Trauma Therapy and EMDR for Adults
Structured trauma processing for adults who have experienced specific traumatic events and are ready to reduce the hold those experiences have on their daily life.
What does trauma therapy help with?
Treatment is most beneficial to people who have experienced a specific, identifiable traumatic event or set of events in adulthood or childhood. That includes:
- Vehicle accidents and serious injuries
- Physical or sexual assault
- Workplace accidents, injuries, or violent incidents
- Witnessing violence or a traumatic event involving others
- Sudden or unexpected loss
- Medical emergencies or traumatic medical experiences
We focus on something intense that happened to you, that your brain and nervous system have not fully been able to let go of yet.
How unresolved trauma can affect the present
The effects of trauma are not always what people expect. Many people assume that if they are not having dramatic flashbacks or reliving events in vivid detail, they must not really be traumatized. In reality, trauma shows up in a wide range of ways, many of them subtle or easily attributed to other causes.
Hypervigilance
Constant scanning for danger. Difficulty relaxing. A persistent sense that something is wrong even when nothing obvious is happening. Startle responses that feel disproportionate.
Intrusive memories
Images, sounds, smells, or other sensory fragments from the event that surface unexpectedly. Distressing dreams. A sense of reliving the experience when something triggers it.
Emotional numbing or shutdown
Feeling disconnected from yourself or others. Difficulty experiencing positive emotions. Going through the motions without feeling present. Pulling back from relationships or activities.
Avoidance
Avoiding places, people, activities, or conversations connected to the event. Sometimes the avoidance is obvious; often it happens gradually and without full awareness.
Persistent negative beliefs
Beliefs that formed in the wake of the event about yourself, others, or the world — “I should have done something,” “I’m not safe anywhere,” “I can’t trust my own judgment.”
Physical effects
Tension, chronic pain, fatigue, sleep disruption, and other physical symptoms that are connected to nervous system activation rather than purely physical causes.
If several of these sound familiar and you can connect them, even loosely, to something that happened, that connection is worth exploring in therapy.
What trauma therapy may look like
Trauma therapy is not a single fixed approach. How we work depends on what happened, how your nervous system is responding, and where you are in terms of readiness for active processing work. In general, trauma treatment moves through a rough sequence:
-
Safety and stabilization
Before any active trauma processing, we make sure you have an established foundation. This includes understanding your history, building your capacity to tolerate distress without being overwhelmed by it, and making sure you have enough stability in your daily life to support the work. This can include relaxation skills, DBT and mindfulness tools, or structured methods like STAIR or Seeking Safety.
-
Trauma processing
This is the active phase, working directly with the traumatic memory and its current effects. EMDR and IFS are the primary methods I use here. The goal is to reduce the emotional and physiological charge the memory carries, not to erase it or reach a specific emotional state about it. Processing a memory changes how it is stored and accessed.
-
Integration
Integration involves consolidating what has changed, addressing the beliefs and patterns that formed around the trauma, and building forward rather than staying focused on the past. It is about connecting to a new way of living life.
Not everyone enters therapy at the same point in this sequence. Some people have already done a lot of work and are ready for active processing relatively quickly; others need more time at the stabilization phase before it is appropriate to proceed. Pacing matters, and it is something we assess together as the work unfolds.
What is EMDR therapy?
EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based therapy for trauma that uses bilateral stimulation — typically eye movements, tapping, or auditory tones — to help the brain reprocess distressing memories in a way that reduces their emotional charge. Ryan DeCook is an EMDRIA Certified therapist, meaning he has completed advanced training and supervised hours beyond basic EMDR training requirements.
EMDR is not a new approach. It has been researched extensively since the late 1980s and is recognized by the American Psychological Association, the World Health Organization, and the Department of Veterans Affairs as an effective treatment for PTSD and trauma-related conditions.
A note on how it works: EMDR does not erase memories or require you to revisit trauma repeatedly. The goal is to help the brain process a memory that got “stuck” — stored in a way that keeps triggering the nervous system as if the event is still happening. After processing, the memory typically still exists but no longer carries the same mental, emotional, and physical charge.
What kinds of trauma can EMDR help with?
EMDR is most effective for trauma rooted in specific events — experiences with a clear beginning that the brain has not fully processed. This includes:
- Vehicle accidents and traumatic injuries
- Physical or sexual assault
- Workplace accidents, violence, or near-death experiences
- Sudden loss of someone close
- Witnessing traumatic events
- Medical emergencies, traumatic procedures, or intensive care experiences
EMDR can also address the cumulative effects of repeated difficult experiences, though the approach and pacing may differ from single-event trauma work.
What happens in an EMDR session?
EMDR sessions are structured but not scripted. After thorough preparation work, a typical processing session involves:
- Identifying the specific memory or aspect of the event to focus on
- Noting the associated images, negative beliefs, body sensations, and emotional distress level
- Engaging in sets of bilateral stimulation (eye movements or tapping) while holding the memory in mind — your brain does most of the work here
- Periodically pausing to notice what has shifted and to track where the processing is going
- Closing the session carefully, ensuring you are grounded before leaving
Sessions are 50–90 minutes depending on where we are in the work. Longer sessions are sometimes used during active processing phases to allow enough time to reach a stable stopping point.
The eight phases of EMDR
EMDR follows a structured eight-phase protocol — which is part of why it has been researched so extensively. The structure protects the client throughout, ensures pacing is clinically appropriate, and makes the method replicable across providers and settings.
-
History Taking & Treatment Planning
The therapist gathers background information and maps out the traumatic memories and targets most connected to your current symptoms. This is not a rapid intake; it is a careful picture of where the work needs to go and in what order.
-
Preparation
Before any trauma processing begins, you develop stabilization skills: tools for managing distress during and between sessions. This phase ensures you will not leave a session flooded with nothing to fall back on.
-
Assessment
A specific memory or trauma target is identified. You note the image that represents it, the negative belief it created about yourself, what you would rather believe, and how distressing it feels right now in your body, measured on a 0–10 scale.
-
Desensitization
This is the active reprocessing phase. Using bilateral stimulation, the brain processes the memory and its associations. Emotional and physiological distress typically drops, sometimes gradually, sometimes in larger shifts. You do not need to narrate what is happening; your brain does most of the work.
-
Installation
The positive belief you identified in Assessment is strengthened using bilateral stimulation. The goal is not only to reduce distress but to replace an old negative self-belief — "I am in danger," "I am powerless" — with something more accurate and adaptive.
-
Body Scan
After processing, you scan your body from head to toe for any remaining tension, activation, or discomfort. If any is found, we address it before ending the session.
-
Closure
Every session ends with a deliberate, structured closure, regardless of where we are in the processing sequence. You leave grounded. This is a non-negotiable part of the protocol, not an afterthought.
-
Reevaluation
At the start of each subsequent session, we review what was processed and check whether the gains from the previous session held between appointments. This guides what to target next and how to adjust the work as it progresses.
Do I have to describe the trauma in detail?
No — This is one of the things that sets EMDR apart from talk therapy approaches. You do not need to narrate everything that happened or repeatedly go through the event in full. What EMDR requires is that you can bring the memory to mind, which is different from talking through it in detail.
Some clients share relatively little verbally about what happened and still do significant processing work. Others prefer to explain more context. The level of verbal disclosure is largely your choice.
How do I know if EMDR is a good fit for me?
EMDR tends to be a good fit when:
- There is a specific traumatic event (or events) that you can identify as connected to your current symptoms
- You have enough stability in your life to tolerate some distress during processing sessions
- You are willing to sit with discomfort in session, knowing we will not leave it unresolved before you leave
EMDR may not be the first step if your current situation involves significant instability (active crisis, severe dissociation, or circumstances that make it difficult to do intensive work safely). In those cases, stabilization work comes first.
Worth knowing: EMDR is not a passive experience. It can bring up significant emotion during sessions. The preparation phase exists for good reason and we will not move into active processing until you have the tools to handle what comes up.
What is IFS therapy?
IFS (Internal Family Systems) is a structured therapeutic approach that views the mind as made up of distinct parts — subpersonalities that each carry their own feelings, beliefs, and protective functions. When something traumatic happens, certain parts take on roles to manage the pain: pushing memories down, keeping you numb, staying hypervigilant, or holding deep shame and self-blame. Those roles made sense when they formed. They can become a problem when they no longer fit your current life.
IFS is used in this work to address what is happening around the trauma, not just the memory itself. That includes the parts carrying fear or shame, the protective parts that have been working hard to keep you functional, and the beliefs about yourself that formed in the wake of what happened. Working with these parts directly tends to shift long-standing patterns more effectively than talking about them.
IFS does not require you to relive what happened. It works by building a relationship between your core Self and the parts that have been impacted — rather than pushing through difficult memories head-on. It is often used alongside EMDR, targeting the internal landscape that EMDR processing does not always reach on its own.
Common questions
Trauma and EMDR therapy FAQ.
How do I know if trauma therapy is right for me?
A useful starting point: do you have a specific experience that you can identify as connected to symptoms you’re experiencing now — whether that’s hypervigilance, avoidance, intrusive memories, emotional numbing, or something else? If the answer is yes, and those symptoms are affecting your quality of life, trauma therapy is likely worth exploring. You do not need to have a formal PTSD diagnosis to benefit from trauma-focused treatment.
Is EMDR the same as hypnosis?
No. During EMDR you are fully awake and alert. You are directing your own attention; the therapist is not suggesting anything to your subconscious. The bilateral stimulation (eye movements or tapping) is thought to activate a process similar to what happens naturally during REM sleep. Your brain consolidates memories and processes emotional information. You remain in control throughout.
What if I’ve been living with this for years — is it too late?
No. Trauma memories do not deteriorate or become untreatable with time the way a physical wound might. In fact, many people find that they are more ready to do this work after some distance from the event. What matters is not how long ago it happened but whether you have the current stability and readiness to engage with the processing work.
Can EMDR be done online or does it require in-person sessions?
EMDR can be delivered effectively via telehealth, and a substantial body of research supports online EMDR. The bilateral stimulation is adapted for screen-based sessions, typically using visual tracking on screen or self-administered tapping. I work with clients in California and Colorado via telehealth.
What if I get too upset during a session?
Emotional activation during EMDR sessions is normal and expected — it is part of how processing works. Before we begin any active processing, you will have grounding tools and we will have established a way to safely close down a session if needed. We never leave a session in an unresolved, activated state. The preparation phase exists specifically to make sure you can handle what comes up.
Can trauma therapy and medication work together?
Yes. Trauma therapy and psychiatric medication are not mutually exclusive and are often used together. Some people find that medication reduces baseline arousal enough to make trauma processing more accessible. I do not prescribe medication, but I can work alongside a prescribing provider.
What states do you serve?
I am licensed as an LCSW in California and Colorado. Telehealth sessions are available to adults throughout both states, including the San Francisco Bay Area, Los Angeles, Denver, and Colorado Springs.
What is the difference between EMDR and talk therapy for trauma?
Talk therapy for trauma typically involves discussing what happened and working through your thoughts, emotions, and reactions verbally over time. EMDR uses a different mechanism: bilateral stimulation (usually guided eye movements) while briefly focusing on a target memory. The goal is to help the brain reprocess a stuck memory so it loses its emotional charge, without requiring an extended verbal retelling of the experience. Both approaches can be effective; they work differently and aren’t mutually exclusive. EMDR tends to be more efficient for single-event trauma and PTSD, and is particularly useful when someone finds it difficult to talk through what happened in detail.
How many EMDR sessions does it take to see results?
It depends significantly on the complexity of what’s being processed. For a single, well-defined traumatic event in someone who is otherwise stable, research shows reprocessing can take 1–6 sessions (not including assessment and preparation). Complex trauma, multiple events, or trauma with significant dissociation or nervous system dysregulation may require considerably more time. Preparation work (building stability and safety before active processing begins) also takes time and varies by person. I won’t rush that phase. I’ll give you an honest read on what the timeline is likely to look like for your situation specifically.
Is EMDR therapy scary or overwhelming?
It can bring up strong emotions including fear related to the memory. That is part of how processing works and typically the intensity decreases as EMDR processing continues. It is not “scary” in the sense of being out of control or unpredictable. EMDR is highly structured, and the preparation phase exists specifically to make sure you have the skills to handle what comes up. Before we begin any active processing, you will have grounding tools, we will have built a therapeutic relationship, and you will understand what to expect. We move at your pace. We do not begin processing until you are ready, and we do not end sessions in an unresolved, activated state. Most clients describe it as more manageable than they expected.
Can EMDR help with anxiety, not just trauma or PTSD?
Yes. While EMDR was originally developed for PTSD and is most extensively researched for trauma, it is increasingly used for anxiety conditions, including panic disorder, social anxiety, and specific phobias, particularly when those conditions have roots in distressing experiences. If anxiety is connected to memories or experiences that feel stuck, EMDR can address that underlying material directly. Not every anxiety presentation is a good fit for EMDR, which is why the initial assessment matters: to determine which approach, or combination of approaches, actually fits your situation.
Also offered
Related services.
Trauma often intersects with panic and, in Colorado, with workers’ compensation cases. These pages may also be relevant.
Get started
Ready to start reducing the hold this has on your life?
A free 15-minute consultation is the first step — a low-pressure conversation to talk about what you’re dealing with and whether this approach makes sense.