Bilateral Stimulation
Bilateral Stimulation Patterns
An overview of the seven bilateral stimulation patterns used in EMDR — horizontal, vertical, diagonal, circular, infinity, pendulum and smooth random — and when clinicians choose each.
BilateralSync · Updated · 5 min read
Overview
Visual bilateral stimulation can be delivered in several movement patterns. Horizontal is the classical default; vertical, diagonal, circular, infinity (lemniscate), pendulum and smooth random patterns are used to vary the dual-attention task or to accommodate client preference.
What the evidence says
There is limited comparative evidence between patterns. The working-memory account suggests any pattern that reliably taxes working memory during recall will contribute to reprocessing; clinician and client preference generally drive selection.
In practice
In practice, horizontal is the reliable default; infinity introduces additional trajectory complexity and can feel less mechanical; circular is sometimes used for grounding; pendulum offers a gentle, wave-like motion often preferred for closure; vertical and diagonal add axis variety; and smooth random breaks predictability when a client habituates. BilateralSync supports all seven patterns with instant switching mid-session.
Frequently asked questions
- Which pattern should I start with?
- Horizontal is the standard starting point. Switch based on client feedback, comfort or clinical judgement.
This article is general professional information for clinicians. It is not clinical advice and does not replace EMDR training, consultation or individual clinical judgment. BilateralSync is a tool for delivering bilateral stimulation; it is not a treatment or a medical device.