Bilateral Tapping in EMDR Therapy

What is bilateral tapping?

Bilateral tapping is a tactile form of bilateral stimulation used in EMDR therapy. The therapist or client alternates taps on opposite sides of the body — commonly on the knees, the backs of the hands, or the shoulders. This rhythmic left-right stimulation activates the same bilateral processing mechanisms as eye movements. Tapping is one of the three primary BLS modalities recognized in EMDR clinical practice, alongside eye movements and auditory stimulation.

How it works

The therapist taps alternately on the client's knees, hands, or shoulders while the client focuses on a target memory. Each tap set typically lasts 20 to 30 seconds. The alternating tactile input activates both hemispheres of the brain through contralateral somatosensory pathways. Like eye movements, this dual-attention stimulus taxes working memory resources, facilitating the reprocessing of distressing memories. Tapping can also be self-administered: the client taps their own knees alternately or uses the butterfly hug technique.

When therapists choose this technique

Bilateral tapping is used when clients have difficulty with eye tracking, experience discomfort from sustained eye movements, or prefer tactile stimulation. It is common in sessions with children, clients with visual impairments, and clients who dissociate more readily with eyes-open techniques. Tapping is also used in telehealth EMDR sessions where the client self-administers the stimulation under the therapist's guidance.

Strengths and limitations

Strengths

• Accessible for clients who cannot do eye movements
• Can be self-administered for between-session coping
• Grounding tactile sensation helps clients stay present
• Works well with children and in group settings

Limitations

• Physical touch required when therapist-administered (boundary considerations)
• Less researched than eye movements as a standalone BLS method
• Self-administered tapping may be less consistent in rhythm and intensity
• Some clients find repetitive touch distracting rather than calming

Frequently asked questions

Is bilateral tapping as effective as eye movements in EMDR?

Clinical studies suggest that bilateral tapping produces comparable outcomes to eye movements for most clients. A 2007 study by Servan-Schreiber found no significant difference in EMDR treatment outcomes between tactile and visual BLS. However, eye movements have a larger research base. The most important factor is the client's comfort with the method, as therapeutic alliance and engagement strongly influence results.

Can I do bilateral tapping on my own between EMDR sessions?

Yes. Self-administered tapping — such as alternating knee taps or the butterfly hug — is commonly taught as a self-regulation tool for use between sessions. It can help manage acute distress or anxiety in daily life. However, self-tapping should not be used to process traumatic memories without therapist guidance, as this can lead to incomplete processing and increased distress.

What is the ideal tapping speed for bilateral stimulation?

Most EMDR clinicians use a tapping speed of approximately one tap per second on each side, resulting in a full left-right cycle every 1.5 to 2 seconds. The speed should be fast enough to maintain bilateral alternation but slow enough that the client does not feel rushed or overwhelmed. Therapists adjust the pace based on the client's comfort and processing response.