EMDR Therapy: What Actually Happens in a Session?

You may have heard of EMDR therapy, perhaps through someone who has found it helpful or because you've been looking for ways to address difficult experiences from your past.

But the idea of revisiting distressing memories while following a therapist's moving hand can sound a little unusual. What actually happens during EMDR, and how might it help?

What is EMDR?

EMDR stands for Eye Movement Desensitisation and Reprocessing. It is an evidence-based therapy used to help people process distressing experiences, particularly those associated with post-traumatic stress disorder (PTSD).

Sometimes, even though we know a difficult experience is in the past, reminders of it can continue to trigger strong emotions, uncomfortable physical sensations or negative beliefs about ourselves.

EMDR aims to reduce the distress associated with these memories, so they no longer have the same impact on everyday life.

The aim isn't to erase what happened, but to help the experience feel more firmly in the past.

What happens during EMDR therapy?

EMDR is a structured therapy, and you won't necessarily begin by processing difficult memories straight away.

Understanding your experiences

Your therapist will first spend time getting to know you, understanding your difficulties and exploring what you hope to achieve. Together, you'll identify experiences that may be contributing to how you feel today.

Preparation

Before working with distressing memories, your therapist will help you develop strategies for managing difficult emotions and staying grounded in the present.

Processing memories

When you're ready, you'll be asked to bring aspects of a particular memory to mind while engaging in bilateral stimulation.

This commonly involves following a therapist's moving hand with your eyes, although alternating sounds or tapping may also be used.

After each short set, your therapist will ask what you noticed. Thoughts, emotions, images or physical sensations may arise, and these can change as processing continues.

Over time, the memory may become less emotionally distressing, although everyone's experience is different.

Do I have to talk about everything that happened?

Not necessarily.

EMDR doesn't always require you to describe a traumatic experience in detail.

Your therapist will still need enough information to understand your difficulties and guide the treatment safely, but you won't necessarily have to recount every aspect of what happened.

Will I be in control?

Yes. EMDR isn't hypnosis, and you remain awake and aware throughout.

You can ask questions, take breaks or let your therapist know if something feels too overwhelming.

Processing difficult memories can sometimes bring up uncomfortable feelings, and some people notice increased emotions or tiredness after sessions. Your therapist will work with you to manage these experiences.

How many sessions will I need?

There is no fixed number of sessions that suits everyone.

Some people may need a relatively short course of treatment, while others benefit from longer-term work, particularly where there have been multiple or longstanding traumatic experiences.

The number of sessions will depend on your circumstances, the difficulties you're experiencing and how you respond to therapy.

Could EMDR help me?

EMDR is a recommended treatment for PTSD and may also be considered for certain other difficulties involving distressing memories, although the evidence for these applications varies.

It isn't necessarily the right approach for everyone.

An initial assessment can help establish whether EMDR, trauma-focused CBT or another therapeutic approach would be most appropriate for you.

You don't need to know which therapy you need before seeking help. Part of the process is working together to understand what's happening and consider the best way forward.

Dr Ramona Burrage is a Chartered Clinical Psychologist and BABCP-accredited Cognitive Behavioural Therapist based in Epsom, Surrey. She works with adults experiencing anxiety, trauma-related difficulties and other psychological concerns.

If you're considering therapy and would like to learn more about how I work, please visit the Work With Me section of my website.