Before You Reprocess

Written by Susie Morgan, LMFT, BCETS - August 17, 2025

Too often I hear, “I tried EMDR therapy and I got worse,” or “It felt disorganized and ineffective,” when clients call me for what feels like a last-ditch, desperate effort to find relief. It amazes me that they are willing to reach out again since EMDR therapy left them destabilized, more symptomatic, or simply stalled despite their commitment to healing.

After 20 years of seeing EMDR very effectively alleviate a myriad of severe symptoms by transforming layers of complex trauma, I know this doesn’t have to be the case.  The question is why some EMDR therapy isn’t safe or effective—and just as importantly—what we can do differently so that it is?

In my experience as a clinician treating complex developmental trauma and in my work as an EMDR Trainer and EMDRIA Approved Consultant mentoring other EMDR therapists, the answer keeps coming back to one thing we must have before we reprocess: readiness—ours and our clients’. When we can see what we need to see up front, we can shape EMDR therapy to the person in front of us.

We can’t promise the future, but we can see a lot in advance—enough to predictably protect against unsafe, ineffective outcomes. The lens is readiness has two crucial aspects: what the client’s brain and nervous system are ready to do, and whether we as clinicians are ready with a clear map and a plan.

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The Spectrum of Dissociative Symptoms: Seeing What Kind and How Much is Critical to EMDR Safety

It’s trading a checkbox for a conversation—it’s knowing the spectrum of dissociative symptoms, naming it clearly, normalizing its necessity, and planning accordingly.

The first critical pitfall that makes EMDR unsafe is inadequate assessment of dissociation. Many of us were taught in EMDR Basic Training to rely on the DES, a quick and limited screener, often without any other meaningful training in dissociation.

In my experience, the DES can inadvertently invite clients to hide dissociative symptoms—as the questions can feel unsafe and stigmatizing. We need a safer, normalizing conversation that honors how sophisticated the brain is when it uses dissociation to survive.

In addition, the DES only includes a small handful of clinically significant questions despite its length—leaving out the full range and intersection of ways dissociation can present.

EMDR therapists must be trained to recognize the spectrum of dissociative symptoms, use the more adequate assessment tools we have available, and lean far more on interview and clinical sensitivity than any written measure in order to adequately ascertain what dissociative methods have been developed to protect a client from fully knowing and feeling the trauma they have been through.

Is it derealization or depersonalization only versus parts with first‑person perspective, time loss, and amnesia versus some other constellation of dissociative symptoms?  Our assessment must give us the detail we need—as each requires different handling to keep EMDR therapy safe and effective.

When we miss this, EMDR trauma memory reprocessing can break down dissociative barriers and flood a client with material their system cannot yet integrate—leading to decompensation and rising symptoms. That is not okay —especially because it is preventable.

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History and Preparation as Readiness Assessment: Using Early Tasks to Read Capacity for Safe, Effective EMDR

It’s knowing that what shows up in the procedures of Phases 1 & 2 shows up in reprocessing—having eyes to see the indications in front of us.

During our most basic activities in Phases 1 and 2, like Calm Place and Container, our client’s capacities are already on display in so many ways.

If we know what we are looking for, we will know when we can begin EMDR trauma memory reprocessing and reasonably predict it will be safe and effective.

The starting point is having a clear rubric of what we our client’s brain and nervous system must be able to do for EMDR reprocessing to be safe and effective.

Our task is to engage each step of Preparation and History Gathering with simultaneous eyes to see how each of these capacities show up—and, more importantly, when they don’t.

For example, if the Calm Place is immediately swarmed by sharks or storms—and even prompts to shift or create an imaginal solution won’t hold—the brain is telling us it’s not okay to feel calm. That means we must work on state change first before reprocessing is safe.  A client’s nervous system won’t allow trauma memories to neutralize if feeling okay (let alone better!) is not okay.

Likewise, if the client stays in the driver’s seat—thinking hard, directing the next step—instead of the passenger seat (“follow your brain; let whatever happens happen”), they’re not yet engaging the natural associative channels EMDR depends on. That’s a readiness concern—a capacity to develop and an important reason to pause rather than push ahead.

There is a clear series of readiness factors that, if in place, give a green light for proceeding. However, when one or more are missing, the most effective strategy is not just to stall reprocessing indefinitely and simply focus on more resource development.

Instead, it is far more effective to personalize preparation with strategic interventions directed toward developing the specific aspect or aspects of readiness needed. This way, the client is able to proceed more efficiently from stabilization into trauma memory reprocessing, where far more trauma transformation and symptom relief is possible.

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Our Readiness to Provide Safe and Effective EMDR—Case Conceptualization That Makes a Difference

It’s mapping before you enter the forest—without a map, you risk getting lost or trimming random branches and getting lesser results or worse.

Complex developmental trauma is far more common in our offices than single‑incident PTSD. We see compounding layers—unmet early attachment needs plus adverse life events plus Big‑T trauma.

Before we start, we need  a sense of what is there, what is missing, how it has been organized, and how it has been managed in ways that show up in our clients’ symptoms.  In the Precision EMDR approach, we speak the visual language of trees to understand each of these:

What Trauma Memory Networks (pictured as Dark Trees) are triggering the client’s symptoms? Which core beliefs organize them—such as “I’m unlovable,” “I’m unsafe,” etc.?

What adaptations has the client developed to manage attachment and affect? Which behavioral/nervous-system strategies instinctively come online when the Trauma Memory Networks are activated (pictured as an automatic security protocol that covers the Dark Trees to dampen reactivity as needed)—such as “I must please everyone to be loved” or ”I must submit to be safe?” or I escape these feelings,” etc.?

How robust is the Adaptive Information Memory Network (pictured as a Light Tree), even if it is impossible for the client to access when the Trauma Memory Networks  are triggered?

What’s the quality of the early attachment experiences (which comprise the trunk of the Light Tree)? Were they anemic?

Does the client, despite not having their childhood attachment needs met, have robust adult adaptive resources (the top branches of the Light Tree) that can support processing—or is the adaptive memory network limited overall?

If the adaptive tree is spindly overall, we cannot safely proceed without shoring it up. Otherwise, activating trauma networks risks destabilization. This is where EMDR becomes unsafe and ineffective.

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Safety First: Assess and Shore Up the Light Tree

It’s knowing the significance of a spindly trunk—or spindly adult branches—so we can predict what a client will need before or during reprocessing.

Safety and efficacy hinge on what’s available in the Light Tree and what’s missing. We assess attachment‑rooted trunk strength and inventory the adult adaptive resources that counter specific Trauma Memory Networks.

If relevant adaptive information isn’t available, EMDR therapy cannot reprocess trauma effectively.

When needed, we strategically build what’s missing—so when we open a trauma memory network, the system can actually integrate adaptive information rather than get stuck or flooded.

If we find that our client has a spindly trunk of non-secure attachment experiences, I believe EMDR must focus on shoring up that trunk—just as much as it must focus on reprocessing the Dark Trees of trauma memories.

This repair of the attachment system stimulates resilience—a steadiness in the face of stressors and storms that may come— beyond what is possible with resolving the pain of the Trauma Memory Networks alone.

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Precision EMDR: A Personalized Approach for Each Client

It’s personalizing EMDR therapy, so it is safe and effective for this client.

Precision EMDR’s tagline is “Informed by Legacy—Crafted for Complexity—Delivered with Precision.” At Precision EMDR, I think of this as personalized medicine for mental health. We use the wisdom and evidence-based effectiveness of Francine Shapiro’s protocol and couch it in the delivery method each individual client needs.

We look closely at the person’s capacities and make surgical, strategic modifications—sequencing, interweaves, pacing—so EMDR therapy is both safe and effective. We don’t abandon standard protocol; we tune it to the client’s nervous system.

Just as importantly, we explain the why of each step to our client.  Their understanding allows them to have a meaningful voice and choice in their care.

We name what we see: why we might not be  jumping straight into Trauma Memory Reprocessing, what capacities we’re needing to build through further strategic preparation, and how that protects our ability to make EMDR safe and effective for them.

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Conclusion: Safe and Effective EMDR Starts With What We See Up Front

It’s understanding safety and efficacy begin before reprocessing—what we see up front shapes what happens in the room.

When client and clinician readiness is established, EMDR therapy moves from possibly unsafe and ineffective to reliably safe and effective—delivering profound symptom relief without destabilization.

Safe, effective EMDR begins before reprocessing: see dissociation, assess readiness capacities, map both the Trauma and Adaptive Information Memory Networks, and build what’s missing.

This is how we protect clients from unsafe EMDR and deliver the outcomes EMDR therapy was designed to achieve.
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Want More?

This free 45‑minute video (linked here: Understanding EMDR Therapy) illustrates the Dark Tree/Light Tree imagery and how memory networks relate to symptoms and triggers. We also offer advanced EMDR trainings on readiness, target sequencing, and adaptive‑information assessment—and EMDR Basic Trainings that teach Francine Shapiro’s model along with this precision lens and methodology.