Historically EMDR has been a treatment that is used to treat trauma. Especially when a client has specific trauma symptoms like flashbacks, nightmares, intrusive thoughts. However case conceptualisation in EMDR can help us widen how we can use EMDR. As EMDR has developed, the evidence base has grown. There is now a lot of evidence how EMDR can be helpful with a number of presenting problems. Including using EMDR for anxiety. So please do read on if you want to find out more about how to use EMDR with anxiety.

It’s all about the case conceptualisation 

Shapiro developed her 3 pronged approach to EMDR. Looking at past, present and future. Please do read my blog about case conceptualisation to find out more about this. Click here to read that. So, we start with the middle prong. We would want to be thinking about how the current anxiety presents itself for our clients. It might be our clients have a current anxiety about going into social situations. They might have a health anxiety and be fearful that they are seriously ill. Clients may have a performance anxiety and for example be an elite athlete who struggles to perform in their sport. Our role as therapist is to get a good understanding about what the current anxiety is. We need to develop an understanding of what the triggers the anxiety. It helps to get an example of the most recent time it happened. It might also be helpful to think about what the ANTICIPATORY ANXIETY is for our clients. What are they scared of? What’s the worst thing that could happen around this anxiety? What is the doom scenario? 

This information would fill in the middle prong in our case conceptualisation. From this we can identify what we want to be different in the future. This will help to identify a future template that we could work on. (Want to read more about the difference between flashforwards and future templates, do read my blog post on it here).

So now we have developed an understanding of what’s in the present and future prong. We can begin to think about the past prong. This will all help us see how we can use EMDR for anxiety.

First, worst and most recent 

In thinking about the past prong when working with EMDR for anxiety we really want to identify in our treatment plan the FIRST, WORST and MOST RECENT experience of the current anxiety.

This may naturally have come into your awareness through your Phase 1 history taking but equally it may still be unclear. Often it can be helpful to do a FLOATBACK from a recent experience of the anxiety to see where that takes you.

We work on the FIRST memory even if it might not be a high SUD rating because this is where the seed was planted and the foundation for the current anxiety. We work on the WORST experience because this is when the anxiety generalised out and became a significant problem for our clients. And we work on the MOST RECENT as it is a representation of how the anxiety is a problem for our clients now. 

What other memories to work on?

When we have worked on the past prong we can then focus on the present prong and process current triggers if they are still a problem. We might also do a flashforward and really lean into the anticipatory anxiety that our clients feel. These can be so powerful to do with our clients.

One of the things I love in working with anxiety is when we get to the future prong we can look at doing a future template. We can lay down a realistic blueprint of how our clients want to cope in the future when facing their anxiety. How does our client want to cope with social situations, feeling unwell, performing in their sport, or whatever their anxiety was. 

EMDR is so helpful in working with anxiety.

So yes, EMDR with anxiety is a great way to work. I love working with anxiety with EMDR because there is so much variety in the type of memories you work on and it’s great to do future templates with clients. I love to see clients step into a positive energy about things that they previously thought were not possible. If you want to dive deeper I have an on-demand webinar on this topic that’s available, click here.

Who am I?

Hi, my name is Dr Hannah Bryan and I am a Chartered Clinical Psychologist and a Europe Approved EMDR Consultant and Facilitator and trainee Trainer. In 2006 I trained as an EMDR therapist. I have been an EMDR Consultant since 2014 and an EMDR Facilitator since 2019. 

I am extremely passionate about helping clinicians improve their knowledge and skills in EMDR so that they improve their confidence and practice it more with their clients and more clients recover and heal from the traumas they have experienced.

If you want to stay up to date with my tips and tricks in EMDR or any new services I develop join my email list. You can join by downloading my free Cognitive Interweaves cheat sheet here.

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