What Are Imaginal Interweaves in Trauma Therapy?

In prior articles I provided a basic explanation for Imaginal Interweaves in Trauma Therapy (see my articles Imaginal Interweaves - Part 1 and Part 2).

In the current article, I'm taking a deeper dive to explain Imaginal Interweaves, an intervention I often use in trauma therapy.

What Are Imaginal Interweaves in Trauma Therapy?

Imaginal Interweaves are techniques used in trauma therapy.

Imaginal Interweaves in Trauma Therapy

I learned how to do Imaginal Interweaves in an advanced Attachment Focused EMDR Therapy training about 20 years ago from EMDR expert Laurel Parnell, Ph.D.and I have found them to be an effective way to help clients to heal.

Imaginal Interweaves are techniques used in EMDR and other Experiential Therapies where a trauma therapist guides clients to use their imagination to connect with different aspects of themselves (see my article: Why is Experiential Therapy More Effective Than Traditional Talk Therapy?).

This often includes imagining their younger child self (often called "inner child"). This is especially helpful if clients become stuck when they're processing unresolved trauma. 

Examples might be imagining their current adult self:

• Comforting their younger self

• Defending their younger self from someone who was abusive

• Taking their younger self away from an unsafe, abusive environment to a place where their younger self feels safe

Imaginal Interweaves are:

• Specific therapeutic interventions used in trauma therapy, like EMDR therapy, AEDP, Parts Work Therapy and other Experiential Therapies.

• A tool to process trauma when a client gets stuck during the processing

• Guided imagery the therapist facilitates

• A technique for self connection 

Imaginal Interweaves work by:

• Helping a client to develop internal and external resources

• Bridging different perspectives including a gap between a more vulnerable part of a client and a more capable adult self

• Facilitating new emotional responses by using the imagination to work through overwhelming feelings related to trauma

What Are Some Examples of Imaginal Interweaves?

There are many different types of Imaginal Interweaves.

Imaginal Interweaves in Trauma Therapy

Here are examples of a few:

• Adult-Child Interactions: The adult self comforts the child self to provide a sense of present-day safety and reassurance.

• Expressing Anger: The adult self can be imagined as holding the perpetrator so the child self can express anger while feeling safe.

• Direct Communication: After asking the client's permission, the therapist can speak directly to the child self to find out what the child self needs.

Making a Distinction Between What Actually Happened and An Imaginal Interweave

Trauma therapists make the distinction with the client about what actually happened during their trauma and an Imaginal Interweave.

Imaginal Interweaves in Trauma Therapy

In no way would I try to get a client to believe that something different happened from what actually happened.

The purpose of Imaginal Interweaves is to give clients a new embodied experience using their  imagination while continuing to know that what is being imagined didn't actually happen.

An embodied experience means the client experiences a mind-body connection during an Imaginal Interweave which helps with the integration of the new experience.

To help them to experience an embodied experience, I will help the client to have a felt sense where they feel the new imagined experience in their body. 

This serves as an anchor for the experience in an embodied way rather than just being an intellectual process (see my article: The Mind-Body Connection: Developing a Felt Sense of Your Internal Experiences).

Using an embodied approach facilitates healing.

How Can Imaginal Interweaves Help to Free You From Your Traumatic History?

By processing unresolved trauma using Imaginal Interweaves, you can free yourself from your traumatic history by:

• Overcoming unresolved trauma that keeps you stuck in your current life

• Overcoming false negative beliefs you have about yourself

• Connecting you to your inner resources

• Integrating various internal parts of yourself to achieve improved mental health

• Gaining self confidence to cope with past, current and future challenges

Getting Help in Trauma Therapy

Traditional talk therapy can help you to gain insight into your problems, but it doesn't always help you to heal from trauma.

Experiential Therapy that includes Imaginal Interweaves provides you with a mind-body oriented experience that is a more holistic way to heal.

Rather than struggling on your own, seek help in Experiential Therapy so you can heal and live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have helped many individual adults and couples to work through unresolved 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.

 

Relationships: Dealing With Your Partner's Trauma Triggers - Compassion vs Complacency

Many partners of trauma survivors struggle with their partner's trauma triggers. 

They tell me they don't know what to do to help their partner when their partner becomes triggered.

This article discusses how to avoid responding complacently and how to respond with compassion instead.

What is the Difference Between Compassion vs Complacency?

For someone dealing with their partner's trauma triggers, there is a big difference between compassion and complacency.

Dealing With a Partner's Trauma Triggers

Compassion means offering patient, empathetic support to a partner while complacency involves a harmful indifference or dismissal of a partner's symptoms or efforts to recover from trauma.

A compassionate response helps to establish safety and connection while a complacent response can lead to resentment, emotional detachment and a breakdown of trust.

Let's look at the differences between compassion and complacency in more detail:

Complacency: A Damaging Response

Complacency occurs when a partner stops putting an effort to understand and support a partner's healing journey. This often occurs because the partner who isn't traumatized becomes fatigued or resentful. 

Dealing With a Partner's Trauma Triggers

This can take a heavy toll on the relationship because the partner with trauma feels unseen, unheard, unsafe and alone.

Signs of Complacency:

• Minimizing Your Partner's Feelings: Saying "It's not that big a deal" or "You're making a big deal out of nothing" invalidates a traumatized partner's experience

• Taking a Partner's Triggers Personally: Viewing a partner's trauma triggers as a personal attack, which leads to resentment and defensive behavior

Dealing With a Partner's Trauma Triggers

• Ignoring Triggers: A partner who refuses to adjust their behavior or the environment to accommodate a partner's needs which violates the traumatized partner's safety

• Withdrawing Emotionally: Becoming emotionally distant or apathetic to a partner's emotional needs which leads to emotional disconnection and a breakdown in communication

• Taking a Partner For Granted: A lack of affection and appreciation, as if the traumatized partner's presence is guaranteed which can make feelings of abandonment and worthlessness worse

Compassion - A Supportive Response

A compassionate partner tries to understand the origins of their partner's trauma response instead of reacting defensively to triggered behavior.  

Dealing With a Partner's Trauma Triggers

This approach helps to regulate a traumatized partner's nervous system and offers a steadying presence.

Signs of Compassion:

• Active Listening and Emotional Validation: Listening without judgment, "That sounds difficult. I'm here for you."

Dealing With Your Partner's Trauma Triggers

• Educating Yourself: Take the initiation to learn about trauma's effects on the brain and behavior to gain insight and perspective 

• Creating a Safe Environment: Work together to identify triggers and create a plan for when triggers occur. This might include agreed-upon actions or a "safe word" to use during moments of high distress

• Respecting Boundaries: Honor a traumatized partner's needs for space or control, which is essential for trauma survivors who might have had their boundaries violated

• Patience: A recognition that healing from trauma isn't a linear process and there will be ups and downs along the way (see my article: Progress in Therapy Isn't Linear).

Clinical Vignette

The following clinical vignette, which is a composite of many different cases, illustrates how a partner shifts his behavior from a complacent to a compassionate stance:

Ed and Mary

Before they moved in together, Ed was aware that Mary had been sexually abused as a child, but her triggers became more evident once they were living together.

Ed had a favorite TV police program he liked to watch where the characters in the program were regularly sexually abused as part of the story. 

He couldn't understand why Mary got so triggered whenever he watched the program when she was around. He felt annoyed when Mary said she needed to stop watching the program because she felt like she was about to have a panic attack.

Ed would tell Mary, "Why are you getting so upset? It's only a TV show." 

He also felt Mary was trying to control him whenever she left the room when that program was on, "You need to get over these triggers. Your abuse happened a long time ago. Why are you being so dramatic?'

At her wit's end, Mary invited Ed to attend one of her trauma therapy sessions so her therapist could help Ed to understand and empathize with Mary's trauma reactions.

Dealing With Your Partner's Trauma Triggers

Afterwards, Ed felt ashamed and guilty for his behavior. He told Mary that she was more important to him than any TV program and he wouldn't watch the program when she was around.

He also sought to understand what happened to Mary by asking her questions, which helped to increase his compassion for her.

Over time, Ed noticed that Mary was healing and he validated the hard work she was doing in trauma therapy.

Gradually, Ed's compassion and emotional support for Mary helped to bring them closer together.

Conclusion

A complacent response to a partner's trauma is damaging for the traumatized partner and the relationship.

Dealing With Your Partner's Trauma Triggers

Being compassionate and understanding can support your partner's healing journey.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist

As a Trauma Therapist, I have helped many individual adults and couples to heal from 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.

What's the Difference Between Emotional Co-regulation and Emotional Self Regulation?

People sometimes confuse the terms "emotional self regulation" and "emotional co-regulation" so I'm addressing the differences in this article.

Co-regulation vs Self Regulation

What's the Difference Between Co-regulation and Self Regulation?

When caregivers provide external support to their children, this is an example of emotional co-regulation, which is a foundational step for developing emotional self regulation.

Whereas co-regulation is the process in which one person helps another person to regulate their emotions, self regulation is the ability to manage your own thoughts, emotions and behaviors.

Both skills, co-regulation and self regulation, work together throughout life.

Let's break it down further:

Self Regulation

• Definition: The internal ability to control your own thoughts, emotions and behaviors without relying on others.

• Examples of Self Regulation:
• Doing breathing exercises on your own to calm down
• Managing frustration during an argument by going for a walk to calm down

• Goal: To respond to a situation thoughtfully instead of reacting impulsively

Co-regulation

• Definition: The process of two or more people working together to manage emotions and behaviors. This involves providing support, structure and warmth to help someone to calm down and learn coping skills.

• Examples: 
• A parent helping a child to calm down by speaking in a gentle tone and providing comforting hugs
• One romantic partner helping another to calm down by listening in an attuned way, holding their hand and gently helping them to take relaxing breaths

• Goal: To help someone to feel safe and understood which, in turn, builds their capacity for self regulation

• Relationship Between Self Regulation and Co-regulation: Co-regulation is an essential step in helping someone to self regulate. A caregiver or partner's ability to self regulate is necessary in order for them to help co-regulate others. 

Clinical Vignette

The following clinical vignette illustrates the relationship between self regulation and co-regulation and how psychotherapy can help. As always, this vignette is a composite of many different cases to protect confidentiality:

Paul:

Paul was a latchkey kid. Both of his parents worked two jobs each so they weren't around when he came home from elementary school. 

There were times when he was at home alone that he thought he heard noises in the house and he was so scared he hid under his blanket until his parents came home. 

He knew his next door neighbors were at home, but his parents told him to never let them know he was home alone because they might call the child welfare bureau and then he would  be taken him away from his parents due to childhood neglect.

His parents explained to him they didn't want to leave him alone in the house, but they both needed to work and there were no other relatives to take care of him. They also couldn't afford childcare, so he would hide in fear until his parents came home.

Since Paul grew up being alone much of the time, he was often without his parents' emotional support, so he didn't learn how to manage his emotions.

His teacher told his parents that Paul had a difficult time calming himself down in school when he was upet. She suspected his parents weren't helping Paul to manage his emotions so she encouraged them to help him--although she didn't know they were often away from home.

By the time he went away to college, he was so anxious he was having panic attacks.  A college counselor referred him to a psychotherapist for help. 

His therapist used her co-regulate skills to help Paul. She also taught him self regulation skills by teaching him breathing exercises and other coping strategies. 

Eventually, he learned to regulate his emotions on his own.

After he graduated college, the skills he learned in therapy helped Paul to self regulate and co-regulate emotions with his new girlfriend, Sara.

Conclusion

Young children usually learn to co-regulate with their parents so they can develop self regulation skills as they get older.  However, there are times when children don't learn these skills because their parents are not around or the parents never learned to regulate their own emotions when they were growing. up so they can't help their children to develop skills they don't have.

Fortunately, people who didn't learn to regulate their emotions have an opportunity to learn as adults in psychotherapy.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and a Certified Sex Therapist.

I work with individual adults and couples.

As a Trauma Therapist, I have helped many clients to overcome trauma and manage their emotions so they can lead a more fulfilling life.

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.

Also See My Articles:

What is Emotional Regulation in a Relationship?

Managing Your Emotions During Stressful Times

Emotional Regulation: What is the Difference Between Being Calm and Being Numb?

Relationships: How to Respond in a Supportive Way to Your Partner's Emotional Vulnerability

Many people in relationships don't know how to respond to their partner's emotional vulnerability. This is significant because vulnerability is a pathway to emotional and sexual intimacy.

Responding to Your Partner's Emotional Vulnerability

Why Do People Have Problems Responding to Their Partner's Emotional Vulnerability?

People who have problems responding in a supportive way to their partner's vulnerability might have some or all of the following problems:

• Deep-seated Fears of Their Own Vulnerability: A partner's emotional vulnerability can trigger underlying fears, insecurities and painful memories. Instead of being supportive, these individuals might react to their partner's vulnerability with indifferences, scorn, criticism, disgust or indifference in order to protect themselves from their own feelings of vulnerability.

• An Insecure Attachment Style: A person's attachment style, which is formed in early childhood, can influence their ability to respond in a supportive way (see my article: How Your Attachment Style Affects Your Relationship):

• Avoidant Partners: These partners might pull away from a partner showing vulnerability. They might also feel overwhelmed when their partner expresses deep emotions because they equate intimacy with a loss of independence.

• Anxious Partners: These partners might focus on their own fear of abandonment which makes it difficult for them to respond empathetically to their partner's vulnerability.

• Negative Patterns of Behavior Learned From Past Experiences: Past experiences include early childhood. For instance, if someone was told by their parent that they were "acting like a baby" when they cry, when they become adults, they are more likely to react negatively to their partner's vulnerability. 

Responding to Your Partner's Emotional Vulnerability

• Fear of Intimacy: Even though a partner might crave closeness, their fear of intimacy can cause them to resist getting close to their partner. They might equate vulnerability with "weakness", risk of emotional pain or risk of future betrayal (see my article: The Connection Between Fear of Intimacy and Unresolved Trauma).

• Unresolved Trauma: Partners who have unresolved trauma, including childhood abuse or neglect, can find it difficult to let their guard down to be supportive of their partner.

• Low Self Esteem: A partner who has low self esteem might not feel worthy of their partner's affection. They might interpret their partner's vulnerability as criticism or a setup for an eventual rejection.

• Lack of Emotional Intelligence: A person who lacks emotional intelligence often lacks self awareness so that they might not recognize or understand their own feelings. If they don't recognize their own feelings, they probably won't understand or empathize with their partner's feelings (see my article: Why is Emotional Intelligence (EQ) Important in Your Relationship?).

What Are the Negative Dynamics in a Relationship When a Partner Can't Deal With Emotional Vulnerability?

When an individual has problems dealing with their partner's emotional vulnerability, this can set up a negative cycle where vulnerability is punished: 

• Past Punishment of Vulnerability: When a partner's past experiences of showing vulnerability were met with indifference, hostility or criticism, they might become hesitant to open up emotionally again. This often creates a negative cycle of emotional disconnection.

Responding to Your Partner's Emotional Vulnerability

• Ineffective Communication Patterns: Many couples lack the necessary communication skills and tools to communicate effectively.  For example, if one partner says to the other, "I'm afraid you don't love me anymore", the second partner might become defensive and angry and respond, "Well, it's your own fault. You're always too tired to go out and have fun."

• Defensive Reactions: When a partner shows vulnerability, instead of being supportive, the partner who fears vulnerability might react defensively:

• Stonewalling: Shutting down or withdrawing completely

• Contempt: Responding with sarcasm, mockery or insults

• Defensiveness: Making excuses or blaming their partner

• Attempts For Connection Are Missed: A vulnerable statement is an attempt to re-establish connection and intimacy. When a partner responds negatively to this attempt, it can create emotional distance between the partners.

What Are the Consequences of Negative Responses to a Partner's Vulnerability?

• Erosion of Trust: When a partner realizes that their expressions of emotional vulnerability are met with a negative response, they learn that it's not safe to be open with their partner.

Responding to Your Partner's Vulnerability

• Increased Conflict: When underlying issues remain unresolved, this can lead to more intense conflicts in the relationship.

• Decreased Intimacy: Negative responses to vulnerability often leads to a decrease in emotional and sexual intimacy which creates distance and loneliness.

• Heightened Emotional and Physical Stress: Chronic negative communication patterns raise stress levels which can impact on mental and physical health.

How Can You Break the Negative Cycle?

Breaking the negative cycle is an important strategy for improving a relationship (see my article: Breaking the Negative Cycle in Your Relationship).

The following strategies might be helpful to break a negative cycle in your relationship?

• Take a Break: If you or your partner feel overwhelmed, you can take a break to calm down and collect your thoughts. Before taking a break, have an agreement as to when you will get back together to talk again so that taking a break doesn't become an excuse for avoiding the conversation. Also, if you or your partner have an anxious attachment style, knowing when you will get back together to talk can help to soothe anxiety and fears of abandonment.

• Identify Your Triggers: Develop an awareness as to what your partner says that triggers your fears or defensiveness. Understanding your triggers is the first step. in learning to. manage your emotions (see my article: Becoming Aware of Your Triggers).

• Practice Empathy and Validation: Instead of being critical or getting defensive, try to understand your partner's feelings. You don't have to agree with your partner. You can respond by validating your partner's feelings and saying, "That sounds hard" or "I can hear how much that hurts you" (see my article: How to Develop and Use Validation Skills in Your Relationship).

Responding to Your Partner's Vulnerability

• Use "I" Statements: Instead of blaming your partner, frame your feelings in a nonjudgmental and non-defensive way. For instance, instead of saying "You make me worried when..." say "I feel worried when..."

Get Help in Couples Therapy

• Seek Professional Help: A skilled couples therapist can help you and your partner to identify the negative cycles you get into together and also help you to develop better communication and relationship skills.

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.

I have helped many people to overcome obstacles to having a fulfilling relationship.

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 to Cope With Parents Who Are Trying to Guilt Trip You As An Adult

Parents who try to guilt trip you into doing what they want are usually emotionally immature. Rather than trying to placate them, you need to find healthy ways of dealing with their behavior.

What is Guilt Tripping?

Guilt tripping is when someone tries to manipulate you to control your behavior.

Coping With Guilt Tripping Parents

Aside from wanting to control your behavior, guilt tripping violates your boundaries.

What Are the Signs of Guilt Tripping?

• They Become Passive Aggressive: Instead of being outwardly aggressive, they make passive aggressive or sarcastic comments like, "Well, I guess if you can't come over this Sunday, I'll have to spend the day alone" (passive aggressive) or "Oh sure, don't worry about me, but I won't be around forever" (see my article: Coping With Family Members' Passive Aggressive Comments).

• They Try to Gaslight You: They might try to twist your words or distort the truth to make you question your intentions and behavior, "I don't know why you would rather be with your friends than come here to visit your father and me. Your friends won't always be there for you like we have been" or "You're the reason why your dad and I are unhappy."

• They Give You the Silent Treatment and Become Emotionally Distant: They stop communicating with you and ignore your calls, email and text. This is a form of emotional abuse to punish, gain power over and manipulate.

Coping With Guilt Tripping Parents

• They Remind You About Your Past Mistakes: This is another form of manipulation to try to make you feel like you owe them something. For example: "You're going out with your boyfriend instead of coming to see me? You always make bad relationship choices. Remember, I was who was there for you when you were hurt and upset about your last relationship."

• They Make Negative Comparisons: They might compare you to a sibling, another family member or a friend, "Your sister always comes over every Sunday, but you only come every two weeks."

• They Try to Make You Think It's All Your Fault: They won't take responsibility for their own actions. Instead, they blame you, "Your mother and I have tried to do everything to improve our relationship with you, but you just do things to make it worse."

How to Cope With Parents Who Are Trying to Guilt Trip You

Understand the impact guilt Tripping is having on you: Some people are very good at guilt tripping until they get you to feel the way they want you to feel and do what they want you to do.

Signs Your Parents Guilt Tripping is Affecting You

Recognize the signs that you're being affected by your parents' guilt tripping:

• You Feel Obligated to Them: You feel like you "owe" your parents--even when you know their demands are unreasonable.

Coping With Guilt Tripping Parents

• You Over-justify Your Actions: You keep defending or explaining your actions to your parents.

• You Feel Like Nothing You Do is Good Enough For Your Parents: You might feel like no matter how hard you try, nothing you do is ever good enough for your parents and you'll never be able to please them.

How to Cope With Parents Who Are Trying to Guilt Trip You

• Shift Your Perspective and Be Aware That You're Not Responsible For Your Parents' Feelings: If you're not actively trying to hurt your parents, you're not responsible if they feel hurt or angry that you're not doing what they want you to do. For instance, if you already have plans with a friend and your parents want you to come over on the same day, you have a right to stick with your plans and not try to appease your parents because they tell you you're making them feel hurt. 

• Set Clear Boundaries With Your Parents: Although it can be challenging, you might need to set boundaries with your parents. Let them know what is and isn't acceptable (see my article: Setting Boundaries With Family Members).

Coping With Guilt Tripping Parents

• Prioritize Your Needs: If your parents have been successful at guilt tripping you, you might feel like your needs are insignificant compared to theirs. Be aware you're doing this and make an agreement with yourself to prioritize your own needs.

• Validate Their Feelings: If you detect they have underlying feelings that they're not expressing, validate their feelings. For example, if they try to make you feel guilty about not coming to see them and you detect that their underlying feeling is that they miss you and want to spend time with you, validate that. At the same time, don't give up on your plans to appease them. Instead, you can suggest another day when you can get together with them (if you want to spend time with them).

Coping With Guilt Tripping Parents

• Get Emotional Support From Supportive Friends: Talk to trusted friends who will be emotionally supportive. If you feel apprehensive about talking with your parents and setting boundaries with them, you can "bookend" that conversation by talking to a trusted friend before and after your conversation with your parents. You might even arrange to have these bookended conversation with your friends in advance. 

Get Help in Therapy

The impact of guilt tripping can be traumatic.

Get Help in Therapy

Among other things, lifelong guilt tripping can make you susceptible to getting into a relationship with a partner who also tries to manipulate you with guilt and you might not even be aware of it because it seems "normal" to you.

A skilled mental health professional, who is a trauma specialist, can help you to heal from trauma so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Parts Work Therapist (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

As a Trauma Therapist, one of my specialties is helping clients to overcome 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.

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.