If you’ve just started Eye Movement Desensitization and Reprocessing (EMDR) therapy, you might be wondering if it’s normal to feel worse after a session. The short answer? It can be. EMDR is a powerful trauma therapy designed to help your brain process and heal from distressing memories, but that healing process isn’t always linear. In this blog post, we’ll break down what you can expect after EMDR sessions, why it can be normal to feel a bit off after processing traumatic memories, and how to take care of yourself in between sessions.
What should I expect after EMDR therapy trauma processing?
EMDR therapy sometimes involves revisiting traumatic memories in order to process them and to ultimately reduce their emotional charge. Processing traumatic memories can bring up intense feelings, which if not properly contained may leave you feeling unsettled, emotional, or just plain tired. EMDR therapists typically leave 10-15 minutes at the end of a session for grounding. This step is helps to ensure that you won't experience negative side effects in between sessions.
Sometimes processing continues even after a session ends. You might notice that you have thoughts, feelings, dreams, or physical sensations as you continue to process. Try your best to take note of what you experience -- sharing this information with your therapist can inform your future work together.
What should I expect in my next EMDR session?
After an EMDR processing session, your next therapy session will likely begin with your therapist checking in on how you've been since the last time that you met. This is a great time to share if you felt worse after the session, even if it was just temporarily. This information will help guide your therapist in making adjustments to your treatment in order to suit your individual needs. For example, if you share that you felt dysregulated after processing, your therapist may spend more time helping you to ground yourself in the future.
After that check-in and depending on time, your therapist may help you to continue processing additional memories. Modifications can be made to restrict processing to specific, agreed upon memories (rather than leaving the processing open for you to free associate to anything that naturally comes up). If find yourself feeling much worse between sessions, it might be a good idea to discuss making a processing modification with your therapist.
Why is it normal to feel drained or irritable after EMDR therapy trauma processing?
It can be normal to feel tired or even a bit irritable after an EMDR session. EMDR therapy is hard work. Think of it like going to the gym for your brain -- sometimes you feel a little sore in the process of getting stronger. In EMDR therapy, your brain is working hard to make new neural connections and to integrate these experiences in more adaptive ways. This takes energy, which is why you might notice that you feel tired after a therapy session -- and this fatigue can in turn make you a bit irritable. This is all normal, but it's definitely worth sharing with your therapist -- especially if you find it to be negatively impacting certain areas of your life, like work or school, relationships, or your ability to carry out your responsibilities.
Why is it normal to have vivid dreams or nightmares after EMDR therapy trauma processing?
It can be normal to have vivid dreams or even nightmares after an EMDR processing session. The bilateral stimulation that we use during EMDR processing is the same mechanism that your body naturally uses when you are in REM sleep, so you might find that in between sessions you brain continues to process some of the material explored in therapy. It can be helpful to explore these dreams in your next session with your therapist. Additionally, if these dreams are distressing or making it difficult for you to sleep through the night, you should share that with your therapist as well.
How can I navigate these "normal" post-EMDR feelings?
Before beginning EMDR processing, your therapist should have introduced a variety of grounding exercises to you. These grounding exercises are tools that you can use in between sessions to help you set aside intrusive thoughts or feelings until you are ready to be with them (and maybe that's not until your back in session with your therapist). You can practice deep breathing, take a moment to go to your peaceful place, or put the things that are not serving you away into your container.
Additionally, you should prioritize rest/getting enough sleep, practice self care, and communicate with your therapist how you are feeling.
What should I do if I feel worse after EMDR trauma processing?
If you feel worse after sessions and you find that grounding exercises are not cutting it, check in with your therapist. It's possible that you need additional support at the end of a session to contain the feelings that came up during processing so that you can continue to carry out your responsibilities throughout the week.
While EMDR processing may feel challenging, it should also feel manageable. If it's not and you notice yourself feeling worse and worse after each session, there are modifications that your therapist can make to restrict your processing to specific, agreed upon memories. Over time, you may build the capacity to process memories that previously felt too overwhelming, but this isn’t a requirement to benefit from EMDR.
When is it not normal to feel worse after EMDR sessions?
If notice yourself feeling worse and worse after each session without noticing any improvement, this is an indication that something isn't working. It's possible that EMDR trauma processing is pushing you too far outside of your window of tolerance. Perhaps you and your therapist need to slow down and focus more on building up certain skills before continuing with trauma processing, or you may need to discuss certain modifications that can make the processing more manageable for you. EMDR is not one-size-fits-all. Your therapist should work with you to develop a treatment plan that meets you where you are at.
When Not to Use EMDR
EMDR might not be appropriate for individuals:
Who are not yet able to stabilize themselves through grounding or affect management exercises, or who are not able to maintain dual awareness without significant dysregulation. More practice developing these skills may be necessary before moving onto EMDR processing.
Who are actively suicidal or who currently participate in self-harming behaviors. Therapy should center around ensuring safety and building coping skills before beginning EMDR processing. In the US, 24/7 mental health support is available by calling 988.
Who display high level of dissociative tendencies. Addressing dissociation should come before EMDR processing.
Who do not have appropriate support/stability outside of therapy. In these cases, therapists usually focus on stabilization before moving onto processing trauma.
What is the window of tolerance?
The “window of tolerance” is the emotional range where you can process difficult emotions without becoming overwhelmed or shutting down. EMDR works best when you stay within this window. A skilled therapist will help you stay grounded, using techniques to keep you from feeling too flooded or detached during sessions. If you feel worse after your EMDR sessions, it might suggest that you were pushed too far outside of your window of tolerance. If you suspect this, talk about it with your therapist and discuss processing modifications.
What are EMDR processing modifications?
EMDR processing modifications are changes that your therapist can make to processing in order to keep you within your window of tolerance. That said, you can even choose to start with a modification if you know from the beginning that there are certain memories that would be too overwhelming to process.
What is the ongoing process of healing?
The ongoing process of healing is another of way of saying that healing with EMDR isn’t always linear. You might notice gradual changes, like feeling lighter or less triggered by certain memories, while at same time feeling tired or drained after your sessions. This is normal. Over time, the distress associated with your trauma should fade, and you’ll start to notice greater benefits of the work you’re doing in therapy. Be patient with yourself and remember that healing is a process, not a quick fix.
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EMDR Therapy in NYC, Brooklyn, and Online
If you’re looking for an EMDR therapist that will listen to you and make modifications to suit your individual needs, don't hesitate to reach out. I'm a Brooklyn based therapist, and I offer online EMDR therapy for individuals located in the state of New York. Together we can process your trauma in a way that feels manageable to you.