Dangers of EMDR Therapy: Risks, Side Effects, and What Helps
You want relief from what happened. You also want to know what treatment might bring up, and how you’ll be supported if it feels like too much.
By Jenny Staats, LMSW · EMDR and trauma therapist at High Thrive Counseling · First published October 2022 · Last reviewed October 2026
EMDR is an established treatment for PTSD, and it can bring up distressing emotions, memories, or body sensations. It is not risk-free. Preparation, your ongoing consent, and attention to how you are doing between appointments all matter.
Sources: VA’s EMDR overview · EMDR Institute
Is EMDR therapy safe?
If you’ve searched for the dangers of EMDR therapy, you may be interested in trying it, and a little nervous about opening a door you’ve worked very hard to keep closed.
Fair question. Especially if you have already spent plenty of time holding things together.
EMDR stands for Eye Movement Desensitization and Reprocessing. During part of this structured therapy, you bring an experience to mind while following guided eye movements or another form of alternating stimulation.
The VA/DoD guideline recommends EMDR as one of several leading treatments for PTSD. That supports its effectiveness. It does not promise that every person will benefit or that unwanted effects never happen. Read the VA treatment overview.
Research on side effects also needs improvement. A recent review found that most EMDR trials for PTSD did not mention adverse effects at all, and only one assessed them systematically. We should be honest about that gap instead of assigning a reassuring percentage we cannot support. Read the review of adverse-effect reporting.
Let’s talk about the worry. Ask how your therapist will assess fit, prepare you, and respond if you struggle. Those answers matter more than a promise that everything will be fine. You deserve room for questions.
What side effects can happen with EMDR?
People can notice increased distress, strong emotions, body sensations, or additional dreams and memories during or after sessions. Not everyone experiences these reactions, and a list cannot tell us how often each one happens. The EMDR Institute describes these possible effects.
Here are a few ways to put your experience into words:
- Stronger feelings. “I felt much more upset afterward than I expected.”
- Changes in dreams or sleep. “My dreams have been more intense, and I’m losing sleep.”
- Memories or images coming to mind. “Something came up that I want help understanding.”
- Physical discomfort. “I noticed tension or an uncomfortable sensation during that part.”
- Feeling depleted or sensitive. “I had very little bandwidth afterward. Can we plan for that?”
These are conversation starters. They are not a diagnosis or a checklist of what is supposed to happen.
If you notice fatigue, a headache, or another physical symptom, mention it. Do not assume every new symptom comes from EMDR. New, severe, or unexplained symptoms may need medical assessment.
If eye movements themselves are uncomfortable, say so. Your therapist can discuss adjustments or other forms of alternating stimulation, such as taps or tones. Let them know about physical discomfort or difficulty staying present.
Can EMDR make you feel worse?
It can temporarily increase distress. Focusing on something painful may feel uncomfortable, even when treatment is helping overall. The VA discusses this possibility.
But please do not turn that into a rule that you must get worse before you get better.
Feeling worse deserves a conversation. It does not automatically mean treatment is working, failing, or causing lasting harm.
What matters is the pattern: how intense the reaction is, whether it is easing or escalating, and what is happening to your sleep, safety, work, relationships, and everyday functioning. Cleveland Clinic advises contacting your provider when symptoms change in a new or disruptive way.
You do not need to wait for your next appointment to say, “This feels bigger than what we planned for.”
What kind of support do I need?
Notice and discuss
You feel stirred up, but you can stay present and manage daily needs.
Next step: Use the agreed plan, note changes, and reach out whenever you are unsure.
Contact your therapist promptly
Panic, flashbacks, detachment, or sleep problems are increasing or interfering with daily life.
Next step: Ask to review the plan before further memory processing.
Get urgent help
You cannot stay safe, may act on suicidal thoughts, or face another immediate emergency.
U.S. crisis support: Call or text 988. For immediate danger, call 911 or seek emergency care.
A conversation guide, not a diagnostic test. You can reach out before a problem becomes severe. Sources: Cleveland Clinic and 988 Lifeline.
Who might need a different pace or more support?
Your history matters. So does what is happening in your life right now.
Tell your therapist about feeling detached or losing track of time, difficulty staying safe, substance use, other mental health symptoms, and current danger or instability at home. These details help determine the support and treatment setting you need.
Complex trauma or dissociation does not automatically make EMDR off-limits. It may change the preparation, clinician expertise, pacing, or coordination of care needed. NICE recommends attending to these barriers and the person’s circumstances.
You do not have to arrive perfectly calm or with your entire life alphabetized. The question is whether the proposed treatment plan fits you now.
If something important changes between sessions, tell your therapist. A plan can change with it.
What should a thoughtful EMDR plan include?
EMDR involves eight phases, including preparation, processing, closure, and reevaluation. The work includes checking progress and deciding what needs attention next. Read about the treatment phases.
Here is what I would want you to ask about before beginning:
- Understand the choice: “Why does EMDR fit what I’m struggling with, and what other options do I have?”
- Prepare together: “What will we work on before approaching a difficult memory?”
- Agree on a pause: “If words are hard to find, how can I let you know I need to stop?”
- Plan the ending: “What happens if we run out of time and I’m still upset?”
- Plan for home: “What should I do if I struggle later, and how do I reach you?”
- Review the response: “How will we decide whether this is helping or whether we need to change course?”
These are reasonable questions. You are allowed to ask all six. You are also allowed to bring them on paper because remembering a thoughtful question while feeling nervous is its own little project.
The goal is a shared plan you understand and can participate in.
How do I choose an EMDR therapist?
Look for a mental health professional practicing within their license and scope, with completed EMDR training and experience relevant to your concerns.
EMDR-trained
The clinician has completed EMDR basic training. Appropriate training prepares an eligible clinician to use EMDR in their practice.
EMDRIA-certified
The clinician has completed an additional, optional credentialing process beyond basic training.
Training and certification are distinct. EMDR Institute’s credential explanation.
Credentials are one part of the conversation. You can also ask:
- “How much experience do you have with concerns like mine?”
- “How do you work with someone who gets overwhelmed or disconnected?”
- “What would make you recommend a different approach?”
- “How will you check what happens after I leave?”
Pay attention to whether you can ask questions without feeling brushed off. A good fit includes room for your concerns.
What if a new memory or image comes up?
Tell your therapist what you noticed without pressuring yourself to decide immediately what it means.
A new image, dream, association, or body sensation is not automatic proof of a particular event. Your therapist should avoid supplying an explanation or steering you toward a story.
The aim is to address your distress while handling uncertainty carefully. For a fuller discussion, read Myths and Facts of EMDR.
How can I plan for after a session?
Before the appointment ends, ask: “What should I do if this feels harder once I get home?”
A useful plan is specific enough that you do not have to invent it while upset.
- Know what helps you settle. Discuss ways to feel oriented to the present, and what to do if an exercise makes you feel worse.
- Make a little breathing room. Consider a quieter evening and realistic expectations for work, errands, and conversations.
- Notice what changes. Keep brief notes about sleep, distress, and daily functioning to share with your therapist.
- Know who to contact. Clarify support people, practice response times, and the plan for after-hours concerns.
You might tell someone close to you: “I may want a quieter evening. I don’t need to explain everything from the session.”
There is no requirement to turn the evening into a second therapy appointment. Follow the plan you made with your clinician instead of pushing yourself into more memory processing on your own.
Are EMDR intensives riskier than weekly therapy?
A longer appointment changes the treatment schedule. It does not remove the need for assessment, preparation, breaks, and follow-up.
We cannot assume an intensive will be safer, harder, or more effective for a particular person simply because it lasts longer. Ask how the provider will decide whether that format fits your needs and what will happen if the plan needs to change.
I offer EMDR intensives in Indianapolis at High Thrive. A consultation can help us explore whether weekly sessions or an intensive is a reasonable next step for you.
Frequently asked questions about EMDR risks
Does everyone feel worse after EMDR?
No. There is no required reaction. Feeling very distressed does not prove that treatment is working, and having little distress does not prove that it is failing. Tell your therapist what you actually notice.
How long do EMDR side effects last?
There is no reliable time limit that fits everyone. Ask your therapist what they want you to monitor. Escalating distress or problems with safety and daily functioning deserve attention without waiting for an arbitrary deadline.
Can I stop during an EMDR session?
You can ask to pause or stop. Discuss a clear signal beforehand, especially if speaking becomes difficult when you are overwhelmed.
Do I have to describe every detail of my trauma?
Usually, you do not need to give a detailed verbal account. Your therapist still needs enough information to understand the concern and plan treatment. Read the VA’s patient information.
Can I use an EMDR video or app on my own?
A moving dot or alternating sound does not provide the assessment, treatment relationship, and monitoring involved in EMDR therapy. If you want help with traumatic memories, discuss treatment with a qualified clinician. Ask which between-session exercises are appropriate for you.
What if I have already had a bad experience with EMDR?
You deserve to have that experience taken seriously. Tell your clinician what changed, how long it lasted, and what support was missing. You can ask to review the plan or seek a second opinion. You do not owe any treatment another attempt before your concerns are heard.
Is online EMDR available in Florida?
High Thrive offers online therapy in Florida, and whether EMDR is a fit is assessed individually, as it is for everyone. Learn about EMDR services at High Thrive.
You can start with, “I’m interested, and I’m nervous.” That is plenty to begin a conversation. You do not need to decide whether EMDR is right for you before reaching out.
High Thrive offers EMDR and trauma therapy in Indianapolis, serving Carmel, Fishers, Zionsville, Brownsburg, and surrounding Central Indiana communities.
Schedule a free 15-minute consultation with JennyIn person in Broad Ripple, Indianapolis · Online in Indiana · Online therapy in Florida · Directions to our office
Meet Jenny Staats, LMSW
Warm. Practical. Collaborative. Less “try harder.” More “let’s figure out why this isn’t working.”
Jenny provides EMDR therapy and EMDR intensives at High Thrive Counseling in Indianapolis. Her approach is paced around the person in front of her, not around how much trauma is supposedly meant to fit into a single session.
Jenny also works with teens, young adults, adults, and couples navigating ADHD, anxiety, depression, trauma, overwhelm, relationship stress, premarital concerns, perimenopause, and major life transitions.
- EMDR + Trauma
- EMDR Intensives
- ADHD
- Anxiety + Depression
- Teens + Young Adults
- Couples + Premarital
In person in Broad Ripple, Indianapolis · Online in Indiana · Online therapy in Florida
Sources and further reading
- VA National Center for PTSD: Overview of Psychotherapy for PTSD.
- VA National Center for PTSD: EMDR for PTSD.
- Van Schie & van Veen: Adverse effects of EMDR therapy: A neglected but urgent area of inquiry. Current Opinion in Psychology, 67 (2026).
- NICE NG116: Post-traumatic stress disorder, recommendations.
- EMDR Institute: Frequently Asked Questions.
- EMDR Institute: EMDR training versus EMDRIA certification.
- Cleveland Clinic: EMDR Therapy.
- 988 Suicide & Crisis Lifeline.
This article is general education. It doesn’t replace an individual assessment or treatment, and your clinician can help you weigh options for your particular circumstances. If you are in crisis or may harm yourself, call or text 988, or call 911 in an emergency.