Scientific and Research Committee update – April 2026

By Anthea Sutton

Anthea Sutton (Academic and Research Liaison) & Emily Wood (Chair of the Scientific and Research Committee)

Committee membership

We start this update with some changes – a welcome to new members and special thanks to previous members of the SRC. After two years as chair of the SRC, Dr Jonathan Hutchins has stepped down and Dr Emily Wood has been appointed as our new chair. We would like to thank Jonathan for his tenacity and commitment to progressing EMDR research, especially in the key area of veterans and combat PTSD, and we look forward to working with him further as he remains on the committee to champion veterans research and continues to lead the Veterans Research Network, which he convened in 2025.

Please join us in welcoming Emily back to the SRC (Emily was a previous member of the group and helped to establish the EMDR Publications Database among other research activities). We are delighted to work with Emily as the new chair of the committee. Emily tells us more about her plans below:

Hi everyone, I am a senior research fellow at the University of Sheffield, I am a registered nurse and EMDR therapist. My PhD investigated the use of EMDR with people with long-term depression. I am aiming to build on the work of previous SRC chairs to create a new research strategy for the Association based on the recent prioritisation survey at the conference. I want to make it easier for clinicians to access research and researchers to improve recognition of EMDR in the guidelines.

More changes to the membership have occurred this year, with Emma Mullins-Crocker and Dr Marta de Madariaga López both stepping down to pursue other commitments – a huge thanks to both for their valuable input. We have also welcomed new members Dr Karen Barton and Alex Laurie and look forward to working with them.

Annual Conference 2026

We enjoyed meeting many of you at the conference in Bristol back in March and hearing from those attending online too. The SRC coordinated a research symposium on day 2, where we welcomed Professor Filippo Varese and colleagues from the University of Manchester to present on ‘New frontiers in the treatment and preventions of psychosis using EMDR’.

Professor Filippo Varese presenting at the EMDR UK Annual Conference 2026

© Photography by ShotAway

Dr Jonathan Hutchins presented an update from the SRC, summarising the current evidence base for EMDR and launching our survey to ask you to vote on your research priorities to help inform our research strategy for 2026 and beyond. Thank you for your engagement with this survey. We have received 301 individual responses and we look forward to sharing the findings with you.

Dr Jonathan Hutchins presenting at the EMDR UK Annual Conference 2026

© Photography by ShotAway

The research session concluded before lunch with a series of ‘lightning talks’ delivered by our poster authors. A new addition for the 2026 programme, this segment proved highly successful as the presenters rose to the challenge of summarising their projects in 60 seconds or less.

Lightning talks at the EMDR UK Annual Conference 2026

© Photography by ShotAway

We are also delighted to announce that the winning poster – voted for by the delegates at the conference in person and online – were Dr Lisa-Maria Kraml and Claire Traylor from the Perinatal Community Mental Health Service, Cardiff, and Vale University Health Board, with their poster Using the EMDR Group traumatic episode protocol (G-TEP) for birth trauma: a service evaluation of feasibility, acceptability and early outcomes in an NHS perinatal mental health service. Lisa and Claire are pictured with their poster and receiving their award at the close of the conference. Well done again to you both, and to all our fantastic presenters. The poster area was busy and full of energy as people networked throughout the conference event.

Dr Lisa-Maria Kraml and Claire Traylor and their winning poster at the EMDR UK Annual Conference 2026

© Photography by ShotAway

Looking ahead to 2027, we will again be opening a call for abstracts to present posters at the annual conference. If you are interested, please email us at: researchofficer@emdrassociation.org.uk and we will alert you once the call is open later in the year.

New research

The EMDR Publications Database has been updated to March 2026. You can read all about the latest research here. If you have not done so already, you can access the database with your EMDR UK membership; see the Member Resources section when you login to the members area of the EMDR UK website. If you have any queries about accessing or finding your way around the database, please email: emdrdatabase@sheffield.ac.uk

Evidence briefings

In addition to the EMDR Publications Database, we plan to produce a series of briefings outlining the evidence base and research gaps in key areas of EMDR. We have collated the current evidence base on EMDR with veterans and military personnel. You will be able to read about it in the Summer 2026 issue of the ETQ.

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Note from the editor

By Dean Whybrow

The ETQ Spring edition follows another successful conference. It was great to see so many people discussing and reflecting on EMDR. Among the highlights were the exciting, pragmatic real-world research projects presented as posters. We also welcomed a new president, Russ Hurn, and thanked the past president, Kath Norgate, for her dedication to the role.

This issue brings together a rich and varied set of contributions that reflect the continued evolution of EMDR practice and community. Joanne Porter introduces the newly established Learning Disabilities Special Interest Group (LD-SIG), created in response to growing interest in adapting EMDR for people with learning disabilities, while Ben Stenning offers a reflective account of his first year as an EMDR consultant. Dr Justin Havens shares his personal journey into EMDR and the development of the Flash technique, and Heena Chudasama provides the latest update from the Equality, Diversity and Inclusion Committee. Maya Gagni reflects on Sonya Farrell’s recent training on EMDR and on Jim Knipe’s toolbox techniques for working with complexity and dissociation. Expanding the clinical focus, Deborah Kingston, Jonathan Hutchins and Emma Jackson explore neuro-affirming adaptations across EMDR’s eight phases to better support neurodivergent clients, while Deepti Ramaswamy draws on extensive clinical and research experience to examine the use of EMDR with former violent extremists, highlighting key issues such as engagement, identity and moral injury. Anthea Sutton presents a curated summary of recent additions to the EMDR Publications Database, and Sophie Leader reports on innovative workshops by Cassandra Manning on the use of music within EMDR therapy.

Please continue to send in your articles or contact me with your ideas. This is a journal for the membership and a safe space to share your experiences, opinions, service evaluations, research, and reviews.

Very best wishes

Dean

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Learning Disabilities Special Interest Group

By Joanne Porter

We are delighted to announce the creation of a new Learning Disabilities Special Interest Group (LD-SIG), developed in response to increasing interest in, and recognition of, the need to adapt EMDR for people with learning disabilities.

The LD-SIG offers a friendly, creative and encouraging space in which both new and experienced practitioners can feel comfortable to ask questions and remain curious. It provides opportunities to share resources, highlight local and regional developments and think together about clinical issues.*

The SIG has been in development for over two years and currently takes the form of a lively, well-attended morning discussion group held four times a year.

As chair, I am passionate about adapting EMDR to ensure accessibility. Alongside current SIG members, I am keen to encourage practitioners, whatever their professional background, to feel confident in offering EMDR to both adults and children with learning disabilities.

To celebrate the new SIG, we have opened two new evening dates a year, hopefully making the SIG accessible to those who cannot take time out of their Tuesday mornings.

If you would like to know more about EMDR and people with learning disabilities, have a look at this EMDR Therapy Quarterly article from Spring 2024: EMDR for people with intellectual disabilities.

Meetings are via MS Teams at the following dates and times:

Third Monday of May 18:00–19:00

Third Monday of September 18:00–19:00

Every four months on second Tuesday of the month 09:00–10:00

Please email me at learningdisabilitiessig@emdrassociation.org.uk if you would like me to send you a link to the meetings.

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Me? An EMDR consultant? 

By Ben Stenning

Becoming an EMDR consultant: reflections after the first year.

Ever since completing my basic training and witnessing the power of EMDR firsthand with clients, I knew I wanted to become an EMDR consultant. EMDR transformed how I view trauma and it quickly became the lens through which I formulated all trauma-related difficulties. The prospect of inspiring and upskilling future generations of EMDR therapists in the use of this therapeutic power tool excited me. 

Although I had been eligible for some time, I hesitated to enter the consultant-in-training phase. Despite encouragement from my supervisor, I made my excuses. I told myself I would be ready when I’d read that book, when I’d attended that CPD, when I knew that protocol. I engaged enthusiastically with the vast ocean of EMDR literature and resources out there, although it was often accompanied by an aftertaste of self-doubt: ‘Maybe I’ll feel ready after the next CPD?’ 

I had been an accredited practitioner for five years when I completed my consultant training. I knew the standard protocol back to front, but the thought of completing a live supervision roleplay to a room full of EMDR wizards terrified me. Surely this was the moment I would finally be exposed as a fraud. Yet that wasn’t my experience. I found myself among a diverse group of clinicians, all wrestling with the same anxieties. There was no sense of competition, just a genuine desire for everyone in the group to succeed. From roleplays to presentations and group exercises, as the spotlight was on one of us, the rest all adopted the role of cheerleader, willing them on from the sidelines. Alongside us were the trainers, who from the start normalised imperfection and modelled fallibility. I was sad, albeit exhausted, when the training ended. 

I was a consultant-in-training for a total of eight months, recording supervisions I delivered in my NHS service, watching recordings back in supervision of supervision, and demonstrating all relevant competencies to my supervisor. The process felt robust. I could feel the growth happening in real time. This sense of progress was evident in my recordings and soon my application was submitted. But was I ready? I still wasn’t sure. 

In the language of parts, the part of me with the loudest voice was saying ‘you are not experienced enough, not knowledgeable enough, not credible enough’. This part of me had shown up many times before, often at points in my life when I faced new personal and professional challenges. I knew him well. He had good intentions but he was almost always wrong. 

A few months later, I received the email: ‘Many congratulations Ben, you are now an EMDR Europe accredited consultant.’ Me? An EMDR consultant?! On paper, maybe, but I didn’t feel like one. So why the imposter syndrome? Could it be the word itself: ‘consultant’? As a fellow trainee on the consultant training said, the word is culturally loaded. To me, it is a word associated with being, dare I say it, an expert? I’m certainly not one of those. Or maybe it’s the scarcity of EMDR consultants? According to ChatGPT, the number of EMDR Consultants in the UK is ‘in the low hundreds’. To put that into context, there are over 5000 consultant psychiatrists in the UK (Royal College of Psychiatrists, 2023). EMDR consultants truly are a rare breed. Did I really have the credibility to join this conclave of experts leading on EMDR pathways up and down the country? 

I embraced these feelings. They kept me grounded. After all, this was just the beginning of my consultancy journey and, with a long time to go before I could cash in on my NHS pension, I had plenty of time to find my groove. So, I rode that wave into my next supervision groups. As the months passed, I realised my confidence as a consultant was intertwined with the confidence of my supervisees. Their growing comfort in the therapy room became the foundation for my own self-belief, and this mutual growth continues to shape my journey as a consultant. It’s not about hierarchy; it’s a process underpinned by co-regulation and co-growth. 

Despite being an experienced clinical supervisor of psychotherapists, it took a while for this understanding to shift from head to heart. Of course, I am the supervisor in the room, I am there to provide guidance and answer the supervision question (as long as I don’t forget to ask for it!), but, with time, I saw supervision less from a position of authority and more as a relational process. As my supervisees found their feet, I found mine. And what a joy it was to see this play out. Facilitating therapists in seeing the magic of EMDR unfold before their eyes remains one of the most fulfilling parts of my professional journey to date. 

My EMDR supervision responsibilities have become the highlights of my week. Seeing therapists move from a state of conscious incompetence towards conscious competence has been hugely rewarding. I often reflect on the anxiety and uncertainty I felt when delivering my first processing sessions. Back then, I had no real faith in the model. I now see that same process unfolding with supervisees. We celebrate the wins, we problem-solve the obstacles and I witness their faith in the EMDR process deepen. 

So here I am, 12 months on from getting that email. Despite having a year’s experience under my belt, I now have lower, or should I say more realistic, expectations of myself. Do I have all the answers? Of course not. Do I still have a lot to learn? Absolutely. But me? An EMDR consultant?! Yes, that feels right. I now see that it was never the destination, but the start of the next chapter of learning, one where I grow alongside the clinicians I support. 

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The Flash technique: An interview with Justin Havens 

By Justin Havens

How did you become an EMDR therapist? 

A good question! I am relatively late to the therapy field, having previously served in the military, worked as an engineer and management consultant specialising in improving operations. I trained as a psychodynamic/person-centred/integrative counsellor and was always fascinated about how we could bring about the ‘corrective emotional experience’ (Alexander & French, 1946). I could see the shortcomings in the approaches I was being trained in, so jumped on EMDR as soon as I could, recognising that this provided an elegant, embodied and transformative solution to effecting change in our clients. And the rest is history, as they say! 

Although it is perhaps worth noting that as I saw EMDR therapy as a broad approach for many (most/all?) mental health conditions, I also saw the need to maintain a strongly relational focus and comprehensive application of the EMDR standard protocol across a wide variety of presentations. 

What is the Flash technique? 

The Flash technique is a brief, safe, and effective intervention for partially (or fully) desensitising traumatic memories without clients having to talk, think, or feel those memories. The important question is why is it relevant to EMDR and why was it originally developed by a US EMDR trainer (Dr Philip Manfield)? Since my initial training in EMDR, much of my CPD was around working with complex trauma and how to keep clients in the window of tolerance to avoid either abreaction or dissociation. Fractionating trauma, CIPOS, and pendulation were all techniques I learnt about, which all feed into the question of ‘how much phase 2 prep and stabilisation is required before I can start processing’? The answer to this question is not immediately obvious, and I still see many supervisees battling this question. The tendency is to err towards perhaps spending too long on stabilisation. 

One of my favourite sayings with these supervisees is that ‘the best form of stabilisation is processing!’ Now, of course, we cannot start phase 4 EMDR processing in the first session, for many reasons which we are all familiar with – we don’t know how their system will react to target activation and bilateral stimulation, so we need to understand their system and their history in a fair amount of detail. This is where Flash comes in. Although it is not a name I use to either describe the approach or indeed use the name in the Flash process (I just teach the word ‘blink’ instead), Flash has solved this ‘problem’ – it is brief, safe, and effective, and can be used completely blind to therapist very early on in therapy. In fact, I have used it within the first five minutes of the first session with a client who was getting visibly upset as they shared why they had come to therapy. It took less than 10 minutes, and it allowed the client to resume talking in a much less distressed way, with the ‘target’ memory feeling further away and less distressing. For the most part (as with EMDR), the change in the Subjective Units of Distress (SUDs) is a permanent shift, but it is important to note that unlike EMDR, which is a comprehensive therapy approach, Flash is just an intervention to take SUDs down. The flexibility that it offers is very useful with EMDR but it doesn’t replace EMDR in any way but, rather, enhances it. 

The analogy I sometimes use is that Flash is like a top-down desensitisation, whereas EMDR processing is bottom up and more associative in terms of connections, AIP, and opening up new channels of association. I have found over the years that there is quite a lot of confusion about what Flash is and isn’t, and even fear that proponents of Flash are trying to replace or usurp EMDR – nothing could be further from the truth! Flash simply addresses the problem that EMDR requires high levels of activation, which can sometimes make it difficult for clients and therapists alike. 

How did you learn about the Flash technique? 

I originally hear about Flash on a forum and then attended one of Philip Manfield’s early webinars, who taught Flash v1.0, which was described in the early paper (Manfield et al., 2017). Although this was not the streamlined approach used today, I could see much clinical utility in this approach and invited Philip to the UK to teach it to UK EMDR therapists. It is also worth noting that the name ‘Flash’ comes from this early version, where the process would involve clients ‘flashing’ to the trauma memory and back again (to a resourced state) so quickly that they wouldn’t feel the pain – a bit like passing a hand through a flame very quickly. The major innovation at this time was realising that you didn’t need to ‘go to the trauma memory’ at all, and that the process of blinking would allow this to happen naturally. Further enhancements, such as a more flexible approach to a conversation engaging focus rather than a positive engaging focus, have also made Flash easier to use with all types of clients. 

How do you explain the Flash technique to a client? 

After a brief introduction and invitation to use the technique, a target memory needs to be chosen. This step might only take a fraction of a second if the target is highly distressing (i.e. SUD = 10+) before switching to an engaging focus, such as talking about a favourite TV programme. It is during this time that the therapist says the word ‘blink’, which the client then responds to by blinking three times in rapid succession. After five or so of these triple blinks, the therapist invites the client to take a break and notice if there is any change (yes or no, not a general invitation to ‘what are you getting now?’) in the target memory. Further sets or additional troubleshooting (which might include a tapping and swaying) take place as the distress comes down. Flash can be used to take the distress to a zero, but very often three or four sets will suffice during preparation, and in later stages I would switch to EMDR processing, which I have already described as being more associative. 

The interesting thing is that clients are generally very surprised that rapid change has happened, but not that interested in how it has happened, whereas therapists want to know ‘how’ and the mechanism of action. As with EMDR, there are no definitive answers, but I describe it as a form of memory reconsolidation that is facilitated by targets being put into working memory (which only requires an infinitesimally small amount of activation), and then the pendulation to an engaged focus with the blinks, which somehow engenders consolidation of the memory into a new (less distressing) permanent state. 

When do you use the Flash technique? 

I use Flash in three ways as part of the Standard Protocol. The first is as part of preparation phase, where I want to reduce the trauma load, especially someone with complex trauma. I am not looking to get SUDs to zero but to see some reduction in the most significant traumas that have come up during history taking (sometimes as part of history taking). If there are events that cannot even be mentioned in history taking without causing distress, these would be ideal targets for Flash, which is very flexible; it can be used ‘blind to therapist’ and, moreover, can target time periods; for example, ‘all the abuse that happened between ages of 8 and 12’. Once the SUDs are reduced, this ‘folder of targets’ can then be unpacked and more targets worked on with Flash. Multiple incidents can also be targeted simultaneously with Flash, although I tend not to do this for the most intense memories (i.e. SUD = 10). Being able to tell clients that they won’t have to talk, think, or feel the trauma memories puts them rapidly at ease and I find that once they experience change, it really does enhance the therapeutic relationship. 

Not only do they not need to talk about trauma, they also don’t need to feel associated distress either. For some client groups, such as military veterans and those who have experienced childhood sexual abuse, these are the very reasons they are fearful of engaging with therapy, so Flash really does help with client engagement. 

The second way I use Flash is when working on a specific target during the main part of the work where I ask the client, ‘If you were to think about the target, would you find it overly distressing?’ If they say ‘yes’, I start with Flash. Once SUDs have fallen, perhaps to less than 5, I switch to the Standard Protocol. I find that the associative benefits of EMDR come to the fore at this point. Sometimes Flash takes the SUDs down to a zero, in which case I would return to target and see if there are any other channels of association to be processed (probably with EMDR) before progressing to positive cognition and body scan in the usual way. 

The final way in which Flash can be used is if I have started with the EMDR phase 4 processing and it starts getting too intense. I can then ‘back out’ of the target and, pointing to one side, say ‘let’s put that over there’ and start the Flash process. Once the intensity is down, we can return to the Standard Protocol. I find this approach more effective than trying to engage a client’s calm or safe place at this point. 

What evidence is there to support the effectiveness of the Flash technique 

There are now 27 (12 in 2023) published papers about Flash including randomised controlled trials, use of Flash with EMDR, and as a stand-alone intervention. All these papers can be downloaded from Phil Manfield’s Flash website (https://flashtechnique.com/wp). So even though we do not know exactly how memory reconsolidation is occurring during Flash, the evidence base for its effectiveness is building. 

What is your anecdotal experience of using this technique with patients? 

Flash works – and even a two- or three-point reduction in SUDs that can demonstrate real change to a client is valuable for a 10-minute intervention, and it is often more than that. I have been running three-hour Flash webinars for four years now. I do two live demonstrations with participants in each one and have always had a demonstrable reduction in distress. If I thought results would be more ‘hit and miss’, I wouldn’t subject myself to the stress of that during a webinar! 

I have also been involved with an NHS trust for several years, teaching Flash to many clinicians (not just EMDR) and they are 18 months into a pilot of a cut-down version of Flash (we are calling it flashlite) in their crisis teams, which is showing positive results. 

What further reading would you recommend to clinicians? 

The Flash Technique website has all the latest research papers, so I would keep an eye on that! Philip Manfield has also run an annual Flash research conference over the past two years in July, which has produced some very interesting talks. 

Finally, although the steps involved in using Flash are very simple, and there is really only one variable (the target), I am still surprised about how Flash is not used appropriately, or precisely, especially with intense traumatic memories. The transfer of information about how to do Flash by word of mouth can lead to the meaning and emphasis being changed, even for something as simple as the Flash technique. 

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Update from the Equality, Diversity and Inclusion Committee 

By Heena Chudasama

What a rich and nourishing conference, with the values of the Association clearly radiating through the presentations. As shared by Russell Hurn, President of EMDR UK Association and an active member of the EDI Committee, creating a place of belonging, collaborative development, and growth is central to his vision for the next two years. 

The EDI Committee has been focusing on equality, diversity and inclusion across the Association for the past four years, since its genesis and establishment as a formal committee within the Association. The committee reports to, supports, and advises the Board on EDI practice. While we are still in our infancy, we have witnessed significant change in just four years, achieved through the dedication of volunteers serving as committee and board members. We would like to commend and thank all Association volunteers for their continued commitment. 

It was wonderful to connect with colleagues both nationally and internationally at the conference. I had the pleasure of chairing Peter Pruyn’s presentation and spending time getting to know Karsten R. Böhm, Silva Neves, and Amal Wartalska over the two days. It was also a pleasure to meet Eugene Ellis, the founder of The Black African and Asian Therapy Network (BAATN), who was invited to attend the conference by Russell Hurn. It was wonderful to meet other members of BAATN too. The conference brought together a host of diverse, thought‑provoking, and challenging perspectives. 

Conference 2026 

The 2026 Bristol conference featured: 

• Silva Neves, presenting on relationships, gender, and sexuality 

• Amal Wartalska, presenting on socially inflicted trauma, which she introduced in the special EDI edition (April 2024) 

• Peter Pruyn, an ally and advocate for women’s and reproductive health, exploring how menstrual pain can be addressed using EMDR 

The science and research committee (SRC) presentation similarly encouraged further research and called on attendees to share case studies and research findings. We noted that the presentation on psychosis underrepresented those from minoritised groups who are often over‑represented within mental health services. Once again, minoritised communities risk being marginalised or perceived as ‘hard to reach’ when in fact may be ‘easy to ignore’. The EDI Committee strongly encourages members to report on their work in the form of research, case studies, and presentations, particularly if you are working with marginalised and silenced groups in your services. You can also reach out to the SRC and EDI committee to discuss this further and share your views. 

The SRC and Dean Whybrow (ETQ Editor) are keen to hear your stories and research. Dean is happy to support submissions, and the SRC is also willing to assist where possible. 

Recruitment: join the EDI Committee 

We are currently recruiting two additional members to join the EDI Committee who are committed to EDI practice and research. Please find the link below for further information and how to apply: 

EDI Committee recruitment

A multimedia approach and having a voice 

As you are aware, the Association is committed to a multimedia approach to both supporting and listening to our membership. The EDI Committee continues to source and deliver content with a particular focus on working with marginalised and underserved groups, adapting and developing EMDR practice. 

If you are an EMDR therapist, practitioner, consultant, or trainer and would like to contribute, we would be delighted to hear from you. 

Please reach out to: 

• Dean Whybrow with ETQ contributions or publication ideas 

• Heena Chudasama for webinar ideas and conference contributions 

• Russ Hurn for podcast ideas 

We would also welcome your suggestions for conference topics and speakers related to equality, diversity, inclusion, and social Justice. 

Extraordinary stories 

The EDI Committee would love to hear about your work, or from clients who may wish to share their extraordinary stories. Contributions can take the form of podcasts or written pieces for the ETQ. 

We are actively seeking interviews to help amplify lived experiences and share stories of how EMDR is being used around the world. Our approach is intentionally collaborative and co‑produced. 

Extraordinary stories podcast series 

Please contact us if you are interested in being involved or have a story to share. 

Awareness days 

We aim to work with Special Interest Groups and Regional Groups to highlight awareness days and months. Aisha Docrat will be leading this work. While we may not be able to promote every event, highlighted topics will be rotated. 

If you have any queries, please contact Emma Mullins Crocker. Katy Bell will also continue to support and promote the work in this area. 

Accessible answerphone 

To increase accessibility, the Association’s answerphone has been live since May 2023. 

Accessible answerphone: 0151 372 6802 

This service is available for members who are unable to email. Please note that it is not monitored at weekends or during holiday periods, and responses may take a few days. 

If possible, please email admin@emdrassociation.org.uk 

A process of reasonable adjustments and mitigating circumstances is available to members. Please contact admin to be directed to the appropriate person. 

Heena Chudasama 

HChudasama@emdrassociation.org.uk 

EDI Committee Past Chairperson 

EDI Committee member 

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Bringing the EMDR Toolbox to Life –

By Maya Gagni

Reflections on Sonya Farrell’s training: ‘EMDR & Jim Knipe’s Toolbox Techniques for Working with Complexity and Dissociation’ on 11 April 2026 

Context and rationale for the training 

When I signed into the EMDR Toolbox training on 11 April 2026, I noticed a familiar mix of feelings: curiosity, and a quiet hope that something would ‘click’ in my work with more complex clients. 

I already trust the Standard Protocol deeply – it is the backbone of my practice. At the same time, I often find myself sitting with clients whose histories are layered with developmental trauma, dissociation, shame, and protective parts, and I can feel how much support they sometimes need to help them in processing difficult traumatic events. 

My rationale for attending was very personal. I wanted to feel less alone in those moments when a client’s avoidance, dissociation, or shame steps into the room before the target does. I wasn’t looking for a different way of doing EMDR; I was looking for ways to better accompany clients whose internal worlds are more complex, so that the Standard Protocol can remain central and still feel safe and accessible for them. 

I also felt drawn to the idea of spending a day immersed in Jim Knipe’s lifetime of work, especially knowing that he has now retired. There was something meaningful about learning his tools through someone who has been so close to him professionally. 

Sonya’s clear explanations of the structures, using thoughtful language, and grounded, clear examples, helped me truly embed the learning. It all felt more alive, richer, and clearer as the day unfolded. 

Overview of the EMDR Toolbox model 

I had read EMDR Toolbox book and flashcards before the training, but it was only during the day with Sonya that the model started to feel truly alive for me. 

What stood out immediately was how firmly the Toolbox sits inside the Adaptive Information Processing (AIP) framework. Nothing about it felt like a departure from EMDR; instead, it felt like a deepening of how we can understand and support clients whose systems are doing a lot to protect them. 

The message I heard was not ‘you need a different protocol’, but ‘here are some ways to help your clients reach the protocol when their internal world is complicated by defences, dissociation or shame’. 

The Toolbox, as I experienced it that day, is a collection of conceptual lenses and practical tools that help me notice: 

• when a defence is stepping in to protect 

• when a part is holding a particular experience 

• when shame is blocking access to adaptive information 

• when dissociation is pulling the client away from the present. 

And then, crucially, it offers ways to gently work with those phenomena so that the Standard Protocol can proceed more smoothly. 

Key concepts and clinical ‘tools’ presented 

The day was rich with tools, and I noticed that each one landed in me slightly differently: some as immediate ‘I can use this on Monday’ ideas, others as seeds that will probably grow over time. 

Understanding avoidance and dissociation 

Early in the day, Sonya invited us to look at avoidance and dissociation through a compassionate lens. She described these responses as creative, protective strategies rather than obstacles. It reminded me that when a client ‘won’t go there’, something in them is trying very hard to keep them safe. That reframe alone felt grounding. 

Level of urge to avoid (LOUA) 

LOUA was one of those deceptively simple tools that immediately made sense to me. Asking, ‘On a scale from 0 to 10, how strong is the urge not to think about this?’ felt like such a respectful way of acknowledging the defence. I could feel how processing the ambivalence and block is the stepping stone towards processing more painful material. 

Loving Eyes and Spiritual Loving Eyes for bereavement 

As Sonya described inviting a compassionate perspective, whether from another part or from a spiritual presence (the person we have lost), I could see how clients could begin to see their own pain differently. 

Using a clear step-by-step approach to the Loving Eyes protocol, clients have an opportunity to process traumatic events that feel ‘stuck’ at that point in time. The Spiritual Loving Eyes, used for blocked grief, adds another layer to processing bereavement and grief, allowing clients to process the experience of having lost someone important together with the presence of the person they have lost. 

Back of the Head Scale (BotHS) 

BothHS appealed to the part of me that likes structure. The idea of asking clients where their attention ‘sits’ gave me a concrete way to notice dissociation. Together with CIPOS, BothHS can clearly help me during the preparation phase to gauge how present a client feels before we move into more processing work. 

CIPOS 

CIPOS reminded me of the power of small, steady anchors. As we explored how brief, repeated, present orientation can help clients stay connected while touching on difficult material. It was a reminder that I don’t have to choose between safety and processing; I can weave them together. 

Idealisation, LOPA and attachment 

The discussion around idealisation and the Level of Positive Affect protocol (LOPA) helped me to see how some of my clients will need to process these blocks before moving into phases 3 and 4. Idealisation of the perpetrator, compared with the traumatic responses I see in clients, is often a block to thinking about what actually happened. Understanding idealisation as a protective strategy – and having a way to process it – felt like being given a step-by-step movement towards fully processing difficult targets. 

The Three Lists and shame 

The Three Lists, developed by Jim Knipe and Sonya, offered a structured way to explore attachment experiences. As Sonya described them, I found myself thinking of specific clients and how helpful it would be to map ‘when they were there’, what they learned to survive, and to identify targets within their learned coping mechanisms. 

Shame threaded through many of these discussions, and I left with a clearer sense of how shame can act as a defence, and how tools like Loving Eyes can help loosen its grip. 

Teaching style and training delivery 

A big part of my positive experience of the day was Sonya herself. Knowing her background as an accredited UKCP Integrative Psychotherapeutic Counsellor and EMDR Europe Consultant, with many years of supervision from Jim Knipe, already gave me confidence. But it was how she taught that really stayed with me. 

I experienced her as calm, clear and generous. She seemed to carry a huge amount of knowledge lightly, and I never felt overwhelmed. Her language was straightforward, and she repeatedly linked ideas back to things I already knew – attachment-informed EMDR, polyvagal theory, person centred principles – which helped me to feel oriented rather than lost. 

The structure of the day felt very containing. Having the slides and handouts in advance meant I could relax into listening instead of frantically writing. The slow pace gave me time to digest, and the frequent pauses for questions made the training feel collaborative rather than didactic. 

The case vignette of a complex client was particularly powerful for me. As Sonya walked us through how she used different tools at different points in the work, I could almost see my own clients in front of me. The scripts she shared, the visual diagrams she drew, and the live role plays all contributed to a sense that these tools are not abstract, they belong in real rooms with real people. 

Relevance for specific clinical populations 

As I reflected after the training, certain client groups came to mind very clearly. 

I thought of clients with complex PTSD and developmental trauma, whose histories are full of repeated experiences rather than single events. For them, tools like the Three Lists and attachment-informed work feel especially relevant. 

I thought of clients with dissociative symptoms or more distinct parts-based presentations, including those who might meet criteria for dissociative disorders. For these clients, BotHS, Loving Eyes, parts mapping and gentle internal dialogues seem like ways of honouring their internal organisation while still holding the AIP model. 

I thought of clients whose lives are shaped by shame – those who drop their gaze, apologise for existing, or feel ‘too much’ or ‘not enough’. The idea of shame as a defence, and the possibility of bringing compassionate attention to it, felt particularly important here. 

I also thought of clients with attachment-related difficulties, addictions or neurodiversity. The training helped me see how the same tools can be adapted to different contexts, always with the aim of supporting the client to engage with EMDR in a way that feels safe and manageable. 

Strengths of the training 

When I look back on the day, several strengths stand out emotionally as well as intellectually. 

• I felt held by the structure and pacing; there was no rush. 

• I felt respected as a clinician; the training assumed I already had a solid foundation and was now refining it. 

• I felt inspired by the integration of theory and practice; nothing was presented in isolation. 

• I felt encouraged by the way Sonya normalised dilemmas and difficulties; it was reassuring to hear how she navigates them. 

• I felt energised by seeing the EMDR Toolbox book and flashcards come to life; they now feel like living resources rather than static materials. 

There was also something quietly moving about knowing this training carries forward Jim Knipe’s lifetime of work. It felt like being part of a lineage of clinicians who care deeply about how to sit with complexity. 

Overall reflections and recommendations 

By the end of the day, I felt full of ideas, images, phrases, and possibilities. I felt that my understanding of EMDR had been enriched, especially in relation to clients whose internal worlds are more complex. 

For me, this training was not about fixing something that was broken; it was about widening the path so that more of my clients can walk it. The Standard Protocol remains at the centre of my work. What I gained from the EMDR Toolbox training with Sonya Farrell are additional ways to support clients, especially those with complex PTSD, developmental trauma, dissociation, shame, and attachment-related difficulties, so that they can approach and engage with that protocol in a way that honours their protective strategies and their capacity to heal. 

I would warmly recommend this training to EMDR therapists who find themselves curious about how to sit more confidently with complexity, who want to feel more resourced when defences or parts appear, and who value a reflective, compassionate approach to learning. 

For me, it was a day that brought theory, practice and my own clinical experience into a more coherent and hopeful conversation. 

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Adapting EMDR for neurodivergent clients: Integrating clinical experience and current research 

By Deborah Kingston

Introduction 
‘Neurodivergence’ refers to variations in human brain structure and cognitive functioning that diverge from what is typically considered ‘neurotypical.’ This includes differences in learning, attention, mood, sensory processing and social interaction. Common examples include Autism, ADHD, dyslexia, dyspraxia, dyscalculia and Tourette syndrome. These differences are not deficits to be ‘fixed’ but variations to be recognised and accommodated (Singer, 1999; Armstrong, 2015). 

While EMDR has been shown to be effective for treating trauma, most research has focused on neurotypical populations. Yet many clients in clinical practice are neurodivergent. These clients may present with overlapping neurodevelopmental conditions, such as the high rates of ADHD in individuals with Autism (Antshel et al., 2013; Hours et al., 2022) and may also experience increased rates of mental health difficulties, including anxiety and depression (Brook et al., 2013; Georgiou et al., 2024; McKinney et al., 2024). 

Neurodivergence and trauma frequently intersect. Adverse childhood experiences are more common among neurodivergent individuals (Wilson et al., 2024), and trauma responses can mimic or amplify neurodivergent presentations (McDonald & Ejesi, 2021). For example, the emotional dysregulation characteristics of Autism can intensify PTSD symptom severity following trauma (Cai et al., 2018; Quinton et al., 2024). Similarly, undiagnosed dyslexia can lead to shame and trauma responses rooted in negative educational experiences (Alexander-Passe, 2015). 

Despite these intersections, there remains a paucity of research on EMDR with neurodivergent populations. Existing evidence consists primarily of case studies and small trials, often focused on Autism and ADHD (Buuren et al., 2019; Firat et al., 2023; Guidetti et al., 2023; Leuning et al., 2023). The literature provides promising indications but little systematic guidance for clinicians. This article therefore integrates the available research with clinical insights to outline adaptations and considerations across the EMDR protocol to support neurodivergent clients in accessing EMDR effectively. 

Evidence base for EMDR with neurodivergent clients 
The current evidence base for EMDR with neurodivergent populations is limited but growing. Most studies focus on individuals with Autism and, to a lesser extent, ADHD. 

Several case studies and small trials have shown EMDR to be effective in reducing trauma and stress symptoms in autistic children and adults. For example, Firat et al. (2023) reported successful treatment of specific phobias in two children with Autism using only two 90-minute EMDR sessions. Leuning et al. (2023) conducted a study with 21 autistic adolescents and found significant reductions in daily stress and improved global functioning, though EMDR did not reduce core Autism symptoms. Similarly, Buuren et al. (2019) compared EMDR with treatment-as-usual for 21 autistic adults and found EMDR significantly reduced PTSD symptoms, psychological distress, and some autistic features, with gains maintained at follow-up. 

There is less research on ADHD, but two case studies demonstrate EMDR’s potential. Guidetti et al. (2023) treated a 12-year-old with ADHD and PTSD using EMDR, reporting improved executive functioning and reduced emotional dysregulation at a nine-month follow-up. Gokcen et al. (2022) described a 9-year-old boy with ADHD and a history of sexual abuse whose PTSD and oppositional defiant symptoms improved after five EMDR sessions. 

Currently, no studies have examined EMDR adaptations for clients with dyslexia, dyscalculia or dyspraxia. Much of the adaptation guidance therefore comes from clinical experience and neurodiversity-affirming therapeutic approaches rather than formal research. 

Adapting EMDR across the eight phases 

Phase 1: History taking 
Attention to the therapeutic environment is essential. Lighting, sounds, room temperature and textures should be comfortable and predictable. Clinicians should observe how clients engage with forms and assessments, offering support as needed. Questions may need to be phrased more concretely; for example, “How are you feeling right now?” may be more effective than “How are you?” 

Exploring how clients organise their memories can guide treatment planning. Some may generalise their experiences (e.g., merging multiple bullying incidents), while others describe each event separately. Adjusting pacing is crucial: some clients prefer shorter sessions to avoid overload, while others may need longer to feel fully heard. Direct language should be used when assessing risk (e.g., “Do you have suicidal thoughts?” rather than euphemisms such as “dark thoughts”). 

Phase 2: Preparation 
Bilateral stimulation (BLS) should be tailored. Clients with ADHD may find slow BLS frustrating, whereas some clients with Autism struggle with eye movements and prefer tactile or auditory methods. Clients with dyslexia or dyspraxia often find tapping easier but may worry they are ‘doing it wrong.’ Normalising this is important. 

Calm or safe places should be adapted to individual sensory preferences. Some may prefer movement-based or textured imagery, while others prefer minimal sensory input. Photographs, music, scents or tactile objects can support affective engagement if visualisation is difficult. For clients with tics or Tourette syndrome, noticing calm sensations during resource installation can reduce tic frequency, especially when incorporating movement. 

Phase 3: Assessment 
Clarifying questions collaboratively ensures understanding before memory activation. Reviewing the worksheet together can reduce confusion. Some neurodivergent clients compartmentalise experiences, recounting events without emotional engagement; therapists may need to help them connect memory and affect. 

Scales may need adaptation. Clients may describe validity of cognition or subjective units of distress (SUD) qualitatively (e.g., ‘low,’ ‘medium,’ ‘high’) rather than numerically. Emotional expression may be physical rather than verbal; using tools such as an emotions wheel can support identification. Therapists should observe body language as well as verbal responses. 

Phase 4: Desensitisation and reprocessing 
Set length and speed should be flexible. Clients with ADHD may benefit from shorter, faster sets; clients with slower processing speeds may need longer. Some neurodivergent clients talk extensively during processing – this may reflect avoidance or their neurocognitive style. Therapists can allow brief sharing during BLS, then return the focus to the task. 

Movement-based techniques can help regulate arousal. Some clients may pace or march on the spot during BLS, which can keep them within their window of tolerance. Emotional intensity should be validated, particularly for clients who have been told they are ‘too much.’ Adapt SUD measurement flexibly, as some clients may simply indicate their distress is gone without a number. 

Phase 5: Installation 
Positive cognitions should use the client’s own language. Some clients with Autism may resist formulaic ‘I’ statements, and ecological cognitions, such as “it’s in the past,” may be more congruent. If clients express boredom or frustration during installation, therapists should not take this personally but adapt accordingly. 

Phase 6: Body scan 
Some clients prefer not to close their eyes or need explicit guidance to notice body sensations. Language should be clear and concrete, focusing on observable tension or relaxation rather than abstract internal states. 

Phase 7: Closure 
Praise should be genuine and non-patronising; some neurodivergent clients may be suspicious of praise due to negative educational experiences. Post-session processing should be explained concretely (e.g., “Your brain is like a computer running a background program”). Note-taking expectations should be managed carefully to avoid triggering shame or perfectionism. 

Phase 8: Re-evaluation 
Therapists should check that previous targets remain resolved and adapt questioning as needed. Some clients may move quickly to new material; others may benefit from re-completing parts of the protocol to notice changes. 

Additional considerations 

Environmental sensitivity: Changes in the therapy room or schedule can be distressing. Therapists should communicate changes clearly and be prepared to repair ruptures if clients perceive them as intentional. 

On-the-spot method: Originally developed for clients with dementia (Amano & Toichi, 2014), this method involves applying adapted EMDR procedures in real time when distress arises. For neurodivergent clients, similar in-the-moment desensitisation can be helpful when sudden environmental changes trigger intense reactions. 

Timeliness: Punctuality and clear communication about delays are crucial, as unexpected lateness can provoke significant anxiety. 

Conclusion 
Neurodivergent clients bring unique strengths and challenges to EMDR therapy. While formal research on EMDR adaptations for neurodivergent populations is limited, existing studies and clinical experience suggest that thoughtful, individualised modifications can make EMDR more accessible and effective. By attending to sensory preferences, communication styles, processing speeds and environmental sensitivities, clinicians can deliver EMDR in a way that is both neuro-affirming and faithful to the standard protocol. 

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When the extremist becomes the client: EMDR with former violent extremists 

By Deepti Ramaswamy

Introduction 

Violent extremism is a topic that has at various points occupied a significant presence within the media and social landscape, as extremist events have touched many lives in many countries, often leaving lasting scars (Horgan, 2008). Yet globally there is no agreed definition of what violent extremism is, with countries defining it in different ways and legal processes responding in varied ways: some focusing on punishment, others on prevention, others on rehabilitation and reintegration. Psychological, sociological, and political models have attempted to explain the phenomenon (Borum, 2011) and, while research exploring links between mental health and extremism is growing (Marsden & Lewis, 2021) those links remain poorly understood (Gill et al., 2021). In the UK, extremism is addressed through the Prevent programme (HM Government, 2024), which aims to prevent people from entering extremism and to support those who wish to leave. For those thought to pose a greater risk, the Channel panel (HM Government, 2025), a multidisciplinary group that includes police, healthcare, housing, and social services, works to devise a needs-based approach. Interventions vary in focus: some address ideology as the root cause, using ideological and religious mentors to challenge it; others target social deprivation and seek to meet basic needs such as housing, healthcare, education, and employment. To address mental health difficulties, there are referrals to NHS mental health services, alongside the development of specialist services such as Vulnerability Support Hubs, which co-locate police and mental health professionals to enable earlier identification and intervention. 

This article draws on learning I have gained over 4.5 years of working with former violent extremists formerly associated with the far right, Islamist movements, and involuntarily celibate (incel) communities. The participants were living in the community and no longer involved with statutory services. The work combines EMDR therapy and narrative approaches to explore how this population disengages from extremism and works towards reintegration. While this might sound like a niche area, much of what I have learnt is relevant to clinicians working with those who present with a range of internalising and externalising difficulties, including suicide and self-harm, addiction, forensic histories, antisocial behaviour, and other presentations that render people hard to reach. As I slowly untangled these lives, I realised that despite the demonisation and othering so prevalent in media narratives, these people are so much like everyone else. I could see echoes of their experiences in the lives of other clients who had nothing to do with extremism. This gave me hope. 

Violent extremism is best understood as a multi-final process: a single starting point that can lead to a range of outcomes (Corner et al., 2019). It begins with trauma or adversity, followed by exposure to possible solutions, the social reinforcement of those solutions, and the presence or absence of alternatives. The Adaptive Information Processing (AIP) model of EMDR offers a natural and powerful lens: unprocessed early experience, shaped and compounded by environment, driving increasingly entrenched and ultimately harmful responses (Shapiro & Maxfield, 2002). While through one lens the behaviour might seem incomprehensible, the lens of the AIP framework allows for a much more nuanced understanding. 

It is important to state clearly that I do not seek to minimise or excuse the harm that violent extremism causes to individuals, communities, and society. That harm is real and serious. What I do argue is that effective clinical work requires the capacity to hold two things simultaneously: an unflinching awareness of the harm a person has caused, and an equally clear-eyed understanding of the harm that has been done to them. This is not a moral equivalence. It is a clinical necessity. It is also worth noting that given the lack of a shared definition, ‘violent extremist’ encompasses a wide spectrum: from those who hold radical views privately to those who enable, recruit, radicalise, or fundraise to the smaller minority who directly commit or plan acts of violence. The public image tends to collapse this entire spectrum into a single figure. Clinically, that flattening is not useful. The individuals described in this article were, in the main, people trying to leave and trying to understand how they had arrived at this point. 

Getting through the door 

Before any EMDR can take place, the first challenge is engagement. Unlike private practice or NHS services where clients choose to attend, with this population, the obstacle is not a lack of need or even, at some level, a lack of desire for help. The obstacle is the gulf, often felt as insurmountable, of fear and mistrust that lies between where they are and where therapy begins. 

The very idea of therapy can elicit responses such as ‘What do I need therapy for? I am fine’, ‘Talking doesn’t do anything anyway’, and ‘What’s in it for you?’ Much of this resistance is rooted in prior experiences of seeking support from professionals that proved fruitless, and in a normalisation of distress so profound that panic attacks, nightmares, and flashbacks no longer seem to warrant comment or intervention. Psychoeducation, offered before any therapeutic contract is in place, can therefore be an important first step. 

Further challenges typically follow: inappropriate peer referrals (‘Can you help my mate?’), difficulties with literacy, and a deep institutional distrust that makes informed consent and therapy agreements genuinely difficult to navigate. Responses such as ‘I don’t do paperwork’ and ‘I trust you, why do I need to sign stuff?’ are common. Practical barriers to attendance are also significant: financial instability and lack of employment make in-person attendance costly and complicated. For those working online, securing a private, safe space can be difficult, and limited access to suitable devices or digital skills sometimes led to requests to conduct sessions via WhatsApp or Facebook. 

Each of these challenges requires careful negotiation and a recognition that ideal conditions are rarely available to this group. The task is to find an ethical, collaborative, and safe way forward that may require creativity and compromise on both sides. The overarching lesson is straightforward: flexibility is not an optional feature of this work. It is the work itself. Clinicians working with people who misuse substances, those with forensic histories, or young people involved in gangs will recognise much of this terrain. 

History-taking, stabilisation and phases 1 and 2 

The structure of the work is summarised in Table 1, which maps the correspondence between Herman’s three-phase model, the EMDR protocol and the ACT-informed consolidation phase. 

The starting point in every case was narrative: tell me your story from birth to the present, in the context of your extremist involvement. Tell me who, what, where, when, how. Tell me what affected you, influenced you, changed you, hurt you, helped you. Tell me whatever you want. Time and again, clients described this as the first occasion on which they had been listened to without interruption and without an agenda. Previous therapeutic encounters had typically been symptom focused or offence focused: tell me about your crime, your drinking, your risk. Constructing a timeline together helped people begin to understand how they had come to be where and who they were. 

The experience of having one’s full story witnessed, even when this took three or four sessions, was consistently reported as profound. Identifying the key themes running through a life, recognising both the accumulation of smaller injuries and the pivotal crossroad moments, had a transformative quality extending beyond information-gathering. This experience of being heard without agenda is not unique to this population: it is frequently described by clients who have had repeated contact with services focused on the number of clinical contacts or risk management rather than understanding. 

This process was accompanied by psychoeducation drawing on several frameworks: compassion-focused therapy to address shame and self-criticism (Gilbert, 2009); polyvagal theory to help clients understand their bodily reactions, dissociation, and emotional numbing (Porges, 2011); attachment theory to illuminate interpersonal patterns (Bion, 1962; Bowlby, 1988; Schore, 2021; Winnicott, 1960); internal family systems to support a more compassionate relationship with conflicting internal states (Schwartz, 2013); and the AIP model to frame the whole. Each framework was introduced in response to clinical need rather than as a sequence and, together, they produced not just intellectual understanding but a meaningful reduction in self-blame and shame. 

Skill-building in this phase was broad and individually tailored (mindfulness, breathing and grounding, connecting with parts, safe or calm place, calm state, resource team, pendulation and the light stream) alongside tools drawn from other approaches as needed. The goal was to ensure sufficient internal resourcing before any trauma processing began. With this population, that resourcing phase consistently required more time and space than standard protocol might suggest. 

A second narrative interview followed the completion of this phase, capturing shifts in self-understanding that psychometric measures alone would not easily have revealed and giving clients an opportunity to tell their story anew. The practice of structured narrative-telling at multiple points across the therapeutic journey has been one of the most significant learnings from this work, and one I now incorporate into my broader practice. 

Phases 3 to 8: client-led targeting and processing 

While standard EMDR practice involves a formulation-based approach to identifying past events, present triggers, and future concerns, the targeting process here was intentionally and explicitly client led. The completed timeline enabled the clients to identify the events they believed had most shaped their story: the crossroads moments. This was a deliberate clinical choice, designed to offer a degree of control and agency that had frequently been absent from their prior therapeutic encounters and, indeed, from much of their earlier lives. 

Notably, identified targets rarely related directly to extremism. They were more likely to be a friend’s suicide, the loss of a parent without the chance to repair a relationship, or sustained childhood bullying. Just as in the narrative interviews, one enters expecting extremism to be the central preoccupation only to discover that clients define themselves, and locate their pain, quite differently. The extremism was rarely the whole story, and rarely even the most painful part of it. This finding echoes what many clinicians observe when working with offending populations or those with complex presentations: the presenting problem rarely reflects the depth or origin of the distress. 

Phases 3 to 7 followed standard EMDR protocol, with one meaningful addition to Phase 7. Alongside standard closure, clients were actively supported to bring wounded aspects of their earlier selves safely into the present and to begin constructing a future template: a concrete image of themselves navigating life differently. This left people with a sense of agency and forward momentum at the close of each session, rather than simply contained. 

Phase 8 focused not only on residual disturbance in relation to the processed target but also on observable behavioural change. The explicit question was: how is this making your life better? This is always implicit in EMDR but, here, it was made more visible and deliberate. In part, this reflected the clinical reality that these clients often needed support in recognising and naming their own progress; in part, it reflected the fact that behavioural change in this population also functions as a meaningful indicator of ongoing deradicalisation and reintegration. 

Across the entire process, four narrative interviews were woven through the work: before therapy began, after Phases 1 and 2, after the trauma processing block, and after the final ACT-informed phase. In this last phase, clients identified core values and constructed a concrete image of what a life guided by those values might look like (Hayes et al., 2013). The progression across all four narratives was consistently one of the most moving aspects of the whole project: a record of change that belonged entirely to the person narrating it. 

Identity after extremism: The work of becoming someone new 

EMDR can change how people understand themselves. When the person in question carries a publicly known and socially reinforced identity as a violent extremist, that process carries particular weight. The establishment of a new, grounded identity needs to be actively supported, both through the internal work of therapy and through external anchors: relationships, activities, and meaningful social roles. 

Early relational trauma frequently produces not only impaired emotion regulation but also a fragmented, unstable sense of self, one shaped by the responses of inconsistent caregivers rather than by any secure internal foundation. In this context, it is important for therapy to address not only what the person is no longer but also who they are now and what that means going forward. Failing to do so risks leaving a psychological void that others offering containment, belonging, and purpose may rush to fill. This is why the ACT-informed consolidation work at the end of therapy matters as much as the trauma processing that precedes it: it works alongside the future template to consolidate identity and support confidence in a viable path forward. 

The question that recurred most often in this phase was: what else is there? Once someone is no longer an extremist and no longer only a former extremist, who are they? What are they allowed to become? Rebuilding a sense of self that is neither defined by extremism nor entirely by its renunciation requires active clinical attention and honesty about the limits of what therapy can achieve when society itself remains unforgiving. For many, rebuilding relationships, employment, and community belonging is complicated by a past that is, to varying degrees, known and stigmatised. Drawing on Janoff-Bulman’s (1992) work on shattered assumptions and Neimeyer et al.’s (2010) work on meaning reconstruction after loss, what many clients were navigating was the loss of the world they had known inside extremism, alongside the loss of the person they might have become. Helping people grieve both and bridge the gap between the life they find themselves in and the life they had imagined is some of the most delicate work in the entire process. Similar processes of identity reconstruction are encountered when working with those leaving cults or coercive relationships, those in recovery from addiction, and those released from long custodial sentences – anyone for whom a former identity, however harmful, provided structure and belonging. Beneath it all lies the same fundamental human need: to matter, to be seen, to be valued, to be believed in as someone who has something to contribute (Billingham & Irwin-Rogers, 2021). 

Epistemic trust, psychosocial reality, and the limits of therapy 

Trauma, and particularly attachment and interpersonal trauma, erodes epistemic trust (Fonagy & Allison, 2014). It leaves a lasting mark, making it difficult for people to identify reliable sources of support, to feel genuinely understood, or to believe that another person’s intentions are benevolent and worth engaging with. For this population, whose histories are typically saturated with relational rupture, betrayal, and exploitation, rebuilding epistemic trust is not a by-product of effective therapy. It is one of its central tasks. 

Working with former violent extremists therefore involves more than symptom reduction and trauma reprocessing. It involves helping people understand how they came to be where they were, rebuilding the capacity to trust, and supporting them to move towards having their fundamental unmet needs finally, tentatively, met. 

It is equally important to be clear about what therapy cannot do. When symptoms reduce and stability increases, the psychosocial reality of these clients’ lives does not disappear. Barriers to employment and housing persist, alongside ongoing financial insecurity, often compounded by a criminal record or degree of public notoriety and the stigma that goes with it. The process of building new relationships while carrying the fear of being seen only as who one used to be is slow and frequently painful. Stability, it turns out, comes with its own demands, and these are often felt most acutely once the immediate crisis has passed. The combination of psychological fragility and practical instability is familiar to anyone working with homeless populations, those leaving the care system, or survivors of domestic abuse, groups for whom the gap between clinical recovery and functional stability is wide and rarely acknowledged in standard outcome measures. 

Evidence suggests that alongside psychological support, people need practical assistance with housing, employment, education, and finances to scaffold their everyday lives (Marsden, 2017), as well as social relationships with people willing to take a chance on them (Clubb et al., 2024). Therapy can be a crucial part of the reintegration process but it cannot be the whole of it. Holding awareness of the wider context and collaborating where possible with other services and supporters is a necessary part of clinical practice with this group. 

The therapeutic relationship: Endings, inconsistency and the danger of opening up 

When someone has never experienced relational safety, has never been listened to without judgement, or given space to think without an agenda, the first time this happens in therapy can be deeply destabilising. Attachment can be intense and ambivalent: clients may push and pull, disappear without explanation, or oscillate between engagement and withdrawal. It is important to be alert to this from the outset: to name it, normalise it, and work through it as a live clinical issue. Unaddressed, it can make endings harmful and, for a population already marked by profound relational rupture, that is a risk that must be taken seriously. 

Inconsistency in attendance was a recurring feature: forgotten appointments, ghosting, the pattern of someone declining further sessions and then returning six months later. Managing inconsistency required genuine flexibility and a conscious effort not to interpret it as personal failure or a breach of the therapeutic frame. Therapists working with adolescents, with people who misuse substances, or with those who have experienced repeated placement breakdown in care will be well acquainted with this pattern of approach and withdrawal. Simultaneously holding warmth and structure, flexibility and self-compassion, was an ongoing clinical and personal discipline. 

A consistent challenge was what might be called the danger of opening up. When someone begins to feel things, often for the first time, the experience can be overwhelming. The fear that powerful feelings will not stop, that they will take over and render functioning impossible, is especially acute for clients with an absence of adequate support networks and for whom destabilisation could be costly. It is important to prepare clients for this possibility and to agree explicitly that they will let you know when it happens, so that pace and depth can be adjusted. I now raise this possibility early, and frame it not as a sign that something has gone wrong, but as a sign that something is working. 

Fear of change also deserves direct clinical attention. Some clients had built an organising narrative around victimhood that functioned to justify, or at least explain, what they had done. Others had constructed an equally fixed narrative around intrinsic badness or unworthiness. When therapy begins to complicate either story, the question of how to go on, and who one will become, can feel genuinely threatening. The possibility of becoming a different person, one who no longer fits easily into existing relationships and communities, is not abstract for people who already know what it is to be isolated. These fears are best brought into the room explicitly and early, and the question of how therapy might affect existing relationships should be thought through in advance wherever possible. 

Neurodivergence: An emerging dimension 

An additional complexity that emerged across the work was neurodivergence. A growing body of research suggests a prevalence of neurodivergent traits within extremist populations (Moskalenko et al., 2022; Walter et al., 2021) and this was reflected in clinical experience. In my experience, many of my participants identified as possibly neurodivergent. Of significance was how they made sense of this possibility: did it explain the lifelong sense of not belonging, of never being quite enough? Did it account for their pathway into extremism? And, crucially, did it mean that what happened was not entirely their fault? And what implications did this have for their path forward?  

This is clinically rich and ethically complex territory. A neurodivergent framework can offer genuine relief and a more compassionate self-understanding. It can also, when not held carefully, become a means of avoiding accountability. The clinical task is to hold both possibilities without collapsing into either: neither dismissing the significance of a neurodivergent framework nor allowing it to foreclose the important work of taking responsibility for harm caused. 

Therapist support, supervision and self-care 

The level of support I had during this work is worth describing, not as a standard that others must meet but as an illustration of what this work can require. Alongside clinical supervision with my EMDR consultant, I had research supervision, peer-process work to identify and work through the personal and ethical challenges the work raised, narrative supervision with colleagues working with similar material, and access to personal therapy. Each of these served a distinct function and, together, they made the work sustainable. 

The point is not that all EMDR therapists require this exact structure. It is that working with this population will, in ways that are difficult to predict in advance, press on your own values, ethics, moral frameworks, and political beliefs. It will affect relationships with people in your personal life, not all of whom will be supportive of work that involves sitting with compassion alongside people whose actions many find unforgivable. It may also challenge the therapist’s own sense of professional identity. These pressures do not arrive solely from the clinical material: life does not stop, and events in the public domain reverberate directly into the therapy room. In the course of this work, further extremist attacks occurred in the UK and elsewhere. The impact landed immediately in sessions, triggering memories, shame, guilt, and fear in clients, and requiring the adaptation of treatment plans and a return to safety and stabilisation work. This is not an exceptional circumstance. It is the ordinary reality of working with this population and it requires the therapist to be prepared (Geelhoed et al., 2024). 

Countertransference is intense and multifaceted. I noticed fear and, at times, moral discomfort, which required active management to prevent it from contaminating the therapeutic space. I also noticed, more unexpectedly, moments of genuine admiration: for the courage required to leave, for the grief of losing an identity, and for the determination to rebuild. Vicarious traumatisation is a real risk. Access to skilled supervision, ideally with someone who understands both the clinical and contextual dimensions of this work, is essential rather than desirable, and therapists undertaking this work should feel able to advocate for adequate support within their organisations. 

A wider clinical relevance: Extremism closer to home 

Violent extremism can seem like something that belongs out there in the world, associated with dramatic events and identifiable perpetrators. In reality, the gradual normalisation of extremist ideas means that more people are engaging with them than the headline figures suggest. These individuals do not present to therapy as extremists. They present as people struggling with anger, depression, low self-esteem, self-harm, suicidality, and shame. They are people whose legitimate frustrations about their lives have found expression in frameworks that offer simple explanations and clear enemies: the far-right narrative that one is entitled to more, the incel narrative that inadequacy is women’s fault, and the broader radicalising narrative that violence is the only meaningful response to injustice. 

There is nothing pathological about feeling frustrated, powerless, or unseen. These are normal human experiences and the impulse to connect with others and seek solutions is healthy. The problem arises when those connections involve polarisation, the construction of a rigid ‘us and them’, and radicalisation, understood here as the endorsement or use of violence to protect ‘us’ from ‘them’. This is not about changing people’s political beliefs. Radical or unconventional thinking does not, of itself, lead to violence. That pathway is neither inevitable nor well-established (McCauley & Moskalenko, 2017). For a small minority, however, engaging in violence can come to seem like the only available means of changing an intolerable situation. 

We are living through a period of significant socioeconomic disruption, geopolitical instability, and widespread fear. These conditions narrow the psychological window for nuanced thinking, particularly for those already struggling to find solid ground, those who feel profoundly inadequate and powerless to change their circumstances. In such a climate, ideologies that offer purpose, belonging, and an identified enemy are more, not less, appealing. EMDR therapists are likely to encounter clients who are somewhere on this continuum, whether or not they present that way. Recognising the clinical features, understanding the psychological conditions in which these ideas take root, and approaching these presentations with the same non-judgemental curiosity that characterises good trauma practice, is both a clinical necessity and an ethical one. 

Conclusions and summary 

Working with former violent extremists has been the most demanding, and in many ways the most rewarding, clinical work of my career. It has tested skills, ethics, resilience, and conceptual frameworks in ways that were not fully anticipated. It has also confirmed, more deeply than any other work I have undertaken, the capacity of EMDR to reach those who have been considered unreachable: to offer, even to those who have done or been part of terrible things, the possibility of integration, meaning, and genuine change. 

The key messages for EMDR therapists are these. First, this population is treatable. The complexity is real but not prohibitive and the potential for meaningful therapeutic change is significant. Second, supervision and self-care are clinical necessities, not optional additions. Third, the line between perpetrator and victim is rarely clean, and the ability to hold both simultaneously, without premature resolution, is central to effective practice. Fourth, the skills this work requires are largely those that experienced EMDR therapists already possess, particularly those working with other hard-to-reach populations. The framework is sound. What is needed is the willingness, and the flexibility, to apply it. 

Therapy alone is not enough. Alongside psychological support, people need practical assistance and genuine social connection with others willing to take a chance on them. Epistemic trust, eroded by years of relational harm, must be painstakingly rebuilt. A new identity, grounded and sustainable, must be actively constructed rather than assumed to follow naturally from symptom reduction. And beneath all of it, the same fundamental human need: to matter, to be seen, to be believed in as someone of value. 

What I return to here at the end: these people are so much like everyone else. The echoes of their experience in the lives of other clients, struggling with shame, with belonging, with the distance between who they are and who they had hoped to be, were constant. That recognition did not minimise what had happened. But it made the work feel possible. And it made it feel, without question, worth doing. 

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Research News

By Anthea Sutton

EMDR Publications Database

A selected summary of recent research added to the EMDR Publications Database

Systematic reviews and meta-analyses

A new systematic review focusing on psychological treatments for children aged 12 years and under with trauma-related symptomology (Alkaersig et al. 2026) has been added to the database this quarter. Published in Clinical Psychology Review, the study found that EMDR therapy demonstrated small to moderate effects in treating trauma-related symptoms in this younger population. The study describes the evidence for EMDR as ‘emerging but promising’. It was noted that only 6 EMDR controlled studies were available for the meta-analysis compared with 24 for trauma-focused cognitive behavioural therapy (TF-CBT). Only one of the included EMDR studies employed an active control intervention, leading the review authors to advise that future research efforts should move beyond effectiveness studies (compared with passive controls such as waitlist or treatment as usual) and focus on head-to-head comparative studies between TF-CBT and EMDR for children under 12 years of age. A further recommendation was the need for studies involving culturally diverse samples, as current evidence is mainly focused in Europe, North America, and Oceania.

Also examining the evidence in children and adolescents, a systematic review of trauma treatments for refugee and asylum-seeking minors with uncertain residence status found that EMDR, either as a single intervention or in combination with other interventions (TF-CBT, KIDNET, conversational therapy, or play therapy) produced moderate to high effect sizes, challenging the idea that residence stability is a prerequisite for successful treatment (Nahlen Bose & Diaz 2026). The authors recommend that future research could focus on:

• including younger children (most studies involved adolescents, typically ranging from 12 to 18 years and few studies included children under 7 years of age)
• an equal distribution of participants, as there was a predominance of male participants across most studies
• stratifying results based on developmental age
• longer follow-up: follow-up measures (ranging from 2 weeks to 2–3 months in most cases) were conducted in approximately half of the studies.

Randomised controlled trials (RCTs) and feasibility studies

Specific delivery methods are explored in many of the trials added to the database this quarter. In the field of adolescent mental health, an RCT demonstrated that virtual reality-based EMDR effectively improved depressive symptoms and neurocognitive performance in adolescents with major depressive disorder (Yan et al. 2026).

Clinical applications for specific conditions also saw new evidence:

• Substance use disorders and PTSD: A trial in the Netherlands compared simultaneous with sequential treatment, finding that simultaneous delivery was preferred by participants and that EMDR is an effective alternative to prolonged exposure in these cases (Lortye et al. 2026)
• Binge-eating disorder: Two RCTs investigated the use of EMDR for adults with binge-eating disorder. A pilot study with Australian adults found that a 10-session EMDR protocol was feasible and resulted in significantly larger reductions in binge-eating symptoms, anxiety and sleep disturbances compared with a waitlist control (Hatoum et al. 2026). A study involving female Italian inpatients with obesity and trauma histories, compared a four-week EMDR intervention to CBT and found no significant difference between the two treatments, as both yielded similar, although small, improvements in depression, anxiety and binge-eating symptoms (Guerrini Usubini et al. 2026).
• Neurodevelopmental disorders (Italy): The EMDR Integrative Group Treatment was found to be a feasible and promising intervention for reducing trauma-related stress in parents of children with neurodevelopmental disorders (Cavalera et al. 2026).

Research protocols

Several protocols for forthcoming trials have been added to the database as follows:

• DeprEnd EMDR (Pakistan): A mixed-method RCT protocol aimed at culturally adapting and testing the clinical effectiveness of the DeprEnd protocol for major depressive disorder via in-person and online modalities (Khan et al. 2026).
• B.R.E.A.S.T. study (Italy): A protocol for a longitudinal RCT assessing the efficacy of the EMDR Recent Traumatic Episode Protocol in reducing psychological distress in patients undergoing surgery for breast cancer (Ligorio et al. 2026).
• Sky-Flash (Turkey): A protocol evaluating an internet-based EMDR Flash intervention designed to manage exam anxiety and improve wellbeing among university students (Koksal et al. 2026).
• N-of-1 trials for depression (Italy): A prospective observational design protocol to identify individual characteristics that predict response to EMDR therapy for depressive symptoms (Cortado et al. 2026).

Other research

We collect all types of research study design for the EMDR Publications Database, here is a selection of varied types of research new this quarter.

Group EMDR for disaster-affected adolescents (Filazoglu Cokluk 2026)

• Study design: This research used a quasi-experimental convergent mixed-methods design, comparing an experimental group with a control group (N = 120).
• Geographic location: Turkey.
• Research topic: The study evaluated the effectiveness of the EMDR Integrative Group Treatment Protocol (EMDR-IGTP) in reducing symptoms of PTSD, depression and anxiety while enhancing resilience among Turkish adolescents affected by the 6 February earthquakes.
• Findings: Participants receiving the group therapy showed significant reductions in PTSD, generalised anxiety and depression scores as well as improved psychological resilience, although the intervention’s impact on social anxiety and panic disorder was minimal.

EMDR for adolescents with social anxiety disorder (Inci Izmir 2026)

• Study design: A 12-week follow-up study using a single-group design (N = 26) with assessments at baseline, 4 weeks, and 12 weeks.
• Geographical location: Turkey.
• Research topic: The investigator examined whether EMDR is an effective psychotherapy for reducing the severity of social anxiety disorder in adolescents.
• Findings: All adolescents in the study showed clinical improvement by the end of the 12th week, with substantial decreases in anxiety scale scores and subjective units of disturbance.

Intensive EMDR for adults with intellectual disabilities (Bierman et al. 2026)

• Study design: This research employed a nonconcurrent single-case A-B-A design involving six adult participants.
• Geographical Location: Netherlands.
• Research Topic: The study evaluated the feasibility, potential effectiveness and safety of an intensive EMDR programme for adults with mild intellectual disability or borderline intellectual functioning who have PTSD and complex psychiatric comorbidities.
• Findings: Five of six participants experienced a significant reduction in PTSD symptoms, with three no longer meeting diagnostic criteria. The intervention was completed by all participants without any reported adverse events or drop-outs.

The role of negative cognitions in EMDR outcomes (Collins & Carbajal 2026)

• Study design: A quasi-experimental pilot study (N = 6) comparing an experimental group (no negative cognitions assessed) with a control group (Standard Protocol with negative cognitions assessed).
• Geographical location: United States.
• Research topic: The researchers aimed to determine whether identifying negative cognitions in the EMDR Standard Protocol significantly impacts PTSD and physical symptom outcomes.
• Findings: The study found no statistically significant differences between the two groups, tentatively suggesting that the specific assessment of negative cognitions may not be an essential component for effective memory reprocessing. However, the authors recommend further investigation because of the small sample size.

What else has been added to the database this quarter?

The most recent update to the database was in March 2026, when 39 new publications were added. Newly added publications can be easily viewed by clicking on the ‘NEW’ tag. Within the NEW tag, you can then select further tags of interest to see what has recently been added for specific topics and research types. Table 1 provides an overview of the topics and study designs added to the database this quarter. Please note that topic areas are not mutually exclusive; some publications may appear in more than one category.

Table 1: New research by topic and study design

How we populate the database (methods)

The EMDR Publications Database is developed collaboratively with the Sheffield Centre for Health and Related Research and is provided as a free resource for Association members. If you have not yet accessed this useful resource, you can find out how to do so in the members’ area of the EMDR UK website.

The EMDR Publications Database is a collection of peer-reviewed research and dissertations/theses focusing on EMDR. It contains over 2000 references, many of which have access to the full text. The references are categorised by ‘tags’ (keywords) relating to the clinical area and study type, allowing for easy browsing. The database can also be searched using specific terms of interest.

Searches to populate the database are conducted on the following international databases: MEDLINE, Embase, PsycINFO, ProQuest Dissertations & Theses, and PTSDpubs.

The next update of the publications database will be in July 2026 but, in the meantime, if you have any queries or comments, you are welcome to get in touch at: a.sutton@emdrassociation.org.uk.

If you are an EMDR UK member and wish to request access to the database, please email the team at the University of Sheffield: emdrdatabase@sheffield.ac.uk

Disclaimer: this update reports study findings only; the research included in the database has not been assessed for quality and we recommend that evidence users make their own assessment before applying recommendations into practice. You can find out more about critical appraisal of research here: EMDR UK Association research webinars: Developing critical analytic skills – EMDR Therapy Quarterly

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EMDR+Music Integrated Model: Using music as an interweave in EMDR

By Sophie Leader

East Anglia Networking Day (26 April 2025) and Yorkshire Sculpture Park (08 November 2025)

Presented by Cassandra Manning MA, MSc, EMDR and EMDRIA Approved Consultant and Integrative Psychotherapist

As an introvert, I rarely put myself in the position of writing and sharing my own experiences. However, attending the East Anglia regional day last year in Ely was such an inspiring event for me that I felt getting out of my comfort zone and sharing with others would be a good idea.

I should probably point out that I am fairly new to the practice of EMDR. I am in the process of applying for my accreditation and I look forward to many more years of practising and learning more about what has now become my favourite modality of all.

The East Anglia Group networking day last April was Sandra’s very first presentation about her practice and innovations integrating music as an interweave. Ad de Jongh’s use of Queen’s We Will Rock during COVID-19 lockdowns served as a catalyst. As a professional singer with training in music and imagery therapy, Sandra took the natural step of exploring further music’s power as an interweave. Apparently, she had very tentatively raised her hand at the end of the previous regional day when attendees were asked if anyone would like to volunteer and share any innovation in their practice. I am sure I am not alone in feeling very grateful for that moment of courage to share her work with us.

Excitingly, the presentation started with an experiential exercise. We were asked to think of a recent positive experience and were invited to tap it in as Sandra played a selection of four or five tracks. After listening to the tracks, people were invited to share their responses to the exercise. This felt like an extremely revealing and powerful entry into the world of EMDR+Music. It was fascinating to hear about the range of reactions to each track. Examples of responses included: ‘I loved this track’, ‘I found that track so irritating I could not stay connected to my positive experience’, and ‘something clicked and it made my positive experience even more vivid in my mind’s eye’.

This was a great illustration and reminder of everyone’s uniqueness and the danger of assuming otherwise. Like everything else in life, music is received and perceived by the listener in a unique manner. What might sound majestic to me might sound ridiculous to you.

For my part, some tracks felt a little disconnected to my experience but one felt like it fitted and clicked into place like the last piece of a jigsaw or a new pair of glasses that allows you to see and feel things more clearly (apologies for the average metaphors but it is hard to describe). The track somehow enhanced how I already felt in relation to my chosen positive experience. It made it more vivid and colourful in my mind’s eye. It was a very physical experience too. My body felt incredibly light and I could feel the joy of that original moment in a very focused and intense way.

The track in question was Spring I by Max Richter’s Recomposed (Vivaldi, The Four Seasons). Some found it irritating or even repetitive but, for me and for reasons that neuroscientists might explain much better than I ever will, it just felt right.

After that, Sandra explained how music can potentially be used in different phases. From resourcing to processing or installing PCs, music could be used to augment what is already there or help unlock what might need accessing more fully. I loved the idea that music could help those who might struggle to connect with a difficult emotion. It also made so much sense, knowing how powerful music can be at expressing or evoking emotions.

Like the reassuring presence of a co-facilitator in the room, music could be there to hold your client’s hand with its steady (heart) beat and returning form. It could also meet your client where they truly are by matching their emotions – whether deep sadness or anger – as if to say ‘I get it, I feel it too’.

To illustrate these points further, Sandra shared some of the most genuinely powerful demonstrations I have ever seen. I would like to acknowledge my sincere gratitude to Sandra’s clients for agreeing to share those incredibly moving and powerful moments with us.

After the Ely workshop, I found out that a full-day workshop was planned later in the year in the beautiful Yorkshire Sculpture Park (November 2025) and decided to attend, as I felt eager to learn more. The Yorkshire workshop was another great day with more time and space to expand on each aspect presented in Ely. Yet again, hearing about people’s unique experiences during the experiential learnings was fascinating and at times very moving.

Drawing from neuroscience research, Sandra also mentioned some very interesting facts such as the unique and active process at play when our bodies, like instruments (neurons and hormones included) literally resonate internally with the music we hear. I was also quite taken by the idea that our brains can adapt to new music in a way that is helpful to the EMDR process.

This is only a brief overview of what Sandra shared during those two workshops. There is much more to discover and understand about the use of music in EMDR. For my part, I feel inspired to carry on learning more. As well as my regular supervision, I have started attending one of Sandra’s supervision groups and am in the process of developing my offering of music as an interweave to some of the people I work with.

Resources

Huberman, A. (2023, 18 September). How to Use Music to Boost Motivation, Mood & Improve Learning. Huberman Lab Podcast. [Video]. YouTube. https://www.youtube.com/watch?v=gveDhZW-rUk

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