If you are thinking about EMDR therapy, you probably have questions. What actually happens in a session? Will I have to relive my worst memories? How long until I feel better? And is it normal to feel worse before I feel better?

These are common questions, and knowing the answers can make starting EMDR feel a lot less intimidating. This guide walks through what EMDR sessions look like, how long treatment usually takes, and the side effects some people notice along the way.

A quick refresher: what is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured, evidence-based therapy that helps people heal from trauma and other distressing experiences.

When something painful happens, the memory can get "stuck" with the same emotions and body sensations you felt at the time. EMDR uses bilateral stimulation, such as guided eye movements, tapping or tones, while you briefly focus on the memory. Over time, the memory becomes less intense and less tied to the present.

For a full overview of how EMDR works and who it helps, visit our EMDR therapy page.

Before reprocessing: getting ready

Many people are surprised to learn that EMDR does not start with difficult memories. The first sessions focus on getting to know you and making sure you feel steady.

History and goals. Your therapist will ask about your background, what brings you to therapy and what you would like to feel different. You do not need to share every detail of what happened. Together you will identify a few target memories or situations to work on.

Building coping skills. Before any reprocessing begins, your therapist will teach you grounding and calming techniques. A common one is the "calm place" exercise, where you picture a place that feels peaceful and safe. Another is the "container" exercise, where you imagine putting distressing thoughts away until your next session. You will use these skills during sessions and in between them.

This preparation stage can take one session or several. For people with complex or long-term trauma, it often takes longer, and that is a normal part of doing EMDR safely.

What happens during a reprocessing session

Once you feel ready, you will start working on your first target memory. A typical reprocessing session looks something like this:

• Setting up the memory. Your therapist asks you to bring up an image from the memory, the negative belief connected to it (such as "I am not safe" or "It was my fault"), and where you feel it in your body. You will rate how distressing it feels on a scale from 0 to 10.

• Bilateral stimulation. You hold the memory in mind while following your therapist's fingers or a light with your eyes, or while noticing tapping or tones. This happens in short sets of about 20 to 30 seconds.

• Noticing what comes up. After each set, your therapist will ask, "What do you notice now?" You might notice a thought, image, feeling or body sensation. You do not need to explain it in detail. You simply notice and continue.

• Strengthening a positive belief. As the memory becomes less upsetting, your therapist helps you connect it to a healthier belief, such as "I survived" or "I am safe now."

• Closing the session. Every session ends with time to settle. If a memory is not fully processed, your therapist will use your coping skills to help you leave feeling grounded.

Sessions usually last 60 to 90 minutes. Many people describe the experience as watching the memory from a distance, or like scenery passing by a train window. You stay awake and in control the whole time, and you can pause whenever you need to.

Do you have to relive your trauma?

No. This is one of the biggest differences between EMDR and many other approaches. You bring the memory to mind briefly, but you do not have to describe every detail out loud or stay in it for long stretches. Your therapist focuses on what you notice in the moment, not on retelling the full story.

That said, reprocessing can bring up strong emotions. Feeling sad, angry or shaky during a set is common, and your therapist is trained to help you move through it at a pace that feels manageable.

How long does EMDR take to work?

There is no single answer, because it depends on your history and goals. In general:

• Single events, such as a car accident or one frightening experience, may need fewer reprocessing sessions. Some people notice a change within a few sessions.

• Complex or long-term trauma, such as childhood trauma or repeated experiences over many years, usually takes longer. Preparation may take more time, and there may be more memories to work through.

• Most people meet weekly, which helps keep momentum between sessions.

Your therapist will check in with you regularly about progress. One useful sign is when a memory that once felt like a 9 or 10 now feels closer to a 0 or 1, and the negative belief you started with no longer feels true.

If you are carrying memories from childhood, our post on facing repressed memories of childhood trauma may also be helpful.

Common side effects of EMDR

Because EMDR helps your brain process difficult material, it can stir things up for a while. Side effects are usually mild and temporary, and they are often a sign that processing is still happening. Some people notice:

• Vivid dreams or more dreams than usual

• New memories, thoughts or feelings coming up between sessions

• Feeling tired or drained after a session

• A temporary increase in distress before things start to ease

• Headaches or lightheadedness, especially after eye movement sets

• Feeling emotionally raw for a day or two

These effects tend to fade as treatment continues. Using the grounding skills you learned, getting good rest and keeping a few notes about what comes up can all help. Bring anything you notice to your next session, since it often gives your therapist useful information.

If side effects feel overwhelming, tell your therapist. They can slow the pace, spend more time on coping skills or adjust your plan.

Can you do EMDR on yourself?

You may see videos or apps that claim to offer "self EMDR." While some calming techniques, like the butterfly hug, can be helpful for grounding, full EMDR reprocessing is best done with a trained therapist. Working on traumatic memories without support can leave you feeling flooded and without a safe way to close the session.

A trained EMDR therapist provides structure, keeps an eye on your stress level and makes sure you leave each session feeling steady.

Is online EMDR as effective?

Online EMDR follows the same structured approach as in-person sessions. Instead of following your therapist's hand, you may follow a moving dot on the screen or use self-tapping, such as alternating taps on your knees or shoulders. Many clients find it comfortable to do this work from a familiar, private space at home.

At Lartey Wellness Group, you can do EMDR in person at our Laurel office or online from anywhere in Maryland, including Baltimore, Columbia, Silver Spring and Annapolis.

Getting started with EMDR in Maryland

If past experiences still affect how you feel, think or react today, EMDR may be worth exploring. It can help with trauma and PTSD, and it is also used for anxiety, panic, phobias and distressing memories. Many clients combine EMDR with support for depression or other concerns.

Our trained EMDR therapists see clients in person in Laurel and online across Maryland. We accept Maryland Medicaid and most insurance plans, and our team will check your benefits before your first session. You can meet our clinicians or learn more about EMDR therapy in Laurel and online.

Request an appointment or call (800) 994-5403

If you are in crisis right now, call or text 988 for free, 24/7 support, or visit our crisis resources page.

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