How long is the first session?

Generally between 60 and 90 minutes, depending on the therapist and how much history needs to be gathered. Some practices split the initial assessment across two sessions.

It's possible, but not required. Talking about what brings you to therapy can generate emotion, and that's completely normal. Your therapist is prepared to support you and will never push you beyond what you can handle in that moment.

Do I have to tell everything in the first session?

No. The first session is an initial contact, not an interrogation. Your therapist needs a general overview, not every detail. You can say "I went through something difficult in childhood" without getting into specifics. Details are addressed gradually and only when clinically necessary.

When will the eye movements start?

Trauma memory processing with bilateral stimulation begins in Phase 4 (Desensitization), which usually comes after 1 to 3 preparation sessions. Your therapist may use brief bilateral stimulation during preparation to install calming resources like the Safe Place, but full processing doesn't start until you're ready.

Is EMDR safe? Can it make things worse?

EMDR is a therapy validated by the WHO and the APA with decades of research. During processing, it's normal to temporarily feel intense emotions, but the protocol has built-in safety mechanisms: the regulation techniques (Phase 2) and the ability to stop at any time. Your therapist will assess whether you're ready before starting processing.

What if I don't feel anything or it doesn't work for me?

Everyone responds differently. Not feeling anything intense in the first session is completely normal and doesn't mean it isn't working. EMDR processing sometimes produces subtle changes that are noticed in the following days. If after several processing sessions you don't notice improvement, your therapist will adjust the approach.

Does online EMDR therapy work?

Yes. Online EMDR therapy has been shown to be equally effective as in-person therapy. Bilateral stimulation adapts to digital format (visual movement on screen, alternating sounds). See our comparison online vs. in-person EMDR for the differences and evidence.

Can I do EMDR if I'm already in another therapy?

Yes, though it's important that both professionals are informed. EMDR is compatible with most therapeutic approaches. If your other therapy also works directly with traumatic memories (such as Prolonged Exposure), coordination between professionals is especially important.

Learn About EMDRPsychoeducation

First EMDR session

A guide for patients starting EMDR therapy

The first EMDR session isn't what many expect: there are no eye movements or trauma processing. It's a preparation session where your therapist gets to know you, explains the process, and ensures you have the necessary tools before beginning.

Reading7 min

Abstract watercolor illustration of an open doorway in golden and sand tones, representing the start of EMDR therapy

What happens in the first EMDR session?

If you're feeling nervous before your first session, that's completely normal. Many people feel the same way. The most important thing to know is that no traumatic memories are processed in the first session. There are no eye movements and nothing that will catch you off guard. You are in control the entire time.

The first session corresponds to Phase 1 (History taking) of the EMDR protocol: your therapist gets to know you, gathers information about your situation, and begins outlining a treatment plan. They are not there to judge you; they've heard it all and their only goal is to help.

You'll be asked about your personal history, the reasons that bring you to therapy, your current symptoms, and relevant life experiences. You don't need to remember everything clearly or have a complete narrative: a general reference is enough ("I had an accident", "I went through a difficult relationship"). Fragmented or unclear memories are perfectly valid as a starting point.

You'll also be told how EMDR works, what to expect from the process, and all your questions will be answered. Before starting treatment, your therapist will ask for your informed consent: they'll explain possible effects of processing (intense emotions, vivid dreams) and ensure you understand your rights, including the right to stop at any time.

You may be asked to complete some brief questionnaires to assess your symptoms and ensure the approach is right for your case. This is a normal part of a thorough clinical evaluation.

In many cases, the first session also includes the beginning of Phase 2 (Preparation): you'll learn emotional regulation techniques like the Safe Place or the Butterfly Hug, so you have calming tools before processing begins.

How to prepare for your first EMDR session

Days before

Think briefly about what brings you to therapy: you don't need a complete narrative, just a general idea ("anxiety", "a memory that haunts me", "something from my childhood").
Prepare a list of questions you want to ask: about the process, estimated treatment duration, your therapist's EMDR experience, or any concerns.
If you have previous reports or diagnoses, bring them to the session. They can help your therapist, though they're not essential.
If you take medication, don't change or stop it before starting EMDR without consulting your doctor. EMDR is compatible with most medications.

Day of the session

Wear comfortable clothing and have a light meal beforehand. There's nothing physically demanding, but comfort helps.
If your session is online, find a private space, check your internet connection, and have headphones ready. If it's in person, you'll arrive at a quiet office.
Don't schedule anything stressful right after. Leave at least 30 minutes of buffer in case the session runs long or you need a transition moment.
It's completely normal to feel nervousness. Your therapist knows this and will start at a pace that feels comfortable. You can stop at any time.

What happens after the first EMDR session

Most people leave the first session feeling relieved for having taken the first step. You've talked about important topics and it's normal for your mind to stay a bit "switched on."

Some people experience a degree of emotional activation in the following days from having discussed their history. If that happens to you, it's completely normal. Use the regulation techniques your therapist taught you (Safe Place, breathing). More intense reactions (vivid dreams, memories surfacing) are more common after processing sessions, which come later.

Actual processing (Phase 4) doesn't begin until you're ready. Depending on your case, this might be in the second or third session, or after several preparation sessions if the trauma is complex. If your therapist decides you need more stabilization time, it doesn't mean EMDR isn't for you — it means they want to ensure the process is safe and effective.

Some people notice improvements from the first preparation sessions, especially if they've never learned emotional regulation techniques. The Safe Place and Butterfly Hug are useful tools in themselves, regardless of EMDR processing.

Your therapist may ask you to keep a brief journal between sessions, noting any memories, emotions, or sensations that arise. This helps identify the memories that will be the focus of processing. If emotions become too intense, contact your therapist between sessions — you don't have to wait until your next appointment.