How long does feeling worse after EMDR usually last?

There's no fixed timeline. Some people feel it ease before a session even ends, as their distress rating drops. For others, feelings or memories keep surfacing for a day or two afterward. Shorter sessions on smaller, everyday targets tend to settle faster than long sessions on heavier material.

What's the difference between normal 'worse before better' and EMDR making things worse?

Normal processing looks like a spike in distress that eases by the end of a session, plus maybe some tiredness or vivid dreams afterward. A more serious pattern is distress that stays high for days, keeps climbing, or leaves you unable to function normally. That second pattern deserves a professional's help, not just patience.

What should I do if I feel worse during self-guided bilateral stimulation?

Stop and ground yourself if your distress rises above about a 7 out of 10 and won't settle within a few minutes. Keep future sessions shorter and your target smaller. If the pattern keeps repeating, or feels like more than you can manage alone, bring it to a trained professional.

Does feeling worse mean EMDR isn't working?

No. A temporary spike often means a memory network is genuinely activated, which is part of how processing happens. It's not a scorecard. Plenty of useful processing also happens without a strong spike. Judge progress by the pattern across sessions, not by how any single session feels.

Is it normal to feel worse after EMDR at first?

Q: Is it normal to feel worse after EMDR at first?

Yes. Many people feel a temporary spike in emotion, memories, or fatigue during the first few sessions. EMDR's professional association calls this an abreaction and describes it as a normal, potential part of processing, not a sign of harm. Distress that keeps climbing instead of settling is a different, less common pattern worth taking seriously.

Yes, for many people. EMDR can stir up feelings, memories, or fatigue before things settle, especially in the first few sessions. This is a real, normal part of processing, not a sign anything is wrong, and it usually eases within hours to a couple of days. Distress that keeps climbing or won’t settle is different, and worth slowing down for.

Why do you feel worse before you feel better?

EMDR asks you to briefly hold a distressing memory in mind while you follow a moving light, tone, or tap: bilateral stimulation, the rhythm at EMDR’s core. Bringing a memory into focus activates it. Something that has been sitting quietly can feel louder before it feels resolved.

The EMDR International Association’s glossary has a name for this: an abreaction, a wave of strong sensation or emotion that surfaces during reprocessing. EMDRIA describes an abreaction as a normal, potential part of processing a target. The distress isn’t caused by the treatment itself; it comes from a memory network that is now switched on.

There’s a working theory for why the spike tends to fade rather than build. A 2012 review in the Journal of Experimental Psychopathology found that holding a memory in mind while tracking a second demanding task, like eye movements, taxes your working memory. That competition is thought to be why the memory loses vividness and emotional charge as a session continues, after its initial activation.

Is this backed by real research, or just something people say online?

It’s genuinely under-studied, but the evidence that exists points the same way. A 2020 review in BJPsych Open found only one small pilot study of internet-delivered, self-administered EMDR.

Of 15 people who enrolled, 11 finished, and symptoms briefly worsened in 3 of the 15 between the start of treatment and the end. By the 3-month follow-up, that same group reported feeling better rather than worse, and 55% of participants overall no longer met the criteria for PTSD. That’s close to the exact pattern this page is asking about: a temporary dip, not a lasting decline.

Therapist-led EMDR shows a similar pattern, though it’s tracked even less carefully. A 2025 review in Current Opinion in Psychology checked 51 randomized trials of EMDR for PTSD and found only 9 even mentioned adverse effects, with just 1 using a real, predefined method to track them. In 5 of those 9, patients did report adverse effects, typically mild and temporary. Feeling worse at first is a known, plausible pattern, just not measured as carefully as it should be.

How long does the “worse” part usually last?

There’s no fixed timeline. Some people feel it lift before the session ends, as their distress rating drops back down. For others, feelings, dreams, or memories keep surfacing for a day or two afterward. Shorter sessions on smaller, everyday targets tend to settle faster than long sessions on heavier material.

What should you do before anything else?

If you’re working through material on your own, three habits matter more than any technique.

Stabilize first. Spend a few minutes grounding yourself or picturing a calm place before you bring anything stressful to mind. That gives your nervous system somewhere to return to.

Go slow. Pick one small, specific target, not a whole chapter of your life, and keep sessions short. Small, manageable targets are far less likely to push you outside your window of tolerance, the zone where you can feel distress without being overwhelmed by it.

Know your stop conditions. If your distress rises above a 7 out of 10 on the SUDS scale, the 0-to-10 measure EMDR uses for distress, and won’t come back down within a few minutes, stop. Switch to grounding, and consider working with a professional on that material. Our guide to building an emotional safety plan walks through setting these limits before you need them.

Where does self-guided practice fit in?

Practicing bilateral stimulation on your own works best on everyday stress: a tense meeting, a rough week, a mind that won’t slow down. Heavy trauma calls for a trained professional beside you. Keeping targets small and sessions short is exactly how you keep any temporary dip small too. EmEase, a self-guided EMDR app, lets you set the pace of each session at app.emease.com, so practice stays a wellness habit rather than something that outpaces what you’re ready for.

When is “worse” something more than normal processing?

Usually just processing	Worth taking seriously
Distress spikes during a session, then eases by the end	Distress stays high for days and keeps climbing
Some tiredness, vivid dreams, or a few tears afterward	Feeling foggy, unreal, or unable to function day to day
Emotion clearly tied to the target you worked on	New, overwhelming memories surfacing that you didn’t choose

That second column is a different question from this one: whether EMDR can leave you worse off overall, not just uncomfortable at first. We answer that directly in can EMDR make things worse? If you’re unsure whether self-guided practice fits your situation at all, is self-guided EMDR safe? is the honest place to start.