What actually happens in an EMDR session?
If you've been looking into EMDR, you've probably read that it involves moving your eyes from side to side while thinking about something difficult. This side-to-side motion is called bilateral stimulation. It mimics REM sleep and enhances memory processing. That's true, but it's only a small part of the picture, and it can make EMDR sound stranger than it is. Here's what actually happens, step by step.
EMDR stands for Eye Movement Desensitisation and Reprocessing. It's recommended by NICE and the World Health Organisation (WHO) for post-traumatic stress, and works on the idea that some distressing memories get "stuck". Instead of being filed away as something that happened in the past, they keep firing as if they're happening now: the racing heart, the dread, the old beliefs about yourself, the 'sick in the stomach', 'tight chest' or stiff/aching bodily sensations. EMDR helps the brain finish processing those memories so they lose their charge.
The therapy follows eight phases. They don't each take a session; some take minutes, and some we return to many times. A session typically lasts for 90 minutes.
1. Getting to know you and your history
We start by talking. I'll ask about what brings you to therapy, what's been happening in your life, and what you'd like to be different. We'll gently identify which memories or experiences seem to be feeding your current difficulties. You do not need to describe anything in detail at this stage.
2. Preparation
In this phase I will explain how EMDR works and together we build ways for you to feel calm and grounded. This is an important phase enabling you to feel safe and held in future phases. We create a 'safe place' and a 'container' utilising a 'calm space' and 'container' visualisations. I shall introduce grounding exercises that you can use during and between sessions. You'll also agree a stop signal, so you're always in control. Some people spend several sessions here. You can return to your safe place and put intolerable memories, emotions and thoughts into your container until you are ready to process them at any time.
3. Assessment
We choose one memory to start with. I will ask you to bring to mind an image from it, the negative belief that goes with it (something like "I'm not safe" or "It was my fault"), and the belief you'd rather hold instead. You'll rate how distressing the memory feels on a scale of 0 to 10, and how true the positive belief feels.
4. Desensitisation
This is the part people usually picture. You will identify the worst moment of a troubling memory and a negative belief about it. While thinking of snapshot image of the moment and thought you shall follow a set of side-to-side movements with your eyes or pay attention to alternating pulsator sensations from pulsators held in each hand or sounds that alternate from left to right in headphones. Most people prefer holding pulsators during in person sessions. I shall ask you to allow your mind to 'go with' whatever comes up and just notice it. After each short set, we pause and I'll ask what you noticed. It might be a thought, an image, a feeling in your body, or nothing much at all. Then we carry on. You don't need to talk through the memory in detail, and you can stop whenever you need to. This process is repeated until the memory causes less distress. This may happen in one session or many.
5. Installation
As the distress comes down, we strengthen the positive belief you chose earlier, so it feels more true when you think of the memory.
6. Body scan
I'll ask you to notice whether any tension or discomfort remains in your body when you think of the memory. If it does, we process that too.
7. Closure
Every session ends with you feeling settled, whether or not we've finished working on a memory. We'll use the grounding techniques from the preparation phase. Some people notice dreams or new thoughts between sessions; I'll suggest keeping a brief note of anything that comes up. Remember, you can use your safe place and container visualisations to remain centred and safe between sessions.
8. Re-evaluation
At the start of the next session, we check how things have been and whether the memory still feels distressing. Then we decide together what to work on next.
What people often ask
Will I lose control? No. You stay fully aware throughout, and you can stop at any time. EMDR is not hypnosis.
Do I have to tell you everything that happened? No. Many people find this one of the most helpful things about EMDR. You don't have to put the worst moments into words for the therapy to work. This is significant benefit of EMDR, eliminating reliving traumatic experiences.
How many sessions will I need? It depends on what we're working with. A single distressing event may need only a handful of sessions after preparation. Experiences that occurred over a long time, or began in childhood, usually take longer.
Is it right for me? EMDR suits many people, but not everyone, and not at every point in their lives. That's something we'd think through together before starting.
If you're wondering whether EMDR could help with what you're carrying, I offer a free 30-minute consultation, in Harrogate or online. Get in touch and we can talk it through.