EMDR therapy

EMDR, eye movement desensitisation and reprocessing, is a structured therapy that helps your brain process distressing memories so they stop intruding on the present. You do not need to describe what happened in detail. NICE recommends it for post-traumatic stress disorder, and it is delivered here entirely online by an HCPC-registered clinical psychologist.

What EMDR is and the evidence for it

EMDR was developed by the psychologist Francine Shapiro in the late 1980s and has since become one of the most heavily researched trauma treatments available. NICE guideline NG116 recommends it as a first-line treatment for post-traumatic stress disorder in adults, alongside trauma-focused CBT, and the World Health Organization has made a similar recommendation. Dozens of randomised controlled trials support these recommendations, generally showing large and lasting reductions in trauma symptoms.

The approach works differently to most talking therapies. Rather than exploring an experience in conversation, you bring a memory briefly to mind while your psychologist guides you through sets of bilateral stimulation, usually eye movements or alternating taps. The idea, drawn from a model called adaptive information processing, is that overwhelming experiences sometimes get stored in a raw, unprocessed state, with the original images, sensations and beliefs still attached and still active. EMDR appears to help the brain finish the filing job it did not manage at the time, so the memory becomes something that happened rather than something still happening.

What EMDR helps with

EMDR has the strongest evidence for PTSD and trauma, including single-incident trauma such as an accident or an assault, and more complex or repeated trauma from earlier in life. It is also used, with a growing though younger evidence base, for phobias, complicated grief, and forms of panic where a specific past experience appears to be driving current symptoms. Trauma connected to pregnancy, birth or loss falls within our perinatal work as well, and EMDR is one of the approaches a psychologist may draw on there. Because EMDR works with memory directly rather than through extended conversation, it can help even when the experience itself is difficult to put into words.

What a course of EMDR sessions looks like

EMDR follows a structured protocol, though the pace adapts to what you need. Early sessions focus on history taking and preparation: understanding your background and current difficulties, agreeing which memories to work on, and teaching stabilisation and grounding skills before any reprocessing begins. Some people need only one preparation session; others, particularly with a longer or more complex history, spend considerably more time here, and that time is not wasted.

Once preparation is complete, reprocessing sessions follow a consistent shape. You identify the target memory, the belief attached to it and how distressing it currently feels, then work through sets of bilateral stimulation with brief check-ins between each one. Every session, whether or not the memory feels fully processed by the end, closes with a grounding phase so you leave settled rather than activated. A single distressing event often resolves within six to twelve sessions in total. Longer-standing or repeated trauma usually takes more, because there is more history to work through and the pace has to respect what you can manage.

How EMDR works online

The parts of EMDR that matter most, thorough assessment, careful preparation, sustained attention during reprocessing and a proper close to each session, all transfer to video without loss. What changes is the method of bilateral stimulation. Your psychologist shares a screen showing a point moving left to right, which you follow with your eyes, or guides you through self-administered tapping if eye movements do not suit you or your connection is unreliable. Both approaches are supported in the research on remote EMDR delivery.

A private, uninterrupted room and a stable connection are the only real requirements. Before any reprocessing, you and your psychologist agree what happens if you become very distressed or the call drops, typically a number to call, a grounding exercise you have already practised, and an understanding that you will not end a session while still activated. Many people also find that processing difficult material somewhere familiar, rather than in a clinic they then have to leave and travel home from, makes the work more manageable rather than less.

EMDR and life in Islington

For people living around Angel, Highbury, Canonbury or Barnsbury, fitting a course of EMDR around a working week in N1 is often a practical concern as much as a clinical one. Reprocessing sessions can leave you feeling a little tired or unsettled for the rest of the day, and doing that work from home rather than a clinic near Upper Street means there is no commute on the Victoria or Northern line to manage straight afterwards, just time to settle before getting on with the evening.

Who EMDR may not suit right now

EMDR is not always the right starting point, and a good assessment says so honestly rather than pushing ahead regardless. It is usually sequenced differently, or held back for a while, when there is significant dissociation, active dependence on alcohol or drugs used to manage distress, danger that is still ongoing rather than in the past, or a recent period of high risk or crisis. A major event in the next few weeks, an exam, a court date, a house move, is also not the moment to open up difficult material. None of these situations rule EMDR out permanently. They are reasons to build stabilisation first, and your psychologist will explain what that looks like for you if it applies.

If you need support right now

EMDR is not a crisis service, and reprocessing work is not appropriate while you are in crisis. If you are thinking about ending your life or harming yourself, please call 999, call NHS 111 and select the mental health option, or contact the Samaritans free, any time, on 116 123.

Getting started

EMDR here is delivered online. If you think EMDR might fit your situation, our get started page is the quickest way to tell us what has been going on.