What is EMDR therapy?
What is EMDR therapy?
Eye Movement Desensitization and Reprocessing (EMDR) is a type of psychotherapy that is commonly used to treat post-traumatic stress disorder, as well as other psychological struggles. Francine Shapiro developed this therapy in 1987.
The sessions involve talking about traumatic memories while engaging in bilateral stimulation. Bilateral stimulation can be side-to-side eye movement, tapping on each shoulder or knee, or audio pings in one ear than the other.
How to choose my EMDR therapist?
Once you are ready to start EMDR therapy, the next step is to find the right therapist for you. A therapist can conduct EMDR therapy online or in-person. Both have their advantages and disadvantages, and you will need to decide which style you would prefer.
Online sessions give you flexibility to work more to your schedule, as well as allow you to have sessions from the comfort of your own home. In-person sessions may give you a deeper feeling of connection with your therapist.
When looking for your therapists, you should be mindful about picking the one that best suits your communication style.
Ask yourself these questions:
Do I feel safe?
Do I feel comfortable sharing?
Do I like my therapist’s manner of communicating?
Keep in mind that once you have established a therapeutic relationship, your therapist may begin to push back on some preconceived ideas or thinking patterns you have and challenge you to change. This is good. You want someone who does not judge you but can push you gently in the right direction to make positive changes.
What do EMDR sessions look like?
EMDR therapy should only be conducted by a trained EMDR therapist. The number of sessions can vary depending on whether it is being used to treat a single-trauma event or complex trauma. Many single-event memories can be processed over several EMDR sessions, although this varies considerably depending on the nature of the memory, current life stressors, and individual differences.
The sessions typically follow this pattern:
A. 1-2 sessions: Introduction & Background
If this is our first time meeting, we will discuss what brought you to seek therapy. We will also discuss any past therapeutic work you have done (what you found helpful and what didn’t work for you). We will begin to dive into your background. We will discuss what changes you would like to see happening in your life. These sessions are important to get a baseline understanding of what brought you here and where you would like to go. These sessions are also a critical moment to discover if we are the right fit as therapist and client.
B. 1-2 sessions Current & New Coping Skills
Before diving into EMDR therapy, we need to ensure that you have strong coping skills in place that can help you deal with any emotional turmoil that comes up outside of sessions. We will discuss your current coping strategies (both healthy and unhealthy). Together, we'll identify coping strategies that fit your lifestyle and practice them before beginning memory processing. Once you have a good toolbox of coping skills, we can move on to the next step.
C. 1 session EMDR Preparation
We will decide together on the appropriate trauma memory to begin with. We want to pick a memory that is still troubling but not too extreme. If this is your first time doing EMDR therapy, the goal of this first memory is to allow you to experience the therapy without feeling overwhelmed. This allows you to understand how the therapy works, get more comfortable during the sessions, and see the results of it so that we can work on more distressing memories in the future. This preparation session will ask you for all the relevant background information on the trauma memory we will work on, as well as indicate the baseline of how troubling this memory is to you. Having this baseline means that we can evaluate progress along the way. During this session, I will walk you through what EMDR therapy will look like and address any questions or concerns you may have.
D. 4+ Sessions EMDR Therapy
Now we begin EMDR therapy. We prime ourselves with the trauma memory and the negative thought we hold about ourselves, and begin the bilateral stimulation. The aim is to allow the mind to wander without trying to focus it to go in any one direction. The goal is to allow your brain to process the memory in a new way so it becomes less emotionally distressing. We try not to judge what comes up nor place pressure on ourselves on what we think we “should” think.
At the end of the sessions, we will have one or more coping skills to decrease the emotional turmoil felt during the session, with the aim of bringing you back down to neutral. As always, you will be asked to continue practicing your coping skills between sessions.
Once we get to a place where I notice the focus trauma memory is no longer seeming disturbing or troubling to you, we will reassess it and determine if more EMDR is needed or if the EMDR memory has been processed.
E. 1 Session: Closing the Trauma Memory
Once we have established that the chosen EMDR memory has been processed, we will have a dedicated session to “close” the memory. The aim is to consolidate the positive thought you want to have of yourself with the memory.
F. What next?
Once you process that first memory, many clients see the results and immediately want to work on another traumatic memory. If we decide to do so, then we complete Step C – Step E with each new trauma memory brought up.
Some clients may not want to complete any further EMDR therapy and prefer a more relaxed and less structured talk therapy. Your therapist should adapt their therapeutic structure to best suit your needs.
Common Questions and Concerns
1. What does EMDR feel like?
The experience is often different from what people expect. Rather than forcing yourself to think in a particular way, you simply notice whatever comes to mind. Some people notice memories becoming clearer or new memories altogether, while others notice emotions, physical sensations, or seemingly unrelated thoughts. Sometimes your mind may even jump off topic, thinking about your grocery list or work tasks. Everyone’s brain works differently.
Your therapist will periodically pause to check in, but there are no right or wrong responses. The process unfolds naturally, and your only task is to notice whatever your mind brings up.
2. Will I have to talk in detail about what happened?
Not necessarily. Unlike some therapies, EMDR does not require you to describe every detail of a traumatic experience. Your therapist needs enough information to guide treatment safely, but much of the processing occurs internally. You remain in control of what you choose to share.
3. Will I lose control during EMDR? What if I become overwhelmed during a session?
No. You remain awake, aware, and in control throughout the session. You can stop at any time, ask questions, or take a break. Your therapist is trained to help you regulate difficult emotions. EMDR includes preparation, coping skills, and pacing strategies to help ensure treatment remains manageable. Your therapist will regularly check in with you.
4. Is EMDR hypnosis? Can it change my memories?
No. EMDR is not hypnosis. You remain fully conscious and aware during treatment. There is no loss of control, and you make your own decisions throughout the session. You are given the tools to let the therapist know if you need a break or to stop the session.
5. Will it make me relive my trauma?
EMDR involves briefly accessing distressing memories, but the goal is not to relive them. Instead, your therapist helps you process them in a way that reduces their emotional impact over time. While some emotions may arise during treatment, you will work within your window of tolerance and use coping skills when needed.
6. Will I feel worse before I feel better?
A trauma memory is like an open wound that has not been treated. Untreated means it is more likely to become infected and cause major problems in the long-term. If you or someone else accidentally touches the wound, it can cause you to scream, cry, or lash out at those around you as you are hurt.
EMDR therapy is like finally addressing the wound. We will need to inspect it, clean it out, and sew it back up. This process can be emotionally difficult, but when given the right coping tools, you can handle the pain of the cleaning process. Once the wound is thoroughly clean, we sew it shut.
EMDR does not erase the wound: there will still be the psychological scar. When someone or something triggers it, we do not feel the same pain or debilitation that we did when it was untreated.
Some people notice temporary increases in emotions, vivid dreams, or new insights between sessions as the brain continues processing. These reactions are usually temporary and are discussed as part of treatment planning. Your therapist will help you develop strategies to manage any discomfort between sessions.
7. What happens if we end a session before the trauma memory is fully resolved?
This happens often, as it usually takes multiple sessions to process one single trauma memory. Before the end of the session, we will use grounding and coping skills to lower your emotional discomfort. We aim to bring you back as close to neutral as we can. We will continue the processing during the next session of EMDR.
8. What kind of problems can EMDR help with?
EMDR was originally developed to treat trauma and PTSD, but research also supports its use for many other concerns, including anxiety, panic, phobias, grief, distressing life experiences, low self-esteem related to adverse experiences, and some forms of depression. Your therapist will help determine whether EMDR is appropriate for your concerns.
9. Is it evidence-based?
Yes. EMDR is considered an evidence-based treatment for PTSD by numerous professional organizations and has a growing body of research supporting its effectiveness for other conditions. Research continues to expand our understanding of when and how EMDR is most helpful.
10. What if I can’t remember everything that happened?
You do not need perfect memories for EMDR to be effective. Therapy focuses on the memories, emotions, body sensations, and beliefs that are currently causing distress. Missing details or incomplete memories do not prevent successful treatment.
11. Is it suitable for everyone?
No. EMDR can be highly effective, but it is not appropriate for everyone at every point in time. Factors such as current safety, emotional stability, substance use, dissociation, and available support are considered during assessment. Your therapist will discuss whether EMDR is the best fit for your current needs.
12. Can I continue taking medication while doing EMDR?
Yes. Many people participate in EMDR while taking prescribed medications. If you are taking medication, I ask my clients to keep taking prescribed medication (including anything prescribed by a psychiatrist) and follow their treatment plan. Some clients do notice that they require less medication as the EMDR decreases the emotional turmoil or difficulties.
13. How will I know if it is working?
Many clients notice that distressing memories become less emotionally intense, triggers feel more manageable, physical tension decreases, and negative beliefs about themselves begin to shift. Progress is also reflected in improvements in daily functioning and quality of life. As therapist and client, we check in regularly to evaluate your current coping and psychological well-being.
14. What should I expect between sessions?
Between sessions, your brain may continue processing. You may notice new memories, emotions, dreams, or insights. Many people find it helpful to keep a journal of anything significant that arises and discuss it during the next session. Your therapist will also encourage you to practice coping strategies between sessions.
15. What if it doesn’t work for me?
No therapy works the same way for every person. If EMDR is not giving you the desired results, your therapist should work collaboratively with you to understand why and discuss alternative approaches or adjustments to your treatment plan. Therapy should always be individualized to your needs.
16. Can EMDR help if my trauma wasn’t ONE major event?
Yes. Many people seek EMDR for repeated stressful experiences, childhood adversity, relationship difficulties, or chronic emotional wounds rather than a single traumatic event. If this is the case, we will discuss which specific memory is best to focus on, as well as what other traumatic memories may be linked with it.
17. What if I don’t believe it will work?
It's normal to be uncertain. You do not have to be fully convinced for EMDR to be effective. Your therapist welcomes questions and will work with you to help you decide whether EMDR is a good fit.
18. How often should I have sessions?
More doesn’t necessarily mean better. This varies from client to client, but ideally, EMDR should be around once a week, ensuring continuity each week. We do not want large breaks between the sessions, as it can hinder progress and feel like we are restarting each time.
Some clients want to have daily sessions to focus on dealing with the trauma memory as quickly as possible.
We will work together to find the appropriate schedule of sessions based on our availability and your goals.
19. How will I feel after having an EMDR session?
Every client is different, and each client may have different experiences even from one session to another. Some clients feel emotionally drained. Some feel tired or exhausted, even wanting to take a nap. Some feel no different than before the sessions. For my clients, I recommend that they ensure they have an hour after sessions to fully decompress and give themselves time before engaging in anything too strenuous or stressful.
If you want to learn more about EMDR and whether it is the right fit for you, you can book a free 30-minute consultation to discuss further: huxleysiona@gmail.com
