PublishedSep 4th, 2026•10 min read
Signs to Pause or Reassess EMDR: Fit and Readiness
Author
Marian Ting
LMFT
Clinical Reviewer
Katie Moran
LCSW
Pausing or reassessing EMDR is a normal part of good trauma care, not a sign of failure. EMDR (eye movement desensitization and reprocessing) is a structured, eight-phase trauma therapy. Pausing or reassessing means slowing the pace, returning to stabilization, or adjusting the plan when the timing or fit is not right. If you are in the middle of EMDR, considering starting, or wondering whether the pace needs to change, that kind of self-reflection is a sign you are engaged in the process, not a sign something has gone wrong.
This page covers how to think about EMDR fit, readiness, and when slowing down or adjusting the approach makes sense. It is for anyone considering EMDR or already in treatment who wants to understand what to watch for and how to talk with their therapist about it.
At-a-glance: EMDR fit and readiness
What EMDR is | A structured, eight-phase trauma therapy |
|---|---|
Stabilization first | Reprocessing only begins after preparation and grounding phases are adequately completed |
Readiness for EMDR | Enough stability and coping skills to process safely without becoming overwhelmed |
Signs to pause or reassess | Feeling destabilized or shut down, dissociating, distress that does not settle, new crises in your life, feeling stuck in treatment |
Pausing means | A normal pacing adjustment, not a failure or proof that EMDR does not work |
Signs EMDR is working | Memories feel less charged, fewer intrusive symptoms and triggers, feeling more grounded |
If you are in crisis | 988 Suicide and Crisis Lifeline (call or text 988) |
EMDR therapy at Octave | Fully licensed EMDR-trained therapists; avg $28/session through insurance |
How EMDR works: The eight phases and why stabilization comes first
EMDR has eight phases that can each take multiple sessions to complete. Trauma reprocessing, the part most people picture, does not start until adequate preparation and stabilization have been completed. An EMDR therapist who has trained with the EMDR International Association (EMDRIA) guides you through eight phases:
- Phase 1: History-taking, rapport-building, and having questions answered. Your therapist learns about your trauma history and gauges if EMDR is a good fit.
- Phase 2: Preparing and stabilizing through grounding techniques (e.g., imagining a calm place, breathwork, relaxation, self-compassion, and self-soothing). You test the bilateral stimulation (BLS), which often involves eye movements, body tapping, or auditory cues.
- Phase 3: Assessing memories to target first, based on how distressing they are. You also identify negative beliefs or fears they cause regarding yourself, others, or the world.
- Phase 4: Trauma reprocessing with BLS (bilateral stimulation) to generate new insight, perspectives, and emotional resolution. This occurs across multiple sessions, and your therapist checks in frequently to evaluate progress.
- Phase 5: Installing new perspectives and more positive or adaptive beliefs with BLS. Your therapist frequently measures how strongly the beliefs resonate on a physical, mental, and emotional level.
- Phase 6: Body scanning to further internalize the beliefs so they resonate even as you recall the traumatic memories. The body scan is to check for any lingering tension or challenge connected with the processing, so it can be addressed before the session ends.
- Phase 7: Closing sessions when reprocessing is unfinished by using grounding techniques. You are guided to set aside the therapy content so you are not feeling destabilized as you go about your day.
- Phase 8: Reevaluating at the beginning of each session to see how EMDR is affecting you, naming any positive or negative outcomes in your daily life, and tracking trauma symptoms.
Preparation and stabilization strongly impact how trauma reprocessing will go. You learn to use visualization, body relaxation, and emotion regulation skills to stay within your window of tolerance during reprocessing. The window of tolerance is the zone of nervous system regulation where you can process memories safely and effectively.
As described by Corrigan and colleagues in the Journal of Psychopharmacology in 2011, being outside that window can lead to hypoarousal (feeling numb or shut down) or hyperarousal (emotional flooding or panic). If during Phase 4 you enter either state, your therapist is there to help you re-regulate.
How to tell if you are ready for EMDR
Readiness for EMDR means having enough stability and coping skills to process difficult material without becoming overwhelmed or shut down. If you are unsure whether you are ready, that does not mean you never will be. Sometimes your therapist will focus more time in preparation so you can start using coping skills for trauma symptoms in daily life first.
Other times, EMDR might not yet be a good fit due to:
- Being in an active crisis: EMDR may not be suitable yet if there is self-harm, suicidality, untreated addiction, or psychosis. Sometimes these are trauma symptoms that EMDR can help treat after adequate stabilization. For example, the EMDR DeTUR protocol (Desensitization of Triggers and Urge Reprocessing, a specialized approach for reducing the pull of self-destructive urges) was developed for people experiencing active self-harm.
According to Adams and colleagues in the European Journal of Psychotraumatology in 2020, EMDR may be feasible for people with psychosis if adequate preparation comes first.
- High life instability: If you are undergoing a major life change or a destabilizing situation, you may not be in a space to start EMDR. Unstable housing, domestic violence, or lack of private space for sessions (if doing them virtually) can also make it difficult to engage safely.
- Severe and untreated dissociation: Dissociation is a nervous system response that can arise from trauma where you feel disconnected from your body, emotions, memories, or surroundings. Reprocessing may be delayed to focus on stabilization and coping skills. Careful assessment and preparation are the key.
According to Leeds and colleagues in the Journal of EMDR Practice and Research in 2022, therapist expertise is critical, and use of multiple targeted assessments (tools that screen for dissociative symptoms beyond standard questionnaires) is recommended.
- Inadequate therapist rapport: You need to feel safe enough to trust the EMDR process. If you have the impulse to perform or feel highly self-conscious, these might be signs you are still building trust. EMDR developer Francine Shapiro emphasizes in the 2001 book Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures that the therapist-client relationship is integral to a positive treatment outcome.
Each of these factors can be addressed with care and time. An attuned therapist will help you build the regulation skills needed to prepare you for EMDR later on.
Signs it may be time to pause or reassess EMDR
There can be clear signals that pausing, slowing, or adjusting the current approach is warranted. Often it involves returning to Phase 2 to increase stabilization and learn more coping tools before continuing. Signs include:
- Consistent overwhelm or shutdown: If you keep finding yourself outside your window of tolerance (overwhelmed, shut down, numb, or dissociated), adjustment may be needed. As described by van der Hart and colleagues in the Journal of EMDR Practice and Research in 2014, complex, longer-term trauma may require modifications to address reactions like dissociation, with prolonged preparation and more gradual exposure.
- Consistent flooding: If you keep feeling flooded during or after sessions, a pivot is warranted. Try to track how well you are able to function mentally and emotionally during the rest of your day. Some distress is normal, but if you are having flashbacks, nightmares, or other serious signs, let your therapist know.
- Life instability: If an unexpected crisis, unsafe situation, or major life change occurs, share it with your therapist. You might benefit from pausing EMDR and focusing on present-day challenges in therapy instead to rebuild stability or establish safety.
- Feeling stuck: You might feel stuck during BLS reprocessing, with little decrease in distress despite ongoing sessions. Your therapist may pause reprocessing to explore blocking beliefs: thoughts like "This will not work," "I do not deserve to feel better," or "Letting go means losing part of who I am." These are common and can reflect how your mind is trying to protect you, or fears of how change will impact the future.
Jim Knipe, creator of the Blocking Beliefs Questionnaire, notes in the 2014 book EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation that these moments call for shifting focus to the belief itself while continuing stabilization work.
Sometimes this reveals that your specific presentation, such as frequent dissociation or a complex trauma history, calls for more specialized support than your current therapist offers. That is not a sign anything has gone wrong. One benefit of a therapist network like Octave's is that you and your therapist can openly discuss what is working and, if needed, get referred to another provider within the network without starting your search over. Being upfront about your needs is a normal part of good trauma care.
These are all valid reasons to consider making treatment adjustments, not to conclude EMDR itself has or will fail to work for you.
Comparison table: EMDR is going well vs. time to pause or reassess
| Signal | EMDR is going well | Time to pause or reassess |
|---|---|---|
| During sessions | Activated but able to stay present | Consistently overwhelmed, shut down, or dissociating |
| Between sessions | Distress settles; you can use coping skills | Distress does not settle; you feel destabilized |
| Memories | Feel gradually less charged | Feel more intense with no relief over time |
| Life outside therapy | Stable enough to do the work | A new crisis or unsafe situation has arisen |
| What it means | Keep going, with normal ups and downs | Slow the pace, return to stabilization, or revisit the plan |
Pausing or slowing down is not failure
Adjusting the pace of therapy is a normal part of good clinical care, not a sign that something is not working. Options include adapted BLS sets, more gradual memory exposure, revisiting stabilization, or shifting focus temporarily to talk therapy or urgent present-day challenges.
A well-trained EMDR therapist expects this kind of friction and welcomes problem-solving together, even if raising it feels uncomfortable at first. You do not need a solution in mind; just be upfront about how you are feeling.
Recalling traumatic memories is naturally distressing. As long as you can stay in or return to your window of tolerance, moving through that distress, rather than avoiding it, supports memory integration and resolution. Your therapist will help you re-ground as needed. But trust your gut: if you are too overwhelmed, let them know you would like to pause.
How to tell if EMDR is working
Progress in trauma therapy comes with normal highs and lows, and a hard session is not the same as being stalled. Signs that EMDR is working include:
- Memories feel less charged and more settled in the past. Where a memory once triggered a full-body stress response, it starts to feel like something that happened rather than something happening right now.
- Fewer or less intense trauma symptoms such as intrusive thoughts, hypervigilance (being constantly on alert), or anxiety in daily life. You might notice you can drive past a place connected to the trauma without your heart racing, or that an unexpected loud noise no longer leaves you shaken.
- More capacity to stay grounded and cope with stress. Situations that used to knock you off balance for days may still be hard, but you recover more quickly.
- Less painful self-beliefs and fears, and a more adaptive perspective on the traumatic events. Where you once thought "It was my fault," you may start to believe, on a gut level, that you did the best you could.
These signs reflect EMDR's primary treatment goal: helping you feel more neutral when you recall the trauma without being triggered. This does not mean the memories will carry no emotion; sadness, anger, or grief may still come. But over time, those feelings tend to become more manageable rather than destabilizing. The positive beliefs reinforced through BLS, such as "I am safe now," "I did the best I could," or "I can trust myself," begin to resonate more fully, and physical reactions to the memories tend to ease.
Talk with a trauma therapist about whether EMDR fits
A note on crisis support
If you find yourself in an emotional crisis as you go through EMDR therapy, particularly if you are between sessions, please contact the 988 Suicide and Crisis Lifeline (call or text 988). If you are actively suicidal or in immediate danger, call 911.
How Octave supports you
Octave's trauma therapists are fully licensed, average 10+ years of experience, and include clinicians trained in EMDR who pace the work to your readiness. Octave does not work with trainees or pre-licensed associates, so the clinician guiding your EMDR brings real depth to stabilization, pacing, and knowing when to pause or adjust.
89% of Octave clients report a strong therapeutic alliance with their matched provider, and clients are 40% more likely to continue therapy at Octave than at other practices. Most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. 40 million Americans are in-network, FSA and HSA are accepted, and matching typically happens within 1-3 business days.
Octave is therapy only; if your care involves medication or a higher level of care, our Care Navigation team can help point you toward the right resources and coordinate with your providers. Exact costs vary by plan and are always confirmed before care begins.
Frequently asked questions about EMDR fit and readiness
EMDR is well-suited to processing distressing memories and trauma, and it is most effective once you have enough stability and coping skills to work through difficult material safely. If you are interested, a trained EMDR therapist will assess your readiness and history first, and will build stabilization with you before any reprocessing. Being unsure is normal, and the assessment is part of the process.
Consider pausing or adjusting if you feel consistently overwhelmed or shut down during or after sessions, if you dissociate during reprocessing, if distress does not settle between sessions, if a new crisis or unsafe situation arises, or if you feel stuck. These are signals to slow the pace, return to stabilization, or revisit the plan with your therapist, not signs that EMDR has failed.
No. Pausing, slowing the pace, doing more stabilization, or adjusting the plan are normal parts of good trauma care. Trauma processing is not linear, and a skilled therapist expects to adjust the pacing to keep the work tolerable. Needing to pause is information that helps tailor your care, not a personal failure.
EMDR may not be the right first step if you are in an active crisis, have severe untreated dissociation that needs stabilization first, lack grounding and coping skills, or do not have a safe environment for sessions. These are usually "not yet" rather than "never": stabilization work can build the foundation so EMDR can help later.
It can feel overwhelming, like being flooded by emotion, or shut down and numb, or you may dissociate (feel disconnected). These signal that processing has moved outside your window of tolerance. Tell your therapist; they can slow down, shorten the sets, or return to grounding so you stay within a range you can manage.
Signs of progress include memories feeling less intense or charged, fewer or less disruptive intrusions and flashbacks, and a greater ability to stay grounded. Progress is usually gradual and not linear, so small shifts and the occasional hard session are normal. Your therapist will track this with you.
Some people notice temporary effects between sessions, such as vivid dreams, fatigue, or heightened emotion. These are usually part of processing and settle with time and your therapist's support. If they are intense or persistent, that is worth discussing, and your therapist can adjust the pace.
Yes, EMDR can be delivered effectively in virtual sessions for many people, and Octave offers virtual, in-person, and hybrid care. A safe, private space and a trained therapist who paces the work matter more than the format.
Coverage for therapy, including EMDR, is common under mental health parity laws. At Octave, most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Exact costs vary by plan and are always confirmed before care begins.
Sources
Corrigan, F. M., Fisher, J. J., & Nutt, D. J. (2011). Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25(1), 17-25. https://doi.org/10.1177/0269881109354930
Adams, R., Ohlsen, S., & Wood, E. (2020). Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of psychosis: A systematic review. European Journal of Psychotraumatology, 11(1), 1711349. https://pmc.ncbi.nlm.nih.gov/articles/PMC7144286/
Leeds, A. M., Madere, J. A., & Coy, D. M. (2022). Beyond the DES-II: Screening for dissociative disorders in EMDR therapy. Journal of EMDR Practice and Research, 16(1), 25-38. https://doi.org/10.1891/EMDR-D-21-00019
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures (2nd ed.). New York, NY: Guilford Press.
van der Hart, O., Groenendijk, M., Gonzalez, A., Mosquera, D., & Solomon, R. (2014). Dissociation of the personality and EMDR therapy in complex trauma-related disorders: Applications in phases 2 and 3 treatment. Journal of EMDR Practice and Research, 8(1), 33-48. https://doi.org/10.1891/1933-3196.8.1.33
Knipe, J. (2014). EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation. Springer Publishing Company.
About the Author
Marian Ting
LMFT
I'm a licensed therapist who writes to help make therapy concepts more accessible. My focus areas include mood disorders, relationship trauma, and major life transitions. As I've learned through my own mental health journey, you don't have to push forward in solitude or work through hard things alone. Finding the right therapist fit can make a meaningful difference.
