The Complete Guide to EMDR:What to Expect Before, During, and After
You have been dealing with the same patterns for years, yet you cannot seem to get unstuck: the anxiety, recurring patterns in relationships, phobias, and traumatic memories that will not go away. You have tried traditional psychotherapy, including CBT, DBT, and many other approaches, for years. Then a friend mentions EMDR. You know you have heard of it, but you do not know enough about it. Maybe it is time to take a deeper dive into this different approach.
Hi, I’m Laurie, an EMDR Therapist in Connecticut and I would love to be your guide to understanding what to expect before, during, and after an EMDR session.
EMDR therapy is an evidence-based treatment for PTSD and other trauma-related disorders. It is recommended by the World Health Organization (WHO), the American Psychological Association (APA), the U.S. Department of Veterans Affairs (VA), and the International Society for Traumatic Stress Studies (ISTSS).
In this guide, we will walk you through what EMDR therapy is and what to expect before, during, and after an EMDR therapy session. It is important to note that this article covers what to expect generally. Each person and each treatment plan is different. An experienced provider can respond flexibly to a patient's needs and adapt accordingly. We will discuss this in more detail later. By the end of this article, however, you will have a much better picture of what actually happens and whether this approach is right for you.
What Is EMDR Therapy?
EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured, body-based approach to therapy that was originally designed to treat PTSD. However, it is now used to treat many mental health conditions, including depression, anxiety, childhood trauma, and addiction, to name a few.
The theory behind it is called the Adaptive Information Processing model. The basic idea: your brain has a natural system for processing difficult experiences and filing them away as “over.” Under normal circumstances, a bad day gets processed and loses its emotional charge over time. But with trauma — or with experiences that were too overwhelming, too fast, or too unsafe — that natural processing gets interrupted. The memory stays “stuck,” still carrying the original emotional intensity, still capable of hijacking your nervous system years laterThis model helps us understand how a person's past experiences influence their current perceptions, feelings, thoughts, and behaviors. When people can adaptively process negative events, they can move past them, and the events become “something that happened.” However, traumatic childhood or adult memories can become stuck. Essentially, the “past is present” in everyday life, as past disturbing events become linked to current experiences. For example, someone who experienced parental rejection and alienation may believe they are “unlovable.” Then, in future relationships, even when those relationships are loving, the person may resist intimacy because of these past experiences.
EMDR uses bilateral stimulation, working-memory tasks, or both (more on these techniques later) while you bring a specific memory to mind. Through this process, the memory loses its “charge.” In other words, the memory itself does not change appreciably. However, the client's experience of the memory changes significantly: the memory becomes less disturbing, and the person perceives both the memory and, ultimately, themselves differently.
One of the primary differences between EMDR and traditional psychotherapy is that there is much less talking required. Much of the work happens in silence with attention to the body and somatic attunement. This is often a breath of fresh air for people who have difficulty with verbal processing or don’t have words for what happened to them.
3. Before Your First Session
Finding the Right Therapist
EMDR therapy requires specialized training beyond the mental health licensure required in your state. The most reputable training programs are conducted through EMDRIA, the EMDR International Association, which is considered the gold standard for EMDR therapy worldwide. You can search EMDRIA's directory directly or obtain referrals from friends or other medical professionals. Check whether the provider is EMDR-certified. This means the provider has completed advanced education and supervision beyond basic EMDR training. You may also want to ask how long the provider has used EMDR therapy in practice. This will help you distinguish between providers who use EMDR infrequently and those who use it regularly or every day.
Initial Consultation or First Session
Your first conversation with a potential EMDR therapist will cover some of your background and what brings you to therapy now. If this is only a 15-minute consultation, the therapist will try to assess your readiness and commitment to this type of therapy. Not everyone is suited to this approach, and an experienced therapist will begin evaluating fit during the first conversation. Assuming you and the therapist agree that the approach makes sense, you will meet for a more in-depth consultation or your first session. During your first session or first few sessions, case conceptualization will begin and continue to develop throughout treatment.
History-taking and building your target list
Before any reprocessing work begins, your therapist will spend time understanding your therapy history, including any issues to be addressed, as well as your trauma and family histories. Your therapist will then begin identifying specific memories or issues to work on. This is often referred to as building a “target list.” There may be specific memories that need to be prioritized, as well as “themes” across similar memories that reflect a negative belief that persists in the present.
Building resources before the hard part
Before the hard part🌿 PAUSE • BREATHE • NOTICE • GROUND 🌿 Preparation is part of the therapy—not a detour.
Typically, trauma processing does not begin in the first session. However, there are instances when doing so is necessary and appropriate. In those cases, clinicians use specialized protocols to proceed safely. Usually, there is a preparation phase focused on building coping skills—such as a “safe place” visualization, grounding techniques, and other tools for regulating distress. This is not a delay tactic; it is what makes the later reprocessing work tolerable and safe.
Addressing fears upfront
Many people hesitate about EMDR because of misconceptions — that it’s hypnosis, that it’ll erase memories, or that it’s not “real” therapy because it doesn’t involve much talking. A good therapist will address these directly, and it’s worth naming your own worries at this stage rather than sitting with them quietly.
Setting expectations
You remain in control and can pause, slow down, or stop at any time. Knowing this ahead of time makes the actual experience far less intimidating.
4. During an EMDR Session
Walkthrough of the 8 Phases
History-taking: Reviewing family history and therapeutic background and beginning to set treatment-related goals.
Preparation: Assessing current coping skills, including breathing and stabilization techniques that can help when you are in distress.
Assessment: Selecting memory “targets” related to current symptoms. Negative core beliefs may or may not be identified, depending on treatment goals.
Desensitization: Bilateral stimulation, working-memory tasks, or both begin while you hold the memory in mind, allowing associations, emotions, and thoughts to change. At the end of desensitization, the disturbance is significantly reduced, and the client can hold the memory in mind more easily.
Installation: Strengthening a positive belief. This may include resourcing, such as the Resource Development and Installation protocol, or a future template—imagining future scenarios in which the positive belief is true—with or without bilateral stimulation.
Body scan: Checking the body for physical signs of discomfort while holding the memory in mind. If the scan is clear, the person should feel fairly neutral while recalling the target memory.
Closure: Using relaxation techniques that may include breathing, meditation, or other methods of returning to a calm state.
Reevaluation: Reviewing progress at the start of each session and when a target is completed. Clinicians will check for concerns that may have arisen after prior sessions and for signs that progress toward overall treatment goals—such as less anxiety and greater emotional awareness—is moving in the right direction.
What Bilateral Stimulation Actually Feels Like
Bilateral stimulation can look very different depending on the client's needs and whether therapy is conducted in person or via telehealth. In person, clients may choose eye movements, which can involve looking at a light bar or following a therapist's hand or a pen. Another popular option is using “tappers,” which allow clients to feel alternating vibrations from one hand to the other.
During this process, clients may experience waves of emotion along with physical sensations. Memories associated with the target memory may surface as well. The therapist will check in regularly to ensure that the client remains within the “window of tolerance.” This means that the client's emotional experiences during desensitization and reprocessing are not overwhelming and remain generally tolerable. This is where a therapist's experience and level of training truly matter and why it is important to choose a therapist with appropriate experience and training. The therapist will make adjustments, pause, or stop as needed for the client's comfort. By the end of the session, your SUDS (Subjective Units of Distress) score will typically be lower, and the memory will feel less intense.
Session lengths vary. A regular therapy session may last 50–90 minutes, while extended or intensive sessions may last up to three hours.
5. After a Session
Aftercare matters☕ AFTER THE SESSION ☕ Give yourself permission to slow down, notice what you need, and let the work settle.
Although every client's experience after a session differs, some experiences are common. Clients may feel tired and emotionally “raw.” They may also have more vivid dreams or experience mental fog. Occasionally, clients have headaches after a session. If you experience migraines, discuss this with your therapist. I often describe EMDR as a HIIT workout for the brain. This is an important time to listen to your body and, in general, take it easy. This means different things for different people, but it is generally not a good time to make major decisions or do an intense physical workout. Other positive effects may also occur, such as making connections to present experiences and relationships and gaining greater overall insight.
Your therapist will check in with you at the beginning of each session about symptoms, any adverse experiences, and changes in SUDS. This is a good time to raise any questions or concerns and discuss any progress you have noticed.
Each person experiences progress differently, and outcomes vary widely depending on factors such as the client's needs, the complexity of the issues, the case conceptualization, and the treatment plan.
6. What Results Look Like Long-Term
What can change PAST → processed memory → PRESENT The event remains part of your story; the goal is a different relationship with the memory.
Over time, EMDR may change how clients experience a memory and view themselves in relation to it. The facts of the event remain but recalling it may provoke less distress.
Clients may also develop more adaptive beliefs about themselves, feel better able to manage distress, and respond differently in relationships, work, or other demanding situations.Treatment timelines differ. A single-incident trauma may require less time than chronic or complex trauma, but duration cannot be predicted from diagnosis alone. Discuss likely pacing and milestones with your therapist so expectations remain realistic.
7. Is EMDR Right for You?
EMDR therapy is best established as a treatment for PTSD and other trauma-related symptoms. Clinicians may also use adapted EMDR protocols for other concerns, but the evidence and recommended approach vary by condition; ask a prospective therapist about their training, the rationale for treatment, and the evidence relevant to your needs.
EMDR therapy may need to be delayed, adapted, or delivered alongside stabilization when a client is experiencing active psychosis, significant dissociation, or elevated safety risk. A qualified therapist should assess readiness, discuss relevant risks, and monitor safety throughout treatment.
If you are comparing EMDR with other approaches, ask a qualified therapist how each option aligns with your history, symptoms, preferences, and treatment goals.Continue raising concerns throughout treatment so you understand the process and can participate in decisions about pace and progress.
8. Conclusion + CTA
EMDR therapy differs from traditional talk therapy, and uncertainty about the process can make it feel intimidating. Understanding how treatment is prepared, paced, and monitored can help you decide whether to explore it further. If the approach seems relevant to your needs, schedule a consultation with a qualified EMDR therapist and ask how they would tailor treatment to your history, goals, and readiness.
Next steps:
Learn more: Visit www.emdria.org for research, educational resources, training standards, and a therapist directory.
Schedule a consultation: Meet with a qualified EMDR therapist to discuss your goals, ask about their training and experience, and determine whether the approach may be a good fit.
Sources: World Health Organization, Guidelines for the Management of Conditions Specifically Related to Stress; American Psychological Association, Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults; U.S. Department of Veterans Affairs and Department of Defense, Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder; and EMDR International Association training standards and provider resources.
