Modified Preparation and Reprocessing

Standard protocols and procedures of EMDR therapy can be both too much and not enough for people who experience complex trauma and dissociative disorders (DDs). Personalized adjustments to these procedures are often effective and serve to avoid risks of premature associations and harm to the client. This chapter will guide readers toward a balanced approach to finding a way forward through the phases of EMDR that match practitioner competencies and client needs. It explores the relationship between Stage 1: Stabilization and EMDR therapy and then examines Phase II: Preparation modifications and adaptations, including resource development, affect tolerance/phobias work, identifying and accessing ‘adaptive material,’ and incremental containment and consent. Nuanced Stage 2: Trauma Processing is discussed, including fractionation of targets and restricted reprocessing. For clients with DDs, more specialized tools and additional approaches described in Part IV may be necessary. Examples are offered to support measuring progress, determining the next steps, and measuring progress in the EMDR frame and beyond.