Eye Movement Desensitization and Reprocessing (EMDR) therapy is a widely used treatment for trauma and post-traumatic stress disorder (PTSD). Recognized by organizations like the World Health Organization (WHO) and the American Psychiatric Association (APA) as an effective therapy for trauma-related symptoms, EMDR has helped many individuals process and heal from traumatic memories. However, like any form of therapy, EMDR comes with potential risks and possible side effects that should be carefully considered.
While EMDR therapy can be highly effective, understanding the potential dangers and side effects is crucial for making an informed decision about your mental health treatment. In this article, we’ll explore the possible negative effects of EMDR therapy, how to mitigate them, and why working with a qualified and experienced therapist is essential for a safe and successful experience.
What Is EMDR Therapy?
EMDR therapy was developed by Dr. Francine Shapiro in the late 1980s as a way to help individuals process and heal from distressing memories. The therapy is based on the idea that traumatic memories can become “stuck” in the brain, leading to emotional distress, intrusive thoughts, and other mental health challenges.
EMDR therapy involves a structured eight-phase process where patients recall traumatic events while simultaneously engaging in bilateral stimulation, such as side-to-side eye movements, tapping, or auditory cues. This dual action is believed to help the brain reprocess traumatic information, allowing the memory to be integrated into a more adaptive and less distressing form.
How EMDR Works
The eight phases of EMDR therapy include:
- History Taking and Treatment Planning – The therapist gathers a detailed history of the patient’s trauma and mental health to create a tailored treatment plan.
- Preparation – The therapist explains the EMDR process and teaches relaxation techniques to manage emotional distress during sessions.
- Assessment – The patient identifies the traumatic memory and the associated negative beliefs, emotions, and physical sensations.
- Desensitization – The patient recalls the traumatic memory while engaging in bilateral stimulation, which helps reduce the emotional intensity of the memory.
- Installation – Positive beliefs are introduced to replace negative ones associated with the traumatic memory.
- Body Scan – The patient identifies and releases any lingering physical sensations tied to the memory.
- Closure – The therapist ensures the patient is emotionally stable before ending the session.
- Reevaluation – In follow-up sessions, the therapist assesses progress and addresses any unresolved issues.
Potential Dangers and Side Effects of EMDR Therapy
Although EMDR therapy can be highly effective, it’s not without risks. The process of confronting traumatic memories can be emotionally intense and may lead to short-term and long-term side effects.
1. Emotional Distress During and After Sessions
One challenge of EMDR therapy is the intense emotions it can trigger. Since the therapy involves revisiting traumatic memories, it can bring up feelings of sadness, fear, or anger. While this is part of the healing process, it can be overwhelming for some individuals, especially those with complex trauma or emotional sensitivity.
Revisiting traumatic experiences can lead to intense emotional reactions during or after therapy sessions. Some patients report experiencing:
- Intense sadness, fear, or anger
- Emotional outbursts
- Crying or panic attacks during therapy
This emotional distress can linger even after the session ends, making it difficult for some individuals to return to normal daily functioning. Without proper grounding techniques, the emotional impact can feel overwhelming.
2. Increased Anxiety and Intrusive Thoughts
EMDR therapy requires patients to revisit distressing memories, which can sometimes intensify feelings of anxiety and unease. When traumatic memories are brought to the surface, it can trigger a flood of emotions that may feel difficult to manage. For some individuals, the process of reprocessing these memories may heighten symptoms of anxiety and emotional sensitivity, even outside of therapy sessions. This can make daily life more challenging, as feelings of fear, vulnerability, and emotional discomfort may linger.
Some of the most common symptoms that patients report include:
- Flashbacks
- Racing thoughts
- Restlessness
- Intrusive memories
While these symptoms often subside over time, they can disrupt sleep patterns, work performance, and personal relationships.
3. False Memories and Memory Distortion
A major concern with EMDR therapy is the risk of creating false memories. When recalling traumatic events under emotional distress, the brain may “fill in gaps” to make sense of the experience, leading to distorted or inaccurate recollections. This can cause confusion and emotional conflict, making it hard for patients to separate fact from perception.
False memories can complicate personal relationships and even lead to legal issues if the distorted memories involve others. A trained therapist can help patients process memories accurately and reduce the risk of reinforcing false details.
Common examples of memory distortion include:
- Misremembering events
- Confusion about what actually happened
- Falsely accusing others of actions they didn’t commit
False memories can complicate personal relationships and legal matters if the distorted memories involve other individuals.
4. Physical Side Effects
EMDR therapy not only affects emotional processing but can also trigger physical reactions. The process of revisiting traumatic memories activates the body’s stress response, similar to the “fight or flight” reaction. This can lead to a surge in adrenaline and heightened nervous system activity, which may cause uncomfortable physical sensations during or after sessions.
While these symptoms are usually temporary, they can be unsettling and make it difficult for patients to feel relaxed or grounded after therapy. Understanding that these physical reactions are part of the brain’s natural response to processing trauma can help patients feel more prepared and supported throughout treatment.
Common physical side effects include:
- Dizziness and lightheadedness
- Muscle tension
- Headaches or migraines
- Nausea or upset stomach
- Rapid breathing or heart rate
These symptoms can occur due to the brain’s stress response being activated during the processing of traumatic memories.
5. Vivid Dreams and Nightmares
EMDR therapy involves processing traumatic memories, which can lead to increased mental activity as the brain works to reorganize and integrate these experiences. This heightened brain activity often extends into sleep, causing vivid dreams and nightmares. Since sleep is when the brain processes and consolidates memories, EMDR can stimulate this process, making dreams feel more intense and emotionally charged.
Patients may find themselves reliving traumatic events through nightmares or experiencing dreams with strong emotional content that reflects the themes of the trauma being processed in therapy. This can disrupt sleep patterns, making it harder to fall or stay asleep, and leading to increased fatigue and mood swings during the day.
Common sleep disturbances include:
- Vivid, emotionally intense dreams
- Nightmares related to the trauma
- Difficulty falling or staying asleep
These sleep disturbances can lead to daytime fatigue, mood swings, and increased anxiety.
6. Dissociation and Feeling Disconnected
EMDR therapy can sometimes trigger dissociation, especially in individuals with a history of severe trauma or post-traumatic stress disorder (PTSD). Dissociation is a defense mechanism the brain uses to protect itself from overwhelming emotional pain. During EMDR sessions, when traumatic memories are being processed, the brain may react by mentally “checking out” or disconnecting from the present moment as a way to cope with the emotional intensity. This can create a feeling of being detached from reality or observing oneself from a distance, as if watching events unfold from the outside.
Dissociation can manifest in different ways depending on the individual and the severity of the trauma. Some people experience a sense of emotional numbness, where they feel emotionally flat or disconnected from their feelings. Others may have a more physical sense of detachment, such as feeling that their body is not their own or that their surroundings are unreal. These symptoms can interfere with the therapy process by making it difficult to stay grounded and engaged during sessions.
Common dissociative symptoms include:
- Feeling detached from reality
- Numbness or lack of emotional response
- Feeling as if you are watching yourself from the outside
Dissociation can interfere with therapy progress and daily functioning, requiring careful management by the therapist.
7. Retraumatization
While EMDR therapy is designed to help patients process and heal from traumatic memories, there is a risk that it can unintentionally retraumatize some individuals. Retraumatization occurs when the therapy process brings up intense emotional pain or distress that the patient is not yet prepared to handle. This can happen if the therapist moves too quickly through the phases of EMDR, especially the desensitization and processing stages, without adequately preparing the patient to cope with the emotional intensity.
Facing traumatic memories requires a certain level of emotional readiness and stability. If a patient begins EMDR therapy before they have developed sufficient coping mechanisms or emotional resilience, revisiting these painful memories can feel overwhelming and destabilizing. The brain may react to the resurfacing trauma as if the original event is happening again, triggering a fight-or-flight response. This can lead to panic attacks, emotional breakdowns, and increased feelings of fear and helplessness.
Patients who are retraumatized may experience a worsening of their symptoms, including heightened anxiety, intrusive thoughts, sleep disturbances, and emotional numbness. The sense of vulnerability that retraumatization creates can undermine the patient’s trust in the therapy process and make them hesitant to continue treatment.
Signs of retraumatization include:
- The therapist moves too quickly through the phases
- The patient is not emotionally prepared to face the memory
- The patient lacks proper coping mechanisms to handle emotional distress
Retraumatization can lead to a worsening of symptoms and an increased sense of vulnerability.
8. Emotional Sensitivity and Mood Swings
EMDR therapy can heighten emotional sensitivity as the brain processes traumatic memories. Patients may experience sudden mood changes, including emotional highs and lows, irritability, and tearfulness. Some report feeling emotionally raw or detached as their brain adjusts to new emotional patterns.
These mood swings can strain relationships and disrupt daily life. Increased frustration, emotional outbursts, or feeling numb are common reactions. Symptoms may include:
- Emotional highs and lows
- Increased irritability or frustration
- Tearfulness or emotional numbness
These emotional shifts can strain relationships and disrupt work and daily activities.
9. Temporary Worsening of Symptoms
It’s not uncommon for patients to feel worse before they feel better with EMDR therapy. As the brain processes traumatic memories, emotional and physical symptoms may temporarily intensify. This is part of the brain’s natural adjustment process, but it can feel overwhelming.
Some patients experience increased emotional reactivity, heightened anxiety, or worsening depression in the days following a session. Physical symptoms like muscle tension, headaches, and fatigue are also common. Symptoms may include:
- Increased anxiety and depression
- Strong emotional reactions
- Muscle tension and restlessness
While these effects are usually short-term, they can be distressing. Therapists often recommend grounding techniques and relaxation exercises to help manage symptoms during this phase.
10. Feeling Overwhelmed After Therapy
EMDR sessions can be emotionally intense, leaving some individuals feeling overwhelmed afterward. Processing deep emotional material can activate the body’s stress response, making it hard to relax and reset.
After a session, patients may feel mentally and physically drained, making it difficult to focus or complete daily tasks. Emotional exhaustion and fatigue are common as the brain works to reorganize traumatic memories. Symptoms may include:
- Trouble focusing or thinking clearly
- Physical and mental fatigue
- Emotional exhaustion
These feelings are usually temporary, but practicing relaxation techniques and self-care after sessions can help ease the transition back to normal activity.
How to Minimize the Risks of EMDR Therapy
While EMDR therapy has potential dangers, the risks can be managed and minimized through proper preparation and professional care.
1. Work with a Qualified and Experienced Therapist
EMDR therapy should only be conducted by a licensed therapist with specialized training in EMDR. A qualified therapist will:
- Conduct a thorough assessment before starting therapy
- Prepare the patient with grounding techniques
- Monitor emotional and physical responses during sessions
2. Pace the Process Appropriately
A skilled therapist will adjust the pace of therapy to match the patient’s emotional capacity. If sessions are progressing too quickly, it can increase the risk of retraumatization and emotional overwhelm.
3. Use Grounding and Relaxation Techniques
Grounding exercises help patients stay present during sessions and reduce emotional intensity. Common techniques include:
- Deep breathing
- Progressive muscle relaxation
- Visualization exercises
4. Monitor Physical Reactions
Patients should report any physical discomfort or distressing symptoms to their therapist. Adjusting the type or speed of bilateral stimulation can help reduce physical side effects.
When to Avoid EMDR Therapy
EMDR therapy may not be suitable for everyone. Individuals with the following conditions should consult with a healthcare professional before starting EMDR:
- Severe depression
- Psychotic disorders (e.g., schizophrenia)
- Unmanaged bipolar disorder
- Active substance abuse
- Severe dissociative disorders
Benefits and Effectiveness of EMDR Therapy
While EMDR therapy has potential risks, it is highly effective for treating trauma and improving emotional health. Research shows that many patients experience significant relief from symptoms like anxiety, flashbacks, and emotional distress after just 6 to 12 sessions.
1. Reduces PTSD and Anxiety Symptoms
EMDR therapy is proven to reduce symptoms of post-traumatic stress disorder (PTSD) and trauma-related anxiety. Patients often report fewer flashbacks, better sleep, and improved emotional stability.
2. Fast and Long-Lasting Results
Unlike traditional therapy, EMDR often produces faster results. Patients frequently feel more balanced and less reactive to triggers after a few sessions.
3. Improves Emotional Regulation
By helping the brain reprocess traumatic memories, EMDR reduces emotional intensity and improves overall emotional control.
4. Effective for Co-Occurring Conditions
EMDR addresses both trauma and mental health issues like depression, anxiety, and bipolar disorder, improving overall mental health.
5. Boosts Self-Esteem and Positive Thinking
EMDR helps patients replace negative self-beliefs (“I’m not good enough”) with positive ones (“I am strong”), improving confidence and emotional resilience.
Is EMDR Therapy Right for You?
EMDR therapy can be highly effective for treating trauma, but it’s not the right fit for everyone. While many people experience significant relief, others may find the process emotionally challenging. Success depends on working with a skilled therapist who can guide you through the process safely and adjust the pace to match your comfort level.
Dr. Datta and his team at Tresna Mental Health have immense expertise in trauma and addiction treatment. He creates personalized treatment plans tailored to each patient’s needs, ensuring therapy is safe, supportive, and effective. If you’re considering EMDR therapy, contact us today to schedule a consultation and take the first step toward healing.
