If you are considering EMDR therapy, you may be wondering what actually happens once you are in the room with your therapist. Will you have to describe everything that happened? Will the eye movements begin immediately? What if the memory becomes overwhelming?
An EMDR session is more structured than many forms of talking therapy, but it is not a rigid process carried out in exactly the same way for everyone. The pace and focus should be adapted to you, your experiences and how you respond during the session.
Importantly, EMDR does not usually begin with immediately processing your most distressing memory. The early part of therapy involves understanding what has brought you to EMDR, explaining the process and helping you prepare for the work.
What happens during the first EMDR session?
Your first EMDR session will usually feel more like an assessment and an initial therapy conversation than a processing session.
Your therapist will ask about the difficulties you are experiencing, how they affect your life and what you would like to change. You may discuss relevant past experiences, present triggers and situations that you find difficult.
You should not be expected to describe every traumatic experience in graphic detail. Your therapist needs enough information to understand what you are experiencing and to begin developing a treatment plan, but EMDR does not depend on giving a detailed verbal account of everything that happened.
Your therapist should also explain:
- What EMDR therapy involves
- How bilateral stimulation is used
- What you might notice during processing
- How you can pause or stop at any point
- Possible emotional reactions during and following a session
- How you will work together to keep the process manageable
This is also an opportunity for you to ask questions and decide whether you feel comfortable working with the therapist.
If you are still deciding whether this approach suits you, read Is EMDR Right for Me?
Preparing for EMDR processing
Before working directly with distressing memories, your therapist will usually spend time helping you prepare.
This may include identifying ways to settle your nervous system, stay connected to the present and manage difficult feelings between sessions. Different therapists use different preparation exercises, and these should be adapted to the individual rather than treated as a standard checklist.
Preparation may involve:
- Breathing or grounding exercises
- Noticing physical sensations
- Creating a calming or supportive mental image
- Identifying people, places or activities that help you feel supported
- Practising the bilateral stimulation that may be used later
- Agreeing on a clear signal to pause the process
Some people need relatively little preparation, while others benefit from spending longer developing a sense of safety and stability. Taking longer at this stage does not mean that you are doing EMDR incorrectly or that it will not work for you.
Choosing a memory or target
When you and your therapist agree that you are ready to begin processing, you will identify a particular “target” to work with.
A target is often a distressing memory, but the work may also focus on a current trigger, an upsetting image or a negative belief connected to earlier experiences.
Your therapist may ask you to identify:
- An image that represents the most difficult part of the experience
- A negative belief about yourself connected to it
- What you would prefer to believe about yourself
- The emotions you notice
- Where you feel the distress in your body
- How disturbing the memory feels at that moment
Common negative beliefs might include “I am not safe”, “I am powerless” or “It was my fault”. These beliefs are not assumed by the therapist; they are based on what the experience means to you.
What happens during EMDR processing?
During processing, you will be asked to bring the target memory and its associated thoughts, emotions or physical sensations to mind. At the same time, your therapist will guide you through short sets of bilateral stimulation.
Bilateral stimulation alternates between the left and right sides. It may involve:
- Following the therapist’s fingers with your eyes
- Watching a light move from side to side
- Listening to alternating sounds
- Tapping on alternate sides of the body
Eye movements are commonly associated with EMDR, but they are not the only option. Your therapist can discuss which type of bilateral stimulation feels most comfortable and appropriate for you.
After each short set, the therapist will pause and ask what you notice. An image, thought, emotion, memory or physical sensation may have emerged. Sometimes the change is clear; at other times, very little appears to happen initially.
You are not required to analyse what comes up or decide whether it is relevant. You will usually be encouraged to notice it and allow the process to continue.
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Find Out About EMDR TherapyAre you in control during EMDR?
You remain awake, aware and in control throughout an EMDR session. EMDR is not hypnosis, and a therapist cannot remove a memory or make you reveal something against your will.
You can ask to pause or stop at any point. A therapist should monitor how you are responding and help you remain connected to the present rather than pushing ahead regardless of your level of distress.
Processing can bring up strong emotions, but it is not supposed to become an endurance test. Feeling completely overwhelmed is not evidence that EMDR is “working better”.
You can read more about the precautions and safeguards in “Is EMDR Safe?“
What does successful processing feel like?
The aim of EMDR is not to erase a memory. You should still know that the event happened, but it may begin to feel less immediate, vivid or emotionally charged.
People sometimes notice that:
- The image becomes less clear
- The memory feels further away
- Their physical tension reduces
- A different perspective emerges
- The negative belief feels less convincing
- They can remember the experience without feeling as though it is happening again
The process is not always dramatic. Changes may develop gradually across several sessions, particularly when someone has experienced repeated, complex or childhood trauma.
How does an EMDR session end?
Your therapist should leave enough time to bring the session to a proper close. You may be guided through a grounding or calming exercise and asked how you feel before leaving.
A memory does not have to be fully processed within one appointment. If the work is unfinished, the therapist can help you contain it and return to it during a later session.
At the beginning of your next appointment, you will usually review what you noticed after the previous session. Processing can sometimes continue between appointments through changes in dreams, thoughts, emotions or memories.
Some people feel calm or relieved afterwards. Others feel tired, emotional or more aware of related material for a short time. More information about these experiences is available in EMDR Side Effects
How long is an EMDR session?
EMDR appointments are often 60 to 90 minutes, although the exact duration varies by therapist and service. I offer EMDR intensives, which are longer than 90 minutes.
The number of sessions needed also varies. A single, clearly defined event may require fewer sessions than repeated trauma, childhood experiences or difficulties connected to several periods of a person’s life.
No therapist can responsibly promise an exact number of sessions before understanding your circumstances and how you respond to treatment.
Does every appointment involve eye movements?
No. EMDR is a complete therapeutic approach, not simply a technique involving eye movements.
Some appointments may focus on assessment, preparation, reviewing changes, strengthening coping resources or deciding what to work on next. Your therapist may also slow down or temporarily pause processing if something changes in your life or additional support is needed.
This flexibility is an important part of responsible EMDR practice.
A therapist’s perspective
As an accredited psychotherapist and EMDR therapist, I understand that starting EMDR can feel unfamiliar. You do not need to arrive knowing which memory to choose, how to describe it or whether you are “ready enough”.
These are things we explore together. The work should be collaborative, paced carefully and based on what you need—not on forcing you through a predetermined process.
For a broader explanation of the therapy, visit EMDR Therapy: How It Works and Who It Helps
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