EMDR and Aphantasia: Adapting Preparation Without Visualization
EMDR therapy includes a number of preparation strategies that rely on visualization, such as safe place, container exercises, and resource development imagery. While these techniques can be effective for many clients, they do not work the same way for everyone.
Some clients have difficulty forming mental images, and others are unable to visualize at all. This can significantly impact how they experience EMDR preparation and may lead clinicians to question whether the client is struggling with engagement, dissociation, or readiness.
In reality, this may reflect aphantasia, a variation in how individuals experience mental imagery - and it is more common than many clinicians realize.
When preparation strategies that rely on visualization are not working, the next step often depends on how the client is responding to those interventions:
• If a client reports that imagery feels blank, inaccessible, or unclear → the next step is determining whether this reflects a difference in how they process information rather than resistance or lack of engagement
• If clients can describe experiences conceptually but do not form visual images → the next step is adapting preparation strategies to match how they naturally access memory through somatic, emotional, or cognitive channels
• If preparation feels ineffective or frustrating despite effort → the next step is identifying what is not connecting and adjusting the method rather than assuming the client is not ready for EMDR
What Is Aphantasia?
Aphantasia refers to the inability to voluntarily generate mental imagery. Individuals with aphantasia may understand concepts such as a “safe place,” but they do not experience a visual image when asked to imagine one. Instead, they may think in words, concepts, or sensory impressions that are not visual in nature. For example, a client might know what a beach is like or describe it accurately, but they do not “see” it in their mind.
Aphantasia exists on a spectrum. Some individuals experience little to no imagery, while others may have dim or vague images. At the other end of the spectrum is hyperphantasia, where imagery is extremely vivid. Current estimates suggest that less than 1% of the population experiences profound aphantasia, while approximately 2–6% experience imagery that is vague or dim. As awareness increases, these estimates may continue to evolve.
For additional information and self-assessment tools, the Aphantasia Network (aphantasia.com) provides resources such as the Vividness of Visual Imagery Questionnaire.
Why This Matters in EMDR Preparation
Many EMDR preparation strategies assume that clients can create and engage with internal images. When a client cannot visualize, these interventions may feel confusing, ineffective, or even frustrating.
Clients may report:
“I don’t see anything”
“It just feels blank”
“I don’t think I’m doing this right”
Without recognizing aphantasia, clinicians may misinterpret this as resistance, avoidance, or lack of readiness. In reality, the issue is often not whether the client can engage in preparation, but how preparation needs to be adapted. When preparation strategies are not working as expected, it can be helpful to step back and identify what specifically is not connecting for the client.
A Brief Clinical Note
This is something I also experience personally—I do not visualize. Rather than seeing images, I tend to access experiences through how they feel in my body or through conceptual understanding. And I can still do EMDR effectively without relying on visual imagery.
This is important to emphasize: if a client cannot visualize, it does not mean they cannot engage in EMDR. It simply means the approach to preparation and processing needs to be adjusted.
Signs a Client May Struggle With Visualization
Clients are not always aware that their experience differs from others, so they may not initially identify this as a difficulty.
Some indicators include:
difficulty describing visual details in imagery exercises
relying on verbal or conceptual descriptions instead of images
reporting that imagery feels blank or inaccessible
Noticing these patterns early can help clinicians shift their approach before frustration develops.
Adapting EMDR Preparation Without Visualization
When a client cannot visualize, the pathway to preparing your client for reprocessing changes.
EMDR does not require visualization. What we are actually doing is helping the client activate and process memory networks in the way their brain has stored the experience. For some clients, that will be visual. For others, it may be primarily emotional, cognitive, or somatic.
As Shapiro notes, when you ask a client to think of an incident, they will access their own subjective experience of that memory. That is why EMDR includes multiple channels: thoughts, beliefs, emotions, and physical sensations, rather than relying only on imagery.
If a client is not visually oriented, they are not necessarily encoding or retrieving memories visually. That is not a limitation, it is simply a difference in how their brain processes information.
If a client says, “I don’t get a picture,” that is okay. A more helpful question is: “What do you notice?”
If you’re finding that preparation strategies are not working as expected, especially when clients are unable to visualize or access imagery-based resources, having a structured way to identify what is not connecting can help you make clearer clinical decisions. The EMDR Phase 2 Problem-Solving & Readiness Tool Adaptations for Resources provides practical guidance for adapting preparation strategies by helping you evaluate whether resources are accessible under activation, identify barriers such as difficulty with imagery, and shift approaches to better match how the client processes experience.
→ EMDR Phase 2 Problem-Solving & Readiness Tool Adaptations for Resources
From there, if you want a more concise version you can reference quickly during sessions, the Quick Guide: EMDR Phase 2 Troubleshooting & Adaptations provides a streamlined version of these same decision points so you can quickly identify whether the difficulty reflects intrusion, disconnection, or parts-based interference and apply targeted adaptations in real time.
→ Quick Guide: EMDR Phase 2 Troubleshooting & Adaptations
Expanding Beyond Visual Resourcing
In practice, clinicians often adapt resourcing in more concrete and sensory-based ways. Clients may:
describe a place rather than visualize it
draw a safe place or container
bring in pictures or videos that evoke a sense of calm
bring a physical object to session that represents safety or containment
use a literal container (e.g., a box or mason jar) during exercises
For clients participating in telehealth, pets can also be incorporated as part of grounding and resourcing. The goal is not to create a visual image. It is to help the client access a felt sense of safety, stability, or regulation.
Somatic and Sensory-Based Access
Many clients with aphantasia naturally access experiences through the body. Instead of asking what they see, clinicians can ask:
“What do you notice in your body?”
“What feels different when you are more grounded?”
These clients may rely more heavily on:
body sensations
emotional shifts
physical cues of safety or activation
In practice, this often means spending more time strengthening somatic awareness and using the body as an anchor during preparation. You may also find that the body scan phase becomes particularly important, as memory networks may be accessed more physiologically.
Rethinking “Safe Place” and Container Exercises
When clients cannot visualize, traditional scripts for safe place or container exercises often need to be modified rather than abandoned.
Instead of asking clients to “see” a place, clinicians might ask what helps them feel even slightly more settled, what they notice when they feel more grounded, or what kind of environment feels calming or steady to them. Some clients may be able to describe a place even if they cannot picture it. Others may benefit from drawing it, bringing in images or videos, or using sensory cues to connect to the experience.
Containment can also be adapted in concrete ways. A client might describe what it means to set something aside, use language or intention to create distance, or use physical gestures to represent putting something away. Some clients may prefer to draw a container, while others benefit from bringing in a physical object—such as a box or jar—to serve as a literal representation during the exercise.
These adaptations preserve the purpose of the intervention while changing the method. The focus remains on helping the client access regulation and a sense of control in a way that fits how they process experience.
Clinical Decision-Making
When working with aphantasia, the key clinical question is not whether a client can engage in EMDR, but whether preparation has been adapted effectively.
If clients are able to:
regulate emotional activation
remain oriented to the present
access stabilization strategies
then they may be ready to move forward, even without visualization-based skills. If not, additional preparation may be needed — but the focus should remain on fit, not forcing a specific technique.
Conclusion
Aphantasia highlights an important principle in EMDR therapy: effective preparation is not about using specific techniques, but about achieving specific outcomes. When clinicians adapt preparation strategies to match how a client processes information - whether through sensation, cognition, or external supports - they create a foundation for safe and effective trauma processing. Visualization is one pathway, but it is not the only one. Flexibility in preparation allows EMDR therapy to be accessible to a wider range of clients, including those who experience the world without mental imagery.
This is one part of a broader EMDR treatment process. If you want to see how preparation, stabilization, readiness, and processing fit together across EMDR phases, you can start here:
→ EMDR Training & Treatment Hub
In practice, preparation decisions often come back to how well the approach fits the way a client processes experience. When visualization is not accessible, the focus shifts to identifying how the client naturally engages with memory through sensation, emotion, or cognition, and adapting preparation strategies accordingly. When those adaptations allow clients to access regulation, remain oriented, and use stabilization strategies under activation, EMDR can move forward effectively without relying on imagery.
If you’re looking for a more in-depth, step-by-step approach to adapting preparation strategies, evaluating readiness, and making treatment planning decisions across different clinical presentations, the EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing course walks through how to build and adjust preparation in practice so you can apply these decisions more consistently over time while earning continuing education credit.
→ EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing
Research References
Zeman, A. (2024). Aphantasia and hyperphantasia: Exploring imagery vividness extremes. Trends in Cognitive Sciences, 28(5), 467–480.https://doi.org/10.1016/j.tics.2024.02.007
