Sometimes experiences from the past continue to affect us long after they are over. You might understand intellectually that you are safe now, for example, while your body continues to react as though you are in danger. Or you may find yourself repeatedly overwhelmed by shame, fear, helplessness or beliefs such as I’m not good enough, I’m unsafe, or I’m on my own.

Eye Movement Desensitisation and Reprocessing (EMDR) is a psychotherapy that helps the brain process experiences that have remained emotionally “stuck”, so that they can begin to feel like something that happened in the past rather than something that is still happening now.

EMDR has a strong evidence base for the treatment of post-traumatic stress disorder (PTSD) and is recommended in international treatment guidelines. It is also increasingly used to work with other difficulties that may be connected to distressing life experiences, including anxiety, panic, grief and the effects of difficult or traumatic childhood experiences.

What does EMDR therapy involve?

EMDR is more than simply bringing up a difficult memory and using eye movements. Therapy begins with taking time to understand what is happening for you now, your history, and how your past experiences may be connected to the difficulties you are experiencing in the present.

Together, we develop an understanding of what we might work on and what you may need in order to approach that work safely and effectively. For some people, it is possible to begin processing particular memories relatively quickly. For others — particularly when there has been longstanding or repeated trauma, difficult childhood experiences, or a lack of safety and support growing up — we may spend more time building the skills and resources needed before working directly with painful memories.

When we do process a memory, I will ask you to notice aspects of the experience, such as an image, emotions, thoughts or sensations in your body. You will then engage in bilateral stimulation, most commonly by following my fingers with your eyes as they move from side to side.

You don't need to describe everything that happened in detail. During processing, I will periodically ask you what you are noticing, but you remain in control of how much you tell me.

Over time, the aim is for the memory to become less emotionally charged and for new, more adaptive ways of understanding the experience — and yourself — to emerge.

What if there isn’t one traumatic event?

Not everyone who comes to EMDR therapy has experienced a single traumatic event. Sometimes the difficulties we experience in adulthood develop through repeated experiences over many years — for example, growing up with criticism, rejection, instability, emotional neglect, or without enough safety, comfort or emotional support.

In these circumstances, you may not have one particular memory that explains how you feel. Instead, you might notice longstanding patterns such as feeling that you are not good enough, finding it difficult to trust or rely on other people, becoming easily overwhelmed by rejection or conflict, or feeling alone even when you have people around you.

EMDR can be adapted to work with these kinds of experiences. Therapy may involve identifying particular memories that contributed to these patterns, as well as working with present-day situations that trigger the same feelings and beliefs.

When important emotional needs were not adequately met in childhood, processing painful memories is only part of the work. Therapy may also involve helping you develop new ways of understanding and responding to yourself, and building experiences of safety, compassion and connection that may have been missing in the past.

This work is usually more gradual than EMDR for a single traumatic event. We will work together to decide what to focus on and when, rather than assuming that you need to revisit every difficult experience from your past.

How long does EMDR therapy take?

The length of EMDR therapy varies considerably from person to person. Some people seeking help following a single traumatic event may notice significant change within a relatively small number of sessions. When difficulties have developed through repeated or longstanding experiences, therapy will usually take longer.

How long we work together will depend on what you would like help with, your history and current circumstances, and how you respond to the therapy. We will regularly review how the work is progressing and whether EMDR continues to feel like the right approach for you.

EMDR is not about processing every difficult memory you have ever had. Often, working with particular experiences can have effects beyond that individual memory, including changing related beliefs, emotional responses and present-day triggers.