The Preparation Phase of EMDR Therapy: What to Expect in Your First Few Appointments

Many people expect to start EMDR reprocessing right away in their first session. Yet the EMDR process requires several preparation steps to help ensure all goes well and is as effective as possible. I’d like to share what we do and why we do this, so you can avoid surprises and feel confident at your first EMDR appointment.

Preparation: Mastering Calming and Peace 

In EMDR, our goal is to reprocess traumatic memories that were not stored properly or processed well at the time of the event. These memories are causing trouble now. Due to the nature of some of these memories, it helps to know how to immediately establish safety, calmness, and ownership over yourself and the process. If preparation is ignored, EMDR therapy may lead to negative results (a fancy way of saying: make things worse). 

It is important for therapy clients to feel safe. EMDR involves intentional activation of the nervous system. For some clients, this might bring terror or flashbacks, for instance, so therapists first guide the clients in mastering ways to calm down the nervous system in case they need it. Feeling in control helps the process go better. 

You also want to begin EMDR therapy in a neutral, calm state of mind. In that way, you can really observe what is happening in your mind and notice sensations in your body without affecting or distorting them.

The preparation phase of EMDR can take from one to several appointments. In these sessions, you will learn to calm and balance your nervous system yourself, when you need to (a handy skill to have in any situation). You will use these new skills, for instance, the Safe Place or Container exercises, during your therapy session or between sessions, as needed. 

You will work together with your therapist to master these techniques until you feel completely confident in going forward. It’s definitely okay to tell your therapist whenever you need to take a break at any time! If you have a hard session, use as many of these calming exercises as you need to, to feel calm again. 

You should walk out of an EMDR therapy session feeling as good or even better than when you went in. To achieve this, we must do a little preparation work.

Set a Stop Signal

You, the client, are always in control. Always. In an EMDR session, you always have the choice to stop whatever you and your therapist are doing, at any time. You can take a break or go to a calming exercise. 

Because this is so important, in the preparation phase you will also establish, with your therapist, a stop signal. Many people in my office just raise their hand. Once you choose your signal, your therapist knows that when you do that—whatever is happening—everything stops. 

Learn the Safe Place Exercise

(Also called Calm Place or Peaceful Place.) This exercise is where you get into a flow state. 

Safe Place is a visualization technique where you find a place in your life where felt your best. Happy. When time stopped (in a good way) and you were immersed in what you were doing or where you were. My Safe Place is floating on a river in Laos, with no people around. Just me and Mother Nature. Yours can be different. It’s anywhere you felt completely safe, calm, secure, positive, and able. By practicing going there, you can create a refuge for yourself at any moment.

Your Calm Place is magic. It can have a powerful effect on your brain. In one study, a group of people learned to play a short tune on the piano and their brains were studied. Another group simply sat there and imagined playing those same notes, and yet the same brain changes occurred! 

That’s the power of visualization. And that’s the power of your Safe Place: when you visualize yourself in your Safe Place, your brain (at least part of it) believes that you are actually there and safe. This technique can become an instant vacation balm for you.

Safe Place is also a diagnostic tool. If you cannot bring yourself to your Safe Place, then you are not ready to start your EMDR treatment. 

Feel free to ask your therapist to go there with you. You can start a therapy session and/or end one with Safe Place. Any time things are getting too overwhelming while you’re reprocessing, you can take a break and go to your Safe or Calm Place. 

Learn the Container Exercise

The Container is another visualization exercise, where you can leave any memories, images, thoughts, and feelings in a container of your choice. The Container can be anything you want: a bank safe (real) or an imaginary underground base in the Sahara desert. Wherever and whatever your container is, you are the only one who ever has access to it. 

Sometimes when an EMDR session ends, you may still feel some disturbance related to the work you did with your therapist. In this case, you want to “store” this disturbance somewhere, until your next session. You never want to leave a session and take the disturbance with you. You need to leave it in a place where you can find it next time you go to see your therapist. 

Your Container is ideal. It can be locked, sealed, put underground, sent to outer space or anywhere you feel like putting it. You can use your container at the end of the session if your level of disturbance (a measure that will be assessed on a 0-10 scale) is not a 0 or a 1. Or you can use it between sessions when you need it. 

Choose Your Allies

Not all EMDR therapists use Allies, but it’s a tool that I find very helpful and often use in the preparation phase. Your allies are the people or figures (real or imaginary) that will be there to support you whenever you need them. You can choose your first-grade teacher, Obama, the Buddha, Jesus or your best friend from high school. It could be Yoda, Tyler Durden or the dog you had when you were 8. 

Generally, allies fit into one of three categories:

  1. Protector Figures. This is a person, a figure or an animal that make you feel really safe.
  2. Nurturing Figures. All those figures that you feel nurtured by when they are around you. (Grandmas are popular in this category.)
  3. Wise Figures. These are people or figures that inspire you with their wisdom. These can be teachers, professors, mentors, or spiritual figures like the Dalai Lama.  

Choose a Bilateral Stimulation Option

To stimulate the brain to reprocess, EMDR uses a few gentle devices (that you can choose from) to activate both sides of the brain. The preparation phase will introduce you to these Bilateral Stimulation (BLS) devices, and you can explore them in a positive way before using them. 

For instance, there are pulsers (sometimes called buzzers or tappers) that gently vibrate in your hands as you hold them or a bar of lights that you can let your eyes follow back and forth. The choice is yours.

How Long Does Preparation Take?

Preparation for EMDR can take one or two sessions. Or it can take weeks, months, and, very rarely, years. If you are not ready to start reprocessing and you jump into the deep water of emotional trauma, you can end up feeling flooded with disturbing thoughts and emotions with no ability to cope. 

Your therapist should not allow you to start reprocessing if you’re not ready. The right amount of time is exactly as long as it takes.

6 Tips Before You Begin EMDR Reprocessing

  1. Accept: Everyone Is Different. There are no “right” or “wrong” feelings or experiences. There are only yours, and they are what they are.
  1. Let Whatever Happens Happen. This is a core tenet of EMDR. Avoid censoring your reprocessing and just let whatever is happening to continue. (Unless you feel overwhelmed and want to stop, of course.) 
  1. Speak Freely and Give Feedback. Your therapist wants to help you. To best do that, it is important for you to share accurate feedback about what you experience during your processing. 
  1. Connect with Your Body. It helps to have a body sense as you go. If you are practicing your Safe Place, pay attention to how it feels in your body to be there, to be safe. If you’re imagining your protector, notice what your body feels when your protector is around. 
  1. Remember: You Are In Control. You are in control. (I know, I said that twice because it’s important.) You can stop the processing whenever you feel a need to. Use the stop signal you agreed on with your therapist, close your eyes, or just say “stop.” 
  1. Use the Tools between Sessions. It may happen that distressing unresolved memories arise between sessions when you are without your therapist. It is possible to experience disturbing emotions or sensations as your memories shift, or have new dreams or nightmares, new memories, or flashbacks. Thanks to the preparation phase, you have new tools that you can use to re-establish calm and safety. By all means, use them.

By the time you finish your EMDR therapy, some memories will stop affecting your day-to-day life. Those memories will shift, becoming a part of your past, a simple fact, a story that happened to you and not an event that keeps triggering you. 

To start this reprocessing, from which so many have experienced deep and permanent relief, your therapist will walk you through the preparation phase so you can master some of the skills I’ve described. 

Then you will be ready to begin. Best of luck!

Rotem Brayer is an EMDR therapist practicing in Denver, Colorado. He divides his time between helping refugees to improve their mental health and maintaining a private practice.

Resources and Further Reading

1. Hensley, Barbara. Therapy Primer (Second Edition): From Practicum to Practice. Springer Publishing Company, 2015.

2. Levine, Peter A. Trauma and Memory: Brain and Body in a Search for the Living Past: A Practical Guide for Understanding and Working with Traumatic Memory. North Atlantic Books, 2015.

3. Parnell, Laurel. A Therapist’s Guide to EMDR: Tools and Techniques for Successful Treatment. W W Norton & Company, 2010.

4. Shapiro, Francine. Eye Movement Desensitization and Reprocessing (EMDR) Therapy (Third Edition): Basic Principles, Protocols, and Procedures. The Guilford Press, 2017.

5. https://www.nytimes.com/2007/05/29/health/29book.html
6. Flow/ Mihaly Csikszentmihalyi

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