Eye Movement Desensitization and Reprocessing (EMDR) is a popular and effective form of therapy that changes how memories are stored in the brain. It is generally safe and effective. However, like any therapeutic method, EMDR is not without risks and dangers. The risks depend on the individual, their history, and the skill level of the therapist.

This article explains EMDR and discusses the possible risks to help you understand the possible dangers of EMDR therapy and decide if it is a treatment you want to pursue, and what to look for in an EMDR therapist to know you’re being treated by an expert.

What is EMDR?

To understand the potential dangers of EMDR, you need to know how it works.

EMDR is a therapy process that targets traumatic memories that get “stuck” in the brain, ones that trigger emotional pain, flashbacks, and intrusive thoughts. It helps your brain reprocess those memories so they lose their emotional charge and become neutral. When a negative memory is neutralized, you feel an experience of freedom around it. You no longer react emotionally and physically when you think of it. And when you feel calm around that memory that used to make you feel bad, you act more positively because you’re not triggered.

During an EMDR session, an EMDR therapist uses a wand or object that they move side to side, or plays sounds in each ear, as they guide you to discuss a memory that feels unpleasant. The side-to-side activations stimulate both sides of your brain. It causes a form of stimulation overload and calming of the nervous system, which is the body’s communication network, sending messages between the brain and the rest of the body to control everything we think, feel, and do. This leads to a recalibration of the memory in the brain. And the result is that you can recall and discuss a once bad memory, and it no longer bothers you.

The therapy is commonly used to help people recover from major trauma and PTSD. However, it can be used for anyone who would like to move past negative events and emotions. Any event that you feel is holding you back and that makes you feel bad can be processed during an EMDR session.

EMDR was established by an American psychologist and researcher, Francine Shapiro, who discovered the technique in 1987 when she accidentally noticed that her own distressing thoughts became less intense as her eyes moved rapidly back and forth while walking in a park. Curious about this effect, she started experimenting systematically and found that guided eye movements could reduce the emotional impact of traumatic memories in others. This led to the development of EMDR as a therapeutic method.

At this stage, neurological technology has not evolved to the point where scientists can understand the direct brain mechanisms that explain why EMDR therapy is effective. However, what is known from research is that it is. The theory on why it works has to do with the back-and-forth movement used in EMDR. It is believed that this movement activates memory processing mechanisms of the brain. These are the same mechanisms that are active during a phase of sleep called rapid eye movement (REM). During REM, memories are processed and stored in a way that they can be retrieved later. Therefore, during an EMDR session, you activate and work with these same memory processing centers of the brain to recalibrate how a memory is stored and retrieved and your emotional experience of it.

Scientists also believe that during intense events, the brain and nervous system can be overstimulated, causing a traumatic memory to be stored in a way that the brain can’t make sense of it. So then, any time there is a present-day event or cue in your environment that reminds you of the memory, it reactivates the event. This can mean you experience flashbacks, bad dreams, or anxiety. EMDR is a way to bring the event to the forefront and to reprogram it so it is properly processed and loses any negative cognitive or emotional weight.

The EMDR process—8 stages 

To understand the possible risks, it’s useful to understand the process of EMDR. This type of therapy has eight stages. 

1. History Taking

Your therapist will first gather your full psychological history. They will work with you to identify specific “targets”, which are the memories, you want to work through during EMDR session. During this stage, they are also assing your readiness for this type of trauma processing. The question they aim to answer is this: Is the person stable enough?

2. Preparation

Your therapist will explain what you can expect during EMDR. During this phase you will also be taught emotional regulation tools such as deep breathing, visualization, “safe place” imagery. The goal is to build trust and safety between you and your therapise before processing trauma and to give you techniques to handle recalling a negative event.

3. Assessment

During stage three, you will choose one target memory to focus on. You will work memory by memory or might process an event in bits so it’s not overwhelming. Before you begin the EMDR session, you’ll be asked to identify:

• Visual image: To think through a snapshot of the event
  
• Negative belief about oneself: To consider what you thought in that moment. For examples “I am powerless”
  
• Emotions: What did you feel? For instance, you might recall feelings of fear, shame, disgust.
  
• Body sensations: What did you feel in your body?
  

Also, you’ll be asked to define a positive belief you would prefer (e.g., “I am strong and safe”).

4. Desensitization

Your therapist will then use bilateral stimulation (BLS) which is a process of moving eyes left-right following fingers or light bars, or sometimes taps or tones alternating between the left and right sides to stimulate alternating sides of the brain during the process. This helps to calm the nervous system and match the new emotional state with the old memories.

While focusing on the traumatic memory, you will be doing this the bilateral stimulation process. After a short set of movements, your therapist will ask questions like, “What do you notice now?” The brain begins to process the memory in ways it couldn’t before, often leading to new insights, reduced distress, or changes in the memory.

5. Installation

Once the distress around the memory lowers, your therapist will help you “install” positive believes(e.g., “I am safe now”).Bilateral stimulation continues while focus on this positive association.

6. Body Scan

You’ll focus on the original memory and the new positive belief while scanning the body for any leftover tension, pain, or discomfort. If any physical sensations arise, those areas are processed until the body feels calm.

7. Closure

At the end of each session, whether or not full processing is complete, your therapist will make sure you feel grounded and safe. Use of calming techniques are brought in and used if needed. You will be reminded that processing may continue between sessions (dreams, feelings).

8. Reevaluation

At the beginning of the next session, your therapist will check-in:

• Has the memory stayed neutral?
• Is there new material to work on?
  

You’ll adjust the plan if needed and repeat a similar process to work through the memories until they are neutral.

Now, that you understand the process, you can see why it’s critical you work with a therapist that is trained in EMDR and someone you trust. Let’s dive into the dangers of EMDR therapy so you know how to avoid them.

Potential Dangers and Risks of EMDR Therapy

Since EMDR therapy involves reliving past emotional events that have a negative association there are some risks with the therapy.

Risk 1: Emotional overwhelm and distress

During EMDR, since you actively reprocess traumatic memories, this can sometimes trigger intense emotional reactions, such as:

• Panic attacks
  
• Dissociation
  
• Crying or yelling uncontrollably
  
• Feeling destabilized for hours or days after a session
  

Some people say they feel worse before they feel better, especially early in treatment.

Risk 2: New traumas surfacing

Sometimes, EMDR can uncover other hidden or repressed memories. You might face disturbing images or sensations unexpectedly. You might not be prepared to deal with multiple layers of trauma all at once. This can cause new anxiety, depression, or a relapse into unhealthy coping mechanisms.

Risk 3: Dissociation

People with a history of complex trauma (e.g., childhood abuse, neglect) are at higher risk of dissociating during EMDR. This means feeling detached from reality or yourself or losing a sense of time and space. Severe dissociation can make therapy unsafe if not handled properly. Dissociation needs careful monitoring and sometimes special stabilization techniques before EMDR should even begin.

Risk 4: Inadequate preparation or poor therapeutic support

EMDR requires a strong bond of trust between the therapist and patient. It also requires building emotional resilience first to be able to handle the negative feelings when they arise. Without proper support a you could experience retraumatization rather than healing. Also, not all therapists are equally skilled. An inexperienced or poorly trained EMDR therapist can easily make mistakes that worsen a client’s mental health. Make sure you feel safe with your therapist and are aware that they have proper EMDR training.

Risk 5: False memories

There is some controversy about EMDR and the possible creation of false memories. When you revisit and reinterpret traumatic events, there is a small risk you may misremember or distort events, especially if leading questions are used. This could have serious emotional and even legal consequences. Again, a great therapist will be cognizant that this can happen and unsure they do not encourage the creation of false memories.

Who should be cautious with EMDR?

People who may need specialized assessment before doing EMDR include:

• Those with Borderline Personality Disorder (BPD) or unstable emotional regulation
  
• Those with dissociative disorders (e.g., DID)
  
• Those actively struggling with addiction
  
• Those who are suicidal or severely depressed
  
• Those without a stable support system
  

In some cases, EMDR may be delayed, or other therapies may be prioritized first before attempting trauma reprocessing.

EMDR is powerful but requires an expert pracitioner

When done correctly by a qualified, experienced therapist, EMDR can be transformative for trauma recovery. But when rushed, mishandled, or used with vulnerable populations without careful preparation, it can cause significant psychological distress and even harm.

If you areconsidering EMDR, you should. But, make sure your therapist is EMDRIA-certified (or equivalent). Spend time in preparation and stabilization phases first to feel safe, informed, and in control at all times during therapy.