EMDR is generally considered a safe psychological therapy when it is delivered by a suitably trained therapist. It is non-invasive, does not involve medication and does not require you to describe every detail of a traumatic experience.
However, safe does not mean that EMDR will always feel easy or comfortable. Processing difficult memories can temporarily bring up strong emotions, physical sensations, dreams or previously forgotten details. Careful assessment, preparation and pacing are therefore essential.
As an accredited psychotherapist and EMDR therapist, I do not begin memory processing simply because somebody has asked for EMDR. I first consider their current circumstances, emotional stability, support, coping resources and ability to remain within a manageable level of distress. EMDR needs to be adapted to the person rather than delivered as though everyone responds in the same way.
Is EMDR a recognised treatment?
EMDR is an established psychological therapy with a substantial evidence base, particularly for post-traumatic stress disorder.
The National Institute for Health and Care Excellence recommends EMDR as a treatment for adults with PTSD or clinically important symptoms of PTSD in certain circumstances. The World Health Organization also includes EMDR among the psychological interventions that should be considered for adults with PTSD.
These recommendations do not mean that EMDR is automatically appropriate for everybody. They mean there is sufficient clinical evidence for it to be offered as a recognised trauma treatment following an appropriate assessment.
Can EMDR make you feel worse?
Some people feel temporarily more emotional, tired or unsettled during a course of EMDR. This can happen because the therapy activates memories, emotions, beliefs and physical sensations connected to the experience being processed.
Possible short-term reactions include:
- Feeling tired after a session
- Increased emotions or sensitivity
- Vivid or unusual dreams
- New memories or details coming to mind
- Temporary changes in sleep
- Physical sensations associated with a memory
- Continued processing between sessions
- Feeling more aware of triggers or patterns
These reactions do not necessarily mean that EMDR is causing harm. They can be part of the brain continuing to process material activated during the session. Nevertheless, significant or prolonged distress should never simply be dismissed as “part of the process”.
Your therapist needs to know if you are struggling between sessions so that the pace, preparation or choice of target can be reconsidered. Read more about this in Can EMDR Make Things Worse? and EMDR Side Effects.
How is EMDR carried out safely?
Safe EMDR involves considerably more than asking someone to think about a traumatic memory while following a therapist’s fingers.
EMDR uses an eight-phase treatment protocol. Before trauma processing begins, there should normally be an assessment, discussion of your history and development of a treatment plan. Your therapist should also explain what EMDR involves and help you prepare for managing emotions during and between sessions.
Safety measures may include:
- Assessing your current symptoms, history and circumstances
- Discussing risk and any concerns about self-harm or suicide
- Identifying existing coping strategies and supportive people
- Explaining how trauma responses and EMDR processing work
- Agreeing on a clear stop signal
- Practising grounding and emotional regulation techniques
- Helping you develop a safe or calm place
- Beginning with a manageable memory rather than the most distressing experience
- Adjusting the speed and length of bilateral stimulation
- Checking your level of distress throughout the session
- Allowing enough time to close the session safely
- Reviewing your response before continuing with further processing
Preparation is not a test that you must pass. It is a collaborative phase used to establish what support and pacing you may need.
My article about what happens in an EMDR session explains the process in more detail.
Want to Understand EMDR in More Depth?
Explore my recommended EMDR books for clients, therapists and anyone interested in how trauma processing works.
View the Best Books for EMDRDo you have to talk about every detail?
No. One difference between EMDR and some other trauma therapies is that you are not usually required to give a detailed verbal account of everything that happened.
You will need to give your therapist enough information to understand what you are working on and to help keep the therapy safe. During processing, however, much of the work can take place internally. You may only need to briefly report what you notice between sets of bilateral stimulation.
You remain in control and can ask to pause or stop at any point. A therapist should not pressure you to disclose details that are unnecessary for the work.
For a broader comparison, see EMDR vs Talking Therapy.
Who may need additional preparation before EMDR?
Having complex needs does not automatically mean that you cannot have EMDR. It may mean that the therapy requires more preparation, slower pacing, shorter sets of bilateral stimulation or support from other professionals.
Additional care may be needed when someone is experiencing:
- Severe dissociation
- Current instability or an ongoing crisis
- Significant risk of suicide or self-harm
- Active substance dependence
- Psychotic symptoms
- Severe emotional dysregulation
- An unsafe or abusive living situation
- Serious physical health concerns
- Limited support outside therapy
- Several major pressures happening at once
A therapist should consider the whole person rather than relying on a diagnosis alone. In some cases, another difficulty may need to be addressed before trauma processing begins. In others, a modified or carefully phased approach may be possible.
If you are unsure about your circumstances, read Is EMDR Right for Me?
Is EMDR safe for childhood trauma?
EMDR can be used to work with childhood trauma, including experiences that have affected self-esteem, relationships and a person’s sense of safety. However, childhood trauma is not always represented by one clear memory. It may involve repeated experiences, disrupted attachment, neglect or long-standing beliefs about the self.
This can make assessment, preparation and treatment planning particularly important. Therapy may need to address several connected memories or “clusters” rather than one isolated event.
Some people need time to build trust in the therapeutic relationship before they feel ready to process early experiences. Others may need additional work around dissociation, boundaries, emotional regulation or protective responses.
Read more in EMDR for Childhood Trauma.
Can EMDR erase memories?
No. EMDR does not delete memories or make you forget what happened.
The aim is to reduce the present-day emotional and physical distress connected to a memory. After successful processing, you should still be able to remember the event, but it may feel more clearly located in the past rather than as though it is still happening now.
You may also develop a more balanced understanding of yourself. For example, a belief such as “I am powerless” may begin to shift towards “I survived and I have choices now”.
Claims that EMDR erases memories, hypnotises people or removes their control are among the common EMDR myths and misconceptions.
Signs that EMDR may be moving too quickly
EMDR should be challenging enough to allow meaningful processing without repeatedly leaving you unable to cope.
Signs that the current pace may need reviewing include:
- Feeling overwhelmed for prolonged periods after sessions
- A significant increase in risky behaviour or substance use
- Being unable to function at work or home
- Severe disruption to sleep
- Feeling persistently detached or unreal
- Becoming frightened of attending sessions
- Feeling unable to tell your therapist to stop
- A noticeable deterioration that is not settling
This does not automatically mean that EMDR must end. It may mean that you need more preparation, a different target, shorter processing periods or a pause while you regain stability.
Is online EMDR safe?
EMDR can be provided online when it is clinically appropriate and suitable arrangements are in place.
Before online processing, the therapist should know where you are, have an emergency contact plan and discuss what would happen if the connection failed. You should have a private space where you are unlikely to be interrupted and enough time to settle before returning to work, driving or caring responsibilities.
Online bilateral stimulation can involve guided eye movements, self-tapping or digital tools. The method should be selected according to what feels manageable and effective for you.
For some people, attending from home feels safer. Others benefit from the physical separation and containment of a therapy room. Neither option is automatically better.
So, is EMDR safe?
For most people, EMDR is a safe and recognised psychological therapy when it is provided by an appropriately trained professional following careful assessment and preparation.
It can bring up difficult emotions and memories, so it should not be treated as a quick technique or rushed. Safe practice means working collaboratively, monitoring your response and adapting the therapy when necessary.
You should understand what is happening, be able to ask questions and remain free to pause or stop. Feeling challenged during therapy can be normal; feeling pressured, ignored or repeatedly overwhelmed is not.
To learn more about the therapy, visit my main guide: EMDR Therapy: How It Works and Who It Helps
Want to Understand EMDR in More Depth?
Explore my recommended EMDR books for clients, therapists and anyone interested in how trauma processing works.
View the Best Books for EMDR
