Those looking for information about EMDR almost always find enthusiastic pages. They are written by professionals trained in EMDR — myself included — and this makes it difficult to form a balanced opinion.
This page attempts to do the opposite: to also talk about the limits, the possible side effects, and the situations in which EMDR is not the right choice. Not because I don't believe in it — I use it in my work — but because a person considering a course of treatment has the right to know this too.
The pros: what the evidence says
It is a recognized treatment for trauma. EMDR is recommended by international guidelines for post-traumatic stress disorder, based on controlled studies. It is not an alternative or niche technique: it is among validated treatments.
It often requires less time compared to other approaches for treating single, circumscribed traumas.
It doesn't require telling everything in detail. For those who struggle to put an experience into words — which often happens, especially with trauma — this is a concrete advantage.
It doesn't involve homework of an exposure-based type, which in other protocols is often the part where people give up.
The cons, stated honestly
The evidence is stronger for some disorders than others. For post-traumatic disorder, the evidence is robust. For other conditions — depression, eating disorders, addictions — the research is younger and the results less established. Those who present it as a solution for everything are going beyond what the data supports.
There is still debate about what the active ingredient is. Whether it is the bilateral stimulation itself or the exposure to the memory within a protected framework is still a matter of scientific debate. It works, but the mechanism is not as clear as popular accounts suggest.
It doesn't work for everyone. Like any treatment, it has non-response rates. It is not a flaw of the person when this happens.
The quality depends heavily on who conducts it. It is a structured eight-phase protocol, and skipping some phases — particularly preparation — not only makes it ineffective, but can be harmful.
Possible side effects
They exist, are generally temporary, and it's right to know about them beforehand.
- Temporary increase in emotional activation in the days following the session
- Vivid or disturbed dreams, or more restless sleep for a few nights
- Resurfacing of related memories that had not been the focus
- Intense tiredness after the session: reprocessing is exhausting
- Physical sensations such as headaches or tension, which usually resolve within a few hours
A therapist who works correctly will warn you about this first, closes each session by bringing you back to a state of balance, and gives you tools to use between sessions. If they don't do this, it's a warning sign.
“I feel terrible after EMDR”: why this happens
This is a frequent search and deserves a serious answer.
A temporary worsening in the following days can be within the norm: material that had remained stuck has been set in motion, and the system needs to readjust. It usually eases within a few days.
But it is not always physiological. Intense and prolonged distress can indicate that reprocessing began without sufficient preparation, that the stabilization resources weren't solid enough, or that the situation required different work before touching that material.
In both cases, the thing to do is the same: tell the therapist, right away, without waiting for the next session. A competent professional slows down, returns to stabilization or reconsiders the approach. If instead they minimize it or insist, you have a problem that isn't related to EMDR.
When it's not indicated
There are situations in which EMDR should be postponed, adapted, or excluded:
- Acute phases of psychiatric decompensation, where stabilization is the priority
- Active suicidal risk, which requires a different type of care
- Ongoing substance use, which interferes with reprocessing
- Absence of stabilization resources: in these cases it is not a definitive contraindication, but what is needed must be built first, and this can take months
- Situations of danger still ongoing: a trauma cannot be processed while it is still being experienced. Safety comes first.
- Certain medical conditions, such as epilepsy or eye problems, for which the stimulation methods need to be adapted
The assessment of all this takes place in the early stages of the protocol. This is why EMDR never begins in the first session.
Is it dangerous?
When conducted correctly, by a trained professional and within a structured process, no. The risks do not come from the technique itself but from applying it in the wrong context: without a preliminary assessment, without preparation, on conditions that require something else, or by someone without adequate training.
Before starting, you can ask the professional where they trained and whether they are registered with the professional register. These are legitimate questions, and a serious therapist will be happy to answer them.
On testimonials
Searching for information you will find many testimonials, both positive and negative. I suggest you take them for what they are: individual experiences, not proof of effectiveness.
You won't find any on this site. Not because there aren't satisfied people, but because publishing patient testimonials is a practice on which professional ethics in the healthcare field is restrictive, and because it wouldn't help anyway to understand whether this approach works for you. That is assessed together, in a consultation.
Frequently Asked Questions
What are the pros and cons of EMDR in summary?
In favor: documented effectiveness on trauma, often shorter timeframes, no need to describe everything in detail. Against: stronger evidence for some disorders than others, mechanism of action still debated, strong dependence on the practitioner's competence, possible transient emotional activation.
How long do the side effects last?
Generally from a few hours to a few days. If they last longer or are intense, this should be told to the therapist without delay.
Can I interrupt an EMDR session?
Yes, at any time. The person remains awake and in control throughout, and agreeing on a stop signal in advance is part of the preparation.
Can EMDR bring back memories I didn't remember?
Related memories not previously focused on may emerge. However, it must be clearly stated that memory does not work like a recording, and no serious approach claims to reliably recover “hidden” memories. This is not the purpose of EMDR.
Is it suitable for everyone?
No, and anyone who says otherwise is oversimplifying. The suitability is assessed case by case, after the initial consultations.
A journey in Florence or online
If you are considering a course of EMDR and want to understand whether it is suitable for your situation, you can contact me for an initial introductory session. I see clients in my practice in Florence, at Via Tommaso Campanella 5, in the Campo di Marte – Coverciano area.
You can find out how the protocol works in the article on EMDR therapy and how a session unfolds, and a general introduction on what EMDR is and what it is for.
If you're considering whether EMDR is right for you, here's how EMDR therapy works in Florence and when it's indicated.
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