What Happens in an EMDR Session? A Walk-Through for the Curious (and Nervous)
You've heard about EMDR. Maybe a friend swears by it. Maybe you've googled it at 11pm and ended up more confused than when you started. Something about eye movements and trauma, but how does that actually work? What would you even do in a session?
If you're someone who likes to know what you're walking into before you walk into it, this post is for you.
EMDR (Eye Movement Desensitization and Reprocessing) is one of the most well-researched trauma treatments available. It's been studied extensively for PTSD, and therapists are increasingly using it for anxiety, depression, grief, shame, and the kind of complex relational trauma that doesn't fit neatly into a single "incident." But despite how effective it is, it can sound pretty strange from the outside.
So let's walk through what actually happens.
First: EMDR Isn't Just Eye Movements
The name is a little misleading. Yes, bilateral stimulation is a core part of EMDR processing, but it doesn't have to be eye movements. Many therapists use alternating taps on the hands or knees, or audio tones that alternate between left and right ears. The point is the bilateral quality (rhythmic, alternating input to both sides of the brain), not the specific form it takes.
Why bilateral stimulation at all? The honest answer is that researchers are still working out the full explanation. The leading theory involves the way your brain processes information during REM sleep. That same rapid back-and-forth eye movement happens naturally while you sleep, and it seems to be connected to how the brain consolidates and integrates experience. Bilateral stimulation during EMDR appears to do something similar: it helps the brain shift out of the stuck, hyperactivated state that traumatic memories get frozen in and move toward something more integrated.
But before we get to that part, there's a lot of important groundwork.
Phase 1 & 2: History-Taking and Preparation (This Takes Longer Than You Might Think)
EMDR has eight phases, but you won't be doing bilateral stimulation from day one. A good therapist won't rush you there.
The first phase is history-taking. Your therapist will want to understand what brings you in, what your life has looked like, and what experiences (big and small) have shaped how you move through the world. In EMDR, we're looking for what we call "targets": the memories, beliefs, and experiences that are at the root of what's keeping you stuck. This isn't always obvious at first. Sometimes what looks like a straightforward single-incident trauma has roots in something much older. We take our time here.
The second phase is preparation, and it's one of the most important parts of the whole process. Before we ever approach a difficult memory, we make sure you have enough internal resources to do so safely. This might involve:
Grounding and stabilization work. Learning to orient to the present moment in your body, so you have somewhere solid to return to.
Installing a "calm place." A visualization or felt sense of safety that you can access when things feel too activated.
Psychoeducation. Helping you understand what EMDR processing feels like, what to expect, and what the "window of tolerance" is (the zone between too activated and too shut down, where real processing can happen).
Some clients spend several sessions in preparation before we touch any trauma material. This isn't stalling. It's building the foundation that makes genuine healing possible rather than retraumatizing.
Phase 3: Assessment — Finding the Memory's Fingerprint
When you and your therapist decide together that you're ready to begin processing, you'll start by identifying a specific target memory.
This doesn't have to be the most dramatic or "worst" thing that ever happened to you. Often we start with something that feels manageable, a memory that carries some charge but isn't completely overwhelming. Your therapist will help you identify:
The image that represents the worst part of the memory, what your mind goes to when you bring it up
The negative belief you hold about yourself in relation to it, something like I am not safe, or I am worthless, or It was my fault
The positive belief you'd rather hold, what you'd like to be true about yourself instead (I am safe now. I did the best I could. I am worthy of love.)
The emotion that comes up when you hold the memory and that negative belief together
Where you feel it in your body, the tightness in your chest, the knot in your stomach, the held breath
The SUDs (Subjective Units of Disturbance), just a number from 0-10 for how distressing it feels right now.
This might sound clinical, but in practice it's a gentle, curious conversation. We're essentially taking a snapshot of where the memory lives in you right now, so we can track how it shifts.
Phase 4: Desensitization — Where the Processing Happens
This is the phase people are usually most curious about.
Your therapist will ask you to bring up the target image, the negative belief, and notice what you feel in your body. Then the bilateral stimulation begins. Maybe they move two fingers back and forth in front of your eyes, or hand you a set of tappers that pulse alternately in each hand.
And then they'll say something like: Just notice whatever comes up.
Here's what's important to understand about this phase: you don't have to do anything. You're not trying to analyze the memory, or find insight, or force anything to shift. You're just noticing whatever images, thoughts, emotions, sensations, or memories arise, and letting your mind go where it goes. Your therapist will check in with you every set of bilateral stimulation, ask what you're noticing, and then send you back in with another set.
What happens can be surprising. Some people move through emotions quickly: sadness, then anger, then something that feels like release. Some people have unexpected memories surface, something from years earlier that seems connected. Some people feel things shift in their body before they feel them shift in their mind. Some sessions feel dramatic. Others feel quiet and subtle, and the shift only becomes clear in the days that follow.
What you won't be doing is narrating a detailed account of your trauma while I sit there taking notes. EMDR processing isn't talk therapy. You don't have to put everything into words. Your brain is doing the work, and your job is mostly just to stay present and not block what's moving.
Phases 5–7: Installation, Body Scan, and Closure
Once the disturbance around the memory has reduced significantly (ideally to a 0 or 1 on that 0-10 scale), we shift gears.
Installation is the phase where we strengthen that positive belief you identified earlier. Remember I am safe now, or I did the best I could? We pair that belief with the original memory using bilateral stimulation, helping it land more deeply. Not just as an idea you agree with intellectually, but as something your body starts to actually believe.
Then we do a body scan, bringing your attention slowly through your body while holding the memory and the positive belief, noticing if there's any remaining tension or discomfort anywhere. If there is, we process that too. The goal is for the memory to feel genuinely neutral in the body, not just tolerable.
Finally, closure. Not every session ends with full resolution. Sometimes we're in the middle of something and need to close it carefully. Your therapist will help you return to a grounded, stable state before you leave the session. You won't be sent back into your day flooded or unmoored.
Phase 8: Reevaluation
At the start of the next session, your therapist will check back in on what was processed. How does the memory feel now? What's shifted? This phase also helps your therapist understand what's ready to be worked on next.
What EMDR Doesn't Feel Like
Because I want to be honest with you about the parts that sometimes get left out:
EMDR can be emotionally tiring. Processing old pain, even in a contained and supported way, takes something out of you. Many clients find they need some quiet time after sessions: a gentle walk, a nap, some space to integrate. Plan for this if you can.
Processing doesn't always feel linear. Sometimes things feel worse before they feel better, and incomplete processing between sessions can mean difficult emotions or vivid dreams for a few days. This is normal. Your brain is working.
EMDR isn't a quick fix, and it's not right for everyone. If your nervous system is very dysregulated, or if you don't yet have enough stability in your daily life, preparation work may need to come first, sometimes for a long time. There's no shame in that. It's not a detour. It's the work.
So, Is It Worth It?
For many people, yes. Profoundly.
Clients often describe something shifting in a way that years of talk therapy hadn't quite reached. Not because talk therapy isn't valuable (it is), but because some of what trauma leaves behind doesn't live in the part of the brain that words reach. It lives in the body, in the nervous system, in the places that are older and deeper than language.
EMDR can get there.
If you've been carrying something for a long time, something that understanding alone hasn't been enough to change, it might be worth finding out what processing could do.
Curious about whether EMDR might be right for you? I offer EMDR therapy for adults in Los Angeles and throughout California via telehealth. I'd love to answer your questions in afree 15-minute consultation.