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What is Attachment-Focused EMDR and How Does It Work for Complex Trauma?

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Editor's Note

If you’ve experienced domestic violence or emotional abuse, sexual abuse or assault, the following post could be potentially triggering.

You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673.

You can contact The National Domestic Violence Hotline online by selecting “chat now” or calling 1-800-799-7233.

You can also contact the Crisis Text Line by texting “START” to 741741.

Eye movement desensitization and reprocessing (EMDR) is a trauma treatment modality developed by Francine Shapiro in the 1980s. The protocol utilizes bilateral stimulation during the recall of traumatic memories to help the client process the memories and alleviate the charge these intrusive memories have upon the individual, thereby reducing symptoms associated with post-traumatic stress disorder (PTSD). Research has proven this method of treatment to be highly effective with those struggling with single-incident trauma, like a car accident or natural disaster. However, the treatment has proven to be less effective for those experiencing symptoms from complex PTSD (C-PTSD) resulting from prolonged trauma, often called developmental or attachment trauma, like child sexual abuse or separation from a parent. 

• What is PTSD?

Enter Laurel Parnell. I first encountered her attachment-focused EMDR after my therapist mentioned it in one of my sessions. She and I had been doing EMDR on and off for a couple of years, targeting one memory at a time to get to it all. While I found that my flashbacks and triggers have reduced markedly with regards to my sexual abuse, my symptoms associated with anything having to do with my covertly incestuous, overly enmeshed mother appeared to be unresolved. My therapist asked if I’d be interested in trying this adapted version of EMDR and I said yes. 

What exactly makes attachment-focused EMDR different from the traditional modality? It tends to be less rigid in its application to the client, adapting to what the client needs and where their brain goes, within the framework of the traditional protocol. Additionally, while the classic protocol does focus on “resourcing” in terms of identifying a “safe place” that the client can return to to ground themselves and reduce their SUD (or subjective units of distress — essentially a rating scale from one to 10 indicating low-level distress to a high level of distress), the attachment-focused protocol incorporates additional resources to expand the ability of the client to self-soothe and ground themselves. These include: nurturing figures (for example an “ideal mother” and “ideal father”), protector figures, inner wisdom figures and an inner support team. These “resources” take myriad forms from people a client actually knows to celebrities, fictional characters or even animals. Once these “resources” are identified and “tapped in,” meaning processed using the bilateral stimulation protocol, the client can begin the attachment-focused EMDR process. 

But what does this actually look like from a practical perspective and how effective is it? Here’s an example of an actual session I had recently. I will preface my description with some qualifiers. My “safe place” is actually a person: Céline Dion. It’s not necessarily common, but my therapist has always been keenly aware of making sure we adjust protocols to accommodate my specific needs. Additionally, because a lot of my trauma involved female figures, my mother in particular, I did not identify an “ideal mother.” It didn’t feel natural. That might change as we continue processing and I am able to let go of some of the charge of my memories, but for now, that’s what we decided upon. 

To begin, I put on headphones that are connected to handheld devices called “tappers.” These are hooked up to a machine that creates a beeping noise and buzzing sensation in the tappers, alternating right to left. We select a target memory that I want to work on and then identify my SUD as it pertains to my memory. Then she activates the bilateral stimulation while I close my eyes and just let whatever comes to mind flow naturally. When the stimulation stops she asks me “what’s coming up for you,” which includes any bodily sensations and feelings. I note them and then we continue for a few more rounds.

Here’s where the protocol shifts into the attachment focus. We invite one or more of my selected “resources” into the memory and then return to the bilateral stimulation. I can only describe this as a “make-believe session.” In a way, I get to access the playful creativity of my inner child to create a new version of my memory, one that feels less triggering. In my last one, I invited Barack Obama to walk me down the aisle at my wedding and have the father-daughter dance with me, something I didn’t get because my parents divorced when I was three and my dad was never in the picture. Once we are done, we reevaluate my SUD, which usually goes down after this. We finish by focusing on my “safe place” for a few rounds of the bilateral stimulation, make sure my SUD is low enough for me to be grounded when I leave the office and then we end the session.

It may seem super-bizarre to someone on first glance, and frankly it felt super-weird the first time I did it. I mean, it’s not like I can rewrite my history. But as my therapist explained to me, the “resources” are really intended to tap into parts of ourselves that we can call upon in times of distress to helps us self-soothe outside of the therapy room. I will say, I actually feel almost giddy after leaving my session. It’s like the act of creating these new “pseudo-memories” dumps a huge amount of dopamine and other feel-good chemicals into my body. 

I’ve only had a couple of these modified EMDR sessions, but I already can feel a shift. I feel more hopeful, less reactive and maybe just a tiny bit more empathy towards my child self. I look forward to continuing to explore the possibilities that exist within the creativity of my mind.

One word of caution: EMDR is exhausting. Even the attachment-focused version requires a lot of physical, mental and emotional energy. I recommend not having too much on your schedule for the rest of the day and being cautious when driving home from your session.

If you are interested in attachment-focused EMDR, be sure to find a certified clinician who has knowledge of the modified protocol. And above all, work with someone you connect with. The therapeutic alliance is the single most important factor in how well therapy works in general, but I feel like it’s particularly critical when doing work that is this intense.

Photo by Jan Tinneberg on Unsplash

Originally published: April 23, 2021
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