If you are considering EMDR therapy, you may wonder what happens during a session. Will you have to relive a difficult experience or describe every detail? What if it feels overwhelming?
These are understandable questions. As a counsellor and EMDR therapist, I see EMDR as one option within a broader therapeutic relationship. We begin by understanding what is happening for you and whether this approach fits your needs. Processing a memory is never the first or only step.
What is EMDR therapy?
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured psychological therapy used to help people process distressing experiences. It is an established treatment for post-traumatic stress disorder (PTSD).
Sometimes an event has ended, but reminders still trigger a strong reaction. A sound, smell, place or situation might bring back anxiety, intrusive memories or a physical sense of danger. You may know that you are safe now while your response feels as if the threat is happening again.
EMDR aims to reduce the distress associated with those memories. It does not erase what happened. The goal is for the memory to feel like something in the past, with less power over your present life.
How does EMDR therapy work?
In EMDR, you briefly bring aspects of a target memory to mind while engaging in bilateral stimulation. This often involves following the therapist’s fingers from side to side. Alternating taps or sounds may also be used.
One proposed explanation is that recalling a memory while following eye movements places demands on working memory, which may reduce the memory’s vividness and emotional intensity. The precise mechanisms are still being studied. EMDR is more than eye movements: assessment, preparation, guided processing and reviewing what has changed are all part of the therapy.
Is EMDR the same as tapping therapy?
No. Alternating taps can be one way to provide bilateral stimulation, but EMDR is a complete therapeutic approach. Calling it “tapping therapy” leaves out the assessment, preparation and processing that give the technique its context.
What happens during an EMDR therapy session?
An EMDR therapy is usually phased. We do not need to begin processing a difficult memory as soon as you enter the room.
- Assessment and history. We discuss what has brought you to therapy, your current circumstances and what you hope will change. This helps us decide whether EMDR is appropriate and what support you may need.
- Preparation. We talk through the process and develop ways to manage distress and feel grounded. You can ask questions and discuss concerns before working on a memory.
- Choosing a target. When you are ready, we identify a memory or experience to focus on. I may ask about an image, a belief about yourself, emotions and sensations associated with it.
- Processing. You notice the memory while following eye movements or another form of bilateral stimulation. After each short set, I ask what you notice. Thoughts, emotions, sensations or other memories may arise; there is no “correct” response.
- Review and closure. We check how you are feeling, use grounding where needed and review what has changed. At later sessions, we can revisit the work and decide together what to focus on next.
The pace depends on you. Preparation may take more than one session, and processing does not have to be completed in a single appointment.
Do I have to talk about my trauma in detail?
Not necessarily. EMDR involves identifying and accessing aspects of an experience, but you do not have to give a detailed verbal account of everything that happened. You can discuss with me what you feel comfortable sharing and what I need to understand to work safely with you.
Difficult feelings can still arise, even without a detailed account. We can pause, slow down or return to grounding if the work feels too much. You remain involved in decisions throughout the process.
What does EMDR therapy feel like?
There is no single experience. You might notice emotions, images, thoughts or physical sensations during processing. You might make a connection that had not occurred to you before. Some changes feel noticeable in the room; others are more gradual.
EMDR does not need to feel dramatic to be useful. We look at whether it is helping with the difficulties that brought you to therapy, rather than comparing your experience with anyone else’s.
What is EMDR therapy used for?
The clearest established evidence is for PTSD and trauma-related symptoms. These can include intrusive memories, nightmares, avoidance, strong reactions to reminders, guilt or shame related to an experience, and feeling on alert long after an event has ended.
EMDR has also been studied for other difficulties, but the evidence is not equally strong across conditions. Having one of these symptoms does not mean EMDR is automatically the right choice. An assessment helps us understand your circumstances and consider the available approaches.
Can EMDR help with anxiety and panic attacks?
Sometimes, particularly when a distressing past experience appears connected to a current reaction. For example, someone who had a severe panic attack while driving might later feel anxious when approaching the same route, then begin avoiding longer journeys.
That does not mean every case of anxiety or panic calls for EMDR. We would explore what is happening now, consider any relevant experiences and decide whether EMDR, CBT, talking therapy or a combination is most appropriate.
Do I need a PTSD diagnosis to have EMDR?
Not necessarily. You do not have to arrive knowing which therapy you need. We can explore that together. There may be circumstances where EMDR is considered without a PTSD diagnosis, just as there may be times when another approach is a better fit even if you specifically asked about EMDR.
Is EMDR recommended in the UK?
Yes. NICE guidance on PTSD recommends offering EMDR to adults with PTSD or clinically important PTSD symptoms who present more than three months after non-combat-related trauma. Between one and three months after such a trauma, NICE says to consider EMDR if the person prefers it.
The guidance says EMDR should be delivered in phases by trained practitioners. It typically involves 8 to 12 sessions, with more where clinically indicated, such as after multiple traumas. That is a guideline rather than a promise about how long your own therapy will take.
Is EMDR therapy safe?
EMDR therapy is an established therapy, but working with traumatic memories can bring up difficult emotions or sensations during and between sessions. Assessment, preparation and a pace that takes account of your response are important parts of the work.
I want you to understand the process, have ways to manage distress and feel able to tell me when you need to pause. We can review how you are responding as therapy progresses and reconsider the approach if your needs change. If you are worried about your safety or struggling to manage between appointments, tell your therapist or seek appropriate urgent support.
How do I know whether EMDR is right for me?
You do not need to decide on a therapy before getting in touch. We can begin with what is troubling you, what you hope to change and any questions you have about EMDR. From there, we can consider whether it is a suitable approach or whether another form of therapy would serve you better.
Frequently asked questions about EMDR therapy
1. What happened in my first EMDR appointment?
Your first appointment usually focuses on understanding your concerns, history and what you want from therapy. Your therapist can explain EMDR, answer questions and discuss preparation. Processing a distressing memory may begin later, once you agree that you are ready.
2. Will I be aware of what is happening during EMDR?
Many people stay aware of the room and their therapist throughout EMDR. You may notice emotions, but you can speak up, ask to pause or use grounding strategies. Your therapist should explain the process and check how you are responding.
3. How many EMDR sessions will I need?
NICE says EMDR for adults with PTSD typically involves eight to twelve sessions, with more when indicated, such as after multiple traumas. The time you need depends on your circumstances, preparation and goals. Your therapist can review progress with you.
4. How might I feel after an EMDR session?
Some people notice tiredness, emotions, dreams or thoughts between sessions. Experiences vary, and changes may be gradual. It can help to allow time afterwards and use grounding techniques discussed with your therapist. Tell them if anything feels difficult to manage.
5. Does EMDR make you forget a traumatic memory?
No. EMDR does not erase a memory or change the facts of what happened. The aim is to reduce how distressing the memory feels and help you respond to reminders. Results vary, and your therapist should review progress with you.
