How Long Does it Take for EMDR to Work?

How Long Does it Take for EMDR to Work? A Guide to Timelines for Eye-Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a powerful, research-backed type of psychotherapy developed by Dr. Francine Shapiro. Designed to help individuals heal from traumatic experiences, EMDR has become a leading approach in the treatment of PTSD, complex trauma, and a wide range of mental health issues.

But if you’re considering EMDR, you might be wondering: how long does it take for EMDR to work? Like many forms of mental health treatment, the answer varies. This article will break down the factors that influence the length of time EMDR takes, what to expect during EMDR therapy sessions, and how EMDR compares to other treatment options.

What Is EMDR Therapy and How Does It Reprocess Traumatic Memories?

EMDR is a specialized type of therapy that uses bilateral stimulation, such as guided eye movements, to help the brain reprocess traumatic memories and replace negative beliefs with more positive beliefs. It works differently from traditional talk therapy or cognitive-behavioral therapy, allowing clients to access and reprocess painful memories without needing to talk about them in detail. The speed, efficiency, and flexibility of EMDR is what attracted me to becoming trained and skilled in using it for healing trauma. 

The EMDR process is structured around 8 standardized phases and focuses on how past events, especially distressing memories, continue to affect your current symptoms, emotions, thoughts, body sensations, and behaviors.

Organizations such as the World Health Organization, Department of Veterans Affairs, and the American Psychiatric Association recognize EMDR as a first-line treatment for post-traumatic stress disorder. Follow the link for help understanding PTSD symptoms.

How Many EMDR Sessions Will You Need?

The question "how long does EMDR therapy take?" or "how long does EMDR take to work?" depends on many factors. Some individuals notice relief after just a few sessions, while others need months of treatment. One of the first factors to consider in estimating the length of treatment is the nature of the trauma being addressed.

• Single event and multi-event trauma are typically associated with PTSD, the most straightforward diagnosis for traumatic disorders.

• Complex and developmental trauma on the other hand, often involved severe and prolonged periods of traumatic stress. Examples include living in a household characterized by physical and/or sexual abuse as a child, living in a home characterized by repeated episodes of domestic violence, threats, and coercion as an adult, or being a hostage or prisoner of war.

• Beyond complex trauma (C-PTSD), some people develop severe dissociative symptoms or co-occurring dissociative disorders that further complicate the treatment process. This doesn’t mean a person with these symptoms cannot recover, but it can extend the length of treatment considerably.

Let’s look at some general timelines:

• Single-incident trauma (e.g., a car accident, natural disaster, or one-time upsetting event):

  • These cases may require just 6–12 EMDR sessions for significant improvement and/or no longer meeting criteria for PTSD.

• Complex PTSD, childhood abuse, or repeated negative experiences:

  • Clients often need longer-term treatment, potentially months or years, depending on the severity of the trauma and specific needs. Research suggests a minimum of 16 sessions in these cases.

• Complex PTSD with co-occurring dissociative disorders:

  • Clients with this type of history and symptoms generally require the longest duration of treatment due to the need to address the dissociative symptoms prior to processing traumatic memories. This can involve months to years of therapy.

• Anxiety disorders, panic attacks, and panic disorders:

  • If these are trauma-related, EMDR can help, but treatment may vary depending on co-occurring issues like substance use disorder or physical health concerns. EMDR therapy typically involves the stabilization of the most high risk or debilitating symptoms first, prior to moving into the underlying trauma.

It’s important to remember that EMDR is not a quick fix. The goal is long-term healing, not just short-term symptom relief. Research provides good general estimates, but each individual is unique. 

Understanding the EMDR Therapy Process

The EMDR process involves eight structured phases, each contributing to the healing process. Here’s a brief overview of each phase:

1. History Taking (First Phase)

   I gather your history, including past trauma, life experiences, and current challenges. This informs the treatment plan and identifies specific targets for reprocessing. Sometimes this is appropriate in the first session but sometimes it's appropriate to address other issues and build safety and stability first.

2. Preparation Phase

   Perhaps the most important part of EMDR. You’ll develop coping mechanisms and build an internal safe place to handle emotional distress. Resourcing positive experiences and building confidence prior to activating trauma can greatly enhance safety and effectiveness. This foundation is critical for those with complex trauma or difficulty regulating their nervous system.

3. Assessment Phase

   Focuses on identifying an image, negative belief, emotional distress, and body sensations while activating the traumatic memory for the following phases.

4. Desensitization Phase

   You’ll engage in bilateral stimulation after activating the disturbing memory, reducing negative emotions and physical responses over time. As the disturbance dissipates, positive and adaptive memories often being linking to the trauma memory, further diluting it’s impact. 

5. Installation Phase

   A positive belief of your choosing replaces the old, negative one, reinforcing new, adaptive patterns. This goes a step beyond desensitization, reprocessing the negative association of the memory in the brain.

6. Body Scan Phase (Final Phase of Reprocessing)

   Focuses on noticing and releasing any lingering tension or physical pain linked to the memory. Once the body agrees with the new positive belief and feels calm and clear, the desensitization and reprocessing phases are complete.

7. Closure (End of Each Session)

   Every session ends with grounding techniques to bring the nervous system back to baseline. Containment and shifting into a regulated state is a skill that is reinforced each session, helping to prevent walking out of session overwhelmed and providing skills to use between sessions. 

8. Re-evaluation (Next Session)

   In the following session, I check in on progress, unresolved negative feelings, or emerging distressing memories.

Each client moves through these phases at a unique pace. Some reach the desensitization and reprocessing phases in just a few sessions; others need extended time in the preparation phase, especially if they struggle with emotional distress or lack stable coping mechanisms. Some trauma memories are fully processed in one session and others require multiple sessions. Follow the link to learn more about what to expect in an EMDR session. 

What Affects How Long EMDR Takes?

A variety of factors can influence how long EMDR takes to work:

• Type of trauma:

  • Single-incident trauma as an adult often resolves more quickly than complex PTSD or childhood abuse.

• Current symptoms:

  • Co-occurring issues like anxiety disorders, panic disorders, dissociative disorders, or substance use disorder may lengthen treatment time.

• Client readiness:

  • A client with a solid support system, confidence in using coping skills between sessions, and positive relationship with their therapist may progress more quickly.

• Physical health and nervous system regulation:

  • Chronic stress, a narrow window of tolerance in the nervous system, and unresolved physical pain can complicate trauma recovery.

• Individual needs and treatment goals:

  • Some seek complete resolution of trauma memories, while others focus on reducing negative emotions and improving daily functioning.

Criteria for Readiness to Begin EMDR

In some cases, it’s not the actual memory reprocessing part of EMDR that extends length of treatment, but the preparation process. Stability, confidence, and readiness for EMDR is crucial for avoiding re-traumatization and ensuring therapy is effective.

• It’s not appropriate to begin EMDR in the following situations:

  • Immediately after a major loss, injury, accident, or other highly disruptive life event.

  • While engaging in substance use in a way that is life-threatening or severely impairing.

  • Immediately following a suicide attempt or while having active suicidal ideation.

  • While in a state of psychosis, severe emotional instability, or with uncontrolled impulses to self-harm.

• Stabilization is necessary for safety:

  • Coping skills are in place and effective for managing distress and symptoms between sessions.

  • An adequate support system of family and friends is available and able to respond if necessary.

  • Dangerous situations or environments have been addressed and a safe living situation is available.

  • Resources for professional or emergency assistance are able to be contacted.

• Medical stability is sufficient:

  • Any physical health conditions that may be exacerbated by increased stress or heart rate have been evaluated and cleared by a doctor.

  • Pregnant women should consult with their doctor prior to beginning EMDR.

  • Certain medications can interfere with the effectiveness of EMDR.

• Timing is important:

  • It’s best if EMDR can be consistent once it begins, activating trauma memories and going on a long vacation prior to resolving them is not ideal.

  • It may not be appropriate to begin EMDR during a period of intense stress with limited time to relax and recover between sessions.

• Dissociation and Dissociative Disorders

  • EMDR can work well for those with dissociative symptoms and even dissociative disorders, however there are precautions and extended preparation protocols to ensure clients are able to stay present and tolerate EMDR prior to beginning memory reprocessing. This requires advanced training and a therapist confident in the approach. I have the training and I’m happy to support clients with dissociative disorders.

None of the above factors render a person ineligible for EMDR, but the specific issue(s) need to be addressed or stabilized prior to beginning. This can often extend the length of therapy.

What the Research Says About EMDR Timelines

Research studies, including those cited by the EMDR Institute and EMDR International Association, show EMDR as an efficient and effective approach for the treatment of PTSD. Over 30 randomized controlled trials (RCTs) make up the evidence base for EMDR as a treatment for single and multi-event PTSD. Results show remission rates with up to 90% of participants no longer meeting criteria for PTSD after as little as 3 sessions and up to 12 sessions. While research on EMDR for complex PTSD is much less extensive, a recent RTC in 2021 found only 3% of participants with a C-PTSD diagnosis still met criteria after 16 sessions.

Meta-analyses confirm that EMDR produces significant improvement in both short-term and long-term outcomes for a variety of populations, from survivors of natural disasters to those affected by substance use and mental health disorders.

Comparing EMDR with Other Trauma Treatment Options

While EMDR is highly effective, it’s not the only treatment option. Some individuals benefit from:

• Cognitive-behavioral therapy (CBT)

• Prolonged Exposure Therapy (PE)

• Cognitive Processing Therapy (CPT)

• Narrative Exposure Therapy

• Traditional talk therapy

These therapies may be better suited to clients who are not yet ready for memory reprocessing or who prefer verbal exploration of past events. Some of these therapies require extensive exposure to traumatic memories in session and between sessions that far exceeds what is required for EMDR. Here you can find an in-depth comparison of the top treatments for PTSD. 

For many, EMDR therapy works quickly and directly by efficiently targeting the root of trauma-related distress.

Final Thoughts

So, how long does it take for EMDR to work? There’s no universal timeline, but most clients begin to notice changes within several EMDR sessions, especially after reprocessing highly relevant traumatic events.

Whether you’re coping with single incident trauma, complex PTSD, or dissociation, EMDR offers a path to meaningful, long-term healing. The key is finding the right therapist, customizing your treatment plan, and allowing your nervous system to guide the pace. Healing from trauma is much like rehabilitating a physical injury, you simply can’t rush it without risking pushing too far too fast. 

In my experience as a trauma-focused psychotherapist, some client’s stay the course and process all of their trauma for full benefit while others gain significant relief quickly from targeting one experience and wrap up therapy sooner. At the end of the day it is always your decision how long therapy lasts, a good therapist will support your goals while giving honest feedback about the risks and benefits.

Ready to Begin Your EMDR Journey?

If you're interested in exploring whether EMDR is right for you, the first step is scheduling a consultation with me. I’d be happy to discuss your goals for healing and help clarify how long therapy might take for your unique situation.

References:

de Jongh, A., de Roos, C., El-Leithy, S. (2024). State of the science: Eye movement desensitization and reprocessing (EMDR) therapy. Journal of Traumatic Stress, 37(2), 205-216.