The first session will begin by exploring your difficulties, thinking about the experiences that may lie behind them, and considering whether EMDR would be appropriate to help. This may take more than one session.

The next step is to introduce the practicalities of EMDR - whether to use:

• eye movements, where you follow the movements of the therapist's hand
• 'tappers', which you hold in your hands and which 'buzz' at a regular pace
• music, through headphones, which oscillates from one ear to the other 
• self-tapping, where you cross your arms and tap your arms with your hands

Where to begin?

When you are ready to begin EMDR we will think about which memories and experiences to address first, and then how to help you manage the powerful and difficult emotions, memories and sensations that accompany these memories and experiences. This may involve introducing certain breathing and relaxation techniques you can use, thinking about calm places you might imagine, or other ways to keep you safe. This process can, in itself, take a number of sessions; in fact, as many sessions as are necessary before you feel ready to proceed.

Staying with the train

We are then ready to begin the processing. A certain amount of distress is inevitable as you face what has previously felt 'too much' - this shows that we are addressing what needs to be addressed. If you can stick with the process, following the therapist's hand, concentrating on the tappers or the music as you let the associations around the event unfold in your mind, then the traumatising events will be 'reprocessed'. The metaphor that is sometimes used is that of staying with the train, even when it is going through the tunnel and everything seems dark, in this way the processing can go on. Hopefully, by the end of the session, the distress related to the event(s) we are focusing on will have lessened. If it has lessened only to a small degree this indicates that more processing is needed in a following session. 

How long is a session?

A session is 50 minutes in length but, if the time is available and you want to continue, it can be beneficial to continue processing the 'memory channel' until you have successfully reprocessed the difficult area. At the beginning of each new session you can decide whether to continue with what we were working on in the previous session, or move on to something new, although it is inadvisable to open up too many new areas until we have worked through the ones we have started. It is always up to you, however, whether to proceed or to stop working on a particular area.

How long does the therapy take?

If the issue is a single instance of trauma that occurred in adult life and you have no early experience of trauma that is being triggered by the later occurrence and, in addition, the event was 'impersonal', for example, a car accident, then this can typically be dealt with in a couple of sessions.

If the issue relates to a repeated trauma, with some personal associations, for example, experiences of bullying, this can take longer. If the issue was long-standing and began early in life, then this will take longer again.

If the issues relate to early life experience, where there was significant trauma, neglect and maltreatment from people on whom you relied, this will likely affect many areas of your life and sense of self, and sessions may need to run for a number of years in order to adequately address the issues. J. Morris-Smith has drawn up a diagram that shows what it is realistic to expect.

It is important to realise, therefore, that when there are significant, early issues that need addressing, EMDR is not a 'magic cure' that will work in one or two sessions, although it is still particularly effective in addressing these difficulties, as it processes the emotional and somatic distress related to the traumatic complexes that talking therapies alone can struggle to process.