What Actually Happens in an EMDR Session

EMDR sessions begin with assessment and preparation. During a later processing session, you bring aspects of a memory to mind while following short sets of bilateral stimulation, such as guided eye movements. Your therapist pauses to ask what you notice and leaves time to close the session. Processing begins when you and your therapist agree it is appropriate. EMDRIA describes these stages of treatment.

You may want help with a painful memory and still feel uneasy about working on it. Will you have to describe every detail? What happens if it becomes too much?

I'm Masood Suliman, a Registered Psychotherapist in Hintonburg, Ottawa. EMDR is a large part of my work with adults experiencing trauma and PTSD. You can find my training, fees and appointment options on the EMDR therapy in Ottawa page.

What happens in the first EMDR sessions?

In my practice, we talk about your history, the difficulties you want help with and what supports you have in daily life. We also spend time finding ways for you to stay connected to the present when something difficult comes up.

With complex or childhood trauma, I pay attention to how you respond to calm or pleasant feelings as well as distress. If even a quiet moment feels uncomfortable, that matters to how we prepare. I want to understand what happens for you rather than assume that an exercise described as calming will feel that way.

The preparation needs to fit the person. EMDRIA explains that the time spent in this phase varies. You do not need to arrive with a set of coping techniques already mastered.

When directly approaching a memory feels too intense, I may consider the Flash Technique as part of the plan. We would discuss why I am suggesting it and what it involves. My PTSD therapy in Ottawa page and complex PTSD treatment guide explain more about how I approach this work.

What happens during EMDR memory processing?

EMDR stands for eye movement desensitization and reprocessing. It is a structured psychotherapy used to treat PTSD. The World Health Organization identifies EMDR among the psychological treatments with the strongest evidence for PTSD.

When we agree to begin processing, we identify a memory to work with, including an image, a belief about yourself, and the feelings or sensations connected to it. I may ask you to rate how distressing it feels. We then use short sets of bilateral stimulation, such as guided eye movements, with pauses to check what you notice. This outline is consistent with the National Center for PTSD's description of EMDR.

You usually do not need to narrate the event in detail, but EMDR processing does involve bringing aspects of it to mind. That distinction matters if your main concern is having to remember at all. We should discuss it before starting. The National Center for PTSD explains this difference.

EMDR is not hypnosis. You can ask to pause or stop. EMDRIA describes the client's ability to stop the process.

This is called dual awareness: attending to the memory while remaining aware of the present. I sometimes describe the aim as having one foot in the memory and one foot in the room with me. If you feel far away, numb or overwhelmed, tell me as best you can. That gives us information about what needs to change in the pace or approach.

The full treatment framework is explained in the eight phases of EMDR. Those phases are not a promise that a memory will be fully processed in one appointment.

Planning for the hours afterward

Thinking about a traumatic experience can be uncomfortable. Some people feel tired afterward or notice memories, images or dreams between appointments. The Royal Devon NHS patient leaflet describes these possibilities. They are worth discussing before processing begins.

Consider what follows your appointment: work, childcare, travel or other responsibilities. Ask your therapist whether the timing leaves enough room for what you may need afterward. For online sessions, discuss where you can speak privately and what you will do if someone interrupts or the connection drops.

Before the session ends, I leave time to reorient and discuss what support you may need. I cannot promise that you will feel calm when you leave. If distress persists, increases or makes daily life harder, raise it with your therapist so the plan can be reviewed. Ask in advance how to make contact and what help to use if the therapist is unavailable.

You can bring brief notes about changes you notice. These might concern sleep, a recurring memory or something that became harder to manage. You do not need to turn them into a detailed trauma account.

When family, culture or faith are part of the difficulty

Sometimes naming what hurt feels disloyal to someone you love. You may be worried that a therapist will dismiss your family, misunderstand your faith or push you toward a conclusion you do not share. Those concerns belong in the conversation too.

In my work, I pay attention to the guilt and shame that can accompany these experiences. We can explore how an event affects you while making room for what your relationships and beliefs mean to you.

Acknowledging that something hurt you, and honouring the people and traditions you love, are not opposites. You can hold both. You also get to tell me when my understanding misses something.

How we will look at change

The aim is to reduce the distress connected to the memory. In our work together, we also need to look at whether anything is changing in your daily life and whether the pace remains manageable.

What would you want to be different? It might be how often a memory interrupts your day, what happens during a disagreement, or how much effort it takes to avoid a reminder. We can return to the concerns you identified when we review the plan.

If little is changing, or something is getting harder, that needs attention. There is no fixed number of sessions I can promise will be enough. For more on the research, read does EMDR really work? If relationships are part of what you want help with, how PTSD affects relationships may also be relevant.

What the consultation can tell you

A short consultation gives us a chance to discuss what you are looking for and whether working together could be a fit. You might want to ask about my experience with your concern, explain a worry about therapy, or check the practical details before booking.

You can keep your description broad. A sentence about how things are affecting your life is a place to begin. There is no need to rehearse a detailed account of a traumatic event for this call.

A consultation is an initial conversation. A fuller assessment and treatment plan take more time. You do not have to decide during the call whether you want to begin EMDR.

Questions to bring to a prospective therapist

Download the questions before starting EMDR (PDF, 1 page).

Choose the questions that matter to you. You can use these with any therapist you are considering:

• What EMDR training have you completed, and what experience do you have with concerns like mine?
• What would you need to learn about me before recommending EMDR? What other options might fit?
• How will we decide when to begin memory processing?
• How can I ask to pause, and what will we do if I feel overwhelmed or disconnected?
• What might I notice afterward, and what support is available between appointments?
• How will we review whether treatment is helping?
• What are the session length, fee, cancellation terms and receipt arrangements?
• For online appointments, how will we handle privacy, interruptions or a lost connection?

It is reasonable to ask for an explanation in everyday language. EMDRIA's questions for prospective therapists also emphasize preparation, training and what happens when someone needs to stop.

Starting EMDR in Ottawa

Individual appointments with me are $200 for 50 minutes, in person at 9 Melrose Ave in Hintonburg or online across Ontario. The office is not wheelchair accessible. Insurance coverage depends on your plan; check whether it covers psychotherapy with a Registered Psychotherapist.

You can use the questions above on a free 15-minute call. My EMDR service page has the practical details, or you can get in touch with a question.

If you are thinking about suicide, call or text 9-8-8, available across Canada 24/7. For emotional support, the Distress Centre of Ottawa and Region is available at 613-238-3311. Call 911 if you are in immediate danger.

This article is for informational purposes only and is not a substitute for professional mental health advice or therapy. Reading it does not create a therapist-client relationship.