Made Simple:
EMDR with Queer Clients

In one sentence: Using a Queer-affirming lens, EMDR therapy helps clients process oppression-based trauma, reclaim Queer joy, and integrate an authentic, affirmed sense of self.

In one paragraph: As EMDR therapists, we believe the brain has an innate capacity to heal, but that traumatic experiences can get "stuck," leading to issues that negatively impact our clients' everyday lives. For Queer clients, the "stuck" information is often the result of a chronic, daily barrage of social ostracism and systemic oppression. These experiences contribute to anxiety, depression, complex trauma, and dissociation. To understand and help our clients, we must expand the EMDR Standard Protocol with a deliberate, Queer-affirming lens.

The problem is not their Queerness and Transness, but the heteronormativity, cisnormativity, Queerphobia, and Transphobia around them.

What's Oppression Trauma?

The cumulative trauma of living in a world that invalidates, misgenders, discriminates against, and erases our clients' identities is called “minority stress.” The core of our work with Queer clients is understanding that this distress is often a normal reaction to oppressive environments. The problem is not their Queerness and Transness, but rather the heteronormativity, cisnormativity, Queerphobia, and Transphobia around them.

Within the Adaptive Information Processing (AIP) model, these chronic experiences of oppression create a web of maladaptively stored memories, which reinforce negative beliefs like "I am unsafe" or "I am broken.”

Our goal is to help our clients reprocess this trauma, understand that identities are not at fault, and allow them to integrate a more adaptive, authentic, and affirmed sense of self.

Queer- & Trans-Affirming EMDR Therapy Across The 8 Phases

Helping Queer clients will not require rewriting the rulebook for EMDR therapy, only adopting an affirming and celebratory lens within each of the eight phases of the standard EMDR framework. Here's what this could look like in practice.

Phase 1: History Taking

More than understanding the client's trauma, this phase should be about understanding their lived experience as a Queer person. This means looking beyond moments of distress into times of joy, comfort, resilience, and belonging related to their identity.

With a more expansive picture of the client's life, we can then ask about how minority stress has impacted their lives. What messages have they received about sexuality and gender? When have they felt invalidated or unsafe because of their Queerness? And how have they internalized these negative beliefs (e.g. "I don't deserve love because I'm Trans")?

These themes will inform the Negative Cognitions (NCs) for target sequence planning and future reprocessing.

Phase 2: Preparation

Phase 2 is about building the foundation for safety and resourcing. This begins with building rapport. Be mindful by practicing cultural humility and remaining open and curious.

With rapport established, we can now strengthen the client's internal resources. Using slow bilateral stimulation (BLS), evoke memories of Queer joy and affirmation—moments of feeling seen, being gendered correctly, or finding community. With body-based resourcing, focus on external grounding (e.g. scanning sensory information) or body-neutral resourcing (e.g. focusing on feet on the floor).

Phase 3: Assessment

When selecting a target for reprocessing, you may focus on past traumatic experiences or the present, ongoing trauma of oppression. Listen for themes of internalized Queerphobia to expand the Negative Cognition. For example:

• "I am unsafe" might mean "It's dangerous to be authentically me."
• "I'm bad" might mean "My body is defective."
• "I don't belong" might mean "My Queerness makes me unlovable."

Pair each Negative Cognition with an adaptive and identity-affirming Positive Cognition. For example:

• "My identity is real and valid."
• "I am resilient and strong."
• "I deserve safety and joy."

Whenever possible, it's helpful to externalize the problem (e.g. "The prejudice was wrong, not me").

Phase 4: Desensitization

During reprocessing, difficult emotions and memories may surface. The therapist's ability to stay present, grounded, and embodied in the face of the client's (and your own) trauma responses is crucial. Your therapeutic presence is a co-regulating anchor that strengthens the client's sense of safety. Here are four considerations during this phase:

• Titrate & Check In: You may need to use more titrated pacing (e.g. using brief grounding techniques between sets) if the client is prone to abreaction or dissociation.
• Validate Emotions: Anger, fear, and grief related to Queerphobia and discrimination are normal, expected, and healthy responses to injustice. Validate, validate, validate!
• Start with the Present: You can target the distress from current events, like anti-Trans laws. The target isn't the law itself (which is a real external threat), but the client's internal response and the feeling of powerlessness, fear, or hopelessness it evokes (e.g. the Negative Cognition, "I am not safe anywhere"). We are desensitizing the impact of the trigger and empowering their internal capacity to cope, even as we validate the reality of the external threat.
• Consent with the Past: Consent is everything. Remind clients that it's okay to trust the wisdom of their nervous systems and to follow its lead and timing. Go with what is accessible and doable now, and don't bypass the body's consent.

Phase 5: Installation

The Positive Cognition must be realistic and adaptive, not just positive. For clients still facing daily oppression, "I am safe" may feel false and may not install fully. Believable Positive Cognitions tend to feel more authentic and congruent, and thus will install more effectively, such as "I can find safe places or safe people.", "I can navigate challenges", or "I have choices in how I respond now".

The goal isn't just a "thought" passing as true. It should have an embodied, felt sense of congruence with the client, resonating with their affirmed identity (e.g. "I am okay just as I am," "My identity is real and valid").

For many clients, an "in-process" Positive Cognition will be more authentic and install more deeply than a static one. For instance, "I am learning that I am worthy," or "I am learning that it's okay to be me".

Phase 6: Body Scan

This phase requires caution, especially when working with folks experiencing gender dysphoria. Always give the client an explicit choice. Consider explaining: "The next step is a body scan. Given that we're talking about feelings of body dysphoria, how do you feel about scanning your body right now?"

If they opt out, always respect it. If they are hesitant or unsure, modify (e.g. Ask them to scan for the felt sense of the Positive Cognition, or ask them to scan for areas of neutrality in their body). Acknowledge that body dysphoria is distinct. Avoid interpreting it as solely a trauma-related disturbance that ought to be "cleared."

Phase 7: Closure

End each session by helping the client contain and ground. Remind them that ongoing distress in disaffirming environments is normal and expected, and doesn't mean they "failed" or that EMDR was unsuccessful. End by re-engaging resources from Phase 2. When processing targets related to Queerness, it can be helpful to use previously strengthened affirmed-self resources.

Phase 8: Re-evaluation

In the next session, revisit the previous target and Positive Cognition. As clients heal from the trauma of oppression, they often feel safer exploring and expressing their identity. Be open to new targets or goals emerging as their sense of self becomes more adaptive and affirmed. This sensitivity to change is all part of the EMDR process, especially with Queer clients in their search for a full and integrated self.

---

Applying EMDR therapy with a Queer-affirming lens isn't about learning a whole new protocol. It's about empathy, humility, and adaptation. It’s about recognizing that, for Queer clients, the trauma is often a systemic, chronic experience. By resourcing Queer joy, targeting the oppressive sources of the trauma, and validating lived experience, we can use EMDR therapy to help our clients embrace their authentic, affirmed selves and live a more adaptive life.

---

Curious to learn more? Find a longer version of Michael's essay in the new book "Queering EMDR Therapy", edited by Roshni Chabra and Dr. Jamie Marich, featuring 27 contributors sharing their voices. Check the book out here.