Getting Started

Getting started with Eye Movement Desensitization and Reprocessing (EMDR) therapy can be both exciting and anxiety provoking. EMDR is a unique and highly effective form of psychotherapy designed to help individuals process and overcome traumatic experiences. If you're considering EMDR or have scheduled your first session, you might be wondering what to expect. This article will guide you through the typical structure and elements of a first EMDR session in a counseling clinic.

What is EMDR?

Before diving into the specifics of a session, it's helpful to understand the basics of EMDR. Developed by Francine Shapiro in the late 1980s, EMDR therapy involves using bilateral stimulation—typically eye movements, but also sometimes taps or sounds—to help the brain process and integrate traumatic memories. This process aims to reduce the distress associated with these memories and help individuals develop healthier ways of coping.

Initial Assessment and Rapport Building

Your first EMDR session will likely begin much like any other therapeutic encounter: with an initial assessment and the establishment of a therapeutic relationship. Your therapist will spend time getting to know you, understanding your history, and discussing your reasons for seeking EMDR therapy.

1. Intake and History Taking

The therapist will conduct a comprehensive intake interview to gather information about your mental health history, current symptoms, and specific traumatic experiences you wish to address. This process is crucial for creating a tailored treatment plan and ensuring that EMDR is appropriate for your needs.

2. Explaining EMDR

Your therapist will provide an overview of what EMDR is and how it works. They will explain the eight phases of EMDR therapy, emphasizing the importance of safety and your ability to remain in control throughout the process. This explanation helps demystify the procedure and sets clear expectations for what lies ahead.

Establishing Safety and Trust

A crucial part of the first session involves building a foundation of trust and safety. EMDR can evoke strong emotions, and it's essential for you to feel comfortable and supported.

3. Creating a Safe Space

Your therapist will work with you to establish a "safe place" or a mental sanctuary that you can retreat to if you become overwhelmed during the EMDR process. This could be a real or imagined location that makes you feel calm and secure.

4. Resource Development

Before diving into trauma processing, your therapist may teach you various coping strategies and grounding techniques. These resources are vital tools that you can use to manage distressing emotions that may arise during and between sessions. Techniques might include deep breathing exercises, visualization, or progressive muscle relaxation.

The EMDR Process

Once the groundwork is laid, your therapist will begin the initial phases of EMDR therapy.

5. Target Identification

Together, you'll identify specific memories, thoughts, or experiences that you want to process. These targets could range from significant traumatic events to smaller, distressing experiences that continue to affect you.

6. Assessment Phase

The therapist will guide you through a structured assessment of the chosen target memory. This involves identifying the vivid visual image associated with the memory, the negative belief about yourself related to the memory, and the emotions and physical sensations it evokes. You will also identify a positive belief that you would like to adopt in place of the negative one.

Bilateral Stimulation

When the brain is bilaterally stimulated (BLS) you reprocess and heal.

7. Desensitization and Reprocessing

The core of EMDR involves bilateral stimulation. In this first session, you might get a brief introduction to this process. Your therapist will ask you to follow their finger movements with your eyes, listen to alternating tones through headphones, or feel taps on your hands, or with a light bar. This stimulation helps to "unlock" the brain's processing capabilities, allowing the memory to be reprocessed and integrated in a healthier way.

8. Checking In

Throughout the bilateral stimulation process, your therapist will frequently check in with you. They will ask you to notice any thoughts, feelings, or sensations that arise. This feedback loop is essential for guiding the session and ensuring that you remain grounded and safe.

Closing the Session

As your first EMDR session draws to a close, your therapist will help you transition out of the processing state and ensure that you feel stable and secure.

9. De-escalation and Review

Your therapist will guide you through techniques to help reduce any residual distress. This might involve returning to your safe place, practicing deep breathing, or discussing any lingering emotions. Finally, your therapist will review the session with you, discussing what was achieved and any insights gained. They will also outline the plan for future sessions and what you can do between sessions to support your progress.

10. Conclusion

Your first EMDR session is a foundational experience designed to prepare you for deeper work. It’s normal to feel a mix of curiosity and apprehension, but keep in mind, your therapist is there to support you every step of the way. By understanding what to expect, you can approach your first session with confidence, ready to begin a path toward healing and recovery.

11. Learn More

Learn about how EMDR therapy works, what it is like, and how widely it is recognized. EMDR therapists discuss how EMDR therapy works and the feedback they receive from clients.