Complex Trauma and EMDR Therapy in Northern Virginia: What Standard Protocols Miss

You've heard EMDR works for trauma. Maybe you've even tried it. But if your trauma wasn't a single incident—if it was years of something more chronic and relational—standard EMDR can feel like it's missing something.

That's because it often is.

Standard EMDR protocols were designed for discrete traumatic events: the kind of trauma that has a clear beginning, middle, and end. A car crash. An assault. A natural disaster. These protocols work beautifully when there's a specific memory to target and reprocess.

But what about the trauma that doesn't have a clear "when"? What about the chronic emotional neglect, the ambient anxiety of growing up in a home where love felt conditional, or the slow accumulation of shame that shaped how you see yourself? This is complex developmental trauma—and it requires a different approach.

In my McLean practice, I work with many people who come to me after trying standard EMDR and feeling like something didn't quite land. The issue isn't that EMDR doesn't work—it's that complex trauma lives differently in your nervous system than single-incident trauma does. Complex trauma is ambient rather than episodic. It's woven into your relational patterns, your sense of self, your nervous system's baseline—not stored as a discrete memory with a clear beginning and end. And treating it requires more than following a protocol.

Why Childhood Trauma Isn't Just "Bad Memories"

When most people think about trauma, they think about what happened. The yelling. The harsh criticism. The unpredictability that kept you on edge. And those things matter—they absolutely do.

But complex trauma is also about what didn't happen. The attunement that wasn't there. The validation you needed but never received. The sense of being seen and understood. The safety and security that never quite formed. Over time, both of these—what happened and what didn't happen—shape your nervous system in profound ways.

Unlike a car accident that happens once and is over, developmental trauma happens repeatedly during the years when your brain is learning how to be in relationship, how to regulate emotion, and what it means to be safe in the world. Your nervous system adapts to survive that environment—and those adaptations become the lens through which you experience everything.

This is why complex trauma often doesn't feel like "memories" in the traditional sense. It feels like:

Hypervigilance you can't turn off. Whether it came from the unpredictability of a parent's mood, the tension you could feel before anything exploded, or the absence of anyone noticing when you were struggling—your nervous system learned to stay on guard. Now you're always scanning for danger, waiting for the other shoe to drop, even when nothing threatening is happening.

Emotional flashbacks. Suddenly feeling small, ashamed, or terrified without a clear trigger—because your body remembers what your mind can't fully articulate.

Relationship patterns that repeat. You choose partners who feel familiar (even if they're not good for you), or you keep people at arm's length to avoid being hurt again.

A sense that something is fundamentally wrong with you. Not just that you experienced difficult things, but that you are somehow defective because of them.

These aren't symptoms you can simply "reprocess" with standard EMDR. They're adaptations—often brilliantly protective ones—that developed to keep you safe in an unsafe or unseen environment. And those adaptations need to be understood and worked with before the deeper trauma can be processed.

The Limitation of Protocol-Based EMDR

Standard EMDR follows a structured protocol: identify a target memory, activate it, use bilateral stimulation (eye movements or tapping) to help your brain reprocess it, and install a new, adaptive belief. For single-incident trauma, this is remarkably effective.

But when you try to apply this protocol to complex trauma, things get complicated.

There's no clear target to pick. How do you target a childhood of emotional neglect? Which memory do you choose when the problem wasn't one event but an entire relational environment?

The trauma is ambient, not episodic. It's woven into your sense of self, your nervous system's baseline, your expectations about relationships. Trying to pick a target can feel like trying to grab smoke.

Parts of you don't want to go there. The defenses that kept you safe as a child—the hypervigilance, the emotional shutdown, the perfectionism—are still working hard to protect you. And they're not about to let you dive into painful material without a fight.

I've worked with many clients in Northern Virginia who are high-achieving and successful on the outside but struggle with pervasive symptoms that haven't resolved with standard treatment. Some have tried EMDR elsewhere and felt either re-traumatized by the process or like nothing really changed. They'd describe sessions where they targeted memories but couldn't access any emotion, or where they felt flooded and overwhelmed with no sense of resolution. Some felt worse after EMDR—more anxious, more destabilized—because the protocol moved faster than their system could handle.

This isn't a failure of EMDR. EMDR is a powerful tool for trauma processing. But when complex trauma is involved, the tool needs to be integrated into a larger therapeutic approach that accounts for the layered, relational nature of the wounding.

How Integrated EMDR Works with Complex Trauma

Treating complex trauma effectively means understanding that EMDR isn't the starting point—it's part of a larger process. Before you can reprocess traumatic material, you need to work with the defenses that have been protecting you from that material. And before you can work with those defenses, you need to understand what they're defending against.

This is where an integrated approach makes all the difference. In my practice, I combine three evidence-based modalities that work together to address complex trauma at different levels:

Internal Family Systems (IFS) helps us understand the parts of you that developed to cope with trauma. The part that stays hypervigilant. The part that shuts down emotion. The part that drives you to achieve. These aren't dysfunctions—they're protective strategies. And they need to be acknowledged, appreciated, and worked with before the deeper trauma can be accessed.

Experiential Dynamic Therapy (AEDP and ISTDP) helps us move beneath those defenses to the core emotions they're protecting you from. We work with your feelings and defenses in the moment as they come up in session, building a safe relational space where your nervous system can gradually learn it's okay to feel. Beneath hypervigilance is often terror. Beneath emotional shutdown is grief or rage or unbearable loneliness. These emotions couldn't be felt or expressed when the trauma was happening—and your system is still avoiding them now. When the therapeutic relationship feels safe enough, these deeper emotions can finally be processed rather than remaining locked away.

EMDR then helps your nervous system integrate what couldn't be processed at the time. This is where EMDR becomes truly useful—not as a dry protocol where you're targeting memories while feeling numb or shut down, but as a tool for processing emotions that are actually present and alive in your body. Once the defenses have been worked with and the core emotions have been accessed, EMDR can help your brain reprocess the relational wounds and install a new, felt sense of safety.

Here's what this might look like in practice:

You come to therapy because you feel anxious in your relationship. Your partner is loving and safe, but you can't shake the feeling that they're going to leave or hurt you. Maybe you withdraw when they ask what's bothering you. Maybe you storm out during conflicts but want to just move on when you return rather than talk about what happened. Maybe you keep your real feelings to yourself because voicing them feels too dangerous. Or maybe you blow up in a rage, again, after promising yourself it wouldn't happen again.

We start by exploring the part of you that stays hypervigilant—the one that's always scanning for signs of danger. Through IFS, we begin to understand that this part developed when you were young and learned that love was unpredictable. It's not trying to ruin your relationship—it's trying to protect you from being blindsided again.

As we work with this protective part, we begin to access the emotions underneath: the terror of being abandoned, the shame of feeling like you weren't enough, the grief of never feeling truly safe with the people who were supposed to care for you. These emotions are painful, but they're also clarifying. This is what your hypervigilance has been protecting you from all along.

Now we can integrate EMDR. We use bilateral stimulation to help your nervous system reprocess those early relational wounds. Not just cognitively, but somatically. Your body begins to integrate a new felt sense: "I was a child who needed safety and didn't get it" rather than "I am fundamentally unlovable." The hypervigilance begins to soften because your nervous system is finally processing what it couldn't process back then.

This is the work I do with clients—EMDR isn't the starting point, it's part of a larger process of helping your nervous system feel genuinely safer. Not just intellectually understanding your patterns, but actually changing the way trauma lives in your body.

EMDR for Complex Trauma: What to Expect

If you're considering this kind of work, it's important to know what to expect. Integrated EMDR for complex trauma is slower than protocol-based EMDR—and that's not a bug, it's a feature.

It takes time to build safety. Before we can access traumatic material, your protective parts need to feel safe enough to release their vice grip. For many people with complex trauma, this alone is healing—learning that it's possible to be vulnerable with another person without being hurt, dismissed, or overwhelmed.

We pay close attention to pacing. Some sessions might feel intense; others might feel like we're moving slowly. That's because we're always working with your system's capacity. Flooding you with more than you can integrate isn't healing—it's re-traumatizing. So we go at a pace that feels challenging but manageable.

We work with the parts that don't want you to remember. It's common for parts of you to resist this work. They've spent years keeping you safe by keeping painful emotions at bay. So we don't override those parts—we work with them. We help them understand that it's safe to let go now, that you're not that vulnerable child anymore.

Integration happens between sessions too. Real change doesn't just happen in the therapy room. It happens when you notice your hypervigilance softening in your daily life. When you feel sadness and can stay with it instead of shutting down. When you take a risk in your relationship and discover you can tolerate the vulnerability.

This approach isn't about managing better. It's about addressing why you developed those patterns in the first place. It's about helping you feel safe enough to finally stop just coping.

Who Benefits from Integrated EMDR?

This work tends to resonate most with people who:

Have tried standard therapy or EMDR and felt something was missing. Maybe you could talk about your trauma but couldn't feel it, or you felt flooded and destabilized without lasting change.

Experience trauma that isn't a single event—it's a childhood shaped by emotional neglect, harsh criticism, unpredictability, or subtle forms of abuse that are hard to name but profoundly shaped who you are.

Are psychologically curious and want to understand yourself at a deeper level. You're not looking for surface-level coping skills—you want to know why you are the way you are and how to change the underlying patterns.

Are done just coping. You've managed for years, maybe even excelled on the outside while struggling on the inside. Now you're ready to address root causes, not just symptoms.

EMDR Therapy in McLean, Virginia

If you're in Northern Virginia and have been searching for an EMDR therapist who understands complex trauma, I'd be glad to talk. I see clients in person in my McLean office and via telehealth throughout Virginia, Maryland, and Washington D.C.

I offer a free 15-minute consultation to see if this approach feels right for you. Not every therapist is a good fit for every person—and that's okay. What matters is finding someone who understands what you're working with and has the training and experience to help you address it at a deeper level.

You don't have to keep managing. Many people find that just talking about these experiences brings some relief—and that's a good place to start.

EMDR Therapy for Anxiety: How It Helps Calm the Body and Mind

Recently, a client asked me a question I hear often: “Can EMDR help with anxiety, or is it only for trauma?”

Many people who’ve read about Eye Movement Desensitization and Reprocessing (EMDR) know it was developed for post-traumatic stress disorder (PTSD), and they worry that if they don’t have “big-T trauma,” it might not apply to them. The truth is, EMDR therapy can be profoundly helpful for anxiety — even when trauma isn’t the main focus.

While EMDR was originally designed to treat traumatic memories, it’s now used to help people reprocess experiences and beliefs that continue to trigger anxiety, even when they’re not consciously remembered as “traumatic.” Many forms of anxiety — from chronic worry and panic attacks to social or performance-related fear — are fueled by implicit memories and body-based responses that EMDR helps bring into balance.

In this post, we’ll look at how EMDR calms the body’s anxiety response, why it’s not just for trauma treatment, and what to expect if you’re considering EMDR therapy for anxiety.

How EMDR Works for Anxiety

When anxiety strikes, it’s as if the body and brain are getting mixed messages. You might know, rationally, that you’re not in danger — yet your heart races, your breathing quickens, and your thoughts start to spiral.

EMDR therapy helps identify and reprocess the roots of these responses.

For example, imagine someone who feels their throat tighten and their chest race whenever they have to introduce themselves to a group — even a small one. They know they’re safe, yet their body feels otherwise. Perhaps years ago, a teacher or classmate embarrassed them in front of others. That earlier experience still lives in the nervous system, so each new moment in the “spotlight” triggers the same fear.

In EMDR therapy, we would target that network — the memory, sensations, and beliefs that keep the body on high alert — to help the brain and body release the fear response and file the memory away as something that happened then, not something happening now. As this reprocessing unfolds, anxiety begins to lose its grip, and the body learns to respond with a greater sense of calm and control.

EMDR Is Not Just for Trauma

Although EMDR is best known as a trauma therapy, it can also help with experiences that don’t look like “trauma” on the surface but still shape how safe we feel in the world. These can include:

• Chronic criticism or rejection in childhood

• Embarrassing or shaming experiences in school or at work

• Medical or dental anxiety

• Fear of judgment, failure, or losing control

Many people with anxiety carry anticipatory fear — a sense that something bad is about to happen. EMDR helps update the brain’s expectations. As the nervous system integrates new information (“I’m safe now,” “I can handle this,” “It’s okay to feel anxious”), the anxiety response naturally softens.

What EMDR Therapy for Anxiety Looks Like

A course of EMDR therapy for anxiety typically unfolds in several phases:

1. Preparation and stabilization – Building trust, learning grounding skills, and identifying current anxiety triggers.

2. Target identification – Exploring memories, sensations, or beliefs that activate anxiety.

3. Reprocessing – Using bilateral stimulation (such as eye movements, tones, or gentle tapping) to reduce distress and integrate adaptive perspectives.

4. Integration – Reinforcing new, balanced responses to situations that once felt overwhelming.

Every person’s process is unique. Some notice shifts quickly, while others find that change unfolds gradually as deeper patterns of fear, avoidance, and self-doubt begin to release.

When Trauma and Anxiety Overlap

Many people who come to therapy for anxiety later discover that past experiences of loss, shame, or fear still shape how safe they feel in the present. EMDR bridges that gap — addressing both the emotional and somatic aspects of anxiety, whether rooted in clear trauma or subtler, repeated stress.

Even if you don’t identify as having “trauma,” your body may still carry echoes of earlier moments of helplessness or fear. EMDR gives the brain and body a chance to resolve those patterns, allowing you to feel more grounded, confident, and at ease.

Frequently Asked Questions About EMDR Therapy for Anxiety

How does EMDR help with anxiety?

EMDR helps the brain and body reprocess experiences that trigger anxiety. By using bilateral stimulation (eye movements, tapping, or sounds), EMDR helps the nervous system integrate memories and sensations that the body still experiences as threatening. As the brain updates these old “danger” signals, anxiety responses naturally decrease.

Is EMDR effective for anxiety even if I don’t have trauma?

Yes. While EMDR was originally developed for trauma, it also helps with anxiety that stems from repeated stress, shame, embarrassment, or chronic fear. You don’t need to identify a single traumatic event for EMDR to be effective — it can target any experience where your nervous system learned to stay on alert.

How many EMDR sessions are needed for anxiety?

The number of EMDR sessions depends on your goals and history. Some people notice improvement in just a few sessions, while others benefit from longer-term work to address deeper or more complex patterns. In general, EMDR for anxiety tends to show meaningful results sooner than traditional talk therapy alone.

Can EMDR make anxiety worse before it gets better?

Sometimes anxiety can increase temporarily as your brain begins to process stored experiences. However, EMDR is structured to include grounding and stabilization skills before any deeper work begins, ensuring you have tools to stay safe and regulated throughout the process. Most people find that their anxiety lessens over time, not increases.

Does EMDR help with panic attacks or social anxiety?

Yes. EMDR has been shown to reduce panic symptoms, fear of judgment, and performance-related anxiety by helping the brain release old fear responses. As those emotional networks are reprocessed, the body learns to stay calm in situations that once felt overwhelming.

Finding EMDR Therapy for Anxiety

If you’re struggling with anxiety, know that effective help is available. EMDR offers a way to go beyond symptom management — to retrain the body’s alarm system and build a deeper sense of safety and resilience.

Learn more about EMDR therapy and how it supports healing from anxiety and other challenges.
If anxiety has been interfering with your life, therapy for anxiety can help you find relief and greater ease.

I offer EMDR therapy in McLean, Virginia, and provide telehealth sessions across Virginia, Washington D.C., and Maryland.

You don’t have to face anxiety alone. With the right support, your mind and body can learn to relax, adapt, and move forward with more peace.

What Actually Happens in an EMDR Session?

Understanding What EMDR Is — and Isn’t

If you’ve heard of EMDR (Eye Movement Desensitization and Reprocessing), you might know it’s an evidence-based therapy for trauma and distressing life experiences. But you might not know what actually happens in an EMDR session. Do you relive your worst memories? Sit through long, painful exposures to triggers? Are you hypnotized? What exactly happens in an EMDR session — and why does it help?

EMDR isn’t about reliving trauma. It’s about helping your brain reprocess experiences that are still “stuck,” so they can be remembered without the same emotional intensity. For example, instead of feeling the rush of panic from a car accident every time you drive, the memory becomes just that — a memory — no longer an alarm going off in your body.

EMDR isn’t hypnosis. You remain fully awake and aware throughout each session, guided to notice thoughts, sensations, and emotions as they arise. The goal isn’t to enter a trance, but to stay connected to both the past and the present as your brain integrates the two.

You don’t have to know all the ins and outs of EMDR to get started, but it’s important to work with a therapist you trust — someone who can guide you through the process, help you make sense of what’s happening along the way, and create a safe space for your mind and body to process at their own pace.

The Eight Phases of EMDR in Everyday Language

EMDR follows a structured framework, but in practice it is collaborative and adaptable. Here’s what the process typically looks like:

1. History Taking & Treatment Planning
You and your therapist begin by exploring your current symptoms, triggers, and life experiences. The goal is to identify the moments or themes that still carry emotional weight. You’ll discuss goals for therapy and decide where to start. You don’t have to tell your entire story all at once.

2. Preparation
Before any processing begins, you’ll focus on building enough safety and stability to approach what still feels threatening. This might include learning ways to calm your body when distress arises, developing grounding skills, and strengthening internal resources that help you stay anchored in the present. The goal isn’t to eliminate all discomfort — it’s to help your nervous system feel safe enough to begin touching what once felt unbearable.

3. Assessment
Together you’ll choose a target memory to focus on. Your therapist will ask about the image, negative belief, emotion, and body sensations linked to that memory. For example, a client might notice an image of a car accident, the belief “I’m not safe,” and a tightness in the chest. These elements provide a roadmap for the reprocessing phase.

4. Desensitization
This is where bilateral stimulation — the “eye movement” part of EMDR — begins. You’ll be guided to notice the memory while following a series of eye movements, alternating taps, or tones in each ear. The therapist stops regularly to check in, and you simply notice what comes up.

During this phase, the brain starts to integrate information that was previously frozen in time. Some clients report flashes of insight or emotion, while others feel calm neutrality. Both are signs of the nervous system doing its work.

5. Installation
Once the emotional intensity has decreased, you and your therapist focus on strengthening a more adaptive belief, such as “I’m safe now” or “I did the best I could.” You continue using bilateral stimulation to help that new belief “take root” where the old one once lived.

6. Body Scan
Because trauma lives in the body as much as in the mind, this step helps identify any lingering sensations. You notice whether your body feels calm or if there’s residual tension. If discomfort remains, the therapist helps you process until your body feels settled again.

7. Closure
Each EMDR session ends with grounding. Your therapist ensures you’re back in the present and feeling stable before you leave. If processing feels incomplete, that’s okay — EMDR unfolds over multiple sessions.

8. Re-evaluation
At the beginning of your next session, you’ll check in about what’s shifted since last time. Often, the memory feels more distant, or the body responds differently to stress. The therapist uses this phase to plan next steps and track your overall progress.

Traumatic experiences can overwhelm the brain’s ability to make sense of what’s happening. When that happens, parts of the memory — emotions, sensations, or beliefs — get “stuck” in a kind of unfinished loop. EMDR helps your brain and body finish that loop, so that you can move from survival mode into understanding and resolution.

You and your therapist move at your pace. EMDR is not a race; it’s a process of helping your brain and body complete what they once couldn’t.

What Bilateral Stimulation Actually Does

Bilateral stimulation simply means engaging both sides of the body — and, by extension, both hemispheres of the brain. It can be done by moving your eyes side to side, tapping alternately on each knee, or listening to tones that switch between ears.

Researchers don’t yet fully agree on why bilateral stimulation works, but several theories help explain its effects. Some studies suggest it mimics the brain’s natural processing during REM sleep. Others propose that it helps reduce emotional intensity by engaging both hemispheres or by improving working memory so distress feels less consuming. Whatever the mechanism, many clients experience noticeable relief as the nervous system reorganizes its response to old stressors.

(I’ll explore the research on how bilateral stimulation works in a future post.)

Clients often describe sensations like sighing, yawning, or feeling lighter — signs that the nervous system is releasing stored tension. You might also experience emotions or images arising unexpectedly, which your therapist helps you track and make meaning of.

You Stay in Control the Whole Time

A common worry is, “What if I get overwhelmed or can’t handle what comes up?” In EMDR, you’re in charge — and your therapist’s role is to help you stay that way.

You can pause at any time. You decide what to share. A skilled EMDR therapist monitors your level of distress carefully and adjusts the pacing to keep you within your window of tolerance — the zone where processing can happen safely.

Because trauma often involves a loss of control, one of the most healing parts of EMDR is learning, within a trusting therapeutic relationship, that you can stay present and make choices even when strong emotions arise.

After an EMDR Session: Integration and Reflection

After a session, your brain may continue processing for hours or even days. Some people feel tired or emotional; others feel clear and calm. You might notice vivid dreams or small changes in how you react to everyday stress.

Integration happens naturally — your mind is making new connections and storing memories differently. Gentle aftercare helps support that process:

• Get adequate rest and hydration.

• Avoid forcing analysis — simply notice what arises.

• Practice grounding or self-soothing if strong emotions appear.

Your therapist will check in at your next session to understand how you’re feeling and decide whether to continue with the same target or move on to another.

Is EMDR Right for You?

While EMDR was originally developed for post-traumatic stress, it’s now used for a wide range of concerns — anxiety, depression, grief, phobias, and painful experiences that continue to echo long after they’ve passed.

It’s especially helpful for people who say things like, “I understand it wasn’t my fault, but I still feel it in my body.” EMDR bridges that gap between knowing and feeling.

That said, EMDR isn’t the right fit for everyone or for every stage of therapy. A thoughtful assessment helps determine whether EMDR is appropriate for your needs right now. If it’s not, your therapist may recommend beginning with other approaches to build the stability and skills that make EMDR more effective later.

The power of EMDR lies not just in the method itself, but in how it’s applied within a safe, attuned, and collaborative relationship.

🌱 Finding Relief Through EMDR

EMDR can help you process what once felt too overwhelming, so you can live with greater ease and self-trust. It offers a way to feel more present, less reactive, and more connected to yourself.

Learn more about EMDR therapy and how it can support your healing process.