PublishedApr 7th, 2026•8 min read
What to Expect in Your First 3 EMDR Sessions for Trauma
Author
Hailey Perez
LMFT
If you’ve been considering Eye Movement Desensitization and Reprocessing (EMDR), it’s natural to wonder what to expect in your first sessions. While EMDR follows a structured, phased approach, each session moves at your own pace, based on what feels right for you. The first EMDR sessions focus on assessment and preparation, working to build safety, trust, and understanding.
The first few sessions of EMDR don’t focus on memory processing, so some people worry that their therapist is delaying treatment. But assessment and preparation are part of the EMDR protocol, which is an evidence-based approach endorsed by the American Psychological Association (APA) and the World Health Organization (WHO) for post-traumatic stress disorder (PTSD). Think about the assessment and preparation phases as building a foundation so that you can move into the reprocessing phase safely and with the skills needed to manage any emotional and physical discomfort.
While this is a general guide of what to expect in your first three sessions of EMDR, keep in mind that early sessions can vary depending on your individual therapist, needs, and goals.
At a glance: The first 3 EMDR sessions
Session 1
A paced overview of trauma history, symptoms, and therapy goals, plus an explanation of the EMDR process and consent/pacing. No bilateral stimulation or trauma reprocessing occurs in this session.
Session 2
Preparation session focused on coping and grounding skills, readiness for processing, and creating a “safe space”/resourcing exercise. No memory targeting or reprocessing yet.
Session 3
Readiness review session that checks stabilization progress and begins identifying target memories or triggers for EMDR. Reprocessing may begin if the client is ready, but some clients need more preparation first.
What Typically Happens in Your First 3 Sessions
EMDR-trained therapists follow Shapiro’s 8-phase protocol. The first three sessions focus on assessment and history, preparation and stabilization, and readiness review and early target identification.
Session One — Assessment and History
- A paced and non-exhaustive gathering of trauma history and current symptoms. Note that there is no need to go into detail if you don’t feel comfortable, as this is not necessary for memory reprocessing.
- Discussion of goals for therapy
- The therapist explains the EMDR therapy process. This includes details on how bilateral stimulation (side-to-side eye movements, cross-armed shoulder taps, or alternating sounds) helps the brain reprocess memories. They’ll also explain how you might feel during and after sessions.
- Regular check-ins to ensure consent and respect the client’s pacing and right to slow down or pause.
- No bilateral stimulation or memory processing occurs in this session.
Session Two — Preparation and Stabilization
- A focus on building coping and grounding tools that the client can use during and between sessions, such as deep breathing, mindfulness, and meditation.
- Assessing readiness for processing, including levels of dissociation (a sense of disconnection from one’s memories, identity, emotions, or surroundings), current safety, and capacity for emotional regulation.
- Establishing a “safe” space, which involves creating a mental sanctuary through visualization. This may also be referred to as a resourcing exercise.
- No memory targeting or reprocessing yet.
Session Three — Readiness Review and Early Target Identification
- Reviewing stabilization skills and how the client has been between sessions.
- Beginning to identify potential trauma targets (specific memories or triggers selected for reprocessing).
- Reprocessing may or may not begin in this session, depending on the results of the readiness assessment. Some clients might need several sessions for preparation and stabilization. This is especially true if they have complex trauma, meaning exposure to repeated or prolonged traumatic events, or dissociation.
- If reprocessing starts this session, the client will focus on the target, noticing related images, thoughts, beliefs, and body sensations. They'll also use bilateral stimulation to start reprocessing the memory.
Find an EMDR-trained therapist
Use all types of our filters to find your next therapist
Signs EMDR Care Is on Track
Signs that EMDR care is on the right path include:
- Sessions that feel structured, with the therapist communicating a clear plan. This means that the client understands what to expect in each session and that each session feels like it has a clear beginning, middle, and end.
- Safety and stabilization are explicitly prioritized before any reprocessing begins. The therapist also checks in about how the client is feeling between sessions. A good way to gauge this is that the client leaves the session feeling emotionally regulated and with self-care tools they can use between sessions.
- The client feels in control of the pacing, meaning that they can pause, slow down, or redirect at any time. The therapist checks in regularly about distress levels and bodily sensations, and the session adapts based on how the client is feeling.
- Initial progress is often subtle. This might be shifts in how a memory feels rather than dramatic breakthroughs. For example, memories might start to feel less vivid or more distant.
Note that it’s normal not to feel “fixed” after the first few EMDR sessions. Some people may find significant relief after 6 to 12 sessions, especially for single-incident trauma. However, EMDR treatment length can vary significantly and may take longer for some people.
It’s also common to experience a variety of emotions, varying from calm to tired and unsettled. Some people also experience vivid dreams, mood changes, headaches, and muscle tension. This is all normal as the brain starts the restructuring process.
However, make sure that you let your therapist know how you are feeling, especially if it starts to feel overwhelming. They can adjust your therapy to a pace that better suits you.
Red Flags and When to Raise Concerns
Potential red flags include:
- A therapist who rushes into memory processing without stabilization
- A lack of explanation about what is happening and why
- Dismissing or minimizing the client’s distress or disorientation
- No apparent awareness of or attention to dissociation
- Skipping consent and pacing conversations
- No collaborative treatment plan or goals
- No safety planning for between-session distress
If you’ve noticed one or more of these red flags, it’s appropriate to raise your concerns. Remember that therapy is collaborative and that clients can and should tell their therapist when something feels off. A good therapist will welcome this.
It’s also appropriate to reassess whether EMDR is the right modality or whether this particular provider is a good fit. If you don’t feel comfortable or feel as though your therapist isn’t hearing you, it might be time to consider a new therapist. Remember that changing providers or modalities is not a failure — it simply indicates it wasn’t the best fit for you.
How Octave Approaches Early EMDR Care
Effective trauma care starts with an experienced, trained therapist. Octave makes that support available.
- Fully licensed, experienced clinicians. Clinicians who are fully licensed with an average of 10+ years of experience—no trainees or associates.
- Specialized training. Hundreds of Octave therapists participate in the Trauma Center of Excellence with documented EMDR training and ongoing clinical consultation. Individuals are matched with therapists who have EMDR training and experience, not generalists.
- Structured intake. Octave therapists follow a structured intake. This assesses trauma history, safety, and readiness before sessions begin.
- Accessible and insurance-supported. Most major insurance providers are accepted, and most clients pay around $28 per session through insurance. Appointments are typically available within 1-8 days, with virtual options for further accessibility.
Octave might not be the right fit when:
- There is a need for residential or intensive outpatient stabilization
- A person is currently in an active crisis and requires immediate intervention
- A person is seeking only out-of-network providers
Frequently Asked Questions about EMDR
No, you will not start processing trauma in the first EMDR session. The first session focuses on creating safety, sharing your background and goals, and understanding how EMDR works. You’ll also go over what to expect in EMDR therapy.
Let your therapist know that you are feeling overwhelmed and need to pause or stop. Remember that you are in control of your sessions at all times. Your therapist can also help you with grounding exercises to ease feelings of overwhelm, anxiety, or stress.
EMDR therapy usually takes 6-12 sessions at a rate of 1-2 sessions per week. However, this number can vary based on your unique experiences, healing process, and goals. Some people may need fewer EMDR sessions for trauma. But others, especially those with complex histories or trauma, may need more.
EMDR preparation teaches you how EMDR works. You also learn coping skills and grounding tools for use during and between sessions. Actual reprocessing involves bilateral stimulation, such as rapid eye movements or cross-body taps, and moves through the steps of desensitization, installation, and body scan.
Yes, you can do EMDR therapy if you are already in another type of therapy for trauma. This can be especially helpful for clients who have multiple goals or clinical concerns, or who are focusing on present-day concerns with one therapist while addressing past trauma in EMDR.
Sources:
American Psychological Association. (2017). Eye movement desensitization and reprocessing (EMDR). In Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD). https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
EMDR International Association. (n.d.). EMDRIA Certified Therapist™ application. EMDR International Association. https://www.emdria.org/emdr-training/emdr-certification-2
EMDR International Association. (n.d.). Experiencing EMDR therapy. EMDR International Association. https://www.emdria.org/about-emdr-therapy/experiencing-emdr-therapy/
World Health Organization. (2013, August 6). WHO releases guidance on mental health care after trauma. https://www.who.int/news/item/06-08-2013-who-releases-guidance-on-mental-health-care-after-trauma
About the Author
Hailey Perez
LMFT
I am present, supportive, and I hold space for all of my patients to feel safe. I have a passion for working with the LGBTQ+ community and youth who have experienced the foster care system. I come from a Humanistic and Jungian approach in which we will build insight and tend to your strengths in order to stimulate the growth of self. Within therapy, we will connect the mind, body, and soul.
