Can You Do EMDR Therapy Online? How Does It Work?

I spent roughly seven years in “talk therapy” before trying EMDR — a form of therapy that supports you in reprocessing memories. The experience turned out to be so powerful and positive that I decided to become an EMDR therapist.

While in talk therapy, I mainly learned a) why I did things I wish I didn’t do and b) how to not be a jerk to myself (and others). My therapist gave me tools that allowed me to respond differently to my triggers. As I worked to manage crippling social anxiety, I learned things like “take a deep breath” and affirmations like repeating “I am safe and lovable” whenever I felt anxious.

While these tools helped me manage for a while, my energy was often zapped from all the mental effort they required. What didn’t happen for me with talk therapy alone was long-term healing.

After starting EMDR, however, I felt a more significant shift. One chilly autumn night, just a few days after an EMDR session, I remember coming home from dinner with my husband at a busy restaurant in downtown Portland, Oregon. He commented on how overstimulating the restaurant was and asked if I was okay (he knew my triggers well).

I replied incredulously, “You know what? I forgot to be scared.”

It’s been years since that night. And, to this day, I no longer struggle with social anxiety. I can’t speak for anyone else, but for me, that change is worth celebrating (and sharing).

Now that EMDR therapy is available online, this unique type of therapy is more accessible than ever. If you’re interested in virtual EMDR and are curious about how it works, I’m here to fill you in — and help you decide if online EMDR is right for you.

What is EMDR and why is it getting so popular?

Eye Movement Desensitization Reprocessing (EMDR) is an extensively researched, and highly effective psychotherapy method that’s proven to help people recover from trauma and manage a wide range of problematic symptoms.

Despite the name, EMDR doesn’t always incorporate eye movements. But the use of bilateral stimulation (BLS) — utilizing sounds or sensations to stimulate both sides of the brain to reprocess information — is the key component. A therapist might snap their fingers in a client's left ear, then their right, or they may place paddles in each of a client’s hands that vibrate at alternate intervals.

EMDR has a quickly growing fanbase. Some clients seek EMDR to get quicker results, sometimes in less than 12 weeks. Others prefer EMDR because they don’t want to re-hash their trauma narrative. EMDR can be done with very little talking.

People are also learning that EMDR is not just for PTSD, but can now effectively treat many conditions such as addiction, anxiety, chronic pain, depression, grief, OCD, phobias, and relational stressors.

What is virtual EMDR therapy and how does it work?

Virtual EMDR implements the same methods of bilateral stimulation (including eye movements, auditory tones, or buzzer options), but may adjust them to fit whatever is available — and whatever works best — for the client.

(In my case, once my EMDR therapist switched to online sessions, she’d pound a round drum while I tapped my knees from home. I realize this may sound like the most “woo-woo” thing ever. But, what can I say, it worked.)

At first, EMDR may elicit some big emotional responses, sensations, or fears. Because of this, it’s good to talk about expectations before you begin. Many don’t know there are actually Eight Phases of EMDR, and the first few phases involve history taking and building resources. Working through these phases together may take weeks, months, or even longer before the “reprocessing” part begins.

Is virtual EMDR effective?

Online EMDR sessions make this type of therapy more accessible, and the good news is that they can be just as effective as in-person.

A 2021 study published in the journal BMC Psychiatry collected efficacy data on a total of 93 patients receiving EMDR therapy online, and found that patients achieved statistically significant and clinically meaningful reductions in symptoms — and that results on-par with those achieved with in-person therapy.

Some EMDR therapists use online tools to support BLS, such as those provided by EMDR Remote, Remote EMDR, Bilateral Stimulation, and others.

Are there downsides to virtual EMDR?

The pros of virtual EMDR seem simple, such as the reality of having easier access (especially for those in remote places or with travel limitations). Virtual EMDR can help save on gas or childcare and may be a fit for anyone wishing to enjoy therapy from the comfort of home or a favorite space.

That said, virtual EMDR may carry similar downsides as any kind of online therapy. You might have unreliable internet service or distractions in your home that could interrupt your sessions.

Some clients also struggle to connect and trust a therapist online (consider young children, for example). A strong relationship and trust is crucial in helping a client avoid overly intense emotional or physical reactions (known in EMDR as abreactions) that can reduce the efficacy of treatment.

Online, it can also be more difficult for therapists to observe the more subtle signals and state changes, such as voice volume or body language. That said, an experienced online EMDR practitioner will reduce the likelihood of this happening by ensuring that they can see and hear you clearly at the start of every session.

What exactly happens in EMDR therapy?

After defining a positive goal, your EMDR therapist will prompt you to recall a specific memory, feeling, and belief (such as “I’m bad or not safe/lovable/capable”). Your therapist will then use a combination of personalized cues, support, and BLS to support your brain in reprocessing the memory.

You may quickly begin to integrate new ideas and feelings (such as “I’m able to learn/I’m safe/lovable/capable” etc.). In subsequent sessions, the therapist will help you re-assess a memory or concern until it no longer has the same negative impact.

Over time the impact of — and your responses to — previously traumatic memories are often reduced or resolved. Through adaptive information processing, you can gain greater calm and functioning in your mind, body, and world.

What does it mean to process a memory “adaptively”?

Imagine that when you were little, someone told you not to touch a hot stove (or perhaps you did and you quickly learned that it led to pain). Information about “hot stoves” was likely stored adaptively, aka appropriately and helpfully. In other words, your automatic thoughts and feelings about stoves succeeded in keeping you safe.

That’s how Adaptive Information Processing (AIP) is supposed to work. On the other hand, sometimes information gets stored in less helpful ways, leading to less helpful automatic thoughts and feelings.

For example, imagine someone has crashed a motorcycle into a bakery. For months or years afterward, this person may become terrified at the smell of bread.

That fear is the result of automatic thoughts and feelings that come up in response to stored information about the smell of bread (it’s dangerous!). In situations like this, it's in our best interest to reprocess information so we don’t have that unhelpful, subconscious response.

How do I get the most out of virtual EMDR?

EMDRIA and other organizations offer many tips to help people get the most out of virtual EMDR. Therapists and clients should work to discuss or resolve any safety, stability, or crisis concerns, including risk behaviors or suicidality, substance abuse, and any recent or upcoming changes to medications or life circumstances.

Clients with specialized or higher acuity concerns (such as co-occurring conditions, CPTSD, ED, DID, or SPMI) should work with someone familiar with those conditions.

Can anyone get great results from EMDR?

With EMDR, I forgot to be scared. That is, my brain and body released an old story about being “scared” in situations when that response was no longer helpful for me. Of course, I still get scared sometimes. So, what’s the difference?

For the most part, I now move more quickly to feeling “safe/lovable/capable” again. The nervous system is calmer. The inner critic is quieter. It no longer needs convincing.

Now, in addition to benefiting from EMDR as a client, I get to walk alongside folks as a counselor, supervisor, and consultant. Like many who have gone through adversity, I’m grateful to know that when something feels painful, it doesn’t have to stay that way forever.

With virtual EMDR, patience, and support, I do believe there’s a way through even the hardest of hard things. But is that experience typical — or even reasonable? Is it reasonable to expect that anyone can experience lasting changes with EMDR?

In many cases, symptoms and conditions once considered “permanent” really can and do change. Even subconsciously, if we once “learned” unhelpful ways of doing things (like fearing the smell of bread), then in theory we can learn to “unlearn it.” Anyone feeling stuck or “out of balance” with their symptoms or condition should consider seeking support (whether that ends up being through EMDR therapy or otherwise, it may be time to take the next step).