How does it work? An EMDR therapy session example
Understanding What Happens in EMDR Sessions
Eye Movement Desensitisation and Reprocessing (EMDR) therapy represents a structured approach to addressing traumatic memories and distressing experiences. Many people considering EMDR treatment wonder what actually occurs during sessions and how the therapy unfolds in practice. Understanding the typical flow of an EMDR session can help demystify the process and prepare individuals for what to expect when they begin this form of therapy and how it compares to other forms of talking therapies.
EMDR therapy follows an eight-phase protocol developed through extensive research and clinical practice. Each phase serves specific purposes, from establishing safety and identifying targets to processing memories and evaluating outcomes. Whilst the overall structure remains consistent, the therapist tailors the approach to each client's unique needs, experiences, and therapeutic goals. This flexibility within structure allows EMDR to address various mental health concerns effectively.
The therapy gained recognition initially for treating post-traumatic stress disorder (PTSD), though its applications have expanded considerably. Research demonstrates EMDR's effectiveness for anxiety, depression, phobias, and other conditions where distressing memories or experiences contribute to current difficulties. The bilateral stimulation—typically eye movements, though sometimes tactile or auditory—facilitates the brain's natural information processing, allowing stuck or unprocessed memories to be integrated more adaptively.
For those seeking information about EMDR, numerous resources exist including professional training videos, educational materials from mental health organisations, and clinical psychology journals. These resources provide valuable insights into the theoretical foundations and practical applications of EMDR therapy. However, experiencing EMDR firsthand differs from observing demonstrations or reading descriptions, as the processing that occurs is deeply personal and unique to each individual.
Therapists who practise EMDR have undergone extensive specialised training beyond their initial mental health qualifications. This training ensures practitioners understand the neurobiology of trauma, the mechanisms of EMDR, and how to apply the protocol safely and effectively. Clients benefit from working with properly trained therapists who can navigate the complexities that sometimes arise during trauma processing and who understand how to adapt the approach when needed.
The following section presents a detailed example of how an EMDR session might unfold, illustrating the key phases and demonstrating how the therapist guides the client through the process. This example, whilst representative of typical EMDR work, is a composite designed for educational purposes. Actual number and format of sessions vary considerably based on individual circumstances, the nature of the traumatic event or memories being addressed, and the client's responses during processing.
A Detailed Example of One EMDR Treatment Session
Sarah, a 34-year-old professional, seeks EMDR therapy for anxiety and panic attacks that began following a car accident two years earlier. During previous sessions, the therapist completed the history-taking and preparation phases, establishing that Sarah has adequate coping resources and identifying the accident as the primary target event for processing. Today's session focuses on the desensitisation phase, where Sarah will process the traumatic memory using bilateral eye movements.
The session begins with the therapist checking in about Sarah's week and ensuring she feels ready to engage in processing work. The therapist reviews the coping resources Sarah learned during preparation, including her "safe place" visualisation and grounding techniques. This brief check-in helps establish that Sarah is in an appropriate mental and emotional state for trauma processing. The therapist explains what will happen during the session and reminds Sarah that she can signal if she needs a break at any point.
Moving into the assessment phase for this particular target, the therapist asks Sarah to identify the most distressing image from the accident. Sarah describes seeing the other vehicle approaching just before impact. The therapist then asks what negative belief Sarah holds about herself when recalling this incident. After some reflection, Sarah identifies the belief: "I am not safe." The therapist helps Sarah articulate a positive belief she would prefer to hold: "I am safe now." Using a scale from one to seven, Sarah rates how true this positive statement feels currently—she reports it as a two, indicating it feels mostly false at present.
The therapist asks Sarah to rate the distress of the memory using the Subjective Units of Disturbance scale, where zero represents no disturbance and ten represents the worst disturbance imaginable. Sarah rates her current distress as an eight. The therapist then asks where Sarah notices sensations in her body when thinking about the accident. Sarah reports tension in her chest and shoulders, along with a feeling of her heart racing. With this assessment complete, the therapist explains that they will begin the desensitisation phase.
The therapist asks Sarah to hold the image of the approaching vehicle in her mind, along with the negative belief "I am not safe," whilst noticing the physical sensations in her body. The therapist begins moving two fingers horizontally across Sarah's field of vision, and Sarah follows these eye movements with her eyes. After approximately 30 seconds of bilateral stimulation, the therapist stops and asks Sarah to "blank it out" and take a deep breath. The therapist then asks, "What do you notice now?"
Sarah reports that she felt intense anxiety during the eye movements but now notices the image seems slightly less vivid. The therapist acknowledges this and instructs Sarah to "go with that" whilst initiating another set of eye movements. This pattern continues—sets of bilateral stimulation followed by brief check-ins about what Sarah notices. Over subsequent sets, Sarah's processing begins to deepen. She recalls details she had forgotten, experiences waves of emotion, and gradually notices shifts in her perspective on the event.
During one set, Sarah spontaneously recalls a memory of her father teaching her to drive as a teenager, emphasising safety and careful attention. This association, arising naturally during processing, represents the reprocessing at work—Sarah's mind is making connections and integrating the traumatic memory with more adaptive information. The therapist encourages Sarah to notice this memory and then returns to additional sets of eye movements, allowing the processing to continue organically.
After several more sets, the therapist checks Sarah's distress level again. Sarah reports it has decreased to a four. The processing continues, with Sarah working through various aspects of the memory—the sounds, the physical sensations, her thoughts in that moment, and the aftermath. The therapist maintains a supportive presence, offering minimal intervention to allow Sarah's natural processing to unfold, whilst remaining attentive to any signs that Sarah might need additional support or a pause in the work.
Eventually, Sarah reports that when she thinks about the accident now, her distress has reduced to a one. The image no longer triggers the same intense anxiety, and she can recall the event without feeling overwhelmed. The therapist moves to the installation phase, asking Sarah to think about the memory whilst holding the positive belief "I am safe now." The therapist asks how true this statement feels on the same one-to-seven scale. Sarah reports it now feels like a six—significantly more believable than at the session's start.
The therapist conducts several sets of eye movements whilst Sarah holds both the memory and the positive belief together, strengthening this adaptive perspective. After these sets, Sarah reports the positive belief now feels like a seven—completely true. The therapist then conducts a body scan, asking Sarah to think about the original incident whilst mentally scanning her body from head to toe, noticing any residual tension or discomfort. Sarah reports feeling calm and relaxed throughout her body, with no remaining physical distress related to the memory.
As the session moves toward closure, the therapist guides Sarah through a brief relaxation exercise to ensure she leaves the session feeling grounded and stable. The therapist explains that processing may continue between sessions, and Sarah might notice dreams, new insights, or memories emerging. They discuss what Sarah can do if she experiences any distress before the next session, reviewing the coping resources established during preparation. The therapist schedules a follow-up session for the following week to continue addressing any remaining aspects of the accident and to evaluate whether additional targets need attention.
Understanding the Therapy Process Through This Example
This example illustrates several key elements that characterise EMDR sessions. The structured approach provides a clear framework, yet the therapy remains flexible and responsive to what emerges during processing. The therapist's role involves facilitating the client's natural processing rather than directing it, trusting that Sarah's mind will make the connections necessary for healing. This client-centred aspect of EMDR distinguishes it from more directive therapy approaches.
The bilateral eye movements serve as the mechanism through which processing occurs, though the exact neurobiological mechanisms remain an area of ongoing research. Current theories suggest that the eye movements may activate similar processes to those occurring during REM sleep, when the brain naturally processes and consolidates experiences. Other forms of bilateral stimulation, such as alternating tactile taps or auditory tones, can achieve similar effects, making EMDR accessible even for clients who cannot comfortably engage in eye movements.
The reduction in distress that Sarah experienced during this single session represents typical EMDR outcomes for straightforward trauma. Some clients process memories completely within one session, whilst others require multiple sessions to fully address a particular target event. Complex trauma, particularly experiences of repeated abuse or neglect over extended periods, generally requires more extensive treatment involving processing multiple memories and addressing various aspects of the traumatic experiences.
The spontaneous emergence of Sarah's memory about learning to drive with her father demonstrates the associative nature of memory processing in EMDR. The brain naturally seeks out resources and more adaptive information during reprocessing. These unexpected connections often contribute to the therapeutic change, as clients access internal resources and perspectives they had not consciously recognised. The therapist's training prepares them to recognise and support these natural processes as they unfold.
It is important to note that not all EMDR sessions proceed as smoothly as this example suggests. Sometimes processing stalls, requiring the therapist to employ additional techniques or strategies. Clients may experience blocking beliefs that need to be addressed before processing can continue. Intense emotions may arise that require the session to pause whilst the client regains stability. These variations are normal and reflect the complexity of trauma processing. Skilled therapists navigate these challenges, adjusting their approach to ensure processing remains safe and effective.
The installation phase, where positive beliefs are strengthened, represents a crucial component often overlooked in simplified descriptions of EMDR. It is insufficient to merely reduce distress; the therapy also aims to help clients develop more adaptive beliefs and perspectives. This positive cognitive restructuring contributes to lasting change, helping clients not only feel better but also think about themselves and their experiences in healthier, more adaptive ways.
Accessing EMDR Therapy and Additional Resources
For individuals considering EMDR therapy, finding a properly trained therapist represents the first step. Professional organisations provide directories of certified EMDR practitioners who have completed recognised training programmes. These practitioners bring various backgrounds—some are psychologists, others are counsellors or social workers—but all share specialised training in applying the EMDR protocol. When selecting a therapist, consider both their EMDR credentials and their experience with the specific issues you wish to address.
Many mental health organisations and EMDR professional bodies maintain websites offering information about the therapy, including educational videos that demonstrate sessions (with actors or willing participants). These resources can help prospective clients understand what to expect and make informed decisions about whether EMDR might suit their needs. However, watching demonstrations differs significantly from experiencing the therapy, as the internal processing that occurs cannot be fully captured in external observations.
The cost and accessibility of EMDR therapy vary depending on location and healthcare systems. Some regions offer EMDR through public mental health services, whilst others require private payment or use of insurance. The number of sessions needed varies considerably—some clients achieve their goals in relatively few sessions, whilst others engage in longer-term therapy. During initial consultations, discuss practical matters such as online or in person treatment, session frequency, expected duration of treatment, and costs to ensure the therapy is feasible for your circumstances.
Training requirements for EMDR practitioners continue to evolve as the field develops. Basic EMDR training typically involves 40-50 hours of instruction, including didactic learning, demonstration, and supervised practice. Many practitioners pursue advanced training in specialised applications of EMDR or in working with particular populations. When seeking treatment, enquiring about a therapist's training background and ongoing professional development can provide confidence in their competence and commitment to delivering quality care.
For those who have experienced trauma or continue to struggle with distressing memories and their impact on daily life, EMDR represents one of several evidence-based treatment options worth considering. The example provided here offers a glimpse into the therapy process, though actual experiences vary widely. Speaking with trained EMDR therapists about your specific situation will help determine whether this approach might benefit you and what you can realistically expect from treatment. With proper support and evidence-based therapy, healing from traumatic experiences is possible, and EMDR has helped countless people move beyond the grip of painful memories toward more fulfilling lives.
