EMDR Negative And Positive Cognitions
Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach designed to alleviate the distress associated with traumatic memories. The EMDR Negative And Positive Cognitions handout is designed to be used during the third phase of the EMDR protocol, in which the therapist explores critical components of the target memory, including any associated negative and positive cognitions. This is an important step as it can help to activate different aspects of dysfunctionally-stored information. Practically, some clients find it difficult to identify appropriate negative and positive cognitions during this assessment phase, so it is recommended to offer the client a list of negative and positive cognitions from which they can choose.
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Introduction & Theoretical Background
Developed by Francine Shapiro in the 1980s, EMDR is now recognized worldwide as an effective treatment for post-traumatic stress disorder (PTSD) by health organizations such as the American Psychological Association (e.g. Courtois, C. A., et al., 2017) and the National Institute For Health And Care Excellence (National Institute For Health And Care Excellence, 2018).
The adaptive information processing (AIP) model (Shapiro, 1995) suggests that an individual’s experiences are assimilated and stored as memory networks containing representations of images, thoughts, beliefs, emotions, and sensations. It proposes that much of psychopathology is due to the maladaptive encoding or incomplete processing of traumatic or distressing experiences:
a particularly distressing incident may become stored in state-specific form, meaning frozen in time in its own neural network, unable to connect with other memory networks that hold adaptive information
(Solomon & Shapiro, 2008)
The goal of EMDR therapy is to ‘reprocess’ any dysfunctionally stored
Therapist Guidance
Negative cognition
"This is a list of words that some people who have experienced trauma use to describe themselves. Read through the list of negative cognitions. When you think of your target image, which words best express your negative belief or current beliefs about yourself? Which words most strongly resonate with you most strongly?"
Checklist for clinicians:
- Has a negative cognition been identified?
- Does the client’s negative cognition refer to themselves, or serve as a judgment of themselves?
- Is the negative cognition stated in the present tense? (i.e. “I am …” rather than “I was …”)
- Does the negative cognition reflect a belief rather than a statement of fact or circumstances (e.g. “I am powerless” rather than “I wasn’t given any choice”)?
- Is the negative cognition stated in the client’s own words?
- Is the negative cognition distinct from but appropriate to the emotion the client identified as relating to
References And Further Reading
- Courtois, C. A., Sonis, J., Brown, L. S., Cook, J., Fairbank, J. A., Friedman, M., & Schulz, P. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. American Psychological Association, 119.
- De Jongh, A., Hafkemeijer, L., Hofman, S., Slotema, K., & Hornsveld, H. (2024). The AIP model as a theoretical framework for the treatment of personality disorders with EMDR therapy. Frontiers in Psychiatry, 15, 1331876.
- EMDR Europe Practice Sub-Committee (2013). EMDR Europe Accredited Practitioner Competency Based Framework. https://emdr-europe.org/wp-content/uploads/2018/06/EMDR-Europe-Practitioner-Forms.pdf
- Hase, M., Balmaceda, U. M., Ostacoli, L., Liebermann, P., & Hofmann, A. (2017). The AIP model of EMDR therapy and pathogenic memories. Frontiers in psychology, 8, 1578.
- National Institute For Health And Care Excellence (2018). Post-Traumatic stress disorder. NICE guideline 116 (NG116).
- Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols and procedures. New York: Guilford Press.
- Shapiro, F. (2017). Eye movement desensitization and