EMDR therapy is often talked about as the go-to treatment for PTSD and trauma, mostly for good reason. It’s helped many clients find relief from overwhelming memories and emotional stress. But it’s not just for PTSD anymore.
More and more, therapists are using EMDR to support people dealing with anxiety. Whether it’s everyday worry, specific fears, or performance-related stress, EMDR can help loosen the grip of old patterns and reactions that may not be serving you anymore, especially when other approaches haven’t quite done the trick.
If you’re curious about how EMDR might work for anxiety in your practice or you’re looking to expand how you use it with clients, this article breaks down how the therapy works, where it’s being used beyond trauma, and what the research is starting to show.
What is EMDR and how does it work?
EMDR, or Eye Movement Desensitization and Reprocessing, is a type of therapy that helps clients deal with upsetting memories and experiences that might be causing anxiety or other mental health issues.
Originally developed to treat PTSD, EMDR has since gained broader recognition for its ability to address a range of emotional and psychological challenges, including anxiety disorders.
Through guided bilateral stimulation, often in the form of side-to-side eye movements, tapping, or auditory tones, clients access and reprocess unresolved memories that may be driving current symptoms.
Unlike talk therapy, EMDR doesn’t rely heavily on discussion or analysis. Instead, it supports the brain in metabolizing stuck experiences so they no longer trigger intense emotional or physical reactions.
A Quick Note on the “Moves” (and Other Caveats)
You might be wondering if it’s the eye movements, taps, or tones that do the heavy lifting in EMDR. The truth is that when researchers strip out the bilateral stimulation and leave only the exposure/reprocessing pieces, clients tend to improve just as much (Lee & Cuijpers, 2013). In other words, it’s that chance to face and metabolize stuck memories—much like an exposure exercise—that appears to be the real driver of change. The side‑to‑side tracking or tapping simply helps you stay focused on the target, but it isn’t strictly necessary for the brain to do its healing work.
A couple more heads‑ups:
- Some critics call EMDR a “purple‑hat therapy,” noting that the flashy eye movements are really just window‑dressing around good old exposure and cognitive processing (see the MentalHealth.com overview).
- Many of the studies comparing full EMDR to “no‑moves” versions suffer from small samples, lack of blinding, or researcher‑allegiance effects—so take claims about a unique bilateral‑stimulation mechanism with a grain of salt (read more on the Trauma Therapist Institute’s critique).
- The Wikipedia “Possible mechanisms” summary also notes that most meta‑analyses find bilateral eye movements add little beyond the core exposure/reprocessing work.
That said, the overall protocol still works wonders for plenty of folks, but it helps to know precisely why it works.
EMDR is supported by many professionals
According to the Adaptive Information Processing (AIP) model, which underlies EMDR, the brain wants to heal and restore mental health. But when an experience is overwhelming or unprocessed, it gets stored in a fragmented or maladaptive way. EMDR helps unstick those memories or moments and reintroduces them to the brain in an adaptive way.
While EMDR might sound unconventional at first, its effectiveness is supported by many therapists and is recommended by organizations like the World Health Organization.
Note: The World Health Organization formally recommends EMDR only for PTSD at this time (WHO, 2013). While national bodies and specialty groups are beginning to endorse its use for other anxiety disorders, the WHO’s official guidance hasn’t yet been updated to cover GAD, phobias, or performance anxiety (Scelles & Bulnes , 2021).
Research Gaps
Although early trials and case studies look promising, there are still fewer high‑quality RCTs of EMDR for GAD and performance anxiety than there are for PTSD. Continued rigorous research is needed to confirm efficacy, optimize protocols, and identify which anxiety subtypes benefit most.
How EMDR can help with anxiety and other disorders
While EMDR is best known for treating trauma, it’s also being used more and more to help clients with anxiety-related challenges. That’s because anxiety often has roots in past experiences that were stressful, confusing, or overwhelming in some way.
These experiences can leave behind emotional “footprints” that shape how clients react to stress, relationships, or situations in the present. EMDR helps uncover and gently reprocess those stuck points, giving the nervous system a chance to reset and respond differently.
For example, some clients can tap into their EMDR sessions when they are walking or running, due to the activity’s bilateral stimulation. So, when someone has a panic attack or a flashback to a traumatic moment, walking or running can actually be used as a coping strategy to keep someone focused on the “here and now”.
Let’s take a look at how EMDR can support healing across different types of anxiety:
EMDR for Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder, or GAD, often refers to the excessive and persistent worry (or hypervigilance) that clients experience in most everyday situations. Whether it’s getting behind the wheel of a car, dealing with customers at work, or struggling to maintain relationships or routines, anxiety can feel extremely overwhelming and even paralyzing for some individuals.
Other common symptoms of GAD include:
- Restlessness
- Tension
- Fatigue
- Trouble concentrating
- Sleep issues
While some issues are tied to one specific event, fear, or trauma, that’s not always the case. That can make treating these clients challenging, but not impossible.
In a 2021 case study by Omeragić and Hasanović, a woman with a 20-year history of anxiety and panic attacks found little relief from talk therapy and medication alone. Through EMDR sessions, she was able to revisit and reprocess emotionally loaded memories. As treatment progressed, her physical symptoms (like chest pressure and panic) eased, and her negative self-beliefs (such as “I am weak”) began to shift toward a more empowered sense of self.
EMDR can help clients with GAD unpack deeply rooted, distressing life experiences and negative beliefs about themselves. This can help break the cycle of hypervigilance that anxious clients experience, allowing them to live more comfortably in their own skin and with other people.
EMDR for specific phobias and concerns
Many phobias are commonly treated with exposure therapy, in which clients slowly face their fear by starting small and building up over time. For example, if a client is afraid of spiders, they might start by looking at a photo of one, then watch a video, and eventually maybe be in the same room as one.
EMDR, when used to treat phobias, works a little differently. Instead of needing the actual object in the room, clients are guided to think about past moments when they felt afraid. You can help their brain reprocess those memories in a safe and controlled way.
When practicing EMDR for phobias, ask your client to think back to the first time they were afraid, the worst time, or even the most recent time. Sometimes, you can guide them through a “flash forward,” where the two of you might imagine a future situation that might set off the client’s fear.
By helping their brain fully process these memories or future fears, EMDR reduces the power the phobia has over them. This helps the brain realize “this phobia isn’t dangerous,” allowing the client to overcome it.
EMDR for performance anxiety
One common anxiety disorder is “performance anxiety,” which most people think of when they say “stage fright.” Public speaking, job interviews, giving a speech, or being the center of attention at a social gathering can be really frightening for some clients. It may cause them to freeze, get shaky, or their minds to go totally blank.
Just like with phobias, EMDR helps clients target memories or experiences in which they may have had a bad experience, giving a speech in school, or someone embarrassed them when they made a mistake.
These moments can get stuck in the client’s nervous system, and EMDR works by helping the brain reprocess them in a way that feels safer and more balanced.
As you work through the problem together, you may find that imagining or remembering these scenarios gets a little easier with time, and the anxiety may go away altogether.
Comparing EMDR with traditional CBT for anxiety
CBT, or Cognitive Behavioral Therapy, is one of the most common types of therapy. It reframes clients’ negative self-talk or internal thoughts to help them create something more positive and balanced.
For example, if a client has a big presentation and their mind says, “I’m going to screw this up,” CBT teaches them to catch that thought, question whether it’s true, and come up with something more balanced, like, “I’ve prepared for this. I’ll do my best.”
Then, you might work on exposure therapy for their specific anxieties or phobias. If a client has a fear of flying, they might look at pictures of airplanes, then watch videos of them. Eventually, you may guide them toward visiting an airport, and then finally taking a flight on an airplane.
CBT is very structured and often includes homework between sessions, taking clients step by step through their therapy process.
The difference EMDR offers
On the other hand, EMDR’s approach helps clients’ nervous systems “digest” old stress so it doesn’t hijack them in the present.
Let’s say a client’s fear of public speaking comes from a time in middle school when they froze during a presentation and everyone laughed. Even if that happened years ago, their body might still respond as if they’re right back in that moment.
EMDR helps their brain reprocess that memory so it’s no longer so emotionally charged. Over time, the memory starts to feel more distant, and their reaction to it becomes calmer.
The brain and body are especially connected when it comes to traumas and fears. EMDR often focuses on the grounding and safety of body and mind to process and ease the response.
This may help clients not only be better at public speaking but also prevent them from taking negative situations like embarrassment or mistakes as badly in the future.
What to expect in an EMDR session for anxiety
Let’s use performance anxiety as an example for a possible EMDR session.
Here’s a general idea of what might happen:
Talking about the problem
You might begin by exploring what kinds of situations trigger the client’s anxiety. Maybe it’s public speaking, playing sports in front of others, job interviews, or even dating.
You’ll also probably want to discuss how their body reacts (like a racing heart, shaky hands, or going blank).
Looking back on where it started
Ask if they can recall any past experiences that might be connected to the fear. Maybe someone laughed when they messed up.
Maybe they froze during a class presentation. These kinds of moments often stick with us, even if they seem small.
Choosing a memory to focus on
Once you’ve identified a memory that feels connected to the anxiety, guide the client through processing it.
Ask them to picture it in their mind and notice what they feel in their body. Then use a technique like eye movements (often with a light that moves from left to right) or tapping to help their brain “reprocess” the memory.
Processing your fears
As the client moves through the memory, their brain gets a chance to realize, “Oh, this isn’t happening anymore,” or “I actually can handle this.” The fear often starts to feel smaller, and their nervous system may react less intensely.
They might also notice new thoughts come up, like “I’m capable,” or “I’m okay.”
Practice facing the future
Toward the end of the session (or in later ones), you might help the client imagine a future performance, like giving a presentation or having a tough conversation.
This is where the “flash forward” technique can come in. They picture the scenario, notice any fear that arises, and use EMDR to process it until it feels easier to imagine.
Check in with your therapist and plan next steps
After the session, check in on how they’re feeling and what comes next. Some clients notice changes after just a few sessions. Others take more time, but many report that things which once felt terrifying now feel manageable.
Helping clients find the right EMDR therapist for anxiety
If you’re not trained in EMDR but have clients struggling with anxiety, you may want to refer them to a specialist. Not all therapists are certified in EMDR, so it’s important to connect clients with someone who has appropriate training and experience.
Here are a few tips to guide clients in finding the right EMDR provider:
- Check for EMDR certification or training. Encourage clients to look for therapists trained through EMDRIA (in the U.S.) or equivalent organizations. The EMDRIA directory can be a helpful starting point.
- Ask about experience with anxiety-related concerns. EMDR is used to treat a wide range of issues, so it helps if the provider has specific experience working with anxiety, phobias, or performance-related fears.
- Encourage clients to trust the therapeutic fit. Like any modality, the relationship matters. Let clients know it’s okay to schedule consultations and ask questions about a therapist’s style or approach.
- Explore virtual options. EMDR can be highly effective in telehealth formats. If accessibility or location is a barrier, many clients benefit from working with EMDR therapists online.
Helping your clients find the right fit can make a significant difference in outcomes. A strong referral and a little guidance can go a long way in helping someone feel supported as they begin EMDR work.
Sources
- EMDR Therapy: What It Is, Procedure & Effectiveness https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy
- Gainer D, Alam S, Alam H, Redding H. A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Innov Clin Neurosci. 2020 Jul 1;17(7-9):12-20. PMID: 33520399; PMCID: PMC7839656. https://pmc.ncbi.nlm.nih.gov/articles/PMC7839656/
- Psychotherapy And Pseudoscience: Five Indicators Of Dubious Treatments https://www.mentalhealth.com/library/psychotherapy-and-pseudoscience
- Understanding the Criticism of EMDR https://www.traumatherapistinstitute.com/blog/Understanding-the-Criticism-of-EMDR
- Eye movement desensitization and reprocessing - Possible mechanisms https://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing#Possible_mechanisms
- Adaptive Information Processing (AIP) Model https://www.emdria.org/about-emdr-therapy/aip-model/#brain
- WHO releases guidance on mental health care after trauma https://www.who.int/news/item/06-08-2013-who-releases-guidance-on-mental-health-care-after-trauma
- WHO guidelines on conditions specifically related to stress https://www.who.int/publications/i/item/9789241505406
- EMDR as Treatment Option for Conditions Other Than PTSD: A Systematic Review https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.644369/full
- How running can help people with PTSD https://www.ptsduk.org/how-running-can-help-people-with-ptsd/4/
- EFFICACY OF EMDR TREATMENT IN GENERALIZED ANXIETY DISORDER AFTER A LONG-STANDING PHARMACOLOGICAL TREATMENT - A CASE REPORT https://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol33_sup1/dnb_vol33_sup1_77.pdf
- EMDR for Phobias https://catherinehynes.net/therapy/emdr/emdr-for-phobias/
Additional Materials Mentioned
