EMDR (eye movement desensitization and reprocessing) is a structured psychotherapy. Early sessions focus on your history and on learning ways to calm yourself. In later sessions you bring a distressing memory to mind while following the therapist's hand from side to side with your eyes, or while hearing tones or feeling taps, in short sets with brief check-ins between them. Here is what to expect from EMDR, phase by phase.
Before you book
EMDR is delivered by licensed mental health professionals, such as psychologists, psychiatrists, clinical social workers and licensed counselors, who have completed specific training in the method. Training and certification bodies differ by country, so ask which EMDR training a therapist completed and whether they work with concerns like yours. Search the Gyfts directory or ask your doctor or current therapist for a referral.
It helps to know the evidence before you start. A 2020 review of 114 randomized trials with 8,171 participants found EMDR had a clinically important effect on PTSD, alongside trauma-focused cognitive behavioral therapy. Tell the therapist about your mental health history, medications, alcohol or drug use and any history of dissociation or self-harm.
When you arrive
The setting looks like most psychotherapy: a private office and two chairs. Your first appointment is mostly conversation, and it usually does not include eye movements. The therapist explains how EMDR works, what it can and cannot do, and how consent works, including that you can pause or stop at any point.
Expect questions about what brings you in, your current symptoms, important past experiences, your supports and how you cope when things get hard. You do not need to tell every detail of a traumatic event in this first meeting. Say what feels manageable, and let the therapist know if talking about the past becomes overwhelming.
During the session
EMDR follows eight phases: history taking, preparation, assessment, desensitization, installation, body scan, closure and reevaluation. One appointment may cover several phases, and some phases take more than one appointment.
In history taking, the therapist learns about your background and current difficulties, identifies memories to work on and checks whether you are ready. In preparation, they explain the process in more detail and teach calming skills, such as picturing a calm place or slow breathing. You may also agree on a simple signal to stop and try a short set of eye movements, tapping or tones to see what suits you.
In the assessment phase you choose a target memory and pick out an image from it, a negative belief about yourself that goes with it (such as "I am not safe"), and a positive belief you would prefer to hold. The therapist asks you to rate how distressing the memory feels on a 0 to 10 scale and where you notice it in your body.
Desensitization is the part most people picture. You hold the memory in mind while following the therapist's hand or a light with your eyes, or while hearing alternating tones or feeling taps, for a short set. Then the therapist pauses and asks something like "What do you notice now?" You answer briefly and continue. You usually do not have to describe the memory aloud in detail.
In installation, the positive belief is paired with further sets. In the body scan you notice any remaining tension. Closure happens in every session, even when work on a memory is unfinished: the therapist helps you return to calm using the skills you learned. Reevaluation opens the next session with a check on what has changed.
What you might notice
The eye movements themselves can feel odd at first. During a set, people often notice images, thoughts, feelings or body sensations shifting from one moment to the next, and distress can rise for a while before it settles. Many feel tired afterward. Between sessions, vivid dreams, new memories or stronger feelings can appear, which is one reason the therapist checks in each time.
Exactly why EMDR helps is still debated. A 2013 meta-analysis found that adding eye movements gave a moderate extra effect in therapy studies, while an earlier analysis had found none. A 2025 review of 55 meta-analytic studies found benefits lasting beyond a month after treatment mainly for trauma-focused cognitive behavioral therapy and EMDR. Results vary between people, and no outcome is guaranteed.
Afterward
Plan something calm after a session if you can, rather than going straight into a demanding task. Use the calming skills you practiced, and be gentle with yourself if you feel drained.
Many therapists suggest keeping a short log of dreams, thoughts or reactions between sessions to bring to the next appointment. If distress feels unmanageable between sessions, contact your therapist. If you also see a doctor or psychiatrist, let them know you are in EMDR therapy so your care fits together.
Length, frequency and cost
Appointment length varies, and some therapists book longer slots for reprocessing sessions, so ask when you book. Sessions are often weekly; one 2023 study of adolescents gave one session a week for 12 weeks. The number you need depends on your history and goals, and a single recent event is often approached differently from many years of difficult experiences.
Because EMDR is a psychotherapy delivered by licensed clinicians, some health plans may cover it as therapy. Fees vary by region, setting and therapist. Ask about the session fee, insurance and sliding-scale options before you start.
Questions to ask and when to check with your doctor first
Useful questions: What EMDR training have you completed? How will we prepare before reprocessing? What happens if I feel overwhelmed? Do you also offer other approaches, such as cognitive behavioral therapy?
Talk with your doctor or psychiatrist first if you are in crisis, have active psychosis, severe dissociation, significant substance use or a neurological condition; EMDR may need extra preparation or a different starting point. Keep taking prescribed medication. If you have thoughts of suicide, call or text 988 in the United States.