EMDR Therapy Quarterly

Dear Dr Whybrow,

I’m writing in response to your recent feature on EMDR and the Power Threat Meaning Framework (PTMF), which I read with great interest. As both a clinician and a doctoral fellowship applicant exploring EMDR in NHS frontline trauma, I wanted to offer a short reflection based on my practice in forensic settings and my engagement with both AIP and PTMF frameworks.

In my clinical experience, the Adaptive Information Processing (AIP) model, when used flexibly and with cultural and contextual sensitivity, aligns more closely with the PTMF than the medical model often associated with EMDR. The clients I have worked with – primarily trauma-affected individuals in the criminal justice system – consistently present with distress that is both structurally rooted and meaning-laden. Delivered in the right way, EMDR has proven to be a profoundly validating tool when clients are supported to integrate trauma into a narrative of survival, agency and context.

Combining EMDR with principles from Compassion-Focused Therapy (CFT) and the PTMF (particularly narrative integration and power analysis) has enhanced its effectiveness in engaging trauma-informed offenders. In these cases, clients respond well when trauma is not treated as a discrete “event” but as a narrative arc embedded in a web of relational, institutional and intergenerational adversity. The AIP model’s attention to meaning-making and re-integration of trauma memories provides a potent vehicle for therapeutic change.

However, my experience also points to clear limitations – particularly with clients experiencing profound clinical paranoia or entrenched threat perception. In these contexts, EMDR’s standard protocol can struggle to create a sense of psychological safety or attunement, even when preceded by extensive preparation. The very act of activating memory networks can feel invasive or re-traumatising to individuals with fragmented or persecutory narratives of self. Here, I have found that PTMF-informed formulation and slower, narrative-focused work is often required before EMDR can be appropriately introduced.

I believe the dialogue between EMDR and the PTMF has only just begun. Rather than being in tension, these frameworks may together offer a more socially literate, non-pathologising trauma therapy model – one that is especially relevant in NHS, prison, and racially minoritised settings. I’m currently pursuing this intersection through my NIHR doctoral fellowship application, which explores moral injury and complex trauma in NHS frontline responders, with embedded co-production and EMDR delivery.

I would welcome further discussion on this, and thank you for creating space for such timely and necessary debate.

Warm regards, 
Alexander Laurie