What Is Eye Movement Desensitization and Reprocessing (EMDR) Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an evidence-based psychological therapy originally developed to treat trauma and Post-Traumatic Stress Disorder (PTSD). It utilizes bilateral stimulation, typically in the form of guided eye movements that mimic rapid eye movement during sleep, while the client focuses on distressing memories or sensations. This bilateral stimulation appears to facilitate the brain’s natural information processing system, allowing traumatic or distressing memories to be reprocessed and integrated in a less emotionally charged way.
For individuals with Autism Spectrum Disorder (ASD), EMDR therapy can be adapted to address specific challenges such as sensory sensitivities, anxiety, and emotional regulation difficulties. The therapy follows a structured eight-phase protocol that includes history-taking, preparation, assessment, desensitization, installation of positive cognitions, body scan, closure, and reevaluation. When applied thoughtfully with autism-specific considerations, EMDR can help process distressing experiences without requiring extensive verbal processing, making it potentially valuable for autistic individuals who may struggle with traditional talk therapies, including cognitive behavioral therapy (CBT).
To learn more about using EMDR practices for autism spectrum disorder (ASD) and comorbid psychiatric disorders, contact Balanced Mind of New York to schedule a complimentary 15-minute consultation.
What Is Autism Spectrum Disorder (ASD)?
According to the Diagnostic and Statistical Manual (DSM-5-TR) that is published by the American Psychiatric Association, Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and interaction, alongside restricted or repetitive patterns of behavior, interests, or activities. These differences typically appear in early childhood and affect how individuals perceive and interact with the world around them. The term “spectrum” acknowledges the wide variation in challenges, strengths, and support needs among autistic individuals. Common features include differences in understanding social cues, sensory sensitivities or seeking behaviors, preference for routines, deep focused interests, and distinctive communication styles.
Many autistic individuals experience co-occurring conditions such as anxiety disorders, depression, eating disorders, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or sensory differences in processing that can significantly impact daily functioning and quality of life. Importantly, autism spectrum disorder (ASD) is increasingly understood as a form of neurodivergence rather than a mental disorder, representing natural human variation in cognitive and sensory processing. This perspective recognizes that autistic individuals often possess unique strengths such as pattern recognition, attention to detail, honesty, and creative thinking, while also acknowledging the genuine challenges that can arise from navigating a world designed primarily for neurotypical experiences.
EMDR Therapy For Autistic Clients
Eye Movement Desensitization and Reprocessing (EMDR) therapy can be a highly effective therapeutic approach for individuals with an autism diagnosis, particularly in addressing memories of traumatic events, anxiety, and sensory-related psychological distress. Many autistic individuals experience heightened sensitivities, social challenges, and a greater likelihood of encountering traumatic experiences, such as bullying or medical trauma.
EMDR treatment can help reprocess distressing memories in a way that feels safe and structured, reducing emotional overwhelm and fostering resilience. By tailoring EMDR therapy techniques to accommodate sensory needs, communication styles, and cognitive processing differences, EMDR therapists can create a more accessible and effective healing experience for clients with Autism Spectrum Disorder (ASD).
Autistic Children
For autistic children, Eye Movement Desensitization and Reprocessing (EMDR) therapy can be thoughtfully adapted to address emotional dysregulation, anxiety, challenging behaviors, and traumatic experiences while respecting their unique sensory and processing needs. The bilateral stimulation component may be modified using tactile tapping or auditory tones rather than eye movements when visual tracking is challenging. Using EMDR with autistic children to process overwhelming sensory experiences, social difficulties, or bullying incidents that may have created emotional distress without requiring extensive verbal expression, making it accessible for those with communication differences.
When implemented by EMDR therapists knowledgeable about autism spectrum disorder (ASD), EMDR treatment sessions can be structured with predictable routines, visual supports, and sensory accommodations to create a safe environment to minimize adverse events. This approach may help children develop improved emotional regulation strategies, reduce challenging behaviors triggered by specific stimuli, and build resilience against social challenges while honoring their neurodivergent perspective.
Autistic Adults
For adults with Autism Spectrum Disorder (ASD) diagnoses, Eye Movement Desensitization and Reprocessing (EMDR) therapy offers a processing-focused approach that can address accumulated experiences of rejection, masking-related exhaustion, and trauma-related symptoms from navigating a predominantly neurotypical world. Many autistic people carry emotional wounds from years of being misunderstood, pathologized, or forced to suppress their natural ways of being, which EMDR treatment can help reprocess and integrate with less emotional distress.
EMDR with autistic individuals emphasizes internal experiences rather than social performance which may feel more accessible than traditional talk therapies that rely heavily on neurotypical communication styles. EMDR therapy can specifically target anxiety around social situations, sensory overload experiences, executive functioning challenges, and internalized ableism that contributes to depression and low self-worth. For late-diagnosed adults with autism spectrum disorder, EMDR therapy may help process complex emotions around missed opportunities and “lost time” before their diagnosis, facilitating greater self-acceptance and the development of an authentic autistic identity free from shame.
The Eight Phases of EMDR for Autism Treatment
The eight structured phases of Eye Movement Desensitization and Reprocessing (EMDR) therapy provide a systematic framework that can be adapted to address the unique challenges faced by individuals with an autism spectrum disorder diagnosis. When tailored to accommodate sensory sensitivities, communication preferences, and processing styles of autistic clients, EMDR therapy can help process distressing experiences, reduce anxiety, and build emotional regulation skills. These phases offer a predictable therapeutic structure that many autistic individuals find comforting while targeting specific difficulties that impact their daily functioning.
Phase 1: History Taking and Treatment Planning Phase
In this initial phase, the EMDR therapist gathers information about the autistic individual’s history, including sensory sensitivities, communication style, special interests, and specific triggers. For autistic people, this phase may involve adapting assessment methods to accommodate communication differences, using visual supports, and allowing for written responses when verbal communication is challenging. The EMDR therapist identifies potential targets for processing, which might include experiences of bullying, sensory overwhelm incidents, social rejection, or meltdown episodes that continue to cause distress. Collaborating with the client (and their caregivers, when appropriate), the EMDR therapist develops a treatment plan that incorporates autism-specific considerations and strengths-based approaches.
Phase 2: Preparation Phase
The preparation phase focuses on building resources and skills needed for effective EMDR processing while establishing a therapeutic relationship that respects autistic neurology. When using EMDR treatment with autistic individuals, this phase may be extended to ensure they fully understand the process and feel comfortable with the bilateral stimulation methods, which can be customized based on sensory preferences. The EMDR therapist teaches self-regulation techniques that align with the individual’s ideal processing styles, such as concrete grounding exercises, special interest-based calming strategies, or visual relaxation tools that can help clients maintain emotional stability during and between sessions.
Phase 3: Assessment Phase
During the assessment phase, the Eye Movement Desensitization and Reprocessing (EMDR) therapist helps the individual identify specific memories or traumatic events to process, along with associated negative beliefs, emotions, and physical sensations. For autistic individuals who may struggle with alexithymia (difficulty identifying emotions), therapists might use visual emotion scales, body mapping techniques, or concrete examples to help identify how distress manifests. The therapist works with the client to establish a baseline Subjective Units of Distress (SUD) scale that makes sense to them, possibly using special interests or concrete numerical ratings rather than abstract emotional descriptions, and identifies positive beliefs they would like to strengthen.
Phase 4: Desensitization Phase
In the desensitization phase of EMDR therapy, the client focuses on the target memory or situation while engaging in bilateral stimulation, allowing the brain to process distressing experiences in new ways. For autistic individuals, therapists may need to modify the pace and intensity of bilateral stimulation to accommodate sensory sensitivities, perhaps using slower eye movements, gentler taps, or adjusting the volume of auditory tones.
This phase of EMDR therapy helps autistic individuals process overwhelming sensory experiences, social traumas, or emotionally adverse events that may have become “stuck” in their nervous system, gradually reducing the emotional charge associated with these experiences and creating new neural pathways for understanding them.
Phase 5: Installation Phase
The installation phase of the EMDR protocol strengthens positive beliefs to replace the negative cognitions that were previously connected to the distressing memory. For autistic clients, these positive beliefs may focus on self-acceptance (“I’m fine being autistic”), capability (“I can handle sensory challenges”), or social worth (“I deserve respect even when I communicate differently”). The EMDR therapist uses bilateral stimulation while the autistic client holds both the memory and the positive belief in mind, helping to strengthen neural connections between the experience and new, more adaptive understandings that support autistic identity and self-advocacy rather than masking or self-criticism.
Phase 6: Body Scan Phase
During the body scan phase of Eye Movement Desensitization and Reprocessing (EMDR) therapy, the client identifies any remaining physical tension or discomfort when thinking about the target memory, addressing somatic components of distress. This phase of the EMDR protocol is particularly important for autistic individuals who may experience intense physical manifestations of stress and anxiety, such as stomach pain, muscle tension, or sensory discomfort. By bringing awareness to these physical sensations and processing them with bilateral stimulation, autistic clients can develop improved interoceptive awareness (internal body awareness) and reduce physical symptoms that often accompany emotional distress, helping to prevent meltdowns and shutdown states.
Phase 7: Closure Phase
The closure phase of EMDR therapy ensures the client feels stable and grounded at the end of each session, particularly important if processing is incomplete. For autistic clients, clear session endings with predictable closure rituals provide necessary structure and security. The EMDR therapist might incorporate the client’s special interests into containment exercises or create visual reminders of coping strategies to use between sessions. Therapists may also provide more concrete instructions about what to expect between sessions, as autistic individuals might benefit from explicit rather than implied guidance about self-care and emotion management until the next appointment.
Phase 8: Reevaluation Phase
In the reevaluation phase of Eye Movement Desensitization and Reprocessing (EMDR) therapy, the EMDR therapist assesses the client’s progress at the beginning of subsequent sessions, determining if treatment gains have been maintained. For autistic clients, this phase of EMDR therapy might include concrete measures of improvement such as frequency of meltdowns, ability to engage in previously triggering activities, or specific behavioral changes rather than focusing solely on emotional shifts.
The therapist also identifies any new processing targets that may have emerged, such as new social challenges or sensory triggers, and adjusts the treatment plan accordingly, ensuring that therapy continues to address the most significant impacts of autism on the individual’s daily functioning and well-being.
Choosing an EMDR Therapist
When seeking an EMDR therapist for an autistic person, look for someone with specialized knowledge in both EMDR therapy and autism spectrum disorder. The ideal therapist should have completed at least basic EMDR training through EMDRIA (EMDR International Association) while also possessing substantial understanding of autism spectrum disorder beyond stereotypes. During initial consultations, ask about their specific experience working with autistic individuals and how they adapt the standard EMDR protocol to accommodate different trauma processing styles, sensory needs, and communication preferences.
A qualified therapist should demonstrate flexibility and patience rather than rigidly delivering EMDR therapy in strict adherence to standardized approaches. They should be willing to modify EMDR treatment methods based on sensory preferences, extend preparation phases when needed, and adjust assessment techniques to accommodate different ways of processing information. Additionally, they should understand that autistic individuals may experience trauma symptoms that don’t meet conventional PTSD criteria but still benefit from processing.
The therapeutic relationship is particularly important, so pay attention to how comfortable the autistic individual feels with the therapist. The right therapist will communicate clearly, avoid assumptions, and adapt their language and interaction style to match the client’s needs. They should be willing to take time to build rapport and understand the client’s unique autism presentation rather than rushing toward trauma processing.
Seek out therapists who actively participate in autism training, research, or communities. Ask about their clinical practice and whether they have access to consultation with other EMDR therapists working with autistic clients. An ideal EMDR therapist will acknowledge the limitations of their knowledge and be committed to ongoing learning about autism while maintaining an attitude of genuine curiosity and respect for autistic perspectives and experiences.
How Do I Pay For EMDR Therapy?
At Balanced Mind of New York, we offer multiple payment options to fit your needs and budget.
In-Network Insurance Provider: Balanced Mind of New York is proud to be an in-network provider for clients covered by Aetna insurance plans.
Out-of-Network Insurance Provider: For all other insurances, we provide superbills for reimbursement. We will contact your insurance company to confirm your eligibility and benefits, including the reimbursement rate for each session. We will also guide you through the process of sending superbills to your insurance.
If you have an out-of-network plan, any reimbursements will be sent directly to you from your insurance provider. Insurance typically reimburses 50-80% of the fee, but note that each policy is different.
Self-Payment Options: If no insurance coverage is available, clients may choose to pay for services out of their own pocket. If you need to pay out of pocket, we offer a sliding scale as part of our commitment to providing affordable care.
We accept Visa, MasterCard, Discover, American Express, and HSA/FSA cards.
Contact Balanced Mind of New York to learn more about your payment options and take the next step on your healing journey.
