Online EMDR therapy

What is EMDR?

Eye movement desensitisation and reprocessing is a structured therapy originally developed by Francine Shapiro in the late 1980s for the treatment of post-traumatic stress. It has since become one of the most extensively researched trauma therapies and is recommended by the National Institute for Health and Care Excellence (NICE) and the World Health Organization (WHO).

EMDR is based on the adaptive information processing model, which proposes that traumatic or highly distressing experiences can become “stuck” in the brain’s memory networks. When this happens, the original images, sounds, thoughts, emotions and body sensations remain vivid and easily triggered, as though the event is still happening. You might find that a particular sound, smell or situation suddenly pulls you back into the memory with the same intensity you felt at the time. This is not a sign of weakness. It is a sign that the memory has not been fully processed and integrated.

EMDR uses bilateral stimulation, typically guided eye movements, tapping or auditory tones, to help the brain reprocess these stuck memories so they can be stored in a more adaptive way. The precise mechanism is still being studied, but the prevailing theory is that bilateral stimulation mimics the rapid eye movement (REM) phase of sleep, during which the brain naturally consolidates and processes information. By activating this process while the distressing memory is held in mind, EMDR allows the brain to make new connections, reduce the emotional charge of the memory and integrate it into your broader life narrative.

Unlike many talking therapies, EMDR does not require you to describe the traumatic event in detail or complete homework between sessions. The processing happens naturally within sessions as your brain’s own healing mechanisms are activated. For many people, this makes EMDR feel less daunting than approaches that involve extensive verbal recounting of traumatic events.

EMDR can be delivered effectively online. Your psychologist will guide you through bilateral stimulation using on-screen visual cues or self-administered tapping techniques, both of which have been shown to be as effective as in-person delivery. Research conducted since the shift to remote therapy during the pandemic has confirmed that online EMDR produces comparable outcomes to face-to-face work.

When it helps

EMDR has a robust evidence base for trauma-related difficulties and is increasingly used for a broader range of difficulties, including:

• Post-traumatic stress disorder (PTSD)
• Complex trauma and childhood adversity
• Single-incident trauma (accidents, assaults, medical trauma)
• Phobias and specific fears
• Grief and complicated bereavement
• Anxiety disorders
• Performance anxiety
• Panic disorder
• Disturbing memories that continue to cause distress
• Low self-esteem rooted in past experiences

EMDR is particularly well suited when your difficulties are clearly linked to specific distressing experiences that you can identify. It can also be effective for people who have tried talking therapies before and found it difficult to put their experiences into words, or who have felt overwhelmed by approaches that require detailed verbal recounting. Because EMDR works with the memory networks directly, it can be helpful even when the events are difficult to articulate.

It is also worth considering EMDR if you notice that your emotional reactions feel disproportionate to current situations. This is often a sign that present-day triggers are activating unprocessed memories from the past, and EMDR can address the root cause rather than just the surface symptoms.

What to expect

EMDR follows a structured eight-phase protocol that provides a clear framework for treatment while allowing flexibility to respond to your individual needs.

Phase 1: History taking. Your psychologist will build a thorough understanding of your history, current difficulties and treatment goals. Together you will identify the specific memories and experiences that are driving your current symptoms.

Phase 2: Preparation. Before any processing begins, your psychologist will teach you stabilisation and coping techniques, such as the safe place exercise and containment strategies. These ensure you feel resourced and in control. Your psychologist will also explain exactly how EMDR works, so you know what to expect.

Phases 3 to 6: Assessment, desensitisation, installation and body scan. These are the active reprocessing phases. Your psychologist will ask you to bring a target memory to mind, noting the image, negative belief, emotions and body sensations associated with it. You will then engage in sets of bilateral stimulation, typically following a moving dot on your screen or using self-tapping (sometimes called the butterfly hug). Between each set, your psychologist will check in briefly, asking you to notice what comes up. You may experience shifts in the imagery, new thoughts or connections, changes in emotion, or physical sensations. The process continues until the distress associated with the memory reduces significantly and a more positive belief about yourself feels true. A body scan then checks for any remaining physical tension connected to the memory.

Phase 7: Closure. Each session ends with your psychologist ensuring you feel stable and grounded. If processing is not complete, the memory is safely contained until the next session.

Phase 8: Re-evaluation. At the start of the following session, your psychologist checks how the processed memory is sitting and whether any new material has emerged.

Most people experience a gradual reduction in the distress associated with the memory over the course of one or more sessions. Some people notice a marked shift within a single session. The total number of sessions depends on the nature and complexity of your difficulties. Single-incident trauma may resolve in 6 to 8 sessions, while more complex presentations, such as complex PTSD arising from prolonged childhood adversity, typically require longer-term work.

The evidence for EMDR

EMDR is one of only two therapies recommended by NICE for the treatment of PTSD in adults, alongside trauma-focused CBT. The World Health Organization also recommends EMDR as a first-line treatment for PTSD. These recommendations are based on a substantial body of randomised controlled trials demonstrating that EMDR produces significant and lasting reductions in PTSD symptoms.

Research shows that EMDR can achieve results relatively quickly compared to some other therapeutic approaches. Studies of single-incident trauma have found that 77 to 100 per cent of participants no longer met the criteria for PTSD after just three to six sessions. For more complex presentations, the evidence supports EMDR as part of a phased treatment approach, with stabilisation work preceding the reprocessing phases.

The evidence base for EMDR has expanded beyond PTSD to include anxiety disorders, phobias, depression, grief, chronic pain and performance difficulties. While the research in some of these areas is still developing, the results are promising and consistent with the adaptive information processing model that underpins the approach.

Online delivery of EMDR has been the subject of growing research interest. Studies published since 2020 have consistently found that online EMDR, using visual dot-following on screen or self-administered tapping, is as effective as in-person delivery. Client satisfaction with online EMDR is also high, with many people reporting that they feel more comfortable processing difficult material in the safety of their own home.

EMDR at The Online Psychologists

At The Online Psychologists, EMDR is delivered by HCPC-registered clinical psychologists who have completed specialist EMDR training accredited by EMDR UK and Ireland or equivalent professional bodies. Our psychologists have extensive experience in adapting the EMDR protocol for secure online delivery.

During your initial consultation, we will take time to understand your difficulties and assess whether EMDR is the most appropriate approach for you. If it is, we will match you with a psychologist who has specific expertise in working with your type of difficulty. For example, if you are seeking help for birth trauma, we will match you with someone experienced in perinatal presentations as well as EMDR.

Online EMDR sessions are typically 60 to 90 minutes to allow sufficient time for reprocessing. Your psychologist will guide you through bilateral stimulation using a secure platform that displays a moving dot on your screen, or through self-tapping techniques that you can follow along with. Both methods are well supported by the evidence. Sessions are usually weekly, particularly during the active reprocessing phase, to maintain momentum.

Many of our clients find that online EMDR offers practical advantages. You can process difficult material in a space where you already feel safe, without the need to travel home afterwards feeling emotionally raw. You also have immediate access to the coping strategies and grounding techniques that your psychologist has taught you, in the environment where you are most likely to need them.

Frequently asked questions

Is online EMDR as effective as face-to-face EMDR? Yes. Research consistently shows that online EMDR produces outcomes comparable to in-person delivery. The key adaptations, using on-screen visual stimulation or self-tapping instead of the therapist’s finger movements, have been validated in clinical studies. Our psychologists are specifically trained in online EMDR delivery and will ensure the process feels natural and effective.

Do I need to talk about my trauma in detail? No. This is one of the aspects of EMDR that many people find reassuring. While your psychologist needs a general understanding of what happened, you do not need to provide a detailed verbal account. During reprocessing, you hold the memory in mind internally. Your psychologist guides the process by checking in with you, but the detailed content remains private unless you choose to share it.

What does bilateral stimulation feel like? Most people describe it as a gentle, rhythmic experience. If using eye movements, you follow a moving dot across your screen. If using tapping, you alternate tapping on your knees or crossing your arms and tapping your shoulders. Neither is uncomfortable. Your psychologist will try different methods with you during the preparation phase to find what works best.

Can EMDR help with things other than trauma? Yes. While EMDR was originally developed for PTSD, it is now used for a range of difficulties where distressing memories or experiences are contributing to current symptoms. This includes phobias, anxiety, grief, low self-esteem and performance difficulties. Your psychologist will assess whether EMDR is appropriate for your specific situation.