EMDR therapy

EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured therapy for memories that have not settled — the ones that, years later, still arrive with the same heat as the day they happened, and still pull the body with them.

It runs to a protocol of eight phases, and the phases matter more than the eye movements most people have heard about. The first several are preparation: history, an explanation of what is going to happen, and building up ways of steadying yourself that work before anything difficult is touched. Only then does the processing itself begin. You hold a specific memory in mind while your psychologist guides sets of what is called bilateral stimulation — usually following their hand with your eyes, sometimes alternating taps or tones. Between sets you say what came up, in whatever form it came, and the next set starts from there. The later phases close the session down deliberately, so you do not leave the room mid-way through something, and check the following week whether what was worked on has stayed settled.

You are awake and in control throughout. You are not hypnotised, you do not lose awareness of the room, and you are not required to describe the memory in detail out loud — which is one of the reasons it is offered to people who cannot face narrating what happened to them.

What it is not: it is not hypnosis, it is not a technique for recovering memories you do not have, and it is not a single dramatic session that deals with everything. It is also not something you are given before anyone has worked out what is going on. EMDR is one of several modalities our psychologists are trained in. Whether it is the one indicated for you is a clinical decision made after an initial session, not a choice you have to make from a website.

PHC is an assessment-first practice. Nobody begins EMDR here because they asked for it by name — they begin it because an initial session found it was what the situation called for.

1. An initial session.We ask what has been going on, for how long, and what it is costing you. Nothing is administered before this conversation. Where the picture needs more than a conversation, emotional assessment and symptom screening decides which further tests, if any, are clinically warranted.
2. A psychologist matched to what that found.Psychologists at PHC are not assigned on availability. Assignment is based on speciality, your presenting needs and clinical fit — and for EMDR specifically, on being trained to deliver it. If the fit is not right, tell us and we will move you to someone else.
3. 50-minute sessions, in clinic or online.A standard session is 50 minutes. The preparation phases take as many sessions as they take, and processing does not start until your psychologist judges that they are done. If a session runs beyond 50 minutes and your psychologist has the time, you can extend by an hour at an extra fee — you are told what that is before it happens. Minor overruns of one to five minutes are not charged.
4. Reviewed as it goes.What you are working on is revisited rather than assumed. EMDR is often used inside a wider piece of trauma therapy rather than on its own, and where thought patterns and habits are carrying as much of the difficulty as the memory is, CBT may be used alongside.

At PHC, EMDR is used with adolescents and adults, and with children where the clinician is trained to adapt it for that age. It is used for a single event and for something that went on for years; the protocol is the same in shape and different in how long the preparation takes.

It is not the first thing that happens in every case, and there are situations where a trained clinician will deliberately not start it yet — where someone has no stable ground to return to between sessions, where a current situation is still ongoing rather than past, or where screening points to something that needs psychiatric input first. You will be told that plainly. EMDR is not started for the sake of starting something.

Not sure whether this is us? Contact us anyway. We will tell you directly whether we can help, and refer you elsewhere if we cannot.

• PTSD

PHC's stated use for EMDR is trauma processing, and PTSD is the condition page that carries it. The wider set of trauma presentations — abuse in childhood or in a marriage, a loss, an accident, a medical event — is covered on trauma therapy, which explains what trauma-informed practice means in a session and where EMDR sits inside it. See every condition we work with.