Notice: For general interest only; may contain inaccuracies. Not a diagnosis, treatment, prognosis, or professional, clinical, or legal advice. Reading this creates no counsellor-client relationship. By reading this page, you agree to these terms. Full disclaimer. In an emergency, call 911.
EMDR (Eye Movement Desensitization and Reprocessing) has a reputation for being mysterious — something involving eye movements that somehow erases trauma. The reality is both more straightforward and more interesting than that. This article explains what actually happens in EMDR therapy, phase by phase, what the research says about how it works, and how to tell whether it is the right fit for you.
I am Samuel Ezzatilord, PhD, RCC, CCC, LMCC, a Registered Clinical Counsellor and EMDR-trained therapist with 25 years of clinical experience — from International Red Crescent trauma work in refugee camps to veterans’ mental health programs and BC health authority hospital care. I work in English and Farsi at Dr Samuel Counselling & Neurofeedback (drsamuel.ca) in downtown Vancouver, BC.
What EMDR Is — and What It Isn’t
EMDR is an evidence-based psychotherapy developed by Francine Shapiro in the late 1980s (Shapiro, 2018). It is one of the most thoroughly researched treatments for PTSD and trauma, recommended by major clinical guidelines including the World Health Organization (WHO, 2013).
It is not hypnosis. You are fully conscious and in control throughout. The eye movements (or other bilateral stimulation — tapping, tones) are a tool, not the treatment itself. The treatment is the reprocessing: helping your brain complete the processing of a traumatic memory that got stuck.
Why Trauma Memories Get Stuck
Shapiro’s (2018) Adaptive Information Processing (AIP) model explains what happens when memory processing is disrupted by overwhelming events. The memory gets stored in a raw, unprocessed form — with the original emotions, body sensations, and beliefs intact. Every time something in the present triggers that memory, you do not just remember it: you re-experience it, as if part of you is still there.
EMDR works by activating the traumatic memory while simultaneously engaging the brain in bilateral stimulation — side-to-side eye movements, or alternating taps or tones. Shapiro (2018) describes how this dual-attention process appears to facilitate the brain’s natural memory-integration mechanism. The stuck memory gets processed. Its emotional charge reduces. It becomes a past event rather than a present one.
Not ready to talk to anyone yet? Text or WhatsApp me one line — “thinking about EMDR” is enough. I reply personally within a day: 604-721-0604.
The 8 Phases of EMDR — What Happens in Each Session
EMDR is structured in 8 phases across multiple sessions (Shapiro, 2018). Here is what each phase involves:
Phase 1: History and Treatment Planning
I take a full history — not just of the trauma, but of your life, your current supports, and what is driving your symptoms now. Together we identify the target memories to work on and the order to approach them.
Phase 2: Preparation
Before processing any trauma, I teach you stabilisation techniques — ways to manage distress if the work becomes overwhelming. This phase can take multiple sessions. You will not be pushed into processing before you are ready.
Phases 3–6: Assessment, Desensitisation, Installation, Body Scan
This is the core processing work. You bring to mind a target memory — a specific image, the negative belief associated with it, and where you feel it in your body. While holding this in mind, you follow my fingers (or listen to alternating tones, or receive alternating taps). After each set, you report what comes up. I follow where your brain goes — you do not have to narrate everything.
Processing continues until the memory’s distress level (measured on a 0–10 scale called the Subjective Units of Disturbance, or SUD) drops to 0 or 1 (Shapiro, 2018). Then a positive belief is installed to replace the old negative one — for example, moving from “I am powerless” to “I can handle it now.”
Phases 7–8: Closure and Re-evaluation
Each session ends with a closure exercise to ensure you leave in a stable state. At the start of the next session, I check what has shifted between sessions — EMDR processing often continues after a session ends, as the brain keeps integrating.
The first 20 minutes are free, by phone, with me — no receptionist, no intake forms, no obligation. You describe what is happening; I tell you honestly whether EMDR is the right approach and what a first block of sessions would look like. If I am not the right fit, I will say so and point you somewhere better. Call 604-721-0604 or book at drsamuel.ca/book-a-call/.
How Many EMDR Sessions Does It Take?
For a single-incident trauma (a car accident, a specific assault, a medical event), significant processing can happen in 6–12 sessions (Shapiro, 2018). For complex or developmental trauma — abuse, neglect, war, or repeated events across years — the process takes longer. The timeline reflects the number and complexity of memories to process, not how “broken” you are.
What People Often Notice After EMDR Sessions
Processing continues after sessions. Many clients notice vivid dreams, sudden memories surfacing, unexpected emotions, or — more often — a quiet sense that something has shifted. The memory is still there, but it feels different: like something that happened to you in the past rather than something happening to you now. Physical symptoms tied to trauma (tension, hypervigilance, startle response) often reduce alongside the psychological ones.
Frequently Asked Questions About EMDR
Does EMDR work for complex PTSD?
Yes, though it takes longer. Complex PTSD (C-PTSD) involves multiple traumatic events, often from childhood, and typically requires more preparation work before processing begins. The WHO (2013) recommends EMDR as a treatment for trauma across a range of presentations, and the structured-phase approach described in Shapiro (2018) can be extended for complex cases.
Is EMDR better than CBT for trauma?
Both are evidence-based for PTSD. A systematic review and meta-analysis of randomised clinical trials found that EMDR and trauma-focused CBT produce comparable outcomes for post-traumatic stress disorder (Khan et al., 2018). Some clients prefer EMDR because it requires less verbal processing of the traumatic content and less homework between sessions. The right choice depends on the individual.
Do I have to talk about my trauma in detail during EMDR?
No. EMDR does not require you to narrate or describe the trauma in detail. You hold the memory in mind internally while the bilateral stimulation facilitates the processing (Shapiro, 2018). Many clients find this a significant relief compared to traditional talk therapy for trauma.
Can EMDR be done by video?
Yes — secure video sessions work well for EMDR. Bilateral stimulation can be adapted for video using visual tracking on screen or self-administered tapping. I offer EMDR sessions in person in downtown Vancouver and by secure video across BC.
Is EMDR safe?
EMDR is well-established and widely used, recommended by the WHO (2013) for conditions specifically related to stress. Like any trauma therapy, it can bring up difficult emotions during processing — which is why the preparation phase matters. I do not begin processing until you have the tools to manage what comes up, and every session ends with a closure exercise to return you to a stable state.
Does Insurance Cover EMDR in BC?
More often than people expect. Most extended health plans in BC cover services from a Registered Clinical Counsellor (RCC), and I direct-bill most plans. If trauma follows a car crash — a common pathway to EMDR — ICBC may fund approved counselling sessions for active claims. Veterans, serving RCMP members, and their families are covered through VAC and RCMP programs, which I also bill directly, along with CVAP, FNHA, and IFHP. On the free call I will tell you plainly which funding route applies to you before you spend a dollar.
درمان EMDR در ونکوور
اگر تجربهی آسیبزا (تروما) شما را از زندگی عادی بازداشته، درمان EMDR میتواند کمک کند. من، دکتر ساموئل عزتیلرد، با بیش از ۲۵ سال تجربهی بالینی، جلسات EMDR را به فارسی و انگلیسی برگزار میکنم — حضوری در مرکز ونکوور یا آنلاین در سراسر بریتیش کلمبیا. بیست دقیقهی اول مشاوره تلفنی رایگان است. برای اطلاعات بیشتر صفحهی مشاور فارسیزبان در ونکوور را ببینید.
Book a free 20-minute call
Call or text 604-721-0604 (WhatsApp works too), or request a callback at drsamuel.ca/book-a-call/. Evening and weekend appointments available, in person in downtown Vancouver or by secure video anywhere in BC. The first 20 minutes are free, by phone, with me personally. More detail: EMDR Therapy Vancouver. جلسات به فارسی برگزار میشود.
Written with expert editorial assistance.
References
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Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder: Systematic review and meta-analysis of randomized clinical trials. Cureus, 10(9), Article e3250. https://doi.org/10.7759/cureus.3250
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Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
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World Health Organization. (2013). Guidelines for the management of conditions specifically related to stress. WHO. https://www.who.int/publications/i/item/9789241505406
