What happens if a positive cognition won't install in EMDR?

Resistance in Phase 5 often signals that the positive cognition isn't actually true, or that closely associated memories haven't yet been processed. If the belief is too aspirational or inaccurate, the nervous system will push back. The cognition may need to be refined before installation can proceed.

EMDR Phase 5 Explained: Installation, Positive Cognitions, and Why Chronic Trauma Changes Everything

Jun 9

Written By Cassandra Minnick

podcast

This blog is adapted from one of our recent podcast episodes. You can take a listen at the button above.

Phase 4 cleared the path. Phase 5 builds something new on it.

EMDR Phase 5, Installation, is where the work shifts from desensitizing a traumatic memory to actively strengthening a more adaptive belief about it. It's a phase that looks deceptively simple for some clients and requires significant, sustained effort for others. The difference comes down to one thing: whether the client is dealing with acute trauma or chronic trauma.

In this blog post, we break down what installation actually involves, how the research has evolved, and why chronic trauma clients need far more support in this phase than the basic protocol alone can provide.

Key Takeaways

In this episode, you'll learn:

What EMDR Phase 5 Installation is and what's actually being installed
What the Validity of Cognition (VOC) scale is and how it's used
What it means to "full evoke" and why it matters
How the research on bilateral stimulation in Phase 5 has shifted
Why Phase 5 looks completely different for acute vs. chronic trauma clients
Why chronic trauma in our culture is almost always relational trauma
Why Phases 2 and 5 are deeply connected for chronic trauma clients

What Is EMDR Phase 5 Installation?

If Phase 4 was about clearing (desensitizing a traumatic memory until it no longer has the same emotional charge), Phase 5 is about building. Specifically, it's about taking the positive cognition identified back in Phase 3 and strengthening it until the client doesn't just intellectually agree with it, but genuinely believes it.

The goal of Phase 5 is to build new neural pathways, not just clear out old ones. That distinction matters more than it might seem at first.

In Phase 3, the therapist and client identified two things: a negative cognition (the false belief the trauma created) and a positive cognition (the more adaptive belief the client wants to move toward). Phase 4 worked to desensitize the memory. Phase 5 takes that now-neutral memory and links it to the positive cognition, then works to strengthen that link until it holds.

The measurement tool used here is the Validity of Cognition (VOC) scale - a zero to seven scale where zero means the positive cognition feels completely false and seven means it feels completely true. The goal is to reach a seven. When a client genuinely believes their new positive cognition (not just thinks it, but believes it) that's what we call "full evoking."

What Phase 5 Sounds Like: The Basic Protocol

Here's how Phase 5 unfolds in session, using my scripted walkthrough for new clinicians:

"When you bring up that original incident, does what you wanted to believe about it - 'I am safe' or 'I can keep myself safe' - still fit? Or is there something better? Think about the original incident and those words. From one being completely false to seven being completely true, how do they feel now?"

Assuming the client reports a seven, the therapist then introduces slow bilateral stimulation while the client holds the positive cognition alongside the original memory, working to install and reinforce that new belief.

One clarifying note: the VOC scale runs from one to seven, while the SUD (distress) scale from Phase 3 runs from zero to ten. They're different tools measuring different things, and newer clinicians sometimes conflate them. Getting the numbers right matters, especially early in practice.

Book a free consultation with Cassandra →

A Note on the Research: Has Phase 5 Changed?

When I was a new EMDR clinician, Phase 5 was presented as having research support roughly comparable to Phase 4. That's shifted.

The research no longer supports bilateral stimulation during Phase 5 as strongly as it once did. The bilateral component specifically, not the phase itself, is what's being questioned.

My position: don't stop. The process of identifying what a client wants to believe about themselves now, and working to strengthen that belief, is valuable. The question is whether bilateral stimulation alongside it actually adds to that value. Until there's definitive data saying it causes harm or is clearly unnecessary, the recommendation is to keep doing it. It's not hurting anything, and it may still be helping.

For newer clinicians especially: stick with the protocol as written. Learn the rules before you start adapting them.

Why Positive Cognitions Must Actually Be True

Before going further into the differences between acute and chronic trauma in this phase, there's an important clinical point worth pausing on.

Positive cognitions have to be genuinely true, not aspirational, not reassuring, not what the client wishes were true. If a positive cognition isn't actually accurate, the client's nervous system will push back on it, and Phase 5 won't move.

I saw this early in my career. I would allow clients to try to install positive cognitions like "I will always be safe" and their brains and bodies resisted, as they should, because that isn't true. No one is always safe.

Using the example of a car accident where a parent's children were in the vehicle: a likely negative cognition might be "I will never be able to keep my kids safe again." A workable positive cognition isn't "I will always keep my kids safe" - that's not true either. Something more accurate might be "I always work hard to keep my kids safe" or "I will walk through hard things with my kids." It's specific, it's honest, and it's something the nervous system can actually accept.

If a client or clinician is hitting resistance in Phase 5, the first question to ask is: is this positive cognition actually true?

Acute Trauma vs. Chronic Trauma: Why Phase 5 Looks Completely Different

This is the most important thing to understand about Phase 5.

For clients addressing acute trauma without a chronic trauma history, Phase 5 is often almost effortless. The memory has been desensitized, and positive cognitions rush in to fill the space almost immediately. I describe it as a void that eager, capable beliefs sprint toward and occupy. These clients already have a foundation of resilience. Phase 5 is simply extending that foundation over the hole that the acute trauma created.

For clients with chronic trauma, it's an entirely different landscape.

Why Chronic Trauma Changes Everything

In our culture, chronic trauma is almost exclusively relational trauma. We live in a relatively safe physical environment - not in war zones, not facing regular predator attacks. But the increasing isolation of single-family households means that when a child's emotional needs aren't being met at home, there are fewer people to step in and fill that gap.

A client who experienced an acute trauma but had a secure childhood likely grew up hearing things like: "You are capable. You are smart. We are here for you." Those messages became deeply held beliefs - mature, confident, ready to fill a void.

A client who experienced chronic relational trauma grew up hearing something very different, even if it was never said out loud: "You're not enough. You're not smart. You're not good." For that client, positive cognitions don't rush in when space opens up because they were never fully formed in the first place.

Imagine positive cognitions as people. For someone with a secure attachment history and only acute trauma, those positive cognitions are full-grown adults - capable, confident, ready to sprint toward the void and take up residence. For someone with chronic trauma who has built some positive experiences in adulthood, those cognitions might exist, but they're more like five-year-olds. They're there. They may even show up. But they're not as capable, not as fast, and there aren't as many of them.

This isn't a judgment… it's a clinical reality that shapes everything about how Phase 5 unfolds.

The Connection Between Phase 2 and Phase 5

For clients with chronic trauma, Phases 2 and 5 are deeply intertwined. The resourcing work done in preparation (the Safe Place, the resource figures, the internal anchors) becomes the raw material that Phase 5 draws on. Without that foundation in place, installation has little to work with.

For significant chronic trauma, a clinician who moves quickly through desensitization and then finds very little in Phase 5 hasn't done anything wrong in Phase 4 - they may just be hitting the reality that this client needs far more investment in Phases 2 and 5 than the basic protocol alone suggests.

Considering EMDR for chronic trauma? Book a free consultation with Cassandra →

Phase 5 Builds the Foundation for Future Resilience

Here's the bigger picture of what Phase 5 is doing, regardless of trauma type.

Phase 5 is building or reinforcing a foundation of resilience. It's setting the client up so that future experiences don't re-traumatize in the same way. For someone with acute trauma and a solid history, that foundation already exists; Phase 5 just repairs the section that the trauma damaged. For someone with chronic trauma, that foundation may never have been built in the first place. The therapy itself is constructing it.

That's a significant difference in scope. And it's why clinicians working with chronic trauma clients shouldn't expect Phase 5 to happen quickly or cleanly and shouldn't interpret a slow or difficult installation as a failure of Phase 4.

Don't Skip Phase 5

Like Phase 2 before it, Phase 5 is a phase that sometimes gets abbreviated or bypassed. My message is the same: don't.

Even as the research on bilateral stimulation in this phase continues to evolve, the process of helping a client identify, articulate, and strengthen a genuine positive belief about themselves is meaningful work. It's not optional. It's not a formality. For many clients, especially those with chronic trauma, it's some of the most important work that happens in the entire EMDR process.

What This Means If You're Considering EMDR

If you're a potential client, you may not need to understand every nuance of Phase 5. But it's worth knowing that EMDR isn't just about processing painful memories, it's also about actively building something more adaptive in their place.

If you've experienced chronic or relational trauma, this phase will likely require more time and more support than it does for someone addressing a single acute event. That's not a sign that something is wrong. It's a sign that your therapist is doing the work carefully.

Questions worth asking:

How do you approach Phase 5 for someone with a chronic trauma history?
What does it look like when a positive cognition isn't landing and what do you do about it?
How do Phases 2 and 5 connect in your practice?

Ready to start EMDR therapy at Seen Therapy Services? Book a free consultation →

Frequently Asked Questions About EMDR Phase 5

What is EMDR Phase 5 Installation?

Phase 5 is where the positive cognition identified in Phase 3 is linked to the now-desensitized memory and strengthened until the client genuinely believes it. The goal is not just intellectual agreement with a new belief, but a felt sense of its truth. This is measured using the Validity of Cognition (VOC) scale.

What is the VOC scale in EMDR?

The VOC (Validity of Cognition) scale runs from one to seven, where one means the positive cognition feels completely false and seven means it feels completely true. The goal of Phase 5 is for the client to reach a seven, meaning they fully believe the new positive cognition, not just think it.

What does "full evoke" mean in EMDR?

Full evoking means the client has reached a VOC of seven.They genuinely and fully believe the positive cognition connected to the processed memory. It indicates that new neural pathways have been built, not just that old distress has been cleared.

Why does Phase 5 look different for chronic trauma clients?

Clients with acute trauma typically have a reservoir of positive beliefs already in place from secure early experiences - those beliefs rush in to fill the space created by desensitization. Clients with chronic trauma, particularly relational trauma, often don't have that same reservoir. Positive cognitions have to be actively built, often in conjunction with the resourcing work of Phase 2, rather than simply reinforced.

Is bilateral stimulation still used in EMDR Phase 5?

Current research no longer supports bilateral stimulation in Phase 5 as strongly as it once did. However, the research doesn't indicate it causes harm. The recommendation is to continue using it until there is clear evidence that it should be discontinued. The process of installation itself, identifying and strengthening a positive cognition, remains valuable regardless of the bilateral component.

What happens if a positive cognition won't install?

Resistance in Phase 5 is often a sign that the positive cognition isn't actually true, or that there are closely associated memories within the same network that haven't yet been processed. A positive cognition that the nervous system can't accept may need to be refined. If the belief is too aspirational or simply inaccurate, the brain and body will push back, as they should.

Related Resources

Hello. Hello. Hello, friends, welcome to the podcast where we simplify everything about mental health. Just kidding. But here's what we are gonna do. We're gonna sit down together a licensed mental health professional, that's me and a regular old Joe as my husband Garth would describe himself. We're gonna talk about the nitty gritty of EMDR, some nervous system mapping, how couples can help each other heal. What's healthy parenting actually look like? Maybe a little bit of good old banter mixed in. All with the goal of making mental health a little bit simpler for you. Quick note, because my lawyer says that I have to, I'm a therapist, but not your therapist. Unless I am. Even if I am. This is still just a podcast. Okay, now have a good listen. Hello, friends. Thank you for joining us. We are on phase five of our eight-part, nine-part, I guess, because we had an introductory episode- Hmm ... nine-part series on what are the eight phases of EMDR. As always, I am joined by Garth. Hey, everybody. Today, we are talking about phase five. In phase five, we are looking at installation. What are we installing? We are installing something better. Hmm. More adaptive thinking. Yeah. So we're gonna chat a little bit about how we do phase five, how research behind phase five has changed since I was a newbie EMDR clinician up until now. Mm-hmm. How that informs what we actually do with phase five and what our kind of goals are for our clients as they move through phase five. Okay. Okay. Before we do that, sir- Yeah ... bant us away. What are your feelings on street food? Just, like, street food in general? Yeah. Do you like it? I mean, I think in general, yes. Yeah. Yeah. Okay. Shortest bant ever- No, but, but like- ... 'cause I, I know your answer, yes- Yeah, no, come on ... you like street food. Come on, come on. Give us more. What, what's your, what's your favorite s- street food, then? Well, I mean, we're not in larger metropolitan areas often, which I feel like you have to be in order to really get, like, a good feel- Yeah, but like- ... for street food ... food trucks and stuff- Sure ... would, I would, I would call a food truck a street food situation. Well, one I think that people that are running food trucks- Mm-hmm ... not always, but often, like, they're hustling. Mm-hmm, yeah. So they, like, want to put out a really good product every single time. Mm-hmm, yeah. Not all of them, but a lot of them, I think, are, like, trying to build to a brick and mortar. Mm-hmm. Right? And so they're, like, building their customer base, and- Mm-hmm ... so I mean, that's a win- Yeah ... for us as the customer, right? Yeah. The, like, and not that larger local restaurants do this, but they can afford to put out, like, a bad couple meals. That's not their goal- Mm. Right ... but they can, whereas a food truck is like, I think, like, at least my mindset would be, like, we have got to get this right every time- Mm-hmm um, to build a good customer base and, like, move towards what we want. Yeah. My favorite street food, we've talked about this on here Almighty Sandwich Shop used to have- Mm-hmm, mm-hmm ... a food truck. So you just like a sandwich? That's your favorite street food, is a sandwich? He- I feel judgment in that from you No, I was, no, I wasn't judging. I wasn't judging. Mm-mm. No. No judgment. But yes. Just that's, that's true. That's accurate though, right? Yeah. Your favorite street food is a sandwich. I think so. What is yours? Kebabs. Yeah. I love a kebab truck. Yeah? Man, a kebab truck. Meat on a stick. It's hard- You got me. You got me ... to beat- I'm hooked hard to beat meat on a stick. Yep. You know, it's hard to beat your kebabs. When we- I make them pretty good here at home, but I don't make them the... I don't know, the, I don't, I don't know how they do it. I need to, to find, like, a, a Lebanese man or something and learn his ancient ways of the kebab making. See, I've never had a kebab better than your kebab. Really? Yeah. Mine aren't... I guess it depends on what you think of as a kebab. M- my understanding is that in some parts of the world, a kebab is actually like a sandwich. It's like a sliced meat sandwich. Mm-hmm. So we've seen, like, 'cause we watch a decent amount of food shows because- Mm-hmm ... you enjoy them, and I enjoy you enjoying them. And I enjoy, like, learning about a culture- Mm-hmm ... through food. Mm-hmm. Yeah. And, like, just, like, big hunks of meat- Mm-hmm ... that they are- Yeah, slicing off ... slicing off. So that's one form of a kebab. Okay. And then another is, like, like I do them here on the grill- Right ... where I marinate some meat and chunk it up and stick it on a skewer with some veggies and stuff and grill it. See, I feel like if we went, like, no matter where we went in the world, right, and when you travel, like, you're introduced to different bacteria and stuff in food that you're not- Mm-hmm ... that your gut biome's not used to. I feel like if we were on a street somewhere and we saw a huge chunk of meat hanging in the air that an old man was slicing meat off, y- you would be like, "I don't care what happens to me over the next- Yeah 48 hours, I'm eating that meat." Yep ... and that would not be worth it to me. Well, it would be to me. So I feel like your passion for street food- Yep ... is o- obviously out, outdone by mine, but- Yeah. I would love to go to a place sometime that has just, like, a crazy ethnically diverse street food section- Yeah and just go and, like, completely gorge myself on varieties of different things. You'll have to research that a little bit. Yeah, yeah. That would be, who has the most diverse street food scene? Yeah. Like, what city- Yeah ... in the United States? Yeah. I mean, I'm sure it's New York. I don't know. Look into it. I think it's gotta be New York I'll look into it, but- We'll circle- pretty sure it's New York We'll circle back. Okay. We should try to start doing some circle backs on here. And- Weren't we gonna circle back on something? In the last episode, we said we were gonna circle back on puffer fish, and I did not do a Google deep dive into puffer fish. It's a memory from when I was five. It happened. I am going to assume that it was something different, and my little five-year-old brain remembers it as a puffer fish, until pictures would prove otherwise- Mm-hmm ... because I do not wanna take our kids to the beach and be worried about puffer fish. Yeah. So yeah. Okay. Didn't do a Google deep dive. Don't need to worry about something that I don't need to worry about. Decided to keep the blinders on. Keep the blinders- ... on. Sometimes you know too much. I think often- Yeah ... we know too much. Yeah. We need to know less. Yeah. Right? Yeah. Because, like, nothing happened. Everything was okay. Mm-hmm. And likely if my kids saw one, it would be fine too. Mm-hmm. Right? Anyway, all right. Moving on to our topic of the day, Phase 5 EMDR installation. You ready for it? Let's install some carpet. I don't know. Let's install some stuff. Yeah. Let's do it. Okay, so we are taking the positive cognition from Phase 3. We're linking it to the now neutral memory because remember, we are supposed to have established dual awareness, and the individual is supposed to be able to acknowledge that this event is no longer threatening to them because it's not happening in the present, and we are strengthening this memory until it gets up to the point where the client can say the validity of this cognition is at a seven on a zero to seven-point scale. Okay. Now, again, when we're a brand-new clinician that's just walking through the basic protocol, I would really encourage you, get these numbers. Get the standard units of distress from zero to 10. Get the validity of cognition from zero to seven. As we move through and advance in our career, oftentimes people do not check in for specific numbers anymore. They are looking for indicators that the client has- Mm-hmm ... reached that, I think I said recently on here that a colleague was talking about working with some new clinicians who had said, like, they full evoked which would mean, like- Oh ... their validity of cognition- Oh. ... got up to a seven. So we are looking for indicators that show us that a client has full evoked, that they truly believe not just think, but believe this new positive cognition. We are working to build new neural pathways not just clearing out old ones. Now, here's where this gets complicated is whenever we're talking about chronic trauma- Mm-hmm ... we can really work to desensitize one memory that was holding up a negative cognition, but there are often you know, 10 others- Right that are holding up that same negative cognition. Now, the cool thing about EMDR is if we have 10 memories that are holding up one negative cognition, it's not this simple, right? But if we could look at it as 10 memories holding up one negative cognition, it would be really atypical to need to go through and desensitize each of those 10 memories. Okay. Usually if you can take out, like, three to four- Mm-hmm ... key memories, then the rest of the memories also start to- Lose their hold. Lose hold. Mm-hmm. I was gonna say lose strength. Yeah. Yeah. Yeah. And you start to kind of vicariously, like, desensitize them- Mm-hmm ... which is really cool. But I will tell clinicians, like, if you cannot get someone to full evoke- Yeah On a memory, being considerate of, is it because there is another memory that's really closely associated- Right ... to this one that's within that memory network, and there may need to be some, like, looping- Okay ... where we come back and, and try again to install this memory. So just like we did in the last episode I'm gonna go back to EMDR Easy- Okay the material that I give new clinicians when they first start in EMDR, and we're just gonna walk through what phase five says. When you bring up that original incident, what does... I'm sorry, I misspoke. When you bring up that original incident, does what you wanted to believe about it- Okay ... the positive cognition, "I am safe," or, "I can keep myself safe," still fit? Mm-hmm. Or is there something better? Think about the original incident and those words, "I am safe, I can keep myself safe." Okay. From one being completely false to seven completely true, how do they feel now? We're assuming that the client says It's a seven, it feels completely true. It- And then- Is there a reason it's a seven, not a 10? I think they were trying to differentiate between s- The 10 and the seven ... standard unit of distress is at 10. Gotcha. Okay. Sorry, that was just stuck in my head. No, that's okay. Yeah. I, I, I would assume that, yeah, they were just trying to- Yeah ... differentiate the two measures. To think about that original incident and those words "I feel safe," or, "I can keep myself safe and follow my fingers." And we're providing slow bilateral stimulation. We're trying to install this new cognition. Mm-hmm. Again, this is straightforward. Like most things with acute trauma, it is not as straightforward with chronic trauma. Here's how things have changed over the years since I was a newbie EMDR clinician- Okay up, up until now. When I was a newbie EMDR clinician, this was, and it still is, part of the basic protocol, and it was taught as having, I don't know, like just as much research behind it as phase four. Mm-hmm. But the, this was held up by research. Phase five is not as held up by research anymore. Okay. And when I say phase five, providing bilateral stimulation in phase five- Gotcha. Okay ... is not as held up by research anymore. Mm-hmm. And I've talked about this briefly before. But what I want to say about it is we're not going to cause harm by providing bilateral stimulation in phase five. Yeah, yeah. Until we hear a definitive, "This is no longer needed"- Mm-hmm ... in phase five, let's keep doing- Yeah, exactly ... bilateral in phase five. I think that phase five is helpful. It's just a question of whether or not bilateral stimulation during phase five- Mm-hmm ... is actually helpful. I think the process of identifying with a client, what do I want to believe about myself now? What do I want- Mm-hmm ... to believe about the world around me now? I, I, I think that's helpful. Yeah. Especially because this step for folks that have experienced and are addressing like truly acute trauma- Mm-hmm ... it's just, it's quick. It almost feels like unnecessary because they just have so many other- Positive cognitions- Mm-hmm that just, like, rush in and, like- Yeah ... floop- Yeah ... take up space here- Right ... as soon as they're able to. Yeah. As soon as that phase four desensitization has happened. With folks that have experienced chronic trauma, it doesn't usually look like that. Mm-hmm. It's not like, "Oh, there's this void. I have all these other positive thoughts to fill it." Yeah. "Let's, zhoop, get them right in there." Yeah. It's more like, "Oh, there's this void. We need to work to fill this now." Yeah. Like, phase- So you're creating those things to fill it with- Yeah ... a little bit. If we, and we're not going to today, but if we really... Like, phase five is connected really to phase two- Mm-hmm closely. We got a ping-pong kind of, like, back and forth when we're working with someone that it's experienced chronic trauma. Mm-hmm. When someone comes in, they haven't experienced chronic trauma, they've experienced an acute trauma, and that's what you're addressing, like I said, they have so many positive cognitions- Mm-hmm ... that phase five almost just does itself, and those positive cognitions just rush in to fill this void. Yeah. Phase five, for someone with chronic trauma, it's almost, it's like own entity. Okay. Like, you're gonna have to- Well, 'cause you're- ... in phase two and phase five- Mm-hmm ... throw a lot of work at somebody who's experienced chronic trauma. Yeah. Go ahead. I'm sorry. Which makes sense, because for an acute trauma, which let's, let's say is a car accident- Sure phase five is something about, like, "I'm not going to get into a car accident the next time I drive." Is it that simple? Is that the- No, no, no, 'cause- Could you- the positive cognition... Okay. Driving is safe. So, like, a- Or- But that's not even true, right? So- Yeah. It's important that when we're working on negative cognitions and positive cognitions- Mm-hmm that we make sure they are false and true. Okay. So a negative cognition needs to be something that's false. A positive cognition needs to be something that's reasonably true. Okay. Okay, so for someone with a car acci- a car accident exam- for example, I will never, let's say that the their kiddos were in the vehicle with them. Yeah. I will never be able to keep my kids safe again. That would be a- That would be a negative cognition ... that would be a likely negative cognition- Yeah ... that would show up for them. Yeah. Right? A positive cognition might be "I always work hard to make my kids safe." Gotcha. Or "I will walk through all of the hard things- Mm-hmm with my kids," right? Like- Mm-hmm ... or, Y- yeah, like I maybe even we are we have bought a, a vehicle with a 9.2 safety rating. I'm making things- Mm-hmm ... up at this point. Right. Something, sometimes it's something that concrete, right? Yeah, yeah. I- so a negative cognition has to be false, and a positive cognition- Okay has to be true. And to say something like, "I'll never be in a car accident again," or, "I'll always be able to keep my kids safe"- Mm-hmm ... those things aren't true. Yeah. Okay. Does that make sense? Mm-hmm. So that- So then someone with chronic trauma has a ton of positive cognitions that they have to fill that void with, right? The goal is to, to have multiple, or is it to have one that is strong enough to fill that void? That's confusing me a little bit, but I wanna rewind before- Okay ... we address that because I'm glad that you brought up this issue with positive cognitions. Mm-hmm. So I just wanna leave it at if you're having a hard time accepting a positive cognition as a client- Uh-huh or installing a positive cognition as a clinician, it might be because that positive cognition is not actually true. Okay. So I have, in, like when I was a newbie EMDR clinician, I would see resistance from clients sometimes because I had made an error, and I was allowing them to try to adopt a cognition that wasn't true, like, "I will always be safe." Hmm. Yeah. And their brains and bodies kind of like pushed back on that, as they should, because that's just not true. And that's- You're going to be unsafe again. Even if they're, they're trying, like cog- cog- cognitively they're trying to do it- Right, they're trying ... but their body's like, "No, you can't always be safe." Yeah. "What are you doing?" Yeah. Yeah. Like, "Mm, uh-uh." Yeah. Like a- and I tell people, like, "That's good." Like, "That's protective," right? No, for sure. Yeah. Okay, so help me understand this, like void and- So I guess what... Well, so if that... Hmm. For an acute trauma EMDR client- Yeah ... their positive cognitions in, in this step, do they typically need as much work as a chronic trauma- No client? No. Okay. They, they've got, like tons of positive cognitions- Right ... from positive experiences- Right ... they have- Mm-hmm ... just ready to rush the door. Perfect. So can you elaborate on that difference for someone with chronic trauma? So in our culture, chronic trauma is often chronic relational trauma. Mm-hmm Um, because we live in, thank God, a relatively safe place. Mm-hmm. Right? And but our culture is becoming more and more, like, one family home isolated. Mm-hmm. And so if parents are not providing for the emotional needs of their children, it's hard for other people to step up and stand in the gap of those emotional needs. Right. Okay. I say all that to say, for someone who's experienced an acute trauma and does not have a chronic trauma history, they likely had, then, a pretty solid childhood with pretty secure attachments. Mm-hmm. So they had people in their corner saying things constantly like, "You are capable. You are smart. We are here for you. We will help you." A- all of those narratives are just s- sitting eagerly- Mm-hmm ... next to the void of this experience- Yeah ... this trauma experience, ready to jump in. Yeah. If someone comes to me and they've experienced chronic trauma, it is likely relational trauma. Yeah. Someone somewhere else in the world could experience chronic trauma- Right, but we're not having lion attacks at any given point- Well, or even- that might cause some chronic trauma ... even, like, war-torn countries- Y- exactly. We're not in war ... but there's a strong community that has not caused trauma. Mm-hmm. Does that make sense? Yeah. Other people, there's been human trauma- Mm-hmm ... like human on human, but there is this community of, like, 50 people who have never hurt me and think I'm wonderful and speak- Yeah wonderful things over me, right? In our culture, chronic trauma is, m- I mean, I, I've not seen data on it, but, like, in my- Almost exclusively Yes. Almost exclusively relational trauma. Yeah. And so I'm dealing with an individual who has just desensitized this experience and now needs to attach a positive cognition to it, but their formative years were spent hearing things like, even if they weren't verbalized- Mm-hmm um, "You're not enough." How am I not enough and then I keep myself safe? Right. Right? Mm-hmm. Like, I can't keep myself safe if I'm not enough. Mm-hmm. Right? "You're not very smart. You're not good. You're not..." You know, et cetera, et cetera, et cetera. Yeah. So they are primed to not have these positive cognitions that are just ready and waiting- Yeah at the door. Yeah. Even if they've had more positive adulthoods, it's like, so the visual I'm getting in my mind right now- Mm-hmm ... is these cognitions are like I'm getting they're not, they're, they're people-ish. Th- they're these like, these little people, and if you had positive cognitions enforced for you as a three-year-old- Mm-hmm those cognitions are like adults now. Mm-hmm. Does that make sense? Yeah. And so s- for somebody with acute trauma, they've got all these full-grown positive cognitions- Mm-hmm ... ready to just sprint towards the void- Yep ... of this memory. They know what they're doing. They know what they're doing. They, yeah. They're ready to take it. Yeah. And then y- let's say that in another instance, I have a client who has a solid ad- adulthood now with, like solid relationships- Mm-hmm ... with their, with their spouse- Yeah ... with friends. But they're... So they have some positive cognitions, but they're like little five-year-old cognitions. Yeah. It's great that they're there- Mm-hmm ... but they're not as mature. They're, they're gonna run in. They don't make as good choices. Well- You know? ... I don't know that we wanna get too in the weeds of the... Yeah. But does that- Yeah ... is that making more sense? Yeah. They're not as capable of managing that void. And there's not as many of them. Yeah. They're newbies. Mm-hmm. Yep. They may not come as quickly. Right. They may be a little bit more apprehensive. Mm-hmm. So yeah, the, the difference... But all of EMDR looks vastly different- Yeah ... for somebody- For sure ... with chronic trauma- Yep ... and somebody with acute trauma. Okay. But phase five is, is not an exception. It looks, it looks very, very different. Yeah. And like I said, phase five for somebody with pretty significant chronic trauma- Mm-hmm ... it's phase two and phase five are gonna need to be really supported, like really, really supported by the clinician- Mm-hmm um, for somebody that has experienced chronic trauma. Yeah. They're not just gonna boop- Right ... happen. Yeah. And I think that is a misconception for people first leaving basic training, is like, well, you know, their distress level went from nine to one and I did go ahead and move on to phase five. But, like they just, there wasn't- Mm-hmm really anything there. And it's like, for somebody with chronic trauma, there's just- Yeah ... there's a lot of work to do. Yeah. I don't know that I can- Yeah ... emphasize that enough. What other questions do we have? I'm gonna look through my notes- That was- ... and make sure that I've covered everything that I wanted to. I think that was about the only one that I had. It sounds like, yeah. So phase five is important because we are creating, We're creating a foundation for future resilience, right? Mm-hmm. Like we were setting up to hopefully not experience re-traumatization. Mm-hmm. Right? And when we use those words, a foundation for resilience, I think it really probably does highlight somebody with acute trauma- Mm-hmm that has not had chronic childhood trauma already has that foundation. Yeah. So we're really just taking a piece of that foundation and putting it in the void or the hole of this trauma. Yeah. Whereas somebody with chronic trauma, we are actively creating this foundation in therapy. Yeah. That foundation of resiliency did not exist maybe before- Mm-hmm they came into therapy, or it was a very thin foundation and we're needing to- Right ... reinforce it. Yeah. So again, just vastly, vastly different for folks that are taking an acute approach versus folks that are coming in with developmental stuff or, I'm sorry, with chronic stuff. Okay. This is another phase that sometimes gets skipped. Do not skip this phase. Obviously again, research is indicating more and more that maybe the bilateral is not necessarily, especially if you're a new clinician, stick with it- Yeah ... until we're told definitively not to. It's not causing any harm, so move forward with it. I do like that, that visual, and I wanna wrap it up and, and leave with that visual, and that is that, This sets a foundation of resiliency. If someone is coming in and they're addressing an acute trauma, we're really just extending the foundation- Mm-hmm. Yeah ... over the hole that this trauma created. Yeah. If someone is coming in and they've experienced chronic trauma, we are actively building up that foundation. Mm-hmm. When you're, when you're addressing chronic trauma with EMDR I- I'll, I'll even generalize. When you're addressing chronic trauma with trauma therapy- Mm-hmm ... you're doing really five different things at once. Mm-hmm. And you have to, and one of the things that you're doing in this phase is you're helping to create a foundation that can cover the hole- Support. Yeah ... yeah, that, that this trauma has, has left. There wasn't a foundation there before. Yeah. Whereas with acute trauma, somebody's already coming in with a foundation. Yeah. There's a bird behind me, isn't there? Mm-hmm. We got a cute little cardinal that's decided to join the podcast. I could tell Garth was distracted by our little... No, I wasn't. We, we've got a little bird feeder above, above my head, and he's come to join us. Well, folks, thank you so much. We always appreciate you having a listen. Again, if you have a question, please feel free to email us at admin@seentherapy.org. Share with a friend. We will be back next week for phase six- Phase six ... of our eight phases. Thank you so much. Bye-bye. Bye. Well, that's all folks. Please see our show notes for ways to connect with us or go give us a follow on Instagram. 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