What to Expect in EMDR Therapy: A Step-by-Step Guide

If you’re considering EMDR therapy, you may have questions about what happens during treatment, how much you’ll need to share, and what your first appointment will involve. Knowing what to expect in EMDR therapy can help you feel more prepared as you explore whether it’s right for you.

EMDR is a structured therapy, and each session serves a specific purpose within the larger treatment plan. At Westlake Psychotherapy of Austin, we guide clients through the EMDR session process step by step and explain each part as treatment progresses.

How Does EMDR Work?

EMDR, or Eye Movement Desensitization and Reprocessing, helps the brain reprocess distressing memories so they carry less emotional intensity when they are recalled. During reprocessing, you focus on a specific memory while your therapist guides a form of bilateral stimulation, most often side-to-side eye movements. Tapping or auditory tones may be used instead. If you want to see what the research says about results, read our guide answering the question, does EMDR therapy work?

You remain in control throughout the process. A session can be paused at any point, and EMDR doesn’t require you to describe a difficult experience in detail. We provide EMDR therapy in Austin within this consistent structure, so each session builds on the one before it.

The 8 Phases of EMDR

EMDR follows eight phases, although the time spent in each phase varies depending on your needs and treatment goals. Here is what each of the EMDR phases involves:

1. History and treatment planning: Your therapist takes a thorough history, discusses your goals, and works with you to identify the past memories and present-day situations that treatment will focus on.
2. Preparation: Your therapist explains how EMDR works and what to expect, and teaches relaxation and grounding techniques that help manage distress during and between sessions. You may also have an opportunity to try bilateral stimulation before it is used to process any distressing material.
3. Assessment: You and your therapist select a target memory and identify the negative belief about yourself connected to it (such as “I am powerless”), along with a preferred positive belief (such as “I am in control now”). You then rate how disturbing the memory feels on a 0-to-10 scale and how true the positive belief feels on a 1-to-7 scale.
4. Desensitization: While holding the memory in mind, you follow short sets of bilateral stimulation and briefly report whatever comes up between sets. The goal is to gradually reduce how distressing the memory feels.
5. Installation: The focus shifts to strengthening the positive belief so it feels more true when the original memory comes to mind.
6. Body scan: While holding both the target memory and the positive belief in mind, you notice whether any physical tension remains, such as tightness in the stomach or shoulders. Your therapist may help you process any remaining physical discomfort.
7. Closure: Your therapist helps you end the session in a manageable emotional state, using grounding or relaxation techniques when needed.
8. Reevaluation: Sessions that follow reprocessing begin with a review of what has come up since the previous appointment and a decision about where to focus next.

Your First EMDR Session

A first EMDR session is similar to an initial appointment in most forms of therapy and is primarily conversational. Your therapist will ask about your history, your goals, and how current stressors or past experiences are affecting daily life. In weekly therapy, reprocessing typically doesn’t begin in the first session, since early appointments are dedicated to history-taking, planning, and preparation.

These early sessions are also a good time to ask questions, including how target memories are chosen and what bilateral stimulation feels like. They give you and your therapist time to get to know each other and build a trusting working relationship, which is an important foundation for reprocessing.

What Happens During a Reprocessing Session

When you and your therapist agree that you are ready, treatment moves into reprocessing. These sessions begin with a brief check-in, followed by sets of bilateral stimulation while you focus on the target memory. After each set, you pause and briefly describe what you noticed, whether an image, an emotion, a thought, or a physical sensation.

There are no right or wrong responses. Some sets bring up new associations, and others may feel relatively neutral. Over the course of reprocessing, the goal is for the memory to become less distressing when it is recalled. Your therapist will reserve time at the end of each session for closure, even if work on that memory is not yet complete.

Processing can continue after a session ends, so it helps to know what is common in the days between appointments. Some people notice:

• New memories, thoughts, or dreams related to the material addressed in session
• Changes in how the target memory feels when it comes to mind
• Feeling more tired than usual after a session

Your therapist may recommend noting these experiences in a journal and using the grounding techniques from preparation if distress comes up between sessions.

How Many Sessions Will I Need?

The length of treatment varies from person to person. It depends on the concerns being addressed, the number of related experiences involved, and how much preparation is needed before reprocessing feels manageable. Standard sessions typically run 50 to 90 minutes.

For clients who prefer a more concentrated format, we also offer EMDR intensives, which involve four to six hours of therapeutic work per day over two to ten days. A consultation can help determine which format best fits your needs and goals.

EMDR for Anxiety and Trauma

The eight-phase structure remains the same regardless of the concern being treated. EMDR was originally developed as a treatment for trauma, and our clinicians also use it to address anxiety, panic attacks, phobias, grief and loss, and concerns related to self-worth. Your treatment plan is built around your own history and goals.

For anxiety, treatment often targets earlier experiences that contribute to current stress responses, along with the present-day situations that prompt them. For trauma, EMDR provides a structured way to process difficult memories one at a time with the guidance of a trained therapist.

Book an EMDR Session at Westlake Psychotherapy

If you have questions about EMDR or want to know whether it’s a good fit, we’re glad to talk them through. A consultation gives you a chance to discuss your goals and learn how treatment would be structured for your situation.

Schedule a 15-minute consultation to speak with our team about EMDR therapy.