Starting therapy can bring a mix of emotions—hope, curiosity, and sometimes a little bit of nervousness. If you’ve been referred to or are considering Eye Movement Desensitization and Reprocessing (EMDR) therapy, you may be wondering what your first session will actually look like. Movies and articles often highlight the part of EMDR where the client follows a therapist’s hand back and forth, or uses buzzers, tones, or other tools for what’s called bilateral stimulation (BLS). While that piece is a central part of EMDR, it’s not usually where things begin.
In fact, your very first EMDR session will look much more like a traditional therapy appointment: a space to get to know your therapist, ask questions, and build a foundation of trust and understanding.
First, you can expect to build trust with your therapist. The therapeutic relationship is one of the strongest predictors of success in therapy, regardless of the approach being used. During your first EMDR session, your therapist will spend time getting to know you, your history, and your goals. You may be asked about why you’re seeking EMDR therapy at this time, what you’ve tried before in therapy, current challenges you’re experiencing, your personal history, including relationships, trauma, or medical conditions. Don’t worry, you won’t be expected to dive into the most painful details of your past right away. The focus is on understanding your story at a pace that feels safe for you. Your therapist may also share a bit about themselves and their approach, so you can begin to feel comfortable and confident in the process. This stage of rapport building sets the stage for deeper work.
Next, you can expect to receive a lot of information. EMDR is going to feel different than any most other therapeutic approaches, and sometimes you may be wondering the efficacy of the process. That’s why psychoeducation is such a big part of the first session. Your therapist will likely explain what EMDR is, talk about how EMDR works, discuss the phases of EMDR, clarify myths, and answer your questions. The goal of this education is to reduce anxiety, build transparency, and help you feel empowered as an active participant in your healing journey.
Additionally, your therapist will likely assess your current coping strategies. Trauma work can bring up strong emotions, so it’s important to know you have ways to self-soothe and stay grounded between sessions. This might include deep breathing exercises, visualization techniques (like imagining a safe or calm place), mindfulness practices, and grounding strategies (such as orienting to your environment or focusing on physical sensations). Some therapists will introduce specific “resourcing” exercises during the first few sessions. These help strengthen your internal sense of safety and prepare you for the more intense phases of EMDR.
Think of it as gathering the supplies you need before going on a big hike—you wouldn’t set out without food, water, or sturdy shoes.
Many clients arrive expecting to start the hand movements, buzzers, or tapping right away. But in most cases, bilateral stimulation is not used during the first session. EMDR is a highly structured therapy, and before moving into memory processing, you and your therapist need to lay important groundwork. This preparation phase may take one or several sessions, depending on your needs and comfort level. Rushing into trauma reprocessing too soon can feel destabilizing, so most therapists will want to ensure you have the right tools and resources first.
Starting EMDR therapy can stir up a wide range of emotions. Some clients feel hopeful and eager, while others feel nervous or unsure. Your therapist knows this and will create space for you to voice those feelings. It’s completely okay to say things like: “I’m not sure I understand this yet,” “I feel nervous about what’s going to come up,” and “I’m worried this will be too overwhelming.” Naming those feelings helps your therapist support you better, and it also reinforces that EMDR is a collaborative process—you’re not going through it alone.
By the end of your first session, you’ll likely have a stronger understanding of what EMDR is (and isn’t), more clarity about the eight phases of EMDR therapy, a sense of your therapist’s style and how they’ll support you, and an idea of the coping skills and preparation work you’ll do before beginning reprocessing. You might also have a follow-up appointment scheduled, with the reassurance that the pace will be tailored to your needs.
Think of this session as orientation day: you’re getting to know your guide, learning the map, and preparing your backpack before setting off on the journey. When you eventually begin using bilateral stimulation and reprocessing distressing memories, you’ll do so from a place of strength, safety, and readiness.
EMDR can be a life-changing therapy, but it starts with something very simple and human: connection, understanding, and trust.