Can emdr make trauma worse

Deborah C. Escalante

Dangers of EMDR Therapy

By Olivia Guy-Evans, published May 09, 2022 | Fact Checked by Saul Mcleod, PhD

Eye movement desensitization and reprocessing (EMDR) therapy is a treatment for mental health that uses eye movements and bilateral stimulation to help people with trauma. EMDR helps people to recall their traumatic events and process them in a new way so as to normalise these memories and make them less triggering and painful.

Psychotherapy and psychology. Emdr therapy help with psychological problems. Sadness, longing, despondency, depression. Eye movement to the right and left.

EMDR was developed in the late 1980s by Francine Shapiro, as a treatment for posttraumatic stress disorder (PTSD), although it has shown to be effective for people with other conditions such as anxiety, panic, and dissociative disorders.

This therapy involves reconnecting the client to their memories in a safe and structured way, following 8 stages from preparation to reprocessing.

EMDR helps people to process any negative images, emotions, beliefs, and body sensations associated with the traumatic memories which seem to be unprocessed and causing harm.

EMDR is an individual therapy which is typically delivered one or two times a week for around 6-12 weeks, although some people may benefit from more or fewer sessions depending on their progress.

Are There Any Dangers of EMDR Therapy?

Since EMDR therapy is used with people who have experienced trauma, it is essential that the practices are safe to use on these individuals.

EMDR therapy has been used for a long time and there have not been any reports of any dangerous side effects. As such, there appear to be no dangers of using EMDR for a victim of trauma.

Overall, EMDR is considered to be a safe therapy. It is recommended by professionals and organisations such as the American Psychological Association (APA) and the World Health Organisation (WHO).

EMDR is a structured therapy with 8 stages that must be followed since these are designed so that the pace of therapy is not too quick or too distressing for the client. Evoking traumatic memories too early in the treatment can be detrimental and take an emotional toll on the client.

Likewise, the bilateral stimulation stage of the treatment requires careful analysis by the therapist to determine whether the client is ready for this step.

Though parts of EMDR may sound dangerous, a skilled therapist will help the client prepare for the reprocessing prior to treatment and will not progress onto this stage until they believe the client is ready.

The therapist will also take the client’s history and teach them coping skills that will assist them in managing EMDR and any potential side effects.

As with any mental health therapy that tackles difficult topics or emotions, side effects may occur, and the therapist will keep this in mind during the sessions. A skilled therapist will develop a treatment plan that helps to minimise these risks.

EMDR Side Effects

It is important to recognise that any form of effective therapy can have potential side effects, so EMDR is not an exception. Understanding the possible risks and challenges of EMDR can better equip both the therapist and the client to ensure the success of the therapy.

Feeling uncomfortable

Any type of therapy can feel uncomfortable, especially at the beginning. Meeting and talking to someone you may not know very well can feel awkward and it may not be easy to share your private thoughts and feelings which can hinder your treatment. 

For those with trauma, therapy is likely to be more challenging. Survivors of trauma may have a hard time trusting others and their survival response may become activated during treatment. 

Surfacing of new memories

As you focus on a past memory, other memories may arise which can be unsettling.

The therapist should work with you to determine how to contain and/or work on these additional memories to minimise your distress.  

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Intense emotions

During the therapy sessions, strong and intense emotions may come out which can last from hours to days after the session.

You may become upset, agitated, or feel on edge after the sessions. These feelings are not long-lasting and typically as therapy carries on, the client improves their processing of emotions. 

Physical sensations 

You may find that during the sessions you experience some physical sensations such as muscle tension and crying.

If this happens, remember you are always in control and can ask for a break if you need one. These sensations are also not likely to continue for very long.

Vivid dreams

It is not unusual to notice new or intense dreams after attending an EMDR session. This may also present as shifts in recurring dreams.

If this happens, this is likely to show that your brain is reprocessing. 

Feeling emotionally sensitive

You may feel more vulnerable to emotions during the EMDR sessions. Staying with a traumatic memory can be tiring and can lead to feeling more sensitive to your emotions so make sure to take time to rest and care for yourself as needed. 

EMDR Myths & Misconceptions

There are many myths and misconceptions about EMDR therapy which can make it confusing for anyone who may be considering this type of treatment. Some of these include the following:

EMDR is only for those with PTSD

Many people may believe that EMDR is not a suitable treatment for them as they are not diagnosed with PTSD.

However, while this therapy was originally developed for those with PTSD, it has also proved beneficial for other conditions including anxiety, depression, panic, and dissociation. 

EMDR is a type of hypnosis

The bilateral stimulation such as the eye movements understandably reminds people of hypnosis. However, this is not the case and EMDR is not hypnosis.

Others may be sceptical about the bilateral stimulation working at all but there is plenty of evidence to support that EMDR with bilateral stimulation is an effective treatment. 

I will start reprocessing my traumatic memories straight away

While some people may feel that they are ready to start reprocessing their traumatic memories straight away, there are other steps that must be taken first.

EMDR requires a thorough preparation stage which includes taking the client’s history, ensuring they can engage in the bilateral stimulation, and that they have coping strategies in place.

Only when the therapist believes the client is ready will they progress onto the reprocessing, which often starts after a few sessions.

Having to discuss trauma in detail

Some people may be put off by some therapies which can require delving into traumatic memories and recounting loads of details.

With EMDR however, clients are not required to share all the details of their trauma. The therapist will only need a few details to help the memories reprocess.

This way, the client has control over how much they wish to share, and they are still likely to experience positive outcomes.

It plants false memories

Since EMDR deals with the reprocessing of memories, some may question whether this therapy can create false memories in people.

However, EMDR does not have the ability to create a memory that was not already there – it only works with memories that exist within the person.

It will cause me to lose control

People may think that engaging in EMDR therapy can cause someone to get so emotional that they lose control.

Any kind of therapy has the potential to make someone feel emotional but becoming so emotional that a client cannot return from it is highly unlikely and has not been reported for EMDR.

The therapist will ensure the client is thoroughly prepared for the reprocessing stage and that they are equipped with the tools and coping skills to manage any discomfort.

The client is also in control of the therapy so if their feelings do become too strong, they can ask to have a break to recover. 

Can EMDR cause dissociation?

Dissociation is characterised by a disconnection between a person’s thoughts, sensory experience, memory, and/or their sense of identity.

Since dissociation can occur as a result of experiencing trauma, it is likely that EMDR therapists will treat clients who are experiencing dissociation.

Although EMDR may not be the main therapy for dissociative individuals, it has the potential to improve their condition. The risks for people with dissociative disorders are inherently the same as with people with PTSD and EMDR is not known to cause dissociation.

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However, breaching the dissociative boundaries too early in treatment can be risky and result in an increase in suicidal ideation or destabilisation.

Therefore, it is important that a skilled therapist goes through each stage of EMDR thoroughly and does not progress to the reprocessing stage until the client is ready. 

Can EMDR make things worse?

If your main coping method is to avoid and minimise your distress, it is often easier in the moment to make you feel better by ignoring your distress.

It can therefore be very uncomfortable to reflect on your trauma in EMDR.

To begin with, it can seem that EMDR makes things more painful, especially if you are working on something that has not been thought about for a long time.

What is important to remember is that these feelings are all a part of the healing process. Even if things get worse for a moment, that moment will not last, and eventually you should feel better than you did before.

There are many reasons why someone may consider EMDR therapy. There are many benefits to the treatment including:

It is not solely for PTSD

While EMDR was devised to help those with PTSD, it is now proven to be beneficial for other disorders such as dissociative disorder, depression, and anxiety, especially when there are links with childhood trauma.

Often, EMDR can be used alongside other therapies to increase its results, especially when used for treating disorders other than PTSD. 

Reduces negative thoughts

EMDR is useful to help identify, and challenge negative thoughts associated with the traumatic memory. For example, many people may blame themselves for what happened to them in the past.

EMDR can help people to see that realistically, they were probably not at fault. EMDR helps to declutter the mind of these negative thoughts and helps to replace them with more helpful and realistic ones. 

Yields fast results

The main selling point of EMDR therapy is that it tends to have rapid results in comparison to other types of therapy.

EMDR focuses directly on the traumatic memory, which is causing the distress, which may be a reason why EMDR can be quicker than other treatments.

Whilst you shouldn’t expect to complete the therapy as quickly as possible, many people who undergo EMDR report positive results sometimes within as little as 3 sessions.

Minimal talking required

In EMDR, there is no pressure to disclose all the details of a traumatic experience. The therapy is likely to be as successful with the therapist only being aware of the basic details of the trauma.

For this reason, EMDR can be favourable for a lot of people who have difficulty discussing their trauma.

Increases self-esteem

Since EMDR targets distressing memories and negative thoughts someone may have about themselves, these thoughts can be changed.

A client may believe that they are weak, powerless, or useless because of their trauma, but processing the trauma can help them see that these negative self-statements are not true.

Changing these negative thoughts about the self into something more positive can have a great impact on the client’s self-worth. 

Supported by research

EMDR has high rates of effectiveness, with as many as 30 clinical studies showing that EMDR is effective for people with PTSD, especially those dealing with a single trauma. 

Studies have shown that EMDR can be just as effective as cognitive behavioural therapy (CBT) for treating trauma (Lewey et al., 2018) and panic disorder (Horst et al., 2017). 

A 2014 study looked at 24 randomised controlled trials that support the effectiveness of EMDR for the treatment of trauma. The results of some of these studies suggested that EMDR therapy is more effective than CBT for trauma (Shapiro, 2014). 

A 2021 study surveyed data from 33 EMDR therapists who gave therapy online. The results showed that EMDR provided over the internet was shown to still help relieve mental health symptoms as it does in person (McGowan et al., 2021). 

Tips for Getting Started with EMDR

There are some steps that can be taken to ensure the effectiveness and safety of the process of undergoing EMDR therapy.

Choosing a therapist

EMDR requires specialist training that isn’t always part of general therapy training. When searching for a therapist, ensure that you find someone who is specifically trained in EMDR.

It is also important to make sure you are comfortable with the therapist you have, and it is perfectly fine to find someone else who may be better suited to your needs. 

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Make sure you ask the therapist questions about EMDR beforehand and discuss what it will be likely, including the possible side effects.

Ask about any questions you may have about the process. You are likely to feel more comfortable if you understand how it works and what a typical session will look like. 

Be honest 

During therapy, communicate with the therapist about your thoughts and feelings. If something is uncomfortable or feels wrong, express this to them. This will help the therapist help you and make the whole experience safer. 

Plan well for sessions

To prepare for the sessions, ensure you do not have any distractions such as turning your phone off. Bring something to drink and ensure you have adequate time before your next engagement.

If you think you are likely to feel tired afterwards, it may be wise to prepare for this and not to plan anything too essential for after the session. 

Learn coping skills

Learning coping skills is part of the preparation stage of EMDR. Take the time to learn and practice these skills so they can be used between sessions.

The therapist will help to assess your current coping skills and teach you what you need to enable the reprocessing part of the therapy.

The more these skills are practiced, the better able you should be able to handle any discomfort that may arise during treatment. 

Attend all the sessions 

As difficult as you may find some of the sessions, especially when thinking about traumatic memories, try to engage in, and complete the full course of the treatment to ensure you are getting the most out of it.

Keep an open mind

While the idea of engaging in bilateral stimulation such as following the therapist’s fingers from side to side may seem like an unusual approach to treatment, try to keep an open mind.

There is plenty of research to support the effectiveness of EMDR methods. 

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

Fact Checking

Content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication.

Cite this Article (APA Style)

Guy-Evans, O. (2022, May 09). Dangers of EMDR Therapy. Simply Psychology. www.simplypsychology.org/dangers-of-emdr-therapy.html

APA Style References

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