Online therapy across the UK
EMDR for trauma
What it is
What EMDR is
Eye movement desensitisation and reprocessing — a therapy developed specifically for trauma, and recommended by NICE for PTSD in adults.
It rests on the observation that traumatic memories are stored differently from ordinary ones. Most memories settle over time: they lose their immediacy, become something you recall rather than something you re-enter. Traumatic memories often don't. They stay vivid, intrusive and physically present, arriving unbidden and bringing the body's alarm response with them.
EMDR appears to allow that processing to complete.
Sessions
What a session involves
You hold the memory in mind while engaging in bilateral stimulation — typically following the therapist's hand or a moving light with your eyes, though other forms work equally well and are often better suited to online delivery.
This happens in short sets, with pauses to notice what's shifted. Over a session, the memory typically becomes less vivid, less charged, and less physically activating. People often describe it as the memory moving from present tense into past tense.
Exactly why this works is still debated. The leading accounts involve working memory — the dual task of holding the memory while attending to something else appears to reduce its vividness — and something resembling the processing that occurs in REM sleep. The evidence that it works is considerably stronger than the consensus on why.
Talking
You don't have to describe what happened
This distinguishes EMDR from most trauma therapies and matters more than it might sound.
EMDR requires you to hold the memory in mind. It doesn't require you to narrate it in detail, or at all. For people who've found that talking about what happened is itself retraumatising — or who simply cannot get the words out — this is often the difference between being able to do trauma work and not.
Fit
Who it suits
Single-incident trauma responds particularly well: an assault, an accident, a medical event, a birth trauma.
It's also used for complex and repeated trauma, though that's a longer piece of work and usually needs a stabilisation phase first — building capacity to tolerate distress before processing begins. Rushing that stage tends to backfire.
EMDR is increasingly applied beyond PTSD, including to distressing memories underlying anxiety, phobias and some eating difficulties. Where trauma sits underneath an eating disorder, sequencing matters, and we'd think about that carefully rather than assuming one should come first.
Online
How it works online
EMDR adapts well to remote delivery, with a growing evidence base behind it. Bilateral stimulation can be delivered through on-screen visual movement, alternating audio tones, or self-administered tactile methods such as alternate tapping.
I'd want to think with you at assessment about whether online is the right setting for your particular presentation — for some people processing significant trauma, being in their own space is an advantage; for others it removes a useful separation between the work and daily life.
About the author
Dr Rachel Megahy
Chartered Clinical Psychologist since 2006, registered with the HCPC and chartered with the British Psychological Society. Specialist expertise in eating disorders, alongside therapy for anxiety, trauma and other psychological difficulties. Online across the UK.