Your First EMDR Session: What to Expect (and what comes next)

When new clients come to me asking for EMDR, chances are, they’ve already done some research, and have some idea of what they are asking for. They usually know that EMDR involves digging into the past, and following something with their eyes. Some know a little more, some maybe a little less, but most have one thing in common: they have enough knowledge to be both curious about learning more, and nervous about what it will be like. And while every EMDR therapist has their own style, I’m hoping this blog post about what to expect in your first EMDR session, and how I approach EMDR with my clients, can help to ease some of those worries.

Let’s Start with a Little More Context

The part about digging into the past and following something with your eyes? That’s true, but it’s only a piece of the bigger picture.

EMDR is an 8-phase model, and the part where you focus on the painful event and move your eyes back and forth (“reprocessing” or “desensitization”) is just one of the phases. There are a few phases before and after reprocessing, and I’ll briefly walk you through them now.

Phase 1: History and Treatment Planning Phase 1 is all about me getting to know you, understanding what you are hoping will be different once we’ve completed treatment, and coming up with a plan to get you there. During this phase, I’ll ask about your family structure, and we’ll discuss your history, including any difficult or traumatic events, as well as negative messaging and other, more subtle experiences that have shaped your beliefs about yourself. I’ll ask about what symptoms or patterns you are hoping to change, and start to make connections between your history and your symptoms.

Phase 2: Preparation Phase 2 is all about helping you feel safe and ensuring that you feel ready (if still a little nervous) to begin reprocessing. I’ll answer any questions you have, teach you a little more about how EMDR works, and how it can help you specifically, and introduce you to different types of bilateral stimulation, or BLS. I’ll also ask how you cope with stress, and teach some new coping strategies, as well as some tools that will help us as we go through EMDR. In my work, I often blend Phase 1 and Phase 2 together. These two phases will be the focus of the first few sessions.

Phase 3: Assessment Based on the history we took back in Phase 1, we’ll choose a Target Memory for our first reprocessing session. I’ll ask you to watch a movie of this memory in your mind, pausing at the worst part. I’ll ask you to focus on the image that represents that worst part, what emotions are coming up, where you feel it in your body, and what it makes you believe about yourself. I will ask how bad it feels, using a 1-10 scale, and return to this scale periodically throughout reprocessing to help assess how you are moving through the memory.

Phase 4: Desensitization/ Reprocessing This is where we begin “reprocessing” the memory. I’ll ask you to focus on the memory, while you engage in bilateral stimulation, typically following a dot across your screen. I’ll ask you to allow your mind to go where it needs to go, without judging or trying to make sense of it. After each “set” of about 30-45 seconds, I’ll have you pause, take a deep breath, and ask you “What came up?” We keep going with each new piece of information until your SUDS reaches a 0, or in some cases, a 1. I may jump in and offer some insight, or some direction, but in this phase, I am generally there to facilitate your reprocessing, and to stay out of the way, allowing your brain to do the healing work that it’s capable of.

Phase 5: Installation Once we’ve reached a 0-1 SUDS in Phase 4, we will identify a new, positive belief about yourself that’s connected to this memory. We will utilize bilateral stimulation (BLS) to strengthen that belief.

Phase 6: Body Scan Once Phase 5 is complete, I’ll ask you to hold in your mind both the target memory, and the new, positive belief, while scanning your body from head to toe, checking for any lingering disturbance in your body. If anything shows up, we’ll reprocess that before moving on.

Phase 7: Closure Closure is about helping you return to a state of relative calm. I will guide you through deep breathing, guided imagery, movement, or other strategies to help you regulate following a Reprocessing session. I’ll also give you an idea of what to expect or what to monitor in between sessions, and may ask you to engage in some mindful self care before returning to your next task.

Phase 8: Re-evaluation At the start of each new session, I’ll ask you how you felt after the previous session, if anything related to the memory or the belief came up for you between sessions, and how the memory feels now. I’ll ask you if you feel okay returning to reprocessing (either that memory, or, if complete, choosing the next target memory) or if there is something else you’d prefer to focus on that day.

So there it is. Your first EMDR session may not feel a whole lot different from any past experiences you’ve had in therapy. It may be a little more thorough, or a little more focused on the past, but overall, the first session is really just about us getting to know each other, making a plan, and me helping you feel grounded and safe before any reprocessing starts. And when you are ready for reprocessing? We’ll take it at your pace, and only when you say you’re ready.

Think of it less like jumping into a cold pool and more like slowly wading in from the shallow end.

Will It Feel Emotional?

It might. Even in an early session, simply talking about what's brought you to therapy can feel pretty emotional. That's completely normal, and I’m here to help you move through it at a pace that feels manageable.

I won’t ask you to sit with more than you can handle. A good EMDR therapist pays close attention to your window of tolerance: the zone where you're able to process difficult material without becoming overwhelmed or shutting down. If something starts to feel like too much, you can say so. You're always in the driver's seat.

A Few Things That Might Surprise You

You don't have to share every detail of what happened. EMDR is not a talk therapy in the traditional sense. You don’t have to talk through every memory, or share every detail of what happened. EMDR processes these memories internally, with your therapist supporting you as you and guiding this process.

It might feel anticlimactic. And that's okay. Some people leave their first session feeling a little underwhelmed, like "that's it?" The early phases of EMDR are intentionally gentle. The depth comes later, once you’ve gotten at least a little bit comfortable with the process, and have established some trust with your therapist.

You might feel tired afterward. Even a first session that doesn't involve formal processing can be surprisingly draining. Give yourself some grace after your appointment. I recommend taking some time for yourself after each EMDR session, especially the first few. Plan to take a walk, stretch, journal and reflect on the experience, or just sit quietly for a few minutes.

Every session doesn’t have to be EMDR. Some of my clients have expressed hesitation about starting EMDR because they worry they will miss having space to talk through things that are going on in their life, or that it will feel too heavy to focus on the past week after week. YOU are in charge of how we spend each session. If you choose to do EMDR every session, we’ll do EMDR every session. If you’d like to have a session now and then to talk through something that’s bothering you, that’s what we’ll do.

What If I'm Nervous About Starting?

Being nervous about starting EMDR (or, for that matter, anything new) is not just okay, it’s pretty standard for most people. Many of the clients I work with arrive at their first session carrying a lot of anticipatory anxiety. They're worried about losing control of their emotions, being overwhelmed, or "doing it wrong."

Here's what I want you to know: you cannot do EMDR wrong. You don't have to perform or prepare or arrive with the right answers. You just have to show up. A huge part of EMDR is just showing up, and trusting the process enough to let your mind go where it needs to go to process the material.

And the fact that you're even thinking about this step? That takes courage. You’ve been carrying all of this for a long time, and it can be scary to think not just of going back into some of these uncomfortable or painful memories, but also to think about what it could be like to finally release it all. But remember that the nervous system that's been working so hard to protect you is also capable of healing, and EMDR is one of the most effective tools we have to help that happen.

Ready to Learn More?

If you're curious about whether EMDR might be a good fit for you, I’d love to connect. You can reach out here to schedule a free consultation and let’s talk.

Susan Candiloro, LCSW-R, is an EMDRIA Certified Therapist and EMDRIA Approved Consultant in private practice in New York and Florida. She specializes in working with high-achieving women navigating anxiety, perfectionism, burnout, and people-pleasing.