Dual Attention Stimuli


During phases 4 through 6 of EMDR1 clients focus on their distressing or desired experiences at the same time as they attend to a dual attention stimulus.

Eye movements are the most commonly used dual attention stimulus, but tapping, tactile stimulation, and auditory tones are also used2. These are usually presented in an alternating bilateral fashion – e.g., first to one ear, then the other, then the first ear, etc.

It is thought that the dual attention component of EMDR facilitates information processing but, as with all forms of psychotherapy, the underlying neurobiological reason for these effects are unknown although a variety of neurobiologists have proposed mechanisms of action.3,4,5 Currently there is research support for working memory theories and the orienting response. A number of studies have indicated that the eye movement reduce emotional distress and memory vividness or enhance recall.6,7,8,9,10,11,12

For more information, see the following topics in the Commonly Asked Questions section:

  • Are eye movements considered essential to EMDR?
  • What has research determined about EMDR's eye movement component?
  • Do eye movements contribute to outcome in EMDR?
  • What are some hypothesized mechanisms of action for eye movements in EMDR?


1Shapiro, F., (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edition). New York: Guilford Press

2Shapiro, F., (1991). Eye movement desensitization & reprocessing procedure: From EMD to EMDR--a new treatment model for anxiety and related traumata. Behavior Therapist, 14, 133-135.

3 Siegel, D. J., (2002). The developing mind and the resolution of trauma: Some ideas about information processing and an interpersonal neurobiology of psychotherapy. In F. Shapiro [Ed.]. EMDR as an Iintegrative Psychotherapy Approach; Experts of diverse orientations explore the paradigm prism. Washington, D.C.: American Psychological Association Books.

4Stickgold, R. (2002). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58, 61-75.

5van der Kolk, B. A. (2002). Beyond the talking cure: Somatic experience and subcortical imprints in the treatment of trauma. In F. Shapiro (Ed.), EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

6Andrade, J., Kavanaugh, D., & Baddeley, A. (1997). Eye-movements and visual imagery: a working memory approach to the treatment of post-traumatic stress disorder. British Journal of Clinical Psychology, 36, 209-233.

7Barrowcliff, A.L., Gray., N.S., MacCulloch, S., Freeman, T.C.A., & MacCulloch, M.J. (in press). Horizontal rhythmical eye-movements consistently diminish the arousal provoked by auditory stimuli. British Journal of Clinical Psychology.

8Christman, S.D., Garvey, K.J., Propper, R.E., & Phaneuf, K.A. (in press). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology.

9Kavanagh, D.J., Freese, S., Andrade, J., May, J. (2001). Effects of visuospatial tasks on desensitization to emotive memories. British Journal of Clinical Psychology, 40, 267-280.

10Kuiken, D., Bears, M., Miall, D., & Smith, L. (2001-2002). Eye movement desensitization reprocessing facilitates attentional orienting. Imagination, Cognition and Personality, 21, (1), 3-20.

11Sharpley, C.F., Montgomery, I.M., & Scalzo, L.A. (1996). Comparative efficacy of EMDR and alternative procedures in reducing the vividness of mental images. Scandinavian Journal of Behaviour Threapy, 25, 37-42.

12van den Jout, M., Muris, P., Salemink, E., & Kindt, M. (2001). Autobiographical memories become less vivid and emotional after eye movements. British Journal of Clinical Psychology, 40, 121-130