EMDR (Eye Movement Desensitization and Reprocessing) has gained recognition as an effective trauma therapy, but like any powerful therapeutic intervention, it can sometimes cause more harm than good when not implemented properly. While many people experience significant healing through EMDR, it’s important to understand how things can go wrong, what warning signs to watch for, and what appropriate protocol looks like.
The Reality of EMDR Complications
Sometimes clients enter EMDR feeling hopeful and ready, only to find themselves in significantly worse condition after sessions. Reports include severe panic attacks lasting weeks, inability to sleep or eat, heightened anxiety around previously manageable situations, and a general sense that the therapy has “broken” something that can’t be fixed.
These experiences aren’t just unfortunate side effects—they often represent fundamental failures in how the therapy was conducted.
Common Ways EMDR Can Go Wrong
1. Inadequate Preparation for Emotional Intensity
Case Example: Sarah’s Shock Sarah had been managing her anxiety fairly well when she started EMDR for childhood emotional neglect. Her therapist spent one session explaining the process before diving into memory processing. After their second session, Sarah felt empowered and clear-headed. Three days later, she experienced her first panic attack in years, followed by a week of insomnia and intrusive thoughts. She felt blindsided, wondering if she was “losing her mind” because no one had prepared her for the possibility of delayed emotional responses.
How It Should Have Been Done: Sarah’s therapist should have spent 4-5 sessions in Phases 1 and 2, thoroughly explaining EMDR in a comprehensive manner. The therapist needed to educate Sarah about how trauma processing can cause delayed reactions, describing normal post-session experiences such as emotional waves, vivid dreams, and body sensations. They should have helped Sarah understand the crucial difference between “feeling worse” temporarily versus actual harm, while teaching specific coping strategies for managing activation. The therapist should have provided clear timeline expectations, explaining that “You might feel stirred up for 2-3 days, then settling typically occurs.” Before any processing began, Sarah should have felt prepared and had a complete roadmap for what to expect throughout her healing journey.
Quality EMDR includes extensive psychoeducation about potential responses to trauma processing. Clients should understand that symptoms can temporarily worsen, that reactions can be intense and physical, and that the brain needs time to integrate the work.
2. Insufficient Foundation Building
Case Example: Marcus’s Overwhelm Marcus began EMDR for combat trauma while still struggling with daily panic attacks and substance use. His therapist was eager to help and moved quickly into processing war memories after just two preparatory sessions. During his third EMDR session, Marcus became so overwhelmed he dissociated for several hours and couldn’t remember driving home. He spent the next month drinking heavily to manage the flood of emotions and imagery that the session had unleashed.
How It Should Have Been Done: Marcus’s therapist should have invested 8-10 sessions in building comprehensive stabilization before any trauma processing. This extensive preparation should have included installing multiple safe place resources and teaching effective grounding techniques like the 5-4-3-2-1 sensory method and bilateral tapping. The therapist needed to address Marcus’s substance use through coordinated care with other providers and focus on building affect tolerance through window of tolerance education. They should have installed protective figure and nurturing figure resources while practicing self-soothing techniques until they became automatic responses. Only when Marcus could consistently return to baseline after mild activation should they have begun processing less intense memories, ensuring he had a solid foundation for the more challenging work ahead.
Phase 1 of EMDR protocol specifically focuses on building resources through grounding skills, affect tolerance, and stabilization techniques. When this foundation is weak, clients can become overwhelmed by material they’re not equipped to process.
3. Starting with the Most Severe Trauma
Case Example: Lisa’s Setback Lisa sought EMDR for various traumas, but mentioned that sexual assault in college was her “big one.” Her therapist decided to tackle this memory first, reasoning that addressing the worst trauma would help everything else fall into place. After processing this memory, Lisa experienced severe depression and couldn’t function at work for two weeks. She developed agoraphobia and couldn’t be intimate with her partner for months afterward.
How It Should Have Been Done: Instead of targeting the sexual assault immediately, Lisa’s therapist should have taken a carefully graduated approach to trauma processing. They should have started with a current trigger like feeling anxious in crowded places, using the standard protocol, then moved to processing a less intense childhood memory, such as being embarrassed at school. The therapist should have worked on a relationship conflict that felt manageable before gradually building up Lisa’s confidence in her ability to process difficult material. Only after 6+ months, when Lisa felt ready and had proven resilience through successfully processing smaller traumas should they have addressed the sexual assault. Each session should have built on previous successes, creating a foundation of trust in the process and in Lisa’s own capacity for healing.
Effective EMDR typically begins with less intense memories or current triggers, allowing both therapist and client to understand how the person responds to processing. Jumping straight to the worst trauma is like performing major surgery without understanding how the patient responds to medical intervention.
4. Lack of Post-Session Safety Planning
Case Example: David’s Crisis David had intense nightmares and flashbacks for a week following his EMDR session on childhood abuse. When he called his therapist’s office in distress, he got voicemail saying she was out of town. The crisis line worker was unfamiliar with EMDR and couldn’t offer specific guidance. David felt abandoned and dangerous to himself, eventually going to the emergency room where staff didn’t understand what EMDR was or how to help him.
How It Should Have Been Done: David’s therapist should have established a comprehensive support structure before beginning any trauma work. This should have included developing a detailed post-session safety plan with specific grounding techniques and maintaining 24-hour on-call availability during intensive processing phases. The therapist needed to coordinate with David’s support system with his permission and create a clear protocol for managing flashbacks and nightmares. They should have scheduled brief check-in calls 24-48 hours after intense sessions and provided written resources David could reference when activated. When David did experience some difficult nights during treatment, he should have felt supported and known exactly what to do, having a clear roadmap for managing challenging moments.
Responsible EMDR practitioners develop clear protocols for managing post-session overwhelm, including specific coping strategies, emergency contact procedures, and sometimes brief check-in calls following intense sessions.
5. Problematic Explanations of Difficult Experiences
Case Example: Jennifer’s Despair When Jennifer experienced severe anxiety and intrusive thoughts following EMDR, her therapist explained that the therapy had “opened a door that couldn’t be closed” and that her trauma was “more activated now.” This language left Jennifer feeling permanently damaged and hopeless about recovery. She stopped attending therapy and began viewing herself as unfixable, leading to months of isolation and depression.
How It Should Have Been Done: When Jennifer experienced post-session activation, her therapist should have provided empowering and hopeful explanations rather than alarming language. The therapist should have explained that “Your system is processing and integrating – this shows the work is happening” and emphasized that “These feelings are temporary and part of your brain’s natural healing process.” They should have reassured Jennifer that “You have the skills to manage this, and we’ll adjust our pace as needed” while helping her understand that “This activation means we found important material – your system is working to resolve it.” Through this supportive reframing, Jennifer should have felt empowered and hopeful about her healing process rather than damaged or permanently harmed.
Skilled therapists help clients understand challenging responses as temporary and workable, not as evidence of permanent damage.
The Ripple Effects of Poor EMDR
Case Example: Tom’s New Fears After a traumatic EMDR experience, Tom developed a fear of therapy itself. He became hypervigilant about any intervention that might affect him emotionally, refusing helpful medications and avoiding mindfulness exercises that had previously helped his anxiety. What started as treatment for one trauma created multiple new fears that complicated his recovery for years.
Red Flags to Watch For
Be cautious of EMDR therapists who rush into trauma processing without extensive preparation, want to start with your most severe trauma, don’t thoroughly assess your coping skills and resources, or fail to explain what post-session experiences might look like. Other warning signs include therapists who don’t have clear plans for managing between-session distress, lack specialized EMDR training, consultation, or ongoing education, or seem uncomfortable discussing potential risks or complications.
What Good EMDR Looks Like
Case Example: Alex’s Complete Success Story Alex’s treatment demonstrated comprehensive appropriate protocol throughout all phases. During Phase 1-2, which lasted 6+ sessions, her therapist conducted a comprehensive trauma history and resource assessment while installing safe place, calm place, and inner wisdom resources. They focused on developing affect tolerance skills and provided thorough psychoeducation about trauma, the nervous system, and EMDR, including practice with bilateral stimulation for resource strengthening and clear safety planning with support system identification.
During the processing phases (3-6), the therapist started with the least distressing memories with SUDS levels of 4-5, processing recent triggers and daily stressors first before gradually working toward more significant traumas. Each session included proper opening with resource installation and closing with return to calm state, along with consistent check-ins about pacing and readiness to ensure Alex felt in control of her treatment progression.
The integration phases (7-8) included future template installation for potential challenging situations, comprehensive body scans to ensure complete processing, ongoing resource strengthening, and relapse prevention planning to maintain gains. Throughout treatment, the therapist maintained regular assessment of progress and adjustment of approach, collaborative treatment planning that respected Alex’s pacing and preferences, and ongoing consultation and supervision to ensure quality care.
This comprehensive approach resulted in steady, sustainable progress where Alex felt empowered and prepared for each step of her healing journey, demonstrating how proper EMDR protocol prioritizes safety, preparation, and gradual progression rather than rushing into trauma processing without adequate foundation building.
The Path Forward
For those who’ve had negative EMDR experiences, healing is still possible, though it may require working with someone who specializes in repairing therapeutic harm and understands the complexity of therapy-related trauma.
EMDR can be profoundly healing when conducted skillfully and ethically. But understanding these potential pitfalls and recognizing what appropriate treatment looks like can help you advocate for the careful, respectful treatment your healing journey deserves.
Your recovery is worth waiting for the right therapist who will prioritize your safety above all else.
Professional EMDR Therapy with Balanced Mind LCSW
If you’re seeking safe, ethical, and effective EMDR therapy, Balanced Mind LCSW provides comprehensive trauma treatment with the careful attention and expertise your healing deserves. Our licensed clinical social workers are specially trained in EMDR and follow the complete eight-phase protocol, ensuring thorough preparation, resource building, and safety planning before any trauma processing begins.
At Balanced Mind LCSW, we understand that every client’s journey is unique. We take the time to build a strong therapeutic foundation, starting with less intense memories and working gradually toward more significant traumas only when you feel ready and equipped. Our approach prioritizes your safety, empowerment, and long-term healing success.
Whether you’re new to EMDR or have had previous experiences that didn’t go well, our trauma-informed therapists provide the supportive, professional care you need to process difficult experiences safely and effectively. We believe in collaborative treatment planning, clear communication about what to expect, and comprehensive support throughout your healing journey.
Contact Balanced Mind LCSW today to learn more about how proper EMDR therapy can help you heal from trauma while feeling supported, prepared, and empowered every step of the way. Your healing journey deserves nothing less than the highest standard of care.