When Should You Not Use EMDR?

Written By

Helen Kaminski, MSc

Updated:

Fact Checked

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EMDR (Eye Movement Desensitization and Reprocessing) is a popular psychotherapy treatment that has been widely used to help people recover from trauma, anxiety, panic, disturbing memories, and many other mental health disorders.

However, EMDR may not be suitable in some situations.

What is EMDR?

EMDR is a form of psychotherapy that helps people process traumatic memories and disturbing feelings much more quickly than just talking to a therapist.

EMDR utilizes bilateral stimulation (BLS), such as side-to-side eye movements or taps, while focusing on past memories or current distress.

The goal of EMDR is to help your brain process experiences that are "stuck" and causing problems.

EMDR can help with PTSD, anxiety, panic attacks, grief, disturbing memories, and more by unblocking previous negative experiences that are continuing to negatively impact you.

When Should EMDR Be Avoided?

While EMDR can provide tremendous relief for many people, there are some situations where it is not recommended:

During a Crisis or Very High Stress

  • If you are currently in the middle of a severe life crisis or trauma, it may be better to wait until you are in a more stable place before undergoing EMDR.

If You Have Severe Mental Illness

  • Those with psychotic disorders, personality disorders, dissociative identity disorder, or substance use disorders tend to do better with other therapeutic approaches until their condition is more stabilized.

If You Cannot Tolerate High Emotion

  • EMDR often brings up intense and painful emotions and body sensations – if you have trouble managing this, EMDR may overwhelm you.
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Other Considerations About EMDR

There are some other important things to consider regarding the suitability of EMDR:

It Requires a Solid Therapeutic Relationship

Having a strong, trusting bond with your therapist is key to effective EMDR work. If you have just started with a new therapist, it is often better to spend some time building rapport in talk therapy first.

It May Seem to Get Worse Before Improving

As EMDR accesses traumatic memories to reprocess them, symptoms sometimes get worse before they get better. So being prepared for an emotional rollercoaster ride is important.

Multiple EMDR Sessions Are Typically Needed

Rarely does EMDR resolve complex trauma or deeply rooted problems in just one session. Being patient with the process and allowing sufficient time is vital.

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Deciding if EMDR is Right for You

Determining if EMDR is appropriate and likely to be helpful given your specific situation is an important conversation to have with the therapist you are considering working with. Every person and their needs are unique.

Being completely open about your symptoms, history, support system, and ability to handle high emotions will allow your therapist to guide you on the best treatment plan.

When to Proceed Cautiously With EMDR

While the above situations may rule out EMDR if currently present, there are some additional cases where proceeding cautiously and slowly with EMDR is wise:

If You Have a History of Severe Trauma

  • Those with developmental trauma, chronic abuse/neglect, attachment wounds or multiple previous traumas often need the therapeutic relationship and coping skills built up first.

If You Struggle with Emotion Regulation

  • Having solid emotion regulation skills before accessing highly emotional memories helps keep things from spiraling out of control. Doing pre-EMDR work on feeling identification, tolerance, and management is key.

If You Feel EMDR is Rushed

  • Therapist experience and proper session pacing are vital – if EMDR moves too fast before you are truly ready to process things, it can risk being ineffective or emotionally harmful.
The decision about using EMDR requires understanding your trauma and mental health history, evaluating your current stability and coping capacity, assessing life circumstances, and determining emotional readiness. 

Moving too quickly into EMDR can risk poor treatment outcomes while avoiding EMDR when it could help allows ongoing suffering. As with any therapy, it is all about proper fit and timing.

What is EMDR Therapy?

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About the author

Helen Kaminski, MSc

Helen Kaminski, MSc

Mindful living for a happier, healthier you. I’m a writer and mental health advocate in Warsaw, Poland, with five years working as a therapist. I hold a psychology degree from the University of Warsaw. I specialize in writing about mental health, using my experiences and academic background to educate and inspire others. In my free time, I volunteer at a Disability Learning Center and go for nature walks. My writing aims to break down mental health stigma and help others feel understood. Social

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