EMDR Therapy - What Is It and Who Does It Help?

EMDR Therapy - What Is It and Who Does It Help?

EMDR therapy (Eye Movement Desensitization and Reprocessing) is a psychotherapeutic method that over the past three decades has gained the status of one of the most effective forms of trauma work. The World Health Organization (WHO) recommends it as a first-line treatment for PTSD in adults, and the American Psychological Association (APA) includes it among methods with strong scientific support. Despite this, many people have never heard of it - or have heard of it but do not understand exactly what it involves. This article explains what EMDR is, how a session proceeds, and who this method can help.

The History of EMDR

The EMDR method was developed by American psychologist Dr. Francine Shapiro in the late 1980s. Shapiro noticed that spontaneous eye movements during a walk reduced the intensity of unpleasant memories. This observation became the starting point for creating a structured therapeutic protocol, which was subsequently subjected to rigorous clinical trials.

Since then, more than 30 randomized controlled trials have been conducted confirming the effectiveness of EMDR in treating trauma-related disorders. The method has gained recognition not only from the WHO and APA, but also from the U.S. Department of Veterans Affairs, which uses it in work with soldiers after combat experiences. In Europe, EMDR has been approved by the National Institute for Health and Care Excellence (NICE) in the United Kingdom and by numerous psychiatric societies, including the Polish Psychiatric Association.

How Does EMDR Work?

The central idea of EMDR is based on the Adaptive Information Processing (AIP) model. According to this model, our brain has a natural system for processing experiences - similar to how the body has a wound healing system. When we experience trauma, this natural mechanism becomes blocked. The traumatic memory becomes "frozen" in the brain in its original, unprocessed form - with all the emotions, bodily sensations, and beliefs that accompanied the event.

This is why people after trauma react as if the threat were still ongoing - because for their nervous system, it truly is. A sound similar to an explosion triggers panic. A smell associated with violence causes nausea. Touch in a certain area of the body leads to rigidity and fear. These are not "exaggerated reactions" - they are unprocessed traumatic material that has been encoded in the neural network.

EMDR helps the brain "unfreeze" these memories and process them in an adaptive way. It uses bilateral stimulation for this purpose - most commonly eye movements following the therapist's finger (hence the name of the method), but also alternating tapping on the knees, holding vibrating devices in the hands, or auditory signals alternating between the left and right ear.

The mechanism of bilateral stimulation is not yet fully understood, but the leading hypothesis links it to processes occurring during the REM phase of sleep. During this phase, the eyes move rapidly from side to side while the brain processes and consolidates memories from the day. EMDR may replicate this natural process, giving the brain the opportunity to process memories that had previously remained blocked.

The Eight Phases of EMDR Therapy

The EMDR protocol consists of eight phases, making it one of the most systematized therapeutic methods. Each phase has a specific goal and the therapist does not proceed to the next one until the previous one has been completed:

• Phase 1 - History-Taking and Treatment Planning. The therapist learns about the patient's history, identifies traumatic memories for processing, and assesses readiness for EMDR work. In this phase, the therapist also creates a "map" of memories to be processed - establishing order and priorities.
• Phase 2 - Preparation. The patient learns emotional stabilization techniques - such as the "safe place" technique, the "container" technique, or breathing exercises - which will enable them to cope with difficult emotions between sessions. The therapist also explains how EMDR works and what to expect.
• Phase 3 - Assessment. Selection of a specific memory for processing. The patient identifies an image, a negative belief about themselves (e.g., "I am worthless"), a desired positive belief (e.g., "I have worth"), emotions, and bodily sensations. They also rate the intensity of distress on the SUD scale (Subjective Units of Disturbance) from 0 to 10.
• Phase 4 - Desensitization. The actual processing using bilateral stimulation. The patient focuses on the memory while simultaneously following the therapist's finger movements. Between sets of eye movements, the therapist asks what is emerging - what images, emotions, thoughts, and bodily sensations. Processing continues until the distress level drops to 0 or 1.
• Phase 5 - Installation. Strengthening the positive belief and connecting it to the processed memory. The patient assesses how true the positive belief (e.g., "I am safe") feels in the context of the processed memory.
• Phase 6 - Body Scan. Checking whether any tension remains in the body related to the memory. The patient mentally scans their entire body, looking for any unpleasant sensations. If they appear, the therapist continues processing.
• Phase 7 - Closure. Stabilizing the patient at the end of the session, discussing what may arise between sessions. The therapist ensures the patient is in a stable emotional state before leaving the office.
• Phase 8 - Reevaluation. At the beginning of the next session, the therapist checks how the patient reacts to the processed memory. Has the distress level been maintained? Have any new memories or dreams appeared?

Who Does EMDR Help?

EMDR was originally developed to treat PTSD, but the scope of its applications is much broader. The method has proven effective in working with many difficulties that have their source in unprocessed past experiences:

• Post-traumatic stress disorder (PTSD) - after accidents, assaults, disasters, combat experiences
• Relational trauma - domestic violence, emotional neglect, childhood abuse
• Anxiety disorders - phobias, panic disorder, generalized anxiety, when a traumatic experience underlies the condition
• Depression - especially when it is connected to difficult past experiences and negative self-beliefs
• Adjustment disorders - difficulties adapting after loss, divorce, or life changes
• Chronic pain - when it has a psychological component and is connected to a traumatic experience
• Personality disorders - especially borderline, where childhood trauma often underlies the condition
• Dissociative disorders - provided appropriate preparation and stabilization

Importantly, EMDR does not require detailed narration of the trauma. The patient does not need to repeatedly recount what they experienced - it is enough to focus on the memory internally. This makes the method particularly valuable for people who find it difficult to verbalize their experiences - for example, survivors of sexual violence who feel ashamed to talk about what they went through.

What Can You Expect After EMDR?

After completing EMDR therapy, patients often describe that the traumatic memory is still present in their memory, but it "doesn't hurt" the way it used to. They can think about it without the wave of emotions that previously overwhelmed them. The image of the memory often becomes less vivid, as if it has moved further away in time. Negative self-beliefs ("it was my fault," "I am weak") are replaced with more realistic and adaptive ones ("I did what I could," "I survived, I have strength").

On the bodily level, patients notice a reduction in tension, better sleep, a decrease in hypervigilance and reactivity. Flashbacks become less frequent, and if they occur, they no longer carry such a strong emotional charge.

How Long Does EMDR Therapy Take?

The duration of therapy depends on the type and complexity of the trauma. A single traumatic incident (e.g., a car accident) in an adult without prior adverse experiences can be processed in 3-6 sessions. Complex trauma - meaning repeated, recurring traumatic experiences, especially from childhood - typically requires longer work, often a dozen or several dozen sessions, including stabilization phases.

A standard EMDR session lasts 50-90 minutes. Processing sessions can be emotionally intense, which is why it is important for the therapist to have enough time to close the session and stabilize the patient. Some sessions - especially early ones - may be devoted entirely to resource building and preparation, without processing traumatic memories.

EMDR Compared to Other Trauma Treatment Methods

EMDR is not the only effective method for treating trauma. Other approaches with proven effectiveness include Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), exposure therapy, Somatic Experiencing (somatic therapy), and schema therapy. Each of these methods has its own strengths and indications.

EMDR stands out with several features: it does not require assigning "homework" between sessions (unlike CBT), it does not require lengthy verbal narration of the trauma (unlike exposure therapy), and its effects are often visible relatively quickly. Comparative studies indicate that EMDR and TF-CBT are equally effective in treating PTSD, but EMDR may be better tolerated by patients who do not want to or cannot narrate their experiences in detail.

You can read more about post-traumatic stress disorder in our article on PTSD - Symptoms and Treatment, and about the impact of childhood trauma on adult life in our article on childhood trauma.

Is EMDR Safe?

EMDR is a safe method, provided it is conducted by a trained therapist. Like any form of trauma work, it may temporarily intensify difficult emotions or dreams - especially between sessions, when the brain continues processing. The therapist prepares the patient for this possibility and equips them with tools for coping.

EMDR is not hypnosis and the patient remains fully conscious throughout. They have control over the process and can ask for a break or to end the session at any time. An EMDR therapist is trained in recognizing signs of dissociation and can respond appropriately if the patient begins to "shut down" during a session.

There are certain contraindications for EMDR: active psychosis, severe dissociative disorders (without prior stabilization), active substance use, and an unstable life situation that prevents regular therapeutic work. This is precisely why the initial consultation is so important, during which the therapist assesses whether EMDR is an appropriate method for the individual.

EMDR at Sztuka Harmonii Psychological Center

At Sztuka Harmonii Psychological Center in Gdansk, EMDR therapy is provided by Malgorzata Kozlowska, MA - a psychologist and psychotraumatologist with certified EMDR training. Ms. Kozlowska works with both single-event trauma and complex trauma reaching back to childhood. She is supported by Aleksandra Ostrowska, MA, also a psychotraumatologist who specializes in working with individuals after difficult life experiences. Long-term therapeutic work with trauma survivors is also supported by Anna Lewicka, MA, a psychotherapist providing individual psychotherapy.

If you experience recurring memories, nightmares, hypervigilance, or avoid situations that remind you of a traumatic event - a psychotraumatological consultation is a good first step. During the session, a specialist will assess your situation, determine whether EMDR is an appropriate method, and propose a treatment plan tailored to your needs.

You do not need to know which therapy method is right for you - that is the specialist's role. It is enough to call and describe what you are struggling with. Call 732 059 980 and schedule your first consultation. We see patients at four offices in Gdansk and Gdynia - choose the location most convenient for you. Online consultation is also available.