In a workshop, Shapiro related how the idea of the therapy came to her while she was taking a walk in the woods, and discerned she had been able to cope better with disturbing thoughts when also experiencing saccadic eye movements.
[6] The person being treated is asked to recall an image, phrase, and emotion that represent a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping.
[7] The 2013 World Health Organization practice guideline says that "Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event.
Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure or (d) homework.
"[8] Many proposals of EMDR efficacy share an assumption that, as Shapiro posited, when a traumatic or very negative event occurs, information processing of the experience in memory may be incomplete.
[9] According to the 2013 World Health Organization practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories.
[24] A 2020 systematic review concluded: "A recent increase in RCTs [randomized controlled trials] of psychological therapies for PTSD, results in a more confident recommendation of CBT-T and EMDR as the first-line treatments.
"[25] A 2023 Cochrane systematic review analyzed psychosocial interventions for survivors of rape and sexual assault experienced during adulthood and concluded that EMDR is a "first-line treatment" for PTSD along with other trauma-focused psychotherapies, such as Cognitive Processing Therapy and Prolonged Exposure.
[50][51] Some scholars have criticized Francine Shapiro for repeatedly increasing the length and expense of training and certification, allegedly in response to the results of controlled trials that cast doubt on EMDR's efficacy.
[58]Furthermore, Novella argues that investigation into EMDR has been characterised by poor-quality studies, rather than tightly-controlled trials that could justify or falsify the mechanisms that have been proposed to support it.
[59] EMDR has been characterised as a modern-day mesmerism, as the therapies have striking resemblances, from the sole inventor who devises the system while out walking, to the large business empire built on exaggerated claims.