Consultation Corner

Welcome to the EMDR Consultation Corner

Whether you’re newly trained in EMDR or deepening your clinical work through consultation, this newsletter is designed to support you in building confidence, clarity, and clinical precision.

Each issue is grounded in what actually comes up in consultation—those moments where the protocol feels less straightforward, clients don’t move the way you expect, or you’re left wondering, “What am I missing?”

This space is meant to bridge that gap.

September 2026 Edition

When Your EMDR Client Isn’t Ready for Reprocessing: Recognizing When Extended Preparation Is Needed

One of the most important clinical decisions in EMDR therapy is knowing when a client is ready to move into reprocessing—and when they need more preparation first. It can be tempting to think of preparation as a brief phase that we move through before getting to the “real work” of EMDR. But for some clients, preparation is not simply a prerequisite to reprocessing. It is the work they need right now.

When “not ready” is actually valuable information

A client may be motivated and eager to begin reprocessing, yet still have difficulty maintaining dual attention, regulating activation, accessing internal or external resources, staying within a manageable window of tolerance, or recovering after emotional activation. Sometimes the signs are obvious. Other times, they emerge only as we begin exploring the possibility of reprocessing. Rather than viewing this as a setback, we can see it as important clinical information. The question becomes: What does this client need in order to become more prepared?

Recognizing when extended preparation may be needed

Extended preparation can be particularly valuable when a client needs additional support developing the capacity to safely engage with traumatic material.

Some indicators may include:

Difficulty regulating intense emotional or physiological activation
Limited access to adaptive coping or grounding strategies
Frequent dissociation or difficulty maintaining present orientation
Significant difficulty returning to baseline after activation
Limited ability to maintain dual attention
A narrow window of tolerance
Difficulty identifying or accessing resources
A history of complex or prolonged trauma
Current instability that makes reprocessing premature
A strong desire to “get through the trauma” despite limited capacity to remain regulated

These signs don't necessarily mean that EMDR reprocessing cannot be successful. They may simply mean more preparation is needed before reprocessing is the appropriate next step.

Preparation doesn't have to mean “waiting”

One of the most useful shifts clinicians can make is to stop thinking of extended preparation as putting therapy on hold. Preparation can be active, intentional, and therapeutic. It can provide opportunities to help clients develop greater awareness of their internal experiences, strengthen resources, increase their ability to recognize and manage activation, and build confidence in their capacity to stay present when difficult material emerges. In other words, extended preparation isn't about keeping clients away from the trauma forever. It's about helping them develop the capacity to approach it safely and effectively.

So, what do you do when your client isn't ready? Instead of asking, “Why can't we move forward with reprocessing?” consider asking:

"What capacity is missing right now, and how can I help the client develop it?"

That question can change the entire direction of the preparation phase. It allows us to move away from a one-size-fits-all approach and toward preparation that is responsive to the individual client. And sometimes, that means spending considerably more time in preparation than we initially anticipated.

A resource for extended preparation

If you find yourself wondering what to do when standard preparation isn't quite enough, I created the EMDR Extended Preparation Workbook to support clinicians and their clients in this part of the therapeutic process. The workbook provides structured material that can help you move beyond simply checking off preparation tasks and instead engage clients in a more intentional, extended preparation process. It can be used to support the clinical work of building readiness, increasing capacity, strengthening resources, and helping clients become better equipped for eventual reprocessing.

Your client's lack of readiness isn't necessarily a roadblock. It may be an invitation to slow down, listen more closely, and build the foundation they need. Because sometimes the most important step toward reprocessing is recognizing that we aren't there yet—and knowing what to do next.

Learn more about the EMDR Extended Preparation Workbook →

August 2026 Edition

When the Best Clinical Decision Is to Slow Down Before Reprocessing

One of the greatest strengths of EMDR therapy is its ability to help clients process traumatic memories efficiently. It's no surprise that many therapists—and often our clients—look forward to getting into reprocessing as soon as possible.

But sometimes the clinical question isn't, "When can we start reprocessing?"

It's, "Has this client's nervous system developed enough capacity to benefit from reprocessing?"

As EMDR therapists, it can be tempting to view preparation as a phase to complete before moving on to the "real work." We teach a few regulation skills, install a Calm Place, practice a container exercise, and then feel pressure to begin processing.

For many clients, that's entirely appropriate.

For others, moving into reprocessing too soon can result in repeated flooding, dissociation, prolonged dysregulation, blocked processing, or a client who leaves sessions feeling worse instead of more integrated.

The issue isn't that EMDR doesn't work.

The issue is that the foundation isn't ready yet.

Extended Preparation Is Active Treatment

Clients with complex PTSD, developmental trauma, attachment injuries, dissociation, chronic emotional dysregulation, or highly protective internal systems often need more than a brief preparation phase. Their nervous systems have adapted over years—sometimes decades—to survive overwhelming experiences.

These clients aren't avoiding the work.

Their nervous systems are communicating what they need before they can safely engage in it.

Extended preparation is not about delaying trauma treatment. It is trauma treatment. Every opportunity to build regulation, increase body awareness, strengthen dual attention, understand protective parts, and expand the client's window of tolerance is preparing the brain for more adaptive processing later.

In many cases, slowing down early allows therapy to move more effectively later.

Shifting the Clinical Mindset

Instead of asking: "How quickly can I get this client into reprocessing?"

Consider asking:

What happens when this client becomes emotionally activated?
Can they notice distress without becoming overwhelmed or shutting down?
Are they able to maintain dual awareness?
Do protective parts consistently interrupt trauma work?
Does the client have enough nervous system flexibility to remain present during processing?

These questions often provide a clearer picture of readiness than simply completing the standard preparation checklist.

Building Capacity Before Processing

When clients have stronger regulation skills, greater awareness of their nervous system, and a deeper understanding of their internal experiences, reprocessing often becomes more effective and more sustainable. Therapists spend less time managing repeated destabilization and more time supporting meaningful adaptive processing.

Preparation is not simply something we "get through."

It is where we build the capacity that makes successful reprocessing possible.

A Resource for Extended Preparation

I created the EMDR Extended Preparation Workbook to support therapists working with clients who need more than the standard preparation phase. Rather than offering a collection of disconnected coping skills, the workbook provides a structured progression that helps clinicians intentionally build readiness for EMDR reprocessing.

The workbook guides clients through foundational psychoeducation, understanding the Adaptive Information Processing model, recognizing patterns of nervous system activation, strengthening regulation, developing dual awareness, working with protective parts, and thoughtfully evaluating readiness for reprocessing.

The goal isn't to keep clients in preparation indefinitely.

The goal is to know when preparation has accomplished its purpose—helping clients develop the stability, flexibility, and internal resources that allow EMDR reprocessing to be effective rather than overwhelming.

Sometimes the most therapeutic decision we make isn't beginning reprocessing sooner. It's recognizing when spending more time building the foundation will ultimately help our clients go further.

Purchase the

EMDR Extended Preparation Workbook

For bulk pricing and discount information,

please contact me directly.

Get Your Copy Today

July 2026 Edition

Working with Dissociative Clients: Creating Safety Before Processing

Clients who experience dissociation often come to therapy carrying the effects of overwhelming stress or trauma. While every person's experience is unique, dissociation can be a protective response that helps someone cope when situations feel too intense or unsafe.

For therapists, recognizing and responding to dissociation with curiosity, patience, and flexibility is essential to building a strong therapeutic relationship.

Recognizing Dissociation

Dissociation can present in many ways. Some clients may describe feeling detached from their thoughts, emotions, or bodies. Others may experience memory gaps, difficulty staying present, feeling emotionally numb, or sensing that the world around them doesn't feel real. These experiences can be subtle and may fluctuate depending on stress levels, triggers, or the therapeutic work being done.

Standardized assessments can be valuable tools for identifying dissociative symptoms and informing treatment planning. The Dissociative Experiences Scale (DES) is a widely used screening instrument that helps clinicians determine whether further assessment is warranted. For clients with more complex presentations, the Multidimensional Inventory of Dissociation (MID) provides a comprehensive evaluation of dissociative symptoms, including pathological dissociation, identity alteration, memory disturbances, depersonalization, and derealization. While these measures are not diagnostic on their own, they can provide important clinical information when interpreted alongside a thorough clinical interview.

Another practical tool is the Back of the Head Scale (BHS), which can help clients increase awareness of their dissociative responses during therapy. The scale invites clients to notice where they feel they are in relation to their body—from being fully present "behind their eyes" to feeling as though they have moved to the back of their head or even outside of themselves. Tracking this experience throughout a session provides both the therapist and client with immediate feedback about changes in presence, engagement, and nervous system activation. The BHS can also help guide pacing, indicating when grounding or stabilization interventions may be needed before continuing with deeper therapeutic work.

When used together, clinical observation, client self-report, and assessment tools such as the DES, MID, and BHS can provide a more complete picture of a client's dissociative experiences and support individualized treatment planning.

Prioritize Safety and Stabilization

When dissociation is present, therapy often benefits from focusing on safety and stabilization before moving into trauma processing. Helping clients strengthen grounding skills, build emotional regulation, and increase awareness of internal experiences can create a foundation for deeper therapeutic work.

Simple interventions—such as orienting to the present environment, practicing mindful awareness, and developing personalized coping strategies—can help clients remain engaged without becoming overwhelmed.

Pace Matters

Progress with dissociative clients is rarely linear. Moving too quickly into traumatic material may increase dissociation rather than promote healing. Instead, treatment is often most effective when guided by the client's window of tolerance, allowing them to remain present while gradually building resilience and capacity.

Regularly checking in about how the client is experiencing the session can provide valuable information and help maintain a collaborative therapeutic process.

A Collaborative Approach

Working with dissociation requires flexibility, consistency, and a strong therapeutic alliance. Empowering clients through choice, transparency, and predictable therapeutic structure helps foster trust and supports long-term recovery.

Consultation and ongoing professional education can also be invaluable when working with complex trauma and dissociative symptoms, providing clinicians with additional perspectives, interventions, and support.

Continue Building Your Clinical Skills

Working with complex trauma and dissociation requires more than mastering a single modality—it calls for ongoing learning, consultation, and a willingness to adapt treatment to each client's unique needs. Investing in advanced training can strengthen your confidence and expand your clinical toolkit.

One excellent resource is the Complex Trauma and Dissociation training offered by EMDR Center of the Rockies, presented by Rachel Walker, MA, LMFT. This advanced course explores how EMDR therapy can be integrated with parts work and attachment-based interventions to address secondary and tertiary dissociation, while emphasizing assessment, case conceptualization, and practical treatment strategies for complex presentations. The on-demand training also offers continuing education credits for eligible clinicians.

For clinicians seeking more in-depth education on dissociation, the trainings by Dolores Mosquera, MS, available through EMDR Advanced Trainings & Distance Learning, are highly regarded. Her courses cover topics such as clinical assessment, treatment planning, complex trauma, dissociative disorders, personality disorders, and adapting EMDR therapy for highly complex clients. Several trainings are co-presented with internationally recognized experts, including Kathy Steele, Suzette Boon, Bethany Brand, and Ruth Lanius, offering a rich, evidence-informed perspective on working with dissociation.

No matter where you are in your professional journey, ongoing education and consultation can help you approach dissociative presentations with greater confidence, clinical flexibility, and compassion.

Coming Soon: EMDR Extended Preparation Workbook

Helping complex clients build safety, stability, and internal resources often requires more than a few preparation sessions. For many individuals with complex trauma and dissociation, preparation is an ongoing therapeutic process that supports successful trauma processing when the time is right.

To support clinicians in this work, I am excited and proud to announce that my EMDR Extended Preparation Workbook is coming soon. Designed for use throughout the preparation phase of EMDR therapy, this practical resource includes structured exercises and worksheets that help clients strengthen grounding skills, develop internal and external resources, increase affect tolerance, and build the confidence needed to remain present during treatment.

The workbook is intended to complement—not replace—the therapeutic relationship by giving clients opportunities to practice skills between sessions while providing clinicians with a flexible framework for extended preparation. Whether you're working with clients who experience dissociation, attachment injuries, or complex trauma, these tools are designed to support greater stabilization and readiness for EMDR processing.

Stay tuned for additional details, release information, and opportunities to incorporate this resource into your clinical practice.

Final Thoughts

Working with dissociative clients invites us to slow down, remain attuned, and prioritize safety throughout the therapeutic process. By meeting clients where they are and respecting the protective function dissociation has served, therapists can help create the conditions for meaningful healing—one grounded step at a time.

June 2026 Edition

Common Mistakes That Quietly Stall Progress (and How to Rethink Them)

There are certain patterns that come up again and again in EMDR consultation—not because clinicians don’t understand the model, but because the work is subtle in practice. Even experienced therapists can slip into habits that slow reprocessing, reduce affect tolerance, or unintentionally keep clients stuck in loops that look like processing but aren’t moving.

This month’s focus is on some of the most common sticking points—and what they’re often pointing to underneath.

The Negative Cognition (NC) Isn’t Quite the Right Fit

When the NC is slightly off, everything downstream can become inefficient.

Francine Shapiro described the NC in EMDR as the negative self-belief that becomes linked to a disturbing memory and still feels emotionally true in the present, even if the person rationally knows it is inaccurate.

The NC should be self-referencing, emotionally felt rather than logically reasoned and tied to the present experience of the memory.

The NC specifically is not a feeling, such as "I am scared." It is not a factual statement about what happened, such as "I was abused as a child." Shapiro reminds us “a negative cognition that is actually true will not be changed.” The NC is a belief the client has about themselves as a result of this past memory/event, such as "I am unlovable."

A helpful NC fine tuning when client's struggle to identify a belief about themselves, ask the client:

"When you think of __________________________ (fill in the client's statement about a feeling, fact or sensation) what negative belief do you have about yourself now?"

Continue to ask this question, filling in their statement of fact or emotion until they identify a belief they are currently holding about themselves as a result of this memory/event.

Returning to Target Too Soon—or at the Wrong Moment

Another frequent misstep is returning to the original target memory before the system has finished what it was doing.

Sometimes this happens because the clinician senses “it’s not changing,” when in reality the processing has shifted away from the explicit image into associated material that still needs space.

Sometimes it's a clinician's impatience wanting to know if the SUD has changed, in the hopes of seeing improvement.

Other times, returning to target at the end of session can prematurely re-anchor the system back into the original disturbance, rather than leaving it in adaptive association or resolution.

A useful question is:
Is the system still moving, or am I interrupting it because I expect movement to look a certain way?

Not all processing returns visibly to the original target. Sometimes it resolves by moving through it.

Checking SUD Too Frequently (or at the Wrong Time)

The Subjective Units of Disturbance scale (SUD) is essential—but it can be overused in ways that disrupt processing.

A common pattern is checking SUD too often during active processing or without returning to target first. This can pull the client out of associative flow and back into cognitive monitoring. Instead of staying in experience, they shift into evaluation: “Is it lower yet? Should it be lower?”

Even more subtly, SUD checks can become premature anchors when the system is still mid-activation.

In general, frequent SUD checking tends to interrupt momentum rather than clarify it. It’s often more useful to let sets run longer and observe change organically before asking the system to quantify it.

BLS Speed, Type and Duration Not Adjusted to the Client’s Nervous System

Bilateral stimulation (BLS) that is too fast or too slow can significantly impact processing depth.

Fast BLS may be appropriate for certain clients or phases of processing, but for others it can push them into cognitive override or emotional flooding. Conversely, BLS that is too slow can under-activate associative networks, leading to intellectualization rather than reprocessing.

Eye movement BLS is the gold standard, but sometimes it's not effective for some clients, or they may need a combination of eye movement and auditory or tactile to truly "sink in" to the reprocessing.

Additionally, the length of each set may need to be adjusted. If a client easily dysregulates or dissociates, shorter sets may be more clinically appropriate. If a client is able to hold dual attention well and is experiencing adaptive processing, a longer set may be beneficial to help move the material from the maladaptive to the adaptive network.

A key clinical skill is noticing:

Is the client staying in experience, or moving into analysis, or distracted by other stimuli?
Is affect present but tolerable, or flattened, flooded or dissociative?
Is there associative flow, or effortful thinking?

BLS speed, type and duration is not a fixed setting—it is a regulation tool.

Underusing Interweaves

Interweaves are often used either too sparingly or too late.

When processing stalls, loops, or becomes overly intellectual, carefully timed interweaves can help the system re-engage adaptive information. Yet clinicians sometimes wait too long, hoping the client will “breakthrough” on their own, or out of their own uncertainty of how to apply an interweave and when.

On the other hand, poorly timed interweaves can interrupt natural processing if used too quickly or too directive.

The key distinction is this:

Are you adding content, or reconnecting access?

Francine Shapiro described interweaves as a way of supplying what is missing from the client's processing network in that moment - often:

information
orientation to present safety
perspective
adult capacity
or choice

Common signs Shapiro gave for when to use an interweave include:

the client repeatedly returning to the same material without change
affect staying extremely high without movement
dissociation or shutdown
persistent blocking beliefs
inability to access adult perspective
confusion between past and present
or inability to generate adaptive associations

Interweaves work best when they restore movement, not when they steer interpretation.

Not Considering Secondary Gains

When a target refuses to fully resolve, it’s worth gently exploring what the system might be maintaining.

Secondary gains are not conscious “benefits” in a manipulative sense—they are protective functions:

Avoiding grief or loss
Maintaining identity built around survival roles
Preserving relational dynamics
Preventing perceived vulnerability

If these are not acknowledged, processing can plateau at a predictable point: right before the system would have to give something up.

Stuckness is sometimes not resistance to healing—it’s loyalty to protection.

It May Be a Feeder Memory or Blocking Belief

When processing repeatedly stalls or circles back to the same emotional intensity, it’s often a sign that the current target is not the true entry point.

Two common possibilities:

Feeder memory: an earlier event that carries the core affect driving the current target
Blocking belief: a deeper structural cognition preventing reprocessing

Shapiro described feeder memories as earlier experiences that continue to fuel present-day reactions, symptoms, and negative self-beliefs. Current triggers often connect to older memory networks with the same emotional themes — shame, helplessness, danger, rejection, or powerlessness.

A blocking belief is different. These are beliefs that interfere with processing or healing itself, such as:
“If I let this go, I won’t be safe,” or “If I stop feeling guilty, I’m a bad person.” Blocking beliefs often emerge when processing becomes stuck, repetitive, or unable to move toward resolution. In Shapiro’s model, these beliefs are usually protective adaptations that once made sense in earlier environments. Rather than fighting the block, EMDR aims to identify and process the experiences that still make the belief feel necessary.

In these cases, continuing to push the current target can feel like effort without movement. The system may be signaling that the actual node is elsewhere.

Closing Reflection

Much of EMDR work is not about doing more—it’s about noticing what is subtly interrupting what is already trying to happen.

When processing stalls, it’s rarely random. It’s usually information:

About pacing
About access
About fit
About protection

Consultation is often where these patterns become visible—not as mistakes, but as signals that the system is doing exactly what it knows how to do, given the conditions it’s in.

And the clinical task is often not to push harder—but to listen more precisely to what the system is already communicating.

Reference:

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.