Using EMDR for Grief and Complicated Bereavement

Most grief resolves on its own, given time and support. Some of it doesn't — a client stays stuck, the loss feels as raw at month eighteen as it did in week one, and standard grief counseling isn't moving the needle. EMDR has a growing evidence base for exactly this kind of complicated, prolonged grief. Here's how it approaches the work, what the research actually shows, and what's worth checking before you start.

When grief becomes something EMDR is built for

Most bereaved people move through grief without it becoming a clinical concern. But a meaningful minority don’t: an estimated 7 to 10 percent of the bereaved population goes on to develop Prolonged Grief Disorder, a persistent and impairing grief response linked to higher rates of further mental health difficulties, sleep disturbance, and reduced work and social functioning (Eye Movement Desensitisation and Reprocessing therapy for prolonged grief, PMC).

That distinction matters clinically. Straightforward grief usually responds well to support, psychoeducation, and time. Prolonged or complicated grief — where the loss stays acutely disruptive well past what’s typical, or where trauma is tangled up in how the death occurred — is where EMDR has something specific to offer that general grief counseling sometimes doesn’t.

Why EMDR fits the mechanics of grief

EMDR’s rationale for grief work rests on two frameworks used together. The Adaptive Information Processing model treats blocked processing — a memory that hasn’t been fully integrated — as the reason certain material stays distressing indefinitely rather than settling with time. The Dual Process Model of grief, separately, describes healthy mourning as an oscillation between loss-oriented work (feeling the pain of the loss directly) and restoration-oriented work (rebuilding a life around the absence). Combined, the case for EMDR is that unprocessed traumatic material connected to a death — how the person found out, images from the moment of loss or its aftermath, guilt-laden self-blame — can block that healthy oscillation from happening at all (PMC).

In practice, that means EMDR grief work often targets more than the loss itself: the phone call, the hospital room, the moment of identification, a particular image that intrudes — the trauma-adjacent memories sitting inside the larger loss, rather than “the death” as one undifferentiated target.

What the research shows

The evidence base here is smaller than EMDR’s PTSD literature, but it’s genuinely encouraging. In studies of people meeting criteria for complicated grief, two-thirds to over 70 percent showed reliable, clinically significant improvement on grief measures by the end of treatment. One trial found EMDR reduced symptoms faster than an exposure-based grief intervention — a median of 8 sessions compared with 13 — while producing comparable results to cognitive behavioral therapy on measures of grief, trauma, and general distress (PMC).

The same review is upfront about the limits: the studies so far tend to have small samples and limited follow-up, and direct comparison against Complicated Grief Treatment — currently the most established specialist intervention — is still thin. Read it as a genuinely promising, still-developing evidence base rather than a settled verdict, in the same honest spirit as the wider research on remote EMDR.

What to check before starting

EMDRIA’s guidance is direct about readiness: grief work with EMDR isn’t something to start in the earliest, rawest weeks after a loss, and it depends on the client having enough coping capacity to stay present with intense emotion without becoming overwhelmed by it (EMDRIA). A few practical checkpoints follow from that:

• Confirm stabilization first. A client who can’t yet access a grounding resource or tolerate moderate distress isn’t ready to target the most acute material. Our calm place resourcing piece covers building that resource before reprocessing starts.
• Watch arousal closely during targeting, especially early on — grief material can swing a client toward flooding faster than some trauma targets do. The window of tolerance is a useful frame for tracking this moment to moment, and it’s worth double-checking over video specifically, where some of the usual physical cues are harder to read.
• Separate complicated grief from unresolved suicidality or safety risk during screening, and have a plan for either before targeting begins. Our screening and informed consent guide covers what’s worth walking through with a client before starting online EMDR generally.
• Expect sleep to be part of the picture. Disrupted sleep is common in prolonged grief and often improves as the underlying distress does — our piece on EMDR for nightmares and sleep problems covers that connection in more depth if a client’s grief is showing up heavily as insomnia or disturbing dreams.

Delivering this work remotely

Grief sessions can run long and carry real emotional weight, which makes the mechanics of the session — a stable connection, a dot that tracks smoothly, sound that doesn’t cut out mid-set — matter more than usual. A CloudEMDR Pro Remote Session sends your client a dedicated link so the bilateral stimulation renders cleanly on their device while you keep full control and a timer on yours, one less thing to manage during an already demanding session.