EMDR Therapy Side Effects and Risks
As a certified EMDR therapist in Seattle, I believe in being transparent about all aspects of treatment, including potential side effects. While EMDR is generally very safe and well-tolerated, it's important to understand what you might experience during and after sessions so you can make an informed decision about your healing journey.
Common Side Effects During EMDR
Emotional Intensity
EMDR activates traumatic memories, which can temporarily increase emotional intensity. You might experience:
Strong emotions (sadness, anger, fear)
Crying or emotional release
Feeling emotionally raw or vulnerable
Temporary increase in anxiety
These reactions are actually signs that processing is happening. With my training in Somatic Experiencing and AEDP, I help you navigate these emotions safely, ensuring they move through rather than overwhelm you.
Physical Sensations
As we process trauma stored in your body, you might notice:
Tingling or numbness
Muscle tension or twitching
Temperature changes
Heaviness or lightness in your body
Fatigue during or after sessions
My certification in trauma-sensitive yoga helps me guide you through these somatic experiences, teaching you to track sensations without becoming overwhelmed.
Vivid Dreams or Nightmares
Your brain continues processing between sessions, which can lead to:
More vivid or memorable dreams
Processing dreams related to the trauma
Temporary increase in nightmares
Old memories surfacing in dreams
This is typically temporary and often signals that your brain is actively working to heal.
After-Session Effects
The 24-48 Hour Window
Most side effects occur within two days after a session:
Feeling "spacey" or unfocused
Emotional sensitivity
Fatigue or need for extra sleep
Continued processing of insights
Physical symptoms like headaches
I always ensure you have coping strategies and my emergency contact information for support between sessions.
Positive Side Effects
Not all effects are challenging. Many clients report:
Feeling lighter or more free
Spontaneous positive memories
Improved sleep after initial disruption
Increased energy once processing completes
Better emotional regulation
Less Common but Important Reactions
Dissociation
Some people, especially those with complex trauma, might experience:
Feeling disconnected from their body
Sense of unreality
Emotional numbing
Difficulty staying present
My extensive training in treating dissociation through the Masterson Institute and somatic approaches helps me recognize and address these responses quickly.
Abreactions
Rarely, clients might experience intense reliving of trauma during processing. This looks like:
Feeling transported back to the traumatic event
Strong physical reactions
Temporary loss of dual awareness
Panic or intense fear
While this can be frightening, I'm trained to handle abreactions safely, using grounding techniques and modified protocols to ensure you stay within your window of tolerance.
Who Might Be at Higher Risk for Side Effects?
Certain factors can increase the likelihood of intense reactions:
Complex Trauma History
Those with multiple traumas or childhood abuse might experience:
More layers of memory networks activating
Stronger somatic reactions
Need for slower pacing
More integration time between sessions
Current Life Stressors
High stress can amplify reactions:
Less capacity for processing
Stronger emotional responses
Need for more stabilization
Longer recovery between sessions
Limited Support System
Having support affects how you manage side effects:
Isolation can intensify reactions
Support helps integration
We might build resources first
Consider timing of intensive work
Substance Use or Medications
These can affect processing:
Some medications blunt emotional processing
Substance use can interfere with integration
We'll discuss your specific situation
Might need coordination with prescribers
When EMDR Might Not Be Appropriate
While EMDR is widely applicable, it might not be the best choice if you have:
Active Psychosis
Current hallucinations or delusions
Severe thought disorganization
Unable to distinguish past from present
Need psychiatric stabilization first
Severe Dissociative Disorders
Diagnosed DID without stabilization
Frequent switching or lost time
No co-consciousness between parts
Need specialized preparation
Medical Conditions
Severe heart conditions (due to emotional intensity)
Seizure disorders (case-by-case basis)
Eye conditions preventing eye movements (we can use alternatives)
Pregnancy (case-by-case, often safe with modifications)
Current Crisis
Active suicidal ideation
Recent suicide attempts
Ongoing domestic violence
Homelessness or survival mode
How I Minimize Risks and Manage Side Effects
Thorough Assessment
Before beginning EMDR, I conduct comprehensive assessment:
Complete trauma history
Current symptoms and functioning
Support system evaluation
Medical and medication review
Previous therapy experiences
Careful Preparation
I never rush into processing:
Build resources and coping skills
Establish strong therapeutic alliance
Teach self-regulation techniques
Practice bilateral stimulation
Ensure you can self-soothe
Modified Protocols When Needed
My extensive training allows me to adapt:
Shorter sessions for high sensitivity
Gentler bilateral stimulation
More resource installation
Increased stabilization work
Integration of other modalities
Ongoing Monitoring
Throughout treatment, I track:
Your response to processing
Between-session experiences
Need for pacing adjustments
Integration of changes
Overall functioning
Managing Side Effects: Your Toolkit
I equip every client with strategies for managing reactions:
Grounding Techniques
5-4-3-2-1 sensory awareness
Bilateral self-tapping
Movement and stretching
Cold water or ice
Connecting with support
Self-Care Between Sessions
Extra rest and sleep
Gentle movement or yoga
Time in nature
Journaling
Avoiding major decisions
When to Reach Out
I provide clear guidelines on when to contact me:
Severe dissociation
Suicidal thoughts
Inability to function
Panic lasting over an hour
Any safety concerns
The Risk-Benefit Analysis
While EMDR has potential side effects, consider:
Effects are typically temporary
Benefits often far outweigh temporary discomfort
Untreated trauma has serious long-term effects
Side effects indicate active healing
Support is available throughout
Informed Consent and Your Choice
I believe in fully informed consent. During our consultation, we'll discuss:
Your specific risk factors
Likely side effects for your situation
Management strategies
Alternative approaches if needed
Your comfort with proceeding
A Safe Approach to Powerful Healing
EMDR's effectiveness comes partly from its ability to activate and process traumatic material. While this can create temporary discomfort, it leads to lasting healing. With my integrated approach combining:
EMDR certification
Somatic Experiencing training
CPT certification
Attachment-focused work
15+ years of experience
I'm equipped to help you navigate any side effects safely while moving toward healing.
Your Safety Is My Priority
If you're considering EMDR but concerned about side effects, let's talk. During our free consultation, we can discuss your specific situation and how I ensure your safety throughout the healing process.
