Attachment-Focused EMDR

1. EMDR therapy adapts to heal attachment trauma and relational wounds

Attachment-focused EMDR (AF-EMDR) is an orientation to the practice of EMDR. AF-EMDR is client-centered and emphasizes a reparative therapeutic relationship using a combination of (1) Resource Tapping to strengthen clients, (2) EMDR to process traumas, and (3) talk therapy to help integrate the information from EMDR sessions and to provide healing derived from therapist–client interactions.

Adapting EMDR for attachment issues. AF-EMDR modifies standard EMDR protocols to address the unique needs of clients with early attachment trauma and relational wounds. This approach recognizes that these clients often lack the foundational sense of safety and trust necessary for processing traumatic memories.

Key adaptations include:

• Emphasis on building a strong therapeutic relationship
• Extended resource development and installation phase
• Flexible, client-centered approach to bilateral stimulation
• Integration of imagination and creativity in processing
• Focus on repairing developmental deficits

By tailoring EMDR to the specific needs of attachment-wounded clients, AF-EMDR aims to create new, healthy neural pathways and repair the damage caused by early relational traumas. This approach allows for deeper healing of core issues that traditional EMDR may not fully address in clients with complex developmental trauma.

2. Resource tapping strengthens positive internal resources for healing

Tapping in resources seems to facilitate their assimilation into the person's whole experience, making these resources more accessible. Tapping in seems to integrate memory networks.

Building internal strength. Resource tapping is a powerful technique that combines imagination, bilateral stimulation, and positive resources to create and strengthen adaptive neural networks. This process helps clients develop internal stability and coping mechanisms.

Key aspects of resource tapping:

• Identifying positive memories, experiences, or imagined scenarios
• Focusing on sensory details to fully activate the resource
• Using bilateral stimulation to enhance and integrate the resource
• Creating a "toolkit" of accessible internal resources

Resources commonly tapped in include:

• Safe/peaceful place
• Nurturing figures
• Protector figures
• Inner wisdom figures
• Ideal parent figures

By systematically developing and strengthening these internal resources, clients build a foundation of safety and stability from which to process traumatic material. This is especially crucial for clients with attachment wounds who may lack positive internal representations to draw upon.

3. Bridging technique uncovers root causes of current symptoms

The idea with the bridging technique is to activate as many of the components as possible (picture, emotions, body sensations, and immediate thoughts or self beliefs) that are linked to the current symptom or problem, and then trace the whole complex back in time to get an early scene that can be reprocessed.

Uncovering hidden connections. The bridging technique is a powerful tool for identifying the early experiences that contribute to current symptoms and triggers. By activating the full sensory and emotional experience of a present-day issue, therapists can help clients trace these feelings back to their origins.

Steps in the bridging process:

1. Identify a current trigger or problematic situation
2. Activate the full sensory and emotional experience
3. Ask the client to trace the feeling back in time
4. Identify the earliest memory or experience that emerges

This technique allows therapists to efficiently target the root causes of ongoing issues, rather than solely focusing on recent events. By processing these early experiences, clients can often experience relief from current symptoms and triggers that may have seemed unrelated to past events.

4. Interweaves facilitate processing when clients get stuck

Interweaves introduce a new perspective and new information, or information that the client "knows" but does not have access to in the state of mind that is activated. Interweaves can be used to link networks together that are not linking on their own, such as information held by the adult self with information that clients are looping in from their childhood.

Unsticking the process. Interweaves are strategic interventions used when clients become stuck or begin looping during EMDR processing. They help clients access new perspectives or information that can facilitate continued processing and integration.

Types of interweaves:

• Inquiry interweaves (e.g., Socratic questioning)
• Truth interweaves (helping clients discern reality)
• Resource interweaves (bringing in positive supports)
• Imagination interweaves (creating new scenarios)
• Sorting interweaves (differentiating past from present)
• Education interweaves (providing missing information)

Therapists must be attuned to their clients' needs and use interweaves judiciously, allowing natural processing to occur whenever possible. When used skillfully, interweaves can help clients move through blockages and achieve deeper healing and integration of traumatic material.

5. Therapist attunement and presence are crucial for attachment repair

When we are attuned to our clients, they don't feel alone like they did when they were originally hurt. One client told me that part of what was so healing for her about our EMDR work was that she had been alone when she was abused, and no one ever believed her when she reported it. During our EMDR work, I was a compassionate witness to her story, giving it validity and creating a feeling of safety she'd never experienced before.

Healing through relationship. The therapist's ability to be fully present, attuned, and responsive to the client is a cornerstone of attachment-focused EMDR. This attunement provides a corrective emotional experience that is crucial for healing early relational wounds.

Key aspects of therapist attunement:

• Empathic resonance
• Non-verbal communication (eye contact, tone of voice, body language)
• Right-brain to right-brain connection
• Ability to tolerate and regulate intense emotions
• Flexibility in responding to client needs

By providing a secure base through attunement and presence, therapists create a safe container for clients to explore and process traumatic material. This relational healing is often as important as the specific EMDR techniques in repairing attachment wounds.

6. Imagination and creativity play a key role in repairing developmental deficits

Clients can imagine and tap in an ideal mother. This is the mother they wish they'd had, a mother who can love and care for them in a consistent, healthy way.

Reimagining the past. AF-EMDR harnesses the power of imagination to create new, reparative experiences for clients with developmental deficits. By imagining and "installing" ideal parental figures or positive childhood experiences, clients can begin to fill in the gaps left by neglectful or abusive caregivers.

Examples of imaginative repair:

• Creating an ideal mother or father figure
• Reimagining birth and early infancy experiences
• Visualizing nurturing interactions throughout developmental stages
• Bringing in animal companions as unconditional love sources

These imaginative exercises, combined with bilateral stimulation, help create new neural pathways that can counteract the effects of early deprivation or trauma. While not changing the past, this approach allows clients to internalize new, positive experiences that can shape their present-day functioning and relationships.

7. Processing proceeds in waves, with gradual integration of new perspectives

There seem to be three stages that clients who had abusive and/or neglectful parents go through in their processing in order to heal childhood attachment wounds. ... Instead of taking perhaps years to pass through these stages in talk therapy, clients can go through all of them in a session, though they may need to revisit the stages repeatedly as they process different traumas.

Waves of healing. EMDR processing often unfolds in a non-linear fashion, with clients moving through various stages of realization, grief, and integration. This process allows for gradual shifts in perspective and emotional processing.

Typical stages of processing parental abuse/neglect:

1. Realizing the limitations of parents
2. Grieving the loss of the idealized parent
3. Integrating a new, more balanced perspective

As clients move through these stages, they often experience:

• Emotional releases (e.g., anger, sadness, grief)
• New insights and realizations
• Shifts in body sensations and emotional states
• Changes in beliefs about self and others

Therapists must be prepared to support clients through these waves of processing, recognizing that healing is not always linear and that clients may need to revisit certain themes or memories multiple times before full integration occurs.

8. Addressing core issues of safety, responsibility, choice, and shame

There are four main issues with corresponding beliefs that frequently cause clients to loop or become stuck: safety, responsibility, choice/control, and shame.

Healing core wounds. AF-EMDR recognizes that many clients with attachment trauma struggle with deep-seated beliefs around these four core issues. Addressing these themes is often crucial for successful processing and healing.

Common beliefs associated with each issue:

• Safety: "I'm never safe" / "The world is dangerous"
• Responsibility: "It's all my fault" / "I'm responsible for others' feelings"
• Choice/Control: "I'm powerless" / "I have no control"
• Shame: "I'm bad" / "There's something wrong with me"

Therapists must be attuned to these themes as they arise in processing and be prepared to use appropriate interweaves or interventions to help clients challenge and shift these deeply held beliefs. By addressing these core issues, clients can develop a more adaptive and empowering sense of self and relationship to the world.

9. Animal companions can serve as powerful healing resources

Animals are unconditionally loving, and I didn't get that from my mother.

Healing through animal bonds. For many clients with attachment wounds, relationships with animals can provide a source of unconditional love and acceptance that may have been missing in early human relationships. AF-EMDR recognizes the power of these connections and incorporates them into the healing process.

Ways to utilize animal companions in therapy:

• Tapping in memories of beloved pets
• Imagining ideal animal protectors or nurturers
• Using animal imagery in safe place exercises
• Incorporating real animals in therapy sessions (e.g., therapy dogs)

The unconditional acceptance and simple presence of animals can help clients access feelings of safety, worthiness, and connection that may be difficult to experience with humans. By tapping into these positive animal relationships, clients can begin to internalize new, healthier models of attachment and self-worth.

10. Pacing and reevaluation are essential throughout the treatment process

Depending on the needs of the client, EMDR can be used every session or it can be interspersed between integrative talk sessions or with other methods.

Tailoring the treatment. AF-EMDR recognizes that healing from attachment trauma is a complex process that requires flexibility and ongoing assessment. Therapists must be attuned to their clients' needs and adjust the pacing and focus of treatment accordingly.

Considerations for pacing and reevaluation:

• Client's ability to tolerate emotional intensity
• Need for resource building vs. trauma processing
• Integration of new insights and experiences
• Changes in symptoms and triggers
• Development of the therapeutic relationship

Regular reevaluation allows therapists to:

• Assess progress towards treatment goals
• Identify new targets for processing
• Adjust interventions as needed
• Celebrate client successes and growth

By maintaining a flexible, client-centered approach to treatment pacing and regularly reevaluating progress, therapists can ensure that the healing process remains responsive to each client's unique needs and capacities.

Last updated: August 26, 2024