What Happens During EMDR Therapy? Your Complete First-Timer’s Guide

Your therapist just recommended EMDR therapy for your PTSD or trauma. Now you’re Googling at 2am wondering: What actually happens in an EMDR session?

Will I have to relive my trauma? What do the eye movements feel like? Will it hurt?

You’re not alone in these questions. EMDR sounds strange if you’ve never experienced it. Moving your eyes side-to-side while thinking about trauma? It seems almost too simple to work.

Here’s the truth: EMDR therapy is not scary, painful, or re-traumatizing when done correctly. You stay in complete control the entire time. You don’t have to describe your trauma in detail. And yes, those eye movements really do help your brain heal.

In this guide, you’ll learn exactly what happens during EMDR therapy from start to finish. We’ll walk through each phase of treatment, what your first session looks like, what the bilateral stimulation feels like, and how long the process takes.

By the end, you’ll know exactly what to expect—no surprises, no fear of the unknown. Let’s start with the basics.

Understanding EMDR Therapy Before Your First Session

Before diving into what happens during sessions, you need to understand what EMDR actually is.

EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a type of therapy that helps your brain process traumatic memories that got “stuck.”

What Is EMDR Therapy?

When you experience trauma, your brain sometimes can’t process the memory properly. The memory gets stored with all the emotions, physical sensations, and negative beliefs intact. That’s why thinking about it still feels awful years later.

EMDR helps your brain finish processing these memories. The memories don’t disappear, but they lose their emotional charge. You can remember what happened without feeling overwhelmed.

Psychologist Dr. Francine Shapiro discovered EMDR in 1989 somewhat accidentally. She noticed her own distressing thoughts decreased when her eyes moved back and forth while walking. She developed it into the structured therapy used today.

More than 110,000 therapists across 130 countries now use EMDR therapy to help people heal from trauma.

How Is EMDR Different from Regular Talk Therapy?

EMDR works differently than traditional therapy in several important ways.

You don’t have to talk about trauma in detail. Unlike regular trauma therapy, you don’t need to describe your traumatic experience extensively. You can keep it as general as “the thing that happened” or “the car accident.” Your therapist doesn’t need details to help your brain reprocess.

It works faster. According to Cleveland Clinic, processing a single traumatic event typically takes 3-6 EMDR sessions. Complex trauma may take 8-12 sessions or more. That’s still significantly faster than years of traditional therapy.

No homework required. EMDR doesn’t require journaling or assignments between sessions. You might jot down thoughts if you want to discuss them, but there’s no required work outside sessions.

Active brain processing. EMDR activates your brain’s natural healing process rather than just talking about problems. The bilateral stimulation helps your brain reprocess memories the way it should have originally.

What Conditions Does EMDR Treat?

EMDR is proven effective for several mental health conditions.

The American Psychological Association and Department of Veterans Affairs both recognize EMDR as an effective PTSD treatment.

EMDR successfully treats:

• PTSD and Complex PTSD (most researched use)
• Trauma from abuse, assault, accidents, or violence
• Anxiety disorders and panic attacks
• Depression related to traumatic experiences
• Phobias with traumatic origins
• Grief and complicated loss
• Performance anxiety

Now that you understand the basics, let’s walk through exactly what happens during EMDR therapy.

The 8 Phases of EMDR Therapy: What Happens Step-by-Step

EMDR therapy follows eight distinct phases. Not all phases happen in every session. Some phases happen mainly at the beginning. Others repeat throughout treatment.

Understanding these phases removes the mystery from the process.

Phase 1: History Taking and Treatment Planning (Sessions 1-2)

Your first one or two sessions focus on gathering your history and creating a treatment plan.

Your EMDR therapist asks about your current symptoms and challenges, past traumatic or distressing events, your goals for therapy, your support system and coping skills, and any mental health conditions or medications.

Creating the target list happens during this phase. Together, you’ll identify specific memories or experiences to target with EMDR. These become your “treatment targets.” Your therapist helps you prioritize which memories to process first.

What this looks like: “When did you first start experiencing panic attacks?” “What event made you feel unsafe?” “Are there specific memories that still bother you when you think about them?”

You don’t describe traumatic events in detail yet. Just general identification of what needs processing.

This phase usually takes 1-2 sessions at the beginning of therapy.

Phase 2: Preparation – Building Your Toolbox (1-4+ Sessions)

Before processing any trauma, your therapist teaches you coping skills and emotional regulation techniques. This phase is crucial—it ensures you can handle any distress that comes up during processing.

Safe Place (or Calm Place) Exercise helps you identify a real or imaginary place where you feel completely safe and calm. Your therapist helps you strengthen this visualization using bilateral stimulation. You can return to this place anytime you feel overwhelmed.

Container Exercise teaches you to mentally “contain” disturbing thoughts or memories. Imagine putting them in a locked box, sending them to space, or sealing them underground. This helps you set aside distress between sessions.

Grounding Techniques keep you present when memories feel overwhelming. This might include the 5-4-3-2-1 sensory technique, breathing exercises, or body awareness practices.

Stop Signal is established early. You create a clear signal (like raising your hand) that immediately stops everything. Your therapist explains you’re always in control and can pause processing anytime.

You need these tools before diving into trauma processing. Some people spend weeks in this phase building resources. That’s completely normal and necessary.

The preparation phase typically takes 1-4 sessions depending on trauma complexity and your comfort level.

Phase 3: Assessment – Identifying the Target Memory

When you’re ready to begin processing, you and your therapist select a specific target memory. Then you identify several components.

The image: What’s the most vivid or disturbing image from that memory?

Negative cognition: What negative belief about yourself goes with that memory? Examples include “I’m powerless,” “I’m not safe,” or “It was my fault.”

Positive cognition: What would you rather believe about yourself? Examples include “I’m strong now,” “I’m safe now,” or “I did the best I could.”

Emotions: What emotions come up when you think about the memory?

SUDs rating (Subjective Units of Disturbance): On a scale of 0-10, how disturbing does the memory feel right now?

Body sensations: Where do you feel it in your body? Tight chest? Stomach tension? Clenched jaw?

These components give you and your therapist a baseline. You’ll track how they change as processing happens.

Phase 4: Desensitization – The Eye Movements Begin

This is what most people think of as “EMDR.” It’s where the bilateral stimulation happens.

The actual process works like this:

First, you hold the target memory in mind—the image, negative belief, emotions, and body sensations. Next, your therapist begins bilateral stimulation.

Bilateral stimulation options include:

• Eye movements: Follow their fingers moving side-to-side
• Tapping: Alternating taps on your hands or knees
• Audio tones: Sounds alternating between left and right ears

This continues for 20-30 seconds (called a “set”). Your therapist stops and asks: “What do you notice?”

You briefly share whatever came up—new thoughts, images, emotions, body sensations, or memories. Your therapist says “Go with that” and starts another set.

This repeats until the memory’s distress level decreases significantly.

What it feels like: The bilateral stimulation is gentle and rhythmic. Eye movements feel like watching a slow pendulum. Tapping feels like light touches. Audio tones sound like gentle beeps.

You stay fully awake and aware. No trance state. No hypnosis. You’re just noticing what your brain brings up.

What processing looks like: As sets continue, the memory typically becomes less disturbing. New insights emerge. Your perspective shifts. The emotional charge decreases.

Example: A car accident memory might start with terror and “I’m going to die.” After processing, it might become “That was scary, but I survived. I’m okay now.”

This phase continues until the SUDs rating drops to 0-1 (no distress or minimal distress).

Phase 5: Installation – Strengthening the Positive

Once the memory no longer feels disturbing, your therapist helps you install the positive belief.

You think about the original memory while focusing on the positive cognition (“I’m strong now,” “I’m safe now,” etc.). Your therapist uses bilateral stimulation to strengthen this new, healthier belief.

The goal is making the positive belief feel true on a visceral, emotional level—not just intellectually.

You rate how true the positive belief feels on a scale of 1-7 (called VoC – Validity of Cognition). The goal is reaching 6 or 7, meaning it feels completely true.

Installation usually happens in the same session as desensitization.

Phase 6: Body Scan – Clearing Residual Tension

Even after the memory feels emotionally resolved, your body might still hold tension.

Your therapist asks you to think about the original memory and the positive belief while scanning your body from head to toe. Do you notice any tension, tightness, or uncomfortable sensations?

If you find any, those areas get targeted with more bilateral stimulation until your body feels completely clear.

Trauma lives in your body, not just your mind. Complete healing includes releasing physical holding patterns.

The body scan phase is brief, usually 5-10 minutes.

Phase 7: Closure – Ending the Session Safely

Every EMDR session ends with closure techniques to help you return to equilibrium.

If processing is incomplete (memory still has some charge), your therapist uses your safe place exercise or other calming techniques to stabilize you before you leave.

Your therapist explains what to expect between sessions. Some processing may continue. You might have vivid dreams. New memories or insights might emerge. This is all normal and means your brain is working.

You’re reminded to use your coping skills if needed and to journal anything that comes up.

The goal is leaving feeling grounded and safe, not activated or overwhelmed.

Closure takes the last 5-10 minutes of each session.

Phase 8: Reevaluation – Checking Progress

Every session begins with reevaluation after you start trauma processing.

Your therapist checks how you felt after the last session, whether anything came up during the week, and what your SUDs rating is for the previously processed memory. They also identify whether new targets emerged.

This phase ensures progress is maintained and guides treatment planning.

Reevaluation takes the first 5-10 minutes of each session after you start processing.

Now let’s talk about what your very first session will actually look like.

What to Expect in Your First EMDR Therapy Session

Many people feel anxious about their first EMDR session. Understanding what really happens helps reduce that anxiety.

Your First Session Won’t Include Eye Movements

Here’s an important reality check: Most people’s first EMDR session doesn’t include any bilateral stimulation or trauma processing.

If your therapist jumps straight to eye movements in session one, that’s a red flag. Proper EMDR requires preparation.

What actually happens in your first session:

• History gathering and background information
• Explanation of how EMDR works
• Questions and concerns addressed
• Beginning to build the therapeutic relationship
• Sometimes starting the preparation phase

Rushing into processing can be overwhelming or ineffective. Good EMDR therapists take time to prepare properly.

Building the Therapeutic Relationship

EMDR requires you to be vulnerable about traumatic experiences. Your therapist needs to establish safety and trust before beginning.

What building trust looks like: Your therapist explains their approach and training. They answer all your questions without rushing. They validate your concerns and fears. They explain you’re always in control. They adapt to your pace and comfort level.

Green flags in a good EMDR therapist include:

• Doesn’t rush you into processing
• Spends adequate time in preparation phase
• Checks in frequently during sessions
• Respects your stop signal immediately
• Adjusts approach based on your feedback

What an EMDR Session Actually Feels Like

Let’s demystify the physical and emotional experience of EMDR processing.

The physical experience of eye movements: Your therapist holds up two fingers and moves them slowly side-to-side about 12-18 inches from your face. You follow with your eyes only—your head stays still. The movement is slow and gentle, not fast or jerky.

It feels similar to watching a slow-motion tennis match. Some people find it slightly tiring for their eyes but not painful.

Alternative bilateral stimulation options: If eye movements don’t work for you (vision problems, dizziness, discomfort), your therapist can use tactile tapping—alternating taps on your hands, knees, or shoulders—or auditory tones that beep back and forth between headphones.

The emotional experience: Processing can bring up strong emotions—sadness, anger, fear, grief. This is normal and expected. Your therapist guides you through it and helps you stay grounded.

Important: You’re not reliving the trauma. You’re observing it from your current, safe place while your brain processes it differently.

The mental experience: During sets, all sorts of things might come up. Different aspects of the same memory, related memories from other times, new insights or realizations, body sensations shifting, or emotions changing. Sometimes nothing at all (also normal).

You just notice whatever happens without forcing or controlling it.

How Long Does EMDR Take?

Typical EMDR sessions last 60-90 minutes. Some therapists offer longer sessions (up to 2 hours) for intensive trauma processing.

Number of sessions needed varies by trauma complexity:

For single traumatic events like a car accident, single assault, or natural disaster, you typically need 3-6 sessions.

For complex or multiple traumas like childhood abuse, multiple deployments, or ongoing domestic violence, expect 8-12 sessions or more.

Some people continue EMDR periodically to process new experiences or maintain gains.

Treatment format options include:

• Standard: Weekly 60-90 minute sessions
• Intensive: Multiple sessions per week or full-day sessions

Both approaches work. Choose based on your needs and schedule.

Does Online EMDR Therapy Work? What’s Different?

Many people wonder whether EMDR can work effectively through a screen. The answer is yes.

Yes, Virtual EMDR Is Just as Effective

Studies show online EMDR therapy produces equivalent outcomes to in-person treatment. The PTSD: National Center for PTSD confirms virtual EMDR effectiveness.

Pre-pandemic, online EMDR was rare. Now it’s widely accepted and increasingly common.

Why virtual EMDR works: Bilateral stimulation adapts perfectly to virtual format. Your therapist uses on-screen moving dots or balls for eye movements, audio tones through your headphones, or self-tapping where you alternate tapping your own knees.

Your brain processes trauma the same way regardless of delivery method.

How Online EMDR Sessions Work

The setup is straightforward. You need a computer or tablet, stable internet connection, private space, and headphones (for audio bilateral stimulation). Your therapist needs the same technology plus bilateral stimulation tools.

Everything works the same as in-person except the delivery method. Your therapist guides you through the same eight phases, using screen-based bilateral stimulation.

Benefits of online EMDR include:

• No travel time or transportation barriers
• Receive treatment from home (often feels safer for trauma work)
• Access specialized EMDR therapists anywhere in your state
• Easier scheduling with evening and weekend options

At The Empowering Space, we provide all EMDR therapy online throughout Texas and Ohio. Our EMDR-certified therapists are experienced in virtual trauma treatment delivery.

How to Prepare for Your First EMDR Therapy Session

Proper preparation helps you get the most from EMDR therapy.

What to Do Before Your First Session

Practical preparation steps:

Get enough sleep the night before. Eat a meal before your session—low blood sugar makes processing harder. Wear comfortable clothing. Arrange for downtime after (don’t schedule important meetings). Have water available. Ensure privacy if doing virtual sessions.

Mental preparation tips:

It’s okay to be nervous—that’s completely normal. You don’t need to have everything figured out. Your therapist will guide you through the entire process. You can stop or pause anytime you need. Not knowing what will come up is part of the process.

Important questions to ask your therapist:

1. What’s your training and experience with EMDR?
2. How many sessions do you typically need to see results?
3. What happens if I get too overwhelmed during a session?
4. How do you adapt EMDR for online sessions?
5. What should I do if difficult memories come up between sessions?

What to Expect After Your Session

Understanding common post-session experiences prevents unnecessary worry.

Immediately after processing sessions: Mental or physical exhaustion is very common. You might feel emotionally raw or sensitive. Some people experience a sense of relief or lightness. Feeling “spacey” or foggy happens sometimes.

In the days following EMDR: Continued processing occurs as your brain keeps working. Vivid dreams are common—this is your brain processing during sleep. New insights or realizations emerge naturally. Related memories may surface. Emotional ups and downs are normal.

All of this means EMDR is working.

Self-care after EMDR sessions:

• Rest and don’t push yourself
• Practice the grounding techniques you learned
• Journal thoughts or memories that come up
• Reach out to your therapist if you feel overwhelmed
• Use your safe place exercise as needed
• Engage in gentle, comforting activities

Red flags to report immediately: Intense suicidal thoughts (call 988 or crisis line), complete inability to function, dissociation that doesn’t resolve, or feeling worse that persists beyond a few days.

These are rare but your therapist needs to know if they occur.

Common Fears About EMDR Therapy (And the Truth)

Let’s address the most common concerns people have about EMDR.

“Will I Have to Relive My Trauma?”

The fear: People worry EMDR means experiencing the trauma all over again.

The truth: No. You’re remembering the event, not reliving it. You stay grounded in the present while thinking about the past. Your adult self observes the memory with your therapist’s support.

It’s more like watching a movie of the event rather than being back in it.

“What If I Can’t Do the Eye Movements?”

The fear: Some people have vision problems, get motion sick, or find eye movements uncomfortable.

The truth: Eye movements are just one form of bilateral stimulation. Your therapist can use tapping or audio tones instead. All methods work equally well.

“What If Nothing Happens During Processing?”

The fear: What if the bilateral stimulation doesn’t bring up anything?

The truth: Sometimes “blank” sets happen. That’s okay and normal. Your therapist knows how to work with this. Sometimes your brain needs quiet processing time.

“What If I Get Too Overwhelmed?”

The fear: What if the emotions are too much and I lose control?

The truth: Your therapist monitors your distress level constantly. You have your stop signal. You learned grounding techniques. Your therapist can pause processing anytime and help you regulate.

EMDR done correctly includes built-in safety measures. You won’t be left overwhelmed.

“Will EMDR Erase My Memories?”

The fear: Some people worry they’ll forget important experiences.

The truth: EMDR doesn’t erase memories. You’ll still remember what happened. The memory just won’t have the same emotional charge. You can think about it without feeling overwhelmed.

Finding a Qualified EMDR Therapist

Choosing the right EMDR therapist matters for successful treatment.

What Qualifications to Look For

Essential credentials include:

• Licensed mental health professional (LCSW, LMFT, LPC, PhD, PsyD)
• Completed EMDR basic training (40+ hours minimum)
• Ideally EMDRIA certified or consultant-level
• Experience treating your specific type of trauma

How to verify credentials: Check EMDRIA’s therapist directory for certified practitioners. Ask about their training and certification directly. Verify professional license through state licensing boards.

Red flags to avoid:

• Can’t clearly explain their EMDR training
• Rushes into processing without preparation phase
• Doesn’t check SUDs ratings or track progress
• Makes unrealistic promises about speed of healing

EMDR Therapy at The Empowering Space

Several of our therapists are EMDR-certified and specialize in trauma treatment. We provide comprehensive EMDR therapy online throughout Texas and Ohio.

What makes our approach different: We never rush the preparation phase. Our therapists are trauma-specialized—EMDR is a core competency, not a side offering. We’ve perfected online delivery. We integrate EMDR with other trauma treatments when needed.

Getting started is simple:

First, browse our EMDR-certified therapists to find your match. Next, schedule a free 15-minute consultation to ask questions about the EMDR process. Finally, begin therapy within 1-2 weeks.

Affordable options available: MSW intern therapists provide EMDR under expert supervision starting at $35 per session. Licensed EMDR clinicians offer competitive rates.

Insurance coverage: While we’re private-pay, many insurance plans cover EMDR therapy. We provide superbills for out-of-network reimbursement. Learn more about EMDR insurance coverage.

Frequently Asked Questions About EMDR Therapy Sessions

What happens during an EMDR therapy session?

During EMDR sessions, you focus on a traumatic memory while your therapist guides bilateral stimulation (eye movements, tapping, or audio tones). You notice whatever thoughts, emotions, or sensations come up. The process continues until the memory loses its emotional charge. Sessions last 60-90 minutes and follow the eight-phase EMDR protocol.

Do I have to talk about my trauma in detail during EMDR?

No. EMDR doesn’t require detailed descriptions of your trauma. You can keep it general like “the thing that happened” or “the accident.” Your therapist only needs to know enough to help you identify target memories. The processing happens through bilateral stimulation, not through talking about details.

How long is an EMDR therapy session?

Typical EMDR sessions last 60-90 minutes. Some therapists offer extended sessions up to 2 hours for intensive trauma processing. Early sessions (history-taking and preparation) may be shorter. Processing sessions need the full time to complete trauma reprocessing work effectively.

What do the eye movements feel like?

Eye movements feel like watching a slow-moving pendulum. Your therapist moves their fingers slowly side-to-side about 12-18 inches from your face. You follow with your eyes while your head stays still. The movement is gentle and rhythmic, not fast or jerky. Some people find it slightly tiring but not painful.

How many EMDR sessions will I need?

For single traumatic events, expect 3-6 sessions. For complex or multiple traumas, plan for 8-12 sessions or more. Every person is different. Your therapist will discuss timeline expectations based on your specific situation and trauma history during the initial assessment phase.

Can I do EMDR therapy online?

Yes, online EMDR therapy is just as effective as in-person treatment. Research confirms virtual EMDR produces equivalent outcomes. Your therapist uses on-screen bilateral stimulation, audio tones through headphones, or guides you in self-tapping. The eight-phase process works the same way virtually.

What are the 8 phases of EMDR therapy?

The eight phases are: (1) History taking and treatment planning, (2) Preparation, (3) Assessment, (4) Desensitization, (5) Installation, (6) Body scan, (7) Closure, and (8) Reevaluation. Not all phases happen in every session. Early sessions focus on phases 1-2, while later sessions cycle through phases 3-8 repeatedly.

Will EMDR make me relive my trauma?

No. EMDR involves remembering the trauma, not reliving it. You stay grounded in the present with your therapist’s support while thinking about the past event. It’s more like watching a movie of what happened rather than experiencing it again. You maintain control throughout the entire process.

What should I expect in my first EMDR session?

Your first EMDR session typically involves history-taking, not trauma processing. Your therapist gathers background information, explains how EMDR works, answers your questions, and begins building therapeutic trust. You probably won’t do any eye movements in your first session. Proper EMDR requires preparation before processing begins.

What happens after an EMDR session?

After EMDR sessions, you might feel mentally or physically exhausted. Some people experience continued processing, vivid dreams, or new insights emerging. Feeling emotionally sensitive or “spacey” is common. These are all normal signs that your brain is actively processing. Practice self-care and use the grounding techniques you learned.

Ready to Begin EMDR Therapy?

You now understand exactly what happens during EMDR therapy. The eight phases aren’t mysterious. The eye movements aren’t scary. The process isn’t about reliving trauma—it’s about processing it safely.

EMDR therapy has helped millions of people heal from PTSD, trauma, anxiety, and other conditions. The bilateral stimulation might seem unusual, but research confirms it works. Your brain has a natural ability to heal from psychological trauma, just like your body heals from physical wounds.

EMDR removes the blocks preventing that natural healing.

Key takeaways to remember:

• EMDR follows a structured eight-phase process
• You stay in complete control throughout treatment
• Eye movements (or tapping/tones) help your brain reprocess memories
• You don’t have to describe trauma in detail
• Processing typically takes 3-12 sessions depending on complexity
• Online EMDR works just as well as in-person therapy

The hardest part is taking the first step. Once you start, your EMDR therapist guides you through each phase carefully. You learn coping skills before processing trauma. You have stop signals if you feel overwhelmed. You end each session feeling grounded and safe.

Your trauma happened in the past. EMDR helps your brain finally recognize that truth on an emotional level.

Start Your EMDR Therapy Journey Today

Stop letting fear of the unknown prevent you from healing.

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Still have questions about what happens during EMDR therapy? Contact us at our contact page or call to speak with someone who can help. We understand starting therapy feels vulnerable. We’re here to make the process as clear and comfortable as possible.

Your trauma doesn’t have to control your life forever. EMDR therapy can help you heal.