EMDR Therapy: Why It Helps — Even If We Don’t Fully Know Why

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been having a cultural moment. It’s showing up in TV shows, celebrity interviews, and social media feeds — often described as a breakthrough treatment for trauma that involves eye movements, handheld buzzers, or rhythmic tapping.

At the same time, articles and researchers continue to debate an interesting question:If EMDR works, do we really understand why?

The short answer is: EMDR is a well-established, research-supported therapy for trauma and distressing memories — even though scientists are still refining their understanding of its mechanisms.

What EMDR Is Designed to Do

EMDR is a structured therapy that helps people process memories that still feel emotionally “stuck.” These memories might relate to:

• Trauma.

• Panic-inducing events.

• Shame-filled experiences.

• Ongoing triggers, related to one or more of the above three experiences, that feel out of proportion to present day living.

Traumatic memories are stored differently than normal memories, often becoming fragmented and lodged in the brain's emotional center (the amygdala, a deeper, primordial part of the brain with evolutionary roots millions of years deep) rather than the narrative-focused hippocampus, leading to vivid sensory/emotional flashbacks instead of coherent stories. They are encoded in the non-verbal, right hemisphere of the brain, making them difficult to put into words. They are encoded as sensory fragments (sights, sounds, smells) and bodily sensations (somatic memory), bypassing the prefrontal cortex (the seat of rational thought, logic, analysis, and decision-making), which explains why triggers cause intense physical reactions without conscious recall. This results in a disjointed, implicit memory that feels like reliving the event.

During EMDR, a person briefly brings a distressing memory to mind while also engaging in a side-to-side form of stimulation — such as eye movements, alternating sounds, or gentle tapping.

Over time, many people notice that the memory feels less intense, less intrusive, and less likely to trigger strong emotional or physical reactions.

So… Why Does It Work?

There are two main schools of thought.

One theory suggests that the bilateral (left-right) stimulation used in EMDR helps the brain reprocess memories in a way similar to what happens during REM sleep. If the memories are stored in the non-verbal right hemisphere of the brain they need to be reintegrated into the verbal left brain, and bilateral stimulation helps facilitate this neural process.

Another explanation, favored by many researchers, is based on working memory. The idea is that holding a painful memory in mind while also doing a second task (like tracking movement or tapping) makes it harder for the brain to maintain the full emotional intensity of the memory. Over time, the memory becomes less vivid and less distressing. This aligns with processes of prolonged exposure, another evidence-based practice for the treatment of anxieties and trauma.

In other words, the memory doesn’t disappear — but it loses its emotional charge.

Researchers are still debating which explanation best captures what’s happening. What most agree on is that EMDR is effective for many people, particularly those dealing with trauma and PTSD.

Does It Matter If We Don’t Fully Understand the Mechanism?

In medicine and psychology, this isn’t unusual. We often know that something works before we fully understand how.

At the same time, ongoing research does matter. Understanding mechanisms helps therapists refine treatments and use them more precisely. But a therapy doesn’t have to be perfectly explained to be helpful and legitimate.

What tends to matter most in therapy outcomes are:

• The client’s readiness and safety.

• The skill of the therapist.

• A clear and structured approach.

• A strong therapeutic relationship.

  
  

EMDR is not magic, and it’s not the right fit for every person or every problem. But when used appropriately and delivered by a well-trained clinician, it can be a powerful tool for reducing the intensity of painful memories.

EMDR Isn’t Just Eye Movements

One common misconception is that EMDR is only about moving your eyes back and forth. In reality, EMDR is a full treatment protocol that includes:

• Careful history taking

• Stabilization and coping skills

• Identifying target memories

• Gradual, structured processing

• Integration and future planning

  
  

The bilateral stimulation is just one part of a larger therapeutic process.

How I Think About EMDR in My Practice

I view EMDR as one tool among several evidence-based approaches for helping people who feel hijacked by their past. It can be especially helpful when someone says:

• “I know I’m safe now, but my body doesn’t feel that way.”

• “This memory still feels like it’s happening.”

• “I keep reacting as if I’m back there again.”

  
  

At the same time, EMDR works best when it’s integrated into a broader therapy relationship that also focuses on emotional regulation, self-understanding, and building a more stable present-day life.

No therapy works in isolation. Techniques matter — and so does the relationship in which they’re delivered.

Considering EMDR?

If you’re curious about EMDR, the most important factor isn’t whether a therapist can give you a perfect neuroscientific explanation. It’s whether you feel safe, understood, and guided through the process at a pace that works for you.

I offer private-pay psychotherapy for adults in Manhattan and Brooklyn, including EMDR as part of trauma-informed treatment when appropriate. Superbills are available for out-of-network reimbursement. You can reach out through the Contact page to learn more.