How to Expand Phase 2 of EMDR with Clients Who Experience High Dissociation

By: Jenn Bovee, LCSW, CRADC, CCTP II, CCHt
EMDRIA Certified Therapist & EMDRIA Approved Consultant

Working with clients who experience high levels of dissociation requires a thoughtful, flexible, and trauma-informed approach. This is especially true when using EMDR therapy. While the eight-phase protocol provides structure, many clinicians find that Phase 2, Preparation, is the heart of the work for clients with significant dissociative tendencies. Expanding this phase is not only clinically appropriate but often essential for ensuring safety, engagement, and long-term integration.

In clinical terms, dissociation is a protective mechanism. It develops for good reason, often in the face of overwhelming or chronic trauma. Clients may present with a range of dissociative experiences, from mild detachment or zoning out to more profound experiences like identity fragmentation or amnesia. Regardless of where they fall on the spectrum, these clients often need a slower, more attuned pace and additional resources before moving into memory processing.

Many EMDR-trained therapists were taught to keep Phase 2 brief. However, for clients with higher dissociation, a longer and more expansive preparation period is not just helpful, it’s often necessary. Phase 2 is where we build the foundation for all that follows. It’s where clients begin to internalize safety, regulation, and trust in the process. And for those who have long lived in a state of survival, these foundations take time.

Stabilization is more than just installing a calm place. It includes co-creating a language of safety between therapist and client. This often involves identifying subtle cues of dysregulation, refining affect tolerance, and ensuring the client has a robust toolbox of grounding skills they can access both in and out of session. Some clients will need repeated practice and reinforcement of these skills before they feel usable in moments of stress or activation.

Clients with dissociative symptoms often struggle with interoception, the ability to notice and interpret internal bodily signals. Helping clients develop somatic awareness can be a powerful addition to Phase 2 work. This might include guided body scans, mindful movement, or simply tracking subtle shifts like warmth, tension, or breath rhythm. The goal isn’t to push clients into the body but to gently build capacity for noticing without judgment. This helps widen the window of tolerance and creates a more stable base for future processing.

It’s also important to be transparent with clients about the EMDR process. Dissociative clients often have parts that hold fear, suspicion, or confusion about therapy. Phase 2 is a place to build collaboration and allow space for all parts of the self to express concerns. This might involve incorporating parts work, whether you formally use a model like Internal Family Systems (IFS) or simply acknowledge the internal experience of different states or identities. Giving voice to protective parts during this phase can increase safety and buy-in.

Creating a consistent structure for sessions also becomes a regulating force. Many clients with dissociation benefit from a predictable session flow. Knowing that there is time for check-in, regulation, resourcing, and a clear close can reduce anxiety and help anchor them in the here and now. This can be especially helpful if their trauma history involves chaos or unpredictability in early relationships.

Some therapists worry that staying in Phase 2 too long is a sign of therapeutic avoidance or that it delays progress. But for clients with complex trauma and dissociation, Phase 2 is progress. When a client starts to notice early signs of disconnection and uses a grounding technique that works for them, that’s a breakthrough. When a client who once dissociated through every therapy session begins to make eye contact or share emotions, that’s Phase 2 doing its job.

For these clients, resourcing may look different than what’s described in the standard EMDR manual. It may include bilateral stimulation paired with imagery of internal safe spaces, working with parts that have not previously engaged, or developing metaphors that resonate with the client’s lived experience. The key is creativity and attunement, not rushing to get to desensitization.

Expanding Phase 2 doesn’t mean endlessly postponing reprocessing. Rather, it reflects a commitment to pacing the work in a way that honors the client’s nervous system. Some clients will signal readiness clearly. Others will need your help tracking subtle signs of capacity and overwhelm. Either way, your attunement to their readiness is part of the healing.

In some cases, clients may reach a level of stabilization where they are ready to process discrete, less complex memories before tackling more distressing or fragmented trauma. This "target hierarchy" approach allows the client to experience success with EMDR while still respecting the need for ongoing stabilization. It’s a balancing act, and one that Phase 2 makes possible.

Therapists also benefit from clinical consultation and support when working with high-dissociation cases. These clients can evoke a deep countertransference, sometimes leaving the therapist unsure of their own sense of timing or effectiveness. Peer consultation and advanced EMDR training can provide guidance, clarity, and reinforcement of what you likely already sense: that slowing down is not failure, it’s clinical wisdom.

Ultimately, Phase 2 is about building safety, capacity, and connection. When we expand it thoughtfully for clients with dissociation, we’re not stepping outside of EMDR; we’re embodying it. The EMDR protocol is a map, but the therapeutic relationship is the vehicle. And for clients with complex trauma, that relationship is often the first safe space they’ve known.

If you’re a therapist offering EMDR and you’re seeking support in navigating complex trauma or dissociation in your clients, I offer consultation and training focused on trauma-informed, paced EMDR therapy. If you’re a client wondering if EMDR is right for you, know that therapy can move at a pace that honors your story and nervous system. You're not too much, and you're not alone.

For more information, please click here: https://www.mymentalwellnesscompany.com/emdr-consultation-cohorts-1