What to Expect in an EMDR Therapy Session
Updated: Sep 3
Eye Movement Desensitization and Reprocessing, better known as EMDR, is a structured form of psychotherapy that was developed to help people process distressing or traumatic experiences. Research supports EMDR as an effective treatment for PTSD, with recent reviews finding meaningful reductions in PTSD symptoms and outcomes comparable to other established trauma-focused therapies.
The idea of revisiting a painful memory can understandably feel intimidating. EMDR, however, is not about forcing yourself to relive everything that has happened to you. Treatment is guided by a trained therapist, and preparation and emotional safety are important parts of the process.
So, what actually happens during an EMDR session?
1. Beginning the Session: Creating Safety
EMDR does not begin with immediately talking through your most difficult experiences. Your therapist will first spend time getting to know what you are experiencing, reviewing your progress, and making sure you have strategies for managing difficult emotions that may arise.
Depending on your needs, preparation may include grounding, breathing, mindfulness, or other techniques that help you stay connected to the present moment. This preparation can be particularly important when someone has experienced complex or ongoing trauma.
Not everyone moves through the preparation stage at the same pace. Your therapist will work with you to determine when you are ready to begin reprocessing.
2. Identifying What You Want to Work On
Once you and your therapist decide that EMDR reprocessing is appropriate, you will identify a memory, situation, belief, or pattern that you would like to work on.
This may involve identifying an image or aspect of the experience that feels particularly distressing, along with emotions, physical sensations, and beliefs about yourself that are connected to it. For example, someone might notice a belief such as “I am not safe,” “It was my fault,” or “I am powerless.”
You will also explore a more adaptive belief you would like to develop, such as “I am safe now,” “I did the best I could,” or “I have choices.”
You do not have to have the perfect words for any of this. Your therapist will help you through the process.
3. Bilateral Stimulation
A distinctive part of EMDR involves what is called bilateral stimulation. This may involve following the therapist's fingers with your eyes, alternating taps, or alternating sounds.
It is important to clarify that researchers do not yet have a definitive explanation for exactly why bilateral stimulation works. Research suggests that eye movements and other forms of bilateral stimulation may interact with working memory and reduce the vividness or emotional intensity of distressing memories, but the underlying mechanisms remain an active area of research.
During a set of stimulation, you will briefly focus on aspects of the memory while allowing your attention to move between the memory and the present moment. Your therapist will then pause and ask what you notice.
4. Reprocessing and Reflection
As the session continues, different thoughts, emotions, physical sensations, memories, or insights may arise.
You might notice that the memory feels less vivid or upsetting. You might remember something you had not thought about in a long time, notice a different perspective on what happened, or simply find that your response to the memory begins to change.
There is no single experience that everyone has during EMDR.
Your therapist will guide the process without telling you what you are supposed to think or feel. The goal is not to erase a memory. Instead, treatment aims to reduce the distress associated with the memory so that it can be remembered without having the same disruptive emotional impact.
5. Developing a More Adaptive Belief
As the distress connected to a target memory decreases, EMDR also works with the beliefs you have about yourself in relation to what happened.
For example, someone who has carried the belief “I am powerless” may begin to connect with a belief such as “I have choices now.” Someone who has felt responsible for something that was not their fault may begin to develop a more compassionate and accurate understanding of what happened.
The intention is not to replace your memories with positive thinking. Rather, it is to help you develop a perspective that feels more accurate, useful, and consistent with the present.
6. Body Scan and Closure
Near the end of a reprocessing session, your therapist may ask you to notice what is happening physically as you think about the memory.
If distress or tension remains, your therapist can help you work with it or use grounding strategies before the session ends. EMDR sessions are structured with closure in mind so that you have an opportunity to return your attention to the present and discuss how you are feeling before leaving.
If there is not enough time to complete a particular target, your therapist may use additional strategies to help you put the work aside safely until the next session.
7. What You Might Notice Between Sessions
People respond differently after EMDR. You may feel tired, reflective, relieved, or emotionally activated. Some people notice changes in dreams, memories, emotions, or reactions between sessions.
These experiences do not necessarily mean that your brain is continuing a specific biological “processing” process, and they are not something you need to interpret on your own. If something unexpected or upsetting comes up between sessions, it is worth discussing with your therapist.
Your therapist can also help you identify practical ways to care for yourself between appointments and manage difficult emotions if they arise.
Frequently Asked Questions About EMDR
How long does EMDR take?
There is no standard number of sessions that works for everyone. Treatment length depends on what you are hoping to address, your history, the complexity of the experiences involved, and how you respond to treatment.
Some people notice meaningful changes relatively early, while others need a longer course of therapy, particularly when there are multiple or longstanding experiences to address.
Do I have to tell my therapist every detail of what happened?
No. EMDR does not necessarily require you to describe every detail of a traumatic experience aloud.
Your therapist will need enough information to understand what you are working on and to provide safe, appropriate treatment, but you remain an active participant in deciding what you are comfortable sharing.
What if I become overwhelmed during a session?
Your therapist can slow down, pause the reprocessing, or return to grounding and stabilization whenever needed.
Preparation is an important part of EMDR, and treatment should be adapted to the individual rather than following a rigid pace. If someone is experiencing significant instability or difficulty remaining grounded in the present, additional preparation may be appropriate before beginning intensive trauma reprocessing.
Does EMDR help with things other than PTSD?
EMDR has been studied for a range of concerns beyond PTSD, including anxiety, depression, phobias, and grief-related difficulties. However, the strength of the evidence varies considerably depending on the condition.
The strongest and most established evidence base is for PTSD. Research into other applications is continuing, and EMDR should not be presented as a universal treatment for every concern.
Is EMDR right for everyone?
EMDR is not automatically the right approach for every person or every situation.
Your therapist will consider your current symptoms, history, ability to stay grounded, goals, and overall circumstances before beginning trauma reprocessing. When there are significant dissociative symptoms, substance-use concerns, severe instability, or ongoing circumstances that continue to pose a threat, treatment may need to begin with stabilization and safety rather than memory reprocessing.
This does not necessarily mean that someone cannot eventually benefit from EMDR. It means the approach and timing need to be individualized.
What Does EMDR Actually Help With?
For people experiencing PTSD, research supports EMDR as an effective psychological treatment. A 2025 systematic review and meta-analysis found that EMDR reduced PTSD symptoms compared with waitlist or usual care, while finding no significant difference in treatment effects between EMDR and trauma-focused cognitive behavioural therapy.
That does not mean EMDR is a cure or that every person will respond in the same way. As with any psychological treatment, outcomes vary from person to person.
For some people, the most meaningful change is that a memory that once felt overwhelming becomes easier to think about. Others may notice changes in how they respond to situations that previously triggered fear, shame, helplessness, or other strong emotional reactions.
The goal is not to forget what happened. It is to help the experience have less control over your life in the present.
Considering EMDR?
Starting trauma therapy can feel like a big step, particularly if you have spent a long time avoiding painful memories or experiences. You do not have to know exactly what you need before reaching out.
At Authentic Living London, Jeanette Leroux is now accepting clients for EMDR therapy. Jeanette provides a calm and supportive space for clients who are ready to explore experiences that may still be affecting them today.
If you are wondering whether EMDR might be a good fit for you, a conversation with a therapist can be a good place to start.
Click here to book a free 15-minute phone consultation.
Now Accepting EMDR Clients
Jeanette Leroux, BA, MSW, a therapist at Authentic Living London, is now accepting clients for EMDR therapy. Jeanette provides a calm, supportive space for clients to safely explore and heal from trauma. Her compassionate and grounded approach helps clients move from feeling stuck in the past to feeling more at peace in the present.
References
Rasines-Laudes, P., & Serrano-Pintado, I. (2023). Efficacy of EMDR in post-traumatic stress disorder: A systematic review and meta-analysis of randomized clinical trials. Psicothema, 35(4), 385–396. doi:10.7334/psicothema2022.309
Simpson, E., Carroll, C., Sutton, A., Forsyth, J., Rayner, A., Ren, S., Franklin, M., & Wood, E. (2025). Clinical and cost-effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post-traumatic stress disorder in adults: A systematic review and meta-analysis. British Journal of Psychology, 116(4), 1128–1149. doi:10.1111/bjop.70005
Wright, S. L., Karyotaki, E., Cuijpers, P., Bisson, J., Papola, D., Witteveen, A., Suliman, S., Spies, G., Ahmadi, K., Capezzani, L., Carletto, S., Karatzias, T., Kullack, C., Laugharne, J., Lee, C. W., Nijdam, M. J., Olff, M., Ostacoli, L., Seedat, S., & Sijbrandij, M. (2024). EMDR v. other psychological therapies for PTSD: A systematic review and individual participant data meta-analysis. Psychological Medicine, 54(8), 1580–1588. doi:10.1017/S0033291723003446
Chen, Y.-R., Hung, K.-W., Tsai, J.-C., Chu, H., Chung, M.-H., Chen, S.-R., Liao, Y.-M., Ou, K.-L., Chang, Y.-C., & Chou, K.-R. (2018). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: A meta-analysis of randomized controlled trials. PLoS ONE, 13(7), e0199431. doi:10.1371/journal.pone.0199431
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