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Worksheet

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Interweave Guidance
EMDR Protocol With

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EMDR Protocol With Interweave Guidance
Description
The  EMDR Protocol With Interweave Guidance worksheet is an information-gathering and
prompt sheet for completing the standard EMDR protocol as well as containing information
about strategies for handling blocked processing. Treatment according to the EMDR model is
three-pronged (addressing past, present, and future), and involves 8 phases. This prompt sheet
addresses the assessment, desensitization, installation, body scan and closure phases (phases 3-7).
The second page of the worksheet describes strategies for dealing with blocked processing, and
the use of cognitive interweaves.

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Instructions

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To gather information about a specific memory on which to begin work the therapist can ask a

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client:

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1. To choose a specific memory, event, or symptom.
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2. To choose a target image representing the worst part of that event.

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3. To identify a negative cognition associated with that event.

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4. To identify a positive cognition associated with that event.

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5. To rate the validity of the positive cognition (VoC, rated 1 – 7).
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6. To identify emotions associated with the target image.

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7. To rate the distress associated with the target image and negative cognition (SUDs, rated 0 –
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10).
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8. To identify any body sensations associated with the target image.

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Protocol instructions are then given for the stages of desensitisation, including rules for managing
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incomplete sessions, and closure. One the reverse of the worksheet are suggestions for common
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interweave strategies to handle blocked processing.

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References
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Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures (2nd
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edition). New York: Guilford Press.

Copyright © 2020 Psychology Tools Limited. All rights reserved.

EMDR – Standard Protocol
Target issue, memory, event, or symptom
“What issue would you like to begin working on?”
Target image
“What image represents the worst part of this event?”
“Which part of this memory bothers you most?”
Preliminary instructions
• “I will tune you in to the target image. We will do sets of bilateral stimulation
(BLS) to help you process your experiences.”
• “I just want you to notice whatever comes up. You may or may not experience
images, memories, emotions, or body sensations.”
• “Whatever happens is ok. There is no ‘right way’ to do EMDR.”
• “I won‘t stop if you say ‘stop’ incase that’s part of what you are experiencing.
Give the stop signal if you want to stop. If you do become distressed it is
normally better if we carry on processing - I want you to try to tolerate as much
emotion as you can.”
• “After each set of stimulation I will ask you to give a brief report of what you
were aware of.”

Negative cognition
“When you think of that incident, what negative thought or belief
Desensitization
• “Bring the target image & negative cognition to mind, notice where you are
feeling it in your body.”
• Set of BLS as fast a client can tolerate comfortably
• If client becomes distressed: “Just notice it”, “Just observe”, “It’s old stuff”

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do you have about yourself now?” • After a set: “What do you get now?”, “What are you noticing?”

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“What negative thing does that incident say about you now?” • If client reports new material: “Go with that”, “Notice that”
(”I” statement)

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Decision tree

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• If client is reporting new material continue with sets of BLS.

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• If SUDS are greater than 0 or 1 further processing is normally necessary.

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• When client reports SUDS of 0 or 1 move to installation of the positive
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Positive cognition • End of a channel: If client reports the same content after two sets of BLS
“When you think of that incident and those negative words

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then return to target.

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[negative cognition] what would you prefer to believe about • If client is stuck or looping: Use unblocking or interweaves (overleaf )
yourself now? “
oa • Do not proceed to installation until: You have returned to target, completed

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(”I” statement) another set of stimulation, no new material has emerged, and SUDS are 0
(or 1).
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Installation of positive cognition

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• “Do the words [positive cognition] still fit, or would another positive statement
be more suitable?”
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VoC (Validity of Cognition)

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• Check VoC: “Think about the original incident and the words [positive
“When you think of that incident how true do those words
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cognition]. How true do they feel now (1-7)?”

[positive cognition] feel to you now on a scale of 1 to 7?”
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• “Bring the target image & positive cognition together in your mind”.
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Complete sets of BLS until no change. (Continue installation as long as long

(Completely false) 1 2 3 4 5 6 7 (Completely true) as adaptive material is emerging)
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• If client reports a VoC of 6 or less continue sets of BLS.

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• If client reports a VoC of 6 or 7 continue until no further material emerges

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then proceed to body scan.

Emotions
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“When you think of that incident and those words [negative

Body scan
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cognition] what emotions do you feel now?”

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• “Close your eyes & concentrate on the incident and the positive cognition.
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Mentally scan your entire body. Tell me if you feel anything.”

• If positive sensations are reported do a short set of slow BLS, if more positive
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sensations are reported give more slow sets of BLS.

• If any discomfort reported process (”go with that”) with fast sets of BLS until
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no further negative sensations reported.

SUDs (Subjective Units of Distress)
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“How disturbing does it feel to you now, on a scale from 0 to 10?” Post-session processing
• “You might find that the processing we have done today continues after the
(No disturbance) 0 1 2 3 4 5 6 7 8 9 10 (Highest disturbance) session. You might become aware of memories, thoughts, sensations or dreams.
Just notice what you experience.”

Location of body sensation Closure of an incomplete session

• An incomplete session is where material remains unresolved and no positive
“Where do you feel that in your body?”
cognition installed (i.e. SUDs > 1, or any other distress).
• Explain the need to stop.
• Consider using:
• Safe place exercise to end with a positive felt sense.
• Metaphor / imagery of putting issues in a container until the next session.
• Lightstream exercise to reduce any remaining distress
PSYCHOLOGYT LS
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Copyright © 2020 Psychology Tools Limited. All rights reserved.
EMDR  –  Interweave Guidance
Blocked processing
If processing is blocked (client is reporting no change after sets of BLS) try these less intrusive/directive/interventional techniques before attempting
cognitive interweaves:
• Change direction of BLS.
• Change length of sets of BLS.
• Change speed of sets of BLS.
• Change modality of BLS (eye movements, taps, tones).
• Focus on the sensation in the body: “Where are you feeling that in your body?”
• Float back for touchstone or feeder memories and then process those: “Just allow your mind to float back to time where you might have felt that before”.

Cognitive interweaves
Cognitive interweaves are strategies to ‘jump start’ blocked processing. The golden rule is to use as minimal an intervention as possible (“stay out of the way”)
and then to allow processing to take place naturally. The aim is not to have a long conversation, but to change the client’s perspective enough to allow them
to continue processing. Interweaves introduce new adaptive information into the memory processing, and are often introduced in the form of a question
the client will be able to give a ‘yes’ or ‘no’ answer for. The aim is to help the client bring on-line adaptive information (e.g. ‘Abuse is never the fault of the
victim’) and to integrate it with their trauma material (e.g. ‘The abuse was my fault’).

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Process interweaves

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Process interweaves aim to keep the client within the ‘window of tolerance’
• Reassurance: “You’re doing well”, “I’m here with you”.

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• Try making the image black & white (e.g. if blood is involved in the image).

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• Try putting something between you and the image (e.g. a sheet of bullet-proof glass).
• Distancing client from the image (e.g. “Imagine the image is on a screen a long way away from you”).

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Content interweaves
Client blocks will typically be related to one of three themes:

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• Responsibility (or defectiveness)
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• Safety
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• Choice (or control)
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A range of interweave types are detailed below: ith
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New information
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• Is the client missing information that it would help them to know?

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Bring ‘on-line’ information the client already has

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• “I’m confused ... ”

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• “That’s interesting ... ”

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• “What if this was your child ... ?”

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• “What would you say to a friend ... ?”

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• “What would a good friend say to you ... ?”

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• “What would your adult self say to your child self?”

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• “What does that child need to hear in order to comfort them?”

• Socratic questions (a short series e.g. “How big were you? ... How big was he? ... So how could you have stopped him?”)
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Verbalization & action

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• “What would you like to say to them now?”

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• “What would like to do that you maybe couldn’t do at the time?” (instruct to “imagine doing that”)

Useful questions
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• “You must have a really good and important reason for believing that, how does thinking about it this way help you?”
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• “How long should you punish yourself for this?”

• “If this was a crime, how long would a court punish someone for it?”
• “How much of the responsibility is theirs?”

Example blocks & interweaves

• Block: “It’s my fault” (responsibility)  Interweave: “I’m confused, is abuse the fault of the victim?”
• Block: “It’s my fault” (responsibility)  Interweave: “Whose responsibility was it to keep you safe?”
• Block: “It’s my fault” (responsibility)  Interweave: “Could you have stopped him?”, “How big were you, and how big was he?”
• Block: “I’m unsafe”(safety)  Interweave: “Are you safe right now?”
• Block: “I’m helpless and powerless” (choice)  Interweave: “Can you choose now?”
• Block: Freezing & feeling helpless (choice)  Interweave: “What does that scared little girl need to hear to comfort her?”

PSYCHOLOGYT LS
®
Copyright © 2020 Psychology Tools Limited. All rights reserved.
Resource details
Title: EMDR Protocol With Interweave Guidance
Language: English (US)
Translated title: NA
Type: Worksheet
Document orientation: Portrait
URL: https://www.psychologytools.com/resource/emdr-protocol-with-interweave-guidance/

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Unless otherwise stated, this resource is Copyright © 2020 Psychology Tools Limited. All rights reserved.

Copyright © 2020 Psychology Tools Limited. All rights reserved.