Your first session is history taking and assessing your readiness as well as demonstrating what EMDR feels like. The second session will involve selecting targets (distressing memories and related incidents). You will also be taught skills to help regulate distress during sessions. The aim is to produce rapid and effective change whilst you maintain as much emotional equilibrium as possible.
The processing phase (session 3 or 4) begins by getting you to focus on the most distressing image associated with the traumatic experience, plus the emotions accompanying the image, body sensations (tight throat, increased heart rate), and an associated negative belief about yourself (e.g., ‘I could not save him’ or ‘I’m unlovable.’). There is no need to describe the memory in detail, and you can focus on those aspects of the memory without having to say them out loud. I (the therapist) do not need to know the detail, which is advantageous if some of your memories make you feel shameful or guilty.
Whilst holding in mind the most distressing image/emotion/body sensation/cognition, and not speaking, you will track a moving object (finger or pointer) across your visual field, for 10 to 40 seconds. (Other, non-visual options are alternating sounds or tapping sensations.)
There is nothing for you to ‘do’ or get ‘right’. Basically, we trust your mind and brain to go where they need to go to allow unprocessed traumatic memories to be processed. I will only intervene if your emotions become overwhelming.
After each set of eye movements, you are asked, ‘What are you noticing?’ (which is briefly reported, although you may choose not to say anything), you will be directed to ‘notice that’ for another set of eye movements (whilst not talking), after which you are again asked, ‘what do you notice?’ This basic, repeated sequence is the core of an EMDR session.
If your memories go forward or backwards in time, to earlier or later parts of the traumatic event, or even to completely different past of future events, it is accepted as normal. There is nothing to get wrong or right, just to trust a proven process with an experienced trained EMDR professional.
Near the end of a processing phase, distressing images are recalled to see if they still have a significant ‘emotional punch’ together with disturbing body sensations. If they are no longer distressing a new positive belief is installed.
Instructions are given to deal with any dreams, thoughts, etc. and the session is closed.