Find Your Best Trauma Therapy Match in 2 Minutes
Struggling to choose between EMDR and CBT for trauma recovery? This personalized assessment helps you discover which approach might work best for your specific needs and preferences.
You’ve been doing the research. You’ve read the success stories, maybe talked to friends who’ve tried it, and something in you is wondering — could EMDR help me?
That’s a brave question to sit with.
The honest answer is: EMDR is one of the most effective trauma therapies available, but it isn’t the right starting point for everyone. And knowing that isn’t a dead end — it’s actually one of the most useful things you can learn before beginning your healing journey.
This guide will help you understand who tends to do best with EMDR, who might need a different approach right now, and what your realistic path forward looks like — whatever that turns out to be.
Because the goal isn’t EMDR specifically. The goal is you feeling better. And there are more ways to get there than you might think.
What you’ll find in this guide:
- The conditions and situations where EMDR may not be the right fit
- What therapists look for when assessing EMDR readiness
- Effective alternatives if EMDR isn’t right for you yet
- How to take a clear next step — without having to figure it out alone
Who Is Not a Good Candidate for EMDR Therapy
EMDR has helped millions of people process trauma that felt impossible to move through with talk therapy alone. For many, it’s genuinely life-changing.
But effective trauma care isn’t one-size-fits-all — and a good therapist will always match the approach to the person, not the other way around.
There are certain situations where EMDR works best, and others where a different approach — at least to start — will get you further, faster. Understanding the difference isn’t about closing doors. It’s about finding the right door for where you are right now.
EMDR tends to work best when:
- You have a specific traumatic memory or event you’re working through
- Your mental health is reasonably stable between sessions
- You have basic emotional regulation skills, or are building them with support
- You’re not in active crisis or ongoing trauma exposure
- You have a therapist you feel safe with
You might be better served by a different starting point if:
- You’re currently managing active symptoms of psychosis, severe dissociation, or uncontrolled bipolar disorder
- You’re in early recovery from substance use
- You’re in a current crisis — housing instability, ongoing abuse, or acute suicidality
- You haven’t yet built the coping tools to stay grounded during intense emotional processing
None of these are permanent. Most are starting points — not endpoints.
In the sections below, we’ll walk through each situation in more detail so you can understand what it means for your specific path.
What a Good Therapist Looks For Before Starting EMDR
Before any reputable therapist begins EMDR with a client, they’ll spend time getting to know you — not just your trauma history, but your whole picture.
This isn’t gatekeeping. It’s good care.
EMDR works by helping your brain reprocess distressing memories while you stay grounded in the present. For that process to feel safe and be effective, a few things need to be in place first. A thorough assessment helps your therapist understand what those things look like for you specifically — and whether EMDR is the right tool to reach for now, or whether some groundwork would set you up for better results.
What therapists typically assess before recommending EMDR:
Emotional stability. Not perfection — but a baseline ability to move through difficult feelings without becoming overwhelmed or shutting down completely. This is sometimes called your “window of tolerance,” and it can be expanded with support before trauma processing begins.
Current life circumstances. Active crisis situations — ongoing abuse, housing instability, acute suicidality — need to be stabilised first. Processing old trauma while new trauma is still happening isn’t safe or effective.
Substance use. Alcohol and drugs interfere with how the brain consolidates memories. Most EMDR therapists ask for a period of sobriety before beginning, typically around 90 days.
Medications. Some medications, particularly high-dose benzodiazepines, can reduce the emotional activation that makes EMDR work. Your therapist may coordinate with your prescriber if this is relevant.
Coping skills. EMDR can bring up intense material between sessions, not just during them. Having grounding techniques and self-soothing strategies in place before you start makes the process significantly safer.
The therapeutic relationship. Research consistently shows that trust between client and therapist is one of the strongest predictors of therapy outcomes — with EMDR especially. Good therapists won’t rush this.
If any of these areas need attention first, that’s not a reason to give up on EMDR. It’s a roadmap. Many people spend a few weeks or months building these foundations — and find that the groundwork itself brings meaningful relief before trauma processing even begins.
Not sure where you stand? Our therapists offer an initial consultation to help you understand your options and what a realistic path forward looks like for you. [Get in touch here →]
What Social Media Gets Wrong About EMDR (And What It Gets Right)
If you’ve spent any time on therapy TikTok or trauma recovery forums, you’ve probably seen EMDR described as something close to a miracle. Breakthroughs in a single session. Decades of pain dissolving in weeks. Tears, then relief, then a whole new relationship with your past.
Some of that is real. EMDR genuinely does produce results that can feel remarkable — and faster than many people expect.
But the version that goes viral is almost always the highlight reel. And when people arrive at therapy expecting that experience, a few things can go wrong.
The myths worth clearing up:
“EMDR works for everyone with trauma.” Not quite. EMDR is highly effective for many trauma survivors — but the research is clear that certain conditions, timing factors, and life circumstances affect both safety and outcomes. A good therapist will always assess fit before recommending it.
“You can start EMDR right away.” Sometimes, yes. But for many people — especially those with complex or developmental trauma — some preparation work first leads to significantly better results. Rushing into trauma processing before the groundwork is laid can actually slow recovery down.
“If EMDR didn’t work for someone, it won’t work for me.” Therapy outcomes depend enormously on timing, therapist fit, and where someone is in their readiness. Someone who wasn’t a good candidate at one point in their life may do beautifully with EMDR later.
“If I’m not ready for EMDR, I’m not ready to heal.” This one matters. EMDR is one tool — a powerful one — but it exists alongside a whole landscape of evidence-based trauma treatments. Not being ready for EMDR right now says nothing about your capacity to heal. It just means your path might look a little different than the one you saw on Instagram.
The most important thing isn’t which therapy you do. It’s that you find an approach that’s right for you, with a therapist who takes the time to understand your situation fully.
Still figuring out what that looks like? We’re happy to help you think it through — no commitment required. [Send us a message →]
What Needs to Be in Place Before EMDR Begins
Perfect — that actually makes this section much stronger. The message becomes “whatever you’re dealing with, we likely have someone who works with that” rather than deflecting people away. That’s a real differentiator for a group practice and worth weaving in explicitly.
Writing the full section now:
Rewritten — “What Needs to Be in Place Before EMDR Begins”
One of the most common fears people bring to a first therapy appointment is “what if I’m too far gone for this to work?”
You’re not. But depending on where you are right now, EMDR might not be your first step — and understanding why can actually be reassuring, because it means there is a step, and it’s closer than you think.
Here’s what therapists look at when assessing EMDR readiness, and what each one means for your path forward.
Mood and emotional stability
EMDR works by activating distressing memories and reprocessing them while you stay grounded in the present. For that to work safely, you need a baseline level of emotional stability — not perfection, but enough steadiness that intense feelings don’t completely overwhelm your ability to stay present.
For people managing bipolar disorder, this typically means working toward mood stability first — often through a combination of medication management and foundational therapy — before trauma processing begins. The good news is that recent research has increasingly supported EMDR as an effective approach for people with bipolar disorder, with the right preparation and timing.
What this means for your path: Stability work isn’t a detour. For many people, it’s where some of the most meaningful early healing happens — and it sets the foundation for EMDR to work far more effectively when the time comes.
Dissociation and grounding
Dissociation — feeling detached from yourself, your memories, or your surroundings — is one of the most common responses to trauma. In its milder forms, it doesn’t necessarily prevent EMDR. In more significant forms, like dissociative identity disorder or severe depersonalisation, standard EMDR protocols need to be adapted or preceded by grounding and stabilisation work.
This isn’t because people with dissociative experiences can’t heal — they absolutely can. It’s because the reprocessing that happens in EMDR requires you to be present enough to stay anchored during the process. Building that capacity first makes the work safer and more effective.
What this means for your path: Specialised therapists work with dissociation directly, using approaches designed to build internal safety and grounding before any trauma processing begins. This work is meaningful and often profound in its own right.
Active psychosis
If someone is currently experiencing hallucinations, delusions, or significant difficulty distinguishing memory from present reality, EMDR isn’t appropriate at that time. The therapy relies on being able to hold a memory at a slight distance — to process it rather than re-live it — and active psychosis makes that distinction too fragile to work with safely.
This is a timing consideration, not a permanent verdict. Stabilisation, often through medication and reality-grounding support, creates the conditions where trauma work becomes possible.
What this means for your path: If this is where you are right now, the most important thing is getting the right support for stabilisation. A good therapist will work alongside your psychiatric care and help you build toward trauma processing when the time is right.
Personality disorders
Conditions like borderline personality disorder (BPD) are sometimes listed as EMDR contraindications — but this reflects older clinical thinking more than current practice. Many people with BPD have significant trauma histories, and trauma-informed approaches are often central to their healing.
What does matter is pacing and preparation. People with BPD often benefit from building emotional regulation and distress tolerance skills — sometimes through approaches like DBT — before or alongside trauma processing. With the right therapist and the right timing, EMDR can be a powerful part of recovery.
What this means for your path: A personality disorder diagnosis doesn’t close the door on EMDR or on healing. It means your therapist will want to understand you fully and build a treatment plan that meets you where you are — which is exactly what good therapy looks like for everyone.
Substance use and early recovery
Active substance use affects how the brain processes and consolidates memories, which reduces EMDR’s effectiveness and can make the emotional intensity of sessions harder to manage safely. Most therapists ask for a period of sobriety — typically around 90 days — before beginning trauma processing.
Early recovery is also a time that calls for its own focused support. Building the foundations of sobriety, establishing coping skills, and stabilising daily life are all meaningful therapeutic work — and they create the conditions for EMDR to work well when you’re ready.
What this means for your path: If you’re in early recovery, you’re already doing something courageous. Therapy during this period can focus on supporting that recovery and building the skills that will make trauma work more effective down the road.
Current crisis or ongoing trauma
Processing past trauma while present-day trauma is still happening — ongoing abuse, acute suicidality, severe housing or financial crisis — isn’t effective and isn’t safe. The nervous system can’t reprocess old wounds while it’s still managing current ones.
This doesn’t mean therapy has to wait. It means the focus shifts to safety, stabilisation, and practical support first. Getting those things in place is the therapeutic work at this stage.
What this means for your path: If you’re in crisis right now, the most important step is reaching out for support — whether that’s a therapist, a crisis line, or both. You don’t have to have everything figured out before you make contact. That’s what the first conversation is for.
Medications
Certain medications can affect how EMDR works — particularly high-dose benzodiazepines, which reduce the emotional activation that the therapy relies on. This doesn’t necessarily mean changing your medication, but it does mean your therapist will want to know your full medication picture and may coordinate with your prescriber if relevant.
What this means for your path: Medication isn’t a barrier — it’s part of the conversation. A good therapist will work with your existing care, not around it.
Whatever your situation, the most important thing to know is this: every one of the circumstances above has a path through it. At The Empowering Space, we have therapists who specialise in complex trauma, dissociation, personality disorders, co-occurring conditions, and early recovery — so wherever you’re starting from, we can likely meet you there.
Not sure what your starting point looks like? Tell us a little about where you are, and we’ll help you figure out the right next step. [Get in touch →]
Physical and Cognitive Considerations: More Flexible Than You Might Think
One of the things people are often surprised to learn about EMDR is how adaptable it is.
The name — Eye Movement Desensitization and Reprocessing — leads many people to assume the therapy literally requires eye movements. It doesn’t. Eye movements are one form of bilateral stimulation, but therapists are trained in several alternatives, and the research supports them equally.
This matters because many of the physical and cognitive factors that might seem like barriers to EMDR are actually well within what a skilled therapist can work around.
Visual impairments
If tracking eye movements is difficult or impossible — whether due to a visual impairment, a neurological condition like MS or Parkinson’s, or the effects of a stroke — bilateral stimulation can be delivered through sound (alternating tones through headphones) or touch (handheld tappers that alternate between hands). The mechanism of the therapy stays the same; only the delivery changes.
What this means for your path: A visual impairment is very rarely a barrier to EMDR. When you reach out to a therapist, simply mention it — they’ll let you know which alternatives they work with.
Seizure disorders
Rapid eye movements can theoretically trigger seizure activity in people with certain seizure disorders, so standard eye movement protocols aren’t used in those cases. Alternative bilateral stimulation methods — sound or touch — are typically used instead, and medical clearance from your neurologist may be part of the process.
What this means for your path: A seizure disorder doesn’t rule out EMDR — it just means a slightly more coordinated approach between your therapist and your medical team.
Cognitive impairments and traumatic brain injury
EMDR works most effectively when someone can hold a memory in mind, track sensations, and engage in a degree of self-reflection during the process. Significant cognitive impairments — from dementia, severe TBI, or other conditions affecting memory and executive function — can make this genuinely difficult.
In these situations, a therapist will assess carefully what’s realistic and may recommend approaches that place less demand on verbal and cognitive processing — somatic or body-based therapies, for example, can be particularly accessible.
What this means for your path: Cognitive differences don’t mean trauma healing isn’t possible. They mean the approach needs to be matched to you — and there are good options that don’t rely heavily on verbal or cognitive engagement.
Intellectual disabilities and autism spectrum conditions
Intellectual disabilities don’t automatically make EMDR unsuitable — but they do mean the therapist needs to adapt their approach to communication and pacing. Similarly, autism spectrum conditions don’t contraindicate EMDR, but sensory sensitivities, communication differences, and the importance of predictability and routine all shape how a skilled therapist will work.
What this means for your path: The key is finding a therapist with experience in neurodivergent-affirming care. The therapeutic relationship and the environment matter enormously here — and when those things are right, meaningful trauma work is absolutely possible.
Pregnancy
Pregnancy doesn’t automatically rule out EMDR, but it does add a layer of consideration. Some therapists prefer to wait until after delivery, particularly for intensive trauma processing, while others work carefully with clients during pregnancy depending on the nature of the trauma and the individual’s stability. This is always a collaborative, case-by-case decision.
What this means for your path: If you’re pregnant and considering therapy, bring it up in your first conversation. A good therapist will talk through the options honestly and help you decide what feels right.
Heart conditions and significant medical concerns
EMDR can bring up intense emotional responses, and for people with certain cardiac conditions, that intensity warrants a conversation with your doctor before beginning. Medical clearance isn’t always required, but it’s worth raising with your therapist so they can help you make an informed decision.
What this means for your path: This is a conversation, not a barrier. Being open with both your therapist and your doctor means you can make the right call together.
The through-line in all of this is the same: physical and cognitive differences change how therapy is approached, not whether healing is possible. A skilled, experienced therapist will adapt to you — not expect you to adapt to a rigid protocol.
Have a specific condition you’re wondering about? We’re happy to answer questions before you commit to anything. [Send us a message →]
What ‘Being Ready’ Actually Means (And Why It’s Not What You Think)
“Am I ready for therapy?”
It’s one of the most common questions people sit with before reaching out — and one of the most misunderstood. The short answer is: if you’re asking the question, you’re probably closer to ready than you feel.
Readiness for EMDR isn’t a fixed threshold you either meet or don’t. It’s more like a set of conditions that a good therapist will help you build toward — sometimes quickly, sometimes over several months — depending on where you’re starting from.
Here’s what readiness actually looks like in practice.
A therapeutic relationship you feel safe in
This might be the single most important factor in any trauma therapy — EMDR included. Research consistently shows that the quality of the relationship between client and therapist is one of the strongest predictors of outcomes, often more than the specific technique used.
For trauma survivors, trust doesn’t always come easily. Past experiences of betrayal, particularly by authority figures or people who were supposed to keep you safe, can make opening up feel genuinely dangerous. A good therapist understands this and won’t push you into trauma processing before that foundation of safety is real.
Building therapeutic trust isn’t a preliminary to the work. In many ways, it is the work — and for some people, it’s where the most profound early shifts happen.
What this means for your path: If you’ve had difficult therapy experiences before, or if trust feels like a significant hurdle, say so in your first session. A therapist worth working with will welcome that honesty and work at your pace.
Coping skills and self-soothing
EMDR can bring up intense material — not just during sessions, but sometimes in the days between them. Having a toolkit of grounding and self-soothing strategies in place before trauma processing begins means you can manage those moments without being overwhelmed.
These skills aren’t something you’re expected to arrive with. Building them is often one of the first things a therapist will work on with you — through breathwork, grounding techniques, visualisation exercises, and other tools that help regulate your nervous system. This phase of therapy is sometimes called stabilisation, and it’s genuinely therapeutic in its own right, not just a waiting room for the real work.
What this means for your path: You don’t need to have your coping skills sorted before you reach out. You just need to be willing to build them — and a good therapist will help you do exactly that.
Life circumstances that allow for some stability
Trauma processing asks something of you between sessions as well as during them. When day-to-day life is in acute crisis — ongoing abuse, severe financial stress, housing instability — the nervous system is already working at capacity just managing the present. Adding intensive trauma processing to that load can be too much.
This doesn’t mean your life needs to be calm or uncomplicated before therapy begins. Most people’s lives aren’t. It means that if there are immediate safety or stability issues, those become the first priority — and addressing them is the therapeutic work at that stage.
What this means for your path: Wherever you are, there is a starting point. Even in the middle of significant life difficulty, a therapist can help you stabilise, build safety, and work toward the conditions that make deeper healing possible.
A note on crisis
If you’re in crisis right now — if you’re having thoughts of suicide or self-harm, or if you’re in an unsafe situation — please don’t wait to reach out. You don’t need to be stable to ask for help. Reaching out is the first step toward stability.
If you’re in immediate danger, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988. They’re available 24 hours a day, seven days a week.
If you’re struggling but not in immediate crisis, we’d still encourage you to get in touch. Our therapists are experienced in supporting people through difficult periods — including helping you get to a place where deeper trauma work becomes possible.
Not sure if now is the right time? Reach out anyway. The first conversation is just a conversation — no commitment, no pressure, just a chance to talk through where you are and what might help. [Contact us here →]
Other Paths to Trauma Healing: What the Research Actually Shows
Here’s something the “EMDR vs everything else” framing misses entirely: some of the most effective trauma therapies in existence aren’t EMDR.
That’s not a consolation. It’s genuinely good news — because it means there are multiple well-researched, clinically supported paths to healing trauma, and the right one for you depends on your specific history, symptoms, preferences, and where you are right now. A skilled therapist doesn’t have one tool they apply to everyone. They have a full toolkit, and they help you figure out which approach — or combination of approaches — is most likely to work for you.
Here’s an honest look at what that toolkit contains.
Cognitive Behavioural Therapy (CBT) and its trauma-focused variants
CBT is one of the most extensively researched therapies in existence, with decades of evidence supporting its effectiveness for trauma, PTSD, anxiety, and depression. Trauma-focused CBT (TF-CBT) and Cognitive Processing Therapy (CPT) are specifically designed for trauma survivors and have strong track records across a wide range of presentations.
CBT works by examining the connections between thoughts, feelings, and behaviours — and gradually shifting patterns that are keeping you stuck. It tends to be structured and goal-oriented, which many people find reassuring, especially early in treatment.
Good fit for: People who prefer a clear, structured approach. Those working through a specific traumatic event or set of events. People who want to understand the “why” behind their symptoms.
Dialectical Behaviour Therapy (DBT)
Originally developed for people with borderline personality disorder, DBT has become one of the most effective approaches for anyone who experiences emotions intensely, struggles with self-destructive behaviours, or finds relationships particularly challenging.
DBT focuses on building four core skill sets: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. For trauma survivors — particularly those with complex or developmental trauma — these skills are often the essential foundation that makes deeper trauma processing possible later.
Good fit for: People with intense emotional responses. Those with a history of self-harm or suicidal ideation. Anyone with complex trauma who needs to build regulatory skills before trauma processing begins.
Somatic and body-based approaches
Trauma lives in the body as much as the mind — and for many people, approaches that work directly with physical sensation and nervous system regulation reach places that talk therapy can’t.
Somatic Experiencing, developed by Peter Levine, works with the body’s natural impulse to complete stress responses that got interrupted during trauma. Sensorimotor Psychotherapy integrates body awareness with trauma processing. Trauma-sensitive yoga offers a gentler entry point for people who find direct trauma work too activating.
These approaches can be particularly powerful for people with early developmental trauma, significant dissociation, or those who find talking about trauma overwhelming or re-traumatising.
Good fit for: People who feel disconnected from their bodies. Those for whom talking about trauma feels inaccessible or retraumatising. Survivors of early childhood or developmental trauma.
Internal Family Systems (IFS)
IFS works from the understanding that the mind is made up of different “parts” — each with its own perspective, feelings, and role — and that trauma often creates conflict or disconnection between those parts. The therapy works by building compassion and communication between them, rather than trying to eliminate or override difficult feelings.
Many people find IFS profoundly validating — particularly the core premise that no part of you is bad or broken, even the parts that have caused problems. It can be particularly effective for complex trauma, dissociation, and people who feel internally fragmented or at war with themselves.
Good fit for: People with complex or relational trauma. Those who feel internally conflicted or fragmented. Anyone who has felt like different parts of themselves want different things.
Accelerated Resolution Therapy (ART)
ART is a newer approach that combines elements of several evidence-based therapies — including some of the mechanisms used in EMDR — to achieve rapid symptom relief. Many people experience significant shifts in fewer sessions than traditional therapy, making it a strong option for people who want to move through specific traumatic memories efficiently.
Good fit for: People seeking relatively fast results for specific traumatic memories. Those who have tried other approaches without success. Anyone who responds well to structured, protocol-based treatment.
Narrative Therapy
Narrative therapy works from the premise that the stories we tell about ourselves shape our experience — and that trauma often creates a story of damage, powerlessness, or shame that doesn’t reflect the whole truth. The therapy helps people examine and rewrite those narratives, reclaiming a sense of agency and identity that trauma can strip away.
Good fit for: People processing grief, identity, or meaning-making alongside trauma. Those who want to reconnect with their own strengths and values. Anyone for whom the story they’ve told themselves about their trauma needs revisiting.
A note on medication
Medication isn’t a therapy on its own, but for many people it’s an important part of the picture — reducing symptom intensity enough that therapy becomes more accessible and effective. If you’re wondering whether medication might be right for you, that’s worth raising with your therapist or GP.
The honest truth is that most good trauma therapy doesn’t look like one clean approach applied from start to finish. It looks like a thoughtful clinician who understands multiple modalities, pays close attention to how you’re responding, and adjusts accordingly. At The Empowering Space, our therapists are trained across a range of these approaches — which means your treatment plan can be genuinely tailored to you, not just to whatever one therapist happens to specialise in.
Curious which approach might suit your situation? We’re happy to talk it through before you commit to anything. [Get in touch here →]
How to Find a Therapist Who Will Actually Get This Right
Reading through everything above, you might be feeling one of two things.
Either a quiet sense of clarity — a feeling that you understand your situation a little better now, and maybe have a sense of what your next step looks like.
Or something closer to overwhelm — because there’s a lot to hold, and figuring out where to start still feels daunting.
Both are completely normal responses. And both point to the same next step: finding a therapist who can sit with you, understand your specific situation, and help you make sense of what the right path forward actually looks like for you.
Here’s what to look for — and what to watch out for.
What good assessment actually looks like
A thorough EMDR assessment isn’t a checklist completed in a single session. It’s a process — usually spanning several appointments — during which a skilled therapist gets to know your history, your current symptoms, your support systems, and your goals. They should be asking questions and listening carefully to the answers, not moving quickly toward a predetermined conclusion.
Good assessment feels like being genuinely understood. It moves at a pace that feels manageable. And it results in a treatment plan that makes sense to you — one you’ve been part of shaping, not one that’s been handed to you.
Questions worth asking a potential therapist
You’re allowed to ask questions before committing to working with someone. In fact, a therapist who welcomes your questions is usually a good sign. Some useful ones:
- What does your assessment process look like before starting EMDR?
- What would you do if EMDR turned out not to be the right fit for me?
- How do you approach clients with [your specific situation — complex trauma, dissociation, bipolar disorder, etc.]?
- What other approaches do you work with alongside or instead of EMDR?
- What does a typical first few sessions look like with you?
You’re not being difficult by asking these. You’re being a thoughtful advocate for yourself — which is exactly the quality that tends to lead to good therapy outcomes.
Red flags to be aware of
Not every therapist who offers EMDR has the depth of training or clinical experience to use it well. A few things worth paying attention to:
Rushing toward EMDR without adequate assessment. A good therapist won’t suggest starting trauma processing after one session. If someone is pushing to move quickly, that’s worth questioning.
Dismissing your concerns or questions. Your hesitations deserve thoughtful responses, not reassurance designed to get you to commit. If a therapist seems impatient with your questions, trust that feeling.
Claiming EMDR works for everyone. It doesn’t — and a therapist who says otherwise either hasn’t encountered the research or isn’t engaging with it honestly.
No clear alternative if EMDR isn’t suitable. A well-trained trauma therapist has more than one approach. If EMDR is the only tool on offer, that’s a limitation worth knowing about.
Promising specific outcomes or timelines. Therapy outcomes are genuinely variable, and any therapist who promises you’ll be “healed in X sessions” is overstating what they can know.
On finding the right fit
Therapeutic fit — the sense that this particular person gets you, that you feel safe with them, that you can imagine being honest with them — matters enormously. Research consistently shows it’s one of the strongest predictors of outcomes, often more than the specific therapy used.
This means it’s okay if the first therapist you speak to isn’t the right one. It’s okay to have a consultation and decide it doesn’t feel right. Finding a good fit is part of the process, not a sign that something is wrong with you or with therapy.
At The Empowering Space, we work with a team of therapists with different specialisms, approaches, and personalities — partly because we know that the right fit looks different for every person. Our intake process is designed to match you with the therapist most likely to be a good fit for your specific situation, not just whoever has availability.
What the first conversation actually looks like
A lot of people imagine the first contact with a therapist as more daunting than it is. At The Empowering Space, reaching out doesn’t commit you to anything. It’s simply a chance to tell us a little about what you’re dealing with, ask any questions you have, and get a sense of whether we might be able to help.
We’ll ask you some questions about your situation. You can ask us anything you want. And together we’ll figure out whether working together makes sense — and if so, what that might look like.
There’s no script you need to follow. You don’t need to have your story perfectly organised or know exactly what kind of help you’re looking for. Coming with questions, uncertainty, or even just a vague sense that something needs to change is more than enough.
Ready to take that first step? We’d love to hear from you. [Contact The Empowering Space →]
Frequently Asked Questions: EMDR Not a Good Candidate
Who is not a good candidate for EMDR therapy?
Who is not a good candidate for EMDR therapy?
People who may need to do some preparation work before starting EMDR include those currently experiencing active psychosis, uncontrolled bipolar disorder, severe dissociative symptoms, or active substance use. People in acute crisis — including those experiencing suicidal ideation, ongoing abuse, or significant housing or financial instability — also typically need stabilisation support before trauma processing begins.
It’s worth saying clearly: most of these are timing considerations, not permanent verdicts. With the right support and preparation, many people who aren’t ready for EMDR today will be in a much stronger position to benefit from it in the future. And in the meantime, there are effective therapies that can begin right where you are.
Why would someone be deemed unsuitable for EMDR?
The core question a therapist is asking during EMDR assessment is: can this person stay grounded while processing intense material — and do they have the support and stability to manage what comes up between sessions?
When the answer is “not quite yet,” it’s usually because something important needs to be built first — emotional regulation skills, a stable therapeutic relationship, a safer living situation, or a period of sobriety. None of those are reasons to give up on healing. They’re the first chapters of it.
Can EMDR make trauma symptoms worse?
Yes — when it’s used with someone who isn’t ready, or by a therapist who hasn’t done adequate assessment. The most common negative effects are distressing thoughts or feelings arising between sessions. In more serious cases, where significant contraindications have been missed, EMDR can cause emotional flooding or psychiatric destabilisation.
This is why thorough screening matters so much — and why working with a well-trained therapist who takes assessment seriously makes a meaningful difference to your safety and your outcomes.
What are the dangers of EMDR therapy?
The risks of EMDR are low when it’s administered by a properly trained therapist with someone who has been appropriately assessed. The risks increase significantly when contraindications are missed, when assessment is rushed, or when a therapist lacks adequate training in recognising when EMDR isn’t appropriate.
Asking a potential therapist about their assessment process and their approach when EMDR isn’t a good fit is a completely reasonable thing to do — and their answer will tell you a lot about their clinical depth.
Who should not do EMDR treatment?
People who should wait before starting EMDR include those with active substance use, currently uncontrolled psychiatric symptoms, significant cognitive impairments that affect memory processing, or those in ongoing crisis situations. People who haven’t yet developed basic emotional regulation and grounding skills are also typically better served by building those foundations first.
None of this means those people can’t be helped — only that the help looks different at this stage than it will later.
When should EMDR not be used?
EMDR should be paused or reconsidered during active mental health crises, periods of acute life instability, or when someone is still in ongoing traumatic situations. Certain medication combinations — particularly high-dose benzodiazepines — can also reduce its effectiveness or make it inadvisable.
Timing in trauma therapy matters enormously. A good therapist will keep revisiting the question of what’s right for you as your circumstances change — rather than making a single decision and never revisiting it.
What are EMDR contraindications?
Clinical contraindications for EMDR include active psychosis, uncontrolled seizure disorders, active substance use, severe dissociative disorders, and high-dose benzodiazepine use. Significant cardiac conditions may require medical clearance before beginning. Many of the conditions that were historically considered absolute contraindications — including bipolar disorder and some personality disorders — are now understood to be more nuanced, with research increasingly supporting EMDR as part of treatment with appropriate preparation.
Can people with bipolar disorder do EMDR?
Increasingly, yes — with the right preparation and timing. Research has moved significantly on this question in recent years, and EMDR is now considered a potentially valuable part of treatment for many people with bipolar disorder, particularly given that trauma histories are common in this population and associated with more severe episodes.
The key factor is mood stability. Active manic or depressive episodes make trauma processing unsafe and ineffective. But with a stable mood baseline — often supported by medication and foundational therapy — many people with bipolar disorder are good candidates for EMDR.
If you have bipolar disorder and are wondering whether EMDR might be right for you, we’d encourage you to reach out. Our therapists have experience working with this population and can give you an honest assessment of where you are and what your options look like. [Get in touch →]
Is EMDR safe for everyone with PTSD?
Not without assessment. EMDR is highly effective for many people with PTSD — including complex PTSD — but co-occurring conditions, dissociative symptoms, current life circumstances, and medication all affect both safety and likely outcomes. A thorough assessment by a trained therapist is the only reliable way to know whether EMDR is right for your specific situation, and what preparation might be needed first.
What are alternatives to EMDR for trauma?
Several highly effective trauma therapies exist alongside EMDR. Trauma-focused CBT and Cognitive Processing Therapy have decades of research behind them. DBT builds the emotional regulation skills that make trauma processing possible. Somatic approaches like Somatic Experiencing work directly with the body’s stress responses. Internal Family Systems addresses the fragmented sense of self that complex trauma often creates. Accelerated Resolution Therapy offers faster symptom relief for specific traumatic memories.
Most good trauma treatment draws on more than one of these — a skilled therapist will help you understand which combination is most likely to work for you.
How do you know if you’re ready for EMDR?
Readiness for EMDR generally involves a few things being in place: reasonable mood stability, basic emotional regulation and grounding skills, a therapeutic relationship with enough trust to feel safe during intense processing, and a life situation stable enough to support the work between sessions.
But here’s the honest answer: you probably can’t fully assess your own readiness, and you don’t need to. That’s what the assessment process is for. If you’re wondering whether you might be ready — or wondering what you’d need to do to get there — the most useful thing you can do is talk to a therapist who can look at your specific situation clearly.
Wondering if you’re ready? That question is exactly what a first consultation is for. Ours are free, and there’s no obligation to commit to anything. [Book a free consultation →]
Can EMDR be harmful if done incorrectly?
Yes, significantly so. Inadequate screening, poor therapist training, or poor timing can cause re-traumatisation, emotional flooding, or serious psychiatric destabilisation in vulnerable individuals. This is why therapist training and certification matters — and why it’s reasonable to ask a potential therapist about their EMDR training, their assessment process, and how they approach clients for whom EMDR isn’t appropriate. The EMDR International Association provides a therapist verification directory if you want to confirm credentials.
Your Next Step Doesn’t Have To Be A Big One
You came to this article with a question — probably some version of “is EMDR right for me?” And the honest answer, as you’ve seen, is: it depends. On where you are right now, what you’re carrying, and what kind of support you have around you.
But here’s what doesn’t depend on any of that:
You deserve support. Whatever your history, whatever your diagnosis, whatever you’ve been told about yourself or your capacity to heal — you deserve care that meets you where you are and helps you move forward from there.
EMDR might be exactly the right tool for you. Or it might be something you work toward, with other meaningful healing happening in the meantime. Or the right path might look quite different from what you expected when you started reading — and turn out to be exactly what you needed.
A good therapist won’t tell you which of those is true before they’ve taken the time to understand you. But they can help you figure it out — and that figuring out, that first honest conversation about where you are and what you need, is often where the real shift begins.
What healing actually looks like
It rarely looks like a straight line. It usually looks like small steps that don’t feel significant in the moment, gradually adding up to something that does. It looks like reaching out when you’re not sure you’re ready. It looks like showing up to a first session with more questions than answers. It looks like finding, sometimes to your own surprise, that you’re more capable of change than you thought.
You don’t have to have everything figured out to begin. You just have to be willing to take one small step.
We’d love to be part of your story
At The Empowering Space, we work with people at every stage of their healing journey — including the very beginning, when everything still feels uncertain and overwhelming. Our therapists bring a range of specialisms and approaches, which means we can meet you wherever you’re starting from and build a path forward that’s genuinely tailored to you.
Whether EMDR turns out to be right for you or not, we’ll help you figure out what is.
The first step is simply reaching out. Tell us a little about where you are. Ask us your questions. Let us help you understand your options.
That’s it. That’s all the first conversation has to be.
We offer an initial consultation so you can get a sense of whether we’re the right fit — with no obligation to commit to anything.
Find Your Best Trauma Therapy Match in 2 Minutes
Struggling to choose between EMDR and CBT for trauma recovery? This personalized assessment helps you discover which approach might work best for your specific needs and preferences.
