By Christina Mathieson, LMFT #115093, founder of My Mental Climb.
TL;DR. A first EMDR session is not the eye-movement, trauma-reprocessing part most people picture. It is history-taking and preparation: your therapist learns your story, explains the process, and helps you build safety and coping tools first. Reprocessing comes later, once the groundwork is in place. EMDR runs on eight phases that map the whole treatment, and it adapts well to telehealth.
If you have booked a first EMDR session, or you are thinking about it, there is a good chance you are picturing the part where your eyes follow something moving back and forth across a screen while a painful memory comes up. That part does happen, and it is not what your first session looks like. Knowing that ahead of time takes a lot of the anxiety out of walking in.
You will not reprocess your trauma on day one
This is the thing most people are relieved to hear. EMDR does not start by opening the hardest memory you have. A first session, and often the second, is about your therapist getting to know you, understanding your history, and mapping out what you want to work on. Nothing gets processed until you have the tools and the safety to handle it. If a therapist tried to dive straight into trauma reprocessing in session one, that would be a sign the protocol is being rushed, not followed.
The first session is history and preparation
The American Psychological Association describes EMDR as an eight-phase therapy, and the first two phases are where a first session lives. In the history phase, your therapist learns your background and works with you to decide which memories or themes to target. In the preparation phase, they explain how EMDR works in plain terms, answer your questions, and help you build resources: grounding skills, a calm or safe place you can return to, and ways to steady yourself if something difficult surfaces. The point of this phase is that you leave every future session able to come back to the present, rather than carrying activation out the door with you.
The eight phases are a map, not an agenda
It helps to know that the eight phases are a map of the whole course of treatment, not eight separate sessions you move through one per week. They are history-taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. Early sessions sit in the first two. Once reprocessing begins, a single session might move through several phases at once. Your therapist paces the whole thing to what your nervous system can actually hold, which is the part that makes it feel safe rather than overwhelming.
What bilateral stimulation is, and how it works over telehealth
The eye movements are one form of what EMDR calls bilateral stimulation, the left-right-left rhythm that helps the brain reprocess a stuck memory. It does not have to be eye movements. Therapists also use gentle tapping or alternating tones, and all three translate to telehealth. Over video, your therapist might use a ball that moves back and forth across your screen, or guide you to tap your own shoulders or knees, and some clinicians use alternating tones through headphones. A laptop or tablet works better than a phone here, mostly so your eyes have room to travel. If you want the fuller picture on remote sessions, we wrote a companion piece on whether EMDR works over telehealth.
What reprocessing feels like when you get there
When you and your therapist do begin reprocessing, in a later session, you hold a memory in mind while the bilateral stimulation runs, and then you simply notice whatever comes up: images, feelings, body sensations, thoughts. You are not performing or explaining. Your therapist checks in on how distressing the memory feels, using a simple 0-to-10 scale, and keeps going until it settles. Many people describe it as the memory losing its charge, so it becomes something that happened rather than something that keeps happening. Every session closes with grounding, so you return to the present before you log off or leave.
Who leads EMDR on our team
On our team, Jalyse Stewart, AMFT #153712 (supervised by Christina Mathieson, LMFT #115093), leads EMDR and trauma work, with EMDR Basic Training through the EMDR Institute and particular experience with women, BIPOC clients, and neurodivergent clients. She typically uses a ball moving across the screen or gentle tapping, and adjusts the pace and sensory setup so the process fits how your nervous system works. If EMDR is something you are considering, a free 15-minute consult with our intake coordinator, who will match you with the right fit, is a low-pressure place to start. We provide EMDR therapy through secure telehealth across California.
Common questions
- What happens in a first EMDR session?
- A first EMDR session is mostly history-taking and preparation, not trauma reprocessing. Your therapist learns your background, maps out what you want to work on, explains how EMDR works, and helps you build coping tools and a sense of safety before any memory is processed. The eye-movement part most people picture usually comes in a later session, once the groundwork is in place.
- Will I have to talk about my trauma in detail in the first session?
- No, you do not have to give a detailed account of your trauma in the first EMDR session, and often not at all. EMDR works on how a memory is stored rather than requiring you to narrate every detail out loud, so the early sessions focus on your history in broad strokes and on building safety. You stay in control of how much you share and how fast you go.
- How does EMDR work over telehealth?
- EMDR works over telehealth by delivering the same bilateral stimulation through your screen instead of in the room. Your therapist may use a ball that moves back and forth across the screen for eye movements, guide you to tap your own shoulders or knees, or play alternating tones through your headphones. Research suggests online EMDR works as well as in-person for many people, though a larger screen (laptop or tablet, not a phone) helps.
- How many EMDR sessions will I need?
- The number of EMDR sessions varies widely depending on what you are working through, from a handful for a single recent event to many months for complex or repeated trauma. The eight phases of EMDR are a map of the whole course of treatment, not eight separate sessions, and your therapist will pace it to what your nervous system can handle. Your consult and first sessions are where you and your therapist estimate a realistic timeline together.
Tagged
Last clinically reviewed: by Christina Mathieson, LMFT #115093.
