What actually happens in an EMDR session
EMDR has eight phases. Here is what each one looks like, so you know what to expect before you start.
EMDR stands for Eye Movement Desensitization and Reprocessing. That is a long name for a fairly simple idea: painful memories can get stuck in the brain, and EMDR helps the brain finish processing them so they stop feeling so raw.
During EMDR, you focus on a hard memory while your attention moves back and forth. You might follow my fingers with your eyes, hear tones in alternating ears, or feel gentle taps on each hand. This back-and-forth is called bilateral stimulation, also referred to as BLS or alternating bilateral stimulation. Researchers are still studying exactly why it helps, but many people find that the memory loses its sting.
The work happens in eight phases. You will not rush through all of them in one visit. Some take a single session, and some take several. Here is what each one looks like.
1. History and planning
We talk about your life and what brought you in, and together we make a plan for which memories to work on. You do not have to share every detail of a memory to work on it.
2. Preparation
Before we go near anything painful, you learn skills to calm and steady yourself, like breathing exercises and mindfulness. We practice them until they feel reliable. We also do imaginal work, which means using your imagination to build inner resources, such as a calm place or a sense of being supported, that you can draw on before, during, and after the desensitization work in phase 4. This is also where trust builds between us. We do not move on until you feel ready.
3. Assessment
You pick a memory to work on. We call this the target. I will ask you to notice the image that represents the worst part of it, the feelings and body sensations that come with it, and the negative belief attached to it, such as “I am not safe” or “I do not deserve to be loved.” Then you rate how upsetting the memory feels on a simple 0-to-10 scale. That number gives us a starting point, so we can both see your progress later.
4. Desensitization
This is the part most people picture when they think of EMDR. You hold the memory in mind while the bilateral stimulation happens, usually for 30 seconds to a few minutes at a time. Between rounds, I check in and ask what came up. We repeat this until the memory’s rating drops to zero or close to it. This can take more than one session, and that is completely normal.
5. A new belief
Once the memory feels less upsetting, you choose a new, true belief to connect with it, for example, “I did the best I could.” Short rounds of stimulation help this new belief settle in.
6. Body scan
Bodies hold on to stress. You bring the original memory to mind and scan yourself from head to toe, noticing any leftover tension or discomfort. We use short rounds of stimulation until your body feels calm too.
7. Closure
Every session ends with time to steady yourself, using the skills you learned in phase 2, so you leave feeling grounded. Your brain may keep processing between sessions. You might notice vivid dreams, strong feelings, or new memories during the week. That is expected. Write them down and bring them to your next session. And if it ever feels like too much, contact me right away. You do not have to wait for your appointment.
8. Checking back in
At the start of the next session, we look at how your week went and re-check the memory we worked on. If it still carries a charge, we keep going. If it feels settled, we decide together what to work on next.
A few honest things to know
EMDR is not hypnosis. You stay awake and in control the whole time.
EMDR should only ever be done with a therapist who has been specially trained in it. It is not something to try on your own.
EMDR works in online sessions too. I offer it both in person and over video, and the bilateral stimulation is adapted for the screen.
You do not have to talk through every detail of what happened for it to work.
It is not a one-session fix. Most people need several sessions, and complicated histories can take longer. That is not a sign it is failing. It is how the work goes.
If you want to read more, the American Psychological Association has a good overview: Exploring the 8 Phases of EMDR.
If you are dealing with trauma or PTSD and wonder whether EMDR might help, I am happy to talk it through with you. There is no pressure to decide anything on the first call.