During an EMDR session, you sit in a chair while a therapist guides you to recall a distressing memory and simultaneously directs your attention back and forth, usually by moving their fingers side to side in front of your face. That’s the image most people picture, but a full course of EMDR involves much more than eye movements. Sessions typically last about 60 minutes, and the actual eye-tracking portion is just one piece of a structured, eight-phase process that includes preparation work, memory processing, and body awareness exercises.
What Bilateral Stimulation Looks Like
The most recognizable part of EMDR is bilateral stimulation, a back-and-forth sensory input that alternates between the left and right sides of your body. The classic version involves following your therapist’s fingers with your eyes as they move horizontally across your field of vision. But finger tracking is far from the only option.
Many therapists use a light bar, a slim device that sits on a table or desk and produces a dot of light that glides from one end to the other. You follow the light with your eyes instead of watching a hand. Other therapists use handheld devices called tappers or buzzers. You hold one in each palm, and they vibrate or pulse in an alternating pattern, left then right. Some setups use headphones that play a tone that shifts between your left and right ears. A therapist might combine methods, pairing auditory tones with eye movements or vibrations, depending on what feels most comfortable for you.
The speed and intensity of the stimulation are adjustable. Your therapist will typically ask whether the pace feels right or whether the vibration is too strong, and you can request changes at any point.
How a Session Unfolds
EMDR follows eight phases, though not every phase happens in every session. The early phases can stretch across several appointments before any memory processing begins.
In the first phase, your therapist gathers your history and identifies specific memories, current triggers, or situations that will become the targets for treatment. This is a conversation, not a processing exercise. You and your therapist decide together which experiences to focus on and in what order.
The second phase is preparation. Your therapist explains how the bilateral stimulation works, what to expect during reprocessing, and teaches you grounding techniques you can use if emotions become overwhelming. One common exercise is the “safe place” visualization: you picture a real or imagined location where you feel calm, notice the positive physical sensations that come with it, and practice returning to that mental image on cue. The therapist may use a short, slow set of eye movements to strengthen that positive association. Some people spend several sessions in this preparation phase before they feel ready to move forward.
Phase three is brief, sometimes as quick as 30 seconds. Your therapist asks targeted questions to bring a specific traumatic memory into your awareness. You identify the image that represents the worst part of the event, the negative belief you hold about yourself because of it (something like “I’m not safe” or “It was my fault”), the emotions that come up, and where you feel those emotions in your body. You rate how disturbing the memory feels on a scale of zero to ten.
What the Reprocessing Phase Feels Like
Phase four, desensitization, is where the bilateral stimulation becomes central. Your therapist asks you to hold the target memory in mind, along with the negative belief and the physical sensations attached to it, while you follow the back-and-forth stimulus. A set of eye movements or taps typically lasts 20 to 30 seconds. Afterward, your therapist pauses and asks what you’re noticing. You might report a new image, a shift in emotion, a physical sensation, or a thought that surfaced. The therapist then says something like “go with that” and begins another set.
During this phase, people commonly experience a range of sensations. You might feel muscle tension shift or release, notice changes in temperature, feel a tightness in your chest or stomach, or experience waves of emotion that rise and then subside. Some sets feel neutral, others intense. The process continues until the disturbance level you report drops to zero or near zero on that same scale.
Once the distress around the memory has decreased, your therapist moves to phase five: reinforcing a positive belief. You’re asked to pair the now-processed memory with a healthier self-statement, something like “I did the best I could” or “I am safe now.” More bilateral stimulation follows while you hold this new belief alongside the memory, until it feels genuinely true rather than just something you’re telling yourself. Your therapist asks you to rate how believable the new thought feels on a scale of one to seven.
The Body Scan and Closing
In phase six, your therapist asks you to think about the target memory and the new positive belief while scanning your body from head to toe. The goal is to notice any lingering tension, discomfort, or negative physical sensation. If something comes up, perhaps a knot in your shoulders or an uneasy feeling in your gut, your therapist does additional sets of bilateral stimulation until it clears. This phase reflects a core principle of EMDR: that unprocessed trauma isn’t just stored as thoughts or emotions but also shows up as physical sensations in the body.
Every session that involves reprocessing ends with a closing phase. Whether or not the memory has been fully processed, your therapist helps you return to a calm, grounded state before you leave. This might involve the safe place exercise you practiced earlier, deep breathing, or another stabilization technique. Your therapist will let you know whether the memory is fully processed or whether you’ll return to it next time.
Session Length and Number of Sessions
A standard EMDR session runs about 60 minutes, though some therapists offer extended 90-minute sessions for reprocessing work. Sessions are usually scheduled weekly. At the start of each new session after reprocessing has begun, your therapist checks in on previously processed memories to confirm the distress is still low and the positive belief still holds. If so, you move to the next target. If not, you continue working on the same memory.
The total number of sessions varies widely depending on the complexity of what you’re processing. A single traumatic event in an otherwise stable life might resolve in a handful of sessions. More complex or repeated trauma often requires a longer course of treatment. Some research protocols use around nine sessions total, with the first devoted to assessment and planning, but early completion is common when symptoms resolve faster than expected.
What Online EMDR Looks Like
EMDR can also be done remotely through video platforms. In online sessions, bilateral stimulation is adapted for your screen. Some therapists use specialized software that displays a moving dot or graphic for you to track with your eyes. Others take a simpler approach, asking you to place two sticky notes on either side of your monitor and shift your gaze between them on cue. Tactile options work well remotely too: your therapist might instruct you to alternate tapping your own knees or shoulders, a technique called butterfly tapping. Auditory tones delivered through headphones are another common choice for telehealth sessions.
The structure and pacing of online EMDR sessions follow the same eight-phase protocol. The main difference is logistical. Your therapist will typically ask you to find a private, quiet space, check your internet connection, and confirm that you can hear and see clearly before beginning any reprocessing work.