Targeting Attachment Trauma in EMDR Therapy

Identifying target memories for clients who have experienced developmental or attachment-based trauma can be tricky. In such cases, it is not simply a matter of identifying overt traumatic experiences in the client’s early life, but also recognising the absence of crucial elements such as validation and emotional attunement from their caregivers. Attachment wounds can give rise to a range of enduring issues, including a sense of defectiveness, emotional inhibition, low self-worth, difficulties expressing needs, and a general mistrust in others.

Small t Traumas

For these clients, the trauma they experienced may be less overt, often referred to as 'small t traumas,' occurring repeatedly during their formative years. The client might perceive these experiences as part of their daily life throughout childhood or even the norm, making it challenging to pinpoint specific events to target in EMDR Therapy. This can also be compounded by some clients struggling to connect emotionally with adverse early life experiences due to developing a range of strategies such as dissociation and emotional suppression to cope in an environment in which their emotional needs were not met.

Zimmerman’s 'Topographic Approach'

In this episode of The EMDR Podcast, Thomas Zimmerman presents a helpful technique referred to as the ‘topographic approach'. It is an adaptation of the traditional floatback/affect bridge EMDR technique that involves asking the client a series of questions to narrow your target search to a memory or constructed representative image relevant to the issue addressed in therapy. I’ve found this to be very helpful when working with clients who have experienced attachment wounding or trauma by omission. I encourage you to check out this great podcast episode!

Here is an overview of steps in Zimmerman’s topographic approach:

Identify and activate a recent event or trigger:

Invite your client to identify a recent event or current life trigger that encapsulates the distressing issue that they wish to address in therapy. For example, a recent argument that triggered their fear of abandonment. Ask the client to describe this recent situation, to activate their emotion and affect.

Check the client’s distress:

Ensure that the recalled event or trigger is distressing for the client. If not, invite the client to select another recent event or trigger that is upsetting to focus on. It is important that the client can connect with the recent event / trigger on a visceral level before proceeding to the next steps.

Identify the negative belief:

Once an appropriate recent or current situation has been identified, ask the client if there is a negative belief that accompanies their distress when they hold the situation in mind. For example, “I’m unlovable”.

‘Topographic’ questions:

Ask the client a series of questions, encouraging them to connect with the emotion, body sensation, and negative cognition each time. They should respond with their initial instinct or ‘gut’ feeling, rather than overthinking their answers.

• What age does this feeling and belief go back to?

• Where do we need to work (home, school, community)?

• Visualise the environment at that age.

• Identify the specific area or room.

• Note if anyone else is present in the memory.

• Recall the first memory that arises.

Reprocess the memory / image:

If the client can identify a memory and it is disturbing, reprocess it using EMDR Therapy. If the client cannot identify a memory, invite them to simply identify what image comes to mind in response to the above questions, and reprocess this constructed representative image as the target.

Going a Step Further

If you’d like further develop your skills in using EMDR Therapy with clients who have experienced developmental trauma, you might be interested in purchasing my ‘EMDR Therapy with Attachment Trauma'' on-demand webinar. This training provides detailed guidance on this topic, helping you to apply EMDR more effectively and confidently with complex clients.

I'm Caroline Burrows, an Accredited EMDR Trainer and Consultant. I’m passionate about bridging the gap between EMDR training and clinical practice. If you're looking to learn EMDR Therapy for the first time, enhance your EMDR skills, or navigate challenges in your EMDR clinical work, I offer training workshops, on-demand webinars, and consultation. I would love to support your EMDR learning journey.