Starting EMDR can feel like a leap. Most people arrive at their first appointment with the same questions: what will actually happen, will I have to relive everything, and what if it is too much? This is a step-by-step walkthrough of your first EMDR sessions, so you know what to expect before you book. I work mainly with medical trauma, and if you want the full picture of what that is and how EMDR helps, start with my guide to EMDR for medical trauma. This post stays with the sessions themselves.
What EMDR is, in one paragraph
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured therapy for memories that still feel as charged and vivid as the day they happened, and NICE recommends it as a first-line treatment for post-traumatic stress. We bring a difficult memory to mind in a contained way while you follow a moving target with your eyes, or use another form of left-right stimulation adapted for online work. Across a number of passes, the memory tends to lose its edge. Nothing gets erased, and you do not forget what happened. The charge settles, and the memory moves into the past where it belongs. I use this approach across different kinds of trauma, from EMDR for birth trauma to frightening diagnoses and difficult procedures.
What the first sessions look like
We do not start with the hardest memory on day one. The early sessions are groundwork. We talk through your history, map out which experiences feel most alive, and agree where to begin. Before any processing, we build your resources: ways to steady yourself, ways to slow a session down, ways to come back to the present if a memory pulls you under.
This stabilisation phase matters, and with medical trauma it often matters more. If your trauma is tangled with an ongoing condition, or has built up across many appointments, we take longer here on purpose. Rushing this stage is one of the things that can make EMDR feel destabilising, so I treat it as the foundation the rest of the work rests on.
What happens when you start processing a memory
When we begin the reprocessing itself, you stay in control of the pace from start to finish. You do not have to narrate every detail of what happened. EMDR asks for far less re-telling than some talking therapies, because the work focuses on the memory and what it brings up, not on a full account.
A single pass tends to look like this. You hold the image, the feeling in your body, and the belief that came with it (something like ‘I am not safe’ or ‘no one will help me’). You follow the stimulation and notice whatever surfaces. We pause, check in, and go again. Some sessions move a great deal. Others feel slower and steadier. Both are normal, and neither tells you the therapy is or is not working.
Afterwards, people vary. Some feel lighter straight away, some feel tired, and some notice the memory carrying on shifting for a day or two as the processing continues in the background. All of this is normal, and we plan for it: sessions end with time to ground yourself, and you take the steadying tools we built in the early sessions with you.
Going back to appointments and scans
For medical trauma, part of the work is often the future, not just the past. You may still need scans, reviews, or treatment for the condition that started all this. Appointments can be a hurdle of their own when the setting is bound up with the memory.
We can work on this head-on. That might mean processing a specific procedure so the dread eases before your next one, or building a plan for how you get through a review without the old panic taking hold. The aim is not to make you tolerate poor care in silence. It is to give you enough steadiness to attend and speak up for yourself when you need to. If being dismissed is part of what hurt you, you may find the piece on medical gaslighting a useful companion.
Is EMDR the right fit for you?
EMDR is not the only route, and it is not right for everyone at every moment. A focused piece of work on a single event (one frightening admission, one procedure) can sometimes be done in a small number of sessions. Trauma that is complex, long-standing, or woven through a chronic illness tends to ask for more time and a wider approach.
Alongside EMDR I draw on Acceptance and Commitment Therapy for the life that trauma has narrowed: the things you have stopped doing, the places you avoid, the version of yourself you want to get back to. There is more on how I combine these on my trauma and EMDR page. The honest answer to ‘is this for me?’ is that we work it out together, in a first conversation, with no pressure to commit.
Ready to talk about whether this could help?
If a difficult experience is still shaping how you live, you do not have to carry it on your own. Book a free 15-minute consultation. It is a conversation, not a commitment. We will talk through what has been going on, what you are hoping might shift, and whether EMDR is the right fit for you.
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