Eye movements, alternating sounds, and left–right taps are three ways to deliver bilateral stimulation during EMDR therapy. They engage different senses—and each has practical advantages.
The right choice depends on comfort, accessibility, treatment goals, and the clinician’s assessment. More intense stimulation isn’t necessarily better.
Three methods compared
Eye movements
Following a moving finger, light bar, or dot from side to side.
Useful whenFollowing a visual target feels comfortable. It requires no audio equipment and is the most extensively studied BLS modality.
ConsiderationsMay be uncomfortable for people with eye strain, dizziness, visual tracking difficulties, or screen sensitivity.
Alternating sounds
Short tones or clicks alternating between the left and right ears.
Useful whenEye movements are tiring or impractical. This method lets users keep their gaze still or eyes closed.
ConsiderationsStereo headphones help maintain clear left–right separation. Sounds should remain comfortable, especially with tinnitus or sound sensitivity.
Tapping or vibration
Alternating gentle taps or vibrations on the hands, knees, or other appropriate locations.
Useful whenVisual or auditory input is unsuitable. Some people prefer physical sensations that don’t demand eye or ear attention.
ConsiderationsTouch preferences and sensory sensitivity matter. Tapping should be gentle and comfortable; clinician-delivered touch requires consent.
Which method should you choose?
Consider these practical starting points rather than assuming one method works best for everyone.
What does the research show?
Eye movements have the strongest direct experimental support. Studies have found reductions in the vividness and emotionality of recalled negative memories. Some small clinical experiments found stronger effects with eye movements than with alternating tones.
A 2020 meta-analysis of laboratory experiments also found effects from alternative attention-demanding tasks, with a modest advantage for eye movements in reducing memory vividness. Preliminary research on bilateral vibration suggests it may limit increases in emotionality during repeated memory recall.
The limitation: These findings do not establish which stimulation modality produces the best long-term PTSD treatment outcomes. Laboratory memory effects cannot be equated with full EMDR therapy.
How does DIYEMDR support these methods?
DIYEMDR combines a moving visual orb with optional left–right guiding sounds, allowing you to use visual and auditory bilateral stimulation together. Stereo headphones help distinguish the alternating sounds. Optional soundscapes provide background ambience.
You can also add tactile stimulation yourself. Gently alternate tapping your left and right knees or thighs with the corresponding hands, tap a tabletop with alternating hands, or try the Butterfly Hug: cross your arms over your chest and gently tap your upper arms, one side at a time.
These methods can be used separately or together. If combining them, keep the tapping comfortable and follow a natural left–right rhythm. Exact synchronization isn’t necessary.
More stimulation isn’t necessarily more effective. Start with one method and add others only if they feel comfortable. Stop if you experience discomfort, disorientation, or overwhelming distress. Independent bilateral stimulation is not a substitute for therapist-guided trauma reprocessing.
Research and further reading
EMDR International Association — Terminology and bilateral stimulation
Van den Hout et al. (2012) — Eye movements versus tones
Houben et al. (2020) — Meta-analysis of eye movements and alternative dual tasks