What Happens in an EMDR Therapy Session? A Step-by-Step Guide
Many people considering EMDR therapy have the same question before they book: what actually happens in there? Not the clinical description, but what you will experience, think, notice, and feel from the moment the session begins to the moment it ends. That uncertainty keeps people from starting. This article walks through an EMDR session from the inside.
If you're in Alberta and weighing whether EMDR might help with trauma, anxiety, or distressing memories that haven't responded to other approaches, The Mental Health Clinic offers virtual EMDR therapy with trained clinicians across the province.
Table of Contents
- What Happens During an EMDR Therapy Session?
- The 8 Phases of EMDR Therapy Explained
- What Bilateral Stimulation Feels Like in EMDR
- What You Might Think or Feel During EMDR Processing
- How People Often Feel After an EMDR Session
- Finding an EMDR Therapist in Alberta
- Frequently Asked Questions About EMDR Sessions
What Happens in an EMDR Therapy Session?
An EMDR session involves a structured sequence of phases, but it doesn't begin with trauma processing. Early sessions focus on history-taking and building internal resources before any memory work begins. When active processing does start, you'll be guided to hold a specific memory lightly in mind while engaging in bilateral stimulation (alternating sensory input through eye movements, audio tones, or tapping). Between each brief set of stimulation, you report what you noticed. The session ends with a deliberate close-down to bring you back to baseline.
That's the broad shape of it. Here's what each part actually feels like.
The 8 Phases of EMDR Therapy Explained
EMDR follows a structured eight-phase protocol developed by Francine Shapiro. The phases don't unfold neatly across eight consecutive sessions; early phases are revisited, and a single session may move through several of them. What matters for understanding the experience is knowing what each phase requires of you.
Phase 1: History and Treatment Planning
This is a conversation. Your therapist gathers a picture of your history, the experiences that have shaped you, current symptoms, and what you're hoping EMDR can help with. You don't have to describe traumatic events in detail. You might say something like "there was a situation involving a family member when I was a child," and that's enough for treatment planning purposes. The goal is identifying targets for processing, not reconstructing a detailed account.
Phase 2: Preparation and Safety
This phase is more active than it sounds. Your therapist introduces you to how EMDR works, what bilateral stimulation involves, and what the processing phases will feel like. You'll practise the type of stimulation you'll use (eye movements, tones, or tapping) so it doesn't feel unfamiliar when it's introduced alongside memory content.
More importantly, you'll develop a set of internal resources: grounding techniques, a calm place visualisation, and containment strategies for managing distress between sessions. In clinical practice, this phase sometimes gets compressed when it shouldn't be. A well-trained therapist won't rush it, because the quality of preparation directly affects whether you can stay within your window of tolerance during later processing.
Phase 3: Identifying Target Memories
When processing is about to begin, your therapist will ask you to identify a specific memory or event to work on. You'll be guided to notice the image most associated with it, the negative belief you hold about yourself in connection with it ("I am powerless," "I should have known," "I am not safe"), and the emotions and physical sensations that come up when you bring it to mind.
You'll also identify a positive belief: what you'd prefer to believe about yourself. You'll rate the current believability of that positive belief on a scale from 1 to 7, and the intensity of your distress on a scale from 0 to 10. These are the Validity of Cognition (VOC) and Subjective Units of Disturbance (SUD) scales. They're not clinical formalities; they give both you and your therapist a concrete way to track what shifts across sets and across sessions.
Phases 4 Through 6: Desensitisation, Installation, and Body Scan
This is the core of active EMDR processing.
With the target memory activated, you follow the bilateral stimulation for a brief set, typically 20 to 30 seconds. Then your therapist asks a simple question: "What do you notice?" or "What came up?"
You might notice a new thought. A physical sensation. A different image. The emotional tone of the memory shifting. Something unrelated surfacing. Whatever comes up is valid information, and the therapist uses it to guide the next set. You're not trying to think anything in particular. The instruction is simply to notice.
This sequence continues until distress reduces substantially, or until the session reaches a natural stopping point and closure is needed. Full resolution of a target memory sometimes happens within one session; often it takes more than one. The SUD scale gives both you and your therapist a way to track what's shifting, not a finish line that has to be crossed before the session can end.
Then your therapist shifts to the installation phase, reinforcing the positive belief you identified while you hold the original memory, running additional sets until that belief feels genuinely true rather than just logically possible.
The body scan follows: you hold the memory and the positive belief together and notice whether any physical tension, tightness, or discomfort remains. Traumatic stress responses aren't only cognitive. They can include physical sensations, autonomic arousal, and somatic responses, and EMDR specifically attends to those bodily experiences rather than treating the memory as purely narrative. The body scan is a standard part of the protocol when a target memory has been fully processed in that session. When processing is incomplete, your therapist will move to closure instead, using containment techniques to help you set aside what's been opened until the next appointment.
Phases 7 and 8: Closure and Re-evaluation
Every session ends with a closure phase, regardless of where the processing has reached. If the target memory hasn't been fully processed, your therapist will guide you through a containment exercise, a way of mentally setting aside what you've opened until the next session, so you're not carrying activated material into your week.
The following session begins with re-evaluation: your therapist checks how you've been since the last appointment, whether any new material has surfaced, and what your current distress level is around the previous target.
What Bilateral Stimulation Feels Like in EMDR
This is what people are most curious about, and descriptions of it don't fully prepare you until you've experienced it.
Eye movements feel like watching something move slowly across your visual field while something else holds your attention in the background. The rhythm is deliberate, not fast. For most people, the physical sensation of following the movement becomes almost automatic within a few sets; the background attention on the memory is what you're primarily aware of.
Audio tones delivered through headphones create an alternating left-right sensation that some clients find easier to stay present with than eye movements. There's less physical effort involved, which can make it a useful option when emotional content is high and you're already using significant cognitive resources to stay regulated.
Self-tapping (alternating knee taps or crossing your arms and tapping your shoulders in what's called the butterfly hug) provides tactile bilateral stimulation. Some people find this the most grounding option, partly because the physical self-contact is regulating in itself.
Eye movements are the most extensively researched method and have the strongest evidence base. Tapping and audio tones are clinically viable alternatives with meaningful outcome data behind them, though the comparative research is less extensive.
Most clients describe a quality of dual attention during bilateral stimulation: part of you is following the stimulation, part is in contact with the memory, and part is observing what's happening. Researchers have proposed several competing explanations for why this produces the effects it does. One hypothesis draws on similarities to REM sleep states, suggesting the brain may process emotional memory during bilateral stimulation in a way that resembles what happens during dreaming. A separate and well-supported explanation, developed through working memory research by Van den Hout and Engelhard, proposes that the stimulation occupies cognitive resources in a way that reduces the emotional intensity of a recalled memory while it's being held in mind. Neither explanation is definitively settled, and the precise mechanism is still actively studied. What the research does consistently show is that the effects on distress are real and clinically meaningful.
What You Might Think or Feel During EMDR Processing
Processing is not predictable in the way that following a script is predictable. This is worth knowing in advance.
Some sets produce nothing you can identify as significant. You notice your own breathing. A neutral image passes through. Your therapist checks in and you continue. This is normal and doesn't mean the session isn't working.
Other sets produce something that feels almost like being pulled toward a memory or thought you hadn't anticipated. A physical sensation intensifies briefly. A wave of sadness comes up without a clear narrative reason. An old scene surfaces with unexpected clarity. Clients sometimes describe this as the memory having texture it didn't have before: "I noticed I was holding tension in my jaw the whole time. I don't know where that came from."
The intensity of what comes up varies significantly between sessions and between individuals. A good therapist will check in frequently during high-activation sets and adjust the pace based on what you're reporting.
What People Often Feel After an EMDR Session
This is the piece that doesn't get enough attention before people start.
Physical fatigue is common after processing sessions. The session may look like sitting in a chair for an hour, but the mental and neurological effort involved is significant. Some clients describe leaving feeling heavy; others describe a specific kind of clarity alongside tiredness. Both are normal.
Emotional material can continue to move after a session ends. You may notice thoughts or images surfacing over the following day or two that feel connected to what you worked on. Some people describe dreams that seem related. This is the brain continuing to integrate, not a sign that something has gone wrong.
Some clients feel relief almost immediately, a genuine sense that the weight of a particular memory has reduced. Others feel emotionally sensitive for 24 to 48 hours, with lower than usual tolerance for stress. A smaller number experience what clinicians sometimes describe as a processing hangover: mild headache, fatigue, difficulty concentrating, or emotional flatness that passes within a couple of days.
What this means practically: plan a gentle transition after your sessions. Avoid scheduling high-stakes commitments directly after an appointment. Have something restorative lined up. This isn't a prescription to avoid your life; it's an acknowledgement that your nervous system has been doing real work and benefits from some recovery time.
One consistent pattern in clinical practice is that clients often can't immediately gauge how much a session did. You may close the laptop, or leave the office, feeling uncertain whether anything shifted, and then notice three days later that you thought about the memory and it didn't pull the same charge it used to. The changes in EMDR often register in the absence of a reaction rather than the presence of one.
Finding an EMDR Therapist in Alberta
If you're curious about whether EMDR is suited to what you're working through, therapy can help clarify that. At The Mental Health Clinic, Amy offers EMDR therapy to adults across Alberta through secure virtual sessions, including a free 20-minute consultation to discuss your history and whether EMDR fits your situation.
Whether you're in Edmonton, Calgary, Red Deer, or a smaller community across Alberta, the structure of an EMDR session stays consistent. What changes is what you bring to it. Understanding what's actually happening inside that structure, what's being asked of you, what you might experience, and what the changes can look like, makes the process considerably less opaque before you start.
Frequently Asked Questions About EMDR Sessions
What happens if I feel overwhelmed during an EMDR session?
Therapists are trained to monitor pacing carefully and help you stay within a manageable level of emotional activation. If distress increases, the therapist may slow the process, pause stimulation, or guide grounding or containment strategies. Preparation skills introduced earlier in therapy are specifically designed for these moments. The goal is to keep the experience tolerable and collaborative.
What if I don’t notice anything during bilateral stimulation?
Some sets feel neutral or uneventful, especially early in processing. This does not mean the session is not working. Changes can occur gradually, and people sometimes notice shifts later in the session or even in the days that follow. Your therapist guides the process based on whatever you do notice, even if it feels subtle.
What if new memories come up that seem unrelated?
It is common for the mind to link related experiences over time. When new material appears, the therapist helps determine whether it is connected to the current target or something to return to later. Processing does not need to follow a perfectly linear path. These associations often help identify the experiences that need attention.
Do I have to finish processing a memory in one session?
No. Some memories take more than one session to fully process. EMDR sessions are structured to include closure, even when processing is still ongoing, so you are not left feeling emotionally exposed between appointments. Your therapist will help you return to a more settled state before the session ends.
Will I lose control or feel unaware of what is happening during EMDR?
No. EMDR does not involve hypnosis or loss of awareness. Most people remain aware of the room, the therapist, and the present moment while noticing thoughts, memories, or sensations connected to the target experience. Many describe it as being aware of both the memory and the present at the same time.
Why does the therapist keep asking “What do you notice?”
The question is intentionally open-ended so your mind can move naturally to the next relevant association. There is no right or wrong answer, and you do not need to analyse or explain your response. Even small observations help guide the direction of the next set. This approach allows the brain to process information without needing to force insight.
Educational Disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you're experiencing mental health concerns that interfere with your daily functioning, please reach out to a qualified mental health professional. If you're in crisis, contact your local crisis line or emergency services immediately.
