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Many clients and therapists feel anxious about the stage of therapy that involves direct trauma processing. Clients may worry about becoming overwhelmed, or fear that once they start thinking about the trauma they will not be able to stop. This is understandable, as PTSD often involves a strong avoidance drive, which is the mind’s way of protecting itself from overwhelming emotion. Therapists also carry concerns. We may wonder whether a client’s mental state will worsen, or feel uneasy watching them in visible distress, worried that we are causing harm. These are valid concerns and highlight the importance of safeguards and preparation before trauma processing begins. It is important to be realistic. Even with the most effective approaches we have, such as EMDR, somatic therapies, prolonged exposure, some level of distress is unavoidable. In EMDR, for example, the memory must be activated for processing to work. The client needs to feel some level of disturbance so that unresolved emotional and physical reactions can be reprocessed. This allows the brain to reorient to the present and make new meaning from a past event. Ideally, clients stay within their “window of tolerance,” where emotions are strong but still manageable. Yet trauma work is unpredictable, and at times big waves of feeling will arise. What matters most is that therapist and client have a trusting relationship and confidence that these states can be navigated safely together. The question then becomes, how do we tell the difference between a normal level of disturbance and retraumatisation? With EMDR specifically, it is common, and we prepare clients for this, to experience some residual disturbance after sessions. Processing often continues for a few days. Temporary increases in intrusions, re-experiencing, anxiety, avoidance, or changes in dreaming and nightmares are within the normal range. These reactions do not mean retraumatisation is occurring. The key point is that these symptoms should settle and not cause a major shift in functioning. Therapist and client should stay in close communication, monitoring how the client is managing and adjusting pacing when needed. Larger traumatic memories, which cannot always be resolved in one session, often lead to some between-session disturbance that is best understood as part of the therapeutic process. We become more concerned if new trauma symptoms appear that were not part of the client’s baseline, such as nightmares when there were none before, or panic attacks that had not been present. A marked and persistent worsening of functioning, such as significant drops in mood, increased irritability, or an escalation of suicidal or self-harming urges, can also indicate that retraumatisation may be taking place. The distinction lies in whether there is a temporary spike in distress that then settles, or a sustained decline in stability and functioning that does not improve. If these kinds of negative shifts appear, it is important to pause and reassess. Clinicians can use standardised tools such as the International Trauma Questionnaire to track symptoms over time. If deterioration is substantial and persistent, we need to ask whether life stressors are overwhelming the client’s capacity to process trauma right now, whether more resources and preparation are needed, or whether the therapist should seek consultation or supervision. The bottom line is that some distress is unavoidable and even necessary in trauma therapy, but substantial and prolonged declines in functioning are not part of the expected process. When that happens, both client and therapist need to take it seriously, pause the trauma processing, and address what is going on. Summary Table: Expected Disturbance vs Concerning Signs in Trauma Processing 
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I have recently come across a very interesting article that made me think about how hardwired we are to respond to affectionate human touch. In their research, Della Longa and colleagues were able to demonstrate that newborns, from their first days of life, react differently to affectionate touch vs other types of touch. They are able to respond to and be soothed by affectionate touch (e.g. stroking), and do not respond in that way to neutral touch (e.g. tapping).
However, when you have lived through neglect or abuse, the body can learn to treat touch as a possible threat. Muscles brace. Breath gets tight. You feel frozen in place. Your system moves into protection, as your body adapted to keep you safe. Relearning safety with touch If you want to explore touch again, go slowly and let consent lead every step. Try one or two of these when you feel resourced:
Tips for staying within your window of tolerance:
When touch is too much You might notice numbness, sudden anger, spinning thoughts, or a drop in mood. That is useful information. Shift to something that regulates without touch, like paced breathing, looking around and naming five colors, or feeling the support of the chair under you. Therapy that can help Trauma focused therapies, including EMDR and approaches that include somatic work, can help the nervous system relearn safety cues. Reference: Della Longa, L., Dragovic, D., Farroni, T. 2021. In Touch with the Heartbeat: Newborns’ Cardiac Sensitivity to Affective and Non Affective Touch. International Journal of Environmental Research and Public Health, 18(5), 2212. PubMed: https://pubmed.ncbi.nlm.nih.gov/33668108/ And Why That’s Not a Sign of Failure
If you've been exploring EMDR therapy and wondering why your progress feels slower than what you’ve seen on TV or heard from other people, you're not alone. EMDR is a powerful therapy - but it’s often portrayed in ways that don’t necessarily reflect the experiences of those with complex trauma. Let’s unpack why EMDR can feel different (slower, more demanding) for those who’ve lived through repeated or early life trauma, and why that’s completely normal. EMDR and Your Brain’s Healing System EMDR (Eye Movement Desensitisation and Reprocessing) helps people heal from trauma by activating the brain’s Adaptive Information Processing (AIP) system. This system is like your brain’s natural healing mechanism - it helps you make sense of difficult experiences and file them away in a healthy way. For many people, the AIP system is supported by core internal beliefs such as:
But What If Those Beliefs Were Never There to Begin With? This is where complex trauma is different. If you grew up in a household where you were neglected, abused, criticised, or had to only yourself to rely on from a young age, your brain may have never had the chance to form those adaptive foundational beliefs. Instead, you may have internalised beliefs like:
EMDR Alone Often Isn’t Enough for Complex Trauma For EMDR to be truly effective, there needs to be something solid to return to - some sense of safety, self-worth, or hope - in the aftermath of trauma. That’s why for people with complex trauma, EMDR is often combined with other therapies to help build those internal structures. These may include, among others:
So How Long Does It Take? The truth is: healing complex trauma often takes years, not weeks or months. The traumatic and damaging experiences have often occurred and accumulated over a number of many years. Many people alternate between phases of resourcing and trauma processing over time. This is normal. This is safe. This is sustainable. EMDR is still an incredibly powerful tool, but the journey looks different when your trauma has happened early, was relational, and prolonged. What You’ve Seen in the Media Isn’t the Whole Story Most EMDR success stories featured in the media are based on single-event traumas- a soldier returning from war, a survivor of a car crash, a person who witnessed a crime. These are real and valid stories, but they don’t represent the reality of those healing from years of emotional neglect, attachment injury, or complex abuse. If EMDR is taking longer for you, it doesn’t mean it’s not working. It means:
The Bottom Line Complex trauma requires compassion, patience, and an integrative approach. EMDR is just one piece of the puzzle, and when used within a supportive, flexible therapy process, it can help you create powerful and lasting change. Take your time. You’re not behind. You’re building something real. Don't give up! A new award-winning study just gave us scientific proof of something many trauma therapists have long suspected: EMDR therapy can change your body at the cellular level.
The study looked at people with treatment-resistant depression - the kind that doesn't shift with medication or standard therapy. These people also had histories of early life stress (neglect, abuse, or other childhood trauma). Researchers treated with them either EMDR or trauma-focused CBT. Both helped, but EMDR stood out - not just in symptom relief, but in what it did to their DNA. Specifically, EMDR was linked to changes in DNA methylation (a process that influences how your genes are expressed), particularly in genes involved in inflammation and immune response. These systems are often overactive in people with childhood trauma histories - and can keep the body stuck in survival mode long after the danger is gone. So what does this mean? It means that we now can use these wonderful bottom-up therapies - such as EMDR - that can help your whole body heal from trauma. Your biology can shift. Your cells can heal. You can experience lasting changes not just in your emotional states, but in your physical health. While this study focused on depression, it opens the door for future research into PTSD and complex trauma too, as well as any other mental health challenges that originate from adverse life experiences and early life stress. Obviously it's still early days, but I am confident that we will see similar results for those conditions as well. For now, it offers something rare and beautiful: hard evidence that deep healing is possible - even for those who’ve felt stuck for years. If you're curious about EMDR, or if you've been carrying old wounds in a body that just won't settle - maybe now's the time to move foward. Reference: Carvalho Silva, R. et al. (2024). Epigenetic changes in treatment-resistant depression after trauma-focused psychotherapy. European Journal of Psychotraumatology, 15(1). https://doi.org/10.1080/20008066.2024.2314913 If you are looking to address long-standing patterns in your behaviour, the answer is yes, more often than not. If you have been doing well for most of your life, and have developed anxiety or mood issues in response to a recent triggering event, than not necessarily.
The majority of clients I see fall into the former category. They sometimes ask - why do we need to talk about the past, if what is bothering me is about the present? That is a very good question, and sometimes it’s hard to see the connection between past events and present responses as it is often outside of our awareness. Our brains, while often very active, also use shortcuts. The way our memory works is contextual. That is, when we are in any given situation, we tend to respond to it based on our prior experiences. We also tend to filter through the information we are exposed to, and generally interpret it to fit with our prior beliefs. If I believe that I am worthless, or unlovable, I am going to look at the world through that lens, and keep finding what I see as "evidence" to confirm those beliefs. This is going to perpetuate my difficulties in relationships with others and myself. To make things even more complex, as an adult you may rationally understand that you are not worthless, however you still feel that way inside. That is because our memories are not just cognitive, they have emotional and somatic components. Now if we ask where and how did I learn that about myself? When was the first time I felt worthless or insignificant? How do I feel in my body when I am thinking this? Then most likely you will be taken back to your childhood experiences, that formed the foundation of this learning about yourself, that is, of course, untrue. Unfortunately, as children we have so little control of the world around us, that one way to feel a little bit more in control is to internalise. If the adults are treating me this way, there must be something wrong with me. And if I figure out what it is, I can change, and they will love me. With therapy, including EMDR therapy, we can start looking at the origins of those core beliefs, and help you process the underlying memories beyond the cognitive level. Then you can not just know that you are worthy and loveable, but feel it too. So yes, we often do need to talk about your childhood and your parents, not to place blame, but to correct those faulty early learning experiences, so that they don’t distort your experience of the present. One of the most frequently asked questions during EMDR sessions is "Am I Doing It Right?". In this post I would like to offer reassurance and clarify expectations around "what is supposed to happen" during EMDR processing.
The short answer is - there is no wrong way to process a memory or a painful experience. There is also no one particular way in which the processing happens for everyone. Your experience is your experience, and that it OK. However, since EMDR is quite different from traditional talk therapy, it requires an adjustment in our expectations. The idea behind EMDR is that it activates and accelerates new learning on a neurological level. The main requirement for this process to happen is to trust your brain to do the processing, which can mean stepping back and letting go. During the processing phase (when we use bilateral stimulation, such as eye moments, to target a memory) you can feel that the memory is close, or more distant. Other memories often emerge, that are likely to be connected to the same neural network. There may be sets where you are more aware of the feelings in your body, there may be sets where you are more aware of your thoughts. Whatever is coming up, I will help guide you through it, and support you in your learning style. Most of us have experienced an occasional sleepless night. Unfortunately, for many of my clients difficulties with falling and/or staying asleep are common.
In the next few posts, I will share some tips on how to help you fall asleep and stay asleep. I am writing this with particular focus on people who have experienced trauma or suffer from anxiety. Trying to fall asleep but your brain just won't stop? Try these strategies:
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Irina PetrovaClinical Psychologist 
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