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Polyvagal Theory and the Window of Tolerance: Understanding Your Nervous System and the Path to Healing, journal blog post by Anthony Colantuono
Polyvagal Theory and the Window of Tolerance: Understanding Your Nervous System and the Path to Healing, journal blog post by Anthony Colantuono
As an EMDR therapist working with adults, children, and adolescents in Southeast Sydney and online, I frequently help clients understand how trauma affects the nervous system. Many people come to therapy wondering why they feel anxious, overwhelmed, disconnected, emotionally reactive, or stuck despite their best efforts to cope.
Two concepts that have become increasingly influential in trauma-informed therapy are Polyvagal Theory and the Window of Tolerance. Together, they help explain how our nervous system responds to stress, danger, relationships, and traumatic experiences, offering a compassionate framework for understanding emotional and physiological reactions.
Rather than asking, “What is wrong with me?”, these models encourage us to ask, “What has my nervous system learned to do in order to keep me safe?”
One of my mentors describes the autonomic nervous system as “150-million-year-old software”: an ancient survival system designed to detect safety, danger, and threat. From this perspective, responses such as fight, flight, and freeze are not signs of weakness or failure, but evolutionary responses that have developed to help us survive.
What is Polyvagal Theory?
Polyvagal Theory was developed by neuroscientist Dr Stephen Porges and provides a neurophysiological framework for understanding how the autonomic nervous system responds to safety, danger, and life threat (Porges, 2007; Porges, 2025). The theory highlights the central role of the vagus nerve in regulating emotional states, social connection, physiological functioning, and behavioural responses.
According to Polyvagal Theory, the nervous system is continuously scanning the environment for cues of safety or threat through a largely unconscious process known as neuroception (Porges, 2007; Porges, 2025). Depending on what the nervous system detects, individuals shift between different autonomic states that influence how they think, feel, and behave.
The Three Primary Nervous System States
1. Ventral Vagal State: Safety, Connection and Regulation
When the nervous system perceives safety, the ventral vagal system becomes dominant. Individuals typically feel calm, grounded, emotionally regulated, and socially connected. In this state, people are generally able to think clearly, communicate effectively, learn new information, and engage positively in relationships (Porges, 2007; Porges, 2011).
Children in a ventral vagal state are often more able to learn, play, explore, and cooperate. Adults are more likely to feel present, emotionally balanced, and capable of navigating life’s challenges.
2. Sympathetic State: Fight or Flight
When the nervous system detects danger, the sympathetic branch of the autonomic nervous system mobilises the body for action. This is commonly referred to as the fight-or-flight response (Porges, 2007).
Symptoms associated with sympathetic activation may include:
Anxiety
Panic
Hypervigilance
Irritability
Racing thoughts
Increased heart rate
Muscle tension
Difficulty relaxing
These responses are adaptive when facing genuine danger. However, trauma survivors may experience sympathetic activation even in situations that are objectively safe because their nervous system has become sensitised to potential threat (Van der Kolk, 1994; Porges, 2007).
3. Dorsal Vagal State: Shutdown and Disconnection
When a threat is perceived as overwhelming or inescapable, the nervous system may shift into a dorsal vagal state. This immobilisation response can result in emotional and physical shutdown (Porges, 2007).
Individuals may experience:
Emotional numbness
Dissociation
Fatigue
Withdrawal
Hopelessness
Reduced motivation
Feelings of disconnection
Research suggests that chronic trauma, particularly relational trauma occurring during childhood, can contribute to patterns of dissociation and difficulties with emotional regulation that persist into adulthood (Schore, 2001).
Understanding the Window of Tolerance
The concept of the Window of Tolerance was originally developed by psychiatrist Dr Dan Siegel and has become a cornerstone of contemporary trauma therapy (Siegel, 1999; Siegel, 2012).
The Window of Tolerance refers to the zone of emotional and physiological arousal in which an individual can function effectively, maintain emotional regulation, process information, and respond flexibly to stress.
When people remain within their window of tolerance, they can experience a range of emotions without becoming overwhelmed. They may feel stressed, challenged, upset, or excited while still maintaining their capacity to think, reflect, and make considered decisions.
Hyperarousal: Above the Window
When activation rises beyond the upper boundary of the window, individuals may enter a state of hyperarousal.
Common experiences include:
Anxiety
Panic
Anger
Hypervigilance
Emotional reactivity
Difficulty concentrating
Sleep disturbance
Hyperarousal closely reflects sympathetic nervous system activation and the fight-or-flight response described in Polyvagal Theory (Corrigan, Fisher and Nutt, 2011).
Hypoarousal: Below the Window
When activation drops below the lower boundary of the window, individuals may enter a state of hypoarousal.
Common experiences include:
Emotional shutdown
Dissociation
Numbness
Withdrawal
Fatigue
Low motivation
Feelings of disconnection
Hypoarousal closely resembles the dorsal vagal response described by Polyvagal Theory and is often observed in individuals with histories of complex trauma (Corrigan, Fisher and Nutt, 2011; Schore, 2001).
How Trauma Narrows the Window of Tolerance
Traumatic experiences can significantly influence how the nervous system responds to future stressors. The brain becomes increasingly focused on detecting danger, often resulting in a narrowing of the Window of Tolerance (Siegel, 2012).
As a result, people may move rapidly into states of hyperarousal or hypoarousal in response to situations that others may perceive as relatively manageable.
For example:
A child exposed to chronic family conflict may become highly reactive to raised voices.
A teenager who has experienced bullying may become extremely anxious in social situations.
An adult who has experienced trauma may find everyday stress triggers intense emotional reactions.
From a trauma-informed perspective, these responses are not signs of weakness. Rather, they reflect adaptive survival responses developed by the nervous system to enhance protection in the face of perceived threat (Van der Kolk, 1994; Schore, 2001).
The Importance of Co-Regulation
The Importance of Co-Regulation
One of the most significant contributions of Polyvagal Theory is its emphasis on the role of relationships in regulating the nervous system. Humans are biologically wired for connection, and experiences of safety are often developed and maintained through relationships (Porges, 2007; Porges, 2025).
Children rely heavily on caregivers to help regulate their emotional and physiological states. Similarly, adults often benefit from supportive relationships that foster feelings of safety, trust, and connection.
This concept is known as co-regulation and is increasingly recognised as a key factor in trauma recovery and emotional wellbeing.
Polyvagal Theory, the Window of Tolerance and EMDR Therapy
EMDR (Eye Movement Desensitisation and Reprocessing) is an evidence-based psychotherapy widely recognised as an effective treatment for trauma and post-traumatic stress disorder (Shapiro, 2014; Miller, 2024).
Many clients beginning EMDR therapy spend considerable time outside their Window of Tolerance. Some become easily overwhelmed by anxiety and intrusive memories, while others experience emotional numbness, avoidance, or dissociation.
A key part of EMDR therapy involves helping clients develop the capacity to remain sufficiently regulated while processing distressing memories. As traumatic experiences are reprocessed, many individuals report:
Reduced emotional reactivity
Increased emotional regulation
Greater resilience to stress
Improved self-awareness
Increased feelings of safety and connection
Enhanced capacity to remain present
Although EMDR and Polyvagal Theory are distinct frameworks, both recognise the importance of nervous system regulation in trauma recovery (Shapiro, 2018; Porges, 2025).
Supporting Nervous System Regulation
While every individual is different, several evidence-informed approaches may support nervous system regulation and help widen the Window of Tolerance:
Strong and supportive relationships
Trauma-focused therapy
EMDR therapy
Mindfulness practices
Breathwork and grounding exercises
Regular physical activity
Healthy sleep routines
Consistent daily structure
Sensory regulation strategies for children and adolescents
Over time, these approaches may help individuals develop greater flexibility within their nervous system, allowing them to navigate stress more effectively.
Current Scientific Perspectives
Polyvagal Theory has had a significant influence on trauma-informed practice, psychotherapy, education, and healthcare. However, some aspects of the theory continue to be debated within the scientific literature. Critics have questioned certain evolutionary and neurophysiological assumptions associated with the model (Grossman et al., 2025).
Despite these debates, many clinicians and researchers continue to regard autonomic regulation, social engagement, and nervous system states as useful concepts for understanding trauma and emotional wellbeing, while research in these areas continues to evolve (Porges, 2025).
Conclusion
Polyvagal Theory and the Window of Tolerance provide valuable frameworks for understanding how the nervous system responds to stress, trauma, and relationships. These concepts help explain why people may become anxious, reactive, disconnected, or overwhelmed, particularly following adverse life experiences.
For adults, adolescents, and children, developing awareness of nervous system states can be an important step towards healing. Through evidence-based approaches such as EMDR therapy, individuals can learn to regulate emotional responses, process traumatic memories, expand their Window of Tolerance, and build a greater sense of safety, resilience, and connection in everyday life.
References
Corrigan, F.M., Fisher, J.J. and Nutt, D.J. (2011) ‘Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma’, Journal of Psychopharmacology, 25(1), pp. 17–25.
Grossman, P., Ackland, G.L., Allen, A.M., Berntson, G.G., Booth, L.C., Burghardt, G.M., Buron, J., Dinets, V., Doody, J.S. and others (2025) ‘Why the Polyvagal Theory is untenable: An international expert evaluation of the Polyvagal Theory and commentary upon Porges (2025)’, Clinical Neuropsychiatry, 22(3), pp. 192–222.
Miller, P.W. (2024) ‘The evolution and future of eye movement desensitisation and reprocessing therapy’, BJPsych Advances, 30(4), pp. 239–241.
Porges, S.W. (2007) ‘The polyvagal perspective’, Biological Psychology, 74(2), pp. 116–143.
Porges, S.W. (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication and Self-Regulation. New York: W.W. Norton.
Porges, S.W. (2025) ‘Polyvagal theory: a journey from physiological observation to neural innervation and clinical insight’, Frontiers in Behavioral Neuroscience, 19. Available at: https://doi.org/10.3389/fnbeh.2025.1659083.
Schore, A.N. (2001) ‘The effects of early relational trauma on right brain development, affect regulation, and infant mental health’, Infant Mental Health Journal, 22(1–2), pp. 201–269.
Shapiro, F. (2014) ‘The role of Eye Movement Desensitization and Reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences’, The Permanente Journal, 18(1), pp. 71–77.
Shapiro, F. (2018) Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols and Procedures. 3rd edn. New York: Guilford Press.
Siegel, D.J. (1999) The Developing Mind: Toward a Neurobiology of Interpersonal Experience. New York: Guilford Press.
Siegel, D.J. (2012) The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. 2nd edn. New York: Guilford Press.
Van der Kolk, B.A. (1994) ‘The body keeps the score: memory and the evolving psychobiology of posttraumatic stress’, Harvard Review of Psychiatry, 1(5), pp. 253–265.
Van der Kolk, B.A. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.
EMDR Therapy for Grief: A Clinical Perspective on Healing After Loss, beyond Kubler Ross
EMDR Therapy for Grief: A Clinical Perspective on Healing After Loss, beyond Kubler Ross
journal blog post by Anthony Colantuono
As an experienced social worker working across community mental health, counselling services, palliative care, emergency departments, and now victim services, I have supported individuals through many forms of grief — from expected loss to sudden, traumatic bereavement.
When I first began my training in EMDR therapy (Eye Movement Desensitisation and Reprocessing), I was initially surprised — and somewhat hesitant — to learn that EMDR could be used as a treatment for grief. At the time, I associated EMDR primarily with trauma. However, my clinical perspective has evolved significantly.
Can EMDR Help with Grief?
Emerging research suggests that EMDR is an effective intervention for individuals experiencing complicated or prolonged grief, where the mourning process becomes persistent and distressing. Prolonged Grief Disorder can significantly impact emotional wellbeing, functioning, and quality of life (Spicer, 2024).
EMDR is grounded in the Adaptive Information Processing (AIP) model, which proposes that distressing experiences — including aspects of bereavement — can become “stuck” in memory networks. This can prevent individuals from integrating the loss and accessing more adaptive or meaningful memories of the deceased (Solomon & Rando, 2012).
Through structured processing, EMDR helps individuals:
Reduce the emotional intensity of distressing memories
Reprocess traumatic aspects of the loss
Integrate the experience more adaptively
Reconnect with more positive or nostalgic memories
When Is EMDR Useful for Grief?
In my clinical work, EMDR has been particularly helpful in cases of traumatic bereavement or unresolved grief, including:
Sudden or premature death
Death by suicide or homicide
Shock-related losses
Persistent, overwhelming sadness
Situations where distressing memories overshadow meaningful reflections of the loved one
In these presentations, grief is often intertwined with trauma. EMDR helps process these distressing elements so that the grieving process can continue in a more natural and integrated way.
What Does the Research Say?
A randomised controlled trial found that EMDR significantly reduced grief symptoms, trauma symptoms, and emotional distress, with outcomes comparable to cognitive behavioural therapy (CBT) (Meysner, Cotter & Lee, n.d.).
Similarly, recent research highlights EMDR as a promising therapy for prolonged grief, supporting individuals to process past memories, current triggers, and future fears associated with the loss (Spicer, 2024).
A Shift in Clinical Practice
My initial hesitation has shifted to a deep appreciation of EMDR as a valuable approach in grief work. While EMDR does not “remove” grief — nor should it — it can reduce the intensity of traumatic distress that may be blocking the natural mourning process.
For many clients, this creates space for grief to evolve into something more bearable, meaningful, and integrated.
Find out more about EMDR on this website.
References
Meysner, L., Cotter, P. & Lee, C.W. (n.d.) Evaluating the efficacy of EMDR with grieving individuals: A randomized control trial. Available at: link_titlehttps://spj.science.org/doi/pdf/10.1891/1933-3196.10.1.2turn1search3
Solomon, R.M. & Rando, T. (2012) Treatment of grief and mourning through EMDR: Conceptual considerations and clinical guidelines. European Review of Applied Psychology, 63(4), pp.231–239. Available at: link_titlehttps://www.emdria.org/resource/treatment-of-grief-and-mourning-through-emdr-conceptual-considerations-and-clinical-guidelines-european-review-of-applied-psychology/turn1search12
Spicer, L. (2024) Eye Movement Desensitisation and Reprocessing (EMDR) therapy for prolonged grief: theory, research, and practice. Frontiers in Psychiatry. Available at: link_titlehttps://pmc.ncbi.nlm.nih.gov/articles/PMC11056564/turn1search1
See our EMDR page for EMDR specialised psychotherapy services
Why Do Traumatic Memories Get Stuck? Understanding Trauma, Memory and How the Brain Tries to Protect Us
Why Do Traumatic Memories Get Stuck? Understanding Trauma, Memory and How the Brain Tries to Protect Us
journal blog post by Anthony Colantuono
journal blog post by Anthony Colantuono
Why can I forget what I ate for lunch last Tuesday, but remember something painful that happened years ago?
Why can I forget what I ate for lunch last Tuesday, but remember something painful that happened years ago?
It is a question many people ask themselves:
"Why can I forget ordinary things so easily, but remember certain moments with incredible detail and imagery?"
You might not remember what you had for lunch last week, the conversations you had on a particular Tuesday, or what you did on an average weekend. Yet you may vividly remember a frightening experience, a painful interaction, a moment of humiliation, a loss, or a time when you felt unsafe.
Why does the brain do this?
The answer lies in one of the brain's most important functions: protecting us from danger.
Our brains are not designed to record every moment equally. They constantly filter information, deciding what needs to be remembered and what can safely fade into the background.
A routine day at work, a familiar drive home, or an ordinary meal usually does not require long-term storage. These experiences are processed and integrated without needing much attention.
However, experiences involving threat, fear, intense emotion, or a sense of danger are often prioritised.
From an evolutionary perspective, this makes sense.
A brain that remembers danger is more likely to keep us safe.
The same system that helped our ancestors remember where predators lived or which environments were unsafe continues to operate today. The threats we face may have changed, but our nervous system still asks:
"Could this happen again?"
When the answer feels like it might be yes, the brain pays attention.
The Brain's Job Is Not to Make Us Happy—It Is to Keep Us Alive
The Brain's Job Is Not to Make Us Happy—It Is to Keep Us Alive
The human brain has evolved over millions of years to detect and respond to threats.
A useful way to understand this is to think of the brain as a prediction system. It constantly uses past experiences to help prepare us for future situations.
If something painful or frightening happened before, remembering it may help us avoid similar danger in the future.
For example:
Someone who was bitten by a dog may become cautious around dogs.
Someone who experienced betrayal may become more alert to signs of rejection.
Someone who was involved in a serious accident may become fearful when driving.
Someone who experienced criticism or humiliation may become highly sensitive to judgement.
These responses are not random.
They are examples of the brain attempting to learn from experience.
In many cases, this protective learning is helpful. It allows us to adapt, make safer choices, and respond appropriately to future situations.
The difficulty arises when the brain continues to respond as though danger is still present, even when the original threat has passed.
Why Are Emotional Memories So Powerful?
Why Are Emotional Memories So Powerful?
Not all memories are stored in the same way.
Everyday memories—such as what we ate, what we wore, or what we did on a particular day—often have little emotional significance. They are not essential for future survival, so they may naturally become less accessible over time.
Emotionally significant memories are different.
When we experience something threatening, the brain increases attention and activates systems involved in survival, including stress hormones and emotional processing networks.
Research has shown that emotional arousal can strengthen memory formation, particularly for experiences that the brain interprets as important or dangerous (McGaugh, 2003).
This explains why people can sometimes remember a traumatic event with remarkable clarity while struggling to recall ordinary details from the same period.
The brain is effectively saying:
"Pay attention. This matters."
What Does Trauma Mean?
What Does Trauma Mean?
The word trauma is often used in everyday conversation, but in psychology it refers to experiences that overwhelm a person's ability to cope, creating lasting emotional, psychological, or physiological effects.
Trauma is not defined only by what happened.
It is also influenced by:
how threatening the experience felt
whether the person felt powerless or trapped
whether they had support at the time
their previous experiences
their developmental stage
their ability to process what occurred
Two people can experience similar events and have very different responses.
This does not mean one person is affected more "appropriately" than another.
It reflects the complexity of the human nervous system.
Big "T" Trauma and Little "t" Trauma
Big "T" Trauma and Little "t" Trauma
Clinicians often use the terms "Big T trauma" and "little t trauma" as informal ways of describing different types of distressing experiences.
These terms are not formal diagnostic categories in the DSM-5-TR or ICD-11. Instead, they are commonly used to help explain that trauma can arise from both major life-threatening events and repeated or overwhelming experiences that affect a person's sense of safety, identity, or relationships.
Big "T" Trauma
Big "T" Trauma
Big "T" trauma generally refers to events involving significant threat, danger, or a major disruption to a person's sense of safety.
Examples may include:
serious motor vehicle accidents
natural disasters
physical assault
sexual assault
combat exposure
life-threatening medical events
witnessing severe injury or violence
sudden traumatic loss
kidnapping or captivity
experiences of torture
major childhood abuse
These experiences can be associated with symptoms such as intrusive memories, nightmares, avoidance, heightened alertness, and changes in mood or beliefs about oneself and the world.
Little "t" Trauma
Little "t" Trauma
Little "t" trauma generally refers to experiences that may not involve immediate threat to life but can still have a significant emotional impact, particularly when they are repeated, overwhelming, or occur during vulnerable periods of life.
Examples may include:
ongoing bullying
emotional neglect
repeated criticism
chronic family conflict
relationship betrayal
rejection or abandonment
experiences of shame or humiliation
feeling consistently unsafe or unsupported
difficult childhood experiences
persistent invalidation of emotions
workplace harassment
painful interpersonal experiences
While these experiences may be underestimated by others, the brain responds to perceived threat—not simply to whether an event meets an external definition of danger.
An experience that communicates:
"I am not safe,"
"I am powerless,"
"I am not valued,"
or
"Something bad could happen again,"
may become deeply significant to the nervous system.
Why Do Some Memories Become "Stuck"?
Why Do Some Memories Become "Stuck"?
Under normal circumstances, the brain processes experiences, integrates them, and stores them as memories of the past.
You remember what happened, but you also know:
"That happened then. I am safe now."
Sometimes, after overwhelming experiences, this process does not happen effectively.
The memory may remain strongly connected with:
intense emotions
physical sensations
negative beliefs about oneself
feelings of helplessness
fear responses
Later, reminders of the original experience can activate these responses.
A person may intellectually understand that they are safe, yet their body reacts as though the danger is happening again.
This is why people often describe trauma responses in ways such as:
"I know I'm safe, but my body doesn't feel safe."
"I understand it is in the past, but it feels present."
"I wish I could just move on, but my brain keeps bringing it back."
These experiences reflect the way the brain has learned to respond to perceived threat.
Part 2 — Why Trauma Can Feel Like It Lives in the Body, the Brain's Alarm System, Neuroplasticity and How Healing Happens
Part 2 — Why Trauma Can Feel Like It Lives in the Body, the Brain's Alarm System, Neuroplasticity and How Healing Happens
Why Do Trauma Memories Feel Like They Are Happening Now?
Why Do Trauma Memories Feel Like They Are Happening Now?
One of the most confusing aspects of trauma is that people often know something happened in the past, yet their emotional and physical responses can feel immediate and overwhelming.
A person may think:
"I know I am safe now, so why does my body react as though I am still in danger?"
This occurs because memories are not stored as simple facts. They are stored as networks of information involving thoughts, emotions, physical sensations, images, and meanings.
For example, a person involved in a serious car accident may remember:
the sound of impact
the feeling of panic
the sensation of their heart racing
the belief "I am not safe"
the smell of the vehicle
the sight of the road
Years later, driving on a similar road may activate parts of this memory network, producing anxiety or fear.
The brain is not necessarily making an error.
It is responding according to information it has learned.
The challenge is that the brain may continue responding to reminders of past danger even when the person is safe in the present.
The Brain's Alarm System: A Smoke Detector Analogy
The Brain's Alarm System: A Smoke Detector Analogy
A helpful way to understand the autonomic nervous system is to imagine it as being like a smoke detector in your home.
Imagine your house catches fire.
The smoke detector does exactly what it was designed to do. It detects danger and sounds an alarm to warn you that something requires your attention.
The alarm is not a problem.
It is a protective response.
Now imagine you burn a piece of toast.
Smoke rises from the toaster, and the same smoke detector activates. The alarm sounds with the same urgency as it would during a house fire.
The smoke detector is not broken.
It is doing its job.
However, it is responding to a situation that does not represent the same level of danger.
Our nervous system can work in a similar way.
When we experience something threatening or overwhelming, the brain learns to pay attention to cues that may signal danger. This ability is essential for survival. It helps us recognise patterns, avoid harm, and prepare for possible future threats.
However, after traumatic or highly distressing experiences, the brain's threat detection system can become sensitised.
This means the alarm system may activate more quickly in response to reminders of past experiences.
A reminder may include:
a particular smell
a sound
a location
a relationship dynamic
a tone of voice
a physical sensation
an emotion that resembles the original experience
The response may include:
increased heart rate
muscle tension
anxiety
fear
anger
a desire to escape
emotional overwhelm
The nervous system is not trying to make life difficult.
It is attempting to protect the person using information gathered from previous experiences.
The difficulty is that the alarm system may respond to a reminder of past danger rather than an actual threat in the present.
Trauma therapy aims to help people develop a greater sense of safety while allowing the brain to process experiences that may remain emotionally unresolved.
Why Trauma Responses Can Feel Automatic
Why Trauma Responses Can Feel Automatic
The human nervous system is designed to react quickly.
When the brain detects possible danger, it can activate survival responses including:
fight
flight
freeze
appease or fawn responses
These responses can occur before conscious reasoning has time to fully evaluate what is happening.
This is why someone may experience:
a racing heart before they understand why
sudden anxiety
tension in their body
an urge to escape
emotional reactions that feel stronger than the current situation appears to warrant
These reactions are often connected to learned associations between present-day cues and previous experiences.
The brain is constantly trying to predict and prepare.
Sometimes this protective system continues responding to situations that are no longer dangerous.
Can the Brain Change After Trauma?
Can the Brain Change After Trauma?
The encouraging news from neuroscience is that the brain is not fixed.
The ability of the brain to adapt and change throughout life is known as neuroplasticity.
Neuroplasticity allows humans to learn new skills, develop new patterns of thinking, and form new emotional associations.
This means that the way the brain responds to past experiences can change.
Healing does not mean forgetting what happened.
It means the memory can become integrated as something that happened in the past rather than something that continues to signal danger in the present.
Psychological therapies support this process by helping people develop new ways of understanding experiences, regulating emotions, and responding to reminders of the past.
How Does EMDR Therapy Help With Trauma?
How Does EMDR Therapy Help With Trauma?
Eye Movement Desensitisation and Reprocessing (EMDR) is a structured psychotherapy approach developed by Dr Francine Shapiro in the late 1980s.
Shapiro's early observations regarding eye movements and distressing thoughts led to decades of clinical research and refinement. Her persistence in developing and investigating EMDR contributed significantly to modern trauma treatment.
Today, EMDR is recognised internationally as an evidence-based therapy for post-traumatic stress disorder (PTSD) and other trauma-related difficulties.
EMDR is not about erasing memories.
The goal is not to remove the past.
The goal is to help the brain process distressing memories so they become less emotionally overwhelming and more integrated.
Many people describe the change as:
"I know it happened, but it no longer feels like it is happening to me."
The Eight Phases of EMDR Therapy
The Eight Phases of EMDR Therapy
EMDR follows a structured approach that prioritises safety, preparation, and individual readiness.
Phase 1: History and Treatment Planning
Phase 1: History and Treatment Planning
The therapist works collaboratively with the client to understand their experiences, current difficulties, strengths, and goals.
Phase 2: Preparation
Phase 2: Preparation
Before processing distressing memories, clients learn strategies to regulate emotions and manage distress.
This phase is essential because effective trauma therapy requires both approaching difficult experiences and maintaining a sense of safety.
Phase 3: Assessment
Phase 3: Assessment
The therapist identifies specific memories, beliefs, emotions, and physical sensations connected with the issue being addressed.
Phase 4: Desensitisation
Phase 4: Desensitisation
During this phase, the client focuses briefly on aspects of the memory while engaging in bilateral stimulation.
Bilateral stimulation may include:
guided eye movements
alternating sounds
alternating tactile stimulation such as tapping
Phase 5: Installation
Phase 5: Installation
The therapy strengthens more adaptive beliefs, such as:
"I survived."
"I have choices now."
"I am safe in the present."
Phase 6: Body Scan
Phase 6: Body Scan
The client notices any remaining physical sensations connected with the memory.
Phase 7: Closure
Phase 7: Closure
Sessions are brought to an appropriate conclusion, ensuring the client feels grounded and able to return to daily life.
Phase 8: Reevaluation
Phase 8: Reevaluation
The therapist reviews progress and identifies further areas requiring attention.
Can EMDR Be Done Online?
Can EMDR Be Done Online?
Yes. EMDR can be delivered through telehealth when clinically appropriate.
Online EMDR has become increasingly accessible through secure platforms that allow therapists and clients to use different forms of bilateral stimulation remotely.
In my practice, I use BilateralStimulation.io, which provides options including:
visual bilateral stimulation through guided eye movements
auditory bilateral stimulation through alternating sounds
tactile bilateral stimulation through tapping techniques
The most appropriate method is selected collaboratively depending on client preference, comfort, and clinical suitability.
Online EMDR allows many people to access structured, evidence-informed trauma therapy from the privacy and convenience of their own home.
Part 3 — The Science of EMDR, Research, Healing and Understanding Trauma
Part 3 — The Science of EMDR, Research, Healing and Understanding Trauma
How Does EMDR Work? Understanding the Proposed Mechanisms
How Does EMDR Work? Understanding the Proposed Mechanisms
While research strongly supports EMDR as an effective treatment for PTSD and trauma-related symptoms, researchers continue to investigate exactly how EMDR produces therapeutic change.
There is currently no single universally accepted explanation for its mechanism of action. Instead, several complementary theories have been proposed.
Adaptive Information Processing Model
Adaptive Information Processing Model
Dr Francine Shapiro proposed the Adaptive Information Processing (AIP) model as the theoretical foundation of EMDR.
The model suggests that the brain has a natural capacity to process experiences and integrate them into existing memory networks.
However, when experiences are overwhelming, memories may become stored in a way that remains disconnected from adaptive information.
This may contribute to intrusive memories, emotional distress, physical reactions, and negative beliefs about oneself.
According to the AIP model, EMDR supports the processing and integration of these memories so they become less disturbing and more connected with present-day understanding.
Working Memory Theory
Working Memory Theory
Working memory refers to the brain's limited capacity to hold and process information.
Research suggests that recalling a distressing memory while engaging in another demanding task, such as bilateral eye movements, may reduce the vividness and emotional intensity of that memory.
This theory proposes that the memory becomes less overwhelming because the brain is processing competing information at the same time.
Orienting Response Theory
Orienting Response Theory
The orienting response is a natural process in which attention is directed toward new or changing information in the environment.
Some researchers suggest that bilateral stimulation may activate this response, helping reduce physiological arousal and creating conditions that support emotional processing.
Memory Reconsolidation Theory
Memory Reconsolidation Theory
Modern neuroscience suggests that memories are not fixed recordings stored permanently.
When memories are recalled, they can temporarily become more flexible before being stored again. This process is known as reconsolidation.
Some researchers propose that EMDR may support the updating of distressing memories by allowing new information, safety, and adaptive meanings to become associated with previously threatening experiences.
The Contribution of Dr Francine Shapiro
The Contribution of Dr Francine Shapiro
The development of EMDR represents an important contribution to the field of trauma psychology.
Dr Francine Shapiro's research, clinical innovation, and persistence led to the development of a structured therapeutic approach that has now been studied internationally for several decades.
Her work contributed to a greater understanding of the relationship between traumatic memories, emotional distress, and adaptive processing.
While research continues to refine our understanding of why EMDR works, its effectiveness for many trauma-related difficulties is supported by a substantial evidence base.
Trauma Therapy Is About More Than What Happened
Trauma Therapy Is About More Than What Happened
Trauma therapy is not only about the event itself.
It is also about:
what the experience meant to the person
beliefs that developed afterward
emotions that remain unresolved
protective patterns that developed
the impact on relationships and daily life
Every person's experience is unique.
Effective therapy respects the complexity of each person's story and works collaboratively towards meaningful change.
Learning From Research, Mentors and Clients
Learning From Research, Mentors and Clients
The understanding and treatment of trauma continues to evolve through scientific research, clinical supervision, professional education, and the experiences of those who seek support.
The work of trauma therapy is shaped by many teachers—including researchers, supervisors, colleagues, and the clients who courageously share their experiences.
Each contributes to a deeper understanding of the remarkable capacity of the human brain and nervous system to adapt, heal, and grow.
When Should Someone Consider EMDR Therapy?
When Should Someone Consider EMDR Therapy?
EMDR may be helpful for people experiencing:
traumatic memories
PTSD symptoms
anxiety linked to past experiences
panic responses
nightmares
disturbing memories
childhood experiences that continue to affect adulthood
relationship trauma
feelings of shame, guilt, or fear connected to past events
A comprehensive assessment can help determine whether EMDR is an appropriate approach.
Final Thoughts: Why Do Some Memories Get Stuck?
Final Thoughts: Why Do Some Memories Get Stuck?
The brain remembers what it believes is important.
Sometimes this includes moments of connection, joy, and meaning.
Sometimes it includes experiences associated with danger, fear, and pain.
These memories are not evidence that the brain has failed.
They reflect a powerful protective system that evolved to help humans survive.
However, when past experiences continue to create distress in the present, support is available.
Through evidence-based approaches such as EMDR therapy, many people are able to reduce the emotional intensity of difficult memories and develop a stronger sense of safety, confidence, and freedom.
References
References
American Psychiatric Association (2022) Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. 5th edn, text revision. Washington, DC: American Psychiatric Association.
Brewin, C.R., Gregory, J.D., Lipton, M. and Burgess, N. (2010) ‘Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications’, Psychological Review, 117(1), pp. 210–232.
Brewin, C.R., Andrews, B. and Valentine, J.D. (2000) ‘Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults’, Journal of Consulting and Clinical Psychology, 68(5), pp. 748–766.
Cahill, L. and McGaugh, J.L. (1998) ‘Mechanisms of emotional arousal and lasting declarative memory’, Trends in Neurosciences, 21(7), pp. 294–299.
Ehlers, A. and Clark, D.M. (2000) ‘A cognitive model of posttraumatic stress disorder’, Behaviour Research and Therapy, 38(4), pp. 319–345.
Foa, E.B., Hembree, E.A. and Rothbaum, B.O. (2007) Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences: Therapist Guide. New York: Oxford University Press.
International Society for Traumatic Stress Studies (ISTSS) (2019) ISTSS Prevention and Treatment Guidelines for Posttraumatic Stress Disorder. Available at: https://istss.org (Accessed: 1 August 2026).
Lee, C.W. and Cuijpers, P. (2013) ‘A meta-analysis of the contribution of eye movements in processing emotional memories’, Journal of Behavior Therapy and Experimental Psychiatry, 44(2), pp. 231–239.
LeDoux, J.E. (1996) The Emotional Brain: The Mysterious Underpinnings of Emotional Life. New York: Simon & Schuster.
LeDoux, J.E. (2012) ‘Rethinking the emotional brain’, Neuron, 73(4), pp. 653–676.
McEwen, B.S. (2007) ‘Physiology and neurobiology of stress and adaptation: Central role of the brain’, Physiological Reviews, 87(3), pp. 873–904.
McGaugh, J.L. (2003) Memory and Emotion: The Making of Lasting Memories. New York: Columbia University Press.
Milad, M.R. and Quirk, G.J. (2012) ‘Fear extinction as a model for translational neuroscience: Ten years of progress’, Annual Review of Psychology, 63, pp. 129–151.
Nijdam, M.J. and Vermetten, E. (2018) ‘The importance of treating trauma-related disorders’, European Journal of Psychotraumatology, 9(sup1), Article 1503020.
Phelps, E.A. and LeDoux, J.E. (2005) ‘Contributions of the amygdala to emotion processing: From animal models to human behaviour’, Neuron, 48(2), pp. 175–187.
Shapiro, F. (2018) Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. 3rd edn. New York: Guilford Press.
Shapiro, F. (2001) Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures. 2nd edn. New York: Guilford Press.
Siegel, D.J. (2020) The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. 3rd edn. New York: Guilford Press.
Stickgold, R. (2002) ‘EMDR: A putative neurobiological mechanism of action’, Journal of Clinical Psychology, 58(1), pp. 61–75.
van der Kolk, B.A. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.
World Health Organization (2013) Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: World Health Organization.
World Health Organization (2023) ICD-11: International Classification of Diseases for Mortality and Morbidity Statistics. Geneva: World Health Organization.
Yehuda, R. and LeDoux, J. (2007) ‘Response variation following trauma: A translational neuroscience approach to understanding PTSD’, Neuron, 56(1), pp. 19–32.
See Service page link below
The eight phases of EMDR;
The eight phases of EMDR;
History taking
Grounding and stablisation work, (eg Safe Place, container, CIPOS, Flash)
Target identification
Desensitisation
Installation (of adaptive thought)
Body scan - clear the body of residual sensations associated with the event
Re-evaluation (checking for residual disturbance and clear body scan.
Closure.
Understanding the Circle of Security: Building Stronger Relationships Between Parents and Children
Understanding the Circle of Security: Building Stronger Relationships Between Parents and Children
As parents, we all want our children to feel safe, confident and emotionally secure. Yet every child experiences moments of worry, frustration, sadness or uncertainty. Understanding how children seek comfort, reassurance and independence can help parents respond with confidence and strengthen their relationship with their child.
The Circle of Security® is an evidence-based relationship model that helps parents understand their child's emotional needs and build secure attachment. Rather than focusing on "perfect parenting", the Circle of Security encourages parents to be "good enough"—responsive, consistent and emotionally available most of the time.
What is the Circle of Security?
What is the Circle of Security?
Children naturally move between two important needs throughout the day.
One need is to explore their world. Children learn by playing, taking safe risks, trying new experiences and becoming increasingly independent.
The other need is to return to a trusted adult when they feel tired, frightened, overwhelmed, hurt or uncertain.
The Circle of Security describes this natural movement as a circle.
At the top of the circle, children need their caregiver to:
Support exploration
Delight in their achievements
Encourage independence
Help them feel confident
At the bottom of the circle, children need their caregiver to:
Welcome them back
Provide comfort and reassurance
Help organise overwhelming emotions
Protect them when needed
Help them feel safe enough to explore again
When children repeatedly experience this pattern, they gradually develop a secure attachment and greater confidence in themselves and others.
Why is Secure Attachment Important?
Why is Secure Attachment Important?
Secure attachment provides the foundation for healthy emotional, social and psychological development.
Children with secure relationships are more likely to:
Develop healthy self-esteem
Build positive friendships
Regulate their emotions more effectively
Develop resilience after setbacks
Feel safe asking for help
Become confident and independent over time
Attachment is not about creating dependence. In fact, children who feel emotionally secure are often more willing to explore, solve problems and develop independence because they know they have a safe relationship to return to.
Understanding Behaviour as Communication
Understanding Behaviour as Communication
Children do not always have the words to explain how they are feeling.
Instead, emotions are often communicated through behaviour.
For example:
Anger may hide fear.
Withdrawal may reflect anxiety.
Defiance may represent feeling overwhelmed.
Clinginess may indicate a need for reassurance.
Emotional outbursts may occur when a child's nervous system becomes overloaded.
When parents begin asking, "What is my child trying to tell me?" rather than "How do I stop this behaviour?", new opportunities for connection emerge.
The Balance Between Nurture and Boundaries
The Balance Between Nurture and Boundaries
One of the greatest strengths of the Circle of Security model is recognising that children need both emotional connection and clear boundaries.
Children thrive when parents can be:
Warm and emotionally available
Calm during difficult moments
Consistent with expectations
Predictable with routines
Confident in setting appropriate limits
Boundaries do not damage attachment. When delivered calmly and consistently, they actually help children feel safe.
Restoring parental confidence and authority is often an important part of supporting family relationships.
When Families May Benefit From Support
When Families May Benefit From Support
Sometimes families experience challenges that make connection more difficult.
These may include:
Anxiety
Trauma
School refusal
Emotional regulation difficulties
Behavioural challenges
Family separation
Grief and loss
Neurodevelopmental differences
Stress within the family
Seeking support is not a sign of failure. It is an opportunity to strengthen relationships and develop practical strategies together.
How Counselling Can Help
How Counselling Can Help
At Interpersonal Therapy, counselling is tailored to the unique needs of each child and family.
Support may include:
Strengthening parent-child attachment
Developing emotional regulation skills
Helping children understand and express emotions
Building confidence and resilience
Supporting parents with practical strategies
Restoring healthy boundaries and parental confidence
Addressing the impact of trauma or anxiety on family relationships
Where appropriate, therapy is collaborative, recognising that parents and caregivers play a central role in supporting lasting change.
Final Thoughts
Final Thoughts
No parent gets it right all the time.
Children do not need perfect parents—they need caregivers who are willing to repair relationships, remain emotionally available and continue learning about their child's needs.
The Circle of Security reminds us that every moment of connection helps build a child's sense of safety, confidence and resilience. By strengthening attachment and understanding children's emotional needs, families can create relationships that support healthy development throughout childhood and adolescence.
If you would like support with your child's emotional wellbeing, behaviour or family relationships, Interpersonal Therapy provides evidence-based child and adolescent counselling in Caringbah, the Sutherland Shire, with Telehealth appointments available across Australia.
Stages of Conflict
Stages of Conflict
Interpersonal Psychotherapy (IPT) outlines conflict in stages that help identify and address relational issues. The stages typically include: (1) Negotiation, where individuals attempt to communicate their needs or concerns; (2) Impasse, where communication breaks down and tension escalates; and (3) Dissolution, where the relationship deteriorates or ends if the conflict remains unresolved. IPT focuses on helping individuals recognise these stages, improve communication, and explore ways to resolve conflicts or cope with navigating outcomes in a healthy, adaptive manner.
EMDR and The Adaptive Information Processing System
EMDR and The Adaptive Information Processing System
Eye Movement Desensitisation and Reprocessing (EMDR) is a psychotherapy approach designed to help individuals process and resolve traumatic memories by engaging the brain’s natural healing mechanisms. Central to EMDR is the Adaptive Information Processing (AIP) model, which posits that psychological distress arises when traumatic experiences are inadequately processed and stored in a dysfunctional state. EMDR facilitates the reprocessing of these memories through bilateral stimulation (e.g., eye movements), allowing the brain to integrate them adaptively—reducing emotional intensity and enabling healthier cognitive and emotional responses.
See page on EMDR services avaiable both in person in Caringbah and online.
The Mammalian Dive Reflex
The Mammalian Dive Reflex
The mammalian dive reflex is a physiological response triggered by cold water contacting the face, leading to slowed heart rate, reduced blood flow to the extremities, and a shift to oxygen-conserving mode. In Dialectical Behavior Therapy (DBT), this reflex is harnessed through the TIPP skill (Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation) to help rapidly regulate extreme emotional states. By immersing the face in cold water or holding a cold pack against it, individuals can activate the dive reflex, inducing a calming effect that helps reduce acute distress and restore emotional balance.
The History of Dialectic Behaviour Therapy
The History of Dialectic Behaviour Therapy
Dialectical Behavior Therapy (DBT) was developed in the late 1980s by psychologist Marsha M. Linehan to treat individuals with borderline personality disorder (BPD), particularly those struggling with chronic suicidal thoughts and emotional dysregulation. Linehan, recognising the limitations of traditional cognitive-behavioral therapy (CBT) for these patients, integrated mindfulness and acceptance-based strategies drawn from Zen Buddhism with CBT techniques. The result was a structured, skills-based therapy focused on four core areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Over time, DBT has been adapted for a range of mental health conditions, including eating disorders, substance use disorders, and PTSD.
Cognitive Behaviour Therapy
Clinical Research for Anxiety and Depression (CRUFAD) is a great online resource I have recommended over the years when canvassing treatment pathways for Anxiety and Depression, specifically cbt.
I'm a registered clinician with Clinical Research for Anxiety and Depression (CRUFAD). It can be great tool to use in therapy sessions (and between appointments) to explore strategies and thinking patterns. Thinking about thinking can be challenging, which is where a good therapist comes into the equation. Cognitive Behavioural Therapy (CBT) will involve basic homework, it is well researched and evidence based. I firmly support the use of evidence based modalities in my practice to work toward good outcomes.
Here is a useful links for general information on CBT.
https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt
NB I use an eclectic approach and draw on a variety of evidence based modalities, not just CBT.
Sleep Hygiene
It is well researched that a poor nights sleep can inadvertently have an effect on mood (both in the short and long term). The Blackdog institute has developled an evidence based app which targets psycheducation around sleep hygiene and establishing good sleep routines. when treating mood disturbances such as anxiety and depression or just general low mood, sleep hygiene is an important facet of the treatment plan.
Link for "Sleep Ninja" fact sheet:
https://www.blackdoginstitute.org.au/wp-content/uploads/2023/04/BDI_Sleep-Ninja_Fact-sheet-v2.pdf
Link for "Sleep Ninja" promotional video:
Scholarly article.
Werner-Seidler, A., Johnston, L., & Christensen, H. (2018). Digitally-delivered cognitive-behavioural therapy for youth insomnia: A systematic review. Internet Interventions, 11, 71-78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084877
Diaphragmatic Breathing
(also called "belly breathing") is a basic tool I suggest for stress management, ruminative thinking and sometimes anxiety. It can be a very effective grounding tool.
The only time I can say to NOT attempt diaphragmatic breathing is in an acute panic attack, for example, when you are highly distressed and suffering shortness of breath (there are other exercises for this).
The key to effective diaphragmatic breathing is good posture, whether this be laying on your back or sitting comfortably in a chair with good back support and regulating your breathes, being present in the moment.
When doing this exercise correctly, you will feel a rise and fall on your abdomen, just above the belly button, NB, being postured in a slouched or slumped position or short and panicked breathes will not be effective when practicing this exercise.
Be present in the moment and feel your body and mind recalibrate itself.
Progressive Muscle Relaxation
Progressive muscle relaxation may be helpful with stress management and ruminative thinking which may be attributing to insomnia, there is a helpful link below with an automated youtube clip verbal prompts through the exercise. Before bed can be useful to target ruminative thinking that may be causing insomnia or difficulties falling asleep.
https://www.youtube.com/watch?v=ihO02wUzgkc
https://www.youtube.com/watch?v=1nZEdqcGVzo
Understanding Victim Services Support in NSW
Understanding Victim Services Support in NSW
The New South Wales (NSW) Victim Support Scheme provides practical and financial assistance to victims of violent crime to help with recovery and access to justice. Support includes counselling, financial aid for immediate needs, recognition payments, and assistance with justice-related costs. For survivors of institutional child sexual abuse, the National Redress Scheme offers monetary payments, counselling, and a personal apology from responsible institutions. Both schemes aim to acknowledge the harm experienced by victims and support their healing, with applications requiring specific eligibility criteria and documentation.
How to access Medicare Counselling Sessions.
How to access Medicare Counselling Sessions.
Under Australia’s Better Access initiative, individuals can access Medicare-subsidised counselling sessions with a registered mental health professional (such as a psychologist, social worker, or occupational therapist). To begin, visit a GP who will assess your mental health and, if appropriate, prepare a Mental Health Treatment Plan. This plan allows you to access up to 10 individual sessions per calendar year, with partial Medicare rebates. You may also be eligible for group therapy sessions. After the initial six sessions, a review with your GP is required to access the remaining four.
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