The EMDR Therapist Weekly aims to provide a weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next. To achieve this, we want to invite subject matter experts as guest writers. So this week, I'm excited to share our first guest writer piece.

Jocelyn Rose is a UK-based EMDR practitioner, supervisor, and researcher. A primary author of the book, Psychedelic Assisted EMDR Therapy, she's contributed to scholarly articles and presentations on the same topic.

I've learned a lot from her during my time volunteering on the international working group for psychedelic-assisted EMDR and I'm excited for you to learn from her as well!

Without further ado, Jocelyn Rose writes:

Extending EMDR Principles to Support Adverse Psychedelic Experiences

As psychedelic therapies gain visibility in both clinical practice and research settings, EMDR therapists are increasingly likely to encounter clients struggling with the after-effects of adverse reactions to psychedelic experiences. While many report lasting benefits, others are left with distress, anxiety, or perceptual disturbances. EMDR principles can be adapted to support such presentations, whether arising from structured clinical environments or recreational contexts.

Adverse psychedelic experiences can present in a diverse number of ways. For example, in clinical research, Serious Adverse Events (SAEs) can occur even under carefully controlled conditions, with participants sometimes experiencing overwhelming fear, panic, or psychological destabilisation during or after dosing. These reactions may persist into the days or weeks following the session, requiring additional therapeutic support to ensure safety and integration.

Hallucinogen Persisting Perception Disorder (HPPD) is another condition which involves the re-experiencing of perceptual disturbances such as visual trails, afterimages, halos, or distortions that first emerged under the influence of a hallucinogen. These symptoms, often accompanied by anxiety, depersonalisation, or derealisation, can cause significant distress or impairment in daily functioning.

Clients often describe adverse reactions to psychedelics as overwhelming experiences. Moments where the psyche encountered material that was too intense, too fragmented, or too unsupported to integrate. This conceptualisation aligns naturally with EMDR’s understanding of unprocessed traumatic memory networks.

A common feature among clients who present after adverse psychedelic reactions, such as HPPD, is the emergence of pervasive negative cognitions (NCs). Typical examples include “I am permanently damaged” or “There is something wrong with me.” While these beliefs appear to be generated by the drug experience itself, EMDR’s three-pronged approach suggests that they are rarely created in isolation. More often, the psychedelic encounter has simply activated pre-existing maladaptive networks rooted in earlier life experiences.

From this perspective, the drug experience functions less as the origin of the NC and more as the amplifier. A perceptual shift, frightening dissociation, or overwhelming sense of “losing control” can instantly resonate with entrenched themes of defectiveness, shame, or self-blame. When this is paired with a belief of “I am not safe” or “I can’t trust myself / others”, which can further compound the difficulties. When these earlier networks are unprocessed, the individual is far more vulnerable to interpreting an adverse psychedelic effect as confirmation of being irreparably broken.

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Introducing PsyA-EMDR

The Psychedelic Assisted EMDR (PsyA-EMDR) adapted standard protocol provides a framework to target these experiences. When the adverse drug memory is processed in context with earlier life memories that underpin the same NC, the perceptual and emotional symptoms typically diminish.

Clients report increased distance from their distress, and the negative beliefs often shift toward more adaptive positions such as “I can recover” or “I am ok now.” Importantly, it is not necessary for the perceptual changes (e.g., visual tracers) to completely resolve for a meaningful therapeutic outcome. The transformation lies in altering the meaning and reducing the associated distress, and when the anxiety diminishes, so too will the symptoms.

Recognising that individuals prone to adverse psychedelic reactions often hold NCs in the defectiveness/self-responsibility domain offers a practical clinical implication for screening. By identifying these themes during preparation phases (if able to work with a client before they participate in psychedelic therapies), therapists can proactively target them using standard EMDR before dosing occurs. Alongside psychoeducation about potential risks, this pre-emptive work may reduce the likelihood of destabilising experiences during treatment.

This perspective also sheds light on why people with neurodivergence may be more vulnerable to difficult psychedelic experiences. The issue is not a congenital or inherent “fragility” but rather the impact of growing up neurodivergent in a neurotypical, often ableist world. Repeated experiences of invalidation, exclusion, or being “different” can instil a deep-seated belief that “there is something wrong with me.” When a psychedelic experience amplifies self-referential material, these pre-existing belief structures can be magnified, tipping the balance toward overwhelm of an already sensitive nervous system. PsyA-EMDR as a preparation tool offers a way to both address these longstanding NCs and reduce the risk of re-traumatisation in psychedelic contexts.

Several points emerge for therapists considering the use of EMDR to treat adverse reactions to psychedelics:

1. Grounded in the AIP Model: Adverse psychedelic experiences can be conceptualised within the AIP model as unprocessed memory networks. We do not need to reinvent our approach. EMDR offers a ready framework that can be used with adaptations to support it to better fit with psychedelic contexts.
2. Stabilisation is Crucial: Clients may be highly sensitised, with altered sensory processing or existential fears. Extended resourcing and careful titration of exposure are often required.
3. Stay Non-Pathologizing: Clients often fear being dismissed or dismiss themselves as “crazy” or “permanently damaged”. Framing their experience as an incomplete integration rather than a psychiatric disorder can be containing.
4. Integration, Not Erasure: Some perceptual changes may persist. The therapeutic aim is not always to “remove” these phenomena, but to shift the client’s relationship with them so they no longer dominate or destabilise. By addressing other trauma themes through EMDR and supporting clients with complementary holistic interventions, residual symptoms often decrease in intensity and disruptive impact, and may even be experienced as meaningful, positive or personally insightful reminders of AIP.
5. Cross-Context Relevance: Whether the entry point is in a clinical setting, in recreational use or research participation, the therapeutic task is similar: helping clients safely process overwhelming moments so they can integrate the experience.

As psychedelic research expands into mainstream availability, EMDR therapists are uniquely positioned to support patients, clinical trial participants, and recreational users alike. For psychedelic medicines to achieve widespread and sustainable use, there must be reliable ways of addressing the psychological fallout of difficult or destabilising experiences. PsyA-EMDR offers a promising pathway, bridging trauma therapy and psychedelic medications in a manner that is practical, evidence-informed, and firmly grounded in the same principles that make EMDR effective across so many other treatment domains.

As EMDR therapists, our role is not to advocate for or against psychedelic use, but to be available when the journey leaves someone unmoored. In that space, PsyA-EMDR provides a compassionate and effective pathway back to an equilibrium of the Self.

Jocelyn Rose

Connect with Jocelyn on LinkedIn or her website. Take a deeper dive on this topic and get her book from the publisher or on Amazon.

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