What Is EMDR Therapy and How Does It Work?

According to Erica Spartos, LMFT (CA #81057), EMDR - Eye Movement Desensitization and Reprocessing - is an evidence-based therapy that helps people heal from trauma and distressing experiences without requiring them to retell everything that happened. Recognized by the American Psychological Association and the World Health Organization as an effective treatment for PTSD, it works by using bilateral stimulation to help the brain reprocess memories that are stored in a fragmented, unresolved state. This post explains the protocol in depth, and if you're already looking for EMDR therapy in San Francisco specifically, you can skip ahead to that page directly.

What does EMDR stand for?

EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed in the late 1980s by Dr. Francine Shapiro, who noticed that certain eye movements appeared to reduce the intensity of distressing thoughts. What began as an observation became one of the most researched trauma therapies in the world.

Today, EMDR therapy is recognized as an effective treatment for PTSD and trauma by the American Psychological Association, the World Health Organization, and the U.S. Department of Veterans Affairs. It is used by therapists across the country and around the world to help people heal from experiences that have stayed with them far longer than they should.

How is EMDR different from regular talk therapy?

In traditional talk therapy, healing often happens through conversation. You talk about what happened, explore how it affected you, and over time develop new ways of understanding your experience.

EMDR works differently. Rather than focusing on what you say about an experience, it focuses on how that experience is stored in your nervous system. The goal is not to analyze the past but to help your brain process it.

Many people come to EMDR after years of talk therapy that helped them understand their patterns but did not shift them. EMDR frequently creates movement in exactly those places.

What is happening in the brain during EMDR?

According to Erica Spartos, LMFT, when something overwhelming happens, the brain does not always process it the way it processes ordinary experiences. When something overwhelming happens, the brain does not always process it the way it processes ordinary experiences. Instead of filing the memory away, the brain can store it in a fragmented, unresolved state, along with all the emotions, physical sensations, and beliefs that were present at the time.

This is why a smell, a sound, or a certain look from someone can suddenly bring a past experience flooding back with full force. The memory is stored as if it is still happening.

EMDR uses bilateral stimulation, typically guided eye movements, audio tones, or gentle tapping, to activate both sides of the brain simultaneously. This process is thought to mimic what happens during REM sleep, when the brain naturally consolidates and processes memories. The distress attached to the memory begins to loosen. The memory does not disappear, but it loses its emotional charge.

What does EMDR therapy actually look like in a session?

EMDR follows a structured eight-phase protocol. Here is what that looks like in practice:

History and preparation: In the early sessions, your therapist gets to know your history, understands what you are bringing in, and explains how EMDR works. This phase is not rushed. You will not begin processing until you feel grounded and ready.

Resourcing: Before any trauma processing begins, your therapist will help you build internal resources, tools to help you stay regulated during and after sessions. This might include guided visualization, breathwork, or identifying a sense of inner safety.

Assessment: You and your therapist identify a specific memory or experience to focus on, along with the negative belief it left behind, such as "I am not safe" or "It was my fault."

Desensitization and reprocessing: This is the active phase. Your therapist guides bilateral stimulation while you hold the memory in mind. You do not need to narrate what is happening. You simply notice. The brain begins to process the material on its own.

Installation and body scan: A positive belief replaces the negative one. Your therapist checks whether any distress remains in the body.

Closure and reevaluation: Each session ends with grounding. Future sessions check whether the processing held and identify what to work on next.

Standard EMDR is delivered weekly in fifty-minute sessions, though some clients opt for EMDR intensives in San Francisco when they want a concentrated stretch of work.

Do I have to talk about everything that happened?

No. This is one of the most common misconceptions about EMDR and one of the reasons many people choose it.

You do not need to retell the full story of what happened. You do not need to go into graphic detail. EMDR does not require you to relive the experience verbally in order to process it. Many clients find this to be a significant relief, especially those who have already talked about their experiences extensively and found that the talking alone was not enough.

What can EMDR help with?

EMDR was originally developed for PTSD and single-incident trauma. The research base for these applications is extensive. Over time, clinicians and researchers have found it effective for a much broader range of experiences. In Erica Spartos's clinical experience over 20 years of practice in San Francisco, EMDR has been effective for a much broader range of experiences than it was originally developed for, such as:

• Complex and developmental trauma

• C-PTSD

• Anxiety and panic

• Phobias

• Depression rooted in past experiences

• Grief and loss

• Low self-esteem and shame

• Experiences that talk therapy has not been able to reach
  

If you have been carrying something for a long time and have not been able to put it down, EMDR may be worth exploring.

Is EMDR available via telehealth?

Yes, says Erica Spartos, LMFT. Online EMDR therapy is widely used and well-supported by research. Online EMDR therapy is widely used and well-supported by research. Many clients find that working from their own space actually supports the EMDR process. You are already in a familiar environment, which can make it easier to stay grounded during and after processing.

At Life Circle Center, EMDR therapy is available via telehealth across California. If you are in San Francisco, the Bay Area, or anywhere else in the state, you can access the same quality of care without commuting or rearranging your day.

How long does EMDR therapy take?

It depends on what you are bringing in. For a single recent traumatic event, meaningful resolution can happen in as few as three to twelve sessions. For more complex or longstanding trauma, the process typically takes longer. Most clients begin to notice meaningful shifts within the first few months of consistent work.

The preparation phase varies person to person. Some people are ready to begin processing within the first few sessions. Others need more time building internal resources and establishing safety before moving into active reprocessing. Your therapist will follow your lead.

Is EMDR right for me?

EMDR is not the right fit for everyone, and it is not the only approach that works. But if any of the following sounds familiar, it may be worth a conversation:

• You have been in therapy before and feel like you understand your patterns but cannot change them

• You have experiences from your past that still feel present and alive in your body

• You find yourself reacting to current situations with an intensity that does not quite fit

• You have anxiety that feels older than your current circumstances

• You have tried talking about what happened and it has not been enough
  

You do not need a PTSD diagnosis to benefit from EMDR. Many people who come to EMDR therapy do not identify as trauma survivors in the traditional sense. They simply know that something happened, it affected them, and they are ready to address it. If you're weighing whether EMDR specifically is right for you, or whether broader trauma-focused care would be a better starting point, that question is often easier to answer in a consultation than in a blog post.

EMDR Intensives in San Francisco

Some people come to EMDR with a specific window of time and a clear intention to do concentrated work. For those clients, EMDR intensives are worth considering.

Rather than the standard once-weekly session model, an EMDR intensive condenses the work into longer, dedicated blocks - typically two to three hours in a single sitting, scheduled over consecutive days or within a compressed timeframe. This format allows for deeper processing without the week-long gaps that can sometimes slow momentum.

EMDR intensives are particularly well suited for:

• People with a specific traumatic event they want to process and resolve

• Clients who have already done preparatory work and are ready to move into active reprocessing

• Those with limited availability for weekly therapy due to work or travel

• People relocating to or from San Francisco who want to complete a focused piece of work before their circumstances change

  
  

At Life Circle Center, EMDR intensives are available via telehealth across California and on a limited basis in San Francisco. If you are interested in an intensive format, the free 30-minute consultation is the right place to start, we can talk through whether your goals and readiness are a good fit for that structure.

EMDR therapy in San Francisco and across California

Erica Spartos is an EMDR-trained Licensed Marriage and Family Therapist, CA License #81057, with 20 years of clinical experience in San Francisco. She completed her EMDR training through Sonoma PTI in 2021 and works with teens, young adults, and families navigating trauma, anxiety, and life transitions.

EMDR therapy is available via telehealth across California. Limited walk and talk sessions are available within San Francisco.

Curious Whether EMDR Might Help?

I offer a free 30-minute phone consultation to talk through what you are carrying and whether EMDR therapy might be a good fit. There is no obligation and no pressure.

Schedule a Free Consultation

Written by Erica Spartos, LMFT, CA License #81057