Made Simple:
Attachment-Informed EMDR

In one sentence: Approaching EMDR with a clear, explicit, and early focus on attachment—that is, how a client came to be who they are today—can unlock deeper, more lasting therapeutic change.

In one paragraph: Our earliest experiences of attachment determine how each of us learns to deal with life, big and small. As EMDR therapists, if our standard training isn't supplemented with an understanding of how attachment works, progress may get stuck, particularly in Phases Three and Four. Attachment-informed EMDR can overcome this by cutting through the “noise” of a client's current presentation to the “signal” of how they got to be the way they are. This opens the door for therapists not only to understand but to rewire those earliest experiences.

Curiosity about a client's attachment story is our best pathway to the key targets whose processing will lead to most lasting change.

ai-EMDR's Six Points of Focus

Standard EMDR unfolds within the framework of Francine Shapiro's eight brilliantly-conceived Phases, but therapy can often stall if we don't understand how a client's presentation (whether it's anxiety, nightmares, relationship difficulties, grief, OCD or so much more) has its roots in early-life attachment experiences. This is how attachment-informed EMDR (ai-EMDR) complements the standard phases. It adds six points of focus that help us work with how our clients became who they are:

1. Case Conceptualisation: In Phase 1, allow history and treatment planning to be informed by a radical curiosity about what a client's presentation might really be about. How did they learn in their earliest formative experiences to self-soothe, to manage emotion, to be in the world? Ask a client about their history, but listen for cues between the lines, which will tell the deeper story.

2. Resourcing: In Phase 2, supplement preparation with richer imaginal resourcing that reaches deeper than your client's standard calm/safe place. Here, ai-EMDR doesn't just give clients tools to stay safe but (with credit to Laurel Parnell and her Attachment-Focused EMDR) taps in a rich team of nurturing, protective, and wise figures. Beyond a sense of safety, this fires up the client's imagination in preparation for the deeper attachment-informed work that will take place in Phase 4.

3. Targeting: In Phase 3, we don't just target what the client thinks they know to be the root issue. We focus in parallel on how, in the here and now of their experience, the deep past is informing both their emotions and their behaviour. Rather than waiting for an appropriate “floatback” moment to emerge in the processing, we “bridge” proactively, inviting the client to “Drop Back in Time”, “As Far as You Can Go”, to “The First Place You Land”—in imagination or memory. This often brings us to formative stories that the client has never connected to their current issues—experiences which may even appear positive or benign yet which are unerringly the place the nervous system wants therapy to begin.

4. Appropriate Activation: In ai-EMDR, we simplify and reorder EMDR’s standard assessment phase, with its sequence of Image, Negative Cognition (NC), Positive Cognition (PC), Validity of Cognition (VoC), Emotion, and Body. While that approach is perfect for single-incident adult traumas, more often in ai-EMDR we use the modified protocol and the simplified language of Image, Emotion, Body, and finally Belief. We don't insist on numbers (such as the VoC scale from 1 to 7), and (most challenging for traditional EMDR therapists to accept), we allow the PC to emerge organically during processing.

5. Reveal, Repair, Rewire: In EMDR's Phase 4, rather than staying out of the way and focusing primarily on bringing down the SUDs as might be the case in the classic approach, EMDR with attachment is prepared to work more creatively and proactively with a client's formative experiences. Drilling right down into childhood as if it's still happening in the present, we reveal the stories, help to recast them as if for real, and literally rewire a client's survival-informed neural circuitry which of course made sense at the time but which is now so often well past its use-by date.

6. Session Structure: Finally, ai-EMDR sessions can be more focused than standard EMDR. After the usual check-in, every session begins with activating (or re-activating) the present as a gateway into the client’s formative past. At the end of every session, after the often powerful rewiring work of Phase 4, it’s good to return to our starting point in the here and now (often a trigger moment) to check how it has shifted. A short burst of BLS taps in that change, and that tighter session structure can mean fewer sessions ending mid-flight and less need to turn to containers and special places to soothe the client for reengagement in the world.

There's a cheerful mnemonic that can help keep these six focus areas of ai-EMDR in mind:
Charlie Chaplin (CC – Case Conceptualisation)
Recognises (R – Resourcing)
That (T – attachment-informed Targeting)
Attachments (A – Appropriate Phase 3 Activation)
aRe (R – Reprocessing and Rewiring)
Seriously Salient (SS – Session Structure).

The Seven Kinds of Target

Curiosity about a client's attachment story is our best pathway to the key targets whose processing will lead to the most lasting change.

To that end, it can help to distinguish between seven kinds of targets.

One is obvious: the DSM-V Criterion A events like car crashes, torture, bomb attacks, or sexual violence, which need targeting in their own right, and which the Standard Protocol often handles well.

But there are six other kinds of targets which require special attention—three of them in the present, and three in the past:

The Presenting Past

The Presenting Past concerns present-day moments where early attachment programming is being reactivated. Its three target types include:

• Future Fear: Anticipation of a forthcoming event (for example a presentation, pregnancy, a date, or a fear of flying) can trigger anxiety, paralysis, compulsive safety behaviours and much else. These emotions are almost always more about the past than they are about the present, and are rich starting points from which we can bridge.

• Present Trigger: Rather than a forthcoming event, present triggers are about momentary activation of old stories in the here and now: the raised eyebrow from a boss, a partner shutting down in an intimate sexual moment, a burst of road rage. Again, these are emotions driven by root formative experiences from the past—perfect bridging points.

• Pervasive Feeling: Not specifically about an immediate or forthcoming narrative, a pervasive feeling can manifest in a general sense of free-floating fear or guilt, kicking in for example immediately upon waking up. Here, we might use the early steps of the standard Lightstream exercise (shape, colour, texture, etc.) to access the body's story, and bridge from that. With addictions and eating disorders, we can also bridge from what Jim Knipe calls the level of urge.

The Actual Past

The Actual Past is what emerges when we bridge, the stories to which the nervous system takes us when we follow its lead. Its three forms of targets include:

• Stepping Stones: Sometimes a client bridges from the here and now but gets entangled on the way back into the past in more recent stories that may be good to target but which aren't actually the root cause of how they continue to experience themselves today. We can honour these as “stepping stones”, paving the way to earlier survival-informed patterns which are calling for more direct work. Common examples might be cutting or eating disorders during teenage years.

• Portals: Similar but distinct, a portal might be an earlier memory that isn't the specific reason the client is the way they are today, but constellates the microsecond formative moments—very often in the experience of mother and her experience of Self in the world—that shaped how our clients' nervous systems learned to deal with life.

• Root Formative Experience: This is the real shaping event, the actual root formative experience. It can be in the kitchen with mom, or at the family meal table. It may be something very obvious. It may also be very subtle, like a client who remembered being four and putting hot chilli peppers on her hated little sister's ice cream. Decades later, mother's critical response and the absence of attachment repair continued to compromise this client's willingness as an adult to be bold and creative. Great target.

A Concluding Thought

Over the years, there has been much controversy around attachment-focused, or attachment-informed, EMDR. It's encouraging that we're now, it seems, beginning to move beyond those arguments.

Far from being just an EMDR tool, attachment is at the heart of how every human being—every person born of a woman's body and brought up in the context of relationship—builds up, especially through their first 1001 days from conception, the database for the rest of their life.

Whether consciously recalled or not, personal and collective experience continues to shape how the nervous system responds, especially when it senses a threat, real or imagined.

So, in summary, what might be the three most vital elements of successful attachment-informed EMDR?

Targeting is the first.

Targeting is the second.

And targeting is the third.

A truth which may well apply to EMDR as a whole.

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To learn more about ai-EMDR check out Mark Brayne's excellent book Unleash Your EMDR - a Guidebook for Attachment-Informed, Integrative, Transpersonal EMDR or take a look at the workshops he offers on his website.