What to Expect During an Eye Movement Desensitization and Reprocessing (EMDR) Session

What is eye movement desensitization and reprocessing (EMDR)?

Eye movement desensitization and reprocessing (EMDR) is a nontraditional type of psychotherapy. It is most commonly used for the treatment of trauma and post-traumatic stress disorder (PTSD). It is particularly helpful for individuals with PTSD who have difficulty talking about the traumatic event or have a history of dissociation when discussing the traumatic event.

Most forms of psychotherapy used for PTSD focus on changing thoughts, emotions and responses related to a traumatic event. EMDR focuses on the memory of the event. The goal is to change how the memory is stored in the brain in order to reduce or eliminate the negative symptoms that are triggered by the memory.

During EMDR, an individual briefly focuses on the traumatic memory while engaging in bilateral eye movements or other movements, such as tapping, as directed by a therapist. This allows the individual to be exposed to the memory while being distracted, which can decrease the vividness of the memory and the emotions associated with it.

What to expect during an EMDR session

The number of sessions is typically between three and twelve, depending on the complexity of the trauma. Each EMDR treatment lasts approximately 90 minutes. Eight phases occur during these sessions. Early sessions usually include phase one and two, with the remaining phases occurring during later sessions, often at different times.

1. Patient history
   During the first phase, the provider will ask questions and gather information concerning life history. This information helps determine whether a person is a good candidate for EMDR. They will also ask about disturbing thoughts, memories and events the individual wishes to focus on during the EMDR sessions. Goals will be set for the progression of therapy.
2. Preparation and education
   The provider will discuss the process of EMDR sessions and what to expect. Together, the individual and therapist will develop a toolkit of coping mechanisms to help with grounding during and after the sessions.
3. Assessment
   The components of the targeted memory, including the thoughts, emotions, and body sensations that surround the memory, are identified. In addition to establishing the negative beliefs regarding an experience, a provider will help with determining positive or neutral concepts moving forward.
4. Desensitization and reprocessing
   Unpleasant memories will be activated to help identify feelings, thoughts, body sensations, etc. As reprocessing occurs, guidance is provided for new thoughts, feelings, and other insights that may appear. During this phase, a sense activation (e.g., eye movement, tapping, light, sound, pulsating devices, etc.) will be utilized.
5. Installation
   The individual will focus on positivity to move forward during this phase. The therapist guides them through reprocessing the memory with a new belief in mind.
6. Body scan
   Bodily sensations will be examined while thinking of the event or experience that is being reprocessed. Ideally, the bodily symptoms experienced should gradually decrease until they are gone or more manageable.
7. Closure and stabilization
   During the later sessions, the therapist will discuss potential, future experiences and how to self-soothe and stabilize in everyday situations. Guided imagery or meditation may be practiced until the individual feels calm and safe enough to end the session.
8. Re-evaluation and continuation of care
   The therapist will determine how to proceed with continuing care. They may suggest additional sessions or adjusted goals. They can also help the individual contemplate the future and how to better handle difficult emotions.