EMDR therapy, short for Eye Movement Desensitization and Reprocessing, is an evidence-based treatment that helps the brain reprocess traumatic memories so they stop driving present-day fear, anxiety and shame.
It is endorsed by the World Health Organization, the American Psychological Association and the U.S. Department of Veterans Affairs.
At Seattle Trauma Counseling, certified EMDR therapists provide treatment in person at our Kirkland and Edmonds offices and online across Washington State. Reaching out starts with a free consultation.
The defining feature of EMDR is bilateral stimulation, a rhythmic, alternating sensory input delivered to both sides of the body. In most sessions this takes the form of guided eye movements (the reason EMDR is sometimes called eye movement therapy), though tactile taps or auditory tones are equally valid and often used when eye movements are uncomfortable. Bilateral stimulation appears to activate a neurological process similar to what occurs during REM sleep, the phase of sleep during which the brain consolidates and integrates memory. This is why clients often describe EMDR as "doing something" rather than just talking: the processing is not purely cognitive. It is bodily, adaptive, and often faster than clients expect.
Because our practice is a somatic trauma collective, EMDR at Seattle Trauma Counseling is delivered by clinicians who also work with the body, not only the memory.
EMDR is only as good as the clinician guiding it. Every EMDR provider at Seattle Trauma Counseling is a licensed trauma specialist who has completed formal EMDR training, and our team includes therapists certified through the EMDR International Association (EMDRIA), a step beyond basic training that requires additional supervised clinical hours and consultation. If you have been searching for an EMDR practitioner near you, meet the full team on our Find A Therapist page and we will help you match with the right clinician for your history and goals.
EMDR therapy follows a structured eight-phase protocol developed to ensure client safety, preparation, and thorough processing. These phases are not mechanical steps. A skilled EMDR therapist moves through them responsively, adapting to each client's pace and history.
First sessions at Seattle Trauma Counseling are dedicated to history-taking and building your relationship with your therapist, not to active trauma reprocessing. You will not be asked to revisit painful memories in your first appointment. Your therapist will want to understand your history, your current life circumstances, your goals for treatment, and your existing internal resources.
If EMDR is identified as an appropriate fit, preparation work begins. For clients with complex trauma histories, this preparation phase may span several sessions before any reprocessing begins. Stability comes first.
EMDR can feel unfamiliar, particularly the bilateral stimulation, but clients typically adapt quickly. Between sessions you may notice that memories shift, that new material surfaces, or that emotional responses in daily life change. This is a normal part of the processing window and an indication that the work is continuing.
EMDR does not end when the session does. Your brain continues integrating the material it worked on, often for one to three days, and knowing what is normal makes that window easier.
Feeling tired, foggy or emotionally raw is common. Many clients describe an "EMDR hangover": fatigue, vivid dreams, waves of emotion or a spaced-out feeling after a processing session. This is a sign that your brain is still working, not that something has gone wrong. It typically settles within a day or two.
Plan a soft landing. Where possible, avoid scheduling demanding meetings, difficult conversations or long drives immediately after a session. Gentle movement, an early night, and drinking water all support the process. Hydration will not speed up reprocessing on its own, but processing sessions are physically taxing, and clients consistently feel better when they treat the rest of the day gently.
Notice, but do not force. New memories, images or connections may surface between sessions. You do not need to analyze them. Jot them down if you wish and bring them to your next appointment. Your therapist reviews this material in the reevaluation phase.
Use your resources. The grounding and containment skills you built in the preparation phase exist for exactly this window. If anything between sessions feels bigger than those tools, contact your therapist rather than waiting.
Most practices offer EMDR as a standalone technique. Seattle Trauma Counseling is a collective of somatic trauma therapists, which changes how EMDR is delivered. Trauma is stored in the body as well as in memory networks, and our clinicians are trained to work at both levels in the same course of treatment.
Depending on your history and goals, your therapist may integrate EMDR with Sensorimotor Psychotherapy, Internal Family Systems, Brainspotting, Trauma Release Exercises or the Safe and Sound Protocol. For clients who want to move faster than weekly sessions allow, our therapy intensives format can concentrate EMDR preparation and reprocessing into extended sessions across a shorter span.
EMDR is not the right fit for every client or every presenting concern. It requires sufficient psychological stability, a capacity to tolerate the distress that arises during processing, and a therapeutic relationship strong enough to hold that process safely. Clients actively in crisis, experiencing active psychosis, or without sufficient internal stabilization resources may need preparatory work before beginning EMDR reprocessing. This is not a limitation of EMDR itself, but a reflection of the care we take in ensuring you are ready for the processing work. Our therapists assess readiness with you before any reprocessing begins.
At Seattle Trauma Counseling, EMDR is offered within a broader relational framework, meaning the therapeutic relationship is treated as the container, not just the delivery mechanism. Our therapists are trained in EMDR alongside complementary modalities that support clients across the full arc of trauma recovery.
If you are considering EMDR therapy in the Seattle area and want to understand whether it is a fit for your specific history and goals, we welcome an initial conversation. The first step is simply to reach out.
EMDR therapy helps the brain reprocess traumatic memories that have become "stuck," stored in a way that triggers distress, avoidance, or intrusive symptoms when recalled. During treatment, bilateral stimulation (typically guided eye movements, alternating taps, or audio tones) is used while the client briefly focuses on a target memory. Over time, the emotional charge attached to that memory decreases and the brain integrates it as a past event rather than an ongoing threat. This process is called adaptive information processing, and it distinguishes EMDR from talk therapies that rely primarily on verbal recounting.
EMDR treatment follows a structured 8-phase protocol developed by Francine Shapiro. The phases are: (1) History-taking and treatment planning, (2) Preparation and resourcing, (3) Assessment of the target memory, (4) Desensitization using bilateral stimulation, (5) Installation of a positive belief, (6) Body scan to check for residual distress, (7) Closure to stabilize the client at the end of each session, and (8) Reevaluation at the start of the next session. Phases 1 and 2 may span several sessions depending on the client's history and stabilization needs.
EMDR is contraindicated or requires significant modification for individuals with active psychosis, People who have a long history of Sexual trauma or acute substance dependence. There are better methodologies to help clients with sexual trauma. Clients with significant emotional dysregulation may benefit from a longer preparation phase before active trauma reprocessing begins. At Seattle Trauma Counseling, every client undergoes a clinical assessment before EMDR treatment is recommended. Not everyone is ready to begin with trauma processing, and that is something we assess together. Clients with bipolar disorder can often still benefit from EMDR, but processing is paced carefully and coordinated with your prescriber, since intensive emotional work should be approached cautiously where there is a history of manic episodes.
The primary debate around EMDR centers on its mechanism of action, specifically whether bilateral stimulation (eye movements) is the active ingredient or whether the outcomes are produced by exposure and reprocessing alone. Some researchers argue that the eye movement component adds little beyond what structured trauma exposure provides. There is evidence that forms of eye movement methods working with sensation awareness were used by Buddhists over 2000 years ago, yet in a different format. However, the clinical evidence for EMDR's effectiveness, across PTSD, trauma, and related conditions, is well-established and endorsed by the WHO, APA, and VA, regardless of the ongoing mechanistic debate. The controversy is largely academic and does not affect the practical utility of the treatment.
Treatment length varies by the complexity of the client's history. Single-incident trauma (for example, a specific accident or event) may resolve in 3 to 12 sessions. Complex or developmental trauma, including childhood abuse, neglect, or relational wounds, typically requires a longer course of treatment. At Seattle Trauma Counseling, we assess pacing based on each client's window of tolerance and readiness. Some clients spend several sessions in preparation and stabilization before active reprocessing begins.
During active reprocessing, clients typically describe a floating, observational quality, noticing memories, images, sensations, or emotions without feeling fully immersed in them. Many clients report feeling lighter or more neutral about a previously distressing memory by the end of a session. Some experience temporary emotional or physical fatigue after early sessions as the brain continues processing between appointments. Most clients describe the experience as manageable and meaningfully different from retelling trauma verbally. Yes, you can talk during EMDR, and brief check-ins between stimulation sets are built into the protocol, though far less narration is required than in talk therapy. Crying during or after a session is common and completely normal; it is part of the emotional material moving, not a sign the treatment is going badly.
There are no strict prohibitions, but we recommend avoiding three things in the hours after a processing session: high-stakes commitments such as major decisions or difficult conversations, since your emotional state is still settling; alcohol and recreational substances, which interfere with the memory consolidation the session started; and packing your schedule so tightly that there is no room to feel tired. Rest, water, gentle movement and an early night are the better plan. If distress between sessions feels unmanageable, contact your therapist rather than waiting for the next appointment.
Feeling foggy, drained, emotionally raw or oddly lightheaded after EMDR is common enough that clients call it the EMDR hangover. Some people also notice a temporary dip in mood or brief waves of sadness as older material moves. It happens because your brain continues reprocessing the targeted material after the session ends, which consumes real mental and physical energy. For most people it resolves within one to three days. Vivid dreams and new memories surfacing during that window are also normal. If after-effects feel severe, look like a deepening depression, or last well beyond a few days, tell your therapist, as pacing can be adjusted.
EMDR is one of the most researched trauma treatments in existence, with dozens of randomized controlled trials behind it. Across that research, a substantial majority of single-incident trauma clients no longer meet criteria for PTSD after a completed course of treatment, which is why the World Health Organization, the American Psychological Association and the U.S. Department of Veterans Affairs all recommend it. Results for complex and developmental trauma are also strong but typically require longer treatment. No therapy works for everyone, and outcomes depend heavily on preparation, pacing and the therapeutic relationship, which is why we assess fit before reprocessing begins.
The most common obstacles are insufficient preparation, ongoing exposure to the source of the trauma, dissociation that has not been stabilized first, substance use that blunts emotional processing, and a therapeutic relationship that does not yet feel safe enough for the work. None of these mean EMDR is off the table. They mean the sequencing needs adjusting, which is exactly what the first two phases of the protocol are for. If EMDR did not work for you elsewhere, it is worth exploring whether the preparation phase was given enough time.
Yes. While EMDR was initially developed and researched for PTSD, its application has expanded significantly. It is now used for generalized anxiety disorder, social anxiety, phobias, panic disorder, and performance anxiety. The underlying principle, that anxiety is often anchored to unprocessed memories or experiences, applies across many presentations beyond diagnostic PTSD. At Seattle Trauma Counseling, we use EMDR with clients whose anxiety has a trauma or adverse experience component, even when they do not meet full PTSD criteria.
Yes, when depression is connected to unprocessed experiences such as loss, shame, criticism or neglect. EMDR targets the memories and learned beliefs underneath the depression rather than the mood alone, and controlled studies have found meaningful reductions in depressive symptoms when EMDR is added to standard treatment. It is not a replacement for medical care where that is needed, and our therapists will talk with you about how EMDR fits alongside any existing treatment.
Yes. Online EMDR replaces in-office eye movements with screen-based bilateral stimulation or guided self-tapping, and research comparing remote and in-person EMDR has found similar outcomes for most clients. Seattle Trauma Counseling provides online EMDR to clients across Washington State, with the same preparation, pacing and safety practices used in office sessions.
Self-help techniques drawn from EMDR, such as grounding exercises, resourcing and the butterfly hug, can be practiced safely on your own, and Francine Shapiro's book Getting Past Your Past teaches several of them. Full EMDR reprocessing is different. Working through traumatic memories without a trained clinician to pace the process, manage what surfaces and close the session safely can leave you flooded rather than relieved, which is why self-administered reprocessing is not recommended. If cost or access is the barrier, telehealth EMDR and a free consultation are both lower barriers than they may seem.
EMDR is a therapeutic modality, not a separate billing code. It is typically billed under standard psychotherapy CPT codes, which many insurance plans cover. Whether your specific plan reimburses for EMDR-focused therapy depends on your coverage, deductible, and out-of-network benefits. Contact Seattle Trauma Counseling directly to discuss current fees, insurance panels, and sliding-scale availability.
Cognitive Behavioral Therapy (CBT) for trauma, particularly Cognitive Processing Therapy (CPT), focuses on identifying and restructuring distorted beliefs formed by trauma. EMDR works differently: it targets the memory itself rather than the beliefs derived from it, aiming to reduce the emotional intensity of the memory through bilateral stimulation and reprocessing. Somatic therapy works primarily through the body, noticing and releasing stored physical tension. EMDR incorporates body awareness (through the body scan phase) but uses it as a check rather than the primary modality. Many clients find EMDR requires less verbal recounting of traumatic content than CBT-based approaches.
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