EMDR

EMDR is a therapy method for managing traumatic or disturbing thoughts via saccadic eye movement. An alternative to saccadic eye movement is tapping your hand (aka Emotional Freedom Technique, another Pseudoscience). Proponents cite that a benefit of EMDR is that you don’t have to discuss or disclose your traumatic memories and experiences, even though the EMDR has you do just that while the eye movement or equivalent somatic exercise is occurring. The Australian Guidelines for PTSD state that since modern EMDR incorporates TF-CBT elements in its therapy, it has now got about as good as TF-CBT, and is effectively no different to Trauma Focused Cognitive Behaviour Therapy (TF-CBT). That is, whether you do TF-CBT normally or while wiggling your eyes (or similar) makes no difference.

Eye Movement Desensitisation Realisation (EMDR), started as pure Pseudoscience based off the debunked pseudoscience NLP (Neuro-Linguistic Programming) and has now become an expensive Purple Hat Therapy. The unique thing about EMDR from TF-CBT (Trauma Focused CBT) is the eye movement while talking about trauma (may be substituted with other sensory misdirections), which has failed to show any improvements either alone or when combined with TF-CBT to treat trauma.

Part of the Pseudoscience Therapies Series

  • Pseudoscience: a system of beliefs, theories, or practices that are presented as scientific but do not use the real scientific method. (‘pseudo‘ = ‘false‘).

Red Flags

EMDR’s pseudoscience Ref Flags:

  • Purple Hat Therapy
  • Buzzwords / Psycho babble
  • Mechanism is nonsense
  • Quality Research shows “core EMDR doesn’t work”

Origin story

The usual origin story is that EMDR was invented by Francine Shapiro in 1987 while she was taking a walk in a park [Revisiting the Origins of EMDR, 2023]. Shapiro states that she realised that she was able to cope better with disturbing thoughts when she used saccadic eye movement. Saccadic means to rapidly move your eye to different points. Shapiro noted that she was looking at the trees on either side of the path, disturbing thoughts rose and disappeared without intentional effort. Shapiro states that when she specifically considered those thoughts, they seemed to be no longer upsetting.

However…

In 1985 during Shapiro’s fourth year of studying Psychology, two years prior to her stated origin story, Shapiro published a paper in Holistic Life Magazine discussing theories on various topics about NLP (Neuro-Linguistic Programming – another pseudoscience), and the importance of “eye movement patterns“.

In this, Shapiro makes it clear that despite her fourth year studying of psychology, she does not understand the concepts of ‘scientific‘ and ‘reliable‘ :

  • Shapiro states “In other words, Neuro-Linguistic Programming is scientifically rather than merely theoretically based.“
  • Publications at the time showed the NLP was not consistently replicable – a cornerstone of ‘scientific‘.
  • Additionally, the claims made by NLP practitioners are (were) wild, clear signs of pseudoscience.

To review why ‘not consistently repeatable’ and ‘wild claims’ are non-scientific, see Pseudoscience.

It was revealed in 2014 by B. Grimley in his article Origins of EMDR- a question of integrity? that while she worked for Grinder in administration, John Grinder had asked Shapiro to use an NLP technique to assist a friend who had been sexually assaulted, to put them into a “resourceful state” via asking her to “systematically move her eyes through the various accessing positions typical of the major representational systems”. “You may imagine my surprise when I later learned that she had apparently turned these suggestions into a pattern presented in an extended training, with no reference to source, with a copyright and a rather rigorous set of documents essentially restricting anyone trained in this from offering it to the rest of the world” stated Grinder.

Does it work? (Mostly No)

Options: No / Mostly no / Purple hat (usual practice, but pretending to be more), Yes.

TLDR: Early and Middle versions of EMDR were ineffective compared to the TF-CBT. Late EMDR included TF-CBT in its method and became a dishonest Purple Hat Therapy.

  • The unique aspects of EMDR are the ‘eye movement‘ (or some other left right laterality kinesthetic action), which shows no evidence of having any effect on trauma.
  • Much of the older and mid generation research on EMDR compared EMDR to ‘no intervention‘, or ‘placebo‘ which had positive results (better than nothing). This was used to imply that EMDR was effective, and thus ‘evidence based’.
    • A fair comparison would have been to compare EMDR to the gold standard for Trauma TF-CBT.
      • TF-CBT = Trauma Focused Cognitive Behaviour Therapy, the gold standard for treating trauma.
    • The studies that did compared EMDR to TF-CBT showed that EMDR was inferior.
  • Late EMDR included TF-CBT in the training and method of EMDR.
    • Either TF-CBT was copied wholesale into the workshops, or elements were altered slightly and given a different name, but were effectively the same thing.
    • Comparing late EMDR to TF-CBT showed that it was now equivalent in effectiveness to TF-CBT.
      • Therefore, Purple Hat Therapy.
      • Therefore, dishonest.

Mechanism

How EMDR Says it Works

Early EMDR had patients think about their distressing thoughts while doing the saccadic eye movements, latter with tapping or finger clicking (see also EFT / Emotional Freedom Technique on this page). EMDR proponents claim that EMDR works by using bilateral stimulation (saccadic eye movements, tapping, etc), while a person recalls a traumatic memory. This allegedly helps the brain to reprocess the memory similar to REM sleep, with the expectation that this can reduce the memory’s emotional intensity; transform negative beliefs about the trauma; and help integrate the experience into a more adaptive, less distressing memory. This riffs off the ideas of NLP which have also been discredited.

What Science Says

There is zero evidence that any of the mechanisms (eye movement, tapping, clicking) have any scientific credibility. That is, in the absence of CBT, people do not actually improve. Consider that unbiased, rigorous research into the unique aspects of EMDR has not supported the claims in unbiased, rigorous studies, the proposed mechanism is both nonsensical and likely false.

The EMDR syllabus for new practitioners has begun to include TF CBT (Trauma Focused Cognitive Behavioural Therapy) elements. These are either completely copied from TF CBT (not a crime to include quality content), or a rebranded clones of the techniques (different names, similar method). As a result, research into the effectiveness of EMDR began to get better results.

That means, the unique aspects of EMDR are ineffective, despite the claims, and the good results of EMDR in modern times is probably due to the inclusion of TF CBT. The good results in those studies are not better than TF CBT *.

* EMDR proponents are quick to point out the occasional study that shows that EMDR outperformed the average result of TF CBT (and sometimes just CBT). This is disingenuous and misleading statistics.

That is like saying “I once scored a touch on my martial arts instructor, so I’m better at martial arts than them”.

No buddy, you got lucky once or twice.
When you can beat them on average, then you can claim to be better.

Quality Research

ReD Flag Warning: Shapiro’s explanation for why EMDR works is filled with neurology babble, words that sound like science, but don’t mean anything or make any actual neurological sense.

Many of the research papers for EMDR should not have passed peer review. For example, many of them have no control group (like this one), is unblinded (therapy versus medication) or is compared to no treatment (like this relaxation vs EMDR). These faults effectively mean that this is not evidence that EMDR works, so much as people did a studies that included EMDR versus nothing and said “it placed” in the therapy race. Great. Did it place first, in the middle, or last?

Modern EMDR research is confounded due to the recent inclusion of Trauma Focused CBT style practices in the EMDR training, effectively comparing EMDR+TF CBT with TF CBT, and finding them about the same level of effectiveness. That is the very definition of a Purple Hat Therapy– you pay extra for the purple hat, it does nothing, but at least you got a purple hat while you got your regular treatment. (It was totally the purple hat that did the work though, trust me…)

In my opinion the these two particular paragraphs from the Australian Guidelines for the Treatment of Acute Stress Disorder & Posttraumatic Stress Disorder, 2013 are very pertinent.

“Over time, EMDR has increasingly included more treatment components that are comparable with the cognitive behaviour therapy (CBT) interventions… These include cognitive interweaving (analogous to cognitive therapy), image templating (rehearsal of mastery or coping responses to anticipated stressors) , and standard ‘in vivo’ exposure. Combined with its initial inclusion of imaginal focus on traumatic images, EMDR now includes most of the core elements of standard trauma-focussed CBT (TF-CBT). In addition, the protocol has shifted from a single session treatment to eight phases of treatment with the above elements included, comparable in length to standard trauma-focussed CBT. The unique feature of EMDR is the use of eye movements as a core and fundamental component throughout treatment.”

‘Psychological intervention for ASD and PTSD‘ (where ASD means Acute Stress Disorder, not Autism), page 70.

That is, EMDR now effectively includes enough of TF-CBT that modern EMDR is now comparable to receiving TF-CBT. It notes that the unique feature of EMDR is the use of eye movements – which does not improve EMDR + TF-CBT over TF-CBT, aka the eye movement has no apparent effect.

“A member of the multidisciplinary panel objected to the inclusion of a good practice point (GPP) that indicated that eye movements per se had not been proven to have any active effect in the efficacy of eye movement desensitisation and reprocessing(DMR). A vote was taken within the working party in relation to this issue and it was agreed that this GPP should be removed as the question of mechanisms of treatment had not been specifically addressed in the evidence review nor addressed in the recommendations pertaining to any other intervention. One member of the working party dissented from this view given the purported centrality of the eye movement to EMDR as reflected in its title.”

Under the section Development of the Guidelines, Process, page 18

That is, eye movement (or left right switching), the only unique feature of modern EMDR from TF CBT, after 40 years of quality research, has zero evidence of efficacy.

All that is not unique to EMDR is either directly copied TF-CBT, or a ‘technique’ that is a clone of TF-CBT, but with different names, and just as effective as just TF-CBT – the very definition of a Purple Hat Therapy.

Where is the Harm?

TLDR:

  1. The most direct and obvious harm is financial.
  2. Practitioners who do not realise that the core of their therapy is pseudoscience:
    1. Are not likely to follow the Trauma Therapy Fundamentals.
    2. Lie about their treatment being quick, easier and less invasive than TF-CBT.
  3. Promotes the treatment of misdiagnosed PTSD.
  4. Resulting in delayed treatment can lead to significant harm, including death.

Here in Western Australia, EMDR typically costs $5000 for 10 sessions, with some Medicare Rebate available. This is, despite there being no actual evidence that any core aspect of EMDR is effective, and that the only effective part of modern EMDR is the inclusion of principles from TF-CBT (Trauma Focused Cognitive Behavioural Therapy), which you can get for much cheaper from a regular therapist (like us).

An additional risk, though, is that EMDR is a Purple Hat Therapy, so practitioners often do not follow the basic principles of Trauma Therapy.

Most people turn to EMDR because they have been told it is a quick, easier, less invasive treatment for Trauma. However, since modern EMDR incorporated TF-CBT (and finally [therefore] had equivalent statistics to regular TF-CBT), and therefore extended the number of session from 1 session to 8-10 sessions, modern EMDR is not quicker, easier, or less invasive than TF-CBT.

Indirectly, the harm is delayed treatment and often misdiagnosis. Most people who seek EMDR don’t have PTSD or a Trauma led condition, we cover Trauma Myths here. If you really are experiencing PTSD, then you will need to come to terms with your experience rather than just pushing them under the carpet, and if that is the case, then you really should use the proper treatment for it, not a cheap knock off TF-CBT.

Delayed treatment for your actual condition, or erroneous therapy for PTSD, can cause severe instability, which risks self harm and death by suicide. That is quite substantial consequences, far worse than the loss of your finances in seeking treatment that is often wrong and a poor imitation.

6 Phases of Trauma Therapy 1) Understanding Trauma 2 Effective Medication 3) Stabilise Environment 4) Stabilise Self and Interoception 5) Mood Management 6) Trauma Therapy
The Six Phases of Trauma Therapy
Trauma Myths

Summary

  • The risk analysis is that EMDR is an expensive Purple Hat Therapy for actual TF CBT
    • EMDR delays quality treatment, which is TF CBT + Medication
  • Risks
    • High risk of misdiagnosis
    • Risk of unstable results, leading to self harm and or suicide

It is cheaper and wiser to put your dollars to proper TF CBT than to pay for the premium Purple Hat + second rate TF CBT.

Resources

Grimley, B ((2014), Origins of EMDR – a question of integrity?, The Psychologist (24), https://www.researchgate.net/publication/287067610_Origins_of_EMDR-A_question_of_integrity

Rosen, G. M. (2023). Revisiting the Origins of EMDR. Journal of Contemporary Psychotherapy, 53(53). https://doi.org/10.1007/s10879-023-09582-x

Covers, M. L. V., De Jongh, A., Huntjens, R. J. C., De Roos, C., Van Den Hout, M., & Bicanic, I. a. E. (2021). Early intervention with eye movement desensitization and reprocessing (EMDR) therapy to reduce the severity of post-traumatic stress symptoms in recent rape victims: a randomized controlled trial. European Journal of Psychotraumatology, 12(1), 1943188. https://doi.org/10.1080/20008198.2021.1943188

Covers, M. L. V., De Jongh, A., Huntjens, R. J. C., De Roos, C., Van Den Hout, M., & Bicanic, I. a. E. (2021). Early intervention with eye movement desensitization and reprocessing (EMDR) therapy to reduce the severity of post-traumatic stress symptoms in recent rape victims: a randomized controlled trial. European Journal of Psychotraumatology, 12(1), 1943188. https://doi.org/10.1080/20008198.2021.1943188

Carletto, S., Borghi, M., Bertino, G., Oliva, F., Cavallo, M., Hofmann, A., Zennaro, A., Malucchi, S., & Ostacoli, L. (2016). Treating Post-traumatic Stress Disorder in Patients with Multiple Sclerosis: A Randomized Controlled Trial Comparing the Efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy. Frontiers in Psychology, 7, 526. https://doi.org/10.3389/fpsyg.2016.00526

Acute Stress Disorder & Posttraumatic Stress Disorder Promoting recovery after trauma Australian Guidelines for the Treatment of. (n.d.). Retrieved October 5, 2026, from https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/212971/ACPMH_Full_ASD_PTSD_Guidelines.pdf