If you have heard of EMDR therapy but are not quite sure what actually happens during a session, you are not alone. EMDR stands for Eye Movement Desensitization and Reprocessing, and it is a structured type of therapy that can help people work through traumatic or upsetting experiences that still feel emotionally intense in the present.

People often hear about the eye movements used in EMDR and assume that is the main part of treatment. In reality, EMDR involves several steps, and much of the work happens before the eye movements or other forms of bilateral stimulation even begin.

Step 1: Your Therapist Gets to Know You

EMDR usually begins much like other types of therapy. Your therapist will spend time learning about your history, what has been bothering you, and what you would like help with. You may talk about past experiences, current triggers, difficult emotions, or negative thoughts that seem to keep coming back.

You do not have to share every detail of a painful experience right away. The first goal is to build trust, understand what you are experiencing, and begin identifying what may be helpful to work on.

Step 2: You Build Coping and Grounding Skills

Before working directly with difficult memories, your therapist will help you develop tools for managing uncomfortable emotions. These may include breathing exercises, grounding techniques, relaxation strategies, visualization, or identifying calming and positive memories.

This preparation is an important part of EMDR. The goal is not to bring up a painful memory before you feel ready. Instead, your therapist helps you build skills first so you have ways to stay grounded if strong emotions come up during the process.

As EMDR therapist Frank Guastella, LCSW, explains, these resources can help a person approach difficult memories with more strength, courage, hope, and confidence.

Step 3: You Choose What to Work On

Once you and your therapist feel that you are ready, you will identify a specific memory or experience to focus on. This is sometimes called a target.

Your therapist may ask you to notice the part of the memory that feels most upsetting, the emotions connected to it, and any negative belief you have about yourself because of what happened. You may also be asked where you feel the distress in your body and what healthier belief you would like to have instead.

For example, someone may connect a difficult experience with the belief, “I am not safe.” A healthier belief might be, “I am safe now.”

Step 4: Bilateral Stimulation Begins

This is the part of EMDR that most people recognize. While focusing on the memory, your therapist will guide you through bilateral stimulation, which simply means alternating stimulation from one side of the body to the other.

This may involve moving your eyes from side to side, hearing alternating sounds, or using gentle alternating taps. Your therapist will usually guide you through short sets and then pause to ask what you notice.

You might become aware of a thought, emotion, physical sensation, image, or even another memory. There is no correct answer and nothing you are supposed to force. You simply notice what comes up while your therapist helps guide the process.

Step 5: The Memory Begins to Feel Different

During EMDR, the goal is not to erase a memory. Instead, the goal is to reduce the emotional intensity connected to it.

A memory that once felt overwhelming may begin to feel more distant or easier to think about. You may still remember exactly what happened, but it may no longer feel as though you are reliving the experience every time something reminds you of it.

People may also notice a shift in the way they think about themselves. A belief such as “I was powerless” may begin to move toward something healthier, such as “I survived,” “I can handle things now,” or “I am safe.”

Step 6: A Healthier Belief Is Strengthened

Once the memory feels less distressing, your therapist may help you focus more closely on the healthier belief you identified earlier.

Sometimes people already know something logically but do not fully feel it. For example, someone may know that a traumatic event was not their fault but still carry guilt, shame, or fear connected to it.

EMDR can help the healthier belief begin to feel more emotionally real. As Frank describes it, something you already know is true can begin to feel true as well.

Step 7: Your Therapist Checks How Your Body Feels

Trauma and stress do not only affect thoughts and emotions. They can also show up physically through muscle tension, tightness in the chest, shakiness, stomach discomfort, or a general feeling of being on edge.

During EMDR, your therapist may ask you to think about the memory again and notice whether any physical distress remains. If something still feels uncomfortable, you may continue processing it.

This step helps make sure that the memory is not only feeling different mentally, but that the body is also beginning to respond differently.

Step 8: The Session Ends With Grounding

A memory does not have to be completely processed in one appointment. If time is running out or the work is not finished, your therapist will help you shift your attention back to the present.

You may use some of the grounding or relaxation skills you practiced earlier in treatment. Your therapist may also talk with you about what you could notice between sessions, such as changes in thoughts, feelings, dreams, or reactions.

At the beginning of your next appointment, you will usually check in about how things have felt since the previous session and decide where to continue.

Do You Have to Talk About Every Detail?

Not necessarily! One thing many people appreciate about EMDR is that you do not always need to describe every detail of an experience out loud.

Your therapist needs enough information to understand what you are working on, but much of the processing happens internally. You remain awake, aware, and in control throughout the session.

EMDR is not hypnosis, and your therapist is not changing or erasing your memories. The therapist's role is to guide and support the process while you work through what comes up.

What Does EMDR Feel Like?

Everyone experiences EMDR differently. Some people feel emotional during a session, while others notice unexpected thoughts, memories, or physical sensations. Some people feel tired afterward, while others describe feeling calmer or lighter.

Changes may also happen gradually rather than all at once. EMDR is not about forcing yourself to “get over” something. It is about helping the brain process an experience so it does not continue to create the same level of distress in your present life.

Interested in Learning More About EMDR?

If difficult experiences from the past continue to affect how you feel, react, or think about yourself today, EMDR may be worth exploring.

At Long Island Behavioral Health, our therapists can answer your questions about EMDR and help you determine whether it may be a good fit for your needs.

To learn more or schedule an appointment, call 631-551-5095 or e-mail office@longislandbehavioralhealth.com.