You did the hard thing. You sat in the chair (or on your own couch, for telehealth), let your brain go where it usually refuses to go, and came out the other side. Then you got home and felt like you'd carried a couch up three flights of stairs. Or you cried at a truck commercial. Or you had a dream so vivid you woke up checking what year it was.
Welcome to the hours and days after EMDR. Most of it is normal, some of it is actually a good sign, and a small part of it is worth a call to your therapist. Here's how to tell the difference, and how to take care of yourself in between.
The short answer: It's common to feel tired, emotional, or a little stirred up for a day or two after an EMDR session, and to have vivid dreams. Your brain keeps processing after you leave. These effects usually settle before your next appointment. Distress that keeps climbing, sleep that stays wrecked, or urges to use or hurt yourself are reasons to reach out right away.
Why EMDR Keeps Working After You Leave
An EMDR session doesn't end with a clean click when the clock runs out. The memory you were working on is still "open," and your brain keeps sorting it while you drive home, make supper, and sleep.
Francine Shapiro, who developed EMDR, built this right into the protocol. Every session ends with a closure step where your therapist lets you know processing may continue and that new memories, dreams, or feelings may show up. That warning is in there because it happens a lot.
Sleep is probably part of the story. Harvard sleep researcher Robert Stickgold proposed that the back-and-forth attention in EMDR puts the brain into a state that resembles REM sleep, the stage where we dream and where the brain files away emotional memories. It's still a theory, but it fits what clients describe: the night after a session is often the most dream-heavy night of the week.
What's Common in the Day or Two After a Session
Bone-deep tired. Processing is work. A lot of people compare it to the day after a hard workout. A nap is not a character flaw.
Feelings closer to the surface. You might be teary, irritable, or bothered by things that usually roll right off.
Vivid or strange dreams. Sometimes about what you worked on. Sometimes about a goat driving your truck. Both count.
Old memories popping up. Something you haven't thought about in years shows up out of nowhere. That's your brain connecting the dots, not something new going wrong.
Body stuff. A mild headache, tight shoulders, tired eyes, feeling a little spacey.
Feeling flat. Some people feel not much of anything for an evening. That's often your nervous system taking a breather.
Feeling lighter. The part nobody warns you about: plenty of people notice the memory just doesn't hit as hard anymore.
Feeling Worse Doesn't Mean It Isn't Working
This is the part that makes people want to quit, so here's what the research actually says.
A 2023 study in the Journal of Traumatic Stress followed people with PTSD and psychosis, one of the groups clinicians worry about most, through EMDR and prolonged exposure therapy. About 46% had a spike in PTSD symptoms between sessions at some point. Those spikes had nothing to do with worse results or with dropping out of treatment.
An earlier trial in the same population found that people in trauma-focused therapy, including EMDR, had fewer adverse events than people sitting on a waiting list.
A 2024 trial of EMDR for people with personality disorders found that temporary jumps in distress were less likely during EMDR than during no treatment, and most people who kept going after a rough patch improved.
Translation: a rough couple of days usually means you're in the middle of the work, not that the work is failing. Staying stuck has its own costs.
Your After-EMDR Care Plan
1. Schedule like you know what's coming. Don't book a reprocessing session right before a performance review or a double shift. If you're at our Wheelersburg office, sit in the parking lot for five minutes before you pull out. On telehealth, don't go straight from EMDR into a Zoom call with your boss.
2. Be boring on purpose. Water, a real meal, an early bedtime. Your brain is doing renovation work. Give it supplies.
3. Use the skills you built in preparation. Before we ever start reprocessing, we practice tools like a calm place and a container exercise. They're made for exactly this moment. Use them on your couch, not just in our office.
4. Notice it, jot it, don't dig into it. Many EMDR therapists use a quick between-session log (sometimes called a TICES log: Trigger, Image, Cognition, Emotion, Sensation). A line or two in your phone's notes is plenty. Bring it to your next session. You don't have to solve anything at 11 p.m. on a Tuesday.
5. Go easy on the numbing. Alcohol, weed, a third energy drink, three hours of doomscrolling. They can take the edge off tonight, but they make it harder to notice what's coming up and often make tomorrow worse. If you're in recovery, a heavy session can stir up cravings. That's common, and it's something to tell your therapist, not hide.
6. Give your people a heads-up. "I had a heavy therapy day, I might be quiet tonight" saves a lot of misunderstandings at the supper table.
7. Move a little. A walk around the block, some stretching, a few minutes outside. Gentle beats intense.
When It's More Than Normal Processing
Call your therapist (don't wait for next week) if:
distress keeps climbing for several days instead of settling
you can't function at work or at home
nightmares or poor sleep stretch past a week or two
cravings or urges to use come back hard
old coping habits you'd left behind start creeping back in
If you're having thoughts of suicide or self-harm, call or text 988 (Suicide & Crisis Lifeline) any time, or call 911 in an emergency.
None of this means EMDR is wrong for you. It may mean slowing down, spending more time on stabilization, or choosing a different target. That's what good EMDR looks like: paced to you, not to a script.
How We Pace EMDR at Wildflower Wellness Group
At Wildflower, EMDR is never "dive in on day one." We start with history and preparation so you have tools before we touch the hard stuff. Every session ends with closure so you leave grounded, and every session starts by checking in on what showed up since last time. That between-session stuff isn't a side effect to ignore. It's information we use.
We offer EMDR in person at our Wheelersburg office for Scioto County, Lawrence County, and Southern Ohio, and by telehealth throughout Ohio. Josh Adkins, LISW-S, LICDC specializes in EMDR for trauma, including trauma that shows up alongside substance use. Kelsey Shepherd, LISW, LICDC offers EMDR by telehealth for kids, teens, and families.
New to EMDR? Start with EMDR Therapy in Wheelersburg, Ohio: What It Is, Who It Helps, and What to Expect, or read Do I Have to Talk About What Happened for EMDR to Work?
Frequently Asked Questions About the Days After EMDR
How long do side effects last after EMDR?
Most settle within a day or two and are gone before your next session. If something keeps getting stronger instead of fading, tell your therapist.
Why am I so tired after EMDR?
Reprocessing a memory is real mental and emotional work, and your brain may keep at it for hours afterward. Tiredness is one of the most common after-effects.
Is it normal to feel worse after EMDR before feeling better?
It's common. Research on trauma-focused therapy shows that temporary symptom spikes between sessions happen often and aren't linked to worse outcomes.
Can I go back to work after an EMDR session?
Many people do. For reprocessing sessions, a buffer helps, so try not to schedule high-stakes tasks right after.
Should I drink alcohol after EMDR?
It's best to skip it. Alcohol can blunt what you're noticing and make sleep and mood worse the next day. If you're in recovery, make a plan with your therapist for cravings after heavy sessions.
Why do I have weird dreams after EMDR?
Your brain keeps processing during sleep, especially REM sleep. Vivid dreams are one of the most commonly reported after-effects and usually ease within a few nights.
Ready to Talk About EMDR?
If you're wondering whether EMDR fits what you're carrying, we're glad to talk it through. Schedule an EMDR consultation or call 740-301-1039. Questions about cost? See our payment and insurance options, or learn more on our EMDR therapy page.
Research Behind This Post
Burger, S. R., et al. (2023). The bumpy road of trauma-focused treatment: PTSD symptom exacerbation in people with psychosis. Journal of Traumatic Stress, 36(2), 299–309. https://doi.org/10.1002/jts.22907
van den Berg, D. P. G., et al. (2016). Trauma-focused treatment in PTSD patients with psychosis: Symptom exacerbation, adverse events, and revictimization. Schizophrenia Bulletin, 42(3), 693–702. https://doi.org/10.1093/schbul/sbv172
EMDR treatment in patients with personality disorders: Should we fear symptom exacerbation? (2024). European Journal of Psychotraumatology, 15(1), 2407222. https://doi.org/10.1080/20008066.2024.2407222
Stickgold, R. (2002). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58(1), 61–75. https://doi.org/10.1002/jclp.1129
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
