EMDR Target Sequence & Memory Reprocessing 3 — Questions and Answers
Question 1: When a client's SUD does not decrease after multiple sets of BLS, this is referred to as:
- A looping response
- A blocked or plateau response (Correct answer)
- A somatic bridge
- A dissociative episode
Correct answer: A blocked or plateau response
A blocked or plateau response occurs when SUD fails to decrease across multiple BLS sets, signaling the need for a cognitive interweave or another intervention.
Question 2: The 'Cognitive Interweave' strategy is BEST used when:
- The client requests a break from bilateral stimulation
- The SUD drops below 2 and installation can begin
- Processing is blocked, looping, or time is running short (Correct answer)
- The therapist wants to introduce a new memory to process
Correct answer: Processing is blocked, looping, or time is running short
Cognitive interweaves are therapist-initiated statements or questions used when the client is blocked, looping, or when the session is nearing its end and processing must move forward.
Question 3: In EMDR, which component of the target is associated with where trauma is held in the body?
- Negative cognition
- Image
- Body sensation (Correct answer)
- Emotion
Correct answer: Body sensation
Body sensation refers to where the client physically feels the disturbance and is a key element of the EMDR target assessment alongside image, cognition, and emotion.
Question 4: A client processes a car accident memory but during Phase 3 reports multiple equally vivid images from the event. The therapist should:
- Pick the most recent image to start
- Ask the client to choose the image that feels most disturbing (Correct answer)
- Process all images simultaneously during BLS
- Skip the image component and focus only on the negative cognition
Correct answer: Ask the client to choose the image that feels most disturbing
When multiple images are present, the client is asked to select the image that best represents the worst moment or feels most disturbing to use as the target anchor.
Question 5: Which type of memory network does EMDR's Adaptive Information Processing (AIP) model posit is formed when trauma is inadequately processed?
- Episodic declarative memory stored in the prefrontal cortex
- Isolated maladaptive memory networks stored in a state-dependent form (Correct answer)
- Procedural motor memory loops in the cerebellum
- Semantic memory encoded in the left temporal lobe
Correct answer: Isolated maladaptive memory networks stored in a state-dependent form
The AIP model holds that unprocessed trauma creates isolated maladaptive memory networks that retain disturbing affect, sensation, and beliefs in a state-dependent, dysfunctionally stored form.
Question 6: When selecting the initial target in EMDR for a client presenting with a specific phobia, the protocol recommends beginning with:
- The most recent triggering event
- The first time the client encountered the feared object
- The worst/most disturbing incident related to the phobia (Correct answer)
- The client's strongest positive belief about managing the fear
Correct answer: The worst/most disturbing incident related to the phobia
Standard EMDR phobia protocol typically begins with the worst incident that conditioned the fear response, as it often holds the most charge driving the phobia.
Question 7: During reprocessing, a client suddenly reports the original disturbance feels completely different — 'like it happened to someone else.' This shift MOST likely indicates:
- The client is dissociating and needs grounding
- Successful adaptive resolution and perspective shift (Correct answer)
- The client has suppressed rather than processed the memory
- A need to immediately install the positive cognition
Correct answer: Successful adaptive resolution and perspective shift
A sense of emotional distance or perspective shift ('like it happened to someone else') is a hallmark indicator of adaptive resolution in EMDR reprocessing.
EMDR Target Sequence & Memory Reprocessing 3
When a client's SUD does not decrease after multiple sets of BLS, this is referred to as: