So you’re thinking about EMDR. Maybe your therapist mentioned it to you, you heard about it from a friend, or you saw an article about it somewhere. EMDR has grown in popularity in recent years due to its effectiveness at treating trauma, anxiety, grief, and more. EMDR is a transformative treatment for many, but it can be anxiety-provoking to get started when you don’t know what to expect. The very premise of doing eye movements in therapy can feel weird, especially for those who are accustomed to therapy looking like a back-and-forth conversation between therapist and client. Below I will demystify what a typical EMDR treatment session looks like to hopefully make it feel more accessible, less intimidating, and like something you just might want to try.

Before You Get Started

Prior to diving into actual reprocessing, you and your therapist will complete a few preparatory steps. First, you will work with your therapist to identify your present symptoms, struggles, or pain points and then work backward from these to pinpoint past experiences that have created and reinforced them. If this sounds like a lot, rest assured that your therapist will not ask you for long or detailed descriptions of past traumatic or distressing events. Rather, they will be looking for a few word description to summarize what happened so that they know generally what you will be working on.

From here, your therapist may ask some questions and complete some assessments related to physical and mental health symptoms to ensure that EMDR therapy will be a good fit for you. They will then introduce the eye movements to you to make sure that they are comfortable and tolerable. Don’t worry if it feels a bit strange at this point – that’s totally normal! If the eye movements are painful, distracting, or otherwise do not work for you, your therapist will offer other options like alternating taps or tones.

Your therapist will then teach you a series of grounding and emotional regulation skills. These are meant to be used at the end of reprocessing sessions to return you to the present before you leave your session, as well as between sessions to help you manage any uncomfortable thoughts, emotions, or memories that may come up. Lastly, your therapist will orient you to what to expect during reprocessing sessions and respond to any questions or concerns that you have.    

Ready to Reprocess

At this point, you are ready to reprocess. You and your therapist will start a reprocessing session with some back-and-forth conversation about the first memory you identified to work on together. Your therapist will ask you about an image that you associate with that experience, what you believe about yourself in relation to that experience and what you would like to believe about yourself instead, and the emotions and body sensations that come up when thinking about this experience. We ask about these things because EMDR seeks to target all aspects of your memory networks – visual, cognitive (thoughts), emotional, and somatic (body) – so that you can fully work through lingering effects of these experiences in the present.

From here, you will go into doing sets of eye movements. Your therapist will guide you through a set, and then pause to check-in with you with a question like “what are you noticing now?” You will give a brief response, and then you will go right back into another set of eye movements. Your therapist will not do a lot of talking during reprocessing. The reason for this is that EMDR operates from the assumption that your brain is doing its own healing, and your therapist is just there to facilitate, not interfere with, that process. Your therapist will check-in with you periodically to determine whether the experience you are working on is starting to feel less disturbing/distressing.

You will do sets of eye movements until the experience you are working on feels neutral or no longer disturbing to you. At this point, your therapist will work with you to install a positive belief about yourself in relation to this past experience again using sets of eye movements to reinforce. Lastly, you will complete a body scan to ensure that you are not holding onto any residual tension, discomfort, or other unusual physical sensation.

Sometimes all of this will happen in one session, and sometimes it won’t. Either way is totally fine, and if you don’t finish you will just pick back up where you left off next time. Once you do finish one target experience, you will move onto the next target that you re and your therapist identified until there are none left to work through. At the end of every session your therapist will guide you through some of the grounding exercises you established together to ensure that you are leaving your session in a calm and present state of mind. They will also advise you that reprocessing can continue between sessions and let you know what to do if this happens.

Next Steps

Overall, EMDR is a cool treatment approach that works tremendously well for a lot of people. It is different from what many people expect therapy to be like, but with the guidance and support of an experienced and compassionate EMDR therapist it will come to feel normal in no time. Curious about how EMDR therapy may be able to help you? Contact me today to learn more.

Source: Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basis principles, protocols, and procedures. (3rd Edition). The Guilford Press.