A clear, honest account of the EMDR process — from assessment to integration — for anyone considering EMDR therapy at our Harley Street clinic in London.
People do not arrive at therapy because things are going well. They arrive because something has lodged itself inside them — a memory that will not stay past, a feeling that floods in without warning, a body that braces for impact before the mind has even registered the threat. They arrive, often, because they have tried everything else: willpower, distraction, talking about it at length — and still the wound will not close.
EMDR, or Eye Movement Desensitisation and Reprocessing, is one of the most rigorously researched trauma therapies available today. Endorsed by the World Health Organisation, the National Institute for Health and Care Excellence (NICE), and the American Psychological Association, it is widely regarded — alongside trauma-focused CBT — as a first-line treatment for post-traumatic stress disorder. Yet for many people approaching it for the first time, EMDR can seem opaque, even mysterious. What actually happens in the room? What will you be asked to do? Will it require you to relive your worst experiences in graphic detail?
This guide is an honest account of the EMDR process: not a sanitised promotional overview, but a step-by-step description of what you can genuinely expect when you begin EMDR therapy in London — whether you are approaching trauma for the first time, or returning to it after years of trying other routes.
What EMDR Actually Is — And Why It Works
EMDR was developed by American psychologist Francine Shapiro in the late 1980s. The foundational observation — that particular eye movements seemed to reduce the emotional intensity of distressing memories — was, by her own account, partly accidental. What followed was decades of clinical research that transformed that observation into one of the most robustly evidenced trauma treatments in existence.
The working theory is this. When a traumatic event occurs, the memory is not processed and stored in the same way as an ordinary experience. Instead, it becomes frozen in the nervous system in something close to its original raw form — complete with the images, emotions, physical sensations, and beliefs that accompanied it at the time. Each time something triggers that memory, the brain does not register it as the past. It registers it as happening now. This is why trauma does not simply fade with time the way ordinary painful memories do: the nervous system has not yet understood that it is over.
EMDR works by activating that frozen memory whilst simultaneously engaging bilateral stimulation — typically alternating eye movements, taps on the hands or knees, or auditory tones moving between left and right — which appears to engage the brain’s natural adaptive information-processing system and allow the memory to be integrated at last. The experience does not disappear. But its charge does. The past begins to feel like the past.
The process is structured around eight distinct phases. Understanding each of them can make the experience feel considerably less daunting before you begin.
Phase One: History Taking and Treatment Planning
A good EMDR therapist does not rush. The first phase — which may span one session or several, depending on the complexity of your history — involves a thorough exploration of your background, your current difficulties, and the memories or experiences that appear most central to your distress.
This is not simply administrative groundwork. It is the foundation upon which everything else will be built. Your therapist needs to understand not just what happened to you, but how those events shaped your beliefs about yourself and the world around you, how your nervous system learned to respond across time, and what internal resources you already carry. Some clients arrive with a single, clear traumatic event in mind. Others arrive with something harder to name — a pervasive sense of shame, or anxiety that seems to have no single origin, or a pattern of self-sabotage that has shadowed them for years. Both are entirely valid starting points.
In the assessment phase, your therapist will work collaboratively with you to identify which memories or experiences will be targeted in treatment and in what order. The sequence matters: more recent, acute material is sometimes addressed before earlier experiences; in other cases, a network of connected memories from childhood may need to be approached first. The map is drawn with care.
At our Harley Street clinic, this phase also involves careful attention to what practitioners call resourcing needs — making certain that you have sufficient internal stability before any deeper processing work begins. We do not push people into water before they can swim.
Phase Two: Preparation
Before any trauma memory is approached directly, your therapist will spend dedicated time preparing you for the work ahead. This reflects a principle that sits at the very heart of responsible trauma therapy: safety must precede processing.
You will be introduced to the bilateral stimulation method — perhaps practising brief sets of eye movements or alternating taps — so that it feels familiar and manageable rather than surprising. You will also develop what EMDR practitioners call a ‘safe place’ or ‘calm place’: an image, real or imagined, that carries a genuine felt sense of safety in the body. This becomes a resource you can return to at any point during or between sessions, should the work become overwhelming.
Preparation may also involve learning other stabilisation and grounding techniques: regulated breathing, body awareness exercises, or containment imagery. Think of this phase as building a scaffold around the work that is to come. You will never be asked to approach difficult material without a structure in place to support you, and you will not be asked to go somewhere you are not yet ready to go.
It is worth saying clearly: EMDR does not require you to narrate your trauma in graphic detail. One of the features that distinguishes it from some other trauma therapies is that you can process difficult material whilst saying very little about its content. The therapist follows your lead. You remain in control.
Phase Three: Assessment of the Target Memory
When preparation is complete and both therapist and client feel ready, the active processing work begins. The first step is to identify and assess the specific target memory with some precision. This is not about cataloguing details but about anchoring the memory in a way that allows the processing work to be effective.
Your therapist will ask you to bring the memory to mind — not to relive it in full, but simply to hold it lightly — and will then guide you through a series of structured questions:
- What image best represents the worst moment of the experience?
- What negative belief about yourself does the memory seem to confirm — something such as ‘I am powerless,’ ‘I am not safe,’ or ‘I am to blame’?
- What more accurate belief would you prefer to hold about yourself instead?
- What emotions arise when you hold the memory in mind?
- Where do you notice the distress in your body — and how intense does it feel, on a scale from zero to ten?
This structured self-observation is, for many clients, the first time they have been asked to notice their body’s response to a difficult memory rather than simply push it away, override it with logic, or try to make intellectual sense of it. Trauma is not stored primarily as a narrative. It is stored in sensation — in the constriction of the chest, the tightening of the throat, the held breath. EMDR begins at exactly that junction between memory and body.
Phase Four: Desensitisation
This is the phase that most clearly distinguishes EMDR from other therapies, and the one that new clients most often approach with a mixture of curiosity and scepticism. Your therapist will ask you to hold the target memory in mind — along with the associated image, negative belief, and body sensation — whilst simultaneously following a series of bilateral stimulations. In our clinic, this typically involves following the therapist’s fingers with your eyes, or receiving alternating taps.
The sets are brief, typically between fifteen and thirty seconds, and are followed by a pause. After each set, your therapist will ask simply: ‘What do you notice?’ You might notice a shift in the image — it becomes more distant, or its colour changes. You might notice an emotion arising that was not there before, or one that was present beginning to release. You might notice a memory from a different time surfacing, or a bodily sensation shifting. Whatever arises, you report it, without judgement, and the next set begins.
What unfolds during this phase is often remarkable, and consistently unpredictable. Memories shift. Long-held beliefs begin to loosen. The nervous system begins to recognise, sometimes for the first time, that the event is over — that it belongs to the past and no longer requires the same vigilance. The distress level, measured periodically throughout, typically reduces across the session, sometimes dramatically.
This is not analysis or interpretation. The therapist does not explain what the shifts mean or impose a framework upon what arises. It is the client’s own brain doing what it was designed to do — processing, integrating, making meaning — with bilateral stimulation acting as the catalyst. Many clients describe the experience, in retrospect, as something clicking into place: not something added, but something finally allowed to settle.
Phase Five: Installation
Once the distress level has reduced significantly — typically to a two or below on the subjective scale — the focus of the work shifts. Rather than reducing the charge of the negative material, the therapist now works to strengthen the positive belief identified in Phase Three.
You will be asked to hold the original memory alongside the preferred belief — ‘I did the best I could,’ ‘I am safe now,’ ‘I have worth’ — and to rate how true it feels in your body. Bilateral stimulation continues, now with the explicit intention of deepening the connection between the memory and a more accurate, more compassionate sense of yourself.
This phase matters more than many accounts of EMDR acknowledge. Processing the trauma is one essential task. Replacing the distorted beliefs it generated — the quiet convictions of unworthiness, inadequacy, or helplessness that organised around a terrible experience — with something more honest is an equally essential one. Healing is not simply the removal of pain. It is the building of a different relationship with oneself.
Phase Six: Body Scan
With the positive belief installed and the emotional distress reduced, your therapist will ask you to scan your body from head to toe whilst holding the original memory in mind. The question is simple but important: is there any remaining tension, tightness, or physical discomfort?
The body scan reflects one of EMDR’s core convictions — one that also underpins somatic and body-centred approaches — that genuine healing must be complete not just at the level of thought and emotion but at the level of physical sensation. The body keeps the score, as Bessel van der Kolk famously observed, and it must also keep the resolution. If residual distress remains in the body, further sets of bilateral stimulation will address it directly before the session moves to closure.
Phase Seven: Closure
Every EMDR session ends with a closure phase, regardless of whether the processing work on a particular memory is complete. This is not optional. Your therapist will bring you carefully back to a state of equilibrium — using the safe place, the stabilisation techniques established in Phase Two, or other resources — before you leave the room.
This matters, and it matters especially for clients who have not previously experienced structured therapy. Trauma processing can leave the nervous system in an unsettled, heightened, or emotionally raw state. It would be irresponsible to send a client back into their day, their commute, their work, or their family without first attending to that.
Your therapist will also brief you on what to expect between sessions: heightened emotions, unusual dreams, memories that surface spontaneously, or unexpected shifts in mood. These are not signs that something has gone wrong. They are signs that the brain’s processing work is continuing. Keeping a brief journal of what arises between sessions is often encouraged, and you are always welcome to contact the clinic if you have concerns.
Phase Eight: Re-evaluation
At the beginning of the following session, your therapist will review what has happened since you last met. How does the processed memory feel now? What has emerged in the interval? Has any new material come to light that may need to be targeted?
Re-evaluation is not a bureaucratic check-in. It ensures that the work already done has consolidated, and that the direction of treatment continues to be responsive to what is actually happening in your system rather than to a predetermined plan. EMDR is not a linear process. Some memories resolve more quickly than anticipated. Others require multiple sessions of processing. New material often emerges that requires its own targeted work, and the network of associated memories — the original experience and all that attached to it — unfolds in its own time.
The eight phases are a framework, not a rigid sequence. A skilled EMDR therapist moves between them fluidly, guided always by what the client’s system needs.
What EMDR Feels Like
Clients who complete EMDR therapy frequently describe the experience as both strange and unexpectedly natural. Strange, because so much seems to happen without the client having to consciously ‘do’ anything — without analysis, without sustained narrative, without the effortful work they expected. Natural, because the processing that occurs feels, in retrospect, like something the nervous system had been waiting a very long time to complete.
It is not always comfortable. Processing trauma rarely is. There are sessions that feel intense, unsettling, or emotionally exposing. But EMDR is notably different from simply recounting traumatic events in sustained detail. The therapist controls the pace and attends continuously to the client’s window of tolerance. You will never be pushed beyond what is manageable. And the experience of the work — whatever arises within it — consistently points in one direction: towards the past becoming, at last, the past.
Who Is EMDR For?
EMDR is effective for a wide range of presentations beyond acute PTSD, including complex trauma, anxiety disorders, specific phobias, grief, chronic shame, and low self-esteem rooted in early adverse experience. It is available to adults and adolescents, and can be carefully adapted for clients with dissociative presentations when delivered by a suitably trained clinician.
If you are considering EMDR therapy at our Harley Street clinic, the most important first step is an honest initial consultation. At London Trusted Therapy, we offer a careful, individually tailored assessment of whether EMDR is the most appropriate pathway for you — and if so, how to sequence and structure the work in a way that is responsive to your particular history, your current capacity, and your goals for treatment.
The body has been carrying something long enough. EMDR offers it a way home.
115A Harley Street, London W1G 6AL
To enquire about EMDR therapy in London, please contact us via the website or telephone to arrange a confidential consultation.
