In summary:
- Liam Harkins, a clinical psychologist and EMDR Institute trainer, explains how he and other EMDR proponents are using the therapy to treat a range of conditions.
- EMDR theory posits that all psychopathology stems from traumatic memories.
- Those memories can be singular, as is often the case with post-traumatic stress disorder (PTSD), or numerous.
- While a growing body of emerging research supports EMDR’s use in treating a range of conditions, there is a lack of consensus about these more novel applications.
- Harkins is hosting a CPD-approved APS webinar about one of the least-understood concepts in EMDR therapy: ecological validity.
Emerging research shows potential for EMDR to be useful for conditions beyond PTSD. We sat down with a psychologist to explore what this looks like.
It’s been almost 40 years since psychologist Francine Shapiro developed EMDR therapy, a treatment that involves using guided eye movements to help people process traumatic memories.
Since then, extensive research has supported its efficacy, leading many clinicians to recognise it as a leading treatment for PTSD, alongside TF-CBT (trauma-focused cognitive behavioural therapy).
Yet Shapiro always maintained that EMDR had applications beyond PTSD, says Liam Harkins, Director of Breathe Psychology and an EMDR Institute trainer.
“[Shapiro’s] basic premise was that all psychopathology is a disorder of memory. It is all caused by how memories are stored in the nervous system.”
Today, some psychologists are applying EMDR beyond PTSD, although the strongest evidence remains in trauma-related conditions.
“As EMDR practitioners, whether we’re working on PTSD, depression, anxiety or eating disorders, we’re working from the same model — the Adaptive Information Processing (AIP) model that underpins EMDR Therapy.”
Understanding EMDR through PTSD
That’s not to say all mood, anxiety and personality disorders can be simply or effectively treated with EMDR. Different conditions require different approaches and varying degrees of preparation, says Harkins.
In the case of PTSD, preparation can sometimes be more straightforward, particularly where distress is linked to identifiable traumatic memories.
“With PTSD, it’s very apparent what is intruding into consciousness: it’s [usually] a single PTSD incident, a moment in time, and when that memory is triggered and intrudes into consciousness, the client is very aware that it is a memory.”
However, presentations of PTSD can vary, and not all clients experience a single, clearly defined traumatic event, he adds. This is especially true for clients experiencing complex PTSD.
By contrast, clients with depression rarely attribute their low mood to a single traumatic event. Drawing on EMDR's underlying model, Francine Shapiro suggested that such clients may hold multiple memories linked to negative self-referential beliefs.
“With depression, you would be looking for memories that are related to experiences of shame, humiliation and embarrassment, because they seem to be the memories that are intruding into consciousness for those people.”
Identifying these patterns can take time and typically requires a strong therapeutic relationship between psychologist and client.
EMDR and the components of memory
In recent years, practitioners have adopted EMDR to treat a diverse range of conditions, and studies have proliferated. Although it’s worth noting that evidence is still emerging.
Systematic literature reviews have found the therapy shows promise in the treatment of depression, chronic pain and eating disorders.
“I have colleagues who are working with EMDR to treat psychosis and even bipolar disorder,” says Harkins.
To understand how EMDR could be effective across such a broad array of presentations, Harkins says it helps to know how the modality deals with memory.
“EMDR says that memories have components. There’s a sensory component, which is usually an image but could be any of the senses. There’s also a meaning component, an emotion component, and a body-sensation component.”
In the case of chronic pain caused by a single incident, feeling some pain in the present can trigger the body-sensation component of the original memory.
“The feeling of that injury at the time it occurred comes back, and now people have trouble differentiating where they are in time,” says Harkins.
EMDR is also showing great promise in the treatment of obsessive-compulsive disorder (OCD), says Harkins.
Through an EMDR lens, ego-dystonic intrusive thoughts are caused by the meaning component of traumatic memories – commonly related to a lack of control.
“That obsessive-compulsive intrusive thought comes from similar neurobiological features underlying neurobiological mechanisms as intrusive thoughts of single-incident trauma for someone with PTSD. It’s the same phenomenon. We’re just seeing a different way of responding to that sense of overwhelm.”
The future of EMDR therapy
Harkins believes that mainstream acceptance of EMDR as a broad-based treatment is still a way off. The APS evidence review identifies EMDR as having Level 1 evidence for depression, specific phobia, PTSD and CPTSD.
“The evidence bases for presentations like depression and anxiety are still emerging, although despite this lag in research findings, EMDR clinicians are consistently reporting positive results.”
Harkins also stresses that while EMDR has potential in the treatment of an array of conditions, not all patients are suitable.
“Clients who have organic conditions that compromise executive functioning, such as clients with dementia or brain injury, may have trouble accessing memories that may be contributing to their presentation.
“This obviously limits what we can do with EMDR, as memory reprocessing is central to the therapeutic framework.”
And, while Harkins is using EMDR to treat clients with severe trauma, he says not all such clients can safely undertake the protocol.
“If people are still living in very unstable or unsafe environments, their capacity to maintain dual awareness – that is, seeing the present as a safe place and separate from the traumatic experience – would be quite limited.”
Dissociative presentations can require additional caution and specialist expertise when using EMDR.
“Only experienced EMDR clinicians who have undertaken advanced training should work with these presentations,” says Harkins, adding that significantly greater time in the preparation phase is required.
While EMDR may be helpful for a range of clients, it is one of several evidence-based approaches. Its use should be guided by individual needs, careful assessment, clinical judgement, and alignment with the available evidence.
Interested in learning more about EMDR? APS members can join the APS Eye Movement Desensitisation and Reprocessing (EMDR) Therapy and Psychology Interest Group.
Disclaimer: Published on Insights in 2026. The APS aims to ensure that information published is current and accurate at the time of publication. Changes after publication may affect the accuracy of this information. Views expressed by contributors are their own and do not necessarily reflect the position of the APS. Readers are responsible for ascertaining the currency and completeness of information they rely on, which is particularly important for government initiatives, legislation or best-practice principles which are open to amendment. The information provided in Insights does not replace obtaining appropriate professional and/or legal advice.