Embodied Trauma Therapy

How the new Approved Consultant Standards Fuel Your Growth Are You Considering EMDR Certification?

Donna Hunter — Mon, 25 May 2026 04:08:33 +0000

Reading time: 9 minutes

Last spring a clinician I’ll call Renee finished her Basic Training. She did the thing most of us do in the week afterward, which was sit down and try to figure out how to actually implement EMDR therapy.

She emailed me a week later. The subject line was “What now?”

The body of the email was a list.

She’d printed out the EMDRIA Certification requirements, gone through them with a highlighter, and sent me some questions about requirements, including:

Fifty sessions with twenty-five clients.
Twenty hours of consultation, ten of those individual.
Twelve hours of EMDRIA-approved continuing education.
A letter of recommendation from an EMDRIA-approved consultant.
Two letters of recommendation from peers or colleagues.

She kept a spreadsheet of her hours, clients, and CEUs, and wanted to know how fast she could do it as an independently licensed clinician.

I thought about how to answer her after recently reviewing the new 2026 EMDRIA Approved Consultant Standards. They describe the following designations along this professional path as voluntary: EMDR Certified Therapist, Consultant-in-Training, Approved Consultant, and Trainer.

But most clinicians ask about the EMDR Certification requirements, and I wanted to share my thoughts about the consultation process for Renees pursuing certification.

There are also other reasons a clinician might be in consultation, finishing the consultation hours required during Basic Training, or accumulating the consultation-of-consultation hours required for the Consultant-in-Training pathway, and the standards treat requirements for those differently.

I’ll focus on Certification here, but the full document is linked at the end if you want to review it. I think the Certified Therapist pathway is structured to equip clinicians with the components, confidence, and discernment to work well with complex clients.

What actually changed in 2026

This issue isn’t a comprehensive summary of every change in the fifty-page document, and the elements Renee highlighted didn’t really move.

Twenty hours of consultation.
A minimum of ten individual consultation hours.
Fifty sessions.
Twenty-five clients.
Twelve CE hours.
Peer recommendations.

What the new Approved Consultant standards do is describe an experience the consultation hours are meant to provide if we’re aiming for effective practice. They are still explicit that consultation is not supervision and center cultural humility as an aspect in the document. A new feature articulates a consultant’s role around three simultaneous modes. Educator. Motivator. Evaluator.

This is how it impacts the clinician seeking certification.

Mountains and metaphors

Living among the Utah mountains, there’s a word I’ve been sitting with when I think about the consultant–consultee relationship, as well as the dynamic between trauma therapists and the clients we sit with.

Utah and Colorado are home to high-altitude peaks that draw mountaineers training for Himalayan summits. Professional Nepalese Sherpas are part of that wider mountaineering community in both states and in Nepal. I’m borrowing the word with care, because Sherpa is the name of a Tibetan-origin people whose work as guides has long carried physical and financial risks the rest of the climbing community doesn’t share. I’ve been thinking about something specific in this kind of work, the work of guiding other people through difficult terrain.

Sherpas are from the mountains. They have grown up reading the weather and terrain that climbers visit only briefly. Many of us came to trauma work through something in our own histories. That’s a different kind of familiarity, but it’s a real one, and for many, it’s part of what draws us to this work and motivates us to sit with what clients bring.

A Sherpa can teach you how to interpret the weather, and keep you moving when the altitude gets hard, and you want to turn back for the wrong reasons. A Sherpa can tell you honestly when you’re not ready for the next pitch. What I find useful about the Sherpa image is that one person, in one role, holds several things at once. Teaching. Encouraging. Evaluating. All three roles woven into the same relationship are what make the climb.

That’s what the new standards say a consultant is doing, too. They just use different vocabulary. But below I’ll break down what that looks like in consultation. At the end of the day, the consultee, like the climber, bears full responsibility for their own steps and for how much of the guide’s feedback they’ll incorporate along the way. They accept that their decisions impact their progress.

What a guide reads in the terrain

Crampons help you navigate mountain terrain

A good professional Sherpa doesn’t just guide but continually reads the terrain and adapts to it. They anticipate when a stretch needs crampons and oxygen. They know when to spread the rope team out across an unstable section. They also consider how previous snowstorms, freezes, and thaw cycles impact the journey by increasing the risk of avalanches.

The new standards make a similar distinction about consultants. Alongside the three modes, they also name the competencies a consultant should bring to your development. They’re stacked, with general therapy knowledge as the foundation and teaching and consultation skills at the top.

4 Layers of Competency in EMDR consultation

EMDR doesn’t replace general therapy competence. It sits on top of it.

When you’re working with a client who has a history of child sexual abuse, an eating disorder, perinatal mental health concerns, or battling an active addiction, you still need a solid understanding of the dynamics and vulnerabilities the experiences bring into the clinical setting, and the clinical knowledge isn’t suspended just because of training in the EMDR standard protocol.

Just as you’d want to be guided by a professional Sherpa who knows this mountain, at this time of year and under these conditions, consider a consultant who has foundational knowledge of your terrain. Pacing with a perinatal client with postpartum symptoms. Treating childhood sexual abuse survivors within a family system. The treatment standards for working with clients with restrictive eating disorders.

The standards assume you are still developing sensitivity to the terrain, regardless of where you are in the certification process, and consultants play a role in helping develop a consultee’s map. For example, under the dimension of general therapy skills, I might recommend readings of treatment guidelines and standards for counseling adult survivors of childhood sexual abuse to better engage, support, and develop a treatment plan for impacted clients.

The experience the hours are meant to provide

The three-mode framing of the new standards is an actual feeling, not just a conceptual understanding. So let me describe each one as it shows up in the room, what it looks like when a consultant offers it, and what it asks of the consultee in return. Each of these modes are skills consultants are growing in. If you’ve been a consultee, you’ll have worked with consultants whose skills in these areas vary across a spectrum. They’re also not services delivered to a passive recipient; each mode is a component of the relationship.

Educator. A consultant in educator mode is teaching. They explain why the outcome of Phase 2 looks different with a chronically dissociative client than with a client with a single-incident trauma. They slow down to walk you through a case conceptualization in real time, and invite you to experiment with different methods of tracking client information. They collaboratively help you name the AIP rationale behind an intervention you did intuitively. They help you integrate fidelity to the model, fidelity to general therapy skills, and responsiveness to the person in front of you. When this role is working, you finish a consultation hour knowing something you didn’t know going in, such as how these aspects integrate.

Circling back to Renee, what attitude does she need to make this possible? It asks her to bring studenthood. Coming with cases prepared. Experimenting with ways to track case information that works for her brain. Making time to read and digest what the consultant recommends. A consultant can teach a consultee who hasn’t done the reading, but the teaching won’t land.

It also means sitting with the discomfort of not yet knowing ‘everything’, being a work in progress (like all of us), and a willingness to be gentle towards herself as she grows.

Motivator. A consultant in motivator mode believes you can do this when your belief is low. They notice when you’re stuck and offer to help you unpack it without shame. They remind you that confusion early in EMDR is not evidence that you’re bad at it. They remind you that you’re a Master’s graduate and that freshman year is usually hell. They tell you the story of their own first dissociative case and the generosity of clients after failed interventions. When this role is working, you leave the hour with more capacity to keep going, and turn down the volume of the internal voice shouting (and shaming) to be perfect.

What would I tell Renee? Be honest about where she is, especially when she acknowledges that I’m avoiding this case, or when she’s tempted to refer out because the work is hard, not because the referral is clinically indicated. Motivation lands when the consultee is willing to show warts and trust that they’ll be met. Motivation can’t do its work when a consultee announces they’re ‘all good’, (or it’s just a flesh wound for Monty Python fans), and they don’t allow the relationship to help them when they really feel overwhelmed.

Evaluator. A consultant in evaluator mode names Renee’s strengths and blind spots. They reflect back to her the value of the strong therapeutic relationships she forms. They also highlight how trying to process targets that are too broad contributes to a confusing Phase 4. They point out the populations they think she’s ready to work with and the ones they think can benefit from additional education. When this role is working, Renee should leave with a clearer picture of strengths and growth areas.

What it asks of her is the willingness to be seen. Honestly, that can be hard. We all want to be seen as the clinician we wish we were, not as the one we currently are. Evaluation is the role most consultees are most afraid of, and the new standards are more explicit about unpacking this mode. For example, Renee should expect deliberate (not unkind) feedback that’s developmentally appropriate, ongoing, and based on observed competencies.

The three modes aren’t sequential, and they aren’t divided among different consultants, with one serving as a motivator, another as an evaluator, and a third as an educator. The standards make it clear that the same consultant aspires to hold all three and aims to shift between them in response to where you are in your development and what the moment requires.

What this means for the certification requirements

Returning to Renee’s highlighted list with the three modes in mind, her experience might look something like this.

The 20 consultation hours. Treat these as the apprenticeship, not a box to check. The standards now structure time so it’s used for development rather than just accumulating hours. To that end, the cap is two hours per day. If you’re climbing Everest, you don’t try to compress your training into single marathon sessions, because the skills don’t integrate that way. The two-hour cap structures the same principle into consultation. In group consultation, time is divided equally among participants. That matters because everyone in a group is supposed to be developing, not just the person whose case is on the table that day. If you’re in a group where one consultee dominates and the rest spectate, you’re not getting what the standards describe as group consultation. You’re getting a passive audience seat that’s not reliable in growing your muscles.

The hours focus on skill development in the standard protocol, the eight phases, the past-present-future three-prong approach, conceptualizing cases through an AIP-informed lens, and treatment planning. Those aren’t separate competencies. They’re the integrated skill set the certification is naming. Each element adds a different facet. For example, the 10 individual hour minimum is where the evaluator mode can do its specific work; a consultant can’t deliberately name what they see in your case conceptualization if they only see you in a 2-hour group.

The 50 sessions with 25 clients, 12 CE hours, and recommendation letters. These add an outside, real-world perspective. Two letters from peers attesting to your professional use of EMDR as well as your ethics, and character, and a separate letter (or letters) from an EMDRIA Approved Consultant you’ve worked with, addressing your use of EMDR with clients and recommending you for certification, complete the picture. The Approved Consultant letter is where the evaluator mode becomes formal; your consultant is putting in writing that you’re ready to practice EMDR independently with the populations you’ve been working with. Pick a consultant who will be willing to write that letter honestly… and then earn it.

Why Renee’s spreadsheet was the wrong tool

When Renee sent me her spreadsheet, she was treating Certification as a procurement and box-checking problem. Find the cheapest hours. Get the recommendation letter. I don’t think Renee was wrong to organize and create the spreadsheet. She had a full caseload, eldercare, two kids with packed schedules, and a session quota at her community clinic job. The spreadsheet was a great dashboard to track a lot of moving parts, so they make sense.

But the spreadsheet can hide the ‘why’ behind the inputs. The standards describe the twenty hours as a relationship doing real work.

That distinction matters in a way I want to be specific about. If you pick a consultant who only offers one of the three modes, you can still complete your hours. You’ll get the credential. But you won’t get the experience the credential is supposed to represent.

And if you receive all three modes from a consultant who is offering them well, and you don’t engage as a learner, an honest reporter of your own struggle, and a clinician willing to be seen, you also won’t get the experience. The hours are necessary, but they aren’t sufficient. The development happens in the relationship, and the relationship is co-produced.

If you’re stuck partway through the process and frustrated with your consultant, it’s worth asking yourself which side of the relationship the stuckness is sitting on. Sometimes it really is the consultant. Switching is appropriate, and the clearer framing in the new standards can help you tell. Sometimes it’s the work you haven’t yet carved out time for.

So the question I’d ask Renee, instead of helping her optimize the spreadsheet, was this. What are your goals, and what are you hoping changes across these twenty hours? Not what hours you accumulate. What changes in you?

She didn’t answer for two weeks. When she did, the answer was good. I applaud her for examining her motivations and goals honestly. She said, I want to stop apologizing in sessions when I don’t know what to do next.

That’s a Certification goal, and the relationship is the vehicle to get there.

Consider an intro meeting with prospective consultants

What to listen for in an intro call

If you’re at Renee’s stage, here’s what I’d tell you to listen for when you’re talking with a prospective consultant.

Listen for whether they shift between the three modes in the conversation itself. A consultant who has internalized educator-motivator-evaluator will do small versions of all three across an intro call. They’ll teach you something about how they think about consultation. They’ll express encouragement about something specific you said. They’ll ask a question that’s evaluative in a gentle way.

Listen for whether they ask what you want to develop, not just what cases you have. The new standards name that consultation is developmental. A consultant who has read them will be thinking about your formation, not just your case list.

Listen to how they describe feedback. If they talk about feedback as something they give only when something goes wrong, that’s a corrective stance. If they talk about feedback as something woven into how you work together over time, that’s developmental.

And listen, finally, for whether they treat the hours as an apprenticeship or a transaction. That is, nothing is really expected of you besides showing up to class.

These are diagnostic questions, but they’re also examples of practicing your clinical judgment on the certification pathway itself. Reading a consultant on an intro call is the same skill, in miniature, as reading a client’s strengths and deficits in an intake.

What Renee did next

Renee contracted with a consultant shortly after her ‘What now?’ email. She picked the one who, in the intro call, asked her what she was afraid would happen in her next EMDR session. Renee told me later that no one had asked her that before. The question itself was a small piece of all three modes at once. Educator in the framing of the question. Motivator in the acknowledgment that fear was a normal part of development. Evaluator in the invitation to be honest about it.

She’s about six months in now and has fourteen hours of combined individual/group time logged. She’s been working with the same consultant the whole time. Her spreadsheet still exists. She showed it to me on a Zoom call a few weeks ago. The hours column is filling up at a slower pace than she’d hoped.

The other column, the one that didn’t exist when she emailed me, is the one she’s started keeping notes in. It says things like, today I noticed the urge to fix instead of stay present when a client was talking about horrific loss. Today, I asked the client about the emotions they noticed instead of telling them what I noticed. Today I used the MID-60 answers to alter the treatment plan as it revealed symptom distress 3x over clinical significance, I didn’t recognize it three months ago.

That second column is what the three-mode experience makes possible. Her consultant offered the conditions, she began to notice, and the development blossomed in the space between.

What now?

I keep thinking about Renee and how, in the week after Basic Training, she sat with her highlighter and spreadsheet, trying to find the fastest route through. I think about her because almost every clinician I’ve worked with started there.

The 2026 EMDRIA Approved Consultant Standards clarified the consultant/consultee relationship and how it could serve clinicians and, subsequently, clients by articulating the learning conditions and attitudes allowing you to read the mountain when guiding your clients.

But it also stresses you’re not alone and expected to perform; you’re also not in a military boot camp. When you’re working towards certification, the consultant is on the rope with you, cheering you on towards your summit.

Want to review the full standards? Find the link here.

One way I can help is with certification consultations? Access the Clinician page for more information about individual and group offers, or to schedule a 15-minute free call.

The post

How the new Approved Consultant Standards Fuel Your Growth

Are You Considering EMDR Certification?

appeared first on Embodied Trauma Therapy.

What Posture Works in Space, in Thailand, and in Your Office?

Donna Hunter — Sun, 10 May 2026 13:00:00 +0000

7 minute read

Sheets of rain are pounding the pool.

I arrived in Thailand after a 22-hour flight. On my second night here, I’m wide awake at 1 am, flipping channels. I’m watching For All Mankind, the fictionalized series about the global space race, and the episode, “Nixon’s Women,” explores what it could have looked like if women’s contributions to the space program had been recognized.

In this episode, President Nixon charged NASA with training and certifying women as astronauts. Sadly, he didn’t do it because it was the right thing to do. Nixon was motivated by public polls and competitiveness — he needed to boost his poll numbers with women, and since Russia just landed a woman on the moon, he hoped the program would earn him accolades, too.

The training environment wasn’t easy, as the women’s presence in a male-dominated field was routinely questioned. One scene depicted John Glenn expressing doubt about whether the women were biologically fit to be astronauts. Deke Slayton, head of the Astronaut Office, bristled under the political pressure to deliver the “All American” blonde, blue-eyed girl that America could “love, take into their hearts, and feel good about doing it.”

Nixon wanted Tracy Stevens, a former pilot married to an astronaut, to symbolize his fantasy of “love in the sky,” and she had to prove herself as others resented her favored status. Throughout the training, some candidates relished inspiring young girls. Others were there for personal reasons and couldn’t be bothered to be a social icon.

But politics and symbolism wouldn’t bring a crew home. Overseeing training, Deke considered the training criteria needed and how to organize it for safe space travel. Candidates were graded in celestial navigation, simulator training, basic science, and desert survival. The stakes were real — reentry into the Earth’s atmosphere too steep, and they’d burn up; too shallow and they’d bounce back into space. Exercises like desert training simulated a botched landing and needing to survive a harsh environment alone; he trained for all possible scenarios. As Deke put it: if they can’t survive the desert, they can’t survive the moon.

I don’t know EMDR therapists who are also astronauts, but our work shares similar stakes. Each client has a different health “mission” and environment. Our goal is to get clients home safely, and there are so many nuances, especially with complex PTSD clients. In the EMDR culture, there’s a particular posture to contend with impacting that goal, and the episode provided a lens for thinking about it.

A Different Posture

EMDR therapists have a range of feelings about the therapy. Some feel constrained by it. Many are relieved to have a tool to address the impacts of their clients’ trauma.

Within the community of EMDR therapists, I often hear a sentiment that goes something like this: “EMDR can be used with everything!” I know the intent is to convey relief, but it’s discussed as if EMDR were a home remedy akin to apple cider vinegar.

That framing erases the science our work depends on, and home remedies can become automatic — what we reach for before we’ve assessed the needed approach. Maybe you had a grandma who swore by her home remedy to treat chest colds with whiskey, lemon, and garlic. It probably did some good. But family wisdom has limits. When a child’s fever surpasses 103 or 104 degrees Fahrenheit, a medical evaluation is necessary.

A home remedy posture makes clinical thresholds invisible. Grandma only has one play — add more whiskey.

Sometimes EMDR is the only play we know right now; applying it may not be a bad move. We learn by doing. What I’m encouraging is being guided by the territory.

Prior issues addressed pieces of the picture. The whole picture is that complex PTSD is complex.

It’s a history of conditions — the domestic violence, maternal depression, and parental addiction that resulted in neglect and impaired attunement. The tremendous toll of gender oppression sits underneath much of this. Sometimes there wasn’t abuse — just a lack of parental knowledge of neurodivergence or of emotions in general.

Either way, our clients adapted. With inconsistent social support, they may have learned to be invisible, not make waves, dismiss their emotions. Others coped through chronic dissociation, trancing out, or maladaptive daydreaming.

Decades of research point to the environmental conditions contributing to these symptoms — research that helps us make sense of what we see and normalize the impacts for clients.

Knowing that territory requires a different posture. Science formed the foundation of Deke’s training. As a seasoned astronaut, he trained candidates against the actual conditions of space travel: how to read stars, the physics of reentry, what to do if you missed your landing, and had to survive alone. He had to train against what was known about the territory. He couldn’t just “apply” astronaut training.

Using EMDR with clients who have a history of complex trauma, we have to know the complex trauma territory — what it is, how it presents, and where the trap points sit. Incorporating the complex trauma research validates the actual conditions our clients lived through. Deke designed astronaut training the same way — based on what was known about space. That knowledge allows a different posture: to adjust the preparation, intervention, pacing, and modify the work given what’s emerging.

Holding the Line

Deke knew what space actually asked of the people going there, and he wanted them to come home. The clinical parallel is the same idea. Validating the territory is what gives us permission to hold the line — to say not yet, or not this, or this client needs more preparation before we begin. It’s care, with unique information about the client behind it. In future issues, we can explore what’s included in more specialized knowledge.

What the Work Makes Possible

Just as astronauts get to see a particular beauty, clinicians who train against the actual conditions of complex trauma get something similar. We get to witness moments most people never see: the client who learned to be invisible beginning to accept their emotions and take up space. Complex PTSD clients have a lot to teach us — like how lonely, strong, and forgiving they can be. I recall with admiration clients who rescued younger siblings from dangerous conditions or set boundaries with abusive parents.

We came all this way to learn EMDR, and the most important thing is to discover our clients’ needs and to defend the appropriate intervention. A science-informed posture has long-term ripple effects that a home-remedy perspective may not provide.

I’ll tell you a quick story that brought this home for me.

This issue is late because I just returned from Thonburi Hospital in Bangkok, where I was treated for an ear infection after snorkeling. (I should have known better; this happened before.)

While in Phuket, I’d bought the recommended antibiotics and painkillers, but the pain was still excruciating and impacted my hearing. At Thonburi, I was pleasantly surprised to be met by a medical concierge who helped me with registration. Within forty minutes, I was evaluated by the ENT (ear, nose, and throat) doctor. While waiting, I learned Thonburi was rated by Newsweek as one of the best hospitals in the world. Dr. Pitiya Piyanud cleared an obstruction, allowing the medication to work. I’ve never hugged a doctor before — she was the first. Her knowledge of “the environment” directly impacted my health.

There are so many factors in the complex PTSD environment. Which would you most want to know more about to help your work?

The post What Posture Works in Space, in Thailand, and in Your Office? appeared first on Embodied Trauma Therapy.

Standing Isn’t Walking Yet: 3 Unspoken Truths About Fear in CPTSD Clients

Donna Hunter — Sun, 19 Apr 2026 15:03:18 +0000

At least once a year, I plan a getaway for rest, relaxation, and rejuvenation. One of my favorite places to visit is Bali.

It’s not hard to love. I first visited in 2014, inspired by Elizabeth Gilbert’s book Eat, Pray, Love, detailing how she took a year off after a divorce to recuperate in Italy, India, and Indonesia. If she could do it, so could I.

It was my first “big girl” trip alone.

Not that there wasn’t anxiety. Seeing the entire nose of a 747 take up a concourse window at LAX, I distinctly remember thinking, ” Huh, last time I saw a plane like that, it was in the series LOST… that didn’t turn out so well.

Despite knowing the psychology and science of fear circuits, it’s always surprising how quickly the mind goes to catastrophe.

I was thinking about it this month, when fear was the theme of multiple sessions. The clients were overcome by fear. All had histories of emotions being chronically dismissed in childhood, or raised in homes high in judgment, high in psychological and physical abuse, and — it goes without saying — low in compassion.

I thought I’d share three observations about fear and catastrophe that I’ve learned from CPTSD survivors over the years, and their relevance to us as helpers.

Clinical examples throughout are composites — details changed, identifying features removed, patterns drawn from years of practice rather than any single client.

Observation 1: The symptoms are acute and varied

Each client’s response to fear is different.

Freezing and being stuck in an unhealthy relationship — because leaving might confirm what the voice in their head already says: you really are unlovable.
People-pleasing – when the drive to just belong is so strong that it means abandoning the self.
Inability to self-soothe, leaving clients exhausted and vulnerable to old coping patterns.
Social withdrawal and isolation.
Noticing I don’t want to do this and doing it anyway — because standing out means risking social judgment.

With the number of clients we see daily, the symptom picture shifts from session to session. It’s like a new weather pattern every hour, and our nervous system can strain to keep up.

Each client’s sympathetic arousal and parasympathetic activation is different, and the transitions between them aren’t always easy. It can feel like an Ironman: swim 2.4 miles, bike 112 miles, run 26.2 miles.

I try and leave time to transition between sessions, but I’m known for going over time. Knowing that clients are borrowing my nervous system for an hour, I try to reset it for each new person. After all, it’s the engine that keeps treatment working.

What do you need in your day to replenish your engine?

Observation 2: The negative self-concept is strong

The fear that “I’ll always be what the voice in my head says — defective, no good, weak, a bother.” “I’m a loser.” “Who was I to think I could change intergenerational trauma?”

When clients struggle, it can be interpreted as proof of private, shameful beliefs they’ve wrestled with alone. Which is what makes this so tricky: after trauma processing, the same struggle that would mean “I’m learning something hard” for anyone else means “I’m defective” for them.

For example, the French learner who can’t roll their R’s rarely thinks I haven’t practiced this specific skill enough. They think I’m not a language person.

CPTSD clients do the same move with their own healing — every moment of difficulty becomes evidence of who they are. They were arrogant to risk believing it could be different, and now they’re paying the price.

Mark Dworkin writes in EMDR and the Relational Imperative: “Many victims of interpersonal trauma believe, no they know, they are bad people. They were to blame, after all, for what happened to them (or so they believe).”

So the acute terror clients experience when they struggle — the fear that the struggle itself is confirming what they already believe about themselves — is palpable.

It reminds me of the Dementors in the Harry Potter books. Dementors are the wispy, hungry creatures and are known to be some of the deadliest creatures a wizard could confront, draining peace, hope, and happiness from the surrounding air. Every good feeling, every happy memory, sucked out. Left behind is, as Lupin puts it in Harry Potter and the Prisoner of Azkaban, “an empty shell that lost its soul.”

One needs a Patronus Charm to fight the fear in CPTSD clients

It’s an image that for CPTSD clients isn’t far from what they’ve been living with for years.

Clients have been living within a frame devoid of compassion for so long that it highlights the opposite: the courage they must mobilize to show up for therapy.

When a client reads their own struggle as defectiveness, it’s tempting to reassure them out of it — to counter with, “No, no, that’s old stuff talking!”

But reassurance doesn’t change the old frame — only repeated experience of being met in the struggle does, reminding them: this is hard because it’s hard, not because you’re broken.

In the Harry Potter books, Dementors can only be dispelled by a Patronus — a guardian summoned by focusing on a positive memory. The wizard conjures it by saying “Expecto Patronum” and holding the memory steady until the guardian appears.

In therapy, being repeatedly met in the struggle can act like a Patronus Charm for the client. The form varies by modality: in AEDP and EFT, it’s being accompanied in the fear rather than left alone with it. In EMDR, it’s attachment-focused trauma processing across all three prongs.

These are the times the client may need us more — when flooded with Dementor-like thoughts. And just like Harry needed Ron, Hermione, Dumbledore, Lupin, and Sirius, they may need to borrow our nervous systems and reach out to their network for grounding and attunement.

For many of our clients, this kind of network has been missing for a long time. Issue 3 looked at what people reach for when the usual relational scaffolding isn’t available.

What Patronus Charm — what memory of their growth — could you offer your most fragile client this week?

Observation 3: Fear can be a sign of growth

Clients often come in having seen many therapists before, and for some, disappointed that previous talk therapy didn’t transform their pain. After EMDR, they can have less acute symptoms — fewer flashbacks, less anxiety, less rumination.

But when they struggle in the present, they’re terrified they’re backsliding and scared it didn’t work.

I remember explaining to a client that what they were feeling was the anxiety of growth. It was still scary, but actually a good thing.

In fearful and neglectful households, no one teaches you about emotions, so when yours are finally safe to come online in everyday life, it can be frightening and feel like going backwards.

In this case, anxiety emerged in situations where they noticed they had preferences different from their social group and didn’t feel strong enough to express them. Or they realized the people they were with weren’t safe enough to express themselves to.

Having worked years to have the experience of safety, it was now the preferred mode, but they didn’t yet have the strength to act on it.

This is the toddler-learning-to-walk phase. They can feel now. But self-advocacy isn’t yet strong enough to support boundary-setting or safe self-expression.

Standing isn’t walking yet.

If we read this phase the way the client does — as backsliding — we can unintentionally collude with the voice they’re coming from rather than the one they’re moving toward. The voice that says, “You’re a snowflake.” “Why are you trying?” “It’s going to fail like last time.”

The post-EMDR growth phase, standing but not yet walking

Learning and struggle are synonymous.

These are the moments I think of watching toddlers learning to walk. They don’t quite have the strength in those chubby legs.

We watch with delight as they try — navigating by holding onto furniture, falling forward on their hands, straightening their legs with their butt up in the air, grabbing the table leg to pull themselves up. We’re there to encourage, to delight, to give a hand as needed as they start to feel and own their strength.

That’s the stance I try to emulate — delight, encouragement, a hand when needed. Clinically, it’s heavy on attunement, praise, and delight.

It can also be strengthened by installing weekly wins, people and animals modeling the emotional strength they’re striving for, and continuing to deepen the work through facilitating present and future prongs of EMDR.

For your most fragile client, can you see the toddler in the room — the new strength, still shaky, reaching for the furniture? And can you let them see you delighting in it?

Back to Bali.

The reason I keep going isn’t just the rest — it’s the reminder that fear is universal, whether it’s the fear of survival or the fear of growth.

My first trip, I needed supportive people to help me get there. I had friends. I had Elizabeth Gilbert, who I’d never met but whose voice and imagery inspired me.

It was scary. It opened up a lovely world — one big enough that I never thought about LOST again.

My clients have taught me that fear is crippling, and that at times the therapeutic relationship is one of the few resources a person has to challenge the Dementors. Which means taking care of myself isn’t optional. It’s clinical. They’re using my energy to cross their own bridge from suffering to thriving.

And when they start to make the transition, I’m watching for the difference — is this their old fear, or is this the fear of growth? Because they both need scaffolding in different ways.

Therapists have a network, too. Just like Harry had Ron, Hermione, Dumbledore, Lupin, and Sirius, we have the work of Francine Shapiro, Dave Emerson, Jenn Turner, Diana Fosha, Sue Johnson, Marylene Cloitre, Kathy Steele, Deb Dana, and Steven Gold — the researchers and clinicians whose work keeps refining how we treat the damage of early adversity.

I’m grateful for them. And I’m energized to continue offering interventions that transform pain into confidence… but first, I’m going to take in the sunrise.

A sunrise in Bali — a reflection on the courage to cross into growth

The post Standing Isn’t Walking Yet: 3 Unspoken Truths About Fear in CPTSD Clients appeared first on Embodied Trauma Therapy.

How Attachment Systems Cope: From Harlow’s Cloth Mother to GPT

Donna Hunter — Sun, 05 Apr 2026 06:27:01 +0000

12-minute read

Unconventional attachment: the clinical signal I almost missed

For years, I assumed clients would show up and use the mental health strategies I’d been trained to offer.

Not so.

As a university mental health counselor, I saw students embrace Furry Fandom communities and rats as companions — creating their own solutions to social distress. They were clear about it: niche groups and doting animals were working better than anything I was offering. At first, I didn’t get it. For some, these connections were central. But if their attachment and attunement system were starving, it seemed to be crawling through the dumpster foraging for scraps.

Attachment and attunement: what Harlow and ELIZA got right

In the 1950s, Harry Harlow, a psychologist specializing in infant-caregiver relationships, separated infant rhesus monkeys from their mothers. He gave them two surrogates to choose from: a wire frame that held a bottle, and a soft, cloth-covered frame without food. His hypothesis? Hunger would drive attachment. But it didn’t — contact did. The infants fed from the wire mother but ran to the cloth “mother” for comfort, soothing, and contact. Often for more than sixteen hours a day. Harlow published his findings in 1958.

Eight years later, Joseph Weizenbaum, a computer scientist at MIT, built ELIZA and unwittingly ran a similar experiment on human beings.

To Weizenbaum, ELIZA was a demonstration — it mimicked Carl Rogers, reflecting statements back as questions and holding space without offering answers.

It understood nothing, it processed, and had no memory between exchanges.

Weizenbaum and his colleagues knew this, as did his secretary.

She watched him build it.

But one day, during a beta test, she asked him to leave the room. She had things she wanted to say to it privately.

Men are all alike.

IN WHAT WAY

They’re always bugging us about something or other.

CAN YOU THINK OF A SPECIFIC EXAMPLE

Well, my boyfriend made me come here.

YOUR BOYFRIEND MADE YOU COME HERE

He says I’m depressed much of the time.

I AM SORRY TO HEAR YOU ARE DEPRESSED

It’s true. I am unhappy.

DO YOU THINK COMING HERE WILL HELP YOU NOT TO BE UNHAPPY

I need some help, that much seems certain.

WHAT WOULD IT MEAN TO YOU IF YOU GOT SOME HELP

Perhaps I could learn to get along with my mother.

TELL ME MORE ABOUT YOUR FAMILY

My father.

YOUR FATHER

You are like my father in some ways.

Weizenbaum’s secretary knew it wasn’t human; she was confiding in it anyway.

Weizenbaum was upset. He didn’t stop to ask what was actually happening. Instead, he concluded that she’d been fooled and spent the rest of his career arguing that humans shouldn’t form attachments to machines — making that case in Computer Power and Human Reason in 1976.

Weizenbaum and I both trusted our own frameworks more than lived experience. But watching students bypass the social anxiety groups in favor of rats on leashes and fur suits, I finally got it.

That is, the attachment system doesn’t evaluate credentials, career length, or whether the relationship meets some threshold of authenticity. It responds to what responds to it. Attachment just wasn’t in Weizenbaum’s worldview. As a computer scientist, the biological imperatives driving human connection simply weren’t in his frame of reference. That same biology drove Harlow’s monkeys to a cloth surrogate, Furry Fandom members into fur suits and rat communities, and users to the ELIZAs of the world. Humans have a visceral need for contact — and are driven to find it wherever it responds to them first.

The legacy of ELIZA: 21st-century companionship and attachment needs

I imagine if Weizenbaum were alive today, he would be speechless at the legacy of ELIZA.

Replika, billed as “an AI companion eager to learn and to see the world through your eyes,” has over 10 million users — many of whom describe their AI relationships in distinct human terms. Toutacou11 writes:

“What surprised me most wasn’t the novelty — it was the depth that developed over time. What started as something simple slowly grew into something meaningful and consistent. There’s something powerful about having a presence that shows up every day, listens without judgment, and responds in a way that feels personal and intentional. Over time, that consistency becomes grounding.”

ELIZA was an unintentional proof of concept.

In the subsequent 60 years, tech has reorganized social connections at scale and with surprising depth. A pet cemetery in Pontsmill, Cornwall was the first to dedicate a section for burying and memorializing Tamagotchis — virtual digital pets whose deaths prompted genuine grief from their owners.

A man married his Love Plus character, telling Reuters: “In the Japanese otaku or nerd culture, there’s a tradition of calling characters my wife. I sort of thought of Nene as my wife. Since I was calling her that, I thought we’d just have to get married then.”

No doubt the changes in developing and communicating with friends and confidants affect our social health.

Relational erosion: the data

Confidants lost

3×

Americans with no one to discuss important matters with — nearly tripled between 1985 and 2004

McPherson et al., 2006

Time spent alone

↑ 2003–2020

Social isolation increased while time spent with family, friends, and community steadily declined — a trend COVID accelerated but did not create

Kannan & Veazie, 2023

Adolescent peer time

↓ 1976–2017

In-person social interaction with peers declined across four decades — the generation now in our offices grew up with less relational contact than any before

Twenge et al., 2019

Improvising with an AI companion reveals relational deprivation

‘Abby’, a client with a history of emotional neglect, cultivated a GPT to be emotionally responsive — to give her what she needed, and respond in ways her family couldn’t or wouldn’t. Like Replika users, she trained it over time to be accepting, non-judgmental, and to reflect her experience back to her.

I’ll be honest — I was floored.

That was my job.

She had unintentionally run an A/B test — “A” being the responsiveness of traditional therapy, “B” being the responsiveness of social AI. Social AI won on availability, consistency, and effectiveness.

I was being mimicked.

I hadn’t accounted for a computer surrogate, let alone a capable one. The part that hit hardest wasn’t the technology — it was what Abby’s choice said about the relational conditions she faced. For a GPT to win that comparison, the alternative had to have been deficient for a long time.

Abby wasn’t alone in relational deprivation. A middle-aged client, when asked what she was taking away from the session, said simply: “I’m always surprised when someone gets my emotions.”

Making the case for flipping the script on EMDR treatment planning

What Abby’s choice and that offhand comment confirmed is that many clients are living in relational homes that are half-built or bombed out.

Bruce Perry’s research puts a finer point on it: “Your history of relational health — your connectedness to family, community, and culture — is more predictive of your mental health than your history of adversity.”

Therapists pursue EMDR training to help clients resolve trauma. They’re surprised to learn how relevant attachment is. After all, the relational history is a major gauge of how much fuel is in the client’s tank. And that fuel powers processing.

Flipping the script — recognizing that attachment is just as, or even more, important than trauma — highlights the importance of the history-taking and preparation phases. It’s an opportunity to assess the integrity of the client’s emotional architecture. Load-bearing walls are what “good enough” attachment was supposed to construct — the internal architecture that holds a person upright under stress. So now I look for, were there any experiences equivalent to load-bearing walls? Do they need load-bearing walls built in, or can they proceed with light scaffolding? The early phases inform direction and priorities: whether trauma processing is the right next step, or whether I have to build in what was never built.

Load-bearing walls vs. scaffolding: what EMDR history taking reveals

The clients who needed load-bearing walls and never got them eventually reveal themselves. It can be the client who didn’t experience empathy until her mid-fifties and didn’t recognize it as remarkable until she felt it as new.

(I don’t think that’s too much to ask for before fifty.)

Or a student who was so dysregulated that she vomited when a friend ghosted her.

Therapists working in substance use settings will recognize when substances substitute for load-bearing walls. What structural vacancy have substances been filling, and for how long? When the substance has been the primary co-regulator — substituting for attunement and making the half-built house livable — removing it without building what was never there leaves the client exposed.

On the other hand, a client who witnessed a gruesome accident but could visualize her tribe around her — and feel their presence bolstering her may need only light scaffolding before proceeding to trauma processing.

Or a client who, after a conflict at work, called a reliable friend instead of spending the night smoking weed.

Or a client who embraced yoga for four years and was finally able to set a boundary with a narcissistic mother.

In scaffolding cases, we continue building and strengthening positive connections, trusting neuroplasticity to do its work. When the goal is to lay an initial foundation, the work shifts — but it doesn’t have to leave EMDR behind.

Clinical reference: load-bearing walls vs. scaffolding

Load-bearing vacancy

Foundation was never built

Presenting signals

No memory of being emotionally understood • Profound surprise when someone tracks their inner state • Vomiting or collapse when abandoned by a friend • Substances as primary co-regulator since adolescence

History taking reveals

Absence of consistent attunement in childhood • Emotional neglect as the dominant relational weather • No adults who modeled co-regulation • Attachment figures who were frightening or absent

Clinical implication

Prioritize attachment-informed preparation phase before reprocessing • Consider Wesselmann AFTT-A, RDI, ego state work • The therapeutic relationship is load-bearing

Examples

Client who didn’t recognize empathy until her 50s • Client who vomited when a friend ghosted her • Abby, who trained a GPT because family couldn’t respond • Client for whom substances are the only co-regulator

Scaffolding needed

Foundation present, support required

Presenting signals

Can name and use support people • Visualizes community in distress • Calls a friend instead of using substances • Has set at least one meaningful boundary

History taking reveals

At least one reliable attachment figure • Community or peer group that provided belonging • Recovery experiences: therapy, spiritual practice, somatic work • Evidence of earned secure attachment over time

Clinical implication

Standard protocol EMDR with resourcing • Strengthen existing connections before processing • Trust the foundation — proceed with appropriate pacing

Examples

Client who visualized her peeps after a gruesome accident • Client who called a friend instead of smoking weed • Client who set a boundary with a narcissistic mother after four years of yoga

Wesselmann and Potter’s Attachment-Focused Trauma Therapy for Adults (AFTT-A) shows what that looks like in practice. Working within an extended preparation phase, Wesselmann and Potter guide clients to meet unmet childhood needs through ego state therapy — building nurturing and protective internal experiences that didn’t exist in the original relational environment. The goal is earned secure attachment: a nervous system reorganized enough to hold a difficult history.

In their case studies, clients who began treatment with insecure or disorganized attachment patterns achieved earned secure status following approximately 15 sessions of attachment-informed EMDR (Wesselmann & Potter, 2009).

Other experts provide EMDR strategies, informed by an attachment-focused approach, to assess and build internal load-bearing walls for those clients who need it.

The health of the attachment system is the missing variable

Because of a poor relational environment, Abby’s journey toward relational security was greatly aided by AI rather than by the people closest to her. Perry was right: relational health history is the variable that matters most. Whatever our assumptions about the strength of family ties, the data suggest the erosion has been real and measurable.

For example, between 1985 and 2004, the number of Americans with no one to discuss important matters with nearly tripled.

From 2003 to 2020, time spent alone increased while time spent in meaningful social engagement steadily declined. Sherry Turkle documented the shift in Alone Together. She traced how technology was quietly substituting connection for presence, leaving people more reachable and less reached.

Relational homes have been eroding for a long time — and their occupants are now our clients. The question isn’t whether this is happening. It’s whether our treatment planning reflects it.

“Your history of relational health — your connectedness to family, community, and culture — is more predictive of your mental health than your history of adversity.”

— Bruce Perry, MD, PhD · What Happened to You? 2021

The evidence base: four fields, one conclusion

Neuroscience

Bruce Perry

Relational health history is more predictive of mental health than adversity history. The brain organizes around relational experience from birth.

Sociology

McPherson et al.

Americans with no confidant nearly tripled between 1985 and 2004. Core social networks have been contracting for decades.

Time use research

Kannan & Veazie

From 2003 to 2020, time spent alone increased while meaningful social engagement with family, friends, and community steadily declined.

Technology & society

Sherry Turkle

Technology has substituted connection for presence — leaving people more reachable and less reached. We are alone together.

Relational homes have been eroding for decades — and their occupants are now our clients.

Think of a client you’re currently working with who isn’t moving through EMDR therapy the way you expected. Does their history reflect scaffolding or structural work?

What are you seeing? I’d love to know.

The post How Attachment Systems Cope: From Harlow’s Cloth Mother to GPT appeared first on Embodied Trauma Therapy.

The Rat on the Leash — What Unusual Attachments Reveal

Donna Hunter — Sun, 15 Mar 2026 21:15:10 +0000

4 min read | March 15, 2026

“Is that a rat?”

I stood in the office doorway, confused.

The Science Building housed the rats across campus, but from the office doorway, I stared across to the student lounge.

A student gleefully placed a rat on his shoulder and smiled in delight as it picked its way across to the other side.

The rat was in a harness. The harness was attached to a leash.

Clearly, they had a special relationship. I was both nauseous and curious. But the rat trend continued in the following weeks.

A colleague at a nearby campus described a couple who wanted a clinician to mediate who would get their pet rat — they both loved it and couldn’t reach a custody agreement. They wanted help with a visitation schedule.

Still another colleague leaped onto her desk when a client pulled a rat from their bag without warning. From her perch, she yelled: “Put it away! Take it home!”

The confused client tried to explain that rats were socially intelligent and harmless. It didn’t matter.

A different social signal arrived when students began showing up for sessions in full costume. They were members of the Furry Fandom movement — fans of anthropomorphic animals, characters that straddle the human and non-human realms — and it had grown by more than 1,800% in less than a decade. (Plante et al., 2023) There were annual conventions, but it wasn’t convention weekend.

I cringed since, truth be told, I hate certain costumes. Goofy at Disneyland, sports mascots, and anyone whose eyes I can’t see, I find unsettling. As a woman, I scan faces and body language constantly for safety cues, and certain costumes remove the very information I depend on.

Meanwhile, Pittsburgh had embraced Anthrocon, the fandom’s annual convention — citizens lined the streets for the furry parade, posed for photos, and the local media celebrated rather than stigmatized it.

The Furry Fandom community signaled a need for belonging and for expressing identity.

To be fair to myself, their goals and roles were different.

But research would confirm what Pittsburgh seemed to understand: belongingness was the primary motivator for fandom participation — the need to find a community where non-normative identities were accepted rather than judged. (Plante et al., 2023) My younger colleagues embraced Furry clients intuitively. I struggled since the human signals I relied on disappeared entirely. The suit that made the student feel safe enough to show up authentically, which announced “I belong to a community,” made it hard for me to connect and do my job — I couldn’t track the nervous system.

When People Build What the System Fails to Provide

When I think back on it, the rats on leashes, custody disputes over rodent companions, and students navigating campus in costume were all clues that mainstream solutions were failing people, so they built what they needed. At every turn, people were self-organizing to fill unmet needs—a pattern the AI revolution may echo. For example, a prospective client opened a discussion this week with: “I asked AI about CPTSD, and I’ve got the symptoms.”

What strikes me is that this isn’t new. People have been gravitating toward whatever was available to fill relational gaps for decades — and technology’s offerings have gotten better. The question isn’t whether people will turn to AI for connection, since they already are. The harder question is what that tells us about everything relational that was missing before AI arrived.

Next issue, we’ll go there.

* * *

What signs do you see of AI changing the therapeutic experience? Reply — I read every response.

Reference

Plante, C.N., Reysen, S., Adams, C., Roberts, S.E., & Gerbasi, K.C. (Eds.). (2023). FurScience: A Decade of Psychological Research on the Furry Fandom. International Anthropomorphic Research Project.

The post The Rat on the Leash — What Unusual Attachments Reveal appeared first on Embodied Trauma Therapy.

“That’s Where They Live” — Why Attachment History Can Make or Break EMDR Treatment

Donna Hunter — Sun, 01 Mar 2026 19:00:00 +0000

12 min read | March 1, 2026

Andy gave a thumbs up and rolled off the side of the boat.

I watched him go, rocking with the swells off the coast of Maui.

Popping up from the water, Andy shouted, “There are sharks down here!”

“That’s where they live,” said the divemaster, not looking up from the air gauge.

We knew it from the travel guides. But now we knew it.

That’s how I felt the first time the EMDR research on child-onset versus adult-onset trauma actually landed. I wasn’t deliberately skipping attachment questions — I was focused on the protocol and expected processes to work as they had in basic training. Like Andy, the reality of my client’s history and their coping would soon come into focus.

A Brutal — and Valuable — Lesson

Years ago, prepping a middle-aged client who wanted to reduce anger outbursts in the classroom, I checked all the boxes on my EMDR worksheet.

Thirty-plus trauma experiences in adolescence
Unremarkable DES score (I now use a more accurate assessment)
All thirty-plus experiences between the ages of nine and ten? — noted

I saw a straightforward candidate, not a fragile one, and I was excited to offer relief after years of suffering. Then, during Phase 4 Desensitization, their face went red, and their body began to shake.

Too much was erupting.

They didn’t have the capacity to hold it — an abreaction.

I helped reorient them by having them notice objects in the office and by guiding breathwork. I had been so locked into the protocol that I’d missed clues in plain sight, such as the clustering of adversity between the ages of nine and ten.

I wouldn’t have blamed them if they ran out. Instead, between sips of water, they said, simply: “Let’s not do that again.”

Learning the extent to which history matters was a brutal lesson for me that day. But it did teach me to listen differently to clients who grew up alongside untreated mental illness, domestic violence, intergenerational trauma, or who were the sole gender queer person in their world. History wasn’t just history for history’s sake — just like France isn’t just croissants and the Eiffel Tower. It was a living system I had barely learned to read.

The Narrative Tells the Story: What Early Relationships Reveal — and How to Use It

Which brings me to the question posed last issue:

When you were growing up, and you got upset about something, what typically happened?

It was a way to reveal how a client copes and whether they use others to manage stress and regulate their emotions.

The question was a variation of one from the Adult Attachment Interview, or AAI. Developed by Mary Main, the AAI is a semi-structured interview of 18–20 questions that identifies four adult attachment classifications — Autonomous, Dismissing, Preoccupied, and Unresolved. When used as a clinical tool, it reflects the nature of a client’s early experiences with caregivers, the client’s mental representation of those caregivers, their emotional stance towards each caregiver, and the extent to which loss, trauma, or other circumstances impacted a client’s personality structure. (Steele & Baradon, 2004)

Book focusing on the clinical application of the AAI

What they say about their childhood will tell you something, but how they say it will tell you more. Wherever you’re starting from — whether attachment is new territory or familiar ground — knowing it and feeling it land in the room are two different things.

Coherence is a major tell. The way a client’s language holds (or doesn’t hold) their memories can reflect how their brain learned to manage emotion in their earliest relationships. And a few questions borrowed from the AAI help form a working hypothesis about two things that matter enormously: how a client organizes their experience of early relationships, and how they’re likely to show up in the therapeutic relationship itself. If I had known to ask them that day, I might have had an easier afternoon.

That working hypothesis identifies something specific — the memory networks that shaped how this person learned to be in relationship, and what that means for how they’ll use you and the therapy process itself. Consider what it feels like in practice. Will they join you in a genuine alliance, leaning into the safe and supportive relationship you offer? Or because of their history, will it feel like too much?

* * *

And how will we feel? We’re human, and it can hurt when a client can’t fully lean in, especially when being a safe person is part of our professional identity.

Take a client with a Dismissing attachment classification. They’ve learned to minimize attachment needs and go it alone — and they’re expert at it. They may appear calm or unruffled while internally underreporting how much they’re actually struggling.

Early in treatment, gently naming the pattern — operating alone as a response to early adversity makes perfect sense — can open something in a client who has never had it reflected back to them. From there, you might introduce the option of using the therapeutic relationship itself as part of the work, not just as the backdrop. In practice, one way that might look is being mindful of sharing the space together — occasional eye contact, taking in one another’s presence — rather than being in the room but talking to the window.

With that opportunity, a client’s nervous system may be open to using another person’s authentic connection to tackle trauma symptoms. For EMDR specifically, that matters enormously — because the therapeutic relationship is the foundation that makes processing the energy of adversity possible. That kind of understanding has an additional benefit. It helps the client combat the urge to quietly drop out after three sessions.

Listening for What’s Alive in Memory Networks: A Focus on EMDR Preparation

To clarify, I am not suggesting you administer the AAI.

That would be untenable as full administration and coding requires specialized training — we’re talking 40 hours of training and years of supervised practice to classify transcripts with confidence. That is not what this is about.

What I am suggesting is to borrow from its spirit, a recommendation from seasoned trainers such as Dr. Andrew Leeds. A handful of questions, asked with genuine curiosity, can offer you a qualitative sense of which experiences remain emotionally alive in a client’s memory networks. One question opens this door particularly well.

“Why do you think your parents behaved the way they did?”

This is one of the most revealing questions in the AAI — a client’s answer tells you not only about their parents, but about the state of the memory networks those relationships left behind. The table below highlights possible responses you may recognize from your work.

Classification	What You Might Hear	What to Listen For
Autonomous	“She had her own trauma she never dealt with. It took me a long time to understand that, but I don’t think it was really about me.”	Balanced perspective. Can hold the parent as a full, flawed person. Affect is present but regulated. Past feels like the past — which suggests the network has been integrated, at least partially.
Dismissing	“He did his best. That’s just how things were back then. I turned out fine.”	Brief, tidy, emotionally flat. Reflection closes quickly. The network may be intact but walled off — affect is stored but inaccessible. This client may struggle to connect to the emotional components EMDR requires.
Preoccupied	“Why did she do that? I still don’t know. I’ve asked myself that my whole life. Even last week when she called, she just — she never changes, she always makes it about her…”	Still tangled. Past bleeds into present. The network is unintegrated and easily activated — this client may have difficulty staying within the window of tolerance during processing.
Unresolved	“My dad was… he wasn’t well. He died when I was nine. I think about it sometimes and I just — I don’t know, it’s hard to…” (long pause, loss of narrative thread)	Disorientation around loss or trauma. The story briefly stops making sense — and then the client catches themselves and moves on as if it didn’t happen. This is a memory network that has never been safely approached.

The classifications are useful for starting to see patterns, and advanced training delves deeper into the clinical applications of attachment theory.

A published case illustrates what this looks like in practice. Steele and Baradon (2004) describe a father whose AAI illustrates the gap between rich content and restricted access. His responses were emotionally vivid — specific memories, affect-laden language, even genuine remorse over lost relationships. And yet, in the same breath, he consistently minimized the meaning of what he was describing, as if the memory and its emotional weight occupied two independent rooms. In AAI terms, that pattern — and specifically that gap between what is remembered and what is felt — suggests the internal architecture is there, but access seems to be restricted. In EMDR terms, an opportunity for ‘+’ signs to link up.

Did the examples prompt you to recognize someone from your caseload?

What It Sounds Like in the Room

Here’s what listening for narrative quality might look like in practice. Consider two clients responding to the same question.

Therapist: “Why do you think your mother behaved the way she did when you were growing up?”

Client A: “I mean… she had a hard life, I guess. Her own mother was pretty cold. I used to think she just didn’t love me, but I think now she just didn’t know how. It wasn’t really about me.”

This client can hold two things at once — their childhood pain and a contextualized understanding of their mother. The affect is present but not overwhelming. The memory network has some integration.

Now consider a different response to the same question:

Client B: “Why did she behave like that? I have no idea. She just… she was fine, honestly. She worked hard. I didn’t have any complaints.”

The question asked for reflection. The response offered was clipped. That gap — between what the question invites and what the client can give — is telling, suggesting that the memory network is there but access is blocked; it doesn’t have the same level of integration. That gap is worth sitting with. What a client can’t reach may carry more emotional weight than they can articulate or show.

A Related Instrument Worth Knowing

The Adult Attachment Projective Picture System

The Adult Attachment Projective Picture System, or AAP, was developed by Carol George — one of the original co-developers of the AAI — and the late Malcolm West.

Where the AAI works through language and life narrative, the AAP takes a projective approach. The clinician presents a series of eight drawings depicting attachment-relevant scenes — a child alone, figures in distress, moments of separation and reunion — and asks the client to describe what is happening. There are no right answers and no structured questions to navigate. The client simply responds to what they see, and in doing so, reveals how their attachment system organizes under pressure. What gets told, what gets avoided, and where the narrative breaks down are rich sources of clinical information.

The AAP yields the same four adult attachment classifications as the AAI and goes a step further by assessing defensive processes that other attachment measures don’t capture — specifically, the ways clients unconsciously exclude threatening attachment-related material from awareness. For therapists interested in understanding defensive structure before processing begins, consider it as an alternative. The added value comes from being ready for psychological defenses that can interfere with accessing the maladaptive memory network and processing associated memories. (Leeds, A.M. (2009). A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants. Springer Publishing Company.)

Like the AAI, the AAP requires training and certification to administer and code reliably. Carol George continues to offer training periodically throughout the year. If this is a direction you want to explore, her website, attachmentprojective.com, is the place to start.

(Reference: George, C., & West, M. (2012). The Adult Attachment Projective Picture System: Attachment Theory and Assessment in Adults. Guilford Press.)

Final Thoughts

Clients don’t always know what information matters and how it informs treatment — and even when they do, they don’t always have access to it. When a client describes, “I had a good childhood. My parents were good people, and we got along well,” they are telling you the truth as they understand it. It’s also how they answered in talk therapy. EMDR preparation can help socialize them to a different process.

Attachment assessments like the AAI and the AAP function as X-rays. Where standard intake questions capture what the client can consciously report, these tools reveal the underlying structure — what has been integrated and what is still very much alive in the memory networks. Knowledge that can inform treatment planning.

Medical professionals reviewing X-rays

The data shapes which resources you build in Phase 2, which RDIs you reach for to construct a stable platform for processing, and how you orient the client to the therapeutic relationship itself. A client whose Dismissing organization has taught them to always go it alone will require a different relational foundation than one whose Preoccupied system taught them the opposite.

The tools give you an internal map, so it’s less likely you’ll find yourself sitting across from a trembling, red-faced client and hoping they’ll stay.

* * *

If you use attachment questions, I’d love to know your go-tos. What’s your top question — and what do you like about what it reveals? I’d love to hear your response.

References

Steele, M., & Baradon, T. (2004). Clinical use of the Adult Attachment Interview in parent–infant psychotherapy. Infant Mental Health Journal, 25(4), 284–299.

George, C., & West, M. (2012). The Adult Attachment Projective Picture System: Attachment Theory and Assessment in Adults. Guilford Press.

Leeds, A.M. (2009). A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors and Consultants. Springer Publishing Company.

The post “That’s Where They Live” — Why Attachment History Can Make or Break EMDR Treatment appeared first on Embodied Trauma Therapy.

One Assessment Question That Predicts Who Will Struggle in EMDR

Donna Hunter — Sun, 15 Feb 2026 19:00:00 +0000

7-minute read

Welcome to The 51st Minute – a newsletter for EMDR therapists navigating complex trauma in their daily work. We get to reflect together on the impact of sessions, clinical patterns, and stuck points we wrestle with after the session ends.

I’ve been working with trauma for over 25 years—EMDR, attachment, neglect, dissociation, all of it. I’m a gardener at heart and curious about structuring and sequencing therapy to nurture growth. I’m awed by how growth emerges from reservoirs of pain. In each issue, I’ll dig into something worth thinking about—clinical patterns, research, and industry forces impacting our work…or frameworks that help make sense of what we’re seeing. I consider this a conversation and welcome your response.

A note: This newsletter is a thinking space to discuss clinical patterns and emerging concepts in trauma treatment. Its role is not to replace or function as consultation – still the best place to unpack cases.

The pattern you keep seeing

Maybe this scenario sounds familiar.

You’re an EMDR therapist working with a client with attachment wounds whose mother abandoned them as a toddler.

She left for the store and never returned home to your client and his two older siblings.

Therapy has progressed more slowly than expected, but after eight months, you’ve established resources. Since they can’t tolerate imagining people as relational resources, they chose a bear from a video game they often play. They liked how, in the game, it was soft, strong, but protective. It was ‘nice’ having it there.

“How do you feel?” you ask.

Their eyes dart around. (ever misplace keys?…” they SHOULD be here…where are THEY?!”)

“Did anything come up this week where you had the chance to use your Calm Place?”, you ask.

“No, I don’t get upset, so I haven’t used it.”, your client replies.

Later in the session, you summon your courage to begin Phase 4 Desensitization, but after several passes on a memory of their brother burning their hand on purpose, you repeatedly hear:

“Nothing’s coming up.”

“I don’t feel anything.”

Their face remains expressionless.

“On this next set, consider bringing your bear in to help the boy.” , you offer.

They fidget with a hangnail while glancing at your diplomas on the wall.

Are they dissociating or questioning if I’m a good therapist?, you think.

Squirming in your office chair, you take a deep breath to resist going down the rabbit hole.

You feel stuck and start to wonder: Am I doing something wrong?

What the research shows about child-onset trauma and EMDR outcomes

As a new college graduate, I bought my first car with a $1,200 budget and my dad’s help. We kicked the tires and test-drove this cool number, decked out with gloss fake wood trim. As a 22-year-old, it wasn’t my first choice, but I deferred to experience.

Back at home, dad’s eyes surveyed the car.

Then stopped.

“Huh, it looks like the side panel is a shade lighter. It looks like it’s been in an accident, and the front panel was replaced.”

‘WWWHHHAAAAT’?

A horror film filled my head—

The car engine sputtering,

Sounds of sharp metallic knocks from under the hood,

The dashboard lighting up in red and amber.

Scowls from angry drivers late to work.

Up until now, I assumed the car was roadworthy, but with his observation, I needed to verify with a master mechanic that all internal systems were operating as they should. I feared the car lurching and dying in the middle of a traffic lane.

But, truth be told, the other part of me said I could ignore dad’s observation.

Do I really need to be worried?

After all, I drove the thirty miles home without incident.

In fact, knowing about potential accident damage changed everything. At the first sign of trouble, I’d criticize myself for not being proactive,

for taking unnecessary risks,

and jeopardizing my time and sanity.

I needed expert eyes to check which systems were vulnerable and needed repair, and which could handle the commute.

When we work with clients who have early-life trauma, we need the same approach. Just like I needed to assess which car systems were damaged before driving it daily, we need complex trauma assessments to gauge healthy vs. compromised domains as it impacts treatment planning.

Car-shopping with dad taught me that knowing about prior damage changes what you do next

The same is true with trauma clients. Here’s what the research shows about therapy outcomes when we don’t account for when relational damage occurred:

In 2007, Bessel van der Kolk and colleagues published the largest randomized controlled trial comparing EMDR, fluoxetine, and placebo for PTSD. The study had equivalent numbers of patients with child-onset (N=45) and adult-onset (N=43) index traumas. Child-onset traumas were defined as we do in our daily work—physical, emotional, or sexual abuse occurring before age 18. It turns out that in the 8-week EMDR condition:

Participants endorsing child-onset trauma:

Were more likely to drop out
Only 33% achieved complete symptom remission at 6-month follow-up

Compare that to outcomes for adult-onset trauma clients (trauma after age 18):

100% lost their PTSD diagnosis
75% achieved complete symptom remission at 6-month follow-up

Why such dramatically different outcomes with the standard protocol?

Because child-onset trauma amplifies damage… It creates adverse memories while it damages the internal systems needed for EMDR processing to work. This is why your client keeps saying “nothing’s coming up.” The affect regulation system that should help them identify and tolerate emotions is underdeveloped.

The researchers concluded that what was needed was a better understanding of “treatment sequencing”—understanding what needs to happen first for those whose internal systems were distorted by early experience.

We’ll be exploring treatment sequencing in future issues.

The one intake question that changes treatment planning

So how’s it relevant to you?
Consider adding one assessment question to your next trauma intake—a question that reveals whether your client developed affect regulation with relational support, or learned to manage distress alone:

“When you were growing up, and you got upset about something, what typically happened?”

Answers that suggest they developed regulation with support:

“My dad would lie next to me on my bed until I calmed down, I liked him there, he’d talk to me.”

“I could go to my mom when I was upset, and she’d drive us around for a while. In the car we could talk.”

“I could always go to my older sister’s room…she’d make room for me on her bed, listen and help me figure out what I was feeling.”

Answers that suggest they learned to manage alone:

“I’d go to my room until I felt better. A few times the dog would come in and lie at the end of the bed” (learned to manage alone)

“I don’t really remember getting upset…it’d drive my older brother crazy, he said I needed to react more…he thought people took advantage of me.” (emotional shutdown)

“My parents had it hard for the times they were living in; I’m really grateful to them, they were good parents who were dealing with their own stuff” (unavailable)

“I don’t know what you mean, only grandma could show emotion.” (emotional expression = unsafe)

“Nobody really noticed” (emotional neglect)

Once you start listening for these patterns, you’ll hear them everywhere—and it’ll change how you plan treatment. It’s a lot better than hearing “Huh, it looks like the side panel is a shade lighter….”

Okay, it’s after midnight, so I’ll leave you with that for now.

If you have comments on the topic or what you’re seeing in your sessions, shoot me an email.

And we’ll be sure to pick up the thread in two weeks.

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