Dangers of EMDR Therapy: The Real Risks, Side Effects, and Who Should Wait
The dangers of EMDR therapy are real but usually limited. For most people, EMDR is a safe treatment when a trained clinician provides it, and the most common EMDR side effects are temporary, such as vivid dreams, fatigue, headaches, and a short rise in emotional distress after sessions. The bigger risks tend to come from poor fit or poor pacing, like starting memory work before you have steady coping skills in place.
That is the short answer, but it isn’t the whole picture. EMDR has decades of research behind it for PTSD, yet a 2025 review found that only 9 of 51 clinical trials even reported side effects. Below, you’ll find what that gap means, who should wait before starting, how to tell normal processing from a real warning sign, and what to ask a therapist before you book.
If you’re weighing EMDR for trauma or anxiety and still aren’t sure it’s safe for you, a free 15-minute consultation with the EMDR therapy team at Pathways Counseling Services in Scottsdale can help you talk through fit and pacing before you commit to anything. Founder Stephanie Levitt, MA, LPC, NCC, focuses her practice on EMDR, and sessions are available in person or by telehealth across Arizona when clinically appropriate. Here’s what you should know first.
Is EMDR Therapy Dangerous?
EMDR is considered safe for most adults when a trained clinician delivers it. Major guidelines, including those from the World Health Organization and the UK’s National Institute for Health and Care Excellence, recommend it for PTSD.
So when people talk about the dangers of EMDR, they usually mean one of three different things. Sorting them out makes the rest of this article easier to follow.
- Side effects. These are expected, temporary reactions like tiredness, strong emotions, or vivid dreams. They happen with most trauma-focused therapy, not just EMDR.
- Adverse effects. These are unwanted results that happen even when treatment is done correctly, such as symptoms getting worse and staying worse. They are less common, and research tracks them poorly.
- Harm from poor fit or poor practice. This covers starting EMDR during a crisis, moving too fast, or working with someone who isn’t properly trained. Most of the frightening stories online fall into this group, and most of it is preventable.
What Are the Most Common EMDR Side Effects?
The most common EMDR side effects are emotional, physical, and sleep-related, and most are temporary. Some people notice very little. Others feel a clear shift in the hours after a session.
You might leave a session feeling lighter and still feel worn out by evening. Both can be true at once.
Emotional Side Effects
Emotional reactions are the side effects people mention most. They often show up in the hours after a session, while your mind is still working through what came up.
- Feeling more sensitive, tearful, or irritable than usual
- A short-term rise in anxiety or distress
- Related memories surfacing between sessions
- Feeling raw, tender, or emotionally drained
Physical Side Effects
Your body can react to emotional work too. These reactions are usually mild.
- Fatigue, sometimes feeling as tired as after a hard workout
- Headaches or eye strain, especially with eye-movement stimulation
- Lightheadedness or brief dizziness
- Occasional nausea or changes in appetite
If eye movements cause headaches or discomfort, a trained therapist can switch to tapping or alternating sounds instead. These are standard options in EMDR, not workarounds.
Sleep and Dream Changes
Many people notice vivid or unusual dreams during active EMDR treatment. Some have a few nights of lighter or broken sleep.
Mention any sleep changes to your therapist. They help your therapist decide how to pace the next session.
How Long Do EMDR Therapy Side Effects Last?
Most EMDR therapy side effects ease within a day or a few days after a session. That timeline comes mostly from clinical experience, because research has not tracked it closely.
How long reactions last depends on a few things. These include how intense the session was, whether you’re working on a single event or many years of experiences, and how much stress and sleep you’re dealing with outside therapy.
The pattern matters more than the exact number of days. Reactions that fade over time are expected. Reactions that grow, stay the same for a week, or stop you from working or caring for yourself are a signal to call your therapist.
Can EMDR Make Things Worse?
EMDR can temporarily increase distress, but research does not show it makes people worse more often than other trauma therapies. A short spike after a session is different from lasting decline.
That spike can feel alarming, which is why the difference matters. Here is what the better research actually says.
- A 2022 meta-analysis of 56 trials and 4,230 patients found that psychological treatments for PTSD were linked to a lower risk of symptoms getting worse compared with no treatment or other control conditions. The authors concluded these treatments are safe for most adults with PTSD. (Hoppen, Lindemann, and Morina, British Journal of Psychiatry, 2022)
- A 2025 review of 51 EMDR trials found that only 9 mentioned adverse effects. Where patients did report them, they were usually mild and temporary. The authors called for better tracking, since missing data is not proof that harm never happens. (van Schie and van Veen, Current Opinion in Psychology, 2025)
- The same review notes that roughly 5 to 10% of people get worse during therapy in general, even with evidence-based treatments. That figure applies across psychotherapy, not to EMDR alone.
The honest takeaway is that EMDR looks safe for most people, and the research on its risks is still catching up. A good therapist will check in on how you’re doing at every session rather than assume everything is fine.
What Are the Real Risks of EMDR Therapy?
The real risks of EMDR come from how and when it is done, more than from the method itself. These are the key risks worth understanding before you start.
Feeling Overwhelmed When Processing Moves Too Fast
If memory work starts before you have reliable ways to calm yourself, a session can leave you flooded for days. This is sometimes called retraumatization.
EMDR is built to prevent this. The early phases focus on preparation and coping skills, and reprocessing should not begin until those skills are in place.
Dissociation
Some people feel spaced out, numb, or disconnected during or after processing. This is more likely for people with complex trauma histories or a dissociative condition.
Trained EMDR therapists screen for dissociation before starting. When it is present, they usually spend longer on stabilization and adapt how processing works.
Memory Changes and Legal Considerations
EMDR usually makes painful memories feel less vivid and less intense. That is part of how it helps, but it has raised questions about memory accuracy.
An early 2018 study suggested eye movements might increase false memories, but later large replication studies did not confirm it. Researchers do caution that therapist questions during processing could, in rare cases, add details to a memory. (van Schie and van Veen, 2025)
If you may need to testify about a traumatic event, tell both your therapist and your attorney before starting EMDR. They can help you decide on timing.
Working With an Undertrained Provider
EMDR follows a structured eight-phase protocol. A clinician who skips preparation, pushes through distress, or ends sessions without closing them properly raises the risk of a hard aftermath.
Ask about training directly. The section on questions to ask, further down, gives you a short list.
Trying EMDR on Your Own
Apps and videos offer eye-movement or tapping exercises, and some can be fine for relaxation. Using them to work through trauma memories without a clinician removes the safeguards that make EMDR safe, like preparation, pacing, and a plan for closing each session.
Who Should Wait Before Starting EMDR?
Some people are better served by stabilization work before starting EMDR memory processing. Waiting isn’t a failure. It’s often the step that makes EMDR workable later.
| Situation | Why it matters | What usually happens first |
|---|---|---|
| Active crisis or thoughts of suicide | Memory processing can raise distress before it lowers it | Crisis support and safety planning |
| Living in an ongoing unsafe situation | It is hard to process past harm while current harm continues | Focus on safety and present-day support |
| Active, unmanaged substance use | Substances can blunt or complicate processing and coping | Stabilization and substance use support |
| Severe dissociation | Processing can increase feeling disconnected | Longer preparation with an adapted approach |
| Seizure disorders, eye conditions, or motion-triggered migraines | Eye-movement stimulation may not be comfortable or appropriate | Tapping or audio stimulation, plus a check with your doctor |
| Upcoming legal testimony about the event | Memory vividness changes during treatment | A timing conversation with your therapist and attorney |
None of these is automatically a permanent no. They are reasons to slow down and plan carefully with a clinician.
How Do Trained EMDR Therapists Reduce the Risks?
Trained EMDR therapists reduce risk by following a structured eight-phase process that builds safety before any memory work begins. This is how it works.
- History and treatment planning. Your therapist learns about your history, current stress, and supports, and decides with you whether EMDR fits.
- Preparation. You learn what to expect and practice calming and grounding tools, such as imagining a calm place.
- Assessment. You choose a specific memory to work on and note how distressing it feels right now.
- Desensitization. You focus on the memory in short sets while following eye movements, tapping, or sounds.
- Installation. You strengthen a more helpful belief about yourself connected to the memory.
- Body scan. You check for leftover tension or discomfort in your body.
- Closure. Every session ends with steps to help you feel settled before you leave.
- Reevaluation. At the next session, you and your therapist review what changed and adjust the plan.
Along the way, you stay awake and in control. You can pause or stop at any point, and a good therapist will agree on a stop signal with you before processing starts. EMDR also does not require you to describe every detail of what happened out loud.
Why Is EMDR Still Recommended Despite These Risks?
EMDR is recommended for PTSD by the World Health Organization and by NICE in the UK. The American Psychological Association’s 2025 PTSD guideline also includes it among its treatment options.
A 2024 analysis that combined individual patient data from many trials found no overall difference in results between EMDR and other established therapies for PTSD. (Wright et al., Psychological Medicine, 2024) In other words, EMDR is one of several solid options, not a miracle and not a risky outlier.
People often choose it because it doesn’t rely on retelling their story in detail. If you want to compare approaches, our article on EMDR therapy vs. talk therapy walks through the differences.
How Can You Tell Normal Processing From a Warning Sign?
Side effects that fade over a few days are expected. Symptoms that grow, last, or stop you from functioning are not. If you’re reading this after a hard session, start with the table below.
| Usually normal | Call your therapist |
|---|---|
| Tiredness that improves with rest | Exhaustion that gets worse session after session |
| Vivid dreams for a few nights | Nightmares that keep building instead of easing |
| Feeling emotional or irritable for a day or two | Distress that stops you from working or caring for yourself |
| Brief moments of feeling spaced out | Losing track of time or feeling detached for long stretches |
| Memories surfacing, then settling | Memories that feel like they are happening again, over and over |
| A mild headache that passes | Chest pain or trouble breathing, which needs medical care right away |
If you have thoughts of harming yourself, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day. If you are in immediate danger, call 911. Outpatient counseling is not emergency care.
What Can You Do Before and After an EMDR Session?
A little planning around each session can make side effects easier to manage. These action steps are simple and work alongside what your therapist recommends.
- Tell your therapist about your health history, current stressors, and any medications before you start.
- Practice your grounding tools between sessions, not only when you’re upset.
- Schedule sessions when you can have some quiet time afterward, if possible.
- Plan an easy evening after a session, with rest, food, and water.
- Choose gentle activity like a walk instead of intense exercise right after.
- Skip disturbing news or shows for a day or so.
- Jot down short notes about dreams or reactions to share at your next visit.
- Let one trusted person know you’re in active treatment, without needing to share details.
- Speak up if a session felt like too much, so your therapist can adjust the pace.
What Should You Ask an EMDR Therapist Before Starting?
The right questions help you judge whether a therapist is trained and whether they take safety seriously. Most qualified clinicians are glad to answer them.
- Have you completed EMDRIA-approved EMDR training?
- Are you EMDRIA Certified, or do you receive EMDR consultation?
- How do you decide whether I’m ready for memory processing?
- How do you screen for and handle dissociation?
- What happens if a session feels like too much?
- Can we use tapping or sounds instead of eye movements?
- How do you close a session so I leave feeling settled?
- How should I reach you if side effects worry me between sessions?
The EMDR International Association (EMDRIA) sets training and certification standards in the U.S. and is a good place to learn more.
The Bottom Line
The dangers of EMDR therapy are mostly about fit and pacing, not the method itself. For most people, EMDR therapy side effects are temporary and manageable, and the research that exists points to EMDR being safe for most adults with PTSD.
EMDR is not right for everyone, and it’s not right for everyone right now. A careful assessment, solid preparation, and a therapist who checks in at every session are what keep the risks small.
If you’re still deciding whether EMDR is right for you, learn more about EMDR therapy at Pathways Counseling Services, including what sessions look like and how our Scottsdale team approaches pacing and preparation.
Frequently Asked Questions About EMDR Safety
Can EMDR cause false memories?
EMDR is not known to cause false memories, based on current research. An early study raised the concern, but larger replication studies did not find that eye movements increase false memories. Researchers still advise care with therapist questions during processing, and anyone facing legal testimony should discuss timing with their therapist and attorney.
Can you do EMDR therapy on yourself?
You should not do EMDR therapy on yourself to work through trauma. Self-guided eye-movement or tapping exercises can help some people relax, but trauma processing needs the preparation, pacing, and closure a trained clinician provides.
Is it normal to feel worse after an EMDR session?
Yes, it is normal to feel worse after an EMDR session for a short time. Tiredness, strong emotions, and vivid dreams are common and usually ease within a few days. If you feel worse over several sessions, or can’t function day to day, tell your therapist so they can adjust the pace.
Can EMDR trigger dissociation?
EMDR can trigger dissociation in some people, especially those with complex trauma or a dissociative condition. Trained EMDR therapists screen for this before starting and usually spend more time on stabilization when dissociation is present.
Is EMDR safe for children and teens?
EMDR is generally considered safe for children and teens when a clinician trained in working with young people provides it. Reviews suggest it can help young people with trauma, though safety tracking in these studies is limited. Parents can learn more about child trauma counseling and teen therapy at Pathways.
Is EMDR through telehealth as safe as in person?
EMDR through telehealth can be as safe as in person for many people, as long as the therapist decides it is clinically appropriate. You’ll need a private, quiet space and a plan for what to do if you feel overwhelmed after the call ends. At Pathways, your therapist will help you decide whether in-person or virtual sessions are a better fit.
Does EMDR work for anxiety?
EMDR may help with anxiety, especially when the anxiety is tied to past experiences, though the research is less established than it is for PTSD. A 2020 meta-analysis found reductions in anxiety symptoms across EMDR trials. (Yunitri et al., Journal of Psychiatric Research, 2020) You can read more about anxiety therapy for adults at Pathways, or about our trauma and PTSD therapy.
