Is EMDR Dangerous? EMDR Side Effects and Risks Explained
If you’ve been told EMDR could help you, you may have done what many people do next: Googled it.
Then you read about “reprocessing traumatic memories” and started wondering whether opening all of that back up could make things worse.
I hear this fear a lot. You may have spent years figuring out how to keep painful emotions contained. The idea of deliberately going back to them can feel like you’re risking becoming a mess again or undoing all the work you’ve done to function.
So, is EMDR safe?
EMDR is a well-studied trauma treatment, and major clinical guidelines recognize it as an effective treatment for PTSD. It can also have real side effects since processing painful experiences can be emotionally and physically tiring, especially at first, so we’ll do thorough preparation before beginning EMDR processing.
Understanding the risks of EMDR therapy can help you make an informed decision about whether you’re ready to try it.
Is EMDR dangerous? The short answer
For most people who are appropriately assessed and prepared for treatment, EMDR is considered a safe form of psychotherapy. It is included in PTSD treatment guidelines from organizations including the World Health Organization and the U.S. Department of Veterans Affairs and Department of Defense.
That doesn’t mean EMDR always feels good.
EMDR asks your brain and body to engage with material that may be painful, frightening, or deeply uncomfortable. You may feel tired after a session. Emotions can feel more accessible. You may have vivid dreams or notice memories coming up that you haven’t thought about in years.
Those experiences can be side effects of EMDR without necessarily being signs that EMDR has harmed you. It may be a sign that the pain is starting to flow or unthaw, just like a stick of butter that’s been in the freezer and is now on the counter. This is actually a good sign and means we have movement, the pain won’t be stuck forever, and the body is letting us work on the pain.
Where I become more concerned is when someone gets so overwhelmed that their usual coping skills stop working, or when processing begins before they have enough support and resources to handle what comes up. This can happen; but more often than not, since we’ve done thorough preparation for treatment, clients find their skills are a good match to tolerate the new movement.
That distinction matters. Some discomfort can be part of trauma work. Feeling completely destabilized is something your therapist needs to know about, and we’ll work closely together to make sure you stay in a working phase, not overwhelmed or underwhelmed, in treatment.
What EMDR does, in plain language
One way I explain EMDR is that it’s like cleaning out your mental and emotional closet.
When something scary or overwhelming happens, your brain may shove it into the back of the closet and slam the door. You can go on with your life because the door is closed, but your body still knows what’s in there.
EMDR gives us a structured way to open that closet together.
We work at your pace to sort through what’s there. We keep the things your brain and body have learned that help you stay safe and protected. We work on letting go of the fear, pain, shame, or other responses that you no longer need to carry in the same way.
That process can take energy. It can also explain why some EMDR side effects show up during or after a processing session.
What are the common side effects of EMDR?
People respond differently to EMDR. Some people feel tired or emotionally raw after processing, while others leave a session feeling lighter, clearer, or even energized.
Research into adverse effects of EMDR is still surprisingly limited. A 2026 review of randomized controlled trials found that adverse effects have often gone unmeasured or underreported. In the studies that did report them, adverse effects were generally mild and temporary.
In my own clinical work, these are some of the experiences I prepare clients for.
Fatigue after EMDR
EMDR can be tiring, especially during the first few processing sessions.
You’re doing a lot of work in a relatively short period of time, even though you may be sitting in a chair for the entire session. Your brain and body are processing information that they have worked very hard to contain.
I often encourage clients to avoid scheduling something particularly demanding immediately after an EMDR session. When possible, give yourself some room to decompress.
Feeling emotionally raw
You may feel more emotionally sensitive after a session. Something that usually wouldn’t bother you very much might hit harder than expected.
Think about unpacking after a long trip. You open the suitcase and suddenly realize just how much laundry there is to do. Unpacking emotional pain can feel similar. Once everything is out in the open, it can temporarily feel like there is more to deal with.
Vivid dreams or memories
Your brain doesn’t necessarily stop processing when the therapy session ends.
You may have vivid or unusual dreams. Memories, images, feelings, or details can also surface between sessions. Sometimes these are things you haven’t thought about in a long time.
That is useful information to bring back to your therapist at your next session.
Physical side effects of EMDR
Trauma isn’t experienced only through thoughts. Your body is involved too, which means EMDR can sometimes bring up physical sensations.
Some people notice headaches, nausea, lightheadedness, or tension in their jaw, neck, or shoulders. You may also simply feel physically depleted after a demanding session.
If a physical symptom is severe, persistent, or medically concerning, it shouldn’t automatically be attributed to EMDR. Talk with an appropriate healthcare provider about symptoms that concern you.
A temporary increase in the symptoms that brought you to therapy
Sometimes the feelings or symptoms you came to therapy for become more noticeable when you begin working directly with the experiences connected to them.
The important question is what happens next.
If the symptoms increase somewhat and you can use your coping skills to settle your body again, I generally consider that useful information about how the work is affecting you. If your symptoms increase and won’t settle even when you use the skills that usually help you, I want to know.
EMDR side effects can also feel positive
“Side effect” tends to sound negative, but clients can notice positive changes between EMDR sessions too.
You might sleep better. Your thinking may feel clearer. You may feel lighter, more hopeful, or more curious about yourself and your experiences.
Sometimes clients begin noticing these shifts alongside the fatigue and emotional intensity of the early sessions.
How long do EMDR side effects last?
For many people, the negative side effects are most noticeable during the first few processing sessions and begin to ease as the body starts experiencing some of the relief that can come with processing.
I sometimes compare it to starting a new workout routine. The first few weeks can leave you sore and tired. Eventually, you also start noticing that you’re stronger and have more energy.
There isn’t a universal number of hours or days that EMDR side effects should last. Your history, the material you’re processing, your nervous system, and the pace of therapy all matter.
What matters more to me is whether you’re able to return to your baseline between sessions. If the effects are lingering, intensifying, or becoming difficult to manage with the coping strategies you and your therapist have developed, that’s worth discussing.
Why can EMDR feel worse before it feels better?
Imagine coming home from a long trip and opening your suitcase.
Everything was technically contained while the suitcase was zipped. Once you open it, you have clothes everywhere, laundry to do, things to put away, and a mess that wasn’t visible five minutes earlier.
Trauma processing can sometimes feel like that.
When you start unpacking pain that has been contained for a long time, you may initially feel more aware of it. That doesn’t automatically mean therapy is going badly. It means we need to pay attention to how your body is responding and whether the pace still feels manageable.
This is one reason I talk with clients ahead of time about what to expect after EMDR sessions. During the first few sessions, I recommend avoiding intense plans immediately afterward when possible and allowing the rest of the day to be relatively low demand.
I also give clients a line to watch for.
If your symptoms increase somewhat but come back down when you use your coping skills, that can happen during processing. If they increase and you cannot soothe them with the skills that normally work, reach out to your therapist. Something may have been stirred up that needs additional support.
When EMDR isn't the right place to start
One of the biggest misconceptions about EMDR is that once you decide to do it, you immediately start processing your most painful memory.
That isn’t how I practice EMDR.
Before we begin processing, I want to know that you have ways to regulate yourself and that your body is ready to participate in the work.
Consent is a major part of that for me because EMDR involves the body as well as the brain.
There can be a difference between the discomfort that comes with trying something unfamiliar and the feeling that your system genuinely does not have the capacity to manage what might come up.
You might be thinking, “This is new and I’m nervous because I don’t know what to expect.” We can work with that.
Your body may also be telling you, “I don’t feel confident that I can handle what this could bring up right now.” I take that seriously too.
Sometimes we spend more time building safety and stabilization first. A therapist may also need to consider significant dissociation, an active crisis, substance use, medical concerns, or other circumstances that could affect how someone responds to trauma processing.
Waiting to begin processing does not mean you have failed EMDR or that EMDR can never be an option. Sometimes the safest and most effective clinical decision is to prepare first.
Why is EMDR so controversial?
Part of EMDR’s controversial reputation comes from a reasonable scientific question: Why does it work?
Researchers continue to debate how important bilateral stimulation, including the eye movements most associated with EMDR, is to the treatment’s effectiveness. Some researchers believe bilateral stimulation has a specific role. Others argue that much of EMDR’s benefit may come from other parts of the structured trauma-processing procedure.
The mechanism remains debated even though research supports EMDR as an effective treatment for PTSD.
I’m comfortable with some uncertainty here.
There is no one-size-fits-all approach to therapy, any more than there is one pair of shoes that works for everyone. If EMDR is helping you, we keep going. If it isn’t, we reassess.
For some of my clients, EMDR feels like a breath of fresh air after they have talked and talked and talked about their pain without experiencing the relief they hoped for. EMDR gives us a way to invite the body into the healing process along with the brain.
How a well-trained EMDR therapist lowers the risks
Preparation is one of the most important parts of how I structure trauma therapy.
Before processing traumatic material, we work on resources you can use if emotions become intense. We talk about what happens if you become overwhelmed, how you can tell me that you need to stop, and how we will close a session when the processing itself isn’t finished.
One resource I often use is called Container.
Container can be a relief for people who worry that opening painful material will cause it to pour into every corner of their lives.
Unlike trying to shove emotions under a rug or disconnect from them completely, Container creates a deliberate storage place for pain, overwhelm, worry, frustration, rage, anger, or anything else that comes up during EMDR.
We acknowledge that those emotions are there. Then we give them a safe place to exist without allowing them to blanket every other emotion and experience you have between sessions.
Good EMDR therapy also involves ongoing assessment. Readiness at the beginning of treatment doesn’t mean we stop checking. Your therapist should continue paying attention to your responses and adjusting the pace when needed.
And if part of what is holding you back is the thought that what happened to you wasn’t serious enough to justify trauma therapy, you may find it helpful to read When “Not That Bad” Still Hurts.
That hesitation comes up often with experiences tied to faith. If what you're carrying is connected to a church, a religious community, or the beliefs you were raised inside, you can read more about how I approach religious trauma therapy.
Questions to ask before starting EMDR with someone
You have every right to ask a therapist how they practice EMDR before you begin. Some useful questions include:
What EMDR training have you completed? Ask about formal EMDR training and whether the therapist is EMDRIA-certified.
How do you decide when someone is ready to begin processing? Listen for an answer that includes preparation, coping resources, and assessment rather than a fixed timeline.
What happens if I get overwhelmed during a session? Your therapist should have a plan for helping you regulate and should respect your need to slow down or stop.
What if I get stuck or start to shut down? This is an especially important question if shutting down is a common response for you.
How do you end a session if we haven’t finished processing? EMDR includes closure procedures. You shouldn’t simply be sent out the door because the clock ran out.
What should I expect between sessions? Your therapist should talk with you about possible after-EMDR session side effects and what to do if something comes up.
When should I contact you between sessions? Know ahead of time what your therapist considers an expected response and what warrants additional support.
The answers matter, but so does how you feel asking the questions. You should be able to talk openly about your fears and concerns before you agree to begin processing.
Frequently asked questions about EMDR risks and side effects
Can EMDR make things worse?
EMDR can temporarily increase emotional distress or make symptoms feel more noticeable, particularly when you begin processing difficult material. If that increase becomes hard to manage or does not settle with the coping strategies you’ve developed, talk with your therapist so the pace and treatment plan can be reassessed.
Can EMDR be harmful?
Psychotherapy can have adverse effects, and EMDR should not be treated as risk-free. Research to date suggests serious treatment-related adverse events are uncommon, but researchers have also pointed out that EMDR studies have historically done a poor job of systematically measuring adverse effects. Careful assessment, preparation, pacing, and monitoring matter.
Is it safe to do EMDR on yourself at home?
Watching a bilateral-stimulation video or moving your eyes back and forth is not the same thing as receiving EMDR therapy. EMDR is a structured psychotherapy that includes assessment, preparation, processing, closure, and reevaluation. Trauma processing can bring up unexpected material, which is one reason working with a properly trained clinician matters.
Does EMDR work over telehealth?
EMDR can be provided through telehealth, and emerging research supports remote delivery in some populations. The same principles still apply: preparation, consent, pacing, a plan for managing distress, and an appropriate therapeutic setting.
Is EMDR the same thing as hypnosis?
No. During EMDR, you remain awake, aware, and actively participating in the process. You can talk with your therapist, ask questions, slow down, or stop.
How many EMDR sessions before I feel different?
There is no set number. Some people notice changes relatively early, while others need considerably more preparation and processing time. Your history, treatment goals, current stability, and the experiences you’re working through can all affect the timeline.
How will I know when I am done?
Finishing EMDR doesn’t necessarily mean you never think about a painful experience again. Your therapist will help you evaluate how distressing the memory feels now, what you believe about yourself when you think about it, how your body responds, and whether related triggers are still interfering with your life.
Being cautious about EMDR makes sense
If part of you is nervous about EMDR, we’ll get curious about the nervousness rather than letting the emotion make the decision for you.
Your hesitation gives us information. We can talk about what you’re afraid might happen, what your body needs in order to feel safe enough to proceed, and whether EMDR feels like the right next step for you.
You don’t have to prove that you’re ready by pushing yourself faster than your system can handle.
Are you considering EMDR?
If you’d like to understand what the process might look like for you, please feel free to schedule a consultation. I’d be happy to talk through your questions before you decide whether you want to begin.
