Debunking Myths Around the ‘Dangers’ of EMDR Therapy for Eating Disorders

If you are considering Eye Movement Desensitisation and Reprocessing (EMDR), you may have come across warnings about the “dangers of EMDR therapy”. You may have read that EMDR can make symptoms worse, bring back difficult memories or leave people feeling overwhelmed.

In reality, risks are a more helpful term than dangers. EMDR is an evidence-based psychological therapy, but like any therapy, it is not entirely without risk. Trauma-focused work can temporarily increase difficult emotions, memories or physical sensations. This is one reason why EMDR should be delivered by a clinician who is appropriately trained and supervised, following careful assessment and preparation.

For people with eating disorders, there are some additional considerations because eating-disorder symptoms can themselves become ways of managing trauma. This means that the eating disorder and trauma often need to be understood and treated together.

Is EMDR therapy dangerous?

For most appropriately assessed people, EMDR delivered by a suitably trained clinician is considered a safe, evidence-based treatment for trauma and PTSD.

EMDR involves processing distressing memories while using bilateral stimulation, such as guided eye movements, tapping or sounds. A therapist should not simply ask someone to revisit traumatic experiences without preparation.

Before trauma processing begins, the clinician should understand the person’s history, current difficulties, risk and ability to manage distress. Preparation might include grounding and emotional regulation strategies and agreeing how to respond if difficult feelings emerge during or between sessions.

What are the potential risks and side effects of EMDR?

Potential risks and side effects of EMDR therapy may include:

• Temporary increases in emotional distress or anxiety.
• Vivid dreams, intrusive memories, distressing images or physical sensations during or between sessions.
• Emotional or physical tiredness following treatment.
• Increased feelings of dissociation or disconnection in some individuals.
• Difficulty managing distress when trauma processing is poorly timed or progresses too quickly.

These reactions do not affect everyone, and temporary discomfort does not necessarily indicate that therapy is causing harm. However, persistent or worsening symptoms should be discussed with the treating clinician.

More significant concerns include someone becoming persistently overwhelmed or destabilised, or experiencing increased dissociation – feeling disconnected from themselves or their surroundings. This is more likely to be a concern if trauma work is poorly timed, progresses too quickly or takes place without adequate preparation and support.

Trauma therapy can also bring forward memories or fragments of memories. EMDR should not be used as a method of “recovering” memories, and appropriately trained therapists should avoid suggestive questioning or assuming that emerging material is necessarily historically accurate.

Are there additional considerations when using EMDR for eating disorders?

Trauma and eating disorders can be closely intertwined. For some people, restriction, bingeing, purging, compulsive exercise or other eating-disorder behaviours can become ways of managing trauma symptoms. They may help someone numb difficult emotions, create a sense of control, or block or reduce overwhelming feelings, intrusive memories or flashbacks.

This does not make these behaviours safe. However, it is important to understand the function they may be serving.

Trying to remove eating-disorder behaviours without recognising and treating the trauma can leave someone exposed to distress that they previously managed through their eating disorder. Conversely, trauma-focused treatment such as EMDR can temporarily increase distress, which may increase someone’s urge to use eating-disorder behaviours to cope.

This interaction requires particular care when those behaviours already carry significant physical or psychological risk.

The answer is not necessarily to treat one problem completely before addressing the other. Sometimes physical health or particular eating-disorder symptoms need to be stabilised before beginning trauma processing. In other circumstances, addressing trauma alongside the eating disorder may be important in enabling recovery to progress.

Where trauma and an eating disorder are significantly intertwined, treatment will therefore often benefit from a specialist multidisciplinary approach, rather than trauma therapy being provided by a sole clinician in isolation. This allows physical health, nutrition, eating-disorder behaviours, psychological risk, trauma symptoms and emotional distress to be considered and managed together.

What about EMDR and neurodivergence?

Being autistic or having ADHD does not make EMDR inherently unsafe, but the approach may need adapting.

Neurodivergent people may experience sensory stimulation, communication, emotional regulation or internal bodily sensations differently. Someone might benefit from a different pace, clearer explanations, additional preparation or an alternative to eye movements, such as tapping.

Good EMDR treatment should be responsive to the individual rather than expecting everyone to engage with the same protocol in exactly the same way.

How we approach EMDR safely at TLC

At The London Centre, EMDR is provided by clinicians who have undertaken specific training in the approach and receive appropriate clinical supervision. Crucially, trauma treatment is considered within the context of someone’s eating disorder and wider psychological and physical health.

Before recommending EMDR, we consider trauma symptoms, eating-disorder presentation, physical and nutritional health, dissociation, current coping strategies and wider psychological risk. We also consider whether eating-disorder behaviours may currently be helping someone manage trauma-related distress.

For more complex or higher-risk presentations, EMDR will usually form part of a specialist multidisciplinary treatment plan. This means we can monitor not only trauma symptoms, but also eating-disorder behaviours, nutrition, physical health and psychological risk as treatment progresses.

Sometimes the right decision will be to stabilise particular symptoms before beginning EMDR; sometimes EMDR can safely take place alongside eating-disorder treatment. These decisions are made collaboratively, with informed consent and ongoing review, rather than according to a rigid definition of when someone is “ready” for trauma therapy.

Understanding EMDR Risks and Seeking Support

EMDR can be an effective treatment for trauma, but understanding the potential risks and ensuring the right support is in place are important, particularly when an eating disorder is also present.

If you are considering EMDR therapy and are unsure whether it is appropriate for you, The London Centre can provide a specialist assessment to help you understand your options and identify the most suitable approach to treatment.

Get Eating Disorder Help and Advice.

Frequently asked questions about EMDR

How does EMDR compare with CBT for treating trauma, in terms of risk?

Both trauma-focused CBT and EMDR are established treatments for PTSD and can temporarily increase distress because they involve engaging with traumatic experiences. Neither is inherently more “dangerous”; appropriate assessment, clinician training, pacing and monitoring are important for both.

Why might EMDR carry extra risk for someone with an eating disorder or who is neurodivergent?

Eating-disorder behaviours may be helping someone manage trauma symptoms, so trauma work can sometimes increase the urge to use these behaviours. This is particularly important if those behaviours are already medically risky. Neurodivergent people may instead need adaptations to communication, pacing, sensory aspects of EMDR or emotional regulation support.

How can adverse reactions to EMDR be minimised or avoided?

Careful assessment, preparation and pacing are key. Treatment should be monitored and adapted according to how someone responds, rather than progressing through trauma processing regardless of increasing distress or risk.

What questions should you ask a clinic to check their EMDR safety practices before starting?

Ask about your therapist’s EMDR training and supervision, how they assess readiness for trauma work, how they monitor risk and manage dissociation or increased distress, and how treatment would be adapted for an eating disorder or neurodivergence. If you have an eating disorder, it is also worth asking how trauma treatment will be coordinated with your wider care.

A good provider should welcome these questions. Safe EMDR is not simply about following a protocol: it is about understanding the individual, the function their symptoms may be serving, and treating trauma, eating-disorder symptoms and risk carefully and sensitively together.