EMDR Therapy Quarterly

Derek Farrell (11 October 2025)

A continuing professional development report by Jessica Woolliscroft

As trauma therapists, we need to be prepared to engage with our clients’ questions and struggles around good and evil, guilt, responsibility and redemption. Because of this, I was very much looking forward to Derek Farrell’s CPD day on EMDR and moral injury. Professor Derek Farrell MBE needs no introduction to the EMDR community. His interest in moral injury goes back decades; his PhD explored the trauma of abuse by members of the clergy. However, it focused on the perspectives of the abused, rather than the abusers.  I was interested to learn how we might begin to approach the difficult task of working with people who believe they are beyond redemption.

In the Christian tradition, after doing something terrible to another person, we might say that we have ‘sinned.’ The Bible talks of original sin, passed down from Adam and Eve to all their descendants, as a consequence of their failing to follow God’s law. However, the linguistic origin of the word ‘sin’ is worth exploring, as it offers an interesting alternative view. According to the Oxford English Dictionary, the old English ‘sin’ or ‘synn’ came from a Germanic word meaning ‘offence’, ‘wrongdoing’ or ‘moral fault.’ When the Bible was first translated from Hebrew or Greek into English, the word ‘synn’ was chosen for the Hebrew word chata/chattat, or the Greek word hamartia, which both meant ‘to fall short’ or ‘to miss the mark’, like when an arrow misses its target. So, the original meaning of the word in Hebrew and in Greek was to fail to live up to God’s standard. Understanding this linguistic shift from the original ‘missing the mark’ to the current meaning of ‘offence/wrongdoing’ offers us a way back to an earlier time when moral injury was viewed more compassionately. A mistake rather than an intended evil.

Influential thinkers
Derek started his presentation by acknowledging the main influences on his thinking as:

• Ian McGilchrist (2009), whose seminal works on the brain, specifically The Master and His Emissary, illuminate the different roles of the left and right hemispheres. Briefly, the left hemisphere is detail-oriented, whereas the right hemisphere can take a global view and create a gestalt. McGilchrist’s work calls for the need to integrate the hemispheres fully (which is what may be happening through BLS in EMDR), as only an integrated mind can be fully moral and compassionate.
• Paul Gilbert’s (2010) work on compassion focused therapy, and
• Gabor Maté’s (Maté & Maté, 2021) approach to compassionate inquiry.

Throughout the day, Derek introduced some big ideas and questions for us all to ponder, which I have outlined below.

Is moral injury a pathology?
One might think a lack of moral injury would itself be a pathology in most situations. Surely most of us would be haunted if we had to make the decisions clinicians were required to make during the early stage of the COVID-19 pandemic. However, we learnt that moral injury has, in fact, been included in DSM-5 as a diagnostic category. The positive aspect of this is that it enables funding for research and clinical treatment.

There are different types of moral injury
Fleming (2022) identified two distinct categories of moral injury. One is where a person has been forced to commit or observe an act they know is wrong – they feel compromised morally, suffer identity contamination and terrible shame and guilt. The other is when events conspire to create an environment where right and wrong become opaque – a person may end up with an existential confusion or feeling of nihilism – nothing matters anymore because there is no right and wrong. For example, having to stop families being at the bedside of a dying relative due to COVID-19 restrictions.

It helps to normalise non-disclosure
Derek explained that normalising non-disclosure from the beginning helps clients to feel safer in therapy. EMDR therapists can use the blind-to-therapist protocol (which Derek called “the silent protocol”), which reassures clients that memories can be processed without having to share them. Often, as clients gain trust, they do in fact choose to disclose.

PTSD, shame and moral injury – different systems/different response
Based upon the neuro research by McGilchrist (2009), Derek explained how PTSD is fundamentally a fear response, driven by the amygdala, which responds well to the repeated exposure elements of EMDR. Shame involves a different activation system and responds well to compassion. Moral injury, however, is complicated because it results from a shattering of moral codes and betrayal from those in authority. It requires knowledge exchange and the integration of the left and right hemispheres to reach a holistic understanding and rebuild moral codes. The client needs space to explore ideas and rebuild meaning. Because the injury results from relational betrayal, healing is best reached through community.

Forgiveness is complicated
We were warned not to expect people to forgive. Healing may involve forgiveness for some, but for others, their sense of identity and power may require them NOT to forgive.

Empathy gaps and empathy museums
Empathy is relational and activates our feeling senses. We literally feel into how the other is experiencing things. It is also cognitive, in that we can think into the mind of another. Derek described how important social changes came about because of a leap of empathy. For example, the end of the slave trade in Europe and later on the Americas resulted from the ability of influential people to activate empathy for the suffering of slaves, making it a moral imperative to stop slavery. He also spoke of the value of empathy museums – places we can go to develop a feeling for our fellows, helping us understand their lives emotionally and cognitively.

The metaphysics of moral injury
I was most taken by the idea that trauma has an energetic vibration that can travel. Derek referenced the work of Joe Dispenza (2014), who has spent decades researching the influence of thoughts on the body and mind. This led to some fascinating reflections upon the power of prayer, meditation and love to subtly influence events at a distance and to heal moral injury.

Authenticity and self-reflection in EMDR practice
For clients to invest in self-compassion, they must believe the therapist and respect their moral code. This is why therapists must live with authenticity and be authentic in their practice. The client’s attachment style will be crucial. Can the client attach to the therapist enough to engage in the emotional and cognitive empathy exchange? Derek noted that authenticity facilitates attachment.

This was a part of the day that resonated profoundly with me, and which I fully endorse. When someone has been betrayed, their antennae become sensitive to the whiff of falseness. Our clients may want to kill themselves, or they may have judged and damned themselves, so if they open up and confront us with difficult questions, the least we can do is honour their honesty and respond authentically.

Some ‘take-home’ interweaves
Here is a selection of compassion-focused interweaves from the CPD day that I have often used in my practice to address self-hatred and the sense of moral failure.

“I am doing the best I can, and that is enough.”

“The outcome hurts, yet I can still recognise the care and effort I brought to it.”

“As I do this body scan, I allow myself to feel the warmth of compassion.”

Lastly, the use of the compassionate letter, which the client writes to their younger self and reads out in therapy if they feel able to.

Feedback, suggestions and questions
Derek Farrell is an extremely well-organised, experienced and professional presenter. His PowerPoints are beautifully designed and clear, and he moves through his material at a good pace. He occasionally shared case study material, which really brought the presentation to life, and the compassionate letter he read out from a soldier was genuinely moving and thought-provoking. It was also interesting to hear about his research with clinicians suffering from moral injury after the early stage of the COVID-19 pandemic.

I have used much of the material since. After all, nearly all our trauma clients will be experiencing some level of moral injury resulting from betrayal. The client sexually abused as a child will have internalised the shame and guilt to protect their relationship with the abusing parent. This is a CPD event that I can recommend to every trauma therapist, in fact to every therapist, whether EMDR trained or not.

Because the topic is so affecting and difficult to work with, I feel that there was a missed opportunity to have more discussion space and breakout rooms. The day was all lecture – a high-quality lecture, granted – but only ten minutes for questions at the end. It might have been nice to work with some of the self-reflection questions Derek shared or even to do some skills practice, helping each of us to negotiate those dreaded negative/positive cognitions. I think this day could easily be a two-day event with skills training and more discussion of such a fascinating topic.

So, I end this report with a clinical question to ponder: In phase 3 of EMDR, how do we adapt negative and positive cognitions when it may feel ‘rational’ to say, “I have sinned?”

Perhaps the client could be asked, “So therefore I am ………………?”

I had my own thoughts, but I would have valued hearing Derek Farrell‘s reply.