EMDR Therapy

Structured trauma-focused psychotherapy, considered within a fully private treatment plan and adapted to readiness, stability, and individual clinical need.

Eye movement desensitization and reprocessing, commonly known as EMDR, is a structured psychotherapy developed to help people process distressing memories and reduce the symptoms associated with traumatic experiences. It is recognized in major clinical guidelines as one of the trauma-focused psychological treatments that may be offered for post-traumatic stress disorder.

EMDR does not remove a memory or guarantee that a person will no longer feel anything when recalling it. The therapeutic aim is for the memory to become less overwhelming, less intrusive, and less likely to drive present-day fear, avoidance, shame, or physiological activation.

At THE BALANCE, EMDR is not selected solely because a client has experienced trauma. The team first considers diagnosis, current stability, dissociation, substance use, sleep, medical and psychiatric factors, previous treatment, the client’s goals, and their capacity to remain sufficiently present during trauma-focused work.

Each fully private residential program is dedicated to one client. When EMDR is appropriate, preparation, session timing, recovery time, psychiatric support, and the surrounding therapeutic work can therefore be organized around the individual rather than a fixed group schedule.

What Is EMDR?

EMDR is a trauma-focused psychological therapy developed by Francine Shapiro in the late 1980s. The treatment combines elements of history-taking, preparation, memory-focused work, cognitive and emotional processing, body awareness, and bilateral stimulation.

During the processing phases, the client briefly attends to selected aspects of a distressing experience while following a therapist-led form of alternating stimulation. Eye movements are the best-known method, but alternating tactile taps or auditory tones may also be used.

The therapist does not repeatedly ask the client to provide a complete verbal account of every detail. Some clients value this feature, particularly when the experience is difficult to describe. The client still needs to communicate enough for the therapist to assess safety, guide the process, and understand whether the intervention is helping.

How Is EMDR Thought to Work?

EMDR was developed within an explanatory model known as adaptive information processing. The model proposes that some distressing experiences remain insufficiently integrated, so present reminders continue to activate emotions, beliefs, sensations, and responses associated with the original event. This is a clinical model, not proof that a memory is physically trapped in one part of the brain.

Several mechanisms have been proposed. One influential explanation is that holding a memory in mind while completing another task taxes working memory, reducing vividness and emotional intensity. Other possibilities involve attention, learning, memory reconsolidation, expectancy, and the wider therapeutic context. The contribution of bilateral stimulation remains under study; it is inaccurate to explain EMDR as simply activating both cerebral hemispheres. (source: NIMH, 2024)

The Eight Phases of EMDR Therapy

EMDR is more than eye movement. Standard treatment is organized into eight phases, although the amount of time devoted to each phase varies.

1. History-taking and planning. The therapist reviews the presentation, resources, risk, and possible targets.
2. Preparation. The client learns the method, how to pause, and how to return attention to the present.
3. Assessment. A target is identified with associated beliefs, emotions, sensations, and current distress.
4. Desensitization. The client attends briefly to the target during sets of bilateral stimulation.
5. Installation. A more adaptive and credible belief may be strengthened.
6. Body scan. The client notices whether relevant physical activation remains.
7. Closure. The session ends with sufficient orientation and stabilization.
8. Reevaluation. The therapist later reviews the target, symptoms, and need for further work.

The phases are not a rigid promise that every memory will be resolved in one sequence. Treatment may return to preparation, alter the target, or pause memory processing when the client’s response indicates that another priority is more important.

What Happens During an EMDR Session?

Before trauma processing begins, the therapist explains the method, agrees on a stop signal, and confirms that the client can return attention to the present.

During a processing set, the client may hold a selected image, thought, emotion, or physical sensation in mind while following the therapist’s fingers or another bilateral stimulus. Each set is usually brief. The therapist then asks what the client notices and uses that information to guide the next step.

Material may shift in unexpected ways. A memory can become less vivid, another association may emerge, the body may settle, or the client may develop a different perspective. The therapist avoids forcing a predetermined interpretation.

A session can also feel tiring or emotionally demanding. Sufficient time should be allowed for closure and for the client to communicate any significant change afterward.

EMDR for PTSD

EMDR has its strongest evidence base in the treatment of post-traumatic stress disorder. Clinical guidelines from organizations including the National Institute for Health and Care Excellence and the U.S. Department of Veterans Affairs and Department of Defense include EMDR among recommended trauma-focused psychotherapies for PTSD.

Research suggests that EMDR can reduce PTSD symptoms for many clients. Outcomes vary, and no treatment is effective for everyone. The evidence does not justify promising that a fixed number of sessions will eliminate trauma or that EMDR is superior in every case to other established trauma-focused treatments.

The choice among EMDR, trauma-focused cognitive behavioral therapy, cognitive processing therapy, prolonged exposure, and other appropriate approaches depends on the person’s presentation, preference, previous response, provider competence, and wider treatment plan.

EMDR for Complex Trauma

Clients with prolonged, repeated, developmental, or interpersonal trauma may have difficulties that extend beyond one traumatic memory. These can include dissociation, emotional instability, shame, relationship problems, chronic threat sensitivity, substance use, and difficulties with identity or trust. (source: SAMHSA, 2014)

EMDR may be helpful for selected clients, but the work may require more extensive preparation, careful sequencing, and coordination with other therapies. Attempting to process multiple traumatic experiences rapidly can be destabilizing.

At THE BALANCE, readiness is reviewed throughout treatment. The team may prioritize sleep, substance-use stabilization, psychiatric symptoms, safety, emotional regulation, or therapeutic trust before intensive memory-focused work begins.

EMDR in Addiction Treatment

Trauma and addiction frequently overlap, but trauma is not the cause of every substance-use disorder. When distressing memories, shame, loss, or threat responses contribute meaningfully to substance use, trauma-focused treatment may form part of the plan.

EMDR should not replace withdrawal management, medication, addiction counseling, relapse prevention, or practical changes to the environment. Active intoxication, significant withdrawal, severe sleep deprivation, or unstable substance use may interfere with the client’s ability to participate safely in memory processing.

When clinically appropriate, EMDR may be coordinated with Addiction Counseling and Relapse Prevention. The team considers whether trauma processing is improving recovery or adding destabilization at the wrong stage.

Preparation, Stabilization, and Readiness

Preparation is a clinical phase of EMDR, not a brief formality before the “real” work.

The therapist considers whether the client can:

• remain sufficiently oriented to the present;
• recognize when activation is becoming unmanageable;
• use a pause or stop signal;
• recover after a difficult session;
• access appropriate support between sessions;
• distinguish current danger from a trauma reminder;
• communicate changes in risk, substance use, sleep, or symptoms.

Preparation may include grounding, psychoeducation, attention control, imagery, breathing, movement, or other regulation strategies. No single exercise is mandatory, and the therapist should not require a client to proceed merely because a preparation checklist has been completed.

Safety and Possible Difficult Reactions

EMDR is generally considered a psychological treatment rather than a medical procedure, but it can produce difficult reactions.

Possible experiences include: (source: NICE PTSD guideline)

• temporary increases in distress or physiological activation;
• vivid dreams or additional memories between sessions;
• fatigue, headache, or difficulty concentrating;
• emotional sensitivity after a session;
• dissociation, numbness, or disorientation;
• temporary worsening of sleep;
• activation of self-harm, substance-use, or other risk in vulnerable clients.

These effects should not automatically be described as proof that trauma is leaving the body or that treatment is working. The therapist reviews severity, duration, functional impact, and whether the protocol needs to be adapted or stopped.

Any urgent psychiatric or medical change follows the appropriate clinical or emergency pathway.

Who May Need a Different or Adapted Approach?

EMDR is not automatically contraindicated by a complex diagnosis, but additional assessment may be needed when there is acute psychosis, mania, severe dissociation, immediate suicide risk, significant cognitive impairment, unstable medical illness, active withdrawal, or current circumstances in which trauma-focused attention could increase danger.

Physical limitations affecting eye movement do not necessarily exclude EMDR because tactile or auditory bilateral stimulation may be considered. Sensory sensitivity, hearing issues, migraine, neurological history, and client preference should nevertheless be discussed.

The clinician must also assess whether the distressing event is over. Therapy should not be used to increase tolerance of continuing abuse, coercion, or an unsafe environment.

How Many EMDR Sessions Are Needed?

There is no universal number of sessions. A single recent event with limited additional complexity may require a different course from prolonged developmental trauma, multiple losses, dissociation, or significant psychiatric comorbidity.

Some clients begin with an initial target and review the response before deciding whether to continue. Others require a longer preparation phase or alternating periods of trauma processing and stabilization.

THE BALANCE does not promise that one session, one memory, or one intensive week will produce permanent resolution.

How Progress Is Evaluated

Progress is not defined only by a lower distress rating during one session. (source: MedlinePlus, n.d.)

The team considers changes in:

• intrusive memories, nightmares, or flashbacks;
• avoidance and threat responses;
• emotional and physical activation;
• negative beliefs linked to the experience;
• sleep and daily functioning;
• relationships and capacity for closeness;
• substance use or other coping behaviors;
• participation in work, family, and ordinary life;
• appropriate validated clinical measures.

If EMDR increases instability, does not address the main problem, or no longer has a clear purpose, the treatment plan is reconsidered.

EMDR Within the Balance Model

EMDR is considered within Assessment and Treatment Planning and the Multidisciplinary Clinical Model.

Depending on the client, it may be coordinated alongside:

• psychiatric assessment and medication management;
• individual psychotherapy;
• addiction treatment and relapse prevention;
• medical or neurological assessment where indicated;
• sleep, nutrition, movement, and regulation-focused support;
• family or relationship work;
• continuing-care planning.

The purpose is to connect trauma processing with the person’s wider functioning. EMDR should not become an isolated technical procedure disconnected from diagnosis, relationships, behavior, environment, or what happens after residential treatment.

Fully Private EMDR Therapy in Mallorca and Zurich

THE BALANCE provides fully private residential treatment in Mallorca and Zurich, with each residence and program dedicated to one client.

For executives, founders, public figures, celebrities, internationally mobile families, and HNWI or UHNWI clients, privacy can affect whether trauma treatment feels possible. Session timing, professional access, transportation, communication, recovery time, and authorized partner or family involvement can be planned discreetly.

This does not create a different form of EMDR or change evidence standards. The distinction is the one-client environment and the ability to coordinate treatment around a complex individual situation.

Preparing for Continuing Care

Trauma treatment does not end simply because a residential period ends or a selected memory becomes less distressing.

Before discharge, the team considers whether further EMDR is indicated, who will provide it, what remains outside the current scope, and how gains will be supported through psychotherapy, psychiatric care, relationships, sleep, work, routines, and the environment to which the client returns. (source: NCBI, 2014)

Handover requires appropriate authorization and sufficient information for the receiving professional to understand the treatment completed, current risks, remaining targets, and the client’s response.

Frequently Asked Questions

The Article