What is the Purpose of the Preparation and Stabilization Phase in EMDR Therapy?

In the past I've written other articles about EMDR therapy including:

• What is EMDR Therapy? 

• EMDR and the Brain: How Does EMDR Therapy Work?

• Overcoming Trauma With EMDR Therapy

• EMDR Therapy - When Traditional Psychotherapy Isn't Enough

• EMDR Therapy Helps to Achieve Emotional Breakthroughs

In the current article I want to focus on Phase 2 of EMDR Therapy: The Preparation and Stabilization Phase.

Before focusing on Phase 2, let's review the eight stages of EMDR therapy.

The Preparation and Stabilization Phase of EMDR Therapy

What Are the 8 Phases of EMDR Therapy?

The eight phases of EMDR Therapy:

Phase 1: History Taking and Treatment Planning: 

• Taking a thorough family history
• Taking a history of the problem
• Establishing a rapport with the client
• Selecting target memories to process with EMDR

Phase 2: Preparation and Stabilization:

• Teaching the client about EMDR processing
• Helping the client to develop the necessary coping and relaxation skills to process the trauma with EMDR
• Ensuring the client is ready to process the trauma with EMDR

Phase 3: Assessment:

• Identifying the client's negative belief
• Identifying the images related to the traumatic memory to be processed
• Helping the client to identify their level of disturbance about the memory (Subjective Unit of Disturbance or SUD)
• Rating the level of disturbance (SUD)

Phase 4: Desensitization:

• Using bilateral stimulation (tapping, eye movements or tones) while the client focuses on the traumatic memory
• Reducing the client's disturbance (SUD) to a manageable level

Phase 5: Installation:

• Helping the client to identify and integrate a positive belief that contradicts the client's negative belief
• Strengthening the client's positive belief with bilateral stimulation

Phase 6: Body Scan:

• Helping the client to recognize any residual body sensations associated with the trauma
• Addressing any residual discomfort client has with regard to the trauma

Phase 7: Closure:

• Helping the client to develop a calm and grounded state
• Providing strategies so that the client can manage any future triggers

Phase 8: Reevaluation:

• Assessing the client's progress and revisiting the traumatic memory
• Deciding whether any further processing of the traumatic memory is needed

What is the Purpose of the Preparation and Stabilization Phase of EMDR Therapy?

Phase 2, known as the Preparation and Stabilization phase of EMDR, is essential because it:

• Builds Resources: The EMDR therapist helps the client to identify and strengthen internal resources  and external resources as well adaptive memory networks to support the client in processing the trauma.

• Helps to Build Coping Skills: The client learns various coping skills such as a breathing exercise, a container exercise, imagery, and grounding techniques to manage any intense emotions so the client can remain stable.

• Establishes a Relaxing Place Imagery: The client creates a mental image of a relaxing or safe place that they can return to if the processing feels overwhelming or between EMDR sessions.

• Increases Trust and Safety: This phase helps the client to develop trust and a sense of safety as well as enhance the therapeutic alliance between the client and therapist.

• Provides Psychoeducation: The therapist educates the client about trauma, the processing of trauma and what to expect in EMDR therapy. 

• Assesses the Client's Readiness to Start EMDR Processing: The therapist assesses the client's readiness to do EMDR therapy, determining if the client is sufficiently stabilized to proceed with the processing of trauma or if the client needs additional resources or more attention to stabilization. 

Why is the Preparation and Stabilization Phase Important in EMDR Therapy?

Without the necessary preparation and stabilization phase of EMDR, a client can become overwhelmed or retraumatized. 

They might be unable to stay in the present moment during the processing of the trauma or between sessions.

The Preparation and Stabilization Phase of EMDR Therapy

Preparation and stabilization ensures the client has the necessary internal stability and resources to safely process trauma using EMDR therapy.

This phase also helps to reduce the risk of negative experiences and to a better overall outcome for the client.

Clinical Vignette

The following clinical vignette, which is a composite of many different cases to protect confidentiality, illustrates the importance of the EMDR Preparation and Stabilization Phase:

Tom

As a US veteran who experienced significant trauma during the Iraq war, Tom suffered with Posttraumatic Stress Disorder, which is also known as PTSD (see my article: What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

After he heard about EMDR therapy, he had consultations with a few EMDR therapists in his area.

When the therapists spoke to Tom about the need for preparation and stabilization before processing his traumatic memories, he felt discouraged about the time this would take. Understandably, he wanted to get rid of his PTSD symptoms and he wanted it now. 

One of his friends, John, an unlicensed mental health intern, told Tom that he had read books about EMDR therapy.  Even though he had no formal training in EMDR, John felt he could help Tom to overcome his trauma, so he offered to do EMDR for Tom.

Aside from John not being a licensed mental health professional and having no training in doing EMDR, Tom jumped right into Phase 4 of EMDR (Desensitization) by skipping Phases 1-3.

Within minutes of processing the trauma, Tom went into a dissociated state and believed he was back in the battlefield. He had no awareness of the present moment with John. He began shaking, crying and cowering on the floor. It was obvious to John that Tom was being retraumatized.

Panicked and not knowing what else to do, John called 911 and the Emergency Medical Technicians were there with 10 minutes. They helped to stabilize and calm Tom so that he became aware of his current surroundings.  They also suggested he contact his primary care physician.

In addition, the EMTs told John that, as an unlicensed intern, it was unethical and dangerous for him to undertake doing any type of therapy.

A few weeks later, Tom's primary care doctor referred him to a licensed mental health professional who had advanced training in EMDR therapy.

Although the therapy took longer than Tom would have liked, by the time his therapist prepared him for EMDR processing, he felt safe enough with her and prepared to do EMDR.

The work was not quick or easy, but by the time Tom completed EMDR therapy, he was relieved of his trauma symptoms and he felt ready to move on with his life.

Conclusion

EMDR is a safe and effective therapy to process and overcome trauma when done responsibly by a licensed mental health professional who has advanced EMDR training.

This article seeks to explain the importance of the Preparation and Stabilization Phase of EMDR (also known as Phase 2).

The Preparation and Stabilization Phase of EMDR Therapy

All the phases in EMDR therapy are important, however, as illustrated in the clinical vignette above, it's important not to skip any of the phases, including Phase 2, because of the risk of  experiencing negative mental health consequences, including retraumatization.

Some clients who seek help in EMDR therapy are initially disappointed that they cannot immediately start processing their trauma on Day1 in therapy.

They might seek help from unlicensed and untrained people because they think it will be quicker, but many of these individuals become retraumatized and in a worse state than they were originally.

Only seek help in EMDR therapy with a licensed mental health professional who has advanced training in EMDR.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

One of my specialties, as a trauma therapist, is helping clients to process and overcome trauma (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

EMDR Therapy Online is Just as Effective as in Person

Like many psychotherapists these days, I have a hybrid private practice in New York with in person and online sessions.

I know many people are apprehensive about doing online therapy because they believe it won't be as effective as in person therapy. 

I also believed this--until the pandemic made it necessary for therapists and clients to switch from in person to online therapy and I had to try working with clients online.

I was pleasantly surprised to discover that my experience with online therapy, including EMDR (Eye Movement Desensitization and Reprocessing) therapy, has been just as effective as in person sessions (see my article: How EMDR Therapy Works: EMDR and the Brain).

EMDR Online is Just as Effective as in Person

A lot of clients are also surprised to hear that EMDR can be done online, so when they ask me what the difference is between EMDR therapy in person and EMDR online, my response is that the EMDR protocol is exactly the same online as it is in person. 

In other words, the eight phases of EMDR therapy remain the same and the protocol for setting up EMDR sessions is the same.  

What might be different are some minor adjustments to the Bilateral Stimulation used during EMDR (see my article: What is Bilateral Stimulation (BLS) in EMDR Therapy?).

The reason I say might be different is that, depending upon the client's and therapist's preferences for doing BLS, BLS can often be done the same way online as it is in person.  

For instance, if there is a preference for bilateral tapping (the client tapping on their knees or upper arms) this can be done the same way online as it's done in person and this type of tapping is just as effective as eye movements or auditory tones.

Advantages of Online EMDR Therapy

EMDR therapy online has the same advantages as online talk therapy, including but not limited to:

• You Experience Therapy in the Comfort and Safety of Your Home: Some clients prefer to be in the comfort and safety of their own home when they're processing trauma. 

• You Save on Travel Time and Cost: Commuting can be expensive and time consuming, even if you live within New York City, Also, if you're late for a therapy session due to public transportation or traffic, you probably won't get the full hour because therapists often have clients scheduled back to back. Whereas if you're having an online session, you just need to go to where you have your phone, computer or iPad in your home.

EMDR Online is Just as Effective as in Person

• You Experience the Benefit of Greater Access to Therapy: For many clients traveling into New York City might not be feasible on a weekly basis. For instance, if you live in Long Island, Westchester, Upstate New York or anywhere within New York State that isn't Manhattan, you might not find it practical to travel to Manhattan every week, especially if you don't work in Manhattan. Also, there might not be an EMDR therapist in your area, but as long as you live within New York State, you can have online access to therapists anywhere in New York State, including New York City.

The Choice is Yours: In Person, Online EMDR Therapy or a Combination of Both

Whether you do in person or online EMDR therapy, if you are a candidate for EMDR therapy, the choice is yours.

Even if you choose in person therapy, you might have days when you can't commute to Manhattan for a particular reason, so you might need to do a combination of in person and online at times.

Conclusion

Many clients who haven't experienced online therapy are apprehensive about trying it. However, in my experience, most clients who try online therapy, whether it's EMDR or another type of therapy, are often pleasantly surprised to discover that they like it and some even prefer it.

EMDR therapy is just as effective online as it is in person.

In order to do online therapy, you need to have a reliable Internet connection for a cell phone, iPad or computer.  You also need to have privacy to make sure your sessions are confidential.

As of this writing, you must either live in the state where your therapist is licensed to do online therapy or you must be able to come to a therapist's office (even if you live in a different state). This law might change at some point, so check laws in your state.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples in person in my Greenwich Village office and online on Zoom (see my article: What is a Trauma Therapist?)

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Overcoming Your Guilt and Shame About "Thought Crimes"

Committing an act and having a thought about it are two very different things.  But for some people even having the thought is enough to make them feel guilty and ashamed--as if they're "bad."  They might know, logically, that thoughts can't harm anyone but, on an emotional level, they still feel bad (see my article: Understanding the Difference Between Guilt and Shame).

Overcoming Your Guilt and Shame About "Thought Crimes"

What is a "Thought Crime"?
Before we go any further, let's define what we mean by a thought crime.

A thought crime is considered an unacceptable or controversial thought that goes against conventional thinking.

The term thought crime (also known as "thoughtcrime") is derived from the novel, 1984, by George Orwell.  In the novel, a thought crime was a thought that went against the orthodoxy of the government and it was illegal.

As the term is used today by people who consider thoughts to be potentially toxic, a thought crime is anything that they believe goes against their own morals or the conventional morals of the community or society they live in.

As a result, different people will have different definitions of what constitutes unacceptable thoughts. For some people, the idea that there are unacceptable thoughts originates in their past or present religion.  For other people, the idea of unacceptable thoughts is derived from their family of origin.

For some people it's part of their obsessional style of thinking where they get caught up in a cycle of unacceptable thoughts, guilt and shame, and more unacceptable thoughts and so on.

A longstanding unresolved childhood traumatic history can also contribute to feeling guilty and ashamed about unacceptable thoughts (see my article: Are You Living Your Life Feeling Trapped By Childhood Trauma?).

Fictional Clinical Vignette: Overcoming Your Guilt and Shame About "Thought Crimes":
The following fictional vignette provides a typical example of how someone suffers with his unacceptable thoughts and how trauma therapy can help:

John
John was in his early 20s when he contacted a psychotherapist for a consultation.  He told her that he had chronic problems with falling and staying asleep.  He said that, over time, his primary care doctor prescribed different types of medication, but he continued to suffer with insomnia.

During the consultation, he revealed that his past and current medical doctors all ruled out any physiological problems and concluded that the problem was psychological.  However, John indicated that he didn't know of any particular incident that might have caused his insomnia.

When they talked about his family history, John revealed that he was an only child raised by a single mother, who was very strict.  She forced John to go with her to church from the time he was a young child until he moved out and went to college.

He said that his mother was fervent believer in the church's teachings and she imposed strict prohibitions based on those teachings, including the prohibition against premarital sex.  This included not only sexual intercourse but kissing, petting, masturbation and even having sexual thoughts.

John told his therapist that, as a child, he tried to follow his mother's rules, in part, because he was aware that his mother was very unhappy and he didn't want to add to her unhappiness.  He also wanted to avoid punished by her for breaking her rules.

But he admitted to his therapist that there were times when he was alone in his room that he would masturbate, and afterwards he would feel very ashamed and guilty about it.

He indicated that one night when he was 14 and he was alone in his room, he felt sexually aroused under his bed sheets while he fantasized about a girl in his classroom that he liked.  Just as he was achieved an erection, his mother walked in on him and saw it.

Even before his mother began yelling at him, John said, he felt extremely ashamed and guilty.  As his mother yelled and threatened him with eternal damnation, a part of him dissociated so that he no longer felt present in the room.

To add to his humiliation, by the next day, his mother forced him to see their pastor to confess his "sin" and to get help.  For the next six months, John was forced to have weekly sessions with his pastor and he was given relevant homework assignments to read the Bible.

He said that getting caught by his mother and having to see the pastor about his sexual thoughts was a chapter in his life that he never forgot.

From then on, whenever he had any sexual thoughts, he would try to force himself to shift his thoughts to something else.  But there were times when it was too challenging to shift his thoughts and he would pray for hours long into the night to let go of these thoughts.  By the next day, he was exhausted from his lack of sleep.

At those times, he described the guilt and shame as being almost unbearable, and there were times when he contemplated suicide.  But he never made any suicide attempts because he feared that his mother would be devastated and the suicide attempt would be an even bigger sin in his religion than having sexual thoughts.

He said he was further humiliated in his high school when other boys were talking about their sexual exploits and he remained silent.  They laughed at him, teased him, and called him "cherry boy" when he admitted that he had never been sexual.

By the time he went college, he was relieved to leave his mother's home.  Since he was born out of wedlock, John felt angry with his mother for her hypocrisy.  Following his birth, she became very religious.  Although he never confronted his mother about this, he saw her religiosity as being part of her own guilt and shame about engaging in premarital sex.

Throughout his first three years of college, John remained socially isolated and celibate.  By his fourth year, he felt so depressed and anxious that he sought help in the student counseling unit.  He found the counseling to be somewhat helpful in terms of allowing him to recognize his sexual arousal was normal.  This helped to soften his guilt and shame somewhat.

A few months after he started counseling at his college, John felt comfortable enough to masturbate when he was alone, and he had his first sexual encounter with a girl on a date.  Although he no longer felt as guilty and ashamed as he did before, he still felt some discomfort that he was a "bad person."  To make matters worse, he ejaculated prematurely, which made the experience unsatisfying for him and his date and deeply embarrassing for him.

As he and his therapist explored these issues, the therapist asked John if he began having insomnia when his mother caught him being sexually aroused at age 14.  In response, John thought about it for a moment and he was surprised to realize that the insomnia had, indeed, started at that age after his mother caught him.

His therapist helped John to understand the connection the trauma of his mother discovering his sexual arousal, the guilt and shame, and the consequent insomnia which continued through the years.

She also suggested that they process the memory of his mother walking in on him using a form of trauma therapy called Eye Movement Desensitization and Reprocessing (EMDR) therapy to see if his insomnia would resolve (see my articles: How EMDR Therapy Works: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Although it was difficult for John to go back into that memory, during EMDR therapy, he was able to tell his therapist that he still felt somewhat guilty and ashamed about it--even though he knew logically that having sexual thoughts is normal.  He could still remember the horrified look on his mother's face and how angry and disappointed she had been.

As John and his therapist continued to use EMDR, he began to feel better, and his sleep problem started to abate.

Over time, he was able to process his guilt and shame for his sexual thoughts as a 14 year and also for disappointing his mother.  He also felt on a visceral level (not just on rational level) that having sexual thoughts wasn't wrong, and he no longer felt like a "bad person" (see my article: What's the Difference Between Toxic and Healthy Shame?).

Overcoming Your Guilt and Shame About "Thought Crimes"

On the contrary, he could feel that he was actually a very good and decent person and he had nothing to feel guilty or ashamed about.

Over time, as John let go of his negative emotions about sexual thoughts, he also began socializing more easily. Eventually, he entered into a stable relationship with a woman he met at a party, and they were able to have a satisfying sexual relationship.

Conclusion
Feeling guilty and ashamed about having particular thoughts is a common experience for many people.

In the vignette above, the guilt and shame were about sexual thoughts, but any thought can be experienced as taboo.

Guilt and shame can manifest in physical symptoms like insomnia, headaches, stomachaches, backaches and other bodily symptoms.

Making these connections on your own is often difficult, but a skilled trauma therapist can help you to make the connections and also help you to resolve the underlying issues through a form of trauma therapy, like EMDR therapy.

Getting Help in Trauma Therapy
If you've been feeling guilty and ashamed about your thoughts, you might know, on a rational level, that thoughts are harmless.  But on an emotional level, you can continue to feel these negative emotions because intellectual insight isn't enough to help you to change.

Unlike regular talk therapy, which can help you to develop intellectual insight, trauma therapy, like EMDR, gets to the deeper places in your brain where the unresolved trauma resides and helps you to process the trauma to the point of resolution.

Trauma therapy can free from your traumatic history so you can lead a fuller and happier life, so rather than suffering on your own, you owe it to yourself to get help from a skilled trauma therapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapists who works with individual adults (see my article: The Therapeutic Benefits of Integrative Psychotherapy). 

As a trauma therapist, I have helped many clients to overcome longstanding trauma so they could lead happier lives.

I also use Emotionally Focused Therapy (EFT) to help couples with relationship problems.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

How Past Psychological Trauma Lives on in the Present

A history of psychological trauma often lives on in the present.  Among other problems, it can create problems with trusting others.  As a result, people with a history of trauma often have internal conflicts about entering into a romantic relationship.  Many clients come to therapy when their conflict between their fear and their longing for love becomes unbearable (see my article: An Emotional Dilemma: Wanting and Dreading Love).

How Past Psychological Trauma Lives on in the Present

Most people want to form loving relationships, so conflicting feelings of dread and longing for a close relationship pose a painful dilemma.

When the source of the fear involves unresolved psychological trauma, people can't work it out on their own.  They need the help of a skilled trauma therapist.

Fictionalized Scenario: Overcoming Psychological Trauma
The following fictionalized scenario, which is a composite based on many actual psychotherapy cases (with no identifying information), illustrates how trauma therapy can help:

Ann
Ten years after she was sexually assaulted while she was on a date, Ann sought therapy to overcome her fears of socializing and developing relationships with men.

During the initial consultation, Ann told the trauma therapist that she was sexually assaulted while she was a senior in college.  All she remembered from that night was going to the local bar near the college on her first date with Ed.

Her next memory was of waking up in her dorm room feeling groggy, achy and bruised around her legs and genital area.  She had no recollection of anything that happened between arriving at the bar and waking up in her bed.

She said that when she confronted the Ed about about her bruises and her grogginess, he was very anxious around her.  He also gave her a vague apology but, despite her insistence, he refused to say anything more.  After that, Ed refused to talk to her anymore.

Ann told the therapist that she knew she had probably been drugged and raped by Ed, but she was so ashamed about the incident that she never spoke to anyone about it.  She was afraid that others would blame her for the assault. She imagined them telling her, "You should have been more careful" or "Maybe you drank too much."  As a result, she told herself that she would put the incident behind her and try not to think about it anymore.

But far from being able to put the incident behind her, from time on, Ann was fearful of meeting and dating men.  She only went out with men when she knew she would be in a group setting where she felt safe.  But even though Ann felt fearful of being alone with a man, she also felt lonely and she wanted to eventually get married and have children.

A couple of weeks before she came for the therapy consultation, Ann celebrated her 31st birthday with her women friends.  Although she had a good time, Ann was also aware that after her birthday celebration, each of her friends was going home to a boyfriend or a husband, and she was going home alone.  She was also aware that, at 31, she was facing her "biological clock" in terms of having children.

During the next several sessions, Ann and her therapist talked about Ann's conflicting feelings about getting involved with men.

They also talked about EMDR therapy, a therapy that was developed in the early 1980s by Francine Shapiro, Ph.D. specifically to help clients to overcome psychological trauma (see my articles: How EMDR Therapy Works: EMDR and the Brain).

After the preparation phase of EMDR therapy, they targeted the memory of Ann waking up after the date where she was assaulted. While doing this work, Ann discovered that her negative belief about herself was "I'm powerless," which was how she felt that day and also how she felt whenever she thought about going out with men that she was currently attracted to in the present.

Over the next few months, based on the EMDR protocol, Ann and her therapist processed her past memories, her current fears and her anticipated fears about the future.

The work was neither quick nor easy, but it delved deeper and was quicker than talk therapy would have been.

After several months of EMDR therapy, Ann no longer felt traumatized by her memory and she no longer feared going out with men (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Overcoming Psychological Trauma With EMDR Therapy

A few months later, she was able to enter into a dating relationship with a man that she met at a professional meeting.  A year after that, she and her boyfriend got engaged.

Conclusion
The fictionalized scenario above was about a sexual assault, but there are many other types of trauma that pose obstacles in terms of feeling safe enough to develop a romantic relationship, including physical and emotional abuse, early loss of and unresolved grief for a parent, early abandonment, a prior history of infidelity or betrayal in a relationship, and other similar situations.

Usually, people don't make the connection on their own between their traumatic history and the obstacles that are getting in their way, and they discover the effect of their trauma once they begin therapy.

Experiential therapies, like EMDR and other trauma therapy, are usually more effective than regular talk therapy for overcoming trauma (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy to Overcome Trauma).

Getting Help in Therapy
If you're struggling with a history of unresolved trauma, you owe it to yourself to get help from an experienced trauma therapist (see my article: How to Choose a Psychotherapist).

By overcoming unresolved trauma, you can free yourself from your history so that you can lead a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and AEDP therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with adult individuals, and I use Emotionally Focused Therapy (EFT) for couples.

One of my specialties, as a trauma therapist, is helping clients to overcome psychological trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Overcoming Childhood Trauma With Experiential Therapy: What You Fear Now Has Already Happened

For adults who were traumatized as children, childhood trauma (also known as developmental trauma) remains active emotionally and physiologically throughout adulthood without help in therapy (see my article: Developmental Trauma: Living in the Present As If It Were the Past).

Overcoming Childhood Trauma With Experiential Therapy: What You Fear Has Already Happened

Adults with developmental trauma often experience the same fears they felt as children, however, they usually don't realize that they're experiencing emotions from the past rather than the present.

When old emotions get triggered in the present, they can be so powerful that they feel like they're related to the here-and-now rather than the past, but they are really old activation.

The trauma has already happened, but the emotional triggers make the emotions feel like they're current (see my article: Working Through Psychological Trauma: Separating "Then" From "Now").

The reason why they feel like they're from the present is that the trauma hasn't been processed in therapy.  In other words, the trauma remains "unmetabolized" (or unprocessed) in the brain and the nervous system hasn't been "updated" yet.

Although an adult with developmental trauma can try to tell himself that the current trigger is from an old feeling in the past, this usually isn't enough to keep him from getting triggered again.  This is because this type of self talk appeals to the logical part of the brain, the prefrontal cortex and not the deeper part of the brain, the limbic system, where the trauma resides.

Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma
As a psychotherapist with over 20 years of experience helping clients to overcome traumatic experiences, I know that experiential psychotherapy is the most effective modality to overcome trauma (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

As I've mentioned in my other articles, regular talk therapy doesn't get to the limbic part of the brain, which is why clients often develop insight (or an intellectual understanding) of their trauma, but their traumatic symptoms don't change.  They continue to get emotionally triggered in the present (see my article:  Coping With Trauma: Becoming Aware of Your Emotional Triggers).

Experiential therapy includes EMDR therapy (Eye Movement Desensitization and Reprocessing), Somatic Experiencing (also known as SE), clinical hypnosis, and AEDP (Accelerated Experiential Dynamic Psychotherapy).  See my articles: How EMDR Therapy Works: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Fictional Clinical Vignette: Overcoming Childhood Trauma: What You Fear Has Already Happened
The following fictional vignette, which is similar to many actual psychotherapy cases, illustrates how experiential therapy helps clients to overcome developmental trauma so they're no longer triggered in the present:

Ann
Ann started experiential therapy to overcome her fear of getting romantically involved with a new man she was dating.

Two months before she started therapy, Ann met John at a party where they immediately hit it off.  When John took her out on their first date, Ann felt excited and happy to be spending time with him.  They talked for hours and it was clear that they had a lot in common and there was a strong sexual chemistry between them.

But as they continued to date and their feelings for each other deepened, Ann began to feel more fearful than happy to see John.  She knew that she still liked him a lot and that he liked her very much.  But she kept imagining scenarios where John would hurt her and stop seeing her (see my article: Wanting and Dreading Love).

The deeper her feelings became for John, the more fearful she became.  After a while, she was so fearful that there were times when she was tempted to cancel dates with John to avoid her fear. At the same time, she knew that her fear wasn't really about John.

So, she tried to reason with herself by telling herself that her fears weren't related to anything that John was doing or not doing.  But her self talk only calmed her for the moment until the fears resurrected again (see my article: Fear of Abandonment Can Occur Even in a Healthy, Stable Relationship).

She recognized her fears about John as being part of her usual pattern with men.  Whenever she met a man that she really liked, she would become infatuated with him, but as they continued to see each other, her fears of getting hurt would increase to the point where she would end the relationship (see my article: Overcoming Your Fear of Falling In Love and Getting Hurt Again).

Ann didn't want to allow her fear of getting hurt to ruin her relationship with John.  So, she talked to her close friend, Sue, about it.  Sue told Ann that she tried for years to overcome similar fears in regular talk therapy, but talk therapy didn't resolve her problem.  She told Ann that she was able to overcome these fears in experiential therapy, and she encouraged Ann to find an experiential therapist.

After the initial consultation where Ann gave the therapist an overview of the problem and the therapist explained how she worked with experiential therapy, Ann gave her family history in the next therapy session.

Ann explained that she had been close to both of her parents as a young girl, but she was especially close to her father ("I was a real daddy's girl").  Every day she waited up for her father to come home from work so he could read her a bedtime story before she went to sleep.  He would tuck her in and wait until she fell asleep before he left her side.

But shortly after her sixth birthday, her father told her that he had to go away for three months "to get better."  When she asked him if he was sick, he explained that he had a disorder that was completely curable if he got help.  He told her that he loved her and asked her not to worry while he was gone.

Ann told her therapist that she never saw her father again, and her mother refused to talk to her about what happened to her father.

She explained to her therapist that it was many years later, as an adult, that she found out from her paternal aunt that her father had a drug problem and he went to rehab.  However, he left rehab shortly after he arrived, no one ever heard from him since that time, and the family presumed that he was either still in the grips of his addiction or he was dead.  She told Ann that the family tried to find him, but there was no trace of him.

With regard to Ann's fears about her boyfriend, John, her therapist used a hypnotherapy technique called the Affect Bridge to get to the earliest memory related to Ann's fears of being left by John.  It was not surprising to the therapist when Ann's earliest memory of this fear was feeling abandoned by her father.

Over a period of time, using EMDR therapy, Ann's therapist helped Ann to process her earliest memories related to feeling abandoned by her father.  The therapeutic work was gradual, but Ann felt better each time she did an EMDR session with her therapist.

Since EMDR uses a three-pronged approach of working on the past, present and future, Ann and her therapist worked on her fears from the past, her current fears, and her fears about the future.

By attending her EMDR sessions regularly, Ann gradually overcame her fear of being abandoned, and her relationship with John continued to deepen without her usual fear.

Conclusion
The fictional vignette in this article illustrates how developmental trauma can get played out in the present.

In the vignette, Ann already had an awareness that she experienced the same fears in her prior relationships, those fears led her to end those relationships, and her fears about the current relationship weren't related to anything that John was doing.

Although she was determined not to act on her fears in her relationship with John, her attempts at positive self talk to overcome her fears weren't successful because they didn't get to the area in the brain where the developmental trauma resided, the limbic system.

The Affect Bridge from hypnotherapy helped Ann and her therapist to trace back the origin of Ann's fear.  EMDR therapy enabled Ann to process the trauma from the past and her fears about the present and future so that Ann was no longer affected by her childhood trauma.

Getting Help in Therapy
If you're struggling with developmental trauma, you owe it to yourself to work with a licensed mental health professional who practices experiential therapy.

Once you've processed the earlier trauma, you'll be free from your traumatic history so that you can live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Emotionally Focused Therapy for Couples, and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.