EMDR, explained without the jargon

Most people arrive having read the acronym somewhere and formed a slightly strange picture of it — something involving a moving finger and a promise. It is a good deal more ordinary than that, and the part that actually matters is not the eye movements.

The name is unhelpful, so start with what it does

EMDR stands for Eye Movement Desensitisation and Reprocessing, which names one mechanism used in one phase and tells you almost nothing about the therapy. The useful description is this: it works on how a difficult memory is stored, rather than on your account of it. A memory that has not been fully processed tends to keep its original charge, so it surfaces with the same intensity years later. The work is aimed at that, not at the retelling.

It is phased, and the memory is not the first phase

The EMDR International Association describes it as an eight-phase therapy. The early phases are history-taking and preparation — establishing enough stability, and enough in the way of coping resources, that reprocessing is something you can do safely. People are often surprised by how much comes before anything difficult is approached. That ordering is deliberate and it is not a formality.

If the preparation phase is where we spend most of our time together, that is not the therapy failing to start. For a lot of people it is the therapy.

You do not have to tell me the whole story

This is the feature that matters most to the people it matters to. Reprocessing works while you hold the memory in mind, which means it does not depend on a full verbal account of what happened. If you have told the story many times and it has stopped helping, or if you cannot bear to tell it once, that is workable rather than an obstacle.

What the bilateral part actually involves

Side-to-side eye movements, or alternating taps, or alternating tones through headphones. Your attention rests on the memory while it is also engaged by something happening in the present moment. That is the whole of it. It is undramatic to watch and it is not hypnosis; you are awake, oriented and in control throughout, and you can stop.

Whether it suits you is something we decide together

EMDR is not the default here and it is not the whole of trauma work. Early sessions focus on stabilisation regardless, and for some people somatic and mindfulness-based approaches do more of the work, particularly where trauma is showing up physically. Whether to use EMDR at all is a decision made with you rather than announced to you.

I am not going to tell you that EMDR will work. What I can tell you is what it involves, what the preparation looks like, and at what point you would be able to judge for yourself whether it is doing anything.