Can moving your eyes back and forth really help with trauma? If that sounds a little strange, you’re in good company: plenty of psychologists were sceptical when EMDR therapy first appeared. More than 30 years of research later, the answer is clear. EMDR is a well-established, strongly recommended treatment for trauma.

So why does it still come up online as “controversial”? EMDR (eye movement desensitisation and reprocessing) has a strong recommendation in Australia’s PTSD guidelines. The controversy you’ll read about mostly dates back to its early years, and to arguments about how it works rather than whether it works. Understanding that history can help you make a calmer, better-informed decision about your own care.

In this post, we’ll cover:

  • what EMDR therapy is and what actually happens in a session
  • how it’s thought to work, and what the research says
  • why EMDR was once controversial, and why that debate is largely behind us
  • the risks, who it suits, and who might need a different starting point

EMDR therapy: what is it?

EMDR therapy is a structured, trauma-focused psychological treatment that helps people process distressing memories so they feel less raw and less intrusive. American psychologist Francine Shapiro first published research on the method in 1989. Since then, it has grown into a full treatment approach used around the world.

The basic idea is simple. Some memories don’t get “filed away” the way ordinary memories do. Instead, they stay vivid and charged. As a result, a smell, a tone of voice or a crowded room can bring the fear back as if it were happening now. EMDR aims to help the brain process those memories, so they start to feel like part of your past.

In plain terms, EMDR aims to change how much a memory hurts when you touch it. The memory itself stays yours.

EMDR sessions: what actually happens?

In an EMDR session, you briefly hold a distressing memory in mind while following a back-and-forth stimulus. Usually this is your psychologist’s hand moving from side to side, although tapping or alternating sounds can also be used. This “bilateral stimulation” is the part people tend to picture. However, it’s only one part of a much larger structure.

EMDR therapy follows eight phases:

  1. History taking: understanding your background, your goals and which memories to work on.
  2. Preparation: explaining the process and building skills for managing strong feelings.
  3. Assessment: identifying the memory, the image, the belief about yourself and the body sensations attached to it.
  4. Desensitisation: sets of bilateral stimulation while you notice whatever comes up.
  5. Installation: strengthening a more helpful belief, such as “I survived” or “It wasn’t my fault”.
  6. Body scan: checking for any tension or disturbance still held in the body.
  7. Closure: making sure you leave the session feeling settled and grounded.
  8. Reassessment: reviewing how things have been at the start of the next session.

Notice how much happens before the eye movements begin. The first two phases matter a great deal, because processing a painful memory is far safer when you have a clear way to steady yourself. This ties closely to the window of tolerance, the zone where you can feel difficult emotions without becoming overwhelmed or shutting down.

How does EMDR therapy work?

The evidence that EMDR therapy works is strong, and researchers are still refining the explanation of exactly how. The leading explanation is the working memory account. Your working memory, the mental “desk space” you use to hold things in mind, has limited capacity. When you hold a painful memory while also tracking a moving hand, the two tasks compete for that space. As a result, the memory tends to feel less vivid and less emotional while you recall it. Research suggests it may then be stored again in that softer form.

Shapiro’s original explanation, the adaptive information processing model, focuses on how unprocessed memories get “stuck”. In this model, therapy helps link them to more helpful information you already have. You’ll see this explanation on many clinic websites, including our EMDR page. Both explanations share one point: EMDR involves deliberately approaching a memory instead of avoiding it. In that respect, it has a lot in common with other trauma-focused therapies.

Does EMDR therapy work? What the evidence says

Yes. The evidence strongly supports EMDR therapy as an effective treatment for trauma, particularly post-traumatic stress disorder (PTSD) in adults. The Australian PTSD Guidelines, developed by Phoenix Australia and approved by the NHMRC, give EMDR a strong recommendation for adults with PTSD. It sits alongside trauma-focused cognitive behaviour therapy (CBT), cognitive processing therapy, cognitive therapy and prolonged exposure. Similarly, the UK’s NICE guideline recommends EMDR as a psychological treatment for adults with PTSD after non-combat trauma.

Large reviews point the same way. For example, a major systematic review of psychological treatments for adults with PTSD found evidence supporting several trauma-focused therapies, including EMDR.

There are, however, limits to keep in mind. Most of the strongest evidence is for PTSD. EMDR is also used for anxiety, phobias, grief and other distress linked to difficult experiences. However, the research for those uses is thinner and still growing. For that reason, a good assessment comes first. EMDR is one option among several, and it shouldn’t be an automatic choice.

Why is EMDR so controversial?

EMDR’s controversial reputation comes mostly from its early years, and from arguments about why it works rather than whether it works. Three issues fuelled that debate.

  1. The eye movements themselves. Early critics asked a simple question: if you remove the eye movements, does the therapy still work? A 2001 meta-analysis found that EMDR worked better than no treatment and about as well as other exposure-based therapies. However, it found no clear added benefit from the eye movements. Critics took this to mean that EMDR is essentially exposure therapy with an unnecessary extra step. In contrast, a later meta-analysis found that eye movements did add a meaningful effect, in both clinical and laboratory studies. Either way, the evidence for EMDR as a complete therapy is strong.
  2. Early hype and marketing. In its early years, EMDR spread quickly through training workshops, sometimes with bold claims attached. In 2000, a group of psychologists argued that EMDR’s popularity had raced ahead of the evidence. They also said the way it was promoted showed warning signs of pseudoscience. Since then, however, the research base has grown considerably, and major guidelines now strongly recommend it.
  3. Questions about memory. Some laboratory research has asked whether eye movements might affect memory accuracy. In one study, eye movements after learning a word list made people more likely to “remember” related words that weren’t on it. This was a word-list experiment, not a study of trauma therapy. Still, it’s a fair reminder that EMDR should never be used to “recover” memories you don’t already have. Its role is to help you process what you already remember.

Our view: the controversy is mostly history, plus a scientific discussion about mechanism. The evidence that EMDR helps people with trauma is strong, and Australian and international guidelines recommend it.

emdr therapy sydney

Dangers of EMDR therapy: is it safe?

For most people, EMDR therapy is a safe treatment when a trained clinician delivers it after a careful assessment. The “dangers of EMDR” people search for mostly describe how it can feel during treatment.

Because EMDR involves approaching painful memories, it’s common to feel stirred up. You might notice:

  • strong emotions during or soon after a session
  • feeling tired or drained afterwards
  • more vivid dreams, or memories coming to mind between sessions
  • a temporary rise in distress before things settle

These reactions are usually short-lived, and a good EMDR clinician prepares you for them. In fact, that’s exactly what the preparation and closure phases are for.

The genuine risks come from how EMDR is delivered. Problems are more likely if EMDR processing starts without enough preparation, or if the clinician hasn’t completed proper EMDR training. Problems are also more likely if your current life is too unsettled to make room for this kind of work.

EMDR and complex trauma: is it right for everyone?

EMDR isn’t the right first step for everyone, and a good psychologist will tell you if it isn’t right for you yet. EMDR may need to wait, or be adapted, for example if you:

  • are in a current crisis or an unsafe situation
  • often dissociate (feel detached from yourself or your surroundings) when distressed
  • are dealing with severe substance use
  • don’t yet have reliable ways to calm yourself when emotions run high

For people with complex trauma, clinicians take different views on timing. Some favour a long period of stabilisation before any trauma processing. Others argue that trauma-focused work can begin earlier, with the right support. In practice, this decision is personal. It depends on your history, your current life and what feels manageable to you.

“But I don’t want to relive it.”

This is one of the most common worries we hear, and it’s completely understandable. EMDR does involve bringing a memory to mind. However, you don’t need to describe every detail out loud. As the EMDR Association of Australia points out, clients don’t have to talk in detail about their trauma. You also stay in charge of the pace. Your psychologist checks in throughout and can pause at any point.

Some people also worry that EMDR sounds too strange to work, or that it’s “just eye movements”. It’s fair to be sceptical. Here’s the key point: EMDR is a structured therapy with a strong evidence base for PTSD. A registered psychologist delivers it, inside a relationship built on trust. The eye movements are one part of it. The assessment, the preparation and the relationship are the rest.

Choosing the right trauma therapy

EMDR therapy is one of several effective trauma-focused treatments, and the best choice depends on you. Our psychologists offer a range of trauma therapy approaches, including EMDR and trauma-focused CBT, and the right one is chosen after a careful assessment. Some people prefer EMDR because it involves less talking through the details. Others prefer an approach that works more directly with thoughts and beliefs. Neither is the right answer for everyone.

The relationship matters just as much. Research on the therapeutic alliance consistently links a strong bond between client and psychologist with better therapy outcomes. Feeling safe with the person sitting alongside you is part of what makes trauma work possible. That’s why we take matching seriously, from the very first call.

If you’re weighing up EMDR therapy, these questions can help in a first conversation:

  1. Has the psychologist completed EMDRAA-accredited basic training, and how often do they use EMDR?
  2. How will they assess whether EMDR suits you right now?
  3. What will the preparation phase involve?
  4. What other options would they consider, and why?

EMDR Therapy in Sydney

If you’ve been carrying something for a long time, it makes sense to want a clear, honest answer before you try anything new. Feeling unsure about EMDR, or about therapy in general, is a sign you’re taking your own wellbeing seriously.

You don’t have to decide on a treatment before you reach out. Whether you’re looking for EMDR therapy in Sydney or online, our role is to understand your experience. From there, we’ll talk you through the options and help you find the approach and the psychologist that fit.

To learn more, book a free 15-minute call with our Care Coordinator.

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Disclaimer: This article is for general informational purposes only and is not a substitute for individual psychological advice, assessment, or treatment. Reading this content does not establish a therapeutic relationship. If you have concerns about your mental health, please seek support from a registered health professional.