Eye Movement Desensitisation and Reprocessing (EMDR) for Birth Trauma and PTSD

Eye Movement Desensitisation and Reprocessing (EMDR) is one of the most well-established psychological treatments for post-traumatic stress disorder (PTSD) and is recommended by NICE for adults who have experienced trauma. Originally developed by Francine Shapiro, EMDR has been used for more than three decades and is now widely offered within NHS trauma services, specialist perinatal mental health teams and private psychological practice.

For many parents, EMDR is the therapy they have heard most about, yet it is also one of the least understood. People often know that it involves moving the eyes from side to side, but have little idea what actually happens in a session or why those movements are used. Some worry they will lose control or be expected to relive their birth in vivid detail. Others wonder whether EMDR will erase their memories altogether.

In practice, EMDR is a carefully structured therapy that helps the brain process memories that have become psychologically "stuck". The aim is not to forget what happened or minimise the significance of a traumatic birth. Instead, it is to reduce the intensity with which those memories continue to intrude into everyday life, allowing them to become part of your personal history rather than experiences that repeatedly feel as though they are happening again.

Understanding how EMDR works

EMDR is based on the Adaptive Information Processing (AIP) model, which proposes that under ordinary circumstances our brains are remarkably good at processing experience. New events are gradually integrated with existing memories, allowing us to learn from them without constantly reliving them.

Traumatic experiences appear to disrupt this process.

During an overwhelming event such as a traumatic birth, attention narrows dramatically. The brain prioritises immediate survival over reflection and integration. Images, sounds, body sensations, emotions and beliefs that arise during the trauma can become stored in a way that remains relatively isolated from the rest of autobiographical memory. Later, reminders of the birth may reactivate these memories with their original emotional intensity, creating flashbacks, nightmares, intrusive images or overwhelming anxiety.

EMDR aims to help the brain complete the processing that was interrupted during the traumatic experience. Although researchers continue to investigate the precise mechanisms involved, there is good evidence that EMDR reduces the vividness and emotional intensity of traumatic memories and helps people develop more adaptive ways of understanding what happened.

Preparing for trauma processing

One of the most important parts of EMDR happens before any memory processing begins.

Early sessions focus on understanding your history, your current difficulties and the memories that continue to cause distress. We discuss your goals for therapy, explore factors that may influence treatment, and think carefully about whether this feels like the right time to begin trauma work.

Preparation also involves developing strategies that help you remain emotionally grounded throughout therapy. Depending on your needs, we may practise breathing techniques, grounding exercises, imagery or other methods of emotional regulation. These are not intended to suppress emotions, but to help you remain connected to the present while working with difficult memories.

People sometimes imagine that EMDR involves being overwhelmed by emotion from the first session. In reality, careful preparation is one of the reasons the therapy is often experienced as manageable despite working with highly distressing memories.

Choosing a target memory

Rather than trying to process an entire birth experience in one session, EMDR works with clearly defined target memories.

Sometimes this is the moment an emergency alarm sounded. Sometimes it is hearing that an emergency caesarean section is needed, believing that the baby has died, feeling trapped during a medical procedure, or seeing your baby taken away unexpectedly. The target is chosen because it continues to carry significant emotional intensity in the present.

Alongside the memory itself, we identify the belief that became attached to that experience. Parents often describe beliefs such as "I am powerless," "I failed," "I am not safe," or "My body cannot be trusted." These beliefs frequently feel completely true whenever the memory is activated, even if another part of the person recognises that they may not tell the whole story.

We also identify a more helpful belief that you would like to hold once the memory has been fully processed. This is not intended as positive thinking or affirmation. Instead, it reflects a belief that feels realistic and emotionally meaningful, such as "I did everything I could," "I survived," or "I have choices now."

Bilateral stimulation

The most recognisable feature of EMDR is bilateral stimulation. This usually involves following the therapist's fingers with your eyes as they move from one side of your visual field to the other, although alternating taps or sounds can be used instead.

Bilateral stimulation is always combined with focused attention on the target memory. You are never hypnotised, unconscious or out of control. Throughout the session you remain fully aware of where you are and able to pause the process at any time.

Although there is still debate about exactly why bilateral stimulation is effective, several theories have been proposed. One suggestion is that recalling a traumatic memory while simultaneously performing another mentally demanding task temporarily taxes working memory, making the memory feel less vivid and emotionally intense as it is reconsolidated. Other researchers emphasise changes in attentional processing or the brain's natural capacity to integrate emotional experiences. While the underlying mechanisms continue to be investigated, the clinical effectiveness of EMDR is well established.

What happens during processing?

One of the biggest misconceptions about EMDR is that clients spend sessions repeatedly describing their trauma in detail.

In fact, relatively little talking is required during the processing phase itself.

You begin by bringing the target memory briefly to mind while noticing the thoughts, emotions and body sensations associated with it. Following a short period of bilateral stimulation, I simply ask what you noticed. Sometimes people report new memories, unexpected emotions, bodily sensations or changes in the way they now view the experience. At other times they notice very little.

The process is not directed towards a predetermined outcome. The brain often moves naturally between different aspects of the birth, making connections that had not previously been obvious. A distressing image may become linked with information that changes its meaning, or a memory that previously felt fragmented may gradually become more coherent.

Many parents describe this process as surprisingly natural. Rather than forcing themselves to think differently, they notice that the emotional charge associated with the memory begins to reduce of its own accord.

Installation and body scan

As the distress associated with the target memory decreases, attention turns towards strengthening the more adaptive belief identified earlier in the session.

This stage, known as installation, reflects the observation that trauma often changes not only what we remember, but what we believe about ourselves. As memories are processed, beliefs such as "I did everything I could" or "I am safe now" often begin to feel emotionally believable rather than intellectually true but emotionally distant.

Before finishing, we also carry out a body scan, paying attention to any remaining physical tension or discomfort associated with the memory. Trauma is often experienced as much through bodily sensations as through thoughts or images, and residual physical responses can indicate that further processing is needed.

Looking towards the future

One of the final stages of EMDR involves applying new learning to situations that may previously have felt impossible to contemplate.

For parents recovering from birth trauma, this may include attending medical appointments, returning to hospital, considering another pregnancy or imagining a future birth. Rather than repeatedly anticipating catastrophe, therapy helps the brain rehearse these situations while remaining connected to the adaptive learning developed throughout treatment.

This does not eliminate understandable anxiety about future experiences, but it often allows people to approach them with much greater confidence and psychological flexibility.

What does EMDR feel like?

Although every person's experience is different, many clients are surprised by how little they need to explain during EMDR. Unlike some talking therapies, there is no expectation that you repeatedly describe every aspect of your birth in detail. The emphasis is on allowing the brain to process the memory rather than analysing it intellectually.

Processing sessions can be emotional, but they are rarely chaotic. Memories often become less vivid, emotions less intense and bodily reactions less overwhelming as treatment progresses. Many people notice that the birth gradually begins to feel further away, even though they remember it just as clearly.

Importantly, EMDR does not erase memories. It changes the way those memories are experienced. Most parents continue to remember their birth in considerable detail; what changes is that the memory no longer intrudes into everyday life with the same immediacy or emotional force.

Is EMDR right for me?

EMDR is particularly helpful for parents experiencing flashbacks, intrusive memories, nightmares, distressing images or intense physical reactions to reminders of their birth. It is equally valuable for people who find it difficult to put the experience into words or who feel exhausted by repeatedly trying to make sense of what happened.

Some parents prefer a more structured, formulation-based approach such as Trauma-Focused CBT, while others are drawn to the experiential nature of EMDR. In practice, the two approaches are often highly complementary. We begin with a thorough psychological assessment and work together to decide which approach is likely to be the best fit for your difficulties, your goals and the way you naturally process experiences.

Whatever approach is chosen, the aim remains the same: to help your brain process a traumatic experience that has remained unresolved, allowing your baby's birth to become a memory that belongs to your past rather than an event that continues to shape your present.