EMDR Side Effects and Safety: What to Know
EMDR (Eye Movement Desensitization and Reprocessing) therapy asks you to revisit the worst moments of your life while moving your eyes back and forth. It may sound strange, but for many people it works. However, the process itself can be intense, and knowing what's coming makes a real difference.
EMDR therapy is a widely used, evidence-based approach for treating trauma. But effective doesn’t necessarily mean comfortable. Treatment with EMDR therapy can produce short-term side effects like emotional intensity, vivid dreams, and physical fatigue. This is all part of the brain processing difficult memories.
Understanding what to expect, what’s normal, and when to say something can make a real difference in how you navigate the process and whether or not EMDR therapy is right for you.
What this article covers
Is EMDR therapy safe, and what side effects should I expect?
Is EMDR Therapy Safe? What the Research Shows
EMDR is widely recognized as safe and effective for trauma treatment, endorsed by the American Psychological Association, the World Health Organization, and the U.S. Department of Veterans Affairs as a recommended treatment for PTSD.
EMDR has been studied for more than 30 years, with Francine Shapiro first developing it in the late 1980s. Randomized controlled trials have shown it to be effective, including a 2015 study in JAMA Psychiatry that showed that 60% of participants who received EMDR for PTSD were 3 times more likely to no longer have PTSD after 8 weeks of EMDR than those who didn’t receive treatment.
Professional organizations such as EMDRIA (EMDR International Association) also provide training standards and guidelines to support safe and effective EMDR practice.
At the same time, it’s important to understand what “safe” means in this context. Processing traumatic memories can bring up difficult emotions. Some short-term distress is a normal part of how the therapy works, and is not a sign that something is going wrong.
Common Emotional Side Effects of EMDR Therapy
The most common emotional side effects of EMDR therapy include more intense feelings during or after sessions, vivid dreams, increased emotional sensitivity, and the surfacing of memories you may not have thought about recently.
These reactions occur because EMDR uses bilateral stimulation (typically guided eye movements, tapping, or auditory tones) to help the brain reprocess traumatic memories. As that processing happens, emotions connected to those memories can temporarily intensify.
These reactions are typically short-lived, resolving within hours to a couple of days. If they persist or feel unmanageable, your therapist can adjust the pace of treatment.
Physical Side Effects of EMDR Therapy
Physical side effects of EMDR are usually mild and don’t last long. Since trauma can affect both your mind and body, it’s normal to notice some physical reactions as you process it.
Common physical side effects include:
- Fatigue: Emotional processing is cognitively demanding, and feeling tired after a session is one of the most commonly reported effects.
- Headaches: These may result from the intensity of a session or the eye movement technique; your therapist can switch to tapping or auditory tones if needed.
- Dizziness or lightheadedness: Usually temporary and resolves within minutes; slow, deep breathing and staying seated can help.
- Muscle tension or body sensations: Tingling, heaviness, or tension (especially in the neck, shoulders, or chest) can reflect the release of stored tension.
These physical reactions aren’t usually something to worry about, but it’s a good idea to discuss persistent symptoms with your therapist.
How Long EMDR Side Effects Typically Last
Most side effects from EMDR are short-lived and go away within a few hours to a couple of days, though everyone’s experience is a little different.
- Same-day effects: Emotional intensity, fatigue, dizziness, or headaches often ease by the end of the day or the following morning.
- Between-session effects (1–3 days): Vivid dreams, emotional sensitivity, or new memories surfacing are most common during the first day or two after a session and tend to settle before the next appointment. This is often when grounding strategies are most helpful.
- Longer-term patterns: If side effects persist beyond a few days or worsen over multiple sessions, it’s important to let your therapist know. This may indicate a need for more stabilization work or a slower processing pace.
Grounding Strategies for Between EMDR Sessions
If you experience emotional intensity or physical discomfort between EMDR sessions, grounding strategies can help you stabilize until your next appointment:
- Container exercise: Visualize placing distressing thoughts or images into a mental container (such as a box or safe) and closing it until your next session.
- Slow breathing: Inhale for 4 counts, hold for 4, and exhale for 6. This can help calm your nervous system and reduce physical tension.
- 5-4-3-2-1 sensory grounding: Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste to bring your attention back to the present moment.
- Bilateral tapping: Gently tap alternating knees or use a “butterfly hug” to self-administer bilateral stimulation and reduce emotional intensity.
- Physical movement: Walking, stretching, or light exercise can help release physical tension associated with emotional processing.
Your therapist should teach you these or similar coping tools early on, before you start processing difficult memories. If you’re not familiar with grounding techniques or how to use them, it’s a good idea to ask before continuing.
When to Talk to Your EMDR Therapist About Side Effects
You should bring up side effects with your EMDR therapist if reactions feel unmanageable between sessions, worsen over time, or interfere with your ability to function day to day.
Speaking up about your experience allows your EMDR therapist to adjust the pace, revisit stabilization, or modify the approach based on your feedback. Most side effects resolve without intervention, but your therapist can only adjust if they know what you’re experiencing.
If you feel unsafe, are using substances to cope between sessions, or are having thoughts of self-harm, contact your therapist before your next appointment.
Expected Reactions During EMDR | Signs to Discuss With Your Therapist |
|---|---|
Emotional intensity: Stronger feelings that settle within a day or two | Emotional distress that worsens over multiple weeks or feels unmanageable |
Dreams: More vivid or frequent dreams, especially early in treatment | Recurring nightmares that significantly disrupt sleep for more than a few weeks |
Physical sensations: Mild fatigue, headaches, or dizziness that pass quickly | Persistent physical symptoms (e.g., daily headaches, chronic fatigue) |
Memory recall: New memories or details surfacing between sessions | Feeling overwhelmed by memories to the point of impaired daily functioning |
Emotional sensitivity: Feeling more open or raw for a day or two | Ongoing emotional instability that does not ease between sessions |
Who Should Be Cautious About Starting EMDR Therapy
EMDR is a good fit for many people, but in some situations, it may take a bit more preparation or a slightly adjusted approach. It’s always worth talking things through with your therapist before starting:
- Active substance use: Substance use can make it harder to process emotions. In some cases, it may help to focus on stabilization or treatment first.
- Dissociative symptoms: If you tend to feel disconnected from yourself or your surroundings, your therapist may spend more time helping you feel grounded before moving into deeper work.
- Certain medications: Some medications, like benzodiazepines, can blunt emotional responses. It’s a good idea to review any medications with your therapist.
- Frequent or intense flashbacks: If flashbacks feel overwhelming or hard to manage, you may need extra support and coping tools before starting EMDR.
- Neurological conditions: Conditions like epilepsy may require medical clearance, and your therapist can adjust the approach if needed.
These are not disqualifications. They are factors your therapist should assess during the preparation phase. A trained EMDR clinician will tailor the approach to your specific needs.
How Octave Ensures Safe EMDR Treatment
Octave prioritizes safety in EMDR treatment through clinician expertise, structured intake, and individualized care.
- Trained, experienced clinicians: Octave partners only with fully licensed clinicians—no trainees or unlicensed associates. Therapists have 10+ years of experience on average, and many participate in EMDR Centers of Excellence with ongoing consultation.
- Structured intake and safety assessment: Before EMDR begins, Octave’s Care Navigation team evaluates your safety considerations and matches clients based on individual needs, trauma type, and treatment goals.
- Accessible, flexible care: Most clients pay around $28 per session through insurance, with over 95% paying less than $45. Appointments are typically available within 1-8 days, and hybrid (in-person and virtual) care is offered in many locations.
If EMDR through Octave isn’t the right fit right now, the Care Navigation team can help guide you toward appropriate next steps.
Frequently Asked Questions About EMDR Side Effects and Safety
EMDR is not dangerous. It is recognized as a safe and effective treatment for trauma by the APA, the WHO, and the U.S. Department of Veterans Affairs. Side effects are typically mild and short-lived. The perceived "dangers" are usually normal therapeutic reactions to processing difficult material.
The most common side effects include temporary emotional intensity, vivid dreams, fatigue, headaches, and increased emotional sensitivity between sessions. These reactions typically resolve within hours to a couple of days. Physical side effects like dizziness or muscle tension are also reported but are generally mild.
Yes, it is possible to feel temporarily worse as you begin processing traumatic memories. This is a recognized part of the therapeutic process, not a sign that treatment is failing. Your therapist should prepare you for this possibility and equip you with coping tools during the preparation phase.
Most side effects resolve within a few hours to two days after a session. Vivid dreams and emotional sensitivity may persist for a few days but tend to decrease as treatment progresses. If side effects last longer than a week or worsen over time, discuss this with your therapist.
Current research does not support the claim that EMDR creates false memories. A 2025 review in the European Journal of Psychotraumatology examined this concern and found that while EMDR may cause some blurring of peripheral details, it does not implant memories that did not occur. Discuss any memory concerns with your therapist.
Yes. Fatigue after EMDR is one of the most commonly reported side effects. Processing traumatic memories is cognitively and emotionally demanding. Plan for rest after sessions when possible, and avoid scheduling demanding activities immediately afterward.
Use the grounding and stabilization techniques your therapist taught you during the preparation phase, such as the container exercise, slow breathing, or bilateral tapping. If reactions remain intense or unmanageable, contact your therapist before your next scheduled session. They can adjust your treatment pace.
While uncommon, some people may experience heightened anxiety or panic-like symptoms during or after EMDR processing, especially if they have a history of panic disorder. A trained EMDR therapist will monitor your responses and can pause or slow processing if anxiety becomes overwhelming. Preparation-phase skills are specifically designed to help manage this.
Yes. EMDR has been studied and used effectively for depression and anxiety in addition to PTSD. A 2019 study in the European Journal of Psychotraumatology found EMDR safe and associated with significant reduction of depressive symptoms. Your therapist should assess all co-occurring conditions as part of the intake process.
Virtual EMDR is considered as safe and effective as in-person sessions. Online sessions use screen-based bilateral stimulation rather than the therapist's hand movements. Research and clinical experience support comparable outcomes. Octave offers both in-person and virtual EMDR.
Sources:
American Psychological Association (2025). APA Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. https://www.apa.org/about/policy/guideline-ptsd-in-adults.pdf
VA/DoD Clinical Practice Guideline. (2023). Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group. Washington, DC: U.S. Government Printing Office.
van den Berg DP, de Bont PA, van der Vleugel BM, de Roos C, de Jongh A, Van Minnen A, van der Gaag M. Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry. 2015 Mar;72(3):259-67. doi: 10.1001/jamapsychiatry.2014.2637. PMID: 25607833.
World Health Organization. (2013). Guidelines for the management of conditions that are specifically related to stress. World Health Organization.
