Does EMDR Really Work? What the Evidence (and a Therapist) Actually Say

“Does this actually work?” It is one of the first things people ask me about EMDR, and it is a fair question. You may have read the clinical definition already. What you really want to know is whether it will do anything for you, or whether it is just hype.

I’m Masood Suliman, a Registered Psychotherapist in Hintonburg, Ottawa, and EMDR is a large part of how I work with trauma and PTSD. Here is my honest answer: what the research shows, what I actually see change in the room, and, just as important, what EMDR cannot do. If you want the overview of how I offer it locally, you can also read my EMDR therapy in Ottawa page.

My honest answer: yes, when it is done right

EMDR can work, but not as a magic trick, and not in every situation regardless of how we approach it. It works when one specific condition is met: your nervous system has enough tolerance to revisit the trauma and feel some of its charge, while also staying present in the room with me.

I describe this to clients as dual awareness: one foot in the memory, one foot here in my office. If you are pulled completely into the trauma, you are reliving it, and that risks retraumatizing rather than healing. If you stay completely in the present and cannot touch the memory at all, there is nothing to reprocess yet, because you are not ready to go there. The goal sits in between: enough tolerance to revisit the event, to feel it and talk about it if needed, while knowing in your body that it is not happening right now.

When a client can do that, EMDR can genuinely help reprocess traumatic events. When they can’t yet, the honest and ethical thing is to build that capacity first, which I’ll come back to below.

I was skeptical too

If part of you is thinking this sounds like pseudoscience, how can someone waving their fingers in front of me fix my trauma, I understand completely. I was skeptical before I trained in it.

What changed my mind was experiencing it myself during training, and then watching it with clients. I saw severely distressing memories move from what people rate as a 10 out of 10, the worst it gets, down toward a 0, and I saw people start to genuinely believe good things about themselves that they could not access before. Healthy skepticism is reasonable. But it is hard to argue with both the research and what I have now seen many times in the room.

What the research actually shows

EMDR is not fringe. A few markers I trust:

• The World Health Organization recommends EMDR, alongside trauma-focused CBT, as a treatment for PTSD in children, adolescents, and adults.
• The American Psychological Association, in its 2017 clinical practice guideline, recommends EMDR for adults with PTSD.
• Across several randomized controlled trials, 84 to 90 percent of people with a single traumatic event no longer met the criteria for PTSD after only three EMDR sessions, as summarized by the EMDR Institute. That figure is strongest for single-event trauma. Complex trauma usually takes longer, which I explain further down.

There is also evidence that the changes are physical, not only felt. In one small neuroimaging study, researchers scanned people’s brains before and after EMDR and found measurable increases in hippocampal volume, a region involved in memory and the stress response, alongside symptom improvement. The authors rightly urge caution given the small sample, but it points to something I find compelling: EMDR appears to affect the brain and nervous system, not just the conversation. If you like the detail, this review of the proposed mechanisms is a good place to start.

What I actually see change in the room

Research is one thing. Here is what I witness, session to session, that tells me the work is doing something.

The first sign is the nervous system settling. When we begin and a client first brings the memory to mind, I can see the activation: the shoulders rise, there is some fidgeting, a shift in the seat, discomfort or fear or anxiety on the face. After we reprocess the memory and then open it back up, that activation is mostly gone. The memory is still there, but the body is no longer bracing against it.

I want to be clear about what that is and is not. We are not minimizing the trauma or pretending it wasn’t bad. People will still say “that was horrible.” What changes is the second half of the sentence: “that was horrible, and I am okay with it today.” We are not erasing the past. We are reprocessing it so it stops bothering you in the present.

The other changes show up a little later, in how people carry themselves. They start to believe in themselves a bit more. They set more boundaries. The positive belief we landed on in session, something like “I did nothing wrong” or “I have control now,” starts to feel true, replacing the belief the trauma had wired in. You can read more about how that unfolds in a single session in my piece on what actually happens in an EMDR session.

What EMDR cannot do

This matters as much as the rest, and you will not always hear it said plainly. EMDR is not going to fix everything. It is a tool, like other good therapies, for reprocessing traumatic memory.

What it can do is reprocess a past memory, shift the negative beliefs about yourself that got attached to it, and often change the present-day behaviours that grew out of that trauma. What it will not do is resolve every problem in your life, and, depending on your nervous system and the complexity of what you carry, it is usually not a one-session fix. EMDR takes the time it takes. Any therapist who promises a guaranteed outcome or a fixed timeline is overpromising.

Who EMDR helps quickly, and who needs groundwork first

Some people can begin EMDR almost right away. If you came through a single, contained event, a car accident that now makes driving feel unsafe, a mugging, a recent shock, EMDR can often move fairly directly. It can also help with grief, and with many experiences of abuse.

I am more careful with significant, complex childhood trauma. Going straight into processing can overwhelm a nervous system that was shaped by years of it, so with those clients I usually build stability first.

That said, not everyone with childhood trauma needs a long runway. Some people have already done other work and have a nervous system with more tolerance. What I assess is specific: can you tolerate the difficult feeling a memory brings, and can you also tolerate positive feeling, calm and peace, without dissociating most of the time? If both are workable, we can begin. If not, building that capacity is the first phase of the work, not a detour from it. My guide to complex PTSD treatment in Ottawa goes deeper into that pacing, and when a memory is too charged to approach head-on, I sometimes use the Flash Technique to lower the intensity first.

So how long until I feel better?

This is one of the most common questions I get, and the honest answer is that it depends. That is not what most people want to hear, but it is the reality.

Someone with a supportive history and little prior trauma, who comes in after a single recent incident like a car accident, may notice EMDR affecting their nervous system within the first session or two. Someone carrying years of complex trauma, abuse, or neglect will usually need longer, depending on their nervous system and tolerance. Neither pace is better or worse. They are just different starting points, and the work meets you where you are.

Questions people ask

Is EMDR scientifically proven? It is one of the better-researched trauma therapies, and it is recommended by the World Health Organization and the American Psychological Association. Like all therapy it is not a guarantee, but the evidence base is real.

Does EMDR work for everyone? No therapy works for everyone. EMDR works best when your nervous system can hold dual awareness. For complex trauma, we often build that capacity first.

Will EMDR erase my memory? No. The memory stays. What changes is the distress attached to it, so it feels like something that happened rather than something that keeps happening.

How many sessions will I need? For a single event it can be a handful. For complex trauma it is usually longer. I will give you an honest sense of this once I understand your history.

Finding out if EMDR is right for you

You don’t have to decide whether EMDR is right for you before you reach out. That is what a first conversation is for. You can read more about how I work on my EMDR therapy in Ottawa page, or get in touch whenever you are ready.

If you are currently in crisis or thinking about harming yourself, please reach out for immediate support: call or text the National Suicide Crisis Helpline at 988 (24/7), the Distress Centre of Ottawa and Region at 613-238-3311, or 911 if you are in immediate danger.

This article is for informational purposes only and is not a substitute for professional mental health advice or therapy. Reading it does not create a therapist-client relationship.