What is Bilateral Stimulation and How is it Used in EMDR Therapy?

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Bilateral Stimulation in EMDR

Bilateral stimulation (BS) is a technique that therapists use during eye movement desensitization and reprocessing (EMDR) therapy.

BS involves the therapist providing alternating tactile, auditory, or visual stimulation to the patient while they are recalling a traumatic event.

The theory behind BS is that it helps to “unlock” trapped emotions and memories in a safe environment so that they can be processed and healed.

There is a lot of research supporting the efficacy of EMDR therapy in treating trauma, and BS is an integral part of the therapy.

If you are interested in learning more about EMDR therapy or bilateral stimulation, keep reading.

What is bilateral stimulation?

Bilateral stimulation is a type of psychotherapy used in EMDR therapy to help soothe and calm the client’s nervous system. It involves presenting sensory stimuli, such as sounds, tapping, or eye movements, to both sides of the body, activating both hemispheres of the brain.

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Examples of bilateral stimulation techniques include following a ball during a table tennis match, alternate tapping between your left and right sides, listening to music, sounds with headphones. Bilateral stimulation has been shown to reduce distress associated with traumatic memories.

Why is Bilateral Stimulation Used in EMDR Therapy?

The purpose of bilateral stimulation in EMDR therapy is to help the patient process traumatic memories and alleviate the associated distressing emotional and physiological symptoms. This is accomplished by activating both sides of the brain, allowing for easier access to memories, emotions, and experiences that have been stuck in the nervous system.

Through bilateral stimulation, clients can gain distance from their experiences, develop a more positive outlook on the traumatic event, and become aware of the social support systems that are available to help them cope. This allows them to develop healthier coping mechanisms and build up a greater sense of resilience. In addition, bilateral stimulation has been shown to be an effective treatment for PTSD, C-PTSD, anxiety, depression, and many other mental health conditions.

Effects of Bilateral Stimulation

Studies have shown that the use of bilateral stimulation in EMDR therapy can have a dramatic effect on symptoms of depression, anxiety, chronic pain, and motor disability. It can also improve self-esteem, creativity, and happiness, enhance performance, and reduce neglect associated with pain. Ultimately, bilateral stimulation is an effective tool for helping people process traumatic memories and emotions, and it can produce positive, long-lasting results.

How to set up and use bilateral stimulation during your EMDR session?

Step 1: Choose your bilateral stimulation method

There are several different methods of bilateral stimulation that can be used in an EMDR session, including visual, auditory, and tactile stimulation.

  1. Visual Bilateral Stimulation: Visual bilateral stimulation can be used by having the client follow the therapist’s moving lights, finger, or hand movements with their eyes. This can be done in a variety of ways, such as the client following a light bar, or the therapist’s hand moving in a side-to-side pattern in front of the client.
  2. Auditory Bilateral Stimulation: Auditory bilateral stimulation can be used by having the client alternate between listening to tones or taps that switch from one ear to the other. This can be done using a metronome, headphones, or an app.
  3. Tactile Bilateral Stimulation: Tactile bilateral stimulation can be used by having the client alternate between tactile stimuli such as pulsars, vibration, tapping their legs, or tapping their fingers on the steering wheel. This helps to activate both hemispheres of the brain and help to soothe and calm the client’s nervous system.

Ultimately, any type of bilateral stimulation can be effective when used in an EMDR session. It is important to adjust the bilateral stimulation to meet the client’s preferences and working memory taxation. Combining different types of bilateral stimulation can also be helpful depending on the phase of treatment.

Step 2: Purchase EMDR tappers and equipment

What items are needed to set up and use bilateral stimulation during an EMDR session?

In order to set up and use bilateral stimulation during an EMDR session, here is a list of items that you will need:

  1. An EMDR trained therapist: It is recommended that you seek the care of an EMDR professional to process traumatic or distressing events.
  2. EMDR Tappers app: This app was initially designed as a tool for therapists and clients during distance EMDR sessions.
  3. iPhone and/or Apple Watch: These devices will be used to display the animations and provide vibration.
  4. Headphones: Headphones that are capable of stereo (2 channel) sound are needed.

Step 3: Learn how to use your new tappers

For Using EMDR Tappers Hold your device(s) away from your face, so that your eyes will move from side to side as you follow the sphere or other animation that is alternating (side to side) on the app or the video watched.

Step 4: Do a body scan

During a body scan during an EMDR session, bilateral stimulation can be used to help facilitate the process.

Next, your therapist will ask you to select one of the targeted memories you identified in EMDR phase one. You’ll need to identify several components of the memory, including a vivid mental image, a negative belief about yourself, and any related emotions and body sensations. Your therapist will also ask you to come up with a positive belief about yourself related to the mental image.

Once you are prepared, you and your therapist will begin the body scan. During the body scan, your therapist will have you think of the target memory and the positive belief, and observe your physical response. They will ask if you note any residual distress and, if so, take you through more stimulation sets until it is resolved.

By using bilateral stimulation during a body scan, the client can take advantage of the stress reduction effects of the stimulation, helping to reduce the intensity of the emotional charge of the target memory.

Step 6: Begin using your body scan protocol

How can you use your body scan protocol during an EMDR session? Before starting the body scan protocol during an EMDR session, it is important to provide the client with an explanation of the treatment and the procedures, as well as practice the eye movement and/or other BLS components.


Let’s say that Sarah is a client who is undergoing EMDR. Before starting the body scan protocol, Sarah’s therapist will explain the treatment and the procedures to her, as well as practice the eye movement and/or other BLS components. To prepare Sarah, the therapist will ask her to select one of her targeted memories and then identify the emotions and body sensations associated with it. The therapist will then have Sarah rate the positive belief of the memory on a scale of 1-7.

Next, Sarah will listen to headphones with alternating tones or taps while focusing on the memory and the positive belief. After that, the therapist will ask Sarah to observe her physical response while thinking of the memory and the positive belief, and identify any residual somatic distress. If Sarah reports any disturbance, the therapist will use standardized procedures involving the BLS to process it.

Hierarchy in EMDR Therapy

EMDR Therapy is a comprehensive treatment approach that is based on a hierarchy of core elements. The first level of the hierarchy is the therapeutic relationship, which is necessary to establish a strong alliance between the therapist and the client. Some people find it succesful to do the Self-administered EMDR Therapy.

The second level consists of the eight phases of EMDR Therapy, which describe the procedural steps and the course of treatment from the first session to the last.

The last level of the hierarchy is Bilateral Stimulation, which is the most essential component of EMDR Therapy. Bilateral Stimulation involves the alternation of tactile stimulation (e.g. tapping or holding of two fingers) or auditory stimulation (e.g. listening to alternating tones). This stimulation is thought to engage the brain’s information processing system, allowing the patient to process memories and experiences that are causing emotional distress.

Bilateral Stimulation is believed to be effective because it activates both the left and right hemispheres of the brain, allowing information to be processed more effectively. In comparison to other therapeutic modalities, EMDR Therapy is unique in that it centers around the use of Bilateral Stimulation to help the patient reprocess their experiences.

Does EMDR require bilateral stimulation?

Yes, EMDR does require bilateral stimulation. Bilateral stimulation is one of the key components of EMDR, and it has been shown to be an effective treatment for trauma. In EMDR, bilateral stimulation is used to facilitate the movement of memories and emotions from one side of the brain to the other, allowing for faster and more efficient processing of traumatic material.


How is Bilateral Stimulation used in EMDR Therapy?

Bilateral stimulation is an important part of Eye Movement Desensitization and Reprocessing (EMDR) therapy, and it can be a powerful tool to help people process and recover from traumatic events. Here is a step-by-step guide to how it is used in EMDR Therapy:

  1. First, the therapist will explain to the client what bilateral stimulation is and how it works.
  2. Second, the therapist will help the client identify a target for the bilateral stimulation. This can be a traumatic memory, an emotion, or an incident that the client wants to process.
  3. Third, the therapist will use a specific technique of bilateral stimulation, such as eye movements, auditory bilateral stimulation (using tones or taps), or tactile bilateral stimulation (using pulsars or vibration) like the butterfly hug. The client can then focus both on the target and the stimulus that is alternating between sides of the body.
  4. Finally, the client will focus on the target while processing the feelings and emotions that come up.

Bilateral stimulation can be a powerful tool to help people process and recover from traumatic events, and it is one of the key components of EMDR therapy.

What are the benefits of using Bilateral Stimulation in EMDR Therapy?

The benefits of using Bilateral Stimulation in EMDR Therapy can be extensive and may include:

Facilitating processing: Bilateral stimulation is thought to help integrate traumatic memories into the broader context of a person’s life. It may help reduce the intensity of negative emotions and allow for new insights and perspectives to emerge.

Reducing distress: Bilateral stimulation can be calming and help reduce feelings of anxiety and distress. This can be particularly helpful for individuals who have experienced trauma, who may struggle with overwhelming emotions and sensations.

Enhancing focus: Bilateral stimulation helps people focus on their memories and sensations more clearly. This can be especially helpful for individuals who struggle with dissociation or have difficulty staying present during therapy.

Promoting safety: Bilateral stimulation can help create a sense of safety and containment in life, and may make it easier for clients to tolerate difficult emotions and experiences.

Additionally, multiple studies have shown that EMDR therapy featuring bilateral stimulation can be highly effective in reducing chronic pain, pain-related neglect, anxiety, depression, motor disability, and feelings of apathy, as well as being a feasible treatment for long-term depression.

What are the risks associated with Bilateral Stimulation?

Although there is no known direct risk associated with bilateral stimulation, it is important to note that EMDR therapy is not suitable for everyone. If the patient is not properly prepared for the therapy, EMDR can make things worse, could cause emotional distress or worsen existing symptoms.

Other risks include the potential for misdiagnosis and inappropriate treatment, as well as the risk of psychological distress, which can be exacerbated in some people. It’s important to discuss any concerns with a qualified therapist to ensure that the process is beneficial and safe.

What are examples of bilateral stimulation in EMDR?

In EMDR therapy, there are several examples of bilateral stimulation available. These include

  1. Auditory stimulation: The therapist may use headphones or speakers to play sounds that alternate between the left and right ear, while the client holds the traumatic memory in mind. These sounds can be simple tones, music, or nature sounds.
  2. Eye movements: The therapist may ask the client to follow their fingers or a light bar back and forth with their eyes, while holding the traumatic memory in mind. The eye movements should be rhythmic and gentle, with a speed and intensity that is comfortable for the client.
  3. Tapping: The therapist may tap the client’s hands, knees, or shoulders alternately, while the client holds the traumatic memory in mind. The tapping should be rhythmic and gentle, with a speed and intensity that is comfortable for the client.
  4. Handheld devices: Some EMDR therapists use handheld devices that vibrate alternately in the left and right hand, while the client holds the traumatic memory in mind.

The goal is to create a safe and comfortable experience that allows the client to process traumatic memories and other distressing experiences in a more adaptive way.