What to Expect During and After EMDR Therapy

EMDR, or Eye Movement Desensitisation and Reprocessing, is a structured psychological therapy used particularly in the treatment of post-traumatic stress disorder (PTSD).

People often want to know what a session actually feels like, whether it is normal to feel emotional afterwards, and what they should do if memories, dreams or physical sensations become more noticeable between appointments.

The clearest research evidence concerns the effectiveness of EMDR for PTSD. The evidence about specific short-term reactions after individual sessions is much less developed, so it is important not to present a fixed list of “normal” after-effects as though everyone should experience them.

You can also read my main EMDR Therapy page for an overview of how I use EMDR in practice.

What Happens During an EMDR Session?

EMDR is a phased treatment. Before memory processing begins, therapy usually includes assessment, preparation and discussion of ways to manage distress if difficult material becomes activated.

During processing, you are asked to bring aspects of a distressing memory to mind while engaging in bilateral stimulation, most commonly eye movements. Taps or tones may also be used in some circumstances.

You may notice

changes in the emotional intensity of a memory
new thoughts or associations
shifts in bodily sensations
changes in how believable a negative belief feels

The aim is not

to make you as distressed as possible
to force you to disclose every detail
to rush into processing before preparation
to push through if the pace is not manageable

If you want more detail about the structure of a session, see What Does an EMDR Session Look Like?.

How Might EMDR Change a Distressing Memory?

The precise mechanisms of EMDR are still being studied. One of the better supported explanations is the working-memory account.

When a distressing memory is recalled while attention is also occupied by a second task, such as eye movements, both tasks compete for limited working-memory capacity. Experimental research suggests this can reduce the vividness and emotional intensity of the memory.

This does not mean the mechanism of EMDR is fully established. It is more accurate to say that working-memory explanations have empirical support while research into how EMDR produces change is continuing.

What Can Happen After an EMDR Session?

People describe a wide range of experiences after emotionally demanding therapy. These can include feeling tired, emotionally sensitive, thoughtful, unsettled or simply much the same as usual.

Some people also report vivid dreams, memories coming to mind, headaches or temporary changes in emotion. However, high-quality research has not established a reliable list of common EMDR-specific after-effects or how often each one occurs.

A 2025 review of 51 randomised controlled trials of EMDR for PTSD found that adverse effects were poorly and inconsistently reported. Only a minority of studies mentioned them at all, and systematic measurement was rare. Where adverse effects were reported, they were generally described as mild and temporary.

The important point is that you do not need to experience a particular reaction for EMDR to be effective.

Is It Normal to Feel Worse After EMDR?

EMDR involves working directly with distressing memories, so some emotional discomfort is possible. What the research does not support is the idea that feeling worse is automatically expected or proof that treatment is working.

If you notice a temporary increase in distress, that is useful information to discuss with your therapist. If the distress is substantial, persistent, difficult to manage or begins to interfere with everyday functioning, the pace and timing of further processing should be reviewed.

EMDR should be collaborative. You are not expected to simply push through because a session feels too intense.

How Long Do Reactions Last?

There is not enough good-quality evidence to give a reliable standard timeframe.

Statements such as “after-effects normally last 24 to 48 hours” are often repeated online, but current EMDR research has not measured post-session reactions consistently enough to establish that as a general rule.

If something lasts longer than you expected, becomes more intense or causes concern, speak to your therapist rather than assuming it is simply part of the process.

Tiredness, Dreams and Memories Between Sessions

Tiredness

Some people feel tired after emotionally demanding therapy, but fatigue has not been established as a specific or predictable side effect of EMDR. Sleep, stress, medication, physical health and other factors can also affect energy levels.

Dreams or memories

Some people notice dreams, thoughts or memories relating to therapy material. You do not need to analyse them or deliberately continue processing alone. A brief note can be enough if you want to discuss them next time.

If memories become highly intrusive or difficult to manage, contact your therapist sooner rather than waiting for the next appointment.

You may also find Self-Care Strategies to Support Your EMDR Therapy Journey useful.

What About Physical Sensations?

Emotional memories can be accompanied by bodily reactions such as changes in tension, breathing, heart rate or general arousal. These responses may become more noticeable when distressing memories are recalled.

It is not accurate to describe this as trauma being literally stored in, released from or discharged from a particular part of the body. Current evidence does not support that explanation.

New, severe or persistent physical symptoms should not automatically be attributed to therapy. They may need assessment by an appropriate healthcare professional.

What Should You Do Between EMDR Sessions?

notice anything significant without feeling you need to analyse it
make a brief note of memories, dreams, triggers or changes you want to discuss
use any grounding or regulation strategies agreed with your therapist
avoid deliberately pushing yourself into further trauma processing unless this has been specifically agreed
tell your therapist if the level of distress between sessions feels difficult to manage

What happens between sessions should be adapted to the individual rather than treated as a fixed EMDR rule.

When Should You Contact Your Therapist?

Contact your therapist if you experience a marked increase in distress, feel unable to manage what has emerged, notice significant dissociation or find that your usual functioning has become substantially more difficult.

If you are at immediate risk of harming yourself or someone else, seek urgent help rather than waiting for your next therapy appointment. In the UK, call 999 or go to A&E in an emergency.

EMDR Is Not the Same Experience for Everyone

Some people notice clear emotional or cognitive changes after a session. Others notice very little between appointments.

The evidence supports EMDR as a treatment for PTSD, but it does not support the idea that a particular after-effect must occur for treatment to be effective.

This is one reason I prefer to monitor how the therapy is affecting you rather than giving you a checklist of what you are “supposed” to feel.

Sources and Further Reading

Considering EMDR Therapy?

If you are considering EMDR, a free 15-minute consultation gives you an opportunity to briefly explain what you are experiencing and ask questions about whether EMDR or another trauma-focused approach may be appropriate.

Book a Free 15-Minute Consultation