Calm place, container and resources: the EMDR preparation phase

Why preparation comes first

Reprocessing can temporarily bring up strong emotions and body sensations. A client who can't settle themselves may flood, dissociate or start avoiding, and the work stalls. Preparation widens the client's window of tolerance and gives both of you tools to close an incomplete session safely. With a single, recent trauma it may take one session. With complex or developmental trauma it can take much longer.

The calm place exercise

The calm place (or safe place) protocol is part of the standard EMDR preparation phase. The steps:

1. Image. Ask the client for a place, real or imagined, where they feel calm or at ease. It doesn't have to feel completely safe. For some clients safety isn't accessible yet, and calm is enough.
2. Emotions and sensations. Ask what they see, hear and smell, what they feel, and where they notice the pleasant feeling in their body.
3. Enhancement. Help them bring out the sensory details and strengthen the pleasant feeling.
4. Bilateral stimulation. While the client holds the image and the feeling, add a short set of slow movements, roughly 4 to 8 passes. Ask what they notice. Repeat a few times as long as the feeling keeps getting stronger.
5. Cue word. Ask for a word that fits the place, such as “beach” or “forest”, and pair it with the image during another short, slow set.
6. Self-cueing. The client brings up the place with the word, without your help.
7. Cueing with disturbance. The client thinks of a minor annoyance, notices how that feels, then uses the word to go back to the calm place. Practise until it works.

Watch out: if negative material enters the calm place, stop the bilateral stimulation. Fast or long sets can turn resource work into processing. If the place keeps getting contaminated, choose another one, or use a different resource, such as a calming person, animal or object.

The container exercise

A container helps the client put distressing material away until the next session. The client imagines a container strong enough to hold what is left: a safe, a vault, a sealed box. They imagine putting the disturbing images, sounds, feelings and thoughts inside, closing it and placing it somewhere out of the way. The material isn't gone; it waits until you work on it together.

The container is especially useful in phase 7, closure, when a target isn't finished. Practise it during preparation, while nothing is at stake. Use no bilateral stimulation, or only short and slow sets, while you install the container, so you don't start processing what goes into it.

Resource development and installation (RDI)

RDI was described by Deborah Korn and Andrew Leeds (2002) for the stabilisation phase of treatment with clients with complex PTSD. It strengthens specific qualities a client needs, such as courage, calm or the ability to set a boundary. The resource can come from:

• Mastery: a memory of a time when the client had that quality.
• Relationships: a person, real or fictional, who embodies the quality, or someone who supports the client.
• Symbols and metaphors: an image, an animal or an object that represents it.

The client brings up the resource in as much sensory detail as possible, and you add short, slow sets as long as the positive feeling grows. The original paper presented two case studies, so the evidence is preliminary, but RDI is widely used in practice.

Other tools for self-regulation

• Breathing: slow breathing with a longer out-breath than in-breath.
• Grounding with the senses: name 5 things you see, 4 you can touch, 3 you hear, 2 you smell and 1 you taste.
• The butterfly hug: alternating taps on the upper arms or collarbones, developed by Lucina Artigas and Ignacio Jarero. Clients can use it on their own between sessions.
• Light stream: the client imagines a soothing light flowing into the part of the body where they feel tension. It is often used during closure.

Settings for resource work in Remote EMDR

• Slow speed, short sets. Let the ball cross a few times, then press Stop. Resource sets are much shorter and slower than reprocessing sets.
• Calm backgrounds. The toolbar has calm scenes such as ocean, forest or night. Some clients find it easier to hold their calm place with a quiet background; others prefer a plain colour.
• Gentle sounds. If you use bilateral sound, a soft tone or a water drop is gentler than a beep.
• Practice at home. Encourage the client to practise their calm place and cue word between sessions, without bilateral stimulation or with the butterfly hug.

When is a client ready for reprocessing?

There is no single test, but useful signs are:

• the client can bring up their calm place or another resource and notice a change in their body,
• they can use the container or grounding to come down from a moderate level of disturbance,
• they understand and use the stop signal,
• their life is stable enough to handle what may come up between sessions.

If these aren't in place yet, spend more time on preparation, or discuss the case with your supervisor.