Who Should Not Do EMDR: Honoring Readiness in the Healing Process

Eye Movement Desensitization and Reprocessing (EMDR) is a powerful therapy that has helped millions of people find relief from trauma, anxiety, and distressing memories. It is often praised for its ability to create deep shifts in a relatively short period of time. However, while EMDR can be transformative, it’s not the right fit for everyone at every stage of their healing journey. And that’s okay.

In a culture that often glorifies speed and productivity, it can feel disheartening to hear, “Now’s not the time.” But sometimes, the most healing choice we can make is to listen to the part of us that says, “Let’s slow down.”

This blog is for those who are wondering if EMDR is right for them—or right for them right now. It’s also for the therapists, loved ones, and caregivers walking alongside someone who may be considering EMDR.   This post will gently walk you through situations where EMDR may not be appropriate right now, and why pressing pause could actually be a profound act of self-compassion.

EMDR, What is It? What Makes EMDR Unique and Why That Matters

Before we explore who might not be ready for EMDR, it helps to understand a bit about how it works.

EMDR is an eight-phase, structured therapy that involves recalling distressing events while simultaneously engaging in bilateral stimulation—usually through eye movements, tapping, or auditory tones. This process helps reprocess traumatic memories so they no longer carry the same emotional intensity. It’s not about forgetting the memory—it’s about the memory losing its grip on your nervous system.

But that “reprocessing” piece is what makes timing and readiness so essential. EMDR can stir up deeply rooted emotional material, and not everyone is equipped or supported enough to dive into that kind of work. That’s okay. Healing doesn’t have to be rushed.

7 People Who Should Not do EMDR

1. Individuals in Acute Crisis or Danger

If someone is currently in a situation where their safety is at risk—such as living in an abusive relationship, experiencing ongoing domestic violence, severe mental health concerns, or navigating a traumatic work or housing situation —EMDR is typically not recommended. The reason is simple but vital: EMDR requires a felt sense of internal and external safety.

In these cases, the priority must be immediate safety and stabilization. When someone is still in the midst of trauma or harm, their nervous system is in survival mode. Asking the brain to process past traumas while it's still enduring present trauma can be overwhelming and counterproductive.

What’s more helpful? In these situations, therapy may first focus on crisis intervention, safety planning, and building supportive resources before moving into deeper trauma work like EMDR.

2. Severe Dissociation Without Stabilization

Dissociation is a common response to trauma—our brain’s way of protecting us when things feel too overwhelming to process. But in some cases, dissociation can be persistent, severe, and even involve identity fragmentation, as seen in Dissociative Identity Disorder (DID).

EMDR can still be used with dissociative clients—but only when there’s been adequate preparation. Jumping into trauma processing too soon can destabilize someone who already struggles to stay grounded.

Signs that someone might need to delay EMDR:

• Frequent blackouts or lost time

• Feeling disconnected from their body or surroundings

• Difficulty staying present in session

• Parts of self that are frightened of trauma work

What’s more helpful? A skilled EMDR therapist trained in dissociation will often spend significant time in Phase 2: Preparation. This includes building internal communication between parts, grounding strategies, containment techniques, and safe/calm place work. These are not just helpful—they’re essential.

3. Unmanaged Substance Use

Substance use and trauma often go hand-in-hand. For many people, substances have been used as a way to numb pain or cope with overwhelming experiences. That makes sense.  

If someone is actively using substances—whether alcohol, drugs, or even certain medications that affect awareness—it may interfere with the ability to engage in EMDR effectively.

When under the influence, the brain’s ability to stay in the “window of tolerance” (the zone where someone can stay emotionally present without being overwhelmed or shut down) is diminished. EMDR requires being able to feel and track emotions without getting swept away by them.

Why it matters: Trauma reprocessing under the influence can feel chaotic or unsafe. It may also increase the risk of relapse if intense emotional material comes up without strong coping mechanisms in place.

What’s more helpful? Before starting EMDR, individuals with substance use challenges may benefit from harm reduction work, addiction treatment, or other support aimed at stabilization. Once there's more consistency in sobriety and emotion regulation, EMDR can be re-evaluated.

4. Unstable Mental Health Conditions

Individuals with certain untreated or severe mental health conditions—such as active psychosis, extreme paranoia, or bipolar disorder in an acute manic phase—may not be ideal candidates for EMDR until those symptoms are managed.

This isn’t because EMDR can’t be helpful—it absolutely can—but because trauma processing requires a relatively stable baseline. When someone is navigating intense delusions, hallucinations, or rapid mood cycling, the structure and containment needed for EMDR might not hold.

What’s more helpful? Stabilization through medication management, supportive psychotherapy, or psychiatric care can provide the groundwork needed. EMDR may still be possible in the future with collaboration between care providers.

5. Limited Coping Skills or Lack of Support System

EMDR can stir up strong feelings, body sensations, and even intrusive memories. Without solid coping skills or a reliable support network, clients may feel overwhelmed between sessions. That can lead to emotional flooding, avoidance, or even re-traumatization.

Things to ask before starting EMDR:

• Does the client have ways to calm their nervous system?

• Are they able to recognize when they’re outside their window of tolerance?

• Do they have someone safe to reach out to between sessions?

• Are they living in a relatively stable environment?

What’s more helpful? In these cases, the EMDR therapist will likely focus on resourcing—teaching containment strategies, emotional regulation, grounding techniques, and somatic awareness. These foundational tools are not just preparation; they’re part of the healing.

6. Pressure to Do EMDR Before Readiness

Sometimes clients—or even therapists—feel pressure to “hurry up and do the EMDR.” Maybe a client has read about how effective it is and wants to dive in right away. Or maybe there's a push from family members or insurance companies to "fix things fast."

But readiness isn’t about how long someone’s been in therapy or how severe their trauma is. Readiness is about regulation, trust, support, and internal capacity.

It’s okay to say: Not yet.

Starting EMDR before someone feels emotionally prepared can backfire. The therapeutic alliance matters. Feeling safe with your therapist matters. Learning how to stay grounded matters.

And sometimes, talking about trauma in a gentle, exploratory way is what’s most healing—long before any eye movements ever begin.

The question is not, “How quickly can I heal?” but rather, “What do I need right now to feel safe, supported, and whole?”

7. Medical Conditions That Interfere with Participation

In some rare cases, certain medical conditions—such as severe neurological impairments, seizure disorders, or conditions that make eye movement difficult—may require modifications or a reevaluation of whether EMDR is the best fit.

In many of these cases, EMDR can be adapted. Therapists might use tactile stimulation (like tapping) or auditory tones instead of eye movements. However, it’s important to consult with a medical provider and trauma-trained therapist before beginning EMDR if there are underlying health concerns.

Your body’s needs are not obstacles—they are messages. Listening to those messages is part of the healing.

“Not Now” Is Not “Never”

One of the most important takeaways is that not being ready for EMDR right now doesn’t mean you’ll never be ready. Healing is not linear, and it’s certainly not a race.

Some of the most profound EMDR work comes after months—or even years—of building trust, learning to regulate emotions, and getting to know the different parts of yourself. That foundation makes the processing work more effective, safer, and ultimately more transformational.

Trusting the Wisdom of Timing

Therapy is deeply personal. There is no one-size-fits-all approach, and EMDR is just one path among many. If you or someone you love isn’t ready for EMDR right now, that’s not a failure. It’s a sign of wisdom, discernment, and care.

Maybe what’s most needed is safety. Or regulation. Or kindness. Or even permission to rest.

A good EMDR therapist will never rush you. They’ll honor your pacing, listen to your needs, and help you build the internal strength to move forward—when you are ready.