I thought I'd share an interesting example of combining EMDR with a bit of imaginal rescripting. Ideally, the person undergoing EMDR will spontaneously experience certain thoughts, insights, emotions, or sensations, but in some cases, people report that nothing comes up. In such situations, I've found it helpful to add what’s called a cognitive interweave, a question you ask the person about the event before they do a task (such as following a fast‑moving ball on the screen with their eyes). In a way, you're giving a gentle prompt to think a bit more deeply about the event when nothing comes up spontaneously.
Here’s an example from a client of mine with PTSD (some details have been changed to ensure anonymity):
The image we worked with was of him lying in a hospital bed. He was and felt completely alone. I asked him: "Let’s say you step into that image, what would you give your past self?" He became a bit emotional and said: "I would tell myself I’m not alone and I would put my hand on my shoulder for comfort." I said, "Focus on that, see that happening," while he would follow the fast-moving ball on the screen.
After the session, when we checked how much disturbance was left from the image, he noted that when he thought of the image again, he now saw another person with him, that he wasn’t alone. He of course still remembered what the real situation had been, but the sense of loneliness was much less intense. Pretty interesting!
Here's a similar example from a
paper:
Cognitive interweaves, which are short, open-ended questions aimed at providing functional and supportive information during a session, proved to be helpful for Amy to gain a different perspective and take better care of herself. For example, when asked, “What would you like to do for that little girl now?” Amy would respond, “I would give her a hug and tell her that she matters.” The SUD scores [current level of emotional distress or disturbance] decreased rapidly and the sessions consistently ended in a positive manner. Amy increasingly felt a sense of self-worth, and began to feel stronger.