When EMDR Preparation Techniques Aren’t Working
EMDR preparation techniques such as Calm Place, Container, Resource Development and Installation (RDI), grounding, and orientation can look straightforward when they are taught. In clinical practice, clients may have difficulty creating the resource, staying connected to it, accessing it under stress, or maintaining present awareness while using it. Those responses give the clinician additional information about the client’s current preparation needs.
A client may become more activated during Calm Place, repeatedly lose material from the Container, feel nothing during RDI, struggle with imagery, or become less oriented as attention moves inward. Each presentation points toward a somewhat different clinical question. The task is to observe what happens during the exercise, identify the likely barrier, and adapt preparation accordingly.
What Should You Look At When an EMDR Preparation Technique Isn’t Working?
When a preparation exercise becomes difficult, start with what is happening during the exercise itself:
If Calm Place increases anxiety, grief, vigilance, or discomfort → Assess the client’s response to calm or safety and consider changing the resource, language, or degree of activation.
If the Container cannot hold disturbing material → Assess whether activation is exceeding the client’s current containment capacity and whether the Container needs to be modified or reinforced.
If RDI feels inaccessible or disconnected → Assess how the client accesses positive affect, internal resources, bodily experience, and adaptive information.
If imagery is vague or absent → Shift to other channels such as sensation, sound, words, movement, memory, objects, or other concrete representations.
If the client becomes flooded during grounding or resourcing → Reduce activation, increase orientation to the present, and adjust pacing.
If the client spaces out or loses track of the room → Assess dual attention and dissociation before increasing internal focus.
If a resource works in session but disappears under stress → Evaluate accessibility under activation and practice retrieving the resource under mild, tolerable disturbance.
These difficulties can overlap. A client who says, “I can't picture anything,” for example, may have an imagery difference, but another client using the same words may be disconnecting as activation increases. The observable difficulty is the beginning of the assessment.
Difficulty With Calm Place Can Tell You Something About the Client’s Experience of Calm
Some clients can identify a Calm Place quickly and experience a noticeable reduction in activation. Others find that the exercise evokes grief, vigilance, discomfort, or negative associations. A client may choose a location connected with painful experiences, feel uneasy as vigilance decreases, or have difficulty connecting a cue word with the resource.
The first clinical question is what changed when the client attempted the exercise. If a specific location brought up unwanted associations, choosing another location may resolve the difficulty. If the word “safe” creates discomfort, language such as calm, secure, neutral, steady, or another client-selected term may be easier to access. Some clients may do better with a neutral experience where nothing threatening is occurring.
A different pattern appears when calm itself produces activation. A client may relax briefly and then begin scanning for danger, anticipate that something bad will happen, or become uncomfortable as vigilance decreases. In clients with chronic hypervigilance or histories in which periods of calm were unreliable, reduced activation may itself feel unfamiliar or uncomfortable.
Repeatedly deepening Calm Place may reproduce the same response when this pattern is present. Preparation can shift toward tolerating brief periods of neutral or reduced activation, strengthening present orientation, or developing resources that the client can access without the same increase in vigilance.
Clinicians working with this presentation may also want to review When Preparation Needs More Time in EMDR for additional considerations when readiness develops gradually.
When the EMDR Container Exercise Doesn’t Hold
Container difficulties often show up in very concrete ways. The client may report that the Container opens on its own, material leaks out, there is too much to put inside, or opening it feels as though everything will emerge at once.
Those details can guide the adaptation. The Container can be strengthened with locks, barriers, guards, greater distance, or a structure that feels more secure to the client. Multiple containers can separate material by type, intensity, or time period. A small opening or valve can allow access to one piece of material at a time. The client may also imagine placing the Container farther away or having a supportive or protective figure help manage it.
The clinician also needs to observe whether the exercise changes the client's relationship to the disturbing material. Being able to describe an elaborate Container in session does not necessarily mean the client can use it when activated. The clinically useful question is whether the client can access containment when disturbing material begins to intrude. This becomes especially relevant when a resource appears successful in a quiet therapy session but cannot be retrieved during stress, trauma reminders, or between-session activation.
When RDI Feels Flat, Inaccessible, or Activating
Resource Development and Installation (RDI) depends on access to some representation of an adaptive quality or experience. A client may be able to identify the quality they need but struggle to locate an experience connected with it. Another client may describe a resource cognitively without noticing much emotional or somatic connection.
Clinicians can listen during assessment and ordinary session conversation for spontaneous examples of competence, connection, protection, persistence, or other adaptive experiences. Keeping track of these experiences gives the clinician material to return to when a client has difficulty generating a resource on demand.
External resources may also be easier to access. A nurturing figure, protector, mentor, relational resource, fictional character, spiritual figure, pet, or symbol can provide another route into the quality being developed. The clinician can then observe whether the client develops greater emotional or somatic access to that quality as the resource is strengthened.
Negative responses during RDI also deserve attention. Anxiety, confusion, emotional numbing, depersonalization, or discomfort with positive connection may indicate difficulty tolerating positive affect or relational connection. Leeds' Positive Affect Tolerance and Integration Protocol is one procedure clinicians with appropriate training may consider when positive emotional states or connection repeatedly evoke defensive responses (Leeds, 2022).
Difficulty With Imagery Does Not Automatically Mean the Resource Failed
Some clients do not form vivid mental images. Aphantasia is one example, although imagery also varies considerably among people who would not describe themselves as having aphantasia.
Preparation can use the representational channels that are available to the client. A resource might be experienced through body sensation, sound, words, movement, posture, memory, an object, a photograph, or a combination of these. RDI can similarly focus on whatever represents the desired quality for the client instead of requiring a vivid internal picture.
The same flexibility can be used with Calm Place and other preparation exercises. A client who cannot picture a beach may still know what ocean waves sound like, remember the temperature of the air, recognize how their shoulders feel when tension decreases, or use an actual photograph as an external anchor. For a fuller discussion of this presentation, see EMDR and Aphantasia: Adapting Preparation When Clients Cannot Visualize.
Grounding Difficulties Can Reflect Different Regulation Needs
A grounding exercise can also produce useful clinical observations. Some clients remain highly activated despite orienting to the room or noticing physical contact with the floor. Others become less connected as attention shifts toward internal sensations.
When activation is high, preparation may involve smaller amounts of contact with distress, greater distance from disturbing material, shorter periods of internal attention, slower pacing, and repeated orientation to the present. When the client becomes underactivated or disconnected, the clinician may increase environmental orientation, movement, concrete sensory information, or other present-focused input.
Repeated disconnection during grounding warrants additional assessment. Spacing out, depersonalization, derealization, memory disruption, or loss of orientation may indicate that the difficulty extends beyond finding a grounding exercise the client likes. The clinician may need additional information about the client’s dissociative symptoms and how those symptoms change during activation. For a closer examination of this area, see Assessing Dissociation Before EMDR Trauma Processing.
Dual Attention Difficulties Require a Different Response
Dual attention requires enough connection with internal material for therapeutic work while maintaining awareness of the present environment. A client can be emotionally distressed and remain oriented. Another client may appear quieter while becoming increasingly disconnected from the room, therapist, body, or current time.
Signs of unstable dual attention can include becoming absorbed in internal material, losing awareness of the therapist, difficulty answering orientation questions, derealization, depersonalization, or requiring repeated intervention to return to the present. Reorientation may include room scanning, environmental description, sensory grounding, direct orientation questions, or a structured procedure such as Knipe’s Constant Installation of Present Orientation and Safety (CIPOS) (Knipe, 2018).
If present orientation becomes significantly compromised, bilateral stimulation should stop while the clinician helps the client reestablish awareness of the current environment. Repeated difficulty maintaining dual attention may indicate a need for additional Phase 2 work. When dissociation has not been adequately evaluated, the pattern may also indicate a need to return to Phase 1 assessment before proceeding. For additional assessment considerations, see Dual Attention in EMDR: How to Assess It Before and During Trauma Processing.
Look at Accessibility Under Activation
A preparation technique can appear successful when the client is already regulated. Testing whether the resource remains available during mild, tolerable activation gives the clinician additional information about how accessible it may be when the client needs it.
This does not require introducing highly disturbing trauma material. A clinician might use a mild annoyance or another low-level activation and observe whether the client can access the resource, maintain present orientation, and return toward baseline afterward. If accessibility decreases, the resource may need additional practice, modification, or reinforcement before it is relied upon during greater activation.
Three questions can help organize the observation:
Can the client access the resource when activated?
Can the client maintain dual attention while using it?
Can the client reorient and reduce activation afterward?
A substantial change once mild activation is introduced gives the clinician information that may not have been visible while practicing the technique under low-stress conditions.
Match the Adaptation to the Difficulty You Are Seeing
Once the primary difficulty is clearer, the clinician can choose an adaptation based on what is happening during the exercise. A client whose Container cannot hold intrusive material may need changes to containment, while a client who disconnects during resourcing may need greater emphasis on present orientation and dual attention. Difficulty visualizing may call for another representational channel, while activation during positive resource work may require closer attention to how the client experiences positive affect or connection.
The Quick Guide: EMDR Phase 2 Troubleshooting & Adaptations is a condensed in-session reference for these decisions. It organizes common difficulties with Calm Place, Container, disconnection, dual attention, and processing or access differences alongside adaptation options that clinicians can review quickly during clinical work.
→ Quick Guide: EMDR Phase 2 Troubleshooting & Adaptations
When You Need the Full Problem-Solving and Readiness Tool
The Quick Guide is drawn from the larger EMDR Phase 2 Problem-Solving & Readiness Tool. The full tool includes the same troubleshooting and adaptation guidance, along with additional sections for examining resource strength, accessibility under activation, barriers to resource use, dissociation patterns, dual attention, and readiness for Phase 4.
The full version may be useful when a preparation difficulty continues across sessions or when similar problems appear with several resources. It gives clinicians space to document what has been attempted, observe how resource access changes under activation, identify recurring barriers, and bring those observations into the readiness decision.
Clinicians who already have the full EMDR Phase 2 Problem-Solving & Readiness Tool do not need the Quick Guide for additional clinical content. The Quick Guide is simply the shorter reference version for easier use during sessions.
→ EMDR Phase 2 Problem-Solving & Readiness Tool
When Does a Preparation Difficulty Change the Readiness Decision?
One difficult attempt at a resource does not determine readiness by itself. Clinicians can look for patterns across techniques, levels of activation, and sessions.
Repeated loss of orientation deserves closer assessment. So does a resource that remains unavailable whenever activation increases, recurrent dissociation during internal focus, or difficulty returning toward baseline after mild disturbance. These patterns may indicate that additional preparation, assessment, or changes in pacing are needed before trauma processing begins.
Readiness can also change over time. A client who previously used resources effectively may encounter a new stressor, increased dissociation, reduced access to supports, or a target that activates a different set of vulnerabilities. Phase 2 can be revisited throughout EMDR treatment when the client needs additional preparation before continuing reprocessing. For a broader discussion of this decision, see How to Know When a Client Is Ready for EMDR.
Continuing Education for EMDR Phase 2 Preparation
Clinicians who want additional training in selecting and adapting preparation interventions can take EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing. The continuing education course provides more detailed instruction on readiness, stabilization, dissociation, emotional regulation, dual attention, Container, Calm Place, RDI, and other Phase 2 interventions, including their clinical applications, procedural considerations, and supporting references.
The course is designed as supplemental education for licensed mental health professionals who have completed or are completing formal EMDR training. It offers 4 EMDRIA Credits and continuing education credit through an APA-approved sponsor.
→ EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing
EMDR Preparation and Stabilization Resources
Preparation difficulties often intersect with readiness assessment, dissociation, between-session regulation, dual attention, and treatment planning. The EMDR Preparation & Stabilization Hub organizes clinician education and resources across these areas so related clinical questions can be followed in one place.
→ EMDR Preparation & Stabilization Hub
Conclusion
Difficulty with an EMDR preparation technique gives the clinician another opportunity to observe how the client responds to regulation, internal attention, positive affect, imagery, activation, and present orientation. The specific pattern can help determine whether the technique needs modification, another resource would fit better, dissociation needs further assessment, or additional preparation is indicated.
Preparation remains responsive to the client throughout treatment. A resource can be modified, strengthened, replaced, practiced under mild activation, or revisited later. Tracking what happens when the client attempts to use it keeps the clinical decision connected to the capacities the client will need when trauma processing begins.
Research References
Knipe, J. (2018). The CIPOS procedure: Constant installation of present orientation and safety. In EMDR toolbox: Theory and treatment of complex PTSD and dissociation (2nd ed., pp. 185–206). Springer Publishing Company.
Leeds, A. (2016). A guide to the standard EMDR therapy protocols for clinicians, supervisors, and consultants. Springer Publishing.
Leeds, A. M. (2022). The positive affect tolerance and integration protocol: A novel application of EMDR therapy procedures. Journal of EMDR Practice and Research, 16(4), 202–214. https://doi.org/10.1891/EMDR-2022-0015
Leeds, A. M., Madere, J. A., & Coy, D. M. (2022). Beyond the DES-II: Screening for dissociative disorders in EMDR therapy. Journal of EMDR Practice and Research, 16(1), 25–38. https://doi.org/10.1891/EMDR-D-21-00019
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
