Are There Emotional Reactions During EMDR Treatment?

Starting trauma therapy can bring up an important question: can EMDR make you feel worse before you begin to feel better? EMDR therapy involves working with distressing memories and the thoughts, emotions and physical responses associated with them. For some people, that process can temporarily make certain feelings, memories or sensations more noticeable during or after a session.

Feeling emotional, tired or unsettled after EMDR does not necessarily mean the underlying problem is getting worse. Some people experience temporary discomfort as difficult material is addressed, while others notice little or no disruption between sessions. There is no required period of feeling worse after EMDR that must occur for treatment to be effective.

Understanding possible EMDR side effects, what you may notice between appointments and when to speak with your therapist can make the process less uncertain. A trained EMDR therapist can consider your response when determining the pace of treatment rather than assuming the same approach is appropriate for everyone.

Can EMDR Make You Feel Worse at First?

So, can EMDR make you feel worse at first? For some people, the answer is temporarily yes. Difficult emotions, memories, thoughts or physical sensations can become more noticeable when they are being addressed in therapy. This is different from assuming EMDR should cause a person’s overall mental health to deteriorate before improvement can occur.

EMDR focuses on experiences that continue to cause distress in the present. When a distressing memory is activated during treatment, associated thoughts, emotions, images or physical sensations may also become more noticeable. Some people continue thinking about aspects of the session afterward.

How someone responds depends on the individual, the material being addressed and where the person is in treatment. Someone working with a highly distressing experience may respond differently from someone addressing a less emotionally intense treatment target.

If you are unfamiliar with the therapy itself, What Is EMDR Therapy? A Complete Guide provides a broader introduction to EMDR without duplicating that information here.

What Are the Possible Side Effects of EMDR Therapy?

The phrase EMDR therapy side effects is commonly used when people search for reactions that can occur during or after treatment. Unlike medication side effects, however, these experiences are generally associated with engaging with emotionally difficult material and noticing thoughts, emotions or sensations afterward.

Possible short-term EMDR side effects may include:

• Feeling emotionally or mentally tired
• Increased awareness of upsetting memories
• Temporary sadness, anxiety, anger or irritability
• Vivid or unusual dreams
• Related thoughts or memories coming to mind
• Greater awareness of stress-related physical sensations
• Wanting additional quiet or rest after a session

Not everyone experiences these reactions, and having them does not prove that EMDR is working. Likewise, experiencing few EMDR after effects does not mean treatment is ineffective. Progress is better evaluated over time based on the person’s treatment goals and response to therapy.

The American Psychological Association includes EMDR among the psychotherapies used in the treatment of post-traumatic stress disorder and provides additional information about evidence-based treatments for PTSD.

Why Can You Feel Emotional After an EMDR Session?

EMDR can involve focusing on memories that still carry emotional distress while using bilateral stimulation, such as guided eye movements or other forms of alternating stimulation. The purpose is not simply to repeatedly revisit what happened. Treatment is intended to address the way distressing experiences continue to affect a person in the present.

After a session, an emotion may feel more noticeable, a related thought or memory may come to mind or a person may recognize a connection that had not previously been obvious. These experiences can contribute to feeling worse after EMDR temporarily, even when the overall goal of treatment is to reduce the ongoing impact of distressing experiences.

For a detailed explanation of the treatment process itself, see How Does EMDR Therapy Work?.

How Do You Feel After EMDR Therapy?

There is no single answer to how do you feel after EMDR therapy. Some people leave an appointment feeling calm, relieved or less distressed. Others may feel tired, reflective, emotionally sensitive or more aware of the material addressed during the session. Some notice very little immediately.

Responses can also change from one appointment to another. A session focused primarily on history, preparation or treatment planning may feel different from one involving active work with a distressing memory.

This variation is important when asking can EMDR make you feel worse after a particular session. An emotionally difficult appointment does not automatically mean treatment is causing harm, just as feeling good immediately afterward does not establish that the underlying concern has been resolved.

Significant or persistent changes should be discussed with the therapist so they can be considered as treatment continues.

How Long Do EMDR Side Effects Last?

There is no standard amount of time that EMDR side effects last. Temporary fatigue, emotional sensitivity, increased awareness of memories or changes in dreaming may settle relatively quickly for some people, while others may notice reactions for longer.

The duration of EMDR emotional side effects can vary based on the material addressed, current stress levels and individual response to treatment. For that reason, there is no universal timeline that applies to everyone receiving EMDR.

What matters more is whether the reaction is manageable, whether it is resolving and whether it significantly interferes with everyday functioning. Persistent, intense or concerning symptoms should be discussed with the treating therapist rather than automatically attributed to normal EMDR after effects.

Is Feeling Tired After EMDR Normal?

Some people report feeling tired after EMDR therapy, particularly following emotionally demanding sessions. Concentrating on distressing material while noticing thoughts, emotions and physical sensations can require substantial mental and emotional effort.

For that reason, some clients prefer to leave additional downtime after an intensive appointment when their schedule allows. Others feel able to return to their usual activities without difficulty.

Fatigue should not automatically be attributed to EMDR. Persistent or unusual exhaustion can have many causes and should be evaluated appropriately rather than assumed to result from therapy.

Can EMDR Bring Up Memories You Hadn’t Been Thinking About?

Additional memories can sometimes come to mind during or between EMDR sessions. A memory being addressed may have associations with earlier experiences through similar emotions, beliefs, sensations or circumstances, making those connections more noticeable.

This does not mean EMDR reliably uncovers hidden memories or proves that every image, thought or recollection that emerges represents an accurate historical event. Memory is complex and imperfect, and newly emerging material should not automatically be treated as factual simply because it arose during therapy.

The focus is generally on addressing the distress associated with what a person is experiencing rather than attempting to force the retrieval of memories.

Does EMDR Require You to Relive the Trauma?

Concern about having to relive traumatic experiences is one reason someone may wonder can EMDR make you feel worse. EMDR does involve accessing aspects of a distressing memory, but treatment is not intended to require a person to repeatedly describe every detail or remain overwhelmed by the experience.

Before trauma processing begins, the therapist gathers relevant history, identifies treatment targets and assesses preparation for working with distressing material. Preparation is part of the EMDR treatment process rather than something that should automatically be rushed through.

During treatment, the therapist monitors the client’s response and follows an individualized treatment plan. EMDR should not be approached as a test of how much emotional discomfort someone can tolerate.

For more information about using EMDR specifically for trauma symptoms, see EMDR Therapy for PTSD: Helping Your Brain Heal After Trauma.

What If EMDR Feels Too Intense?

If an EMDR session or the period afterward feels unusually intense, tell your therapist. This information can help determine whether treatment needs to slow down, whether additional preparation would be useful or whether the current treatment target should be approached differently.

A therapist may spend additional time on coping or stabilization strategies before continuing trauma-focused work. Treatment can be adjusted according to the individual’s needs rather than following exactly the same pace for every client.

This may be particularly relevant for people with extensive or repeated trauma histories. EMDR Therapy for Complex PTSD (C-PTSD: Healing from Long-Term Trauma discusses considerations related to EMDR and long-term or repeated trauma.

When Should You Talk to Your Therapist About EMDR Side Effects?

You do not need to wait until a reaction becomes severe before mentioning it. Changes that occur between sessions can provide useful information about how you are responding to treatment and what may need attention next.

Talk with your therapist about EMDR side effects or other reactions that are intense, persistent, difficult to manage or substantially interfere with sleep, work, relationships or normal daily functioning. You should also speak up if you are worried about continuing with a particular memory or do not feel adequately prepared for the next stage of treatment.

The question can EMDR make you feel worse should therefore be considered in the context of the individual response rather than answered by assuming every uncomfortable reaction is expected. Providing accurate feedback allows the therapist to evaluate what is happening and determine whether the treatment plan or pace should be adjusted.

Can EMDR Be Done Too Quickly?

Moving into trauma processing before adequate assessment and preparation may make treatment more difficult to tolerate for some people. EMDR is more than eye movements or bilateral stimulation; it is a structured psychotherapy approach that includes history taking, preparation, assessment, processing and follow-up.

The appropriate amount of preparation differs from person to person. Someone working with a single traumatic experience and strong current stability may have different needs from someone with multiple traumatic experiences, ongoing stress or difficulty managing intense emotions.

This is one reason appropriate therapist training and individualized treatment planning matter. The objective is not to move through EMDR as quickly as possible but to use the approach in a way that fits the client’s needs and treatment goals.

Can EMDR Make Anxiety Worse?

EMDR can sometimes temporarily increase awareness of anxiety when a person is working with experiences associated with fear, threat or distress. This does not mean EMDR necessarily causes a lasting increase in anxiety.

For people whose anxiety is connected with distressing experiences, EMDR may be incorporated into a broader treatment plan when clinically appropriate. Whether it is a suitable approach depends on what is contributing to the anxiety and the individual’s treatment needs.

For a closer look at this specific application, see How EMDR Therapy Can Help Relieve Anxiety.

Feeling Worse Is Not a Requirement for EMDR to Work

When people ask can EMDR make you feel worse before you feel better, it is important not to turn a possible short-term reaction into an expectation. Trauma therapy does not need to cause significant suffering in order to be effective.

Some people experience noticeable EMDR emotional side effects after certain sessions, while others do not. Improvement may also develop gradually rather than through an intense emotional breakthrough.

The more useful measure is whether treatment is reducing the effect that distressing experiences have on present-day thoughts, emotions, physical responses and daily life over time. That assessment should happen collaboratively between the client and therapist.

Frequently Asked Questions About EMDR Reactions

Considering EMDR Therapy?

If past experiences continue to affect your emotional well-being, relationships or daily life, EMDR may be one treatment option worth discussing with a qualified therapist. Thrive Psychotherapy provides online EMDR therapy, with treatment tailored to each client’s history, current needs and readiness for trauma-focused work.

EMDR therapy sessions with Thrive Psychotherapy are conducted online, allowing clients to participate from a private, comfortable setting. In-person sessions may be available by special request when appropriate.

Contact Thrive Psychotherapy to learn more about EMDR therapy, ask questions about the treatment process or schedule an appointment.