Everything You Need To Know About EMDR Before Your First Session

Going to therapy can sound scary especially if that therapy method is something you’re not experienced with, or don’t know. EMDR, although highly successful for all kinds of mental health problems, is one of those unfamiliar forms, at least for some people. So, what is EMDR? How does it work? How is it conducted? What can you expect to happen? How can you prepare for the session? 

In this blog post, we will answer these, and many more logical questions to tell you everything you need to know about EMDR before your first session. 

EMDR Foundations and History

Eye Movement Desensitization and Reprocessing therapy, also called EMDR therapy, is an evidence-based therapy specifically made to help with PTSD, trauma-related problems, anxiety and panic, depression and low self-esteem, and all of their related mental health difficulties. 

EMDR therapy was developed by Dr. Francine Shapiro in 1987, originally called EMD (Eye Movement Desensitization.) In 1991, (R) Reprocessing was added, to better reflect the cognitive changes that happen during sessions. 

EMDR uses sensory input to work on traumatic experiences by tackling your memory of them and replacing the beliefs connected to those experiences with more constructive beliefs. Numerous studies show that one EMDR therapy session can give the client benefits that other psychotherapies take years to achieve (EMDR Institute, Inc.). 

What Is The Goal of EMDR Therapy?

EMDR aims to clear the patient’s blockage of emotional processes due to traumatic experiences. In theory, when we are faced with a traumatic experience, memories can get stuck and stay unprocessed, easily disturbing everyday thinking and feeling processes.

With the help of bilateral stimulation (side-to-side fast eye movements, hand tapping, or audio stimuli,) EMDR tackles traumatic experiences in which the brain itself is engaged in following the stimulation. As this happens, it becomes easier to tackle the trauma, go over it, and even substitute certain parts of the memory with beliefs that are more constructive or less self-restraining. 

EMDR is not the same as hypnosis. Bilateral stimulation is used to provoke experiences similar to those that happen during REM sleep. These REM brain waves are optimal for processing and integrating information. Once this process happens seamlessly, you can process the traumatic experience in the safety of a therapist’s office, obtaining the basis to resolve the trauma and integrate the whole experience so it doesn’t interfere with your current life.  

What Can EMDR Therapy Help With?

EMDR was, initially, used to resolve trauma and traumatic experiences, including conditions like PTSD and C-PTSD. While the specific traumatic event is personal and particular to the client and their experiences, there are a few experiences and problems that can be universal. They include: 

  • Sudden death of a loved one

  • Sexual, emotional, physical or mental abuse

  • Natural disasters 

  • First Responder or military trauma

  • Financial stress and loss of a job 

  • Witnessing a crime or violent accident

  • Physical injury or life-altering conditions

  • Post Traumatic Stress Disorder 

Today, Medical News Today (EMDR therapy: Everything you need to know, 2019) cites the EMDR Institute and their 30 controlled studies that show the effectiveness of EMDR for a range of conditions and problems, including PTSD, anxiety, depression, and self-esteem issues. 

What Will Happen In An EMDR Session?

In the first phases of EMDR therapy, the therapist will ask the patient relevant questions that will help him/her get familiarized with the past experiences and events that add to the emotional distress of the patient. Doing so, the therapist can then come up with a personalized treatment plan that tackes the important aspects of the patient’s life. The therapist will also answer all the questions that the patient might have about the process, the duration, the flexibility, and the extent of the therapy in general. 

Once the relevant past experiences are identified as emotional triggers, the EMDR treatment process can start. In this phase of the process, the therapist will use bilateral stimulation, coupled with exercises and questions to recall and visualize distressing memories, helping the patient to internalize and process the whole experience. Scientifically, this is called desensitization, as the emotional distress of the experience itself lowers with the recollection and the reprocessing. With that, the memory of the traumatic experience loses the emotional charge, allowing the patient to achieve closure and healing.

In the next part, we will go into a little bit more detail about the whole process.

Understanding The EMDR Process

EMDR has eight fundamental phases, each of them serving a particular cause and addressing a particular part of the whole treatment. In the initial sessions, you can expect the therapist to conduct history collection, resourcing, and targeting. After these three aspects are covered, the treatment can then move toward active use of bilateral stimulation, desensitization, and reprocessing.

  • History collection 

In the initial part of the EMDR treatment, I will get a detailed understanding of the patient's history by asking relevant questions. 

The content of this conversation will cover the patient’s life story, traumatic events, mental health challenges or processes, some symptoms, and triggers. It will also cover deeper levels of the patient’s mindset, thinking patterns, emotional states, personal beliefs about the traumatic experience (experiences), recurring life themes, and everything else that might be relevant to the treatment. 

This phase builds trust and rapport between the therapist and the client, making sure that we both feel comfortable and can further work together. 

  • Resourcing 

In the second phase of the treatment, we will focus on the positive aspects of the patient’s life. This includes the client’s support systems, personality strengths, coping skills, emotional resilience, etc. For the therapist, these resources are an invaluable asset that can be constructively used down the line, during treatment. 

Trauma work can be very hard and exhausting since traumatic experiences are always coupled with intense and uncomfortable negative feelings. The client’s resources can serve as counter-balance tools as opposed to the trauma. Because they are already successful parts of the client's life, they can be used as “building blocks” that help the client cope, manage, improve, and integrate the traumatic experiences. 

Positive resourcing tools include positive memories and experiences, breathing exercises, passion and hobbies, positive affirmations, relevant people and social circles, and the like.

  • Targeting 

The last step of the initial phase is targeting i.e. pinpointing the specific memories that are traumatic and need to be addressed during treatment. In this process, the therapist and the client jointly discuss and determine the memories that should be worked on. This process is very important, as it is highly individual and personalized. Without it, there is the risk of the process being only partially successful, or, in the worst case, unsuccessful. 

The process of targeting includes: identifying the target memories, evaluating the significance of the memories, assessing the emotional intensity, assessing the cognitive beliefs connected to the traumatic memory, rating the distress, finding resourcing and positive beliefs, and floatback (linked) memories. 

The targeting phase is essential for setting the right path for effective trauma processing and integration. As such, it should accurately assess both the traumatic experiences that need to be worked through, as well as all of the associated beliefs and emotions connected to the experience itself. 

Is EMDR Therapy Painful?

EMDR is not painful, especially not in the classical, physical, sense of the word. Focusing on trauma and traumatic experiences, nonetheless, can be emotionally painful, especially if not previously addressed and completely unprocessed. 

As time passes, and the trauma (traumas) is addressed, thinking about the traumatic experience brings less and less emotional distress, thus becoming less emotionally painful.

What to expect at the very first EMDR therapy session?

The whole EMDR therapy process might take anywhere between 3 and 12 sessions, depending on the particular client and their background. Each session can last anywhere between 60 and 90 minutes. 

The whole process is done only after the client feels empowered and able to control his/her responses to the traumatic experience and recall it without significant emotional distress. 

The first session of EMDR therapy serves to establish trust, gather relevant information about the client’s past experiences, recourse their strong sides, and target the particular traumas that need to be addressed. 

These are the aspects that are usually tackled during the first session: 

  • Establishing mutual trust, respect, and comfortability

  • Childhood experiences and memories

  • Mental processes, thoughts, and beliefs 

  • Traumatic experiences and sources of distress 

EMDR Therapy in Nashville 

In EMDR therapy, it’s essential to establish a good relationship with the therapist and have complete trust in their professionalism and expertise. This is why your EMDR therapist must be certified and highly experienced.

The therapists here at EMDR Therapy Nashville are certified and experienced therapists who have extensively utilized EMDR therapy to help clients with all kinds of experiences and trauma sources. Our therapists work with PTSD, trauma, anxiety, depression, self-esteem issues, triggers, relationship difficulties, and general life dissatisfaction. 

If you want to improve the quality of your life and release the burden of previous traumatic experiences, schedule your initial EMDR session or a consultation and start your healing journey. 

References

Leonard, J. (2019, July 11). EMDR therapy: Benefits, effectiveness, and side effects. Medical News Today. https://www.medicalnewstoday.com/articles/325717 

What is EMDR?. EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (2024, January 3). https://www.emdr.com/what-is-emdr/ 

Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. The Guilford Press.

 

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