When people ask me about EMDR, what they usually want to know is what the eye-movement part feels like. That's a fair question, and I'll get to it. But the honest first answer is that it comes later than most people expect, and everything before it is there on purpose.
EMDR stands for Eye Movement Desensitization and Reprocessing. It's an eight-phase treatment for trauma and PTSD, and it's recommended in the VA and Department of Defense clinical guidelines for PTSD. Here's how those phases actually play out in my office.
The first few sessions: getting ready
At a minimum, it takes us about four sessions to reach the part people picture. Those early sessions cover the first three phases:
- History. We talk about what brought you in, what you've been through, and what you want to be different. You don't have to tell me every detail of anything you're not ready to share.
- Preparation. We build your toolkit: ways to calm your body and steady your emotions when something hard comes up. You use them in session before we ever go near a difficult memory, so you know they work for you.
- Assessment. Together we choose the specific memory we'll work on, called the target, and get a clear picture of it.
This part matters. It lets us build trust, and it lets me see that you have skills you can rely on before we start processing anything. We move forward when you're ready, not on a schedule.
The session people picture
Phase four is desensitization, and it's what most people mean when they ask about EMDR. Here's roughly how it goes.
We bring up the target memory we chose earlier. I'll ask you to notice the worst part of it, along with whatever emotions or body sensations show up as you recall it. Then we begin bilateral stimulation, which just means something that alternates left and right: your eyes following my fingers or a light, small handheld tappers that buzz in each hand, or tones in each ear. It engages both sides of the brain, and it helps your brain do what it couldn't do at the time: process the memory and file it away.
After each short set, we pause and you tell me briefly what came up. Then we start the next set. You don't have to narrate the memory in detail, and you're awake and in control the whole time. You can stop whenever you need to.
Along the way I'll ask you to rate how distressing the memory feels on a scale from 0 to 10. Over the sets, that number comes down. You still remember what happened. It just stops feeling like it's happening now.
How every session ends
We don't stop in the middle of something raw. At the end of each session we use the stabilization skills you learned in preparation, so you leave feeling settled and steady, not stirred up. The remaining phases strengthen a more helpful belief about yourself, check for anything still held in your body, and review where we are at the start of the next session.
Is EMDR right for you?
EMDR is one of the two treatments I use most for trauma, along with Cognitive Processing Therapy. It isn't the right fit for everyone or every situation, and part of my job is helping you figure that out. You can read more on my EMDR page.
That's what the free 15-minute phone call is for. You tell me what's going on, ask me anything about EMDR or anything else, and I'll tell you honestly whether it makes sense for you.
Book a free 15-minute consult or call (330) 439-2157. Sessions are available in my Wooster office or by telehealth for clients located in Ohio.
If you need support right now: if you are thinking about harming yourself or you're in crisis, call or text 988, the Suicide and Crisis Lifeline. If you are in immediate danger, call 911.