What You Can Expect in Your First Eye Movement Desensitization and Reprocessing (EMDR) Session

By: Holly Earnest, M.Ed., APC, NCC

Beginning EMDR therapy can seem scary and unsettling. It may feel unfamiliar or daunting, especially if you’re not sure what to expect or what EMDR truly entails. You may have heard or read others’ experiences with EMDR, or you may already have a preconceived notion of what it is and what will happen during the first and subsequent sessions. However, just as everyone experiences all types of therapy and first sessions differently, EMDR is also experienced differently. Your first session is not about jumping straight into processing difficult or challenging memories. Instead, it is about building rapport with your therapist, getting comfortable with the process, laying out a foundation for therapy, and answering and discussing all your questions and concerns. The first session of EMDR therapy is meant to cultivate an encouraging, safe, slow, and hopeful environment, not a threatening or intimidating one.

Getting To Know You

Amazing! You have scheduled your first EMDR session and are ready to begin this next journey of healing. That takes courage, and you should be so proud of your bravery! But what can you really expect in the very first session?

This first session is all about learning more. Learning more about the therapist's approach and style and, most importantly, what is bringing you to therapy. We will go over your current concerns and challenges, as well as what you’re hoping to work towards in therapy. We may also briefly explore some history components, if tolerable, and engage in dialogue about who you are, where you come from, and where you want to go. This is a great time to explore EMDR, its origin, research-based evidence, and the EMDR therapeutic process as I answer all your pressing questions and concerns by providing psychoeducation on all things therapy. The first session is a low-pressure and relationally important session as it serves as the groundwork for creating and developing a safe, secure, and healthy therapeutic environment.

Learning About EMDR

As mentioned, in the first session you will learn what EMDR is, how it works, the bilateral stimulation methods that are available for you to choose from, and what the different phases of treatment may look like. EMDR consists of eight different phases, and not only will you walk away with a greater understanding of EMDR and its phases, but you will also walk away with a deeper conceptualization of what EMDR treatment can look like. Each of the eight EMDR phases serves a vitally important role in supporting the overall EMDR treatment process. Hint: reprocessing difficult material is only one phase out of the total eight phases.

Identifying What You Want to Work On

If it feels tolerable for you and your nervous system, we may begin exploring experiences, emotions, beliefs, or situations that you'd like to address with EMDR therapy. You do not have to have a specific memory or anything else figured out, as we will explore this together in a safe and regulating environment. However, similar to the history gathering, if this feels especially dysregulating or fear-inducing to do in the first session, we will instead focus on increasing comfort and emotional and physiological safety.

Learning Coping and Grounding Skills

Before processing any difficult experience or memory, and often before history gathering, we will learn, explore, and practice various methods of grounding, regulation, and coping. We will work on some foundational resources for coping and regulation for EMDR, such as a calm place and container, all of which are considered phase two of EMDR therapy. We will practice these resources, build understanding, and strengthen these coping strategies while engaging in slow, bilateral stimulation.

Going At Your Own Pace

EMDR is a collaborative process. You are not expected to share everything at once or discuss anything you aren’t ready to discuss. We will work at a pace that feels manageable and tolerable for you and we will adjust it to whatever pace you (and your nervous system) need. While we will be working together and collaborating on making this experience as conducive and safe as possible, we will also be working with your nervous system to establish regulation, stabilization, safety, and security. This further highlights the collaborative nature of EMDR and working at your pace.

Closing

Your first EMDR session isn't about “doing EMDR perfectly or quickly.” It is not a magic wand. It is about building a foundation, understanding the process, and beginning to identify what and how you want healing to look like for you. It is simply the beginning. We can figure the rest out together.

I hope to see you soon,

Holly Earnest, M.Ed., APC, NCC