EMDR for Grief: Where Trauma Processing Fits in Prolonged and Traumatic Grief
Last reviewed: 10/03/2026
Reviewed by: Dr. Kiesa Kelly
It has been more than a year. Some people tell you that you should be further along by now. When you search for help, you find EMDR clinics describing it as the answer for grief, and you wonder whether reprocessing a memory could loosen something that time has not. You may also wonder whether, if EMDR does not work for you, anything will.
Here is the honest answer about EMDR for grief. EMDR may help some grieving people, and it is most clearly indicated when a death has left PTSD symptoms, such as memories that still feel like they are happening now. But for grief that has stopped moving, the treatments with the strongest evidence are grief-specific therapies, and EMDR's evidence in grief is small and early. Knowing which problem you have is what tells you where to start.
In this article, you'll learn:
What prolonged grief disorder is, in one paragraph, and where to read more
Three misconceptions about EMDR and grief
Why sudden, violent, or traumatic losses are more likely to get stuck
What grief-specific therapy involves, and how strong its evidence is
Where EMDR fits, what the research shows, and what it cannot do
A practical way to decide what to try first
Prolonged grief disorder in one paragraph
Prolonged grief disorder is a diagnosis for grief that stays intense and disabling long after a death. Its core symptoms are yearning for the person, preoccupation with them, or both, along with emotional pain, a disrupted sense of identity, a loss of meaning, and trouble functioning [1]. In the US diagnostic manual, the DSM-5-TR, at least 12 months must have passed since the death for adults; the World Health Organization's ICD-11 uses 6 months [2]. Our post on grief versus depression covers the full criteria, how clinicians tell prolonged grief apart from depression, and what an assessment looks like. This post picks up where that one leaves off: what treatment to try, and where trauma processing fits.
Three misconceptions about EMDR and grief
"EMDR is the proven treatment for grief." EMDR is a recommended treatment for PTSD [9]. For prolonged grief, the evidence is thinner. A 2024 review that is itself enthusiastic about EMDR for grief notes that the research so far has not examined EMDR specifically in people who meet the diagnostic criteria for prolonged grief disorder, that most studies were small, and that none has compared EMDR with complicated grief treatment (now called prolonged grief disorder therapy), the grief therapy with the most evidence [10]. EMDR may well help. "Proven for grief" goes further than the research does.
"Grief therapy just means talking about the person." Grief-specific therapies are structured. Prolonged grief disorder therapy, formerly called complicated grief treatment, is a manualized program of about 16 sessions that works on both accepting the loss and rebuilding a life [2][3]. Its themes include telling the story of the death, learning to live with reminders, connecting with memories, and planning for the future [3].
"If I process the trauma, the grief will take care of itself." Grief and trauma overlap, but they are not the same problem. A 2021 review of treatments aimed at both, summarized in a 2024 review, found that effects tended to be larger for post-traumatic stress than for grief symptoms [2]. Clearing the frightening memories can open the way for grieving. It does not always do the grieving for you.
🧭 Key takeaway: EMDR and grief-specific therapy aim at different targets. The question is not which is better in general, but which problem is in the way for you.
Why some losses get stuck: sudden, violent and traumatic loss
Traumatic losses carry a higher risk of prolonged grief. A meta-analysis of studies of people bereaved by accidents, disasters, suicide, or homicide found that, across studies, nearly half had probable prolonged grief, with wide uncertainty around that estimate and big differences between studies [4]. Rates were higher after violent killings and the death of an only child, and lower as more time passed [4]. The authors caution that the studies varied widely in method [4], so treat the number as a signal of risk, not a forecast for you.
Part of the reason is that two processes can tangle together. Prolonged grief and PTSD, the condition a checklist like the PCL-5 screens for, share some features, including intrusive images, avoidance, and emotional numbness. But they differ in important ways. In PTSD the dominant emotion is fear; in prolonged grief it is yearning and sadness. In PTSD, avoidance is about safety; in prolonged grief, it is about avoiding painful reminders that the loss is real [3]. After a violent or accidental death, the content of the intrusions can overlap, and both processes can be running at once [3].
Picture a man whose brother died in a highway crash. He was the one who got the call, and he drove to the hospital. Eighteen months later, the call still replays several times a day: the officer's voice, the corridor, the curtain being pulled back. He cannot drive past that exit. His heart pounds when his phone rings late in the evening. When he thinks about his brother, he cannot get to the memories of their childhood or their last fishing trip, because the hospital scene gets there first. His grief is real, but fear is standing in front of it.
Or: a woman whose mother died at home after a long illness, with hospice and family around her. There was nothing frightening about the death itself. Two years later, she still sets out two cups in the morning before she remembers. She has stopped seeing the friends they shared, and she feels as if her own life ended in that room. When reminders come, she feels a wave of longing, not alarm. Her grief is stuck, but not because of a traumatic memory.
Or: a father whose adult daughter died by suicide carries both. He replays finding her, and he also replays their last phone call, when he cut the conversation short. The first memory brings terror; the second brings guilt and an aching wish to have said something else.
No study has tested which treatment should come first, so what follows is a clinical rule of thumb, not a research finding. It builds on the differences between PTSD and prolonged grief described above [3].
The distinguishing pattern: when fear, startle, and intrusive images of how the person died dominate, trauma processing is often the first door. When yearning, avoidance of reminders, and difficulty restarting life dominate, grief-specific work usually comes first. When both are present, a plan may need to address both.
🌊 Key takeaway: Ask what keeps coming back. Scenes of the death and a sense of danger point toward trauma. Longing and a life that has not restarted point toward grief.
What actually helps
Grief-specific therapy first: what it involves
The treatments with the most evidence for prolonged grief are grief-focused cognitive behavioral therapies [2]. Many draw on a shared model: prolonged grief is kept going by trouble integrating the reality of the loss, unhelpful beliefs about the loss and one's own grief, and avoidance [2]. Prolonged grief disorder therapy also draws on a model in which healthy grieving moves back and forth between facing the loss and rebuilding life [2]. Most include some mix of exposure, cognitive restructuring, and behavioral activation [2].
The best known is prolonged grief disorder therapy. In its first randomized trial [2], 95 adults with complicated grief received 16 sessions of either this grief-specific treatment or interpersonal psychotherapy, an established depression therapy. Both helped, but 51% responded to the grief-specific treatment compared with 28% for interpersonal therapy, and responses came faster [5].
Broader reviews are broadly consistent. A 2024 meta-analysis of 22 trials with 2,602 bereaved adults found that grief-focused CBT had a medium effect on prolonged grief symptoms right after treatment and a large effect at follow-up, based on fewer trials (7), while cautioning that the studies varied a lot [6]. A 2025 network meta-analysis of 40 trials found that the most effective treatments included elements of exposure, social support, narrative reconstruction, artistic expression, and a cognitive-behavioral approach [8].
Two honest caveats. First, even in successful trials, roughly half of participants still have clinically significant symptoms after treatment [2]. Second, grief-focused CBT appears to work less well when the death was sudden, unexpected, or violent, possibly because grief and trauma reactions are tangled together [2]. That second point is exactly where trauma processing comes in.
📋 Key takeaway: Grief-specific therapy has the strongest evidence for prolonged grief, but it appears to help less after sudden or violent deaths, and many people still have symptoms afterward.
Where EMDR fits
EMDR is one of three therapies the 2023 VA/DoD guideline recommends for PTSD, alongside prolonged exposure and cognitive processing therapy [9]. If a loss left you with PTSD, those recommendations apply to you. Our overview of what EMDR helps with and what to expect covers how the process works.
For grief itself, the trials are few and small:
EMDR versus a brief CBT program for grief. In a small randomized trial of 19 people who said they were struggling with grief (not diagnosed with prolonged grief disorder), both EMDR and a 7-session integrated CBT program reduced grief, trauma symptoms, and distress, and neither did better than the other [11]. A trial this small cannot show that the two are equally effective, and follow-up lasted only about two weeks.
EMDR combined with CBT after homicide. In 85 adults bereaved by homicide, an 8-session program combining CBT and EMDR reduced self-rated complicated grief and PTSD symptoms compared with a waitlist [12]. Because the two were combined, the trial cannot show how much EMDR contributed on its own [12].
A mixed result. A review of the field also describes a trial of combined cognitive therapy and EMDR after a plane crash that reduced depression but did not beat a waitlist on grief or PTSD symptoms [10].
There is also a reason to think processing the memory of the death matters. In a 2014 trial, people who added exposure to memories of the death to group CBT improved more than those who added supportive counseling; among those who finished treatment, 15% still met criteria for prolonged grief at follow-up, compared with 38% [7]. This was imaginal exposure within CBT, not EMDR, and a 2024 meta-analysis actually found larger effects for grief CBTs without exposure [2]. Whether processing the memory of the death is essential is still an open question.
🔬 Key takeaway: EMDR's grief trials are small and often combine EMDR with CBT. The results are encouraging, not settled.
In published descriptions of EMDR for grief, targets have included the moment the person heard the news, the death itself, a last argument, earlier losses or trauma that the new loss reopened, present-day reminders, and fears about the future, with later work preparing for anniversaries and holidays [10][11]. Common themes are responsibility ("I should have done more") and doubt about coping ("I can't manage this") [10].
What EMDR for grief can and cannot do
What it may do: in small studies and clinical reports, people describe disturbing memories of the death feeling more distant, less guilt about the loss, and a warmer connection to the person who died [10]. These are early findings, not guarantees. If you are partway through and processing feels stuck, our guide to when EMDR stalls explains what your therapist can do next.
What it cannot do: bring the person back, or make the loss painless. Grief is not a symptom to process away. The goal of treatment, whatever the method, is grief that is painful but bearable, with room to keep a connection to the person and rebuild a life around the loss [2][10].
🧩 Key takeaway: EMDR is best suited to the trauma inside a loss. Grief-specific therapy is best suited to the grief itself. For sudden or violent deaths, a plan may need to address both. Whether combining them works better than either alone has not yet been tested [12].
When to get evaluated
If you are wondering whether your grief has turned into something more, our grief versus depression guide, linked above, walks through the signs and the 12-month question in detail. A few practical rules can help you choose a starting point:
If the scene of the death, the phone call, or the hospital keeps intruding, and reminders feel dangerous, ask for a trauma evaluation. A PTSD checklist such as the PCL-5 can be a useful starting point, and trauma-focused therapy, including EMDR, may be the first step.
If longing, avoiding reminders, and not being able to restart life are the main problems, ask specifically for grief-focused therapy, such as prolonged grief disorder therapy or grief-focused CBT.
If both are true, ask how the plan would address both, and in what order.
If you mostly feel flat, hopeless, or worthless, not just sad about the person, depression may be part of the picture. The PHQ-9 can help you describe it, and depression is treatable whatever the cause.
Do not wait for a date on the calendar if you cannot function, or if you are having thoughts of not wanting to be alive. Prolonged grief is associated with higher rates of suicidality [1]. Call or text 988 to reach the Suicide and Crisis Lifeline at any time, or call 911 if you might act on these thoughts.
Questions worth asking a provider before you book:
Method: "Do you offer a grief-specific therapy, such as prolonged grief disorder therapy or grief-focused CBT, or only EMDR?"
Sequencing: "How will you decide whether to start with trauma processing or with grief work, and how will we know if it is working?"
Targets: "If we use EMDR, which memories would we work on, and how do you keep my connection to the person intact?"
Fit: "If grief-focused therapy is the better first step for me, can you provide it, or will you help me find someone who does?"
Our specialized therapy services include trauma-focused care, including EMDR. If grief-focused therapy is the better first step for you, we will tell you, and help you find the right fit.
Next step - getting support
Grief that has stopped moving is not a failure of love or effort. Sometimes it is held in place by a frightening memory, and sometimes by a life that has not had room to restart. Trauma-focused therapy such as EMDR is aimed at the first; grief-specific therapy has the strongest evidence for the second; and after a sudden or violent loss, a plan may need to address both. The most useful next step is an evaluation that looks at which problem is in the way, so treatment starts in the right place.
Carrying something that still feels close?
Trauma-focused care — including approaches like EMDR — can help you process what happened at a pace that feels safe, with a clinician who understands trauma responses.
Frequently Asked Questions
Can EMDR therapy help with grief after a death?
It may help some people. EMDR is a recommended treatment for PTSD, so it is most clearly indicated when a loss has left PTSD symptoms. For grief itself, the research is encouraging but small, often combines EMDR with CBT, and has not yet focused on people formally diagnosed with prolonged grief disorder. For yearning and difficulty restarting life, grief-specific therapy has stronger evidence.
What is the most effective therapy for prolonged grief disorder?
Grief-focused cognitive behavioral therapies currently have the strongest evidence, including prolonged grief disorder therapy, formerly called complicated grief treatment. A 2024 meta-analysis of 22 trials found medium effects right after treatment and larger effects at follow-up, with caveats about study quality. Many people still have significant symptoms afterward, so the field is still looking for better options.
When is grief treated as trauma?
When the way the person died keeps intruding: images of the scene or the phone call, fear, a startle response, or avoiding places because they feel dangerous rather than just painful. Those features overlap with PTSD, and if PTSD is present, trauma-focused therapies such as EMDR are recommended for it. Without PTSD, the evidence is thinner: a few small trials suggest EMDR can reduce grief symptoms, but grief-focused therapy has stronger evidence for grief itself.
How many sessions does therapy for prolonged grief usually take?
Structured grief therapies are usually time-limited. Complicated grief treatment, now called prolonged grief disorder therapy, was designed as about 16 weekly sessions over roughly four months, and grief-focused CBT trials have averaged about 12 sessions. Trials of EMDR for grief used short programs of 7 to 8 sessions. In practice, length depends on whether both grief work and trauma work are needed, which a clinician can estimate after an evaluation.
About the Author
Dr. Kiesa Kelly is a licensed clinical psychologist and the founder of ScienceWorks Behavioral Healthcare. EMDR is her preferred approach for treating trauma and PTSD, and her trauma training includes EMDR Basic Training and group consultation through VIA EMDR, EMDR for Attachment Injuries with Debra Wesselmann, and the Flash Technique with Philip Manfield, PhD, and Nina Zadurian. Her clinical work centers on differential diagnosis, which is the core question when grief, trauma, and depression overlap.
Dr. Kelly earned her PhD in Clinical Psychology, with a concentration in Neuropsychology, from Rosalind Franklin University of Medicine and Science. She completed practica, internship, and an NIH-funded postdoctoral fellowship at the University of Chicago, the University of Wisconsin, the University of Florida, and Vanderbilt University, and has more than 20 years of experience in psychological assessment. She is a psychologist, not a physician, and does not prescribe medication.
References
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Disclaimer
This article is for informational and educational purposes only and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. Reading it cannot tell you whether you have prolonged grief disorder or PTSD; only a qualified clinician who knows your history can do that. EMDR should be delivered by a trained clinician and is not a self-help technique. If you are in crisis or thinking about harming yourself, call or text 988, or call 911 in an emergency.