Who should not do EMDR?
Written by the clinical team at The Lyceum Clinic. Clinically reviewed by Sanah Younis, Founder and Clinical Director, BABCP-accredited (no. 1000792). Published 28 October 2026. Last reviewed 28 October 2026.
Clinical perspective: The Lyceum's specialist therapist in EMDR.
What is the preparation phase, and why can it take more than one session?
Preparation (Phase 2) is building the brakes before we drive the car. We cannot open up a terrifying trauma box until I know you have the neurological tools to close it again. We install a 'Safe Place' and grounding techniques. If someone has complex trauma, this can take weeks. If we rush into processing without an anchor, the client will just re-traumatise themselves and dissociate.
What happens if someone is still in danger?
If the client is still living with an abuser or in active danger, we DO NOT do trauma memory processing. Processing breaks down defences, and they currently *need* those defences to survive. We pivot entirely to safety planning, distress tolerance, boundaries, and emotional regulation. We pack the parachute; we don't jump.
For more detail, read about trauma-focused CBT.
Who is this treatment not the right starting point for, and what would you suggest instead?
CBT requires a baseline of safety and cognitive capacity. It is the wrong starting point for someone in active psychosis, severe substance dependency, or active domestic abuse. You cannot do cognitive restructuring when the house is literally on fire. For severe emotional dysregulation or chronic self-harm, I route them to DBT first for stabilisation. For complex, multi-layered childhood trauma where the client dissociates instantly, we do phased stabilisation before any active trauma processing.