Managing Reactions Between EMDR Sessions
EMDR therapy does not only occur during the therapy hour. As memory networks begin to activate and reorganize, clients may notice that processing continues between sessions. These experiences can include emotional shifts, changes in dreams, body sensations, or new insights emerging in the days following a session. Because of this, preparation often includes helping clients understand what may occur between sessions and how to respond to these experiences.
When clients are informed about these reactions in advance, they are often less likely to feel alarmed or overwhelmed when they occur. Preparation helps frame these experiences as part of the brain’s natural processing system rather than as a sign that something is going wrong.
Understanding Between-Session Processing
During EMDR therapy, memory networks associated with past experiences are activated and begin integrating new information. This process does not always stop when the session ends. Clients may notice continued shifts in emotions, thoughts, or physical sensations as the brain continues organizing and integrating material.
These experiences are often consistent with the Adaptive Information Processing model, which suggests that the brain naturally moves toward resolution when conditions support processing. As a result, between-session reactions are often a continuation of the work initiated during EMDR sessions rather than a separate or unrelated experience.
Helping clients understand this process can reduce confusion and support a sense of predictability. When clients recognize that these reactions are part of ongoing processing, they are often better able to observe them without becoming overwhelmed.
Common Reactions Clients May Experience
Clients may report a range of experiences between EMDR sessions. These can vary depending on the individual, the material being processed, and the level of activation during the session.
Some common reactions include:
emotional shifts, including temporary increases or decreases in distress
dreams related to therapy themes or past experiences
body sensations connected to previously processed material
new memories or associations emerging
cognitive insights or changes in perspective
These reactions are often temporary and may shift over time as processing continues. Providing clients with psychoeducation about these experiences can help normalize them and reduce uncertainty.
Normalizing and Monitoring Reactions
One of the most important roles of preparation is helping clients understand that these reactions are often expected. When clients know what to anticipate, they are more likely to interpret these experiences as part of the therapeutic process rather than as signs of regression or instability.
At the same time, it is helpful to encourage clients to observe and track their experiences without overanalyzing them. Simple tracking can provide useful information for both the client and therapist when reviewing progress in the next session. Tracking between-session reactions becomes clinically important as processing progresses. These observations help identify patterns, guide pacing decisions, and clarify how the client is responding outside of session.
Supporting Clients Between Sessions
In addition to tracking experiences, clients benefit from having clear strategies for maintaining stability between sessions. These strategies often build on the stabilization skills introduced during Phase 2 preparation, including grounding exercises, containment strategies, and emotion regulation techniques. Clinicians may also provide structured psychoeducation to help clients understand and respond to these experiences.
When to Adjust Stabilization or Pacing
While many between-session reactions are part of normal processing, there are times when clinicians may need to adjust stabilization or pacing. Indicators may include reactions that persist, intensify, or interfere with daily functioning.
When this occurs, therapists may revisit preparation strategies, strengthen grounding skills, or slow the pace of reprocessing. In some cases, additional assessment of dissociation or regulation capacity may be helpful in guiding treatment decisions. Clinicians can also review readiness factors described in How to Know When a Client Is Ready for EMDR when evaluating whether adjustments are needed.
When between-session reactions become more complex or difficult to interpret, clinicians may need to slow down, gather more information, and consider whether additional stabilization or pacing adjustments are needed.
Helping Clients Know When to Reach Out
Preparation conversations also include helping clients understand when it may be helpful to contact their therapist between sessions. While many reactions are expected and resolve on their own, some experiences may require additional support.
Providing clear guidance can help clients feel more confident about managing reactions while also maintaining safety. The When to Contact Your Therapist During EMDR Therapy guide offers a simple way to outline when additional support may be needed and how to respond to different types of reactions.
Integrating Between-Session Work Into Treatment Planning
Between-session reactions provide valuable clinical information. Observing how clients respond to processing outside of sessions can help therapists make more informed decisions about pacing, stabilization, and target sequencing. For example, clients who are able to notice and move through between-session reactions while maintaining daily functioning may be demonstrating readiness for continued processing. In contrast, clients who experience persistent distress, increasing dysregulation, or difficulty returning to baseline may benefit from additional stabilization before moving forward.
Tracking these patterns over time allows clinicians to adjust treatment in a way that reflects the client’s actual capacity rather than relying solely on in-session observations. This can be especially important when working with clients whose responses shift as deeper memory networks are activated.
Final Thoughts
Reactions between EMDR sessions are a common and often expected part of trauma processing. By helping clients understand these experiences, therapists can reduce uncertainty and support continued engagement in treatment. Preparation, psychoeducation, and stabilization strategies all play an important role in helping clients navigate between-session processing. When clinicians provide clear guidance and structured support, clients are better able to approach these experiences with confidence and maintain stability throughout treatment.
Supporting Clinical Decision-Making Between Sessions
Between-session reactions can provide valuable clinical information, but they are not always easy to respond to in the moment—especially when a client reaches out between sessions with increased distress or unexpected reactions.
If you’re looking for guidance on how to respond in these situations, the Managing Reactions Between EMDR Sessions Clinician Guide offers practical language, stabilization strategies, and decision-making support for common between-session scenarios.
For a more immediate, in-the-moment reference, the Quick Reference Tool: Managing EMDR Reactions Between Sessions provides a condensed version designed for quick clinical use.
Research References
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
de Jongh, A., Amann, B. L., Hofmann, A., Farrell, D., & Lee, C. W. (2024). The status of EMDR therapy in the treatment of posttraumatic stress disorder 30 years after its introduction. European Journal of Psychotraumatology, 15(1), 2287199. https://doi.org/10.1002/jts.23012
Hoppen, T. H., Lindemann, A. S., & Morina, N. (2022). Safety of psychological interventions for adult post-traumatic stress disorder: Meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events. The British Journal of Psychiatry, 221(5), 658–667.
https://doi.org/10.1192/bjp.2022.111
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