What to Expect with EMDR Therapy in Your First Session | Horsham, PA
Walking into your first EMDR session can feel a little like walking into the unknown. You’ve read about it, maybe watched a video or two, and you know it’s supposed to help with trauma, including conditions like post-traumatic stress disorder (PTSD). EMDR therapy involves a structured treatment process that includes thorough preparation, finding a trained therapist, and setting clear goals to ensure a safe and effective experience. But what actually happens when you sit down in that room (or log into that Zoom call) for the first time?
The nervousness makes sense.
You’re about to start something that asks you to revisit hard memories and process traumatic experiences, and your nervous system is already on high alert just thinking about it. But here’s what I want you to know: EMDR is powerful and structured. You’re not going to be thrown into the deep end without support.
The first session isn’t about diving headfirst into your worst memories. It’s about building safety, learning what EMDR actually is, and later moves to making sure your nervous system has what it needs before we go anywhere near the heavy stuff.
If you’re considering EMDR therapy in Horsham or Montgomery County, here’s a clear picture of what the first session looks like, and what it doesn’t.
What to Expect in Your First EMDR Session in Horsham
Let’s start with the environment. Whether you’re coming into our office in Horsham or logging in for an online EMDR session in Pennsylvania, the goal is the same: create a space that feels safe enough for your nervous system to settle.
The room is calm. There’s no pressure to perform or “do it right.” Our EMDR therapists in Horsham are trained professionals who guide you through the initial history discovery process, ensuring you feel supported from the very beginning. That’s not how this works.
The first session is about getting to know each other and starting the process of trust. In EMDR therapy, this stage is often referred to as the initial history discovery phase. It’s about getting to know each other, understanding what brought you here, and orienting you to how EMDR actually works. You’re not jumping into trauma processing. You’re laying the foundation so that when we do start reprocessing later, your system is ready.
If you’ve been searching “EMDR therapy near me” and feeling anxious about what happens next, take a breath. The first session is gentle. It’s collaborative. And it’s designed to meet you where you are.
Phase 1 and 2: History and Preparation in EMDR Therapy
EMDR is organized into eight phases, often referred to as the phases of EMDR, but the first session typically stays in the first phase of EMDR. Later, once we have a relationship, we will move into the second phase and the next phases, with each phase of EMDR building upon the previous one.
Phase 1: History Taking
This is where we talk about what brought you here. What are you struggling with? Are you experiencing a mental health condition such as PTSD or anxiety? What memories or beliefs feel stuck? What does your nervous system do when it feels threatened (freeze, fight, fawn, flight)? The therapist will ask about past trauma and current symptoms to better understand your mental health. We’re gathering information, but we’re not asking you to relive anything in detail.
We’re also mapping out your story in a way that helps us understand what we’ll eventually target in EMDR. Treatment planning is an essential part of this phase, where the therapist develops a treatment plan tailored to your needs. But again, this is mapping, not processing. You’re safe here.
This phase is crucial for identifying mental health concerns and setting the foundation for effective treatment.
Phase 2: Preparation
This is the phase that often gets rushed in less trauma-informed therapy, and that’s a mistake. Preparation is where we build your toolbox. You’ll learn grounding techniques, ways to regulate your nervous system, and skills to help you feel safe in your body. During this phase, you’ll also be taught relaxation techniques such as deep breathing, which are essential for helping you feel calm and manage distress during EMDR therapy. This might include:
Resourcing: Creating an internal sense of calm or safety that you can access during EMDR. These exercises are designed to help you feel calm and grounded.
Grounding exercises: Techniques to bring you back to the present if things feel overwhelming. These techniques are part of a broader set of relaxation techniques used to manage distress.
Container exercises: A way to mentally “put away” distressing material if we need to pause.
We don’t move forward until you feel ready. This is an EMDR preparation session, and it’s just as important as the reprocessing that comes later.
If you’re dealing with complex PTSD or trauma that’s been with you for years, preparation might take more than one session. That’s not a problem. That’s good therapy.
The Role of Bilateral Stimulation in EMDR Therapy
Bilateral stimulation is at the heart of what makes EMDR therapy unique and effective. During an EMDR session, your trained EMDR therapist will guide you through a process that uses gentle, rhythmic stimulation—most commonly through eye movements, but sometimes with tapping or auditory tones. This technique is designed to activate both sides of your brain, helping you process traumatic memories in a way that feels less overwhelming.
When you’re working through a traumatic event or difficult experience, your mind and body can hold onto emotional distress and physical sensations long after the event is over. Bilateral stimulation helps your nervous system “unstick” these traumatic memories, allowing you to process them in a safe, supported environment. As your EMDR therapist leads you through these movements, you may notice that the emotional charge or body sensations connected to the traumatic experience begin to shift.
The goal isn’t to erase the memory, but to help you process traumatic memories so they no longer trigger the same intense emotional or physical reactions. Over time, this can reduce the impact of traumatic events on your daily life, making it easier to move forward. Whether you’re dealing with post traumatic stress disorder, panic attacks, or other forms of emotional distress, bilateral stimulation is a powerful tool in the EMDR process—one that your therapist will introduce at a pace that feels right for you.
What You Might Actually Do in Your First (few) EMDR Session in Horsham, PA
A typical EMDR therapy session lasts about 60-90 minutes and follows a structured approach, with each treatment session tailored to your needs. EMDR therapy is a series of EMDR sessions designed to help you process traumatic experiences, and it usually involves multiple sessions to achieve lasting results.
Here’s what you can expect in real time during your first EMDR therapy session:
You’ll talk about why you’re here.
Not in a “tell me your whole life story” way, but in a “what’s bringing you to EMDR right now” way.You’ll learn about bilateral stimulation.
Your therapist will explain how it works and let you try it out in a low-stakes way: eye movements, buzzers, tapping, or audio tones.You’ll create a “calm place” resource.
Before we ever touch a traumatic memory, you’ll practice EMDR resourcing with something positive.You’ll check in with your body.
Tight chest? Warm hands? EMDR works with body sensations as much as with thoughts, so you’ll be guided to notice body feelings and physical sensations as part of the process.Each treatment session builds on the previous one.
EMDR therapy typically involves multiple sessions, with each appointment helping you process memories, assess your beliefs and feelings, and work toward resolution.
What you won’t do: dive into trauma memories right away. The goal is always stabilization and safety first.
In later sessions, your therapist may introduce more advanced techniques to support your progress, and you’ll discuss what to expect in the next session to ensure ongoing healing and self-care.
What You Won’t Have to Do in EMDR Therapy
Let’s bust a few myths:
You don’t have to share every detail of your trauma story. Unlike standard talking therapy, EMDR therapy focuses on processing disturbing memories without requiring you to recount every detail of your experiences.
You won’t be pushed faster than you’re ready to go.
You don’t have to “perform” or do EMDR a certain way.
You won’t leave dysregulated. A good EMDR therapist closes every session with as much resourcing as possible.
This is especially true for CPTSD EMDR treatment in Pennsylvania, where pacing and closure are essential.
Local and Practical Info for EMDR in Horsham, PA
In-person sessions: Our office in Horsham has easy parking, a private and calm setting, and serves clients from Ambler, Hatboro, Willow Grove, Warrington and across Montgomery County.
Virtual EMDR across Pennsylvania: Licensed to provide telehealth statewide, using audio tones or self-tapping. You’ll need a private, quiet space for safety.
If you’re looking for EMDR therapy near Horsham, Montgomery County, or anywhere in Pennsylvania, we’ll meet you where you are, online or in person.
What Happens After the First EMDR Session?
Some people begin reprocessing in the 2nd or 3rd session.
Others need more time stabilizing and resourcing first. Both are normal, especially with complex trauma.
Re-evaluation is an important part of the EMDR process, where your progress is assessed after several sessions to ensure the therapy is effective and to adjust treatment goals as needed.
EMDR is structured, but never rigid—it adapts to what your nervous system needs. The final phase of therapy involves reviewing your progress, planning for future situations that may trigger distress, and ensuring you have the skills to handle upcoming challenges. Adjunctive therapy may also be recommended alongside EMDR to support ongoing healing and address specific needs.
If you’re already feeling nervous about your first EMDR session, that’s normal. If you’d like to talk through what it might look like for you here in Horsham, you can schedule a consultation today.
FAQs About EMDR Therapy in Horsham and Montgomery County, PA
Is EMDR available online in Pennsylvania?
Yes. We offer secure telehealth sessions statewide. Bilateral stimulation works virtually with eye movements, audio tones or guided tapping.
Do I have to share all the details of my trauma?
No. EMDR does not require you to tell your whole story out loud.
How soon will EMDR start working?
It varies. Some clients notice shifts quickly, others after several sessions. Complex PTSD often requires a slower, steady pace.
How are subjective units used in EMDR?
Therapists use subjective units, such as the Subjective Units of Disturbance (SUD) scale, to measure your level of emotional disturbance or distress related to a memory. This scale helps track progress, with scores ranging from 0 (no disturbance) to 10 (worst).
How does EMDR address negative emotions, negative beliefs, and inappropriate emotions?
EMDR targets negative emotions, negative beliefs, and inappropriate emotions that are generally caused by unresolved trauma or past experiences. The therapy helps identify and process these unhelpful responses, replacing them with healthier, more adaptive beliefs and feelings.
What is the installation of positive belief in EMDR?
During EMDR, therapists help you install a positive belief or positive beliefs to replace negative beliefs. This process strengthens positive self-statements and supports mental healing and personal growth.
Does EMDR focus on specific events or memories?
Yes. EMDR often targets a specific event, specific memories, or a single trauma. Other memories related to the main trauma may also be addressed as they arise during treatment.
Can EMDR cause vivid dreams?
Some people experience vivid dreams after EMDR processing. This is a normal part of the brain’s way of integrating and resolving memories.
Is EMDR effective for treating PTSD and other mental health conditions?
EMDR is widely used for treating PTSD and can also help with other mental health conditions related to trauma, such as anxiety, depression, and emotional disturbance.
Why is it important to work with a qualified therapist?
A qualified therapist has specialized training in EMDR. In some cases, a separate therapist or adjunctive therapy may be involved to support your treatment and ensure the best outcomes.
What does EMDR processing involve?
EMDR processing includes identifying target memories, using bilateral stimulation, and working through the desensitization and reprocessing phases. The goal is to reduce emotional distress and promote adaptive, positive beliefs.
Ready to Take the Next Step?
The first EMDR session is about safety, pacing, and finding your rhythm with your therapist. It’s not about fixing everything in 50 minutes, it’s about starting in a way that feels manageable for your nervous system.
If you’re ready to explore EMDR therapy in Horsham, PA, we’d love to walk with you. Whether you’re dealing with trauma, PTSD, and eating disorder, complex PTSD, or the lingering effects of emotional neglect, we’re here. Schedule your free consultation call today.
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