EMDR Therapy Quarterly

A reflection on the affect-focused EMDR presentations from Ludwig Cornil and Olivier Van Limbergen at the 2024 EMDR UK annual conference

“You want the jam”

I’m not sure if Ludwig Cornil actually said those words, but it’s what I remember. What he was explaining is that, when it comes to childhood relational trauma, as opposed to single-incident adult trauma, what needs to be reprocessed and desensitised isn’t the memory of a stand-alone event but a pervading atmosphere of powerlessness, isolation and shame that is the hallmark of living through a hundred different acts of commission and omission every week, sometimes every day. What did happen, what didn’t happen, and the state of inherent vulnerability in the face of both kinds of experience. This affective state of powerlessness, aloneness and defectiveness in its unbearable totality is the “jam” beyond the individual – the bitter berries of specific moments.

On this basis, argued the presenters, it’s not enough to desensitise and reprocess individual memories for the alleviation of present-day symptoms. Our job is to confidently support our clients into contact with and guide them through the affective state of unbearable childhood pain, entrusting this pain into the hands of bilateral stimulation, wave after wave, not giving up until it’s been truly desensitised.

The bow tie

Using one of their several utterly compelling metaphors, we can visualise a bow tie where a multitude of individual experiences on the left coalesce and bottleneck to create the knot – an intense repeated familiar unbearable affective state in the middle – and from that knot, on the right-hand side, emerge the consequences or symptoms of present-day distress – both the resurfacing pain and the survival strategies mobilised to avoid or numb it.

It is the unprocessed affective state held in dysfunctionally stored memory networks that needs targeting, not the individual memories. This is great news for those of us who might feel overwhelmed in the face of the almost endless list of experiences to target, implying, as it does – and as the speakers emphasised – that we’re not actually going to need a big target plan; we just need to get through any of the many doors available and into the jam in its entirety.

And as this unbearable affective state is desensitised and reprocessed, adaptive information processing inevitably reveals the emergent truth of the client’s inherent goodness, their present-day agency, even if only relatively greater, and their connection with nurturing, protective and wise others, even if only with us as their therapist and their own adult selves for now. And this means that the survival strategies that have been needed to defend against this powerlessness, aloneness and defectiveness may begin to fall away.

Defending ourselves at the level of identity

I scribbled it down furiously when the presenters made it explicit in a way I’d not heard it put before: that the reason we can expect to meet so many skilled and entrenched survival strategies when working with our clients’ relational trauma is because the experiences that have shaped such people are experiences that strike at the foundational heart of their identity as worthy enough, good enough, and lovable enough to deserve and elicit lovingly attuned care. It is an identity of inherent defectiveness against which they must defend themselves at all costs.

And as we all know only too well, it is often these survival strategies that bring the client into our rooms in the first place, as much as the surfacing pain that was bottled up – those maladaptive strategies that are elaborations of our shared survival reflexes of fawning, fighting, fleeing, freezing and flopping – that are the price that our clients – and often we – pay to stay safe from the danger of the past being experienced as the present. Both the resurfacing pain and the mobilised defensive strategy are good enough doorways into an affective state ready to be reprocessed.

Life as phase three

“Life as phase three” was one of the other messages from Cornil and Van Limbergen’s presentation, which had me nodding vehemently in my seat. When the activation of the pain or the survival strategy walks through the door, you don’t need the formal assessment phase because the assessment phase is only necessary to support the client in activating what needs processing. So, if the client is raging about someone in their day-to-day life and this is a familiar survival strategy for them, then you know the dysfunctionally stored pain they’re protecting themselves from is activated. Nothing that takes them out of that activation – not clarifying the NC or the SUD or asking them to decide which emotion they’re feeling – is going to be as useful as rolling up our sleeves and starting the BLS. Life has already provided phase three.

It was powerful to hear, and then to see in the video Van Limbergen and his client so generously shared, how to use emotionally attuned and loaded language to assist the client to maintain the activation of their affective state of suffering and to entrust it – with our accompaniment and encouragement – to the power of BLS, keeping going through each wave until it is truly desensitised and reprocessed.

In the last few years, we’ve all noticed increasing levels of endorsement for judicious flexibility with the standard protocol in order to meet our clients where they are. I particularly remember the inspiring presentations from Naomi Fisher and Caroline Van Diest on autism, neurodiversity and shifting paradigms from the 2023 Annual Conference. Presentations like theirs, and like Cornil and Van Limbergen’s, make it so clear to me that doing anything in the standard protocol for its own sake – completing a formal assessment phase, specifically eliciting a negative cognition with a positive cognition in a matching domain, staying out of the way – is hardly the point. Rather, all formal steps should be understood as important to the extent that they facilitate, firstly, the activation, desensitisation and reprocessing of dysfunctionally stored experience, and then the integration of emerging adaptive perspectives and emotional behavioural responses to our present circumstances.

Hearing Cornil and Van Limbergen’s  version of this endorsement was affirming for all those of us who work flexibly in service to our clients but still carry the aloneness, powerlessness and a sense of defectiveness (hang on a minute…) of the parts of us who are sometimes afraid to be transparent with our consultants and one another about the truth of our skilled creativity and attunement behind closed doors.

Therapist’s fear

So back to that experience for us as therapists of aloneness, powerlessness and defectiveness. This was the most personally gripping and compelling of all the messages in their presentations, and the one that has had the greatest impact on my work.

Whilst it isn’t true for all of us, many in this line of work have our own survival stories. Of course, that’s part and parcel of simply being human, but beyond that, many of us called to the provision of trauma treatment are on our own healing journeys, and I don’t know any of my colleagues who feel as if their healing work is complete. And what this means is that being with our clients can serve as our own phase-three experiences.

To re-crack Ludwig Cornil’s lovely joke, the only tangible difference between us and our clients is who’s paying whom. We cannot and must not, said Cornil, “separate ourselves from our patients.” For many of us, this is a huge part of the transpersonal aspect of EMDR. The often-unnamed truth is that I am being challenged, healed and transformed by my work with clients, at least as much as they ever will be. I’ve never forgotten my Level 3 IFS trainer, Cece Sykes, laughing heartily as she reminded us that while some clients’ lives are transformed by 12 sessions of therapy, many, if not most, of the relationally traumatised will need a handful of years, meanwhile, we therapists need around twenty hours a week for the rest of our lives.

Wading stickily into the bitter jam of our clients’ unbearable childhood pain might be described as going where even angels fear to tread, and the therapist’s fear – understandable as it is – is still not being tended to in effective enough ways. Two recently published articles, “Encouraging Practising EMDR Post-Training” (Dyson, 2024) and “EMDR Therapists: Get Curious Not Cautious” (McGoldrick, 2024), have returned to the study done in 2013 by Derek Farrell and Paul Keenan, showing how few EMDR therapists really hit their stride using this powerful trauma processing approach after training.

This doesn’t surprise me. We are a community where many of us are still on the journey of making contact with and bringing healing to our own inner children and their affective states of fear, defectiveness, aloneness, powerlessness and parentified weight of responsibility. I know only too well how often these states can get triggered in us by our clients, and perhaps never more so than when they arrive for their session re-experiencing the unbearable pain of their childhood or make contact with it during processing.

The message from Cornil and Van Limbergen was clear – we are no different from our clients. Walking into the dark is frightening and triggering, and we risk becoming our clients’ biggest obstacle if we can’t bring abundant and healing attention to the parts of us that are afraid. Conversely, our clients’ provocation of our unhealed childhood trauma makes them our greatest therapists.

Conclusion

I realised by the end of the workshops with these two brilliant humans that they had woven together the courageous intensity of trauma confrontation with the sophistication of the Internal Family Systems Model’s emphasis on therapists’ ‘parts’ and then woven in the transpersonal perspective on the healing gift of therapy for the therapist.

It’s striking to me that the jam analogy is one that applies to what Cornil and Van Limbergen so painstakingly teased apart for us – they also made a jam, or perhaps a relish, as I found their ideas moreish, and it made me want to buy several jars containing every ingredient I have come to love as I’ve started to mature into my journey as an EMDR therapist.

First, there was the strong opening impact of seeing so clearly that individual episodic memories can’t be our targets when we’re dealing with relational trauma from childhood. Instead, we must focus on the overall affective state of unbearable childhood pain, characterised as it is by isolation, powerlessness and defectiveness.

Secondly, they reminded us that entrenched survival strategies are never more necessary than when the experience of childhood wounds us at the level of identity, telling us that we are not good enough, not lovable enough and not deserving enough of better care.

Thirdly, they reminded us to maintain perspective on why and when to use individual elements of the standard protocol and to be alert to life already having completed phase three for our clients before they walk through the door.

Next, they brought honest, challenging focus to the parts of us – similarly wounded as so many of us are – that suffer in the therapist seat and especially suffer fear. They urged us to address, treat and tend to our fear and our fear-masking parts, if we are to serve our clients, before reminding us that this is also how our clients serve us.

This year’s conference was profoundly stimulating. I really felt we were all deeply lucky to have had so many presenters of such amazing calibre challenging and inspiring us across such an array of topics, including working within diversity, considering cultural adaptations, and working with personality disorder and psychopathy. So, a huge thank you to EMDR UK for another fantastic time together this year in beautiful York. Without doubt, the presentations that have stayed with me most powerfully and have influenced my way of thinking and working most significantly since March were Ludwig Cornil and Olivier Van Limbergen’s presentations on affect-focused EMDR. And. In particular, their focus on desensitising the affective state of unbearable childhood pain, and their emphasis on tending to our own fear of this pain as therapists if we are to serve our clients as deeply as possible and indeed deepen our own healing journeys.

Claire van den Bosch is a transpersonally trained psychotherapist, EMDR practitioner and IFS therapist specialising in treating relational trauma and addictive processes. She has been working in counselling and addiction recovery settings since 2004. Positionality statement: "I identify as a white, CIS gender female, bisexual, civil partnered, dual heritage, first generation English, Christian, technical middle class, physically non-disabled, with various trauma-based mental health conditions and as a recovering addict. My gender, social class, sexual orientation, religious and dual-heritage identities are highly significant to my writing and teaching, especially to the extent that these aspects of my identity have been material to my mental health conditions, my addiction recovery status and my healing journey. As a writer and teacher, being transparent about my experience with trauma-based mental health conditions and addiction recovery has become a political aspect of my identity. I am committed to normalising the experiences that many of us have of holding the dual identities of living with and being treated for mental health conditions alongside working professionally in the therapeutic community treating similar conditions. I have an undergraduate degree and a master’s degree in psychology, Philosophy and Physiology, and a postgraduate diploma in Transpersonally Informed Integrative Psychotherapy, as well as being EMDR trained and certified, and most recently trained to Level 3 in Internal Family Systems. My undergraduate experience was highly academic and affirmed the parts of me that are rigorous, scientific, rational, logical and cognitive, whereas my postgraduate diploma allowed the parts of me more interested in subjectivity, symbolism, the unknown and the transpersonal to be reclaimed. I believe my work as a therapist and writer reflects an integration and creative tension between these different ways of being in the world."