What if the most common sticking points in EMDR therapy have clear, evidence-informed answers? In this solo episode, Lorain Moorehead, LCSW draws directly from her EMDR consultations with therapists to answer five questions that come up again and again in clinical practice. From understanding adaptive information processing and the eight-stage EMDR protocol to navigating negative cognitions, assessing dual awareness, and knowing when to adjust bilateral stimulation, this episode is a practical resource for therapists at every stage of their EMDR training and practice. Whether you are newly trained or a seasoned EMDR therapist, this episode will sharpen how you approach your next session.

0:00 - Intro

1:15 - How adaptive information processing works

2:29 - How trauma generalizes across situations

4:30 - The eight-stage EMDR protocol

6:16 - Resourcing and dual awareness

8:20 - Signs a client needs more resourcing

10:20 - Building the trauma timeline: first, worst, and most recent

13:00 - Virtual EMDR and eye movements vs. other bilateral stimulation

16:00 - Negative cognitions and linked trauma targets

18:11 - Why negative cognitions are hard to identify

20:16 - Criteria for a strong negative cognition

22:38 - Belief vs. fact: an important distinction

24:32 - The gut punch test for the right NC

26:42 - When a client is stuck in reprocessing

28:29 - Adjusting BLS length and speed

30:44 - Combining bilateral stimulation modalities

Episode Highlights:

Adaptive information processing is the theory underlying EMDR. The brain has a natural capacity to process experience, but trauma disrupts that process, and what begins as one trigger can generalize to many situations over time.

EMDR is an eight-stage protocol, and the reprocessing portion is only one part of it. The work has already begun long before bilateral stimulation starts.

Assessing dual awareness, the ability to hold one foot in the present and one foot in the past, is one of the most important readiness indicators before moving into reprocessing.

Spending multiple sessions on resourcing is not a delay. It builds the capacity for clients to visit difficult material and return to the present moment without destabilizing.

The trauma timeline does not need to be exhaustive. Focusing on the first, worst, and most recent incidents is enough to identify the full scope of a target without unnecessarily retraumatizing clients in the process.

Eye movements tend to be the most effective form of bilateral stimulation for many clients, and virtual EMDR can be just as productive as in-person sessions when set up thoughtfully.

A negative cognition must be about the self, negative rather than neutral, a belief and not a fact, and felt as present-tense relevant in order to carry the weight needed for reprocessing to move.

Negative cognitions are often shaped in childhood and can persist even when the adult brain understands the situation differently on a logical level. The NC connects with the instinctual layer of belief, not the reasoning one.

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The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum here!

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