EMDR for Complex Trauma: How I Work, Step by Step

If you are looking for an EMDR therapist for complex trauma, you probably want to know two things: what will actually happen, and whether it will be too much. This page answers both. It describes how I work, in phases rather than a fixed number of sessions, because complex trauma doesn’t follow a straight line.

What is complex trauma?

Complex trauma usually comes from experiences that happened repeatedly or over a long time, often in childhood or in close relationships, rather than from one single event. It tends to affect how safe your body feels, how you relate to other people, and how you see yourself.

This matters for therapy. With a single event, we can often focus EMDR on that one memory. With complex trauma there isn’t one event to work on, so the path is less linear, and it needs more preparation.

Why we don’t start with EMDR

I begin with rapport and with building what I call a secure base: a set of tools you can use on your own, between sessions, when things feel like too much.

From there I draw on DBT. Two things matter most at this stage:

• Understanding your window of tolerance. This is the zone where you can feel your feelings and still think clearly, neither flooded nor shut down. You learn to notice when you are leaving it.
• Having tools to come back to it. Knowing how to stay regulated, and how to get regulated again, is what makes the deeper work safe.

Learning what trauma does to the body is also a key part of recovery. Many of the reactions that feel confusing or shameful start to make sense once you understand them.

Your pace, and your body’s “no”

I follow the pace your body feels comfortable with. That sometimes means moving slower than you would like.

Resistance is a key ingredient in this work, not something to push through. It often has a good reason, and overriding it can be too much and leave you more unsettled, not less. So we listen to it and work with it.

There is no deadline for the safety work. EMDR starts when the foundation is there, not before.

What the phases look like

These are phases, not one session. How long each one takes depends on you.

1. Building safety. Rapport, a secure base, DBT skills, understanding your window of tolerance and what trauma does to the body.

2. Preparing for EMDR. Once the safety foundation is in place, we look together at the memories and beliefs about yourself that you would like to work on, and we decide where to begin.

3. EMDR processing. This is the part of EMDR that includes desensitisation, installation and a body scan. We go step by step, at your pace.

4. Closing each session. At the end of every EMDR processing session, we do a safe space visualisation and I help you return to your window of tolerance, so you leave steady.

Because there is not just one event to process, we go back and forth between these phases. That is normal, and it is not a sign that something is going wrong.

EMDR and talking therapy, woven together

Some clients like to alternate EMDR processing sessions with talking therapy sessions. In those, we might explore parts work, or make sense of what came up in processing. Others prefer a different rhythm. We shape it around you.

Book a free call

Can this be done online?

Yes. I work with English-speaking clients online, including people living in Spain, the UK and elsewhere in Europe, expats, and people who are travelling. You can read more about how online EMDR works, and see my fees before you decide anything.

Questions people ask before starting

Does EMDR work for complex trauma? Research suggests it can help, but the evidence specific to complex trauma is still limited. A 2019 review of 51 trials found that EMDR, CBT and exposure therapy were each better than usual care for PTSD symptoms in people likely to have complex trauma. For EMDR that rested on only four trials, which the authors rated as low quality. So I can say it is a reasonable option to consider, and I can’t promise a result.

Do I have to do skills work before EMDR? Researchers are still debating this. A 2026 meta-analysis found no clear difference between phase-based and other approaches on most outcomes, although treatments with more than one phase did better for PTSD symptoms and emotion regulation. For me, the deciding factor is you: if you can’t yet stay within your window of tolerance, going straight into memories is more likely to overwhelm you. That is why I build the foundation first.

Has “skills first, then EMDR” actually been tested? Yes. In a 2024 randomised trial, 68 adults who had experienced childhood abuse did a skills-training phase and then either EMDR or narrative therapy. Both groups improved substantially, on PTSD symptoms, emotion regulation and relationships, and the improvement was kept or grew over the 12 months afterwards. That was a fixed programme (8 skills sessions, then 12 processing sessions), which is different from how I work. Real timelines vary, and I won’t give you a number I can’t stand behind.

Is EMDR better than other therapies? Not according to the best evidence we have. A 2024 analysis of trials in adults with PTSD found no significant difference between EMDR and other psychological therapies. So the question isn’t which therapy is “best”, but which one suits you. If another approach appeals to you more, that is a good reason to choose it, and we can talk it through on a free call.

What if it gets too much? This is the most important question, and the reason for the pace I work at. We build your tools first. We go at the speed your body can tolerate. We treat resistance as information, not something to override. And every EMDR session ends with a safe space visualisation and a return to your window of tolerance, a model that is described in the research literature.

Is this right for you?

I would encourage you to book a free call if:

• you have been through repeated or long-term difficult experiences, and not one single event
• you want to understand what happened to you and why your body reacts the way it does
• you want to go at a pace that respects what feels safe
• you are not sure whether EMDR is right for you yet

You don’t need to know exactly what happened, and you don’t have to tell me on the call. We can simply talk about what you need and whether we are a good fit.

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