Using EMDR to Treat Attachment Injuries

My interest in attachment was sparked when my (now adult) daughter joined our family through adoption in the mid-1980s. At that time, clinical interest in the field was just beginning to grow. As I immersed myself in the attachment literature during my graduate studies, I was struck by the powerful impact early attachment experiences have on all of us lifelong. Upon completion of my first EMDR training with Dr Francine Shapiro in 1995, I found that the Adaptive Information Processing (AIP) model (still in its early stages of formulation) provided a deeper understanding of the longevity of early attachment patterns. I was thrilled by the powerful changes I began witnessing with my clients through EMDR therapy and realized it provided an avenue for healing early injuries and gaining greater attachment security.

If our earliest experiences involve nurturing and protection from attachment figures who are sensitive to our feelings and needs, our store of memory networks is loaded with adaptive information and positive resources toward social and emotional wellbeing. We have a store of pleasurable memories that inform positive interpretations and expectations of others, ourselves, and the world.

The experience of being “seen” and “heard” by a loving other allows us to pay attention to our own internal state, develop compassion for ourselves, and internalize our caregivers’ love and care for us. Our sense of trust and connection allows us to develop the capacity to be a compassionate mirror for others as well. Relationships become a source of meaning and fulfillment. We’re not really alone, even when we’re alone. We know we can reach out, and we know how to be vulnerable and connect. This sense of connection with significant people in our lives provides a buffer to stress and distress and helps us through hard times.

It’s important to note that individuals with secure attachment can suffer from distress and mental health issues too, but they have a foundation of internal resources and external support that allows them to respond more positively and rapidly with some assistance.

Secure early attachments in very early life open our hearts to giving and receiving love. We can trust others, the world, and ourselves. We’re able to find pleasure and fulfillment from our relationships.

When we’re traumatized during attachment experiences, the raw, painful memories stay trapped in our nervous system and throw up roadblocks to trust, connection, and pleasure—all the “stuff of life” that makes it worthwhile! Instead of entering a relationship with an open heart and mind, a relationship of any kind feels like a minefield that requires armor, vigilance, and a guarded heart. This leads to a poor outcome and feelings of alienation, again and again. Maladaptive “quick fix” coping behaviors may feel like the only way to manage the pain, but as we all know, quick fixes can create their own set of problems and further worsen mental and physical health.

EMDR therapy is an ideal approach for healing attachment injuries. It activates core, touchstone memories associated with deep-seated pain, mistrust, and low self-worth and provides an opportunity to integrate the emotional and sensory material with new adaptive perceptions and insights. The processing happens within the client at a deep emotional level, allowing profound positive shifts in clients’ sense of self, belonging, choices, and safety in the world today. Clients gain empowerment to make new choices and decisions in their present lives and recognize differences between early attachment figures and present-day significant others. The attuned, supportive EMDR therapist holds the space for clients with attachment injuries to help them relax their defenses and strengthen their courage and willingness to address their early experiences.

Studies have indeed shown that chronic childhood trauma can affect both functioning and the structure of the brain, including overdevelopment of parts of the more primitive “downstairs” brain, reduction in the volume of the corpus callosum connecting the right and left brain, and reduction in dendritic connections within the prefrontal or “upstairs” brain. Although more research is needed to gain a full understanding of the complex mechanisms that take place during EMDR therapy, multiple studies have used neuroimaging before, during, and after EMDR that provide evidence of a number of neurophysiological changes in the brain during treatment.

Studies have also indicated an “orienting” and relaxation response and a reduction in the vividness of memories due to taxation of the working memory system during EMDR reprocessing of traumatic memories. This calming of the nervous system facilitates new associations, insights, and learning. There are indicators that the regions of the right and left hemispheres of the brain that are activated during EMDR therapy are associated with accelerated learning and integration of information.

I intentionally bring a “mentalizing state” to the therapy office. In other words, I try to stay curious, open, and nonjudgmental, helping clients find just the right words or phrases to help them express what they’re feeling and experiencing in their lives and relationships before I do anything else. I see myself as a mirror, reflecting back to them what I’m hearing and observing and then “holding a space” for them to reflect.

Simultaneously, I’m providing bits of psychoeducation, which I think helps relieve their shame. The trauma and attachment lens makes sense of their present-day reactions and behaviors as normal “trauma brain” responses. Just recognizing their problems as a consequence of traumatic stress and attachment injuries can relieve the shame and self-blame clients have carried around for years. As they begin to connect the dots between the present and past and see that I only hold positive regard and compassion for what they’ve gone through, they’re much less guarded and more willing to take an honest look at the way their lives have unfolded.

Clients’ relationships with their parents in the present and past reflect their particular attachment experiences.

• Clients with more of a preoccupied pattern may continue the demanding behaviors of childhood in an attempt to get the old unmet needs met today.

• Clients with a dismissive pattern may continue an idealizing stance—a “pretend mode” that avoids painful feelings. Dismissive derogatory clients may continue guarding their hearts by denigrating the importance of their relationship with their parents, as they learned to do when they were young.

• Clients with an unresolved/disorganized pattern may continue to feel anxious around their parents today because they’re triggered and operating from a younger state.

I find it helpful to remember that no matter what patterns are ruling clients’ lives, my job initially is simply to provide a calm, co-regulating, and safe “secure base” in which they can reflect on their feelings, beliefs, and present-day patterns. I can mirror, validate, and allow the truth about the client’s and family’s struggles to unfold at the client’s pace. 

It’s tempting to try to assist clients with their shame by simply demonizing their parents. Sometimes we want to help them by saying, “It’s not your fault you’re suffering from these problems, it’s the fault of your parents!” However, this can place clients in a loyalty bind and reinforce the black-and-white, non-mentalizing perspective that someone is to blame. The “mentalizing” reflective approach helps clients view their parents through the same nonjudgmental lens of attachment and trauma that explains their own problems and symptoms. I find it helpful to ask them what might be stuck in their parents’ memory networks, getting in the way of them being their best selves. This allows clients to look at their parents’ behaviors more honestly without feeling disloyal and provides information that will allow their memories to move to adaptive resolution during EMDR.

The research shows clear evidence that individuals with disturbed early attachment experiences can “earn” a secure attachment status in adulthood that allows them to develop a secure attachment relationship with their children. This is hopeful information.

The literature posits the change as happening through an emotionally corrective relationship experience with a secure individual. In my own early case study with three adult clients with non-secure patterns, I saw the achievement of earned security following the completion of approximately 15 sessions of EMDR therapy. Through changes in their nervous system, newfound feelings of self-compassion, insights, and capacity to self-reflect and reflect upon the internal state of others, their attachment patterns changed.

Attachment security is on a continuum, and I postulate that EMDR therapy with an attachment- and trauma-informed clinician is an effective approach to moving clients with disturbed attachment down the continuum toward earned security and improving their capacity to provide experiences of attachment security for their children.

Inadequately processed early attachment trauma is stored in neural networks in a raw form that allows frequent activation. This leads to a feeling state that is younger and stuck in old thoughts and feelings. The younger part of self has an innate desire to get unmet childhood needs met and is often attempting to meet those needs in present-day relationships. Unfortunately, the time for getting childhood needs met through outside relationships is over, and the needs-seeking behaviors lead to problems.

My colleague and co-author, Ann Potter, PhD, refers to “velcro kids” parts. Velcro kids are child parts of self that seem constantly activated, hijacking present-day feelings and perceptions, cut off from the adaptive information stored in the front brain.

Healing and meeting unmet early needs can happen through a strengthened adult self who provides compassion, nurturing, and safety to younger parts on the inside. During the EMDR preparation and stabilization phase, clients can be assisted with meeting needs internally through imagery, dialogue, and slow bilateral stimulation to deepen the associated positive affect. Clients can also be assisted with negotiating roles with the internalized critical voice and/or the overdeveloped protector part of self. Working with parts enhances successful EMDR trauma reprocessing through a stronger and healthier internal system.