What Happens in an EMDR Session?
“Really good witch magic today,” says my client as she gets up from the couch. She’s smiling and laughing as she walks out of the office to get Mexican food with her boyfriend. I smile too.
We’ve just worked through a memory of assault using Eye Movement Desensitization and Reprocessing Therapy (or EMDR for short). In our session, she revisited the memory while following my fingers with her eyes, moving back and forth rapidly. As we did this, she experienced emotions of fear, angry, grief, calm, and hope. She’s started to affectionately refer to EMDR as “witch magic” because of how quickly it has helped her to feel different.
EMDR therapy is a trauma-recovery therapy that helps to reduce the emotional intensity of painful memories. This can help you to have reduced reaction to triggers (or reminders of what happened) and more hope for the future. EMDR tends to help people feel more calm, grounded, hopeful, and confident.
EMDR Therapy has been used for four decades now to heal trauma from sexual assault and abuse, PTSD, anxiety, depression, and psychosomatic symptoms. EMDR does not require you to talk about your trauma or take medication. It’s recommended by the World Health Organization, and American Psychiatric Association, and the US Departments of Veteran’s Affairs and Defense. And studies show that it can reduce PTSD symptoms in 77% to 100% of trauma survivors in just 6 sessions.
So what exactly happens in an EMDR therapy session?
The First Stages of EMDR Therapy
EMDR therapy is comprised of eight stages – not all of which directly involve processing trauma. In the first few stages, your therapist will ask questions to learn about your life and history, work with you to develop goals for therapy, and create an individualized plan based on your goals and history.
Part of this plan includes taking inventory of your resources and strengths, and helping you to build a felt sense of confidence, safety, and calm. These resources can later be integrated into your trauma processing sessions, which can help you move more quickly and gently through the past.
This stage is absolutely essential to the success of trauma reprocessing, and it should not be skipped over or rushed.
Choosing Your Target Memories for EMDR Therapy
There are a variety of approaches to identifying and choosing which memories you will address throughout EMDR therapy.
The first approach is the Floatback Technique, where your therapist works with you using your present-day triggers to identify corresponding memories. Your therapist will guide you in identifying the thoughts, feelings, and images connected to the triggers you encounter. Once you are connected to these aspects of the trigger, it will be easier for you to remember other times in your life when you had the same feelings and thoughts. This technique should only be used with a trained trauma professional, as it may be upsetting or overwhelming for some survivors.
An approach that I prefer to use with clients who have complex histories of trauma is to create a life timeline. While creating this timeline, you and your therapist will highlighting both positive and painful experiences you’ve had throughout your life. You will also identify the negative thoughts and emotions connected to these memories. This will help to guide treatment as you install resources and enhance your connection to your strengths and decide which memories you will target first.
This exercise is inherently triggering and activating, so I only begin this process with complex PTSD survivors after we’ve established a sense of safety and connection in our relationship and spent time resourcing and practicing grounding strategies.
Reprocessing Traumatic Memories
After preparation and resourcing, your therapist will begin to lead you through reprocessing old memories - the “witch magic” part of EMDR!
Your therapist will first ask you a specific set of questions meant to engage different parts of your brain, moving through the limbic system to the prefrontal cortex. These questions are about the images, thoughts, and emotions connected to the experience, and will the same for every reprocessing session.
After the event is adequately activated in the brain (once it feels really vivid), your therapist will guide you in applying bilateral stimulation (BLS).
BLS is the rhythmic application of stimulus to the left and right side of the body. This includes eye movements (moving your eyes back and forth), tapping, and/or tones moving back and forth from ear to ear. Your therapist might ask you to choose what stimulus you prefer, or they may have a recommendation for you to try first.
While your memory is activated and you are applying BLS, you will likely experience a a more rapid processing of thoughts, sensations, emotions, and perspectives on what occurred. Often, your brain will start to remind you of other experiences that have been impacted by the event or by positive and strengthening memories of resilience and courage.
It’s common for one memory to take more than one session to complete. Some EMDR therapists like to extend sessions to 90 minutes or more to give clients the best chance to move through a complete memory.
You will know that you have completed the memory when you can think about the experience without experiencing physical activation (increased heart rate, body tension, sensations of warmth or cold) and when you can remember what happened while thinking adaptive thoughts about yourself, others, and/or the world.
EMDR therapy is a bit different for everyone, but tends to leave you feeling reflective, calm, and more aware of your thoughts and emotions.
The EMDR Therapy Future Template
After you have worked through and processed your traumatic memories, your therapist will then guide you in processing any anxiety or dread connected to the future. Together, you will identify future scenarios and situations where you might be triggered or feel overwhelmed and then use bilateral stimulation to reduce your reaction to those triggers.
Your therapist will use the same questions and structure to address future anxieties as past traumatic experiences. This will help to prepare you to face any lingering anxieties or fears connected to your past that may impact your future.
Understanding what happens in an EMDR session and knowing what you can expect can help you to feel more prepared to go to therapy.
Remember that getting started is often the hardest part, and once you find a therapist you trust to guide you through the process things get easier over time.
How to Find an EMDR Therapist
On most therapy directories, including TherapyDen and PsychologyToday allow you to search for a therapist with a specific speciality or approach, including EMDR Therapy.
You can also search directly on the EMDR International Association’s directory of trained EMDR therapists.