Trauma therapies: EMDR, Imaginal Rescripting and Imaginal Exposure
- Thread starter Oxajil
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Trauma that's not accessible to cognition is in the deep subconscious, stored in the body. Doing somatic therapy of a particular kind and in the correct sequence has been shown to help clear these blockages.
Some traumatic events happen to us before our brains were capable of forming memories, and sometimes even before our emotional centre was developed, or before we were able to speak. It all depends what happened, and when. There might also be ancestral trauma, or past-life trauma at play as well. So we might not actually have memories of or cognitive access to what happened, but (thank God) that's not necessary for healing.
That's because memories are in the body. Trauma is fundamentally an inability to be in the present moment. By working on connecting mind, body, and environment simultaneously, we can create space in the present for difficult body memories to express, and learn to be in the present and in the body in a new way.
I've been doing Irene Lyon's online course Smart Body Smart Mind, and it has been incredibly helpful in accessing trauma and releasing it. Perhaps your friend could have a look at her YouTube videos (example) and the other free resource on her website. She uses the metaphor of building a house. One doesn't start building without education, and that's the place to start, growing in Knowledge of the nervous system.
I had a look at her course and it looks super interesting. Her next one starts in February 2026 and I am going to put my name on her wait list, which will give me some time to contemplate as it's not cheap.
I started reading Deb Dana's 'Polyvagal Practices: Anchoring the Self in Safety' which was published in 2023 which may also be a goodie if we wish to obtain more knowledge of our nervous system.
Added: Sorry, registration starts in February next.
If you do her 21 Day Nervous System Tune Up, you get the cost of that deducted from the Smart Body Smart Mind course. The benefit being that it's something that you can start working with right now and apparently gives a head start for doing SBSM later.
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:
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:
I thought I'd share the following as it's quite interesting:
This concerns a person with PTSD. We successfully worked through several traumatic experiences from her adult life (unrelated to her parents). However, we became stuck on one trauma that wouldn’t process.
As a young teen, she was repeatedly and randomly hit by someone, after which she fell and lost consciousness. She truly believed she was going to die. The amount of fear she experienced when revisiting this trauma was visibly intense, even though she had initially described the event as less distressing than the others.
Eventually, we discovered why it was so difficult to process this trauma. There was an even more painful experience linked to this memory: When she woke up in the hospital, her parents arrived but completely disregarded her. There was no warmth or affection, only shouting. One of her parents even said: "Maybe it would’ve been better if you hadn’t survived."
When recalling this moment, she cried. It became clear that the most frightening or distressing part wasn’t the person who assaulted her, the fall, or the sense of dying, but the feeling of being unwanted by her parents. On a deep level, that emotional abandonment likely felt like a 'death sentence'. The trauma of the physical attack had perhaps functioned as a distraction or form of avoidance from the deeper wound: that moment in the hospital. This realization made a lot of sense to her.
My current impression is that the subconscious mind in people with complex PTSD is often quite skilled at avoidance. Truly core traumas are sometimes hidden beneath other traumatic memories.
That is not to say the trauma of the attack wasn't disturbing, it was. However, it raises the question: Had she received warmth and reassurance from her parents afterward, might that have reframed the event in her mind as one eventually tied to safety and hope, thereby facilitating processing? This is speculative, of course. Overall, she's doing better and feels calmer, but she requires further long-term treatment.
This concerns a person with PTSD. We successfully worked through several traumatic experiences from her adult life (unrelated to her parents). However, we became stuck on one trauma that wouldn’t process.
As a young teen, she was repeatedly and randomly hit by someone, after which she fell and lost consciousness. She truly believed she was going to die. The amount of fear she experienced when revisiting this trauma was visibly intense, even though she had initially described the event as less distressing than the others.
Eventually, we discovered why it was so difficult to process this trauma. There was an even more painful experience linked to this memory: When she woke up in the hospital, her parents arrived but completely disregarded her. There was no warmth or affection, only shouting. One of her parents even said: "Maybe it would’ve been better if you hadn’t survived."
When recalling this moment, she cried. It became clear that the most frightening or distressing part wasn’t the person who assaulted her, the fall, or the sense of dying, but the feeling of being unwanted by her parents. On a deep level, that emotional abandonment likely felt like a 'death sentence'. The trauma of the physical attack had perhaps functioned as a distraction or form of avoidance from the deeper wound: that moment in the hospital. This realization made a lot of sense to her.
My current impression is that the subconscious mind in people with complex PTSD is often quite skilled at avoidance. Truly core traumas are sometimes hidden beneath other traumatic memories.
That is not to say the trauma of the attack wasn't disturbing, it was. However, it raises the question: Had she received warmth and reassurance from her parents afterward, might that have reframed the event in her mind as one eventually tied to safety and hope, thereby facilitating processing? This is speculative, of course. Overall, she's doing better and feels calmer, but she requires further long-term treatment.
Just sharing a part of my trauma processing here too.
I have done a lot of forgiveness to myself and my parents than the abusers. When thinking about what happened when I was young, I eventually get to the question of "where were my parents at that time?", "why was I always alone?", and "why was I not made aware of how I can defend myself?"
I discovered that my deepest hurt came from being alone and feeling betrayed by my primary caretakers when there could have been steps to prevent the traumatic events from happening. I wonder if they have known, will justice be served? Will the circumstances be different?
Just some thoughts that I have yet to revisit...
I have done a lot of forgiveness to myself and my parents than the abusers. When thinking about what happened when I was young, I eventually get to the question of "where were my parents at that time?", "why was I always alone?", and "why was I not made aware of how I can defend myself?"
I discovered that my deepest hurt came from being alone and feeling betrayed by my primary caretakers when there could have been steps to prevent the traumatic events from happening. I wonder if they have known, will justice be served? Will the circumstances be different?
Just some thoughts that I have yet to revisit...
Thank you for sharing, Lucelle. I hope your trauma processing is going well.
I thought I'd share an interesting example of bodily sensations during EMDR:
This case concerns a man in his late 30s who has nerve damage and pain after falling down a flight of stairs. We conducted EMDR on the memory of the fall. The initial image he described was of himself falling, reaching out with his hand, trying to grab onto something.
During EMDR, the image changed: it became blurry, and only a few of his fingers were visible, reaching out but failing to grasp anything. In the changed image, his fingers appeared gray.
It was at this point that he began to feel tension in his fingers, they became very tight. I asked him what color his hand was and whether it looked healthy. Then I asked him to grab something on his desk and notice the sensation, to complete the action his body had wanted to do. I guided him to focus again on the tension in his fingers while continuing the exercise. The tension then moved from his fingers to his arm, then to his shoulder, and finally disappeared.
Afterward, he started to feel a pressure on the right side of the head (possibly where he also landed during the fall), which also disappeared after a few rounds. Then, he experienced an uncomfortable sensation in his stomach.
It seemed that by accessing the traumatic memory, his body was re-experiencing aspects of the trauma. During EMDR, I asked him to name a couple of objects in the room and to feel the floor under his feet. I also asked him if he was alive. This was all to bring his attention to the here-and-now and help his unconscious mind and body understand that he's safe and here in this room.
We also did some imaginal rescripting during EMDR. When reviewing the entire memory and not just the image, he said he saw himself on top of the stairs. We rescripted it in such a way that he was walking away from the stairs. This was also helpful for him.
Eventually, his bodily symptoms went away and the distress associated with the memory was reduced by more than half. His core belief shifted from "I failed to protect myself" to "I did my best to protect myself."
Bodily sensations sometimes come up during EMDR, but this was the clearest example I’ve seen so far.
I thought I'd share an interesting example of bodily sensations during EMDR:
This case concerns a man in his late 30s who has nerve damage and pain after falling down a flight of stairs. We conducted EMDR on the memory of the fall. The initial image he described was of himself falling, reaching out with his hand, trying to grab onto something.
During EMDR, the image changed: it became blurry, and only a few of his fingers were visible, reaching out but failing to grasp anything. In the changed image, his fingers appeared gray.
It was at this point that he began to feel tension in his fingers, they became very tight. I asked him what color his hand was and whether it looked healthy. Then I asked him to grab something on his desk and notice the sensation, to complete the action his body had wanted to do. I guided him to focus again on the tension in his fingers while continuing the exercise. The tension then moved from his fingers to his arm, then to his shoulder, and finally disappeared.
Afterward, he started to feel a pressure on the right side of the head (possibly where he also landed during the fall), which also disappeared after a few rounds. Then, he experienced an uncomfortable sensation in his stomach.
It seemed that by accessing the traumatic memory, his body was re-experiencing aspects of the trauma. During EMDR, I asked him to name a couple of objects in the room and to feel the floor under his feet. I also asked him if he was alive. This was all to bring his attention to the here-and-now and help his unconscious mind and body understand that he's safe and here in this room.
We also did some imaginal rescripting during EMDR. When reviewing the entire memory and not just the image, he said he saw himself on top of the stairs. We rescripted it in such a way that he was walking away from the stairs. This was also helpful for him.
Eventually, his bodily symptoms went away and the distress associated with the memory was reduced by more than half. His core belief shifted from "I failed to protect myself" to "I did my best to protect myself."
Bodily sensations sometimes come up during EMDR, but this was the clearest example I’ve seen so far.
I've had regular bodily sensations come up in EMDR since starting the therapy a month ago.
This is partly due to structure. Nearing to the end of the session, the therapists asks me to scan my body from the top of my head to my feet. If any notable sensations come up, I let her know, and we pause on that spot and use bilateral stimulation to process whatever is there.
In one case, my vision went dark, the entire left side of my body seized, I had a deep and sense of collapsing inwards, and very intense discomfort. After bilateral stimulation, these sensations cleared to some degree, after some movements of my left leg and ankle. I didn't get a sense of what was causing it, just the sensation itself, and the release after autonomous movement.
In another case, I felt a sort of dark and heavy overlay on my eyes, like some sort of filter. When we paused there, my brain showed me the image of an evil psycho clown like Pennywise. It was creepy. It took some time to clear it. Afterwards, I thought that perhaps it was a spirit attachment of some kind, though it could've been a cerebral representation of trauma.
This is partly due to structure. Nearing to the end of the session, the therapists asks me to scan my body from the top of my head to my feet. If any notable sensations come up, I let her know, and we pause on that spot and use bilateral stimulation to process whatever is there.
In one case, my vision went dark, the entire left side of my body seized, I had a deep and sense of collapsing inwards, and very intense discomfort. After bilateral stimulation, these sensations cleared to some degree, after some movements of my left leg and ankle. I didn't get a sense of what was causing it, just the sensation itself, and the release after autonomous movement.
In another case, I felt a sort of dark and heavy overlay on my eyes, like some sort of filter. When we paused there, my brain showed me the image of an evil psycho clown like Pennywise. It was creepy. It took some time to clear it. Afterwards, I thought that perhaps it was a spirit attachment of some kind, though it could've been a cerebral representation of trauma.
I thought I'd share another interesting case example, this time concerning Imaginal Rescripting (IR). The client is a woman who grew up with an emotionally unavailable mother. She never received affection or attention from her. She only heard from her mom that she was a failure and didn't do things right.
The client was slightly sceptic about IR ("How can it work if it's not real, if it's just happening in the imagination?"), but we gave it a try after some explanation.
She didn't have a clear memory in mind, but there was an overall scene: Her, as a child, sitting next to her mom while her mom is watching TV. Her mom wouldn't look at her or acknowledge her in this scene. She felt annoyance, anger and a bit of sadness. The sadness increased and the client started crying. I asked the child what she needs, she said she wants her mom to leave. I entered the scene and addressed the mother firmly, that it's her responsibility as a parent to give her child love and affection and to make sure her basic needs are met. I told her to leave the house and to reflect on her behavior. The parent left, and I asked the child what she wanted to do. According to the protocol, you need to end the rescripting with a fun activity.
After this first session of IR, the client said she didn't expect it to feel like she was there. She said it was helpful to have someone in the room who acknowledged her and who addressed her mom.
The next time, I asked her if she's willing to step in and stand up for her younger self. She did, but before she could address her mom, she had a long pause and started crying. There was a sense of guilt, there was possibly some fear, but in the end she told her what she thought of her (unfiltered). The mom was then told to leave the room. She then hugged her younger self.
The third time, she (her adult self) stepped into the scene as well. This time, she managed to address her mother quicker and with a bit more confidence. She told her that she understands that she (her mom) had a difficult childhood, but that she shouldn't be treated so badly, that she wants the most basic things such as being asked how school was. Once she was done talking to her mom, I asked her "What's happening now?". She said that her mom is giving her a hug. That was unexpected! Perhaps a part of her knew that her mother would understand, and perhaps a part of her was willing to forgive her.
The fourth time she revisited the scene she said she felt okay. There's no more sadness, anger, or guilt connected to this scene. It just is. Her disturbance level went from a 10 to around 0-2. She didn't cry anymore, she felt at peace. Mostly, she was confused about how this method worked at all! She said it felt very strange, but I'm glad it worked for her.
One issue she wanted to address is uncontrollable crying triggered by memories of the past. She noted that the crying has decreased since she's had these sessions. It seems that it works this way:
The client was slightly sceptic about IR ("How can it work if it's not real, if it's just happening in the imagination?"), but we gave it a try after some explanation.
She didn't have a clear memory in mind, but there was an overall scene: Her, as a child, sitting next to her mom while her mom is watching TV. Her mom wouldn't look at her or acknowledge her in this scene. She felt annoyance, anger and a bit of sadness. The sadness increased and the client started crying. I asked the child what she needs, she said she wants her mom to leave. I entered the scene and addressed the mother firmly, that it's her responsibility as a parent to give her child love and affection and to make sure her basic needs are met. I told her to leave the house and to reflect on her behavior. The parent left, and I asked the child what she wanted to do. According to the protocol, you need to end the rescripting with a fun activity.
After this first session of IR, the client said she didn't expect it to feel like she was there. She said it was helpful to have someone in the room who acknowledged her and who addressed her mom.
The next time, I asked her if she's willing to step in and stand up for her younger self. She did, but before she could address her mom, she had a long pause and started crying. There was a sense of guilt, there was possibly some fear, but in the end she told her what she thought of her (unfiltered). The mom was then told to leave the room. She then hugged her younger self.
The third time, she (her adult self) stepped into the scene as well. This time, she managed to address her mother quicker and with a bit more confidence. She told her that she understands that she (her mom) had a difficult childhood, but that she shouldn't be treated so badly, that she wants the most basic things such as being asked how school was. Once she was done talking to her mom, I asked her "What's happening now?". She said that her mom is giving her a hug. That was unexpected! Perhaps a part of her knew that her mother would understand, and perhaps a part of her was willing to forgive her.
The fourth time she revisited the scene she said she felt okay. There's no more sadness, anger, or guilt connected to this scene. It just is. Her disturbance level went from a 10 to around 0-2. She didn't cry anymore, she felt at peace. Mostly, she was confused about how this method worked at all! She said it felt very strange, but I'm glad it worked for her.
One issue she wanted to address is uncontrollable crying triggered by memories of the past. She noted that the crying has decreased since she's had these sessions. It seems that it works this way:
- Trauma or negative event happens.
- The brain fails to fully process/integrate it (it gets possibly stuck in the amygdala/implicit memory).
- The event remains unprocessed. Reminders (conscious/unconscious) trigger associated emotions (sadness, anger, guilt), causing overwhelming responses like uncontrollable crying.
- Person engages in therapy (EMDR/IR/IE or others) to activate the memory (which brings the target memory into working memory through focused recall and exposure).
- With the memory now reactivated ('online'), a window opens for reprocessing.
- The traumatic or negative event receives updated emotional/cognitive meaning (such as "I stood up for myself", "My emotions were valid", "I survived and can focus forward", "It wasn't my fault, I was just a child").
- The memory is then updated and stored into long-term storage (hippocampus and cortex) with less emotional charge.
- Future triggers produce sadness that's manageable and not overwhelming.
Similar to what you wrote above, I read recently in a book about a person who fell from a flight of stairs when she was two years old. Her skull was fractured, she lost consciousness, and nearly died and had to spend a longer period of time in a hospital. For some reason the medical staff didn't allow her parents to see her, and told her not to cry, so she spent weeks feeling terrified and abandoned. As a result, she developed a core belief that no one cared about her because she was bad in some way. While the physical wound healed with time, the core wound of abandonment stayed and affected her life. It's like you've mentioned, it was not losing consciousness, or the physical fall that affected her the most, it was feeling of being unwanted by her parents.
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