Is it Normal to Feel Worse After EMDR?

You've just completed an EMDR session, and instead of feeling relieved, you're feeling worse. Maybe you're more anxious, emotional, or physically uncomfortable than before therapy began. Is this normal? Should you be concerned?

The short answer: Yes, it's completely normal to feel worse after EMDR, especially in the first few sessions. This phenomenon is so common that therapists have a name for it: "processing symptoms" or "reprocessing effects."

Let's explore why this happens, what it means for your healing, and how to navigate this challenging but temporary phase of your EMDR journey.

Image credit: Taylor Grote on Unsplash

Why Do People Feel Worse After EMDR?

The Brain's Natural Processing Response

EMDR works by activating your brain's natural information processing system, which can temporarily intensify symptoms before resolution occurs. Think of it like stirring up muddy water—it gets cloudier before it settles clear.

Key reasons for feeling worse after EMDR:

1. Memory Network Activation

• EMDR deliberately stimulates traumatic memory networks
• These networks contain not just the target memory but connected emotions, sensations, and related memories
• Activation can temporarily increase access to distressing material
• Your nervous system responds as if the trauma were happening now

2. Ongoing Reprocessing Between Sessions

• Your brain continues processing after the session ends
• Dreams, memories, and emotions may surface throughout the week
• This continuation can feel like things are getting worse before they get better
• Your nervous system is essentially doing "homework" between sessions

3. Window of Tolerance Changes

• EMDR temporarily reduces your window of tolerance (ability to handle emotional intensity)
• You may become more sensitive to triggers and stressors
• Everyday situations that usually feel manageable might feel overwhelming
• This is temporary while your nervous system reorganizes

4. Access to Deeper Material

• Sometimes processing one memory unlocks access to related, deeper trauma
• You might become aware of additional issues that weren't conscious before
• This can feel like you're uncovering more problems than you're solving
• Actually, this is part of the comprehensive healing process

The Healing Crisis: Temporary Discomfort Before Breakthrough

Many healing processes follow this pattern: things get worse before they get better. This "healing crisis" is actually a positive sign that your nervous system is actively reorganizing and integrating new information.

What this means:

• Your brain is actively processing and integrating difficult material
• Old neural pathways are breaking down while new ones form
• Your nervous system is learning to respond differently to old triggers
• You're moving through rather than avoiding trauma material

Image credit: Taylor Grote on Unsplash

Common Post-EMDR Symptoms

Emotional Symptoms

Intensified Emotions:

• Increased anxiety, fear, or sadness
• Anger or irritability that seems disproportionate
• Emotional sensitivity to everyday stressors
• Feeling emotionally raw or vulnerable

Memory-Related Changes:

• Increased vividness of traumatic memories
• More frequent flashbacks or intrusive thoughts
• Dreams about therapy material or related events
• Sudden recall of additional memories

Physical Symptoms

Somatic Manifestations:

• Increased muscle tension or pain
• Headaches or migraines
• Fatigue or exhaustion
• Sleep disturbances or nightmares
• Stomach issues or digestive discomfort

Cognitive Effects:

• Difficulty concentrating or making decisions
• Feeling confused or disoriented
• Negative thought patterns resurfacing
• Questioning the therapy or progress

Behavioral Changes

Social and Relationship Impact:

• Withdrawal from social activities
• Increased conflict in relationships
• Difficulty with work or daily responsibilities
• Increased need for alone time

Timeline: What to Expect and When

Immediate After-Effects (First 24-48 hours)

Most common symptoms:

• Emotional intensity and sensitivity
• Physical exhaustion and tension
• Difficulty sleeping or processing dreams
• Feeling "off" or disconnected

What helps:

• Extra rest and sleep
• Gentle movement or stretching
• Warm baths or comfort measures
• Limiting stressful activities

Short-Term Processing (First 1-3 days)

Typical experience:

• Continued emotional processing
• Additional memories or insights surfacing
• Oscillating between better and worse periods
• Increased need for self-care

Support strategies:

• Journaling experiences and insights
• Using grounding techniques learned in therapy
• Staying in contact with your therapist
• Self-compassion and patience

Medium-Term Integration (First 1-2 weeks)

Common patterns:

• Gradual stabilization of symptoms
• Increased clarity and insight about processed material
• Improved emotional regulation (between processing periods)
• Beginning to see lasting changes

Healing indicators:

• Memories feeling less emotionally charged
• Improved sleep and physical symptoms
• Better ability to handle everyday stressors
• Noticing positive changes in responses to triggers

Image credit: Robina Weermeijer on Unsplash

When to Be Concerned: Red Flags

While feeling worse after EMDR is normal, some symptoms warrant contacting your therapist sooner rather than waiting for your next scheduled session.

Contact Your Therapist If:

Severe Symptoms:

• Suicidal thoughts or urges
• Inability to care for yourself (eating, sleeping, hygiene)
• Psychotic symptoms (hearing voices, severe dissociation)
• Risk behaviors toward yourself or others

Prolonged Intensity:

• Symptoms not improving after 3-4 days
• Getting worse rather than better over time
• Inability to function at work or in relationships
• Symptoms more severe than before therapy began

New Concerning Behaviors:

• Substance use increase
• Self-harm behaviors
• Dangerous risk-taking
• Complete emotional shutdown

Emergency Support Options:

Immediate help resources:

• Crisis lines: 988 in US/Canada, 111 in UK
• Emergency services: 911 or local emergency number
• Hospital crisis centers: Most have 24/7 services
• Your therapist's emergency contact: Most provide this for established clients

Supporting Yourself Through Processing

Immediate Self-Care Strategies

Grounding Techniques:

• 5-4-3-2-1 method: Name 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, 1 thing you taste
• Temperature changes: Hold ice, splash cool water, use warm compress
• Movement: Gentle stretching, walking, or yoga
• Sensory input: Strong tastes (mint), smells (essential oils), textures (blanket)

Emotional Regulation:

• Breathing exercises: Box breathing, diaphragmatic breathing
• Safe place visualization: Return to your EMDR safe/calm place
• Resource tapping: Tap alternating sides while recalling positive resource
• Self-soothing: Wrap in blanket, listen to calming music, hug pillow

Physical Comfort:

• Hydration and nutrition: Water, balanced meals, limit caffeine and alcohol
• Gentle exercise: Walking, swimming, or restorative yoga
• Sleep hygiene: Consistent schedule, comfortable environment
• Body care: Warm baths, massage, stretching

Creating a Supportive Environment

Reduce External Stress:

• Limit social obligations: Cancel non-essential activities
• Communicate needs: Tell supportive people you're processing
• Create sanctuary: Make your home environment peaceful and safe
• Set boundaries: Protect your time and energy

Processing Support:

• Journaling: Write down memories, dreams, insights
• Creative expression: Art, music, or movement for processing
• Mindfulness: Gentle awareness without forcing specific outcomes
• Patience practice: Accept healing unfolds at its own pace

Working With Your Therapist

Communicating Your Experience

Before Next Session:

• Be specific about symptoms: What you're feeling, where in your body, when it's worse
• Track patterns: Note when symptoms improve or worsen
• Document insights: Write down any understanding or reframing that emerges
• Rate your distress: Use SUD scale (0-10) for objective measurement

Questions to Discuss:

• "Are these symptoms normal for my stage of processing?"
• "Should we adjust our approach or timing?"
• "Do I need additional resource development?"
• "What can I expect in the next phase?"

Treatment Adjustments

Your therapist might suggest:

Pacing Changes:

• Shorter processing periods per session
• More focus on resource development
• Longer stabilization phases between processing
• Breaking targets into smaller pieces

Technique Modifications:

• Different bilateral stimulation methods
• Slower or faster stimulation
• More frequent grounding breaks
• Additional cognitive interweaves

Support Enhancement:

• More frequent check-ins between sessions
• Additional coping skill development
• Referral for adjunctive therapies (medication, group therapy)
• Crisis planning and safety measures

Image credit: Taylor Grote on Unsplash

The Bigger Picture: Understanding Your Healing Journey

Processing as Progress

Feeling worse after EMDR can be discouraging, but it's actually a sign that the therapy is working. Your nervous system is:

• Integrating difficult material: Rather than avoiding or suppressing it
• Reorganizing neural pathways: Creating new, healthier patterns
• Developing new coping: Learning to regulate more effectively
• Processing related memories: Addressing connected trauma networks

Trusting the Process

Remember:

• Healing isn't linear: You'll have good days and bad days
• Intensity reflects activity: Strong emotions mean processing is active
• Your body knows timing: Trust your need for rest and care
• Temporary nature: These symptoms will decrease as integration completes

Long-Term Benefits

After processing stabilizes:

• Reduced trigger responses: Old situations won't affect you the same way
• Improved emotional regulation: Better ability to handle stress and emotions
• Physical symptom relief: Reduced tension, pain, and somatic complaints
• Increased life satisfaction: Better relationships, work performance, and overall wellbeing

Special Considerations

For Complex Trauma Survivors

If you have:

• Multiple trauma experiences
• Developmental trauma (childhood abuse or neglect)
• Dissociative tendencies
• Limited support systems

You might experience:

• More intense processing symptoms
• Longer integration periods
• More frequent need for stabilization
• Benefit from slower pacing

For Highly Sensitive People

If you're naturally:

• Emotionally sensitive
• Easily overwhelmed
• Prone to anxiety or depression
• Responsive to environment

Consider:

• Longer preparation phases
• More resource development
• Gentle processing approaches
• Extensive self-care planning

For Those with Limited Support

If you have:

• Limited family or friends
• Financial or work stress
• Health challenges
• Current life stressors

Your therapist might help you:

• Develop safety plans
• Access community resources
• Plan for practical needs
• Build support networks

When Processing Is Especially Difficult

Sometimes processing is more challenging than usual. This doesn't mean therapy isn't working—it might mean adjustments are needed.

Reasons for Difficult Processing:

External Factors:

• Current life stress or additional trauma
• Physical illness or hormonal changes
• Lack of sleep or self-care
• Substance use or medication changes

Processing Factors:

• Touching particularly painful material
• Multiple related memories activating
• Hitting resistance or defense mechanisms
• Insufficient preparation or resources

What Can Help:

• Temporary pause on new processing
• Return to resource development
• Different bilateral stimulation methods
• More frequent therapist contact

Looking Forward: Hope and Patience

The Healing Timeline

Everyone's healing timeline is unique, but patterns emerge:

First 1-3 sessions: Often most intense processing Sessions 4-8: Usually see significant symptom reduction Sessions 9-12: Often experiencing lasting positive changes Beyond 12: Consolidating gains and addressing complex issues

Celebrating Progress

Even when you're feeling worse, look for:

• New insights about yourself or your experiences
• Changed perspectives on old situations
• Increased emotional awareness and regulation capacity
• Better boundaries or relationships improvements
• Physical symptoms that are less intense than before

Trusting Your Capacity

Remember that you:

• Survived the trauma - you have strength and resilience
• Chose healing - you're actively working toward wellbeing
• Can handle this - your nervous system is capable of integration
• Deserve support - you don't have to do this alone

Conclusion

Feeling worse after EMDR is not only normal—it's often a sign that the therapy is working. Your brain is actively processing and integrating difficult material, which temporarily intensifies symptoms before resolution occurs.

Key takeaways:

• These symptoms are temporary and usually resolve within days
• Communication with your therapist is essential for support and adjustments
• Self-care isn't optional - it's crucial for healing integration
• Trust the process while advocating for your specific needs

If you're experiencing concerning symptoms or feeling overwhelmed, reach out to your therapist or appropriate crisis resources. Healing happens in community and with support—not in isolation.

Your willingness to feel and process these difficult emotions is actually a sign of incredible courage and commitment to your healing. Even when it feels like you're moving backward, you're building the foundation for lasting healing and transformation.

Image Credits:

• Person processing emotions after therapy: Taylor Grote on Unsplash
• Person feeling emotional after processing: Taylor Grote on Unsplash
• Journaling and self-care after therapy: Robina Weermeijer on Unsplash
• Therapist and client discussing progress: Taylor Grote on Unsplash

This article is for informational purposes only and does not constitute medical advice. If you're experiencing severe symptoms or crisis, please contact your therapist, crisis services, or emergency services immediately.