EMDR: A different approach to treating anxiety

Anxiety is on the rise. NHS England reports generalised anxiety disorder (GAD) among adults aged 16–64 to be 8.5% (2023/24) – up from 4.4% in 2007 and 6.6% in 2014.

Statistics aside, anxiety can feel overwhelming. People describe it in different ways: a constant low hum of dread, a hot rush of panic, the urge to run or hide, or a sense of disconnection from the world. For many, it’s exhausting to mask how much anxiety impacts their life. It can rob joy from the present moment, especially if the mind is caught in past worries or imagined future threats.

Current treatment options

The first-line treatments for anxiety recommended by NICE guidelines in the UK, and offered through the NHS, are cognitive behavioural therapy (CBT) and medication. Whilst these approaches can be effective, they may not work for everyone.

If you’ve tried CBT or medication and they haven’t felt like the right fit, EMDR (eye movement desensitisation and reprocessing) may offer a different way forward.

What is EMDR?

EMDR is a form of psychotherapy that takes a “bottom-up” or " body-up" approach rather than a “top-down” or "mind-down" one:

• Top-down therapies (like CBT) begin by focusing on thoughts to influence feelings and behaviour.
• Bottom-up therapies (like EMDR) start with the body and emotions, helping to calm the nervous system so that thoughts naturally shift too.

EMDR can therefore work without delving into extensive details about difficult memories or feelings. It doesn’t require homework, and although it’s not a “quick fix”, it is usually a shorter-term therapy compared with traditional talking therapies such as counselling or psychodynamic psychotherapy.

How does EMDR work?

In 1987, Francine Shapiro noticed that moving her eyes from side to side reduced the intensity of distressing thoughts. This discovery became the foundation of EMDR.

The idea is that memories formed under distress can become “stuck”, along with the emotions and beliefs connected to them. When something triggers these memories, it can feel as though you are re-living the original experience. EMDR helps the brain reprocess these memories so they are stored in a calmer, more adaptive way, often using side-to-side eye movements.

For people with anxiety, the cycle of persistent worry often links back to earlier experiences – moments of danger, rejection, or failure that reinforced beliefs such as “I’m not safe”, “Something bad will happen”, or “I can’t cope.” Even if there hasn’t been one big traumatic event, the nervous system can feel as though stuck in a constant state of hyper-alertness.

With EMDR, clients can also work on worries about the future – for example, “What if I mess up my presentation?” or “What if my partner stops loving me?” If discussing specific memories feels too difficult, EMDR enables you to process them silently by using a code word (like “lamp” or “table”) to signal when the associated emotions are easing, a technique that can be especially helpful when shame or embarrassment makes sharing details hard.

A client story*

Jim came for EMDR shortly after his 41st birthday. Outwardly successful in his career, inside, he was plagued by anxiety. Increasingly, he worried not only about different future scenarios but also about others detecting his anxiety, fearing his team or clients would see through the confident exterior he had worked so hard to maintain. The run-up to important meetings and presentations became increasingly fraught. The result was sleepless nights and growing self-doubt. Having worked hard during his 30s to establish his own company, Jim felt unable to enjoy what he had created and was drained by having to mask how he felt. Having hidden his struggles for so long, Jim did not feel able to share them with his partner or friends, resulting in a sense of distance from others and isolation. 

After establishing that EMDR was suitable, we first built up calming resources – including an imagined safe place, a favourite beach, that Jim could “visit” whenever sessions felt overwhelming. Over four sessions, we worked through the underlying belief of “I’m not good enough”, which ran through many of his worries.

Jim noticed links to school experiences, where undiagnosed dyslexia left him embarrassed in front of classmates. He also recalled his teenage years as shame-filled, having been labelled 'an underachiever' at school, numbing a sense of failure through using cannabis. By reprocessing these memories, he was able to see them differently and challenge the old self-belief. Over the following months, Jim’s sleep improved and his anxiety eased. Most importantly, he began to feel, genuinely, that he was good enough.

*This case study is entirely fictional. Any resemblance to actual persons, living or deceased, is coincidental.

The evidence

EMDR has a strong evidence base for treating post-traumatic stress disorder (PTSD) and an increasing evidence base for anxiety disorders. It helps the brain respond more calmly to perceived future threats and reframes the old roots of worry, including ones you may not be consciously aware of.

Moving forward

If anxiety feels as though it’s taking over your life and you’re tired of constant worrying, EMDR may be worth exploring. With the right support, your mind has a natural capacity to heal and restore balance. Speaking to a trained EMDR therapist can help you decide whether this approach is right for you.