The inverted EMDR standard protocol for unstable complex post-traumatic stress disorder



Often in the treatment of complex post-traumatic stress disorder (C-PTSD), there is a situation where the affect tolerance of the client is compromised and the client is flooded by trauma-based symptoms at the same time. In one group of these clients, the EMDR Standard Protocol approach works well, especially in moderately stable outpatients. For those clients who are unstable, however, clinical complications can come up and the EMDR process is not as efficient anymore or gets stuck completely. The Inverted EMDR Standard Protocol for C-PTSD is a structured way to assist these clients to reduce their symptoms to the point where they are stable enough to work with more and more of their old memory clusters of the past (most often childhood abuse, neglect, and numerous secondary traumas after that). The proposed tests of the protocol are a way to ensure the client is neither kept too long in affect—avoidant stabilization nor pulled too early into trauma—work that overwhelms her. The protocol seems to be especially useful in clients with psychiatric hospitalization histories or inpatient settings. There are three foci for the Inverted Standard Protocol for unstable C-PTSD based on inverting the EMDR Standard Protocol to meet the needs of unstable C-PTSD clients: the future, the present, and the past.


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“The inverted EMDR standard protocol for unstable complex post-traumatic stress disorder,” Francine Shapiro Library, accessed December 5, 2020,

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