Your first EMDR session probably won't include any eye movements. It will look a lot like regular talk therapy: your therapist asks about your life, what's bothering you now, and what you want to be different.
That surprises people. EMDR (Eye Movement Desensitization and Reprocessing) is known for the eye movements, so it's easy to assume you'll be reprocessing a hard memory on day one. You won't, and you shouldn't be. There's groundwork to do first.
If you feel much worse after an EMDR session and are thinking about ending your life, call or text 988, call 911, or go to the nearest emergency room.
Understanding EMDR Therapy
EMDR is a structured therapy with eight phases: history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation.
Only some of those phases use bilateral stimulation (BLS), the side to side eye movements, taps, or tones EMDR is famous for. EMDR works as intended when it includes all eight phases. So if your therapist starts BLS on a trauma memory in your first session, we have some concerns.
What to Expect in Your First EMDR Session
Initial Assessment
Mostly, you'll talk. Your EMDR therapist will ask about your life, your current symptoms, and your goals for therapy. They may ask you to tell a short version of your life story, including hard events, mental health struggles, and the things that set you off.
This history usually takes at least the first full session, sometimes more. A good history lets your therapist:
See the whole picture. Good, bad, and neutral experiences all count. Important relationships and events shape how you react today, even ones that don't feel connected to why you came in.
Spot themes. Life events link up in patterns you may not notice from the inside. Your therapist is looking for them.
Find what's been missed. Sometimes people haven't connected a past event to how it still affects them. A thorough history can bring that to light.
Plan the work around you. Knowing the specific events, relationships, and themes lets your therapist aim at the roots of your distress.
Notice your strengths. How you've coped so far tells your therapist what resources you already have to build on.
EMDR history taking has nothing to do with "recovered memory" therapy, the approach that was popular decades ago and then largely dropped. An EMDR therapist should never suggest something happened to you that you don't remember. And you're never hypnotized or out of control at any point in EMDR.
Establishing Safety and Trust
You need to feel safe with your therapist before you process anything hard, and that can't happen in a single session. Telling your history is part of how trust gets built. You may share things you've never told anyone.
So the early sessions shouldn't dive into the most upsetting memories. A good pace feels challenging but doable.
Every kind of therapy, EMDR included, tends to work best when you have a good connection with your therapist. If you're not clicking with someone, don't stay just because they're trained in EMDR. Find someone you trust.
Resourcing and Preparation
This is the phase people most want to skip, and the one that most often decides whether EMDR goes well. Resourcing means building the skills and inner supports you'll lean on when processing gets intense.
EMDR needs some distress to work; if a memory doesn't bother you, there's nothing to process. But there's a limit to how upset you can be and still process well. Resourcing keeps you inside that range.
Depending on what fits you, resourcing may include:
Positive memories. Focusing on moments that bring you comfort or joy.
A supportive team. Imagining nurturing or protective figures with you: family, friends, fictional characters, or spiritual figures.
Breathing exercises and affirmations to bring your distress down.
Things you love. Calling up the feeling of being absorbed in an activity you enjoy.
Some EMDR therapists add bilateral stimulation during this phase to help strengthen positive memories.
Some people need a session or two of resourcing. Others need weeks or months to build the skills to face a lifetime of hard experiences. There's no set timeline, and there's no shame in taking the time you need.
We know you want to feel better fast. We wish there were a magic wand to wave (and some EMDR therapists do use a handheld wand for bilateral stimulation). But jumping into a traumatic memory with no coping skills can retraumatize you. That usually leads to shutting down, derails the work, and sometimes leads people to quit therapy altogether.
In our experience, rushed preparation is the most common reason EMDR doesn't work. Many EMDR therapists skimp on it, maybe because many EMDR trainings move fast through resourcing too. Do not work with an EMDR therapist who skips the first two phases.
If you've already tried EMDR and it didn't help, ask yourself whether you were well resourced and prepared first.
Introduction to Bilateral Stimulation
Before reprocessing, your therapist will explain how bilateral stimulation works and what to expect. It might be eye movements, taps, or tones.
It's okay if it looks and feels silly. EMDR is pretty weird looking. If we hadn't seen it help people time after time, we'd think it was nonsense too. A little skepticism is healthy, as long as you give it a fair try.
Targeting a Memory
Targeting comes after that groundwork. When you get there, you and your therapist choose a specific memory to work on. You might start with the most pressing one, like a specific moment from a single traumatic event. Or you might start with a smaller memory to see how you respond.
Targeting is a set of questions that map the memory, usually without bilateral stimulation:
What the memory means to you, and how it has shaped your beliefs, emotions, and behavior.
The negative belief attached to it. After a car accident, that might be "I'm not safe" or "I'm powerless." You may logically know you're safe, but it doesn't feel true.
How upsetting it is now. You'll rate your distress from 0 (none) to 10 (extreme). Your therapist wants to know how upsetting it is to think about today, which may be different from how upsetting it was then. This number becomes the baseline for tracking progress.
The positive belief you'd like to have, like "I am resilient." It's okay if you don't believe it yet. If you already fully believed it, you might not need EMDR.
Earlier memories linked to this one. Your therapist may ask you to "float back" to older memories with the same feeling. They don't always make obvious sense. A bad breakup might float back to being forgotten at school as a kid; the shared theme is feeling abandoned and alone.
Your job here is to answer honestly and stay with the memory, even when it's uncomfortable.
Trauma Reprocessing
Once targeting is done and you're well resourced, reprocessing begins. Some targets move faster than others, and some take many sessions to chip away at. There's no correct speed.
For a single, simpler event, you'll likely need 6 to 12 sessions. Complex trauma takes longer, and most trauma is interconnected, because your brain is always linking experiences to protect you. Some people process faster than others, especially after a single event like a car accident or a single sexual trauma, and teens often do too. If you don't, you're completely normal.
During reprocessing, your therapist will ask "What do you notice?" many times. There's no wrong answer, and a short, honest one works. We cover how to answer "What do you notice?" during EMDR in a separate post.
What the Early Sessions Should Feel Like
Some discomfort is normal, because trauma is uncomfortable to look at. Your therapist should never be the source of it. If you trust the person you're working with, the hard parts get easier to do.
If you want to start with a team that takes these early phases seriously, see if it's a fit with a free 20-minute consultation.
Preparing for Your EMDR Therapy Session
A few simple things on your end help every session go better, starting with the first one.
Rest and Eat Before the Session
Show up rested and fed. Eating a real meal and drinking water helps your body and mind keep up with the work.
Skip Alcohol and Other Substances
Skip alcohol and other substances before your session. Take your medications as prescribed, and tell your EMDR therapist about all of them, since some can interfere with processing. If you see a psychiatrist, your therapist should coordinate with them.
Mental Preparation
It's normal to feel nervous, and a little doubt about such an odd method is fine. Curiosity helps; full cynicism tends to get in the way.
Some people find it helps to jot down a list of positive memories and relationships before they start. If that's hard to do, that's common for people with trauma histories. Tell your therapist it was hard so they know you need extra support with resourcing.
Bringing Comfort Items
Keep things nearby that help you feel safe and grounded: a favorite sweater, a small meaningful object, your pet. One reason we love doing EMDR online is that you can process from the comfort of home, with familiar surroundings that can make processing easier.
After an EMDR Session
This part applies once processing starts, which shouldn't be your first session. (If it is, your therapist likely skipped the assessment and resourcing phases.)
Your brain keeps working after a processing session, so it makes sense to feel tired, foggy, headachy, or to have strange dreams afterward. It also makes sense to feel completely fine.
Rest and Relaxation. Processing sessions can be draining. Plan something low key afterward and let yourself take it easy.
Gentle Movement. Stretching, yoga, or a walk can help your body work through what came up and release some tension.
Nourishment and Hydration. Keep eating well and drinking water through the rest of the day.
Connecting With Support. Reach out to a friend, family member, or your pet. Easy, warm contact can help you feel grounded.
Creative Outlets. Drawing, painting, or journaling can help you sort through feelings and notice new insights.
Mindfulness and Meditation. A few minutes of mindfulness or meditation can bring you back to the present and steady your emotions.
Avoid Overstimulation. Skip intense movies or hard workouts right after a session. A calm evening gives your brain room to keep processing.
When to Seek Additional Support
If you feel much worse after a session, tell your EMDR therapist as soon as you can. They should adjust the pace or add more support.
If you're in severe distress or having thoughts of suicide, call or text 988, call 911, or go to the nearest emergency room.
EMDR With Us, Online in California and Florida
Your brain keeps changing throughout your life, and EMDR can help you process what's been stuck. We've seen people who never thought they'd feel like themselves again go on to fly, drive, or trust again.
We offer EMDR and trauma therapy online for teens (12 and up) and adults in California and Florida, with a slow, well-resourced start before any processing begins.
Yes, for many people. What named studies say about online EMDR, how bilateral stimulation works on video, and what happens if you get overwhelmed. (146 characters)