What to Expect from EMDR Trauma Treatment
If you’ve been living with the effects of trauma, you may have heard the term EMDR mentioned by your doctor, a friend, or in your own research. It’s a well-researched and effective treatment for PTSD, and yet it remains misunderstood. As a result, few people ask for it, even though it can help.
This guide will give you a clear, honest picture of what EMDR is, how it works, and what you can realistically expect if you decide to pursue it.
What Is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed in the late 1980s by psychologist Dr. Francine Shapiro, and has since been endorsed as an effective treatment for trauma and PTSD by major organizations, including the World Health Organization (WHO), the Canadian and American Psychological Associations and Veterans Affairs Canada.
The core idea behind EMDR is that trauma can disrupt the brain’s natural ability to process through and heal from distressing experiences. When something overwhelming happens, the memory can become “stuck” — stored in a raw, unprocessed form that continues to affect how you feel, think, and respond to the world around you. EMDR works by helping the brain resume its natural processing, so the disturbing emotions, images, negative beliefs and body sensations that were connected to traumatic memories fade away, and the ‘neutralized’ memories can be integrated into long-term storage like with any other, non-traumatic experience.
How Is EMDR Different from Talk Therapy?
This is one of the most common questions people ask, and it’s a good one. Traditional talk therapy approaches — including cognitive behavioural therapy (CBT) — involve discussing your experiences, identifying unhelpful thought patterns, and developing new ways of thinking and behaving. This is effective for many concerns, and we use this and other approaches extensively at our clinic.
EMDR takes a different route to relieve symptoms and problems. Rather than focusing primarily on changing thoughts or talking through events in detail, EMDR works directly with the memory itself and with the brain’s natural ability to process information. EMDR still requires clients to work to heal from their trauma, but many people find this aspect of EMDR to be a significant relief.
EMDR isn’t a replacement for other therapies. Sometimes a combination of EMDR and CBT works best, and your therapist will help you to determine the right fit for you.
What Does an EMDR Session Actually Look Like?
The EMDR approach follows eight steps that unfold in a logical and manageable way over the course of your treatment.
Step 1 — History and Treatment Planning: You and your therapist will take time to explore your history together, identifying the specific memories or experiences that are causing the problems, and determine whether EMDR is the right fit for you.
Step 2 — Preparation: Before any trauma processing begins, your therapist will work with you to build stabilization and self-regulation skills. These are tools you can use both inside and outside of sessions to manage your emotional arousal. You and your therapist will move forward only when you’re both confident you’ve built the skills needed to reprocess the memories safely and effectively.
Steps 3 through 6 — Assessment and Processing: This is the heart of EMDR treatment. Working together, you and your therapist will identify a specific memory to focus on — including the image, the negative beliefs associated with it, and the emotions and body sensations it triggers. Your therapist will then guide you through sets of bilateral stimulation (BLS) while you allow whatever comes to mind to simply unfold. Most commonly, the BLS is activated through side-to-side eye movements, but it can also take the form of tapping on both sides of the body or listening to tones in alternating ears. Over the course of these sets, you and your therapist work together to track changes in how the memory feels, especially as it becomes less vivid and less distressing over time.
Steps 7 and 8 — Closure and Re-evaluation: At the end of each session, your therapist will work with you to ensure you leave feeling stable and grounded. At the start of subsequent sessions, you and your therapist will check in together to assess how you’ve been since your last appointment and whether further processing of the target memory is needed.
What Does Bilateral Stimulation Actually Do in EMDR?
Bilateral stimulation (BLS) is the element of EMDR that people are often most curious about. It refers to any form of sensory input that alternates rhythmically between the left and right sides of the body. Most often, this takes the form of side-to-side eye movements, but can also involve alternating tactile taps on the hands or knees, or alternating tones delivered through headphones.
Researchers are still working to fully understand exactly why bilateral stimulation works, but the leading theory is that it mimics what happens in the brain during REM (rapid eye movement) sleep — the stage of sleep during which the brain naturally consolidates and processes the day’s experiences. Stimulating both sides of the body at once appears to “unlock” the brain’s natural processing systems, allowing it to do what it would typically do with ordinary experiences, but couldn’t do with traumatic ones.
What this means in practice is that as you and your therapist work through sets of bilateral stimulation together, you learn to hold your attention in two places at once: On the distressing memory and in the present moment. This dual focus appears to reduce the emotional intensity of the memory while keeping it accessible enough for you to process through it using your calm, rational mind. Over time, the memory loses its power to trigger the same level of distress, and you can build up new, healthier beliefs about yourself and the experience.
What Should I Expect to Feel During and After an EMDR Session?
This is an important question, and one your therapist will discuss with you in detail before any processing begins.
During a session, it is normal to experience a range of emotions as memories and associations surface. Some clients feel sadness, anger, or anxiety as they work through difficult memories. Others notice physical sensations such as tension, heaviness, or a racing heart. This is a sign that your body is actively engaged with the memories and feelings — not that anything is going wrong. Your therapist will be with you throughout, checking in regularly and adjusting the pace of the work to ensure you remain within the window of what you can cope with.
After a session, some clients feel a sense of relief or lightness, while others may feel emotionally tired or notice that memories and feelings continue to surface for a day or two. This is a normal part of the processing, and your therapist will work with you to develop a plan for managing whatever arises between sessions.
It is also worth noting that progress in EMDR is not always linear, meaning some sessions will feel more productive than others, and there may be periods where the work feels slow or difficult. You and your therapist will monitor your progress together throughout the treatment, and adjust the approach as needed.
Is EMDR Right for Me?
EMDR has a strong evidence base for the treatment of PTSD and trauma, but isn’t the right fit for everyone, and isn’t the only effective approach available.
EMDR may be a good option for you if you have experienced a specific traumatic event or series of events that continue to affect your daily functioning, relationships, or sense of self. It is also worth considering if you have tried talk therapy in the past and found it helpful but incomplete, or if you are someone who finds it difficult to put your experiences into words.
EMDR may not be the best starting point if you are currently in crisis, if you are dealing with significant substance use, or if you have limited capacity to tolerate distress. In these situations, your therapist will work with you to build the foundation of skills and stability needed before trauma processing begins — or they might recommend a different approach altogether. Other options, like Cognitive Behaviour Therapy (CBT), Cognitive Processing Therapy (CPT) for PTSD, Intensive Short-Term Dynamic Psychotherapy (ISTDP) are also available.
The best way to determine whether EMDR is right for you is to have an honest conversation with a qualified therapist who is trained in the approach.
Taking the Next Step
At Shift Cognitive Therapy, we understand that deciding to pursue trauma treatment takes courage. Our therapists will work to understand your situation, answer your questions and help to develop a treatment plan that fits your needs, your goals, and your life. We offer in-person and virtual sessions for clients in Oakville and across the Halton Region, and virtual sessions to clients living elsewhere in Ontario.
Reach out to us at 905-849-1288 if you’ve been living with the effects of trauma and are wondering whether EMDR might help.