What Are the Downsides of EMDR Therapy?

The Downsides of EMDR: What to Know Before You Start Trauma Therapy

EMDR is one of the best-known trauma therapies in the world. It’s recommended for PTSD by the World Health Organization and the American Psychological Association, and it has helped a lot of people.

But “well-researched” doesn’t mean “right for everyone.” If you’re thinking about EMDR, or you’ve tried it and felt worse, it helps to know what the downsides can be. That way you can choose the approach that fits your nervous system, not just the one with the biggest name.

This article walks through the most common side effects of EMDR, who it may not suit, and how a gentler alternative called OEI therapy compares.

This article is for information only. It isn’t medical advice. Talk with a qualified trauma therapist about what’s right for you.

What is EMDR therapy and how does it work?

EMDR stands for Eye Movement Desensitization and Reprocessing. It was developed by Francine Shapiro in the late 1980s.

In a typical session, you bring a painful memory to mind while following your therapist’s fingers or a light with your eyes, or while feeling alternating taps or tones. This back-and-forth (bilateral) stimulation is meant to help your brain reprocess the memory so it feels less charged.

Standard EMDR follows eight phases, from history-taking and preparation through to reprocessing and review. For some people with single-event trauma, it can work well in a relatively short time.

What are the side effects of EMDR?

Most side effects of EMDR are temporary. Still, they can be emotionally flooding, and they’re worth knowing about before you begin.

Because suffering is option.

Is it normal to feel anxious or emotional after EMDR?

It’s common to feel a temporary spike in emotion after EMDR. You might notice:

• More anxiety than usual
• Emotional ups and downs
• Tearfulness, sometimes out of nowhere
• Feeling sensitive, raw or irritable

These reactions usually ease within a day or two. But if you already feel fragile, a few days of heightened emotion can be hard to manage alongside work, parenting or a relationship in crisis.

Why do traumatic memories come up after EMDR?

EMDR is designed to “open up” memory networks, and that process doesn’t always stop when the session ends.

Many people notice unexpected or vivid memories of the trauma surfacing during the session or in the days between sessions. Some also have vivid dreams or disrupted sleep. A memory you hadn’t thought about in years can suddenly feel very close.

For some people, this is part of healing. For others, especially if they didn’t expect it, it can feel like the therapy has made things worse.

Can EMDR make trauma worse?

It can, if the pace of the procedure isn’t right for you.

A procedure doesn’t give any room for what is actually happening to you in the present moment.

Can EMDR retraumatize you?

EMDR asks you to hold a traumatic memory in mind while you process it. If that happens too quickly, before you have enough skills and safety in place, the nervous system can become overwhelmed. This is sometimes called emotional flooding.

When you’re flooded, your body reacts as if the trauma is happening again. Instead of processing the memory, you can end up reliving it. In the worst case, this can feel retraumatizing.

Is EMDR safe for complex trauma?

EMDR can cause significant negative effects and destabilization when used for complex trauma (C-PTSD), particularly if proper stabilization is skipped.

Is EMDR right for everyone?

You may need a more gentle approach if you have:

• Complex or developmental trauma, such as childhood abuse or neglect
• Chronic or ongoing trauma, where the harm isn’t over yet, for example living with a partner who is still betraying or gaslighting you
• Severe dissociation, where you often feel numb, spaced out or “not in your body”
• Borderline personality disorder, or intense emotional swings that are hard to regulate

In these situations, the trauma isn’t stored as one neat memory. It’s woven through many experiences and relationships. Pulling on one thread can bring up far more than you’re ready for.

Does EMDR work if the trauma is still happening?

EMDR works best on something that’s in the past. If you’re still in the situation (which trauma feels like), your brain is still reacting to a real, present threat. It can be hard to “reprocess” something that keeps happening.

This is common after betrayal. If you’re still with a partner who hasn’t stopped the behaviour, your nervous system may stay on high alert no matter how many sessions you do. (You can read more about this in If You’re Still With Him After Betrayal, Read This.)

How do I know if EMDR isn’t working for me?

Some discomfort is normal. But consider a different approach, if:

• You feel worse for more than a week after sessions
• You’re having more flashbacks, nightmares or panic than before you started
• You often feel numb, frozen or disconnected during sessions
• You dread sessions because you have to go back into the memory every time
• You’ve done many sessions without any real change

None of this means you’re “broken” or doing therapy wrong. It may just mean your nervous system needs a way that is more kind, gentle way.

Suffering is optional – not a requirement.

Is there a gentler alternative to EMDR?

Yes. One option is Observed & Experiential Integration (OEI), a trauma therapy that grew out of EMDR in Canada in the 1990s. It was originated by family therapist Audrey Cook and developed with Dr. Rick Bradshaw.

Cook noticed that some clients with complex relational trauma became overwhelmed or numb during standard EMDR. So she began working with the eyes more slowly and precisely, often one eye at a time. Those observations became OEI.

How is OEI different from EMDR?

• You don’t have to hold the memory in mind. In OEI, you don’t need to focus on or describe the traumatic event. You don’t have to remember to recover.
• It works at a slower, observed pace. Your therapist watches for tiny “glitches” in your eye movement, small jumps, freezes or blinks that show where your nervous system is still holding on, and works gently at those spots.
• It uses one eye at a time. A technique called Switching covers one eye and then the other. Many clients find this makes processing feel less intense.
• It focuses on the body. OEI pays close attention to what your nervous system is doing moment to moment, which can help people who tend to dissociate or flood.

Many clients who found EMDR too overwhelming find OEI feels more manageable. Like any therapy, it isn’t right for everyone, and you may still feel tired or emotional after a session. Read more about how OEI works in our FAQs →

Is EMDR or OEI better for trauma?

Both can help. EMDR may be a good fit if you have a single, clear traumatic memory and you feel fairly stable day to day.

OEI may suit you better if:

• You’ve tried EMDR or talk therapy and felt overwhelmed or stuck
• You don’t want to retell or relive what happened
• Your trauma is complex, long-term or tied to relationships, like betrayal
• You often feel numb, frozen or disconnected

The most important thing is working with a trauma-trained therapist who goes at your pace.

Where can I find OEI therapy in Vancouver?

If EMDR felt like too much, or you’re looking for a way to heal without reliving the past, OEI may be the next step.

I’m Liana West, a certified OEI therapist offering OEI therapy in Vancouver BC and online. In a free Clarity Session, we’ll talk about what you’ve tried, what’s still keeping you stuck, and whether OEI is a good fit for you.

Let’s connect.