Dangers of EMDR Therapy: Side Effects & Misconceptions

While many find EMDR beneficial, it can carry real risks. These include intense emotional or physical reactions during or after sessions, the resurfacing of previously forgotten or unsettling memories, and incomplete processing that can leave someone distressed. Like all therapies, working with a trained and experienced therapist is essential.

This article is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always seek the advice of your physician, therapist, or other qualified health provider with any questions you may have regarding a medical or mental health condition.

Never disregard professional advice or delay in seeking it because of something you have read on this site.

What is EMDR and how does it work?

Eye movement desensitization and reprocessing (EMDR) therapy is a treatment for mental health that uses eye movements and bilateral stimulation to help people who have experienced trauma.

EMDR is a therapy Francine Shapiro introduced in 1989 for treating traumatic memories. It has since been used for various anxiety disorders like PTSD, panic disorder, and specific phobias.

EMDR helps people recall traumatic events and reprocess them. The goal is to make the memories feel less triggering and painful.

The therapy reconnects the client to their memories in a safe, structured way, following an eight-phase protocol from preparation to reprocessing.

EMDR helps people to process any negative images, emotions, beliefs, and body sensations associated with the traumatic memories, which seem to be unprocessed and causing harm.

How does EMDR differ from traditional talk therapy?

Unlike some therapies that involve talking extensively about your past, EMDR focuses directly on the specific memory causing distress. Many clients share only brief details with the therapist.

It can also lead to faster progress—sometimes within a few sessions—though results vary from person to person.

Why do therapists use eye movements or tapping?

In EMDR, bilateral stimulation—often side-to-side eye movements, tapping, or sounds—is used while recalling distressing memories. The exact reason this helps isn’t fully understood.

Some researchers believe it helps the brain process information more adaptively, while others debate whether it’s essential at all.

Risks and Side Effects of EMDR Therapy

While EMDR is considered safe when delivered by a trained professional, it can cause temporary discomfort—especially when processing distressing memories. Being aware of possible effects can help you prepare and manage them effectively.

Emotional Effects

• Worse before better: Revisiting painful experiences can initially increase distress before improvements are felt.
• Intense emotions: Strong feelings such as sadness, anxiety, or anger may arise during or after a session, lasting from hours to a few days.
• Emotional sensitivity: You may feel more vulnerable or “on edge” between sessions, especially when working with traumatic material.

Physical and Cognitive Effects

• Physical sensations: Muscle tension, crying, fatigue, or other bodily responses can occur during sessions.
• Vivid dreams: New or more intense dreams may appear as your brain reprocesses memories.
• Concentration or sleep changes: Emotional processing can temporarily affect focus or rest.
• Rare effects: In rare cases, hallucinations or a temporary worsening of existing symptoms have been reported, though evidence for these is limited.

Risks of Re-Traumatization

• Unplanned memories: Additional or forgotten memories may surface, which can feel unsettling.
• Overwhelming recall: If trauma is accessed too quickly, it can trigger flashbacks or high distress.

When EMDR Might Not Be Suitable

Who should avoid or delay EMDR therapy?

Several groups may need to delay or avoid EMDR.

• Ongoing trauma: People still living in an abusive or otherwise dangerous situation may lack the safety and stability that processing intense memories requires.
• Severe mental health conditions: Active psychosis, schizophrenia, or severe personality disorders may mean a person does not benefit and could be destabilized unless stabilization work happens first.
• Dissociation or emotional instability: People with severe dissociation or emotional instability may need to build coping skills and stabilize first.

Is EMDR risky for people with certain mental health conditions?

People with dissociative disorders may experience increased distress if memory reprocessing starts too early. In some cases, it may even trigger suicidal thoughts. Extra caution and a slower pace are essential.

Are there situations where EMDR is considered unsafe?

Yes—if a therapist skips the preparation stages or moves into trauma processing too quickly, it can increase emotional risk.

Reducing Risks and Staying Safe

What should you discuss with a therapist before starting EMDR?

Share your mental health history, current coping strategies, and any concerns about the process. This helps the therapist tailor the pace and approach.

How do you find a well-trained EMDR practitioner?

Look for therapists trained and certified by recognized organizations such as the EMDR International Association (EMDRIA) or equivalent bodies in your country.

What coping strategies help manage difficult emotions after a session?

Grounding techniques, relaxation exercises, journaling, and taking breaks during sessions can help you stay within a manageable emotional range.

Practical factors matter too. Session costs and insurance coverage vary widely, and many practitioners now offer EMDR remotely through secure telehealth platforms.

Why EMDR Remains Debated Despite Its Effectiveness

EMDR therapy is widely used and supported by research, although there’s ongoing debate about how it works. The exact mechanism isn’t fully understood, and the role of its hallmark eye movements divides opinion.

Some researchers see the eye movements as essential to EMDR’s effect. Others disagree. They argue the benefit comes from exposure therapy principles alone, with no special role for the movements themselves.

An early meta-analysis by Davidson and Parker (2001) backed that second view: EMDR’s eye-movement component added nothing beyond what exposure alone produced. One review went further, calling EMDR exposure therapy in disguise (Rogers & Silver, 2002).

A later meta-analysis complicated that picture.

Lee and Cuijpers (2013) found a genuine effect for the eye movements themselves. Sceptics still question whether they add anything beyond a placebo effect. Early claims that EMDR was a “one-session cure” have not held up, either.

Most people need several sessions. Early accounts suggested faster results, but progress depends on the trauma’s nature and the client’s circumstances.

A 2020 network meta-analysis pooled 90 trials of 6,560 adults with PTSD across 22 different psychological treatments. It ranked EMDR alongside cognitive behavioral therapy (CBT) as the most effective, with benefits still holding up months later (Mavranezouli et al., 2020).

Panic disorder tells a similar story. A separate trial found EMDR and CBT equally effective there (Horst et al., 2017).

EMDR’s benefits hold up in both in-person and online formats. The real debate, then, is not whether EMDR works, but why.

Common Myths About EMDR—and the Facts

Myth: EMDR is only for people with PTSD.

Fact: While developed for PTSD, EMDR is also used for anxiety, depression, panic, and dissociation.

Myth: EMDR is a form of hypnosis.

Fact: Although bilateral stimulation may look like hypnosis, EMDR is not hypnosis. Whether the eye movements themselves add anything beyond the therapy’s other components is still debated among researchers.

Myth: You’ll start reprocessing trauma immediately.

Fact: EMDR includes a preparation phase—history-taking, coping skills, and readiness checks—before reprocessing begins, often after several sessions.

Myth: You must talk about your trauma in detail.

Fact: Clients control how much they share. Even minimal detail can be enough for effective reprocessing.

Myth: EMDR creates false memories.

Fact: EMDR works only with existing memories. It does not implant new ones.

Myth: You might lose control during sessions.

Fact: Strong emotions can occur, but complete loss of control is rare. Therapists use pacing and coping strategies to keep the process manageable.

Further Information

• APA Guidelines for the treatment of PTSD in adults
• Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Perez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in Psychology, 8, 1668.
• Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal, 18(1), 71.
• Shapiro, F. (1995). Eye movement desensitization and reprocessing.

References

Davidson, P. R., & Parker, K. C. (2001). Eye movement desensitization and reprocessing (EMDR): a meta-analysis. Journal of consulting and clinical psychology, 69(2), 305.

de Jongh, A., Amann, B. L., Hofmann, A., Farrell, D., & Lee, C. W. (2019). The status of EMDR therapy in the treatment of posttraumatic stress disorder 30 years after its introduction. Journal of EMDR Practice and Research, 13(4), 261-269.

Hase, M., Balmaceda, U. M., Hase, A., Lehnung, M., Tumani, V., Huchzermeier, C., & Hofmann, A. (2015). Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting.  Brain and Behavior, 5 (6), e00342.

Horst, F., Den Oudsten, B., Zijlstra, W., de Jongh, A., Lobbestael, J., & De Vries, J. (2017). Cognitive behavioral therapy vs. eye movement desensitization and reprocessing for treating panic disorder: a randomized controlled trial.  Frontiers in Psychology, 8, 1409.

Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of behavior therapy and experimental psychiatry, 44(2), 231-239.

Lewey, J. H., Smith, C. L., Burcham, B., Saunders, N. L., Elfallal, D., & O’Toole, S. K. (2018). Comparing the effectiveness of EMDR and TF-CBT for children and adolescents: A meta-analysis.  Journal of Child & Adolescent Trauma, 11 (4), 457-472.

Mavranezouli, I., Megnin-Viggars, O., Daly, C., Dias, S., Welton, N. J., Stockton, S., Bhutani, G., Grey, N., Leach, J., Greenberg, N., Katona, C., El-Leithy, S., & Pilling, S. (2020). Psychological treatments for post-traumatic stress disorder in adults: A network meta-analysis.  Psychological Medicine, 50 (4), 542-555. https://doi.org/10.1017/S0033291720000070

Mazzei, R. (2021, January 27). What is Resourcing in EMDR Therapy? Evolutions Behavioral Health Services. https://www.evolutionsbh.com/articles/what-is-resourcing-in-emdr-therapy/

McGowan, I. W., Fisher, N., Havens, J., & Proudlock, S. (2021). An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid–19 pandemic.  BMC psychiatry, 21 (1), 1-8.

Rogers, S., & Silver, S. M. (2002). Is EMDR an exposure therapy? A review of trauma protocols. Journal of clinical psychology, 58(1), 43-59.

Shapiro, F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of behavior therapy and experimental psychiatry, 20(3), 211-217.

Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences.  The Permanente Journal, 18 (1), 71.

Shapiro, F. (2017).  Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.

Shapiro, F., & Maxfield, L. (2002). Eye movement desensitization and reprocessing (EMDR): Information processing in the treatment of trauma.  Journal of clinical psychology,  58 (8), 933-946.

Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Perez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review.  Frontiers in psychology, 8, 1668.

van den Berg, D. P., & van der Gaag, M. (2012). Treating trauma in psychosis with EMDR: a pilot study.  Journal of behavior therapy and experimental psychiatry, 43 (1), 664-671.

Wanders, F., Serra, M., & De Jongh, A. D. (2008). EMDR versus CBT for children with self-esteem and behavioral problems: A randomized controlled trial.  Journal of EMDR Practice and Research, 2 (3), 180-189.