References for Podcast 8 How EMDR Therapy Works: The Science of Healing and Neuroplasticity March 2026
This episode explores the question “How does EMDR therapy work?” with its focus on EMDR’s use of bilateral eye movements. Other forms of bilateral stimulation are also discussed including kinesthetic stimulation, such as the Butterfly Hug and bilateral auditory stimulation. Drawing on insights from his textbook, A Guide to the Standard EMDR Therapy Protocols (2nd ed) and an EMDRIA Conference presentation, Dr. Andrew Leeds reviews the latest research studies that clarify and strengthen our understanding of EMDR therapy’s six key mechanisms of action All this and more in Episode 8 of EMDR: The Science behind the Therapy.
Watch or download the video for Dr. Leeds’s EMDRIA Conference presentation
“Mechanisms of action in EMDR therapy”
Download the free PDF of Dr. Leeds’s EMDRIA Conference presentation
“Mechanisms of action in EMDR therapy”
Earn Home Study EMDRIA Credits
Subscribe to my newsletter
Follow me on LinkedIn
References
Arulchelvan, E., & Vanneste, S. (2025). Pathological forgetting from a predictive processing perspective. Neurosci Biobehav Rev, 172, 106109. https://doi.org/10.1016/j.neubiorev.2025.106109
Baek, J., Lee, S., Cho, T., Kim, S.-W., Kim, M., Yoon, Y., Kim, K. K., Byun, J., Kim, S. J., Jeong, J., & Shin, H.-S. (2019). Neural circuits underlying a psychotherapeutic regimen for fear disorders. Nature. https://doi.org/10.1038/s41586-019-0931-y
Bossini, L., Santarnecchi, E., Casolaro, I., Koukouna, D., Caterini, C., Cecchini, F., Fortini, V., Vatti, G., Marino, D., Fernandez, I., Rossi, A., & Fagiolini, A. (2017). Morphovolumetric changes after EMDR treatment in drug-naïve PTSD patients. Riv Psichiatr, 52(1), 24-31. https://doi.org/10.1708/2631.27051
Calancie, O. G., Khalid-Khan, S., Booij, L., & Munoz, D. P. (2018). Eye movement desensitization and reprocessing as a treatment for PTSD: current neurobiological theories and a new hypothesis. Ann N Y Acad Sci. https://doi.org/10.1111/nyas.13882
Carletto, S., & Borsato, T. (2017). Neurobiological correlates of post-traumatic stress disorder: A focus on cerebellum role. European Journal of Trauma & Dissociation, 1(3), 153-157. https://doi.org/10.1016/j.ejtd.2017.03.012
Carletto, S., Borsato, T., & Pagani, M. (2017). The Role of Slow Wave Sleep in Memory Pathophysiology: Focus on Post-traumatic Stress Disorder and Eye Movement Desensitization and Reprocessing. Front Psychol, 8, 2050. https://doi.org/10.3389/fpsyg.2017.02050
Chamberlin, D. E. (2019). The Network Balance Model of Trauma and Resolution—Level I: Large-Scale Neural Networks. Journal of EMDR Practice and Research, 13(2), 124-142. https://doi.org/10.1891/1933-3196.13.2.124
Chamberlin, D. E. (2019). The Predictive Processing Model of EMDR. Front Psychol, 10, 2267. https://doi.org/10.3389/fpsyg.2019.02267
Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17(2), 221-9. https://doi.org/10.1037/0894-4105.17.2.221
Civilotti, C., Cussino, M., Callerame, C., Fernandez, I., & Zaccagnino, M. (2019). Changing the Adult State of Mind with respect to Attachment: an exploratory study of the role of EMDR psycho-therapy. Journal of EMDR Practice and Research, 13(3), 176-186. https://doi.org/10.1891/1933-3196.13.3.176
El Haj, M., Boutoleau-Bretonnière, C., & Janssen, S. M. J. (2021). Eye movements of recent and remote autobiographical memories: fewer and longer lasting fixations during the retrieval of childhood memories. Psychol Res, 85(6), 2466-2473. https://doi.org/10.1007/s00426-020-01403-3
El Haj, M., Nandrino, J.-L., Antoine, P., Boucart, M., & Lenoble, Q. (2017). Eye movement during retrieval of emotional autobiographical memories. Acta Psychol (Amst), 174, 54-58. https://doi.org/10.1016/j.actpsy.2017.02.002
Fleck, J. I., Olsen, R., Tumminia, M., DePalma, F., Berroa, J., Vrabel, A., & Miller, S. (2018). Changes in brain connectivity following exposure to bilateral eye movements. Brain Cogn, 123, 142-153. https://doi.org/10.1016/j.bandc.2018.03.009
Harricharan, S., McKinnon, M. C., & Lanius, R. A. (2021). How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD. Front Neurosci, 15, 625490. https://doi.org/10.3389/fnins.2021.625490
Harricharan, S., McKinnon, M. C., Tursich, M., Densmore, M., Frewen, P., Théberge, J., van der Kolk, B., & Lanius, R. A. (2019). Overlapping frontoparietal networks in response to oculomotion and traumatic autobiographical memory retrieval: implications for eye movement desensitization and reprocessing. European Journal of Psychotraumatology, 10(1), 1586265. https://doi.org/10.1080/20008198.2019.1586265
Holmes, A. (2019). Biological clues to an enigmatic treatment for traumatic stress. Nature, 566(7744), 335-336. https://doi.org/10.1038/d41586-019-00294-8
Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annu Rev Clin Psychol, 3, 1-27. https://doi.org/10.1146/annurev.clinpsy.3.022806.091432
Keller, B., Stevens, L., Lui, C., Murray, J., & Yaggie, M. (2014). The Effects of Bilateral Eye Movements on EEG Coherence When Recalling a Pleasant Memory. Journal of EMDR Practice and Research, 8(3), 113-128. https://doi.org/10.1891/1933-3196.8.3.113
Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action. Front Psychol, 9, 1395. https://doi.org/10.3389/fpsyg.2018.01395
Lanius, U., & Bergmann, U. (2014). Dissociation, EMDR, and Adaptive Information Processing: The Role of Sensory Stimulation and Sensory Awareness. In U. Lanius, S. Paulsen, & F. Corrigan (Eds.), Neurobiology and treatment of traumatic dissociation: towards an embodied self (pp. 213-242). Springer Publishing Company.
Liu, Y., Zhou, Z.-X., Lv, Q., Huang, G., Zhang, H., Wang, Y.-Q., Chen, J.-G., & Wang, F. (2025). A superior colliculus-originating circuit prevents cocaine reinstatement via VR-based eye movement desensitization treatment. Natl Sci Rev, 12(4), nwae467. https://doi.org/10.1093/nsr/nwae467
Matthijssen, S. J. M. A., Brouwers, T., van Roozendaal, C., Vuister, T., & de Jongh, A. (2021). The effect of EMDR versus EMDR 2.0 on emotionality and vividness of aversive memories in a non-clinical sample. Eur J Psychotraumatol, 12(1), 1956793. https://doi.org/10.1080/20008198.2021.1956793
Mertens, G., Bouwman, V., Asmervik, J. F., & Engelhard, I. M. (2019). Changing emotional visual and auditory memories: are modality-matched dual-tasks more effective. Cogn Emot, 1-14. https://doi.org/10.1080/02699931.2019.1666800
Mertens, G., Krypotos, A.-M., van Logtestijn, A., Landkroon, E., Veen, S. C. V., & Engelhard, I. M. (2018). Changing negative autobiographical memories in the lab: A comparison of three eye-movement tasks. Memory, No Pagination Specified. https://doi.org/10.1080/09658211.2018.1507041
Meshreky, K. M., & Lewis, P. A. (2025). Do eye movements in REM sleep play a role in overnight emotional processing? Neuropsychologia, 215, 109169. https://doi.org/10.1016/j.neuropsychologia.2025.109169
Nieuwenhuis, S., Elzinga, B. M., Ras, P. H., Berends, F., Duijs, P., Samara, Z., & Slagter, H. A. (2013). Bilateral saccadic eye movements and tactile stimulation, but not auditory stimulation, enhance memory retrieval. Brain Cogn, 81(1), 52-56. https://doi.org/10.1016/j.bandc.2012.10.003
Nuijs, M. D., Theunissen, T. P. M., van Schie, K., Brouwers, T. C., de Cort, K., Schruers, K. R. J., & Matthijssen, S. J. M. A. (2025). Boosting memory activation to target aversive memories in dual-task interventions. Eur J Psychotraumatol, 16(1), 2581537. https://doi.org/10.1080/20008066.2025.2581537
Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Monaco, L., Lauretti, G., Russo, R., Niolu, C., Ammaniti, M., Fernandez, I., & Siracusano, A. (2012). Neurobiological correlates of EMDR monitoring - an EEG study. PLoS One, 7(9), e45753. https://doi.org/10.1371/journal.pone.0045753
Pagani, M., Amann, B. L., Landin-Romero, R., & Carletto, S. (2017). Eye Movement Desensitization and Reprocessing and Slow Wave Sleep: A Putative Mechanism of Action. Front Psychol, 8, 1935. https://doi.org/10.3389/fpsyg.2017.01935
Pagani, M., & Carletto, S. (2017). A hypothetical mechanism of action of EMDR: The role of slow wave sleep. Clinical Neuropsychiatry, 14(5), 301-305. http://www.clinicalneuropsychiatry.org/pdf/2-paper-Clinical17-5.pdf
Panksepp, J. (2011). The basic emotional circuits of mammalian brains: do animals have affective lives. Neurosci Biobehav Rev, 35(9), 1791-1804. https://doi.org/10.1016/j.neubiorev.2011.08.003
Parker, A., Parkin, A., & Dagnall, N. (2017). Effects of handedness & saccadic bilateral eye movements on the specificity of past autobiographical memory & episodic future thinking. Brain Cogn, 114, 40-51. https://doi.org/10.1016/j.bandc.2017.03.006
Parker, A., Powell, D., & Dagnall, N. (2018). Effects of Saccade Induced Retrieval Enhancement on conceptual and perceptual tests of explicit & implicit memory. Brain Cogn, 121, 1-10. https://doi.org/10.1016/j.bandc.2017.12.002
Propper, R. E., Pierce, J., Geisler, M. W., Christman, S. D., & Bellorado, N. (2007). Effect of bilateral eye movements on frontal interhemispheric gamma EEG coherence: implications for EMDR therapy. J Nerv Ment Dis, 195(9), 785-788. https://doi.org/10.1097/NMD.0b013e318142cf73
Rameckers, S. A., van Emmerik, A. A. P., Boterhoven de Haan, K., Kousemaker, M., Fassbinder, E., Lee, C. W., Meewisse, M., Menninga, S., Rijkeboer, M., Schaich, A., & Arntz, A. (2024). The working mechanisms of imagery rescripting and eye movement desensitization and reprocessing: Findings from a randomised controlled trial. Behav Res Ther, 175, 104492. https://doi.org/10.1016/j.brat.2024.104492
Rousseau, P. F., Malbos, E., Verger, A., Nicolas, F., Lançon, C., Khalfa, S., & Guedj, E. (2019). Increase of precuneus metabolism correlates with reduction of PTSD symptoms after EMDR therapy in military veterans: an 18F-FDG PET study during virtual reality exposure to war. Eur J Nucl Med Mol Imaging, 46(9), 1817-1821. https://doi.org/10.1007/s00259-019-04360-1
Rousseau, P. F., Boukezzi, S., Garcia, R., Chaminade, T., & Khalfa, S. (2020). Cracking the EMDR code: Recruitment of sensory, memory and emotional networks during bilateral alternating auditory stimulation. Aust N Z J Psychiatry, 4867420913623. https://doi.org/10.1177/0004867420913623
Rousseau, P.-F., El Khoury-Malhame, M., Reynaud, E., Boukezzi, S., Cancel, A., Zendjidjian, X., Guyon, V., Samuelian, J.-C., Guedj, E., Chaminade, T., & Khalfa, S. (2019). Fear extinction learning improvement in PTSD after EMDR therapy: an fMRI study. European Journal of Psychotraumatology, 10(1), 1568132. https://doi.org/10.1080/20008198.2019.1568132
Stickgold, R. (2002). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58(1), 61-75. https://doi.org/10.1002/jclp.1129
Stickgold, R. (2008). Sleep-dependent memory processing and EMDR action. Journal of EMDR Practice and Research, 2(4), 289-299. https://doi.org/10.1891/1933-3196.2.4.289
Suh, J., Chang, S., & Park, H. (2025). Optimization of Video Stimuli Parameters in EMDR Therapy Using Artificial Neural Networks for Enhanced Treatment Efficacy. Applied Sciences, 15(2), 934. https://doi.org/10.3390/app15020934
Thomaes, K., Engelhard, I. M., Sijbrandij, M., Cath, D. C., & Heuvel, O. A. V. D. (2016). Degrading traumatic memories with eye movements: a pilot functional MRI study in PTSD. European Journal of Psychotraumatology, 7(0). https://doi.org/10.3402/ejpt.v7.31371
van Schie, K., & van Veen, S. C. (2023). Omitting continuous memory recall from dual-task interventions does not reduce intervention effectiveness. Behav Res Ther, 164, 104291. https://doi.org/10.1016/j.brat.2023.104291
Vanderschoot, T., & Dessel, P. V. (2022). EMDR Therapy and PTSD: A Goal-Directed Predictive Processing Perspective. Journal of EMDR Practice and Research, EMDR-2022. https://doi.org/10.1891/emdr-2022-0009
Verger, A., Rousseau, P. F., Malbos, E., Chawki, M. B., Nicolas, F., Lançon, C., Khalfa, S., & Guedj, E. (2020). Involvement of the cerebellum in EMDR efficiency: a metabolic connectivity PET study in PTSD. European Journal of Psychotraumatology, 11(1), 1767986. https://doi.org/10.1080/20008198.2020.1767986
Vrtička, P., & Vuilleumier, P. (2012). Neuroscience of human social interactions and adult attachment style. Front Hum Neurosci, 6, 212. https://doi.org/10.3389/fnhum.2012.00212
Wadji, D. L., Martin-Soelch, C., & Camos, V. (2022). Can working memory account for EMDR efficacy in PTSD. BMC Psychol, 10(1), 245. https://doi.org/10.1186/s40359-022-00951-0
Wang, S., He, Y., Hu, J., Xia, J., Fang, K., Yu, J., & Wang, Y. (2024). Eye movement intervention facilitates concurrent perception and memory processing. Cereb Cortex, 34(5), bhae190. https://doi.org/10.1093/cercor/bhae190
Wong, S.-L. (2021). A Model for the Flash Technique Based on Working Memory and Neuroscience Research. Journal of EMDR Practice and Research, 15(3), 174-184. https://doi.org/10.1891/emdr-d-21-00048
Wynn, J. S., Ryan, J. D., & Buchsbaum, B. R. (2020). Eye movements support behavioral pattern completion. Proc Natl Acad Sci U S A, 117(11), 6246-6254. https://doi.org/10.1073/pnas.1917586117
Yan, Y., Aierken, A., Wang, C., Jin, W., & Quan…, Z. (2022). Neuronal Circuits Associated with Fear Memory: Potential Therapeutic Targets for Posttraumatic Stress Disorder. … Neuroscientist. https://doi.org/10.1177/10738584211069977
Yoshii, T. (2021). The Role of the Thalamus in Post-Traumatic Stress Disorder. Int J Mol Sci, 22(4). https://doi.org/10.3390/ijms22041730
