When EMDR Met My Body

On trauma activation, the window of tolerance, and what happens when a practitioner becomes the client

Starry by Karina Da Paixao Teixeira

I couldn't write for three weeks. For three weeks, the part of me that makes things went quiet. Not writer's block. The right brain, shut down by trauma activation. The system had other priorities.

Three weeks without words, without painting, without the thing that has been my most reliable form of regulation since I can remember. If you have read my previous reflections, you know what that means for me. Writing and painting are not hobbies. They are how I think. How I stay in the present. How I know I am still here.

EMDR took them from me. At least for a while.

I want to be careful about how I say what follows. I am a counsellor. I understand trauma treatment. I know the research on EMDR, I know Shapiro's theoretical framework, I know the ISSTD guidelines on dissociative presentations. I went into those sessions informed.

And still. What I experienced in the weeks that followed was not integration. It was rupture.

I am writing today partly because I am back. And partly because I think this needs to be said.

What I believe about trauma work

My view, formed through clinical practice and through living inside complex trauma, is this: working with trauma does not mean immersion in trauma. It does not mean the deliberate evocation of traumatic memories as a first move, or a fast move, or sometimes any move at all.

What it means, most of the time, is gradual and indirect approach. As Judith Herman understood and wrote about decades ago, it is fundamental to revisit traumatic experience from a position of safety in the present. That word, safety, is not administrative. It is neurobiological. Without it, the work cannot land. And it is the most precious word in my life.

Complex trauma presents with somatisation and dissociation, and both of these matter clinically and personally. Somatisation is not performance. It is the unconscious, genuine neurological consequence of chronic threat exposure: dysregulation of the autonomic nervous system and the HPA axis. The body carries the imprint of what the mind could not fully process. Muscle tension. Chronic pain. Visceral sensitivity. Altered interoception.

Dissociation is the psyche's defence against what is otherwise unbearable. A disruption of consciousness, memory, identity, and perception. And in complex trauma, the kind that begins early, before there is language for it, before there is any framework to hold it, dissociation is not a symptom that sits alongside the presentation. It is the architecture.

This is where EMDR, which I respect as a modality, requires a more honest conversation.

What Shapiro understood, and what I want to add

According to Shapiro's theoretical framework, traumatic memories are frozen in an unprocessed state, stored with their original affect, sensation, and distorted cognition intact. They cannot connect with the adaptive memory networks that would allow integration: the contextualising, the neutralising, the sense that this happened then, and I am here now.

Bilateral stimulation, the eye movements, the tapping, the auditory tones, is proposed to support dual attention. The person holds the traumatic material in mind while remaining anchored in the present. This dual awareness is what distinguishes EMDR from simple immersion, in theory. The adaptive information processing model is genuinely elegant.

But I want to bring awareness to something the research does not always foreground. EMDR does involve deliberate activation of traumatic memory. And for clients with significant dissociation, that activation, without sufficient stabilisation, without an adequately wide window of tolerance, without Phase 1 work that has actually done what it needs to do, can produce something other than integration.

It can produce rupture.

The ISSTD guidelines are clear on this: caution is required with highly dissociative clients, not because EMDR is immersion per se, but because trauma activation without sufficient stabilisation can trigger dissociative switching and destabilisation. A client with significant affect dysregulation, a fragile therapeutic alliance, or a narrow window of tolerance is not yet a candidate for trauma activation work. The question is not which modality to use. The question is whether Phase 2 is appropriate at all. EMDR's sophistication does not bypass that assessment.

I need to say something else here. Something I am still working out in supervision.

I may bring bias to this reflection. I am personally addressing pre-verbal trauma with active PTSD symptoms. I am the client I am writing about, at least in part. And EMDR has been a genuinely difficult experience for me, one that has led to repeated episodes of splitting between the apparently normal part of daily functioning and the emotionally charged part, where my hypervigilance activates and fixes in trauma time.

I am trying not to drop out of EMDR therapy. But I am close.

What I know from the inside

As many people living with complex trauma know: you don't always know whether a memory is really a memory.

When you are a child, a young adult, you carry suppressed anger and a suspicious relationship with everything, but you don't truly know whether what you remember is the truth. It is so fragmented. All those flashing images. I have them while awake, and occasionally just before falling asleep. I have wondered, for as long as I can remember, how it happens to others, that unpredictable recollection of traumatic moments, arriving without warning in the middle of the day.

Perhaps that is one of the reasons I became a nurse and a psychotherapist. I believe I can read people's silent suffering in their eyes, in their physiology. Even when I don't want to see it. A mirror you want to avoid, because you don't want to think that others have had experiences like the ones that surface, out of nowhere, in the middle of an ordinary afternoon.

In complex trauma, people live between two extremes. Hyperarousal: explosive anger, intense shame spirals, panic, emotional flooding, rapid escalation, difficulty self-soothing. And hypoarousal: emotional numbness, flat affect, disconnection, the inability to access or name feelings, anhedonia. The oscillation between these states is cruel. The worst of it is the unpredictability, which destabilises relationships and creates a pervasive distress that becomes its own significant source of shame.

I return again to Siegel's and Ogden's window of tolerance, because in complex trauma this window is often so narrow it is barely a window at all. Learning, reframing, connection, and integration are only possible when the client is within it. And here lies the core of my concern about premature trauma activation. Not about EMDR as a modality. About timing. About readiness. About the difference between a protocol that is theoretically sound and a client who is somatically not ready for what that protocol asks.

What the body knows before the mind catches up

When I look at what happens in complex trauma, there is a sequence. An overwhelming experience. A nervous system unable to cope or integrate. Dissociation that splits off the unbearable. Unprocessed affect stored somatically. And then body symptoms, dysregulated emotion, intrusive memories, all of which are, despite feeling unbearable, precious information.

They tell you that what happened, happened. The intrusive memories causing the splitting are not imagination. They are cues. The material is fragmented, emotionally and psychologically disorganised. But it is real.

Even as a mental health practitioner with knowledge and personal practice in self-regulation, I have struggled with emotional numbing, identity confusion, and amnesia for trauma material. All considered moderate signs of dissociation. I have supported others through mental health crises, professionally, steadily, and yet I find myself at another step of post-traumatic growth while it is almost unbearable.

You are not alone in this. I am trying to navigate a specific chapter of trauma work, and it seems impossible to simply switch off the defensive responses that are disturbing to both brain and mind. These responses are not failures. They are the system doing what it was built to do, in conditions it was built to handle.

The problem is that the danger is no longer present. The system has not received the update.

The silence before this sentence

I usually write every day. The last two weeks were impossible, following the EMDR sessions.

I call it the silent despair: you function through life, but it feels as though the darkness never quite lets you go. You hold it through the workday, through parenting, through the clinical hours where you are present for someone else's fragmentation. And then you get home and there is nothing left for your own.

What I know now, clinically and personally: I went into those sessions carrying decades of complex, relational, and developmental trauma with attachment disruption. I went with trust. But without adequate Phase 1 preparation. And what happened was that trauma activation outpaced stabilisation.

I know this. I knew it before I could write it here. But knowing something clinically and living it are two very different things.

The fact that I am writing today matters. That is what I want to say to you, if you are in the middle of it: the fact that you are still here, still trying to put words to it, still in the room with your own experience, that matters.

The part that is also structural

There is something I want to say about access, because I think it would be dishonest to leave it out.

Medicare's structure, the limited number of sessions, the expectation that things can be resolved in a handful of appointments, means that people like me are sometimes sent directly into trauma activation work without the stabilisation phase that should precede it. The assessment of readiness gets compressed. The preparation gets abbreviated. And then the person is left holding what got activated, without adequate support to contain it.

I am a single mother. An immigrant. Building a practice. A registered nurse, three or more days a week. These are not obstacles I am listing for sympathy. They are the full picture of what I am holding. And the irony of being someone who understands trauma treatment deeply, while being unable to access the version of it I actually need, is not lost on me.

EMDR has brought suppressed material to the surface. I believe that. I hope it is ultimately for the best. But as a client, I feel that whatever integration I had achieved through previous therapeutic work, these sessions have significantly disturbed it. Perhaps it is simply too much adverse experience for the nervous system to organise calmly. What remains good, and I am looking for what remains good, is that I am learning. The limitations and the possibilities. And that before long I hope to reflect from some distance, and evaluate with more clarity whether EMDR is genuinely safe for most complex trauma presentations.

I have many grounding tools. For the first time, they are not working.

And yet, when I am stuck, as a client, as a therapist, I find I am also curious. Because being stuck always means more learning. More reframing. More understanding of what the brain is trying to do and why.

The researchers say the goal is to increase integration and expand the window of tolerance, so the client no longer needs to fragment in order to survive the present moment. I believe that. I am living toward it.

So, if today is a day when you are thinking of giving up on your trauma work, or on therapy altogether: you are not alone. Feeling my own affect dysregulation, trying to calm my hyperarousal after a flashback, it is suffering. But it is also informative enough to allow me to hold this pain and observe my own inner experience with something approaching compassion.

That, for today, is enough.

With curiosity and care for your story,

Karina

If you're curious…

Herman, J. (1992). Trauma and Recovery. Basic Books.

Van der Hart, O., Nijenhuis, E.R.S., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. Norton.

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.

ISSTD (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115–187.