If you've heard of EMDR, you may have pictured something complicated — eye movements, special equipment, a very clinical room. In reality, EMDR is a structured, well-established form of therapy, and for many people it works well online. I'm Monique Miles, a Licensed Professional Counselor in Texas and a Licensed Mental Health Counselor in Florida, and EMDR is one of the approaches I use in my virtual practice at Momentum Counseling and Consulting. Here's what it actually involves.

What is EMDR, in plain language?

EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed to help people whose past experiences are still affecting their present — memories that don't feel like memories so much as reactions that keep showing up: a tight chest in a certain situation, a flood of emotion that seems bigger than the moment, avoidance you can't quite explain.

The idea behind EMDR is that the brain sometimes stores a difficult experience in a way that keeps it "live." EMDR uses bilateral stimulation — most often guided eye movements, but also alternating sounds or gentle taps — while you briefly focus on parts of that experience. Over a series of sessions, the memory typically becomes less charged. It doesn't erase what happened; the goal is that remembering it stops running your present.

EMDR is not hypnosis. You stay present, you can pause at any time, and you do not have to describe an experience out loud in detail for the work to happen — something many clients find relieving.

Who can EMDR help?

EMDR is best known for trauma and PTSD — single difficult events and longer, more layered experiences alike. In my practice, people explore EMDR for things like:

• Traumatic or distressing experiences that still feel close to the surface

• Anxiety that seems rooted in earlier experiences

• Painful relationship patterns or losses that keep echoing

• Distress connected to life transitions, medical experiences, or events they have "moved on" from on paper but not in their body

EMDR is one approach among several — I also draw on CBT, DBT, and the Gottman Method where they fit. Whether EMDR is right for you is a conversation we have together, not a decision you have to make before you ever book.

What does EMDR look like online?

Virtual EMDR with me follows the same structure it would in an office; we meet by secure video from wherever you are in Texas or Florida:

First, we build the foundation. Before any processing, we spend time on your history, your goals, and — importantly — your coping resources. You'll learn grounding and calming strategies first. We do not rush into difficult material.

Then, we identify targets together — the specific memories or present-day triggers to work on, in an order that feels manageable.

Processing sessions use bilateral stimulation adapted for video. That can mean following a moving visual on your screen, listening to alternating tones through headphones, or using self-tapping techniques I teach you. During sets of stimulation, you notice what comes up — thoughts, feelings, body sensations — and I check in with you between sets. You don't have to perform or get it "right."

We close every session grounded. Sessions end with time to settle, so you're not logging off in the middle of something heavy, and we talk about what you might notice between sessions.

Individual sessions with me are 45 minutes ($150 private pay) or 60 minutes ($175 private pay). For individual therapy, I accept insurance through Alma and Headway. We'll decide together which session length fits the work.

Frequently asked questions

Does EMDR really work over video?

The core elements of EMDR — bilateral stimulation, structured phases, a therapist guiding pacing — translate to video. What matters most is a private space where you won't be interrupted, a stable connection, and headphones if we're using tones. If I ever felt your situation needed in-person care instead, I would tell you directly.

Will I have to talk about my trauma in detail?

No. EMDR does not require a detailed verbal retelling. You'll share enough for us to identify what we're targeting, but the processing itself is largely internal. For people who have avoided therapy because they don't want to narrate the worst things that happened to them, this often matters most.

How many sessions does EMDR take?

It varies. Some people work on a single event over a focused stretch of sessions; others with more complex histories work more gradually. Anyone who guarantees a specific number of sessions — or a specific outcome — is promising something therapy can't honestly promise. We'll set goals together and check in on progress as we go.

What is EMDR not?

EMDR is not a quick fix, not a memory-erasing treatment, and not appropriate as a crisis intervention. It is also not coaching or self-help: it is licensed mental health treatment, provided here for individuals age 16 and older in Texas and Florida. If you're looking for practical planning support rather than treatment — for example, preparing as a couple for a baby — that's a different service, and I'm glad to help you sort out which fits.

A gentle first step

You don't have to decide today whether EMDR is right for you — that's what the first conversation is for. I offer a free 15-minute phone consultation: a short, no-pressure call to ask questions and talk about next steps.

Book your free consultation at mcounselingac.com or call (214) 307-2640.

— Monique Miles, LPC (TX), LMHC (FL), Momentum Counseling and Consulting, PLLC

This post is educational and is not medical advice and is not a substitute for therapy or treatment with your own provider. If you are in crisis or considering harming yourself, call or text 988 (US Suicide and Crisis Lifeline) or call 911.