Reviewed and updated by Iris Hogan, MSW, LICSW · September 2026
Sometimes people come to therapy because some part of their life feels like a bad version of Groundhog Day.
Different relationship, same ending.
Different situation, same fear.
Different year, and somehow they are back in a place they recognize all too well.
Sometimes a woman will say, “I know why I do this.” And often she really does. She may understand where the pattern came from, what happened in her childhood, why she reacts so strongly to certain situations, or why she keeps expecting something terrible to happen.
Many of the women I work with understand themselves remarkably well.
And yet they still find themselves asking:
Why am I here again?
Because understanding something and being able to change it are not always the same thing.
EMDR—Eye Movement Desensitization and Reprocessing—is a structured therapy that helps people work with traumatic or distressing experiences while using bilateral stimulation, often eye movements, alternating taps, or sounds. The goal isn’t to erase what happened. It is to help the memory become less overwhelming and more fully located in the past.
That is one of the things that drew me to EMDR more than twenty years ago.
What Interested Me About EMDR
I was working with people who had lived through horrific, frightening, or deeply vulnerable experiences, and therapy often meant asking them to talk about what had happened in detail, over and over again.
For some people, that was helpful, even freeing. Others described the repeated retelling as overwhelming or even said they felt retraumatized by having to tell the story again and again.
And for some, the thought of sitting across from another person and telling them exactly what had happened was one of the reasons they didn’t seek treatment in the first place.
I remember working with a woman who had carried the effects of sexual abuse for much of her life. She had avoided dealing with it for years in part because she did not want to sit across from someone and tell them the details of what had happened to her.
With EMDR, she didn’t have to.
I needed enough information to understand what we were working on and to make sure we could do the work safely. But I didn’t need every detail.
She could go toward where the distress was without having to tell me everything she encountered along the way.
That was remarkable to me then.
It still is.
Following the Client’s Own Connections
There was something else about EMDR that fascinated me.
The therapist doesn’t have to lead the client toward the connection.
In EMDR, the client can follow the memory pathways that emerge during processing. We may begin with one experience, but another memory comes up—sometimes one that happened years earlier and at first seems only loosely connected.
And then the connection begins to make sense.
EMDR clinicians sometimes use the term “feeder memory” for an earlier experience that may still be contributing to the distress around a more recent one.
For example, a woman might seek my help because she is experiencing flashbacks after a recent car accident. We begin EMDR with that accident.
During processing, an earlier memory emerges: another car accident when she was a child. She remembers sitting frightened in the back seat, hearing her mother scream, and believing they were going to die.
Later, she realizes she had not thought about the childhood accident in years, until it came up during processing.
I didn’t know that memory existed.
I didn’t have to ask, “Did anything like this happen to you when you were younger?”
She made the connection.
That’s one of the things I find so interesting about EMDR. The client can follow the associations that emerge—memories, images, emotions, beliefs, or physical sensations—and sometimes arrive at an earlier experience that helps us understand why the current one carries so much weight.
Sometimes I start working on what appears to be the problem and discover that we’ve actually started somewhere in the middle of the story.
Memories Don’t Seem to Live in Isolation
One of the things EMDR has taught me clinically is how connected our experiences can be.
A smell can bring back a hospital room.
A particular look on someone’s face can suddenly connect with a moment from childhood.
The feeling I can’t get out during a car accident may connect with another experience, years earlier, when there really was no way to get away.
In EMDR, we talk about memory networks—the idea that memories can be connected through images, emotions, physical sensations, beliefs, and other associations.
This comes from EMDR’s Adaptive Information Processing model, or AIP. It is a useful clinical model for thinking about how inadequately processed experiences may continue to be activated by things happening in the present.
I find it useful because it describes a lot of what I actually see happen in my office.
But a useful clinical model isn’t the same thing as knowing exactly what is happening inside the brain.
There is fascinating brain-imaging research beginning to give us pieces of that picture. In one 2023 Nature Neuroscience study, researchers studied people with PTSD as they listened to recordings describing their own traumatic experiences and other sad—but non-traumatic—memories from their lives. Brain-activity patterns associated with the trauma narratives differed from those associated with the sad autobiographical memories.
That doesn’t mean there is a special place in the brain where trauma memories are stored. The neuroscience is much more complicated than that.
But I find the research intriguing because it fits something people with PTSD have been telling us for a very long time:
A traumatic memory can feel different from simply remembering something sad that happened in the past.
We Know EMDR Works Better Than We Know Why It Works
This is an important distinction.
Uncertainty about exactly how EMDR works is not the same as uncertainty about whether EMDR works.
EMDR has its strongest research support as a treatment for PTSD. Major clinical guidelines recognize it as an evidence-based PTSD treatment. The U.S. Department of Veterans Affairs and Department of Defense recommend EMDR alongside Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) as among the most effective trauma-focused psychotherapies for PTSD.
The World Health Organization also identifies EMDR and trauma-focused cognitive behavioral therapies as psychological interventions with substantial evidence for treating PTSD.
EMDR is also used clinically for concerns beyond PTSD, but that doesn’t mean the evidence is equally strong for every kind of distress or every person who seeks therapy.
For PTSD, we have substantial evidence that EMDR can help.
The more complicated question is why.
So Why the Eye Movements?
This is usually one of the first questions people ask me about EMDR.
Why would moving your eyes back and forth while thinking about something painful make any difference?
The honest answer is: we don’t completely know.
One of the better-supported explanations involves working memory—the limited amount of information we can actively hold and work with at one time.
If I ask you to bring a vivid memory to mind while also asking your brain to do something that requires attention, such as following my fingers with your eyes, the two tasks have to compete for some of those limited resources.
A 2022 systematic review of the working-memory explanation found that recalling traumatic material while simultaneously doing another attention-demanding task can make the memory less vivid and less emotionally intense than recalling it alone.
That may explain part of what happens during EMDR.
But part is important.
It doesn’t fully explain why one memory suddenly connects with another, or the woman who begins with I should have stopped it and ends up genuinely experiencing I did everything I could.
It doesn’t entirely explain those moments when someone looks at me and says:
“I know I’ve said that for years. But now I actually believe it.”
Working memory gives us an important piece of the answer.
I don’t think it gives us the whole answer.
Do the Eye Movements Matter?
EMDR can also use alternating taps or sounds, and clients sometimes ask me whether it matters which one we use.
The research is still sorting that out.
Eye movements have been studied most extensively. Tapping and alternating sounds are also used clinically, particularly when they are more comfortable or workable for a client.
A 2025 study of visual and tactile bilateral stimulation found measurable changes in EEG activity and physiological arousal with both.
That doesn’t tell us that tapping and eye movements are equally effective treatments for PTSD. The study wasn’t designed to answer that question.
But it does give us another interesting piece of the puzzle: the effects researchers can measure during bilateral stimulation don’t appear to be limited to eye movements.
Which form I use can depend on the client, what she is comfortable with, and how she responds during processing.
We’re still figuring it out.
What Changes When a Memory Is Processed?
This is the part that is much easier for me to describe from twenty-plus years of doing EMDR than it is to explain from a brain scan.
The memory doesn’t disappear.
My clients still know what happened. But something about the experience of remembering it can change.
I hear things like:
“It feels farther away.”
“I can still see it, but it doesn’t bother me.”
“It’s weird—I know it happened, but I don’t feel like I’m there anymore.”
“The picture is blurry.”
“It doesn’t feel alive anymore.”
Sometimes the change isn’t primarily in the image.
“I feel lighter.”
“I don’t feel so weighed down.”
“I feel peaceful.”
And sometimes what changes surprises me.
A woman who has spent years feeling ashamed of the frightened younger version of herself may look back at her differently:
“I feel compassion for her.”
“I actually feel affection for the younger me.”
Nothing about the facts has changed.
What happened still happened.
But it has become different to remember.
EMDR Can Be Sneaky
I often tell the women I work with that EMDR can be sneaky.
Sometimes nothing particularly dramatic seems to happen during a session. A client leaves thinking, Well, I’m not sure we accomplished much today.
And then she comes back the following week and tells me she drove past the place she had been avoiding—and didn’t realize it until she was three blocks past it.
Or her partner did the thing that normally sends her through the roof, and she was irritated, but not overwhelmed.
Or she realizes she hasn’t had the nightmare.
Or she thinks about what happened and notices:
Huh. That feels different.
Change isn’t always accompanied by a dramatic emotional breakthrough.
Sometimes you notice it because something that used to require enormous effort simply doesn’t anymore.
The Goal Isn’t to Forget
The goal of EMDR isn’t to forget what happened.
Some things shouldn’t be forgotten.
You can remember something and still wish it had never happened. You can know that someone hurt you. You can learn from what happened. You can decide that you will never allow a particular person into your life again.
But perhaps your body doesn’t have to respond every time as though it is happening again.
Perhaps you don’t have to keep arranging your life around making absolutely certain it could never happen again.
The memory can become more fully a memory—something that happened then rather than something that continues to organize the present.
For me, that is one of the most compelling ways to understand what EMDR can help people do.
It doesn’t change what happened.
It can change what happens inside you when you remember it.
EMDR is not a matter of forcing yourself to relive the worst thing that has happened to you. Good EMDR includes preparation, pacing, and attention to whether you are ready to do the work. Sometimes preparation takes time. Sometimes EMDR isn’t the right next step.
If you’re wondering whether EMDR might be appropriate for you, you may also want to read What EMDR Therapy Feels Like and learn more about EMDR Therapy for Women in Seattle and Washington.
I provide EMDR therapy and EMDR intensives for women in Washington State through my telehealth practice. You can schedule a free consultation if you’d like to talk about whether EMDR might be a fit.
Research & Sources
Perl, O., Duek, O., Kulkarni, K. R., et al. (2023). Neural patterns differentiate traumatic from sad autobiographical memories in PTSD. Nature Neuroscience, 26, 2226–2236.
Read the study in Nature Neuroscience
Wadji, D. L., Martin-Soelch, C., & Camos, V. (2022). Can working memory account for EMDR efficacy in PTSD? BMC Psychology, 10, 245.
Read the systematic review on PubMed
Stingl, M., Schäflein, E., Spieler, D., et al. (2025). Bilateral stimulation: differential effects in EEG and peripheral physiology. BJPsych Open, 11(6), e278.
Read the study on PubMed
Department of Veterans Affairs & Department of Defense (2023). VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder.
Read the VA National Center for PTSD overview of recommended PTSD psychotherapies
World Health Organization. Post-traumatic stress disorder.
Read the WHO overview of PTSD and treatment
Until We Meet Again
Until we meet again — breathe gently, walk slowly, and treat yourself with kindness.
— Iris