What is bilateral stimulation and how can it be used in EMDR treatment? — Aspire Counseling (2023)

What is bilateral stimulation? This is a question that is often asked by people who are interested in learning more about Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a powerful psychotherapy treatment that has been shown to be effective for many people who suffer from trauma. And, bilateral stimulation is one of the key components of EMDR, but it is very different than traditional talk therapy so it's common for people to have question about this component of EMDR therapy. In this article, we will explain bilateral stimulation in simple terms and discuss how it can be used in EMDR treatment.

What is Bilateral Stimulation?

Bilateral stimulation (BLS) refers to the use of a stimulus that is presented to both sides of the body. The most traditional form of bilateral stimulation used in EMDR therapy is eye movements, but other forms such as auditory bilateral stimulation (using tones or taps) and tactile bilateral stimulation (using pulsars or vibration) can also be effective. In fact, the therapists at Aspire Counseling frequently use other types of bilateral stimulation so we'll talk more about that in a minute.

Why is Bilateral Stimulation Used in EMDR?

Bilateral stimulation is used in EMDR because it has been shown to be an effective treatment for trauma. In fact, bilateral stimulation is one of the key components that makes EMDR such a powerful treatment for trauma. EMDR has been shown to be an effective treatment for PTSD, anxiety, depression, and many other mental health conditions.

How does Bilateral Stimulation Work in EMDR?

Bilateral stimulation is thought to work in EMDR by activating both sides of the brain which allows for the processing of memories, emotions, and incidents that are stuck in the nervous system. When we experience trauma, our brains can get "stuck" on that event and it can feel like we're reliving it over and over again. Bilateral stimulation is thought to help "unstick" those memories so that they can be processed and resolved.

Essentially, by having you focus both on something distressing while also paying attention to the stimulus activating alternating sides of the body, bilateral stimulation allows the brain to access both sides of the brain which leads to more effective processing of memories. You're able to process things that your brain has otherwise avoided. However, my clients often report feeling much less distressed thinking about things like trauma memories while using BLS than when thinking about it otherwise.

You May Have Noticed How This Works in Your Own Life

Have you ever felt stressed out and you go for a walk or a jog? While running or walking, you may have been thinking about whatever was stressing you out or even talking it through with a friend. And, when you're done with your walk or run, you may have noticed that the thing that was stressing you out doesn't seem as bad as it did before. That's because bilateral stimulation, in this case your alternating feet hitting the pavement, can help activate both sides of the brain which helps with processing and resolving stressors.

While bilateral stimulation is often thought of as eye movements, there are other types of bilateral stimulation that can be just as effective.

Types of Bilateral Stimulation Used in EMDR

As I mentioned, bilateral stimulation usually refers to eye movements but there are other types of bilateral stimulation that can be used in EMDR. Here are some other types of bilateral stimulation that EMDR therapists may use including the therapists here at Aspire Counseling:

Auditory bilateral stimulation

This can be done using tones or taps. The therapist will usually have the client listen to headphones while they hear sounds on each side alternatively.

Tactile bilateral stimulation

This can be done using pulsars or vibration. The therapist will often hold pulsars in each hand and have the client hold them while they feel the pulsing in each hand alternatively. We often call these "buzzies" and I've found that this is what many of my in person EMDR clients really seem to prefer.

There are also bilateral stimulation devices that can be used with EMDR that are worn on the wrists or ankles that provide vibration or tapping. Or, a therapist or client may tap on alternating knees. When providing EMDR to a client online, many of my clients have used the Butterfly Hug as their bilateral stimulation.

Visual bilateral stimulation

This can be done using lights or other visual cues that alternate between each side. At our office in Columbia, many of our EMDR clients use a device we call a "light bar." The therapist will have the client sit in a chair and look at a light that moves back and forth between each eye. We are able to control the speed the light moves and a couple other things which means we can really tailor the experience to your needs. The light bar was actually featured in Grey's Anatomy when Jo participated in EMDR.

Other forms of visual bilateral stimulation can include watching a ball move across a computer screen (something I've used many times with online EMDR therapy sessions), looking at alternating sides of the room or watching a therapist's finger move back and forth in front of your face (this is the classic thing associated with EMDR).

There are a lot of options for bilateral stimulation in EMDR

So, bilateral stimulation is a key part of EMDR and there are lots of different ways it can be done. And, you may have actually experienced bilateral stimulation in your everyday life without realizing it! If you're curious about whether EMDR can help

Does it matter which type of bilateral stimulation an EMDR therapist uses?

Some clients have a preference for one type of bilateral stimulation over another but, in general, any type of bilateral stimulation can be effective. That said, I often find that using a combination of bilateral stimulations can be really helpful depending on the phase of treatment.

For example, I often have a client use something like tapping their knees or the butterfly hug when we're working on resourcing early in treatment. Then, when we're processing more intense memories I like to use something that I can change the speed of or adjust as needed like the light bar or an app that both the client and I login to on the computer.

But, ultimately, bilateral stimulation is bilateral stimulation and your brain doesn't really care what type it is. So, if you have a preference, let your therapist know. If not, don't worry about it!

Other Questions About EMDR & Bilateral Stimulation?

Do you have any questions about bilateral stimulation as used in EMDR treatment? If so, you might want to check out this recent blog post I wrote answering common questions about EMDR. But, if that doesn't cover it, feel free to reach out and we'll be happy to chat with you and take the time to answer all of your questions!

Start EMDR In Missouri

At Aspire Counseling we are proud to offer both online EMDR to anyone in the state of Missouri, as well as in person sessions at our counseling office in Columbia, MO for EMDR therapy. We have several licensed therapists that are not only licensed for EMDR, but other evidence-based counseling services.

Healing is possible, and we understand how intimidating it can be to reach out, however, we encourage you to take that next step by reaching out via phone at 573-328-2288, or filling out a contact form on our website. After this, a member of a team will reach out, and help find an EMDR therapist that fits you for a free consultation.

We also offer a wide variety of mental health service besides EMDR such as, depression counseling, anxiety treatment, trauma therapy, counseling for kids, teens, and college students, along with grief counseling. So, we encourage you to reach out, and give us a try!

About the Author


What is bilateral stimulation and how can it be used in EMDR treatment? — Aspire Counseling? ›

Bilateral Stimulation (BLS) simply means stimulation of both sides, as in both sides of the brain. In EMDR Therapy we use this method to assist the client in processing traumatic memories, and in processing fears or worries of future problems.

What is bilateral stimulation in EMDR? ›

Bilateral stimulation (BLS) refers to the use of a stimulus that is presented to both sides of the body. BLS is a key component of Eye Movement Desensitization and Reprocessing (EMDR).

What is a bilateral stimulation? ›

Bilateral stimulation is stimuli (visual, auditory or tactile) which occur in a rhythmic left-right pattern. For example, visual bilateral stimulation could involve watching a hand or moving light alternating from left to right and back again.

Does EMDR require bilateral stimulation? ›

EMDR treatment is focused on processing distressing memories, incidents or emotions. That is what your brain does naturally while you sleep. So, an EMDR therapist use bilateral stimulation (in various methods) to activate that natural process in the brain with the goal of activating both sides of the brain.

What is bilateral stimulation to clients? ›

Bilateral Stimulation is the use of alternating right, left stimulation such as tapping on the knees, legs or shoulders, tapping toes or feet on the floor, or eye movements. Bilateral stimulation is used to activate and integrate information from the brain's two hemispheres.

How do you perform bilateral stimulation on yourself? ›

While sitting, lay each of your hands palm-down onto your legs. Close your eyes, focusing on your breathing. Then begin to tap your legs with your hands. This creates that bilateral stimulation.

What are examples of bilateral stimulation in EMDR? ›

Some examples of bilateral stimulation techniques include: Following a ball during a tennis match. Alternating stepping on your left and right feet. Patting your shoulders or knees with your hands, alternating between your left and right sides.

What is the importance of bilateral stimulation? ›

Bilateral stimulation works to create electrical activity in different parts of the brain and encourages better communication between the two sides of the brain. That inter-hemisphere communication could hold a key to better emotional processing and regulation for individuals with PTSD or other concerns.

What are natural forms of bilateral stimulation? ›

There are many different ways to bilaterally stimulate your brain. You can walk, run, bike, drum, swim, dance, or kickbox and incorporate bilateral movements.

What is the best bilateral stimulation for EMDR? ›

The most traditional form of bilateral stimulation used in EMDR therapy is eye movements, but other forms such as auditory bilateral stimulation (using tones or taps) and tactile bilateral stimulation (using pulsars or vibration) can also be effective.

What are the best forms of bilateral stimulation? ›

Types of Bilateral Stimulation for EMDR Therapy
  • Eye Movements- light bar or wand.
  • Tactile- hand held device or self tapping.
  • Auditory- sound through head phones.
Jun 27, 2021

Who is not a good candidate for EMDR therapy? ›

There are some people for whom EMDR is not a good choice. Clients with a bipolar disorder or personality disorder diagnosis are not good candidates for EMDR.

How long should you do bilateral stimulation? ›

If you are using the EMDR tappers to build your capacity to go into a more calm and peaceful state, then it is generally recommended to spend 5 to 10 minutes envisioning a real or imagined peaceful place 3 times per day spaced out over the day.

Does bilateral stimulation work for anxiety? ›

This alternate stimulation of each side of the brain can be helpful when people have anxiety, stress or trauma. Bilateral stimulation seems to help the brain with reprocessing stressful and traumatic memories.

Can EMDR help with sleep? ›

EMDR effectively treats a range of disorders (e.g., PTSD, depression, anxiety, stress, etc.), and research shows that engaging in EMDR is an effective treatment for trauma related sleep disturbances.

Can you do EMDR tapping on yourself? ›

It is possible to self-administer EMDR on yourself; however, it is not often recommended. If you do decide to try a self-administered EMDR program, it is recommended to only do so for smaller-scale traumas, such as something "minor" that has happened in the present.

What is an example of tapping in EMDR? ›

Begin tapping your knees, alternating between left and right. Keep this slow, about 1 tap per second, keeping in mind both your safe place and your positive intention. Stay in this moment, relaxing if you can, for the next 5 minutes.

What am I supposed to think about during EMDR? ›

Processing Memories

When ready for the next phases of EMDR therapy, you will be asked to focus on a specific event, thought, image or memory. You will identify the most vivid visual image related to the trauma (if available), a negative belief about yourself, related emotions and body sensations.

What issues are best treated with EMDR? ›

What conditions and problems does EMDR treat? The most widespread use of EMDR is for treating post-traumatic stress disorder (PTSD). Mental healthcare providers also use it in the treatment of the following conditions: Anxiety disorders: Generalized anxiety disorder, panic disorder, phobias and social anxiety/phobia.

What tools are used in EMDR therapy? ›

EMDR buzzers, pulsers, and tappers use two vibration devices that a user holds in their hands or strap onto their wrists. These devices create physical stimuli periodically and the timing is used to create stimuli on alternating sides of the body. The time between the vibrations is usually between 1.5 to 3 seconds.

What are the 2 primary goals of EMDR? ›

The overall goals of Eye Movement Desensitization Reprocessing (EMDR) [Trauma Treatment (Adults)] are: Target the past events that trigger disturbance. Target the current situations that trigger disturbance. Determine the skills and education needed for future functioning.

Which is the first step in the EMDR protocol? ›

The first phase of EMDR is the client history and treatment planning. A detailed history helps the clinician to identify the client's readiness and identify any secondary gains that maintain his/her current problem.

What therapeutic intervention uses bilateral stimulation to treat trauma symptoms? ›

Eye movement desensitization and reprocessing (EMDR) therapy is a psychotherapy that uses rhythmic left-right (bilateral) stimulation to help people recover from trauma or other distressing life experiences.

Is walking bilateral stimulation? ›

First, walking causes bilateral stimulation. Walking is a repetitive, simple movement of your feet, shuffling from left to right, and bilateral stimulation occurs when you cross your midline in this fashion.

What are the most common forms of brain stimulation therapy? ›

ECT and TMS are the most widely used brain stimulation therapies, but there are two other options available: Vagus Nerve Stimulation and Deep Brain Stimulation [VNS and DBS].

What are the 2 forms of brain stimulation? ›

There are several stimulation therapies available:
  • Electroconvulsive therapy (ECT) has been used the longest and is the best studied brain stimulation treatment. ...
  • Repetitive transcranial magnetic stimulation (rTMS) uses a electromagnetic field instead of electrical current to stimulate targeted brain areas.

Who needs bilateral stimulation? ›

Bilateral stimulation is used in therapeutic practices such as eye movement desensitization and reprocessing (EMDR) therapy. EMDR therapy seeks to help people access and process traumatic memories. Bilateral stimulation is used to help clients recall traumatic experiences.

When should you not use EMDR? ›

Because stability must come first, you don't use EMDR to process trauma when a patient is actively abusively using alcohol, drugs, or something to help them feel less. You can't effectively practice EMDR phases 3 – 8 with someone who has yet to experience a safe, trusting relationship.

Do you talk during EMDR? ›

Do you talk during EMDR? There may be some elements of talking during EMDR therapy sessions, but mostly it will be on the part of your therapist. Your therapist will guide your thoughts by prompting you to think about certain aspects of your past, and whether you want to verbally respond or not is up to you.

How long does EMDR therapy last? ›

EMDR therapy is usually done in a series of sessions, with each session lasting 60–90 minutes. The number of sessions needed will vary depending on the severity of the trauma.

What is the success rate of EMDR therapy? ›

Several studies have shown that Eye Movement Desensitization and Reprocessing (EMDR) is incredibly effective for those suffering from PTSD, with some showing as much as a 77% success rate.

How do I prepare for EMDR therapy? ›

So what can you, the client, do to begin to prepare for EMDR?
  1. Know your support system. ...
  2. Engage in some kind of stress reducing body movement each day. ...
  3. Try to get into the habit of taking ten minutes each day to practice breathing exercises or meditation. ...
  4. Try to start a gratitude journal.
Apr 4, 2019

What is the butterfly hug in EMDR? ›

The Butterfly Hug is accomplished by an individual wrap their arms around themselves, so that each hand touches the opposite upper arm or shoulder. They then move their hands like the wings of a butterfly, to tap their arms/shoulders in an alternating rhythm. (as an alternative, the person might just tap their knees.)

What is bilateral stimulation for intrusive thoughts? ›

This bilateral stimulation is meant to engage both sides of your brain. Your therapist might instead tap both of your hands alternately. Recalling trauma while stimulating both sides of your brain helps you store those memories correctly to feel less vivid and fear-inducing.

Why is EMDR so powerful? ›

When you undergo EMDR, you access memories of a trauma event in very specific ways. Combined with eye movements and guided instructions, accessing those memories helps you reprocess what you remember from the negative event. That reprocessing helps “repair” the mental injury from that memory.

Does EMDR release trapped emotions? ›

EMDR therapy uses bilateral stimulation, right/left eye movement, or tactile stimulation, or sound, which repeatedly activates the opposite sides of the brain releasing emotional experiences that are "trapped" in the nervous system.

How long does it take for EMDR to work? ›

Each individual reacts differently to EMDR therapy, but as a general rule, a typical session will last anywhere between 60-90 minutes. Getting to the bottom of a traumatic memory and completely rewiring your brain can take anywhere between three to twelve sessions.

What is the best therapy for intrusive thoughts? ›

Cognitive behavioral therapy is one strategy that is often successful in helping people manage intrusive thoughts. The process may help you to shift some of your general thought patterns, which can enable you to better manage these thoughts when they do occur and might lessen their frequency.

How do therapists treat intrusive thoughts? ›

Intrusive thoughts and all other mental-related problems are treated using two therapies, cognitive behavioral therapy (CBT) and exposure and response prevention therapy (ERPT).

Who is not a good candidate for EMDR? ›

There are some people for whom EMDR is not a good choice. Clients with a bipolar disorder or personality disorder diagnosis are not good candidates for EMDR.

Who would not benefit from EMDR? ›

If you're emotions feel overwhelming or if you tend to shut down when you feel an emotion you may not be ready for EMDR treatment. EMDR therapy relies on your body and mind's ability to process through your thoughts and feelings. If you're unable to process in that way, EMDR therapy may not be effective.

What does EMDR not work well for? ›

Because stability must come first, you don't use EMDR to process trauma when a patient is actively abusively using alcohol, drugs, or something to help them feel less. You can't effectively practice EMDR phases 3 – 8 with someone who has yet to experience a safe, trusting relationship.

How does a therapist know if EMDR is working? ›

If EMDR is working, a person should feel relieved after just a couple of sessions. The traumatic memory will start to be desensitized and will at the very least be less emotionally distressing.

Why do I cry during EMDR? ›

EMDR Therapy helps you to confront a lot of unpleasant stuff circulating in your mind. You will find yourself getting emotional over things that you thought really didn't bother you. You might cry or get pretty angry over some things that happened in your past, and this can feel a bit upsetting. It's alright.

What does trauma release in the body feel like? ›

Some may have a fight-or-flight type of response, which may include muscle tension, heart pounding and sweating because their body "believes it needs to activate," she explains. Others maybe experience a freeze response, which can look like someone who struggles to move or get out of bed.


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