm system—becomes hyperactive after trauma, constantly scanning for danger. At the same time, your prefrontal cortex—responsible for rational thinking—becomes less active, making it harder to think clearly about your traumatic experiences.
This explains why trauma can feel so overwhelming. Your emotional brain is on high alert while your rational brain struggles to make sense of what happened during the original traumatic event.
EMDR therapy helps restore balance. Brain scans show that after successful EMDR treatment, activity decreases in the limbic system (your emotional brain) when recalling the distressing memory, while activity increases in the prefrontal cortex. The anterior cingulate cortex shows increased activity during EMDR sessions, facilitating the processing of emotional memories and resolution of traumatic stress. We've also seen evidence of reduced cortisol levels—your body's main stress hormone—after EMDR therapy.
It's like helping your brain finally complete the processing job it couldn't finish on its own.
Comparing Theories of How EMDR Works
Scientists have several theories about precisely how EMDR therapy works, and the truth likely involves multiple mechanisms working together:
Working Memory Theory: Bilateral stimulation taxes working memory, making traumatic images and negative memory less vivid and emotionally charged
Orienting Response Theory: Eye movements trigger an "orienting response" that activates a relaxation response
REM-Like Processing Theory: Bilateral stimulation mimics REM sleep's memory consolidation processes, potentially enhancing episodic memory retrieval
Interhemispheric Communication Theory: Bilateral movements improve communication between brain hemispheres, strengthening neural networks
Adaptive Information Processing Model: The adaptive information processing model suggests traumatic memories are stored dysfunctionally; EMDR facilitates proper integration into existing memory networks
Research in clinical psychology suggests that EMDR therapy likely works through a combination of these mechanisms rather than any single one.
At Pittsburgh Center for Integrative Therapy, our team has seen how this remarkable therapy helps clients process upsetting memories that have troubled them for years—sometimes decades. The beauty of EMDR treatment is that it works with your brain's natural healing abilities, simply removing the obstacles that have prevented processing.
The Eight Phases of EMDR Therapy
EMDR is not simply moving your eyes back and forth while thinking about a problem. It's a comprehensive, structured eight-phase approach consisting of standardized procedures. Understanding these eight phases helps clarify how EMDR therapy works in clinical practice.
Phase-by-Phase Look at How EMDR Therapy Works in Practice
Phase 1: History Taking and Treatment Planning When you first begin EMDR therapy at Pittsburgh Center for Integrative Therapy, we take time to understand your unique story. We'll explore your history and identify potential targets for processing—these might include previously disturbing events from your past, current situations that trigger distress, or goals for your future.
Phase 2: Preparation Before diving into processing difficult memories, we make sure you have the tools to handle any emotional distress that might arise. We'll teach you relaxation techniques, help you establish a mental "safe place," and thoroughly explain how the EMDR process works. This preparation phase is crucial before the brain stimulated by bilateral movements.
Phase 3: Assessment Here, we zero in on a specific troubling memory to target. We'll ask you to identify the most disturbing image from that memory, along with negative beliefs you hold about yourself because of it (something like "I am powerless" or "I am not good enough"). We'll also identify what you'd prefer to believe instead—your positive cognition—such as "I am in control now" or "I am a worthwhile and good person." Additionally, we assess all the physical sensations that accompany these trauma memories and beliefs.
You'll rate how distressing the memory feels using the Subjective Units of Disturbance (SUD) scale from 0-10, and how true the positive belief feels using the Validity of Cognition (VOC) scale from 1-7. These measurements help us track your progress throughout treatment planning.
Phase 4: Desensitization This is where eye movements come in. You'll focus on the target memory, the negative beliefs, and the physical sensations in your body while following the therapist's finger movements, feeling alternating taps, or listening to alternating tones. After each set of bilateral stimulation, you'll share what you noticed—which might be changes in the image, thoughts, feelings, or physical sensations.
During this phase, the client focuses on the negative memory while the therapist moving their fingers helps guide the bilateral movements. The beauty of this phase is that you don't have to force anything to happen. Your brain naturally moves toward healing. We continue this process until your distress level has significantly decreased, often to a 0 or 1 on the SUD scale.
Phase 5: Installation Once your distress has reduced, we shift focus to strengthening the chosen positive belief you identified earlier. You'll hold this new, healthier belief in mind while continuing eye movements. We repeat this process until the positive belief feels deeply true to you—ideally reaching a 7 on the VOC scale. This phase aims to strengthen positive emotions and beliefs, ensuring that previously disturbing events become adequately processed.
Phase 6: Body Scan Our bodies often hold onto traumatic stress in ways we don't consciously recognize. In this body scan phase, you'll mentally scan your body while thinking about the original troubling memory and your new positive belief. If you notice any tension, discomfort, or unusual physical sensations, we'll target those with additional bilateral movements. This ensures that the processing is complete not just in your mind, but in your body as well.
Phase 7: Closure We never want you to leave a session feeling worse than when you came in. If processing isn't complete by the end of a session, we'll help you use self-calming techniques to regain emotional balance. We'll also give you guidance for managing any emotional distress that might arise between sessions. EMDR therapy sessions generally last for about one hour, and proper closure is essential before ending each session.
Phase 8: Reevaluation At the beginning of each new EMDR session, we check in on the progress made previously. Has the distress stayed low? Is the positive belief still strong? Have any new aspects of the memory emerged? This ongoing evaluation helps us ensure lasting results and identify any new areas that need attention.
Conditions, Candidates, and Results
When people ask how does EMDR work for different conditions, the versatility of this therapy is truly remarkable. While psychologist Francine Shapiro initially developed EMDR for treating PTSD, research has shown it helps with a wide range of mental health conditions.
At Pittsburgh Center for Integrative Therapy, we've seen EMDR treatment create meaningful change for clients struggling with:
Post-traumatic stress disorder (PTSD) – Whether it's childhood events, assault victims' experiences, or other overwhelming traumatic events, EMDR therapy helps the brain process these experiences
Panic disorder and anxiety disorders – The same mechanisms that help process trauma can reduce panic attacks, phobias, and generalized anxiety by addressing their root causes
Depression – Particularly when connected to difficult life experiences, EMDR can help lift the emotional weight that contributes to depressive symptoms
Performance anxiety – Athletes, public speakers, and performers benefit from EMDR's ability to process performance-related fears and build confidence
Traumatic stress disorder – EMDR effectively addresses symptoms of both acute and chronic traumatic stress
The research backing EMDR therapy's effectiveness for treating PTSD is compelling. Studies have found that up to 90% of single-trauma victims experienced significant reduction in PTSD symptoms after just three 90-minute EMDR sessions. A comprehensive review of 24 studies found EMDR to be both quicker and more effective than traditional cognitive behavioral therapy for trauma processing.
Who Is a Good Candidate?
"Is EMDR therapy right for me?" is one of the most common questions we hear at our practice. While how EMDR works makes it suitable for many people, certain factors can help determine if you're likely to benefit.
You might be an ideal candidate for EMDR therapy if you:
Experience symptoms clearly connected to past traumatic experiences
Find it challenging to talk about your trauma in detail (EMDR requires less verbal processing)
Have tried traditional talk therapy without finding the relief you hoped for
Notice strong physical sensations when traumatic memories arise
Are willing to temporarily experience some emotional distress on the path to long-term healing
Some situations might suggest waiting or moving more slowly with EMDR:
If you're experiencing severe dissociation, you might need stabilization work first
Limited support systems during the treatment process can make the work more challenging
At Pittsburgh Center for Integrative Therapy, we believe in careful assessment and personalized treatment planning. Our therapists conduct thorough evaluations to determine if EMDR is appropriate for each individual client, often integrating it with other approaches like cognitive behavioral therapy for the best results.
Benefits, Effectiveness, and Side Effects
EMDR therapy offers several distinct advantages compared to other trauma therapies. Our clients particularly appreciate:
Efficiency – Many people notice significant shifts in fewer EMDR sessions than traditional talk therapy requires
Less verbal processing required – Unlike therapies that require detailed retelling of traumatic events, EMDR doesn't depend on extensive verbal descriptions
Whole-person healing – EMDR addresses both emotional memories and physical sensations, recognizing that our bodies hold trauma too
Lasting results – Follow-up studies show that the benefits of EMDR treatment tend to persist over time, with many people continuing to improve even after therapy ends
While EMDR therapy is generally considered safe, we believe in transparent discussions about potential side effects. During EMDR processing, you might experience:
Temporary emotional distress – As you process difficult material, you may feel increased emotions during or between sessions
Vivid dreams or memories – Many clients notice their dreams become more vivid or previously forgotten memories emerge
Fatigue – The rapid eye movement portion of EMDR sessions can be mentally and emotionally tiring
Physical sensations – As your body releases stored traumatic stress, you might notice physical sensations like tingling or warmth
Most side effects are temporary and actually signal that healing is occurring. Our experienced therapists are trained to help you navigate these experiences effectively, ensuring you have the support and tools you need throughout the process.
EMDR Sessions: What to Expect Before, During, and After
Stepping into therapy can feel like venturing into unknown territory. At Pittsburgh Center for Integrative Therapy, we believe that understanding what to expect can help ease those pre-therapy jitters.
Before Treatment
The EMDR process begins with a thorough assessment where we get to know you—your history, challenges, strengths, and goals. This isn't just about checking boxes; it's about building a relationship where you feel seen and understood.
During this initial phase, we'll discuss whether EMDR therapy is appropriate for your unique situation. We'll explain the process in detail and answer any questions you might have. Most importantly, we'll help you develop personalized coping skills to manage any emotional distress that might arise during treatment.
During Treatment
EMDR sessions at our practice typically last about one hour, giving us enough time to process material deeply while ensuring you leave feeling grounded. For single traumatic events, most clients find relief within 6-12 sessions, though this varies from person to person. More complex traumatic experiences may require additional time—healing isn't a race, and we honor your unique pace.
Some clients benefit from our EMDR Intensive format, which condenses treatment into longer sessions over fewer days. This approach can be particularly helpful for those traveling from a distance or who prefer to immerse themselves in the healing process rather than spreading it over months.
During the rapid eye movement portion of the session, the brain stimulated by bilateral movements begins to reprocess the traumatic memories. An external stimulus, such as the therapist moving their fingers or using tapping techniques, facilitates this bilateral stimulation, helping clients process traumatic memories effectively.
After Treatment
Healing doesn't end when you walk out our door. We schedule follow-up sessions to ensure your progress continues and to address any challenges that arise as you integrate new insights into daily life. Many clients benefit from occasional "booster" EMDR sessions during particularly stressful life transitions.
Preparing for Your First Session
The way you prepare for EMDR can improve your experience and results. Here are some suggestions from our team:
Take some time to reflect on your goals—what specific issues do you want to address?
Plan for self-care after sessions, especially in the beginning
Write down questions or concerns about the process
Consider timing when scheduling sessions—avoid planning important events immediately afterward
Let trusted people know you're starting therapy (you don't need to share details)
Our therapists will work with you to develop personalized stabilization tools during the preparation phase. These might include breathing exercises, grounding techniques, or visualization practices that create internal safety.
Inside the Therapy Room
When you arrive for an EMDR session at Pittsburgh Center for Integrative Therapy, you'll be welcomed into a comfortable, private space designed to help you feel at ease. Here's what unfolds during a typical session:
We begin with a check-in to assess how you're doing and address any questions
Together, we'll identify which memory or issue to focus on during the session
Your therapist will guide you through sets of bilateral movements—the back-and-forth eye movements that help your brain process difficult memories
After each set, the client focuses on noticing what emerges—thoughts, feelings, physical sensations, or images—without judgment
You'll share what you noticed with your therapist, who will offer minimal direction
This process continues until your distress level decreases significantly
Before ending, your therapist ensures proper closure, helping you feel grounded before you leave
Post-Session Integration
After an EMDR session, your brain continues processing traumatic experiences—think of it as your mental computer running a program in the background. Many clients report fascinating experiences in the days following a session:
New insights about previously disturbing events often emerge spontaneously
Dreams may become more vivid during both REM sleep and slow wave sleep as your brain continues processing
You might notice unexpected connections between past experiences and current patterns
Physical sensations might arise as your body releases stored tension
To support this integration process, we recommend several practices:
Journaling can be invaluable for capturing thoughts, feelings, and insights
Physical self-care becomes especially important during EMDR treatment
Emotional self-care means practicing self-compassion and using the coping skills you've learned
Mindfulness helps you notice changes without judgment
Communication with your therapist about significant insights ensures we can incorporate them into your next session
Frequently Asked Questions about How EMDR Works
How does EMDR work so quickly?
The efficiency of EMDR therapy comes from several unique aspects of this approach. Unlike therapies that rely heavily on verbal processing and rational thinking, EMDR directly accesses the emotional memory networks where traumatic stress is stored.
Bilateral stimulation appears to accelerate your brain's natural healing processes. Think about how your body knows exactly how to heal a cut—your brain has similar natural healing mechanisms for emotional wounds that EMDR helps activate.
EMDR also takes advantage of memory reconsolidation—the brief window when recalled memories become temporarily malleable. During this window, your brain can update the memory with new, adaptive information before storing it again.
Research supports this efficiency. A study in the Journal of EMDR Practice and Research found that 84-90% of single-trauma victims experienced significant improvement in PTSD symptoms after just three 90-minute EMDR sessions.
Are eye movements required for EMDR to work?
While "Eye Movement Desensitisation" is right there in the name, the eye movements themselves aren't actually essential for the therapy to work. What matters is the bilateral stimulation—alternating activation of the right and left sides of the body.
At Pittsburgh Center for Integrative Therapy, we offer several alternatives to traditional eye movements:
Tactile stimulation uses alternating taps on your knees, hands, or shoulders
Auditory stimulation delivers alternating tones to each ear through headphones
Some clients benefit from combined methods that engage multiple senses simultaneously
These alternatives to eye movement desensitization are especially valuable if you have visual impairments, experience dizziness with eye movements, find it difficult to track with your eyes, or have certain neurological conditions that affect eye movement.
How long will my EMDR treatment take?
There's no one-size-fits-all answer to this question. The duration of your EMDR therapy will depend on several factors unique to you and your experiences.
Single-incident trauma typically resolves faster—often within 3-6 EMDR sessions. More complex traumatic stress generally requires more time, potentially 12 or more sessions.
Your personal factors matter too. Your natural resilience, existing coping skills, and support systems all influence how quickly you process traumatic memories. Some clients experience significant shifts after just a few sessions, while others benefit from a longer-term approach.
Conclusion and Next Steps
Understanding how does EMDR work opens the door to profound healing possibilities. At Pittsburgh Center for Integrative Therapy, we've witnessed the remarkable capacity of the human brain to heal from traumatic stress when given the right conditions and support.
Our warm, collaborative team of therapists in Murrysville, PA brings specialized expertise in EMDR therapy along with complementary approaches that address you as a whole person. We recognize that traumatic stress doesn't just affect your thoughts—it impacts your brain, body, and spirit in interconnected ways.
When you work with us, you'll experience a personalized treatment plan that respects your unique history, needs, and goals. No two healing journeys look exactly alike, and we honor your individual pace and process.
Beyond EMDR, our group practice offers multiple therapeutic modalities that complement your healing journey, including movement desensitization and reprocessing, somatics, Emotionally Focused Therapy (EFT), Internal Family Systems (IFS), Cognitive Processing Therapy (CPT), and the Safe & Sound Protocol (SSP). Many clients benefit from an integrated approach tailored to your specific needs.
We're proud to serve adults, couples, families, teens, and children throughout the Murrysville area who are working through post-traumatic stress disorder, anxiety, depression, and related challenges. Our therapists bring deep expertise and compassionate presence to every session, creating a safe space for change.
Ready to take the next step in your healing journey? Reach out to us to schedule a consultation and discuss whether EMDR therapy might be the right approach for you. We're here to answer your questions and help you determine if our approach aligns with your needs.
The path to healing begins with a single step. At Pittsburgh Center for Integrative Therapy, we're honored to walk alongside you, supporting your journey toward becoming a worthwhile and good person with greater freedom, peace, and wholeness.