What’s the Difference Between Attachment-Informed EMDR and Attachment-Focused EMDR?
If you are exploring EMDR for trauma linked to early relationships, neglect or difficult childhood experiences, you may come across the terms attachment-informed EMDR and Attachment-Focused EMDR.
The names sound very similar, and both describe ways of adapting EMDR when attachment and early relational experiences are important. However, they do not refer to two equivalent formally recognised treatments, and the terminology can sometimes be confusing.
This article explains where the terms come from, how they differ and what may matter more than the label when choosing an EMDR therapist.
If you are new to EMDR itself, you may want to begin with Philip’s guide to EMDR therapy.
What Does Attachment Mean in Therapy?
Attachment theory concerns the ways early relationships with caregivers can influence expectations of safety, closeness, support and relationships.
Early experiences differ enormously. Some people grow up with caregivers who are consistently available and responsive. Others may experience neglect, frightening behaviour, emotional inconsistency, loss, abuse or relationships in which their needs are repeatedly misunderstood or unmet.
Experiences of this kind can sometimes contribute to difficulties later in life, including:
- fear of rejection or abandonment
- difficulty trusting other people
- strong reactions within close relationships
- shame or negative beliefs about the self
- difficulty recognising or expressing needs
- emotional dysregulation
- dissociation in some people
Not everybody with relationship difficulties has experienced attachment trauma, and attachment patterns should not be used as a simple explanation for every psychological difficulty.
How Does Attachment Relate to EMDR?
EMDR is an established psychological treatment with particularly strong evidence for post-traumatic stress disorder (PTSD).
The standard EMDR model already includes assessment, preparation, memory processing and attention to the client’s ability to tolerate treatment.
For people with multiple traumatic experiences, dissociation, emotional dysregulation or complex relational histories, additional preparation or a slower pace may sometimes be needed.
This is consistent with NICE guidance on PTSD, which recommends that EMDR should be delivered in phases and that people with complex needs may require additional time to develop trust and address barriers to trauma-focused treatment.
Attachment-focused or attachment-informed approaches build on this clinical territory, but they do so in somewhat different ways.
What Is Attachment-Focused EMDR?
Attachment-Focused EMDR (AF-EMDR) is an approach developed by psychologist and EMDR trainer Dr Laurel Parnell.
The approach modifies and extends aspects of standard EMDR with particular emphasis on early relational trauma, therapeutic attunement and developing internal resources before or alongside trauma processing.
The Parnell Institute, which provides training in Attachment-Focused EMDR, describes the model as combining EMDR with Resource Tapping, talk therapy and a reparative therapeutic relationship.
Features associated with Attachment-Focused EMDR
- a strong emphasis on the therapeutic relationship
- additional resource development before processing difficult material
- the use of imagery and supportive or nurturing figures
- Resource Tapping using bilateral stimulation
- attention to unmet developmental and relational needs
- adaptations to standard EMDR procedures where appropriate
Some clients may find imagery and resource-based work particularly accessible. Others may prefer a different style.
It is therefore better to view Attachment-Focused EMDR as a particular developed approach within the wider EMDR field rather than assuming that it is automatically more appropriate for everyone with childhood or relational difficulties.
What Is Attachment-Informed EMDR?
Attachment-informed EMDR is a term particularly associated in the UK with EMDR consultant Mark Brayne.
It describes using an explicit understanding of attachment and formative experiences when conceptualising and delivering EMDR.
Rather than necessarily treating attachment-informed EMDR as a completely separate protocol, Brayne has described it as complementary to standard EMDR, retaining the established EMDR framework while paying greater attention to attachment history, relational experience and the way earlier experiences may organise current difficulties.
In his article What’s in a name? Process matters for EMDR Therapy Quarterly, published by the EMDR Association UK, Brayne explains the thinking behind his use of the term attachment-informed EMDR and its emphasis on formative and relational experience.
Features commonly associated with attachment-informed EMDR
- exploring formative and attachment experiences during case formulation
- considering how early relationships may influence present difficulties
- working carefully with clients who become overwhelmed or dissociate
- using additional preparation and resources where needed
- placing importance on the therapeutic relationship
- integrating attachment thinking while retaining the broader EMDR framework
The precise way attachment-informed EMDR is practised may vary between therapists, so the label alone does not tell you exactly how treatment will be delivered.
Attachment-Informed vs Attachment-Focused EMDR
The simplest distinction is that Attachment-Focused EMDR is a particular approach developed by Laurel Parnell, while attachment-informed EMDR describes an attachment-aware way of conceptualising and delivering EMDR that has been developed particularly through Mark Brayne’s work in the UK.
They overlap considerably.
Both may place greater emphasis than straightforward work with a single traumatic incident on:
- early relationships
- developmental experiences
- therapeutic safety
- preparation and resources
- pacing
- the therapeutic relationship
Attachment-Focused EMDR has its own identifiable training model and techniques associated with Parnell’s work. Attachment-informed EMDR is better understood as incorporating attachment thinking into EMDR case formulation and practice.
Are These Different from Standard EMDR?
They are adaptations or developments within the wider EMDR field rather than replacements for the fundamental principles of EMDR.
Standard EMDR already involves eight phases of treatment, including:
- history-taking and treatment planning
- preparation
- assessment of target memories
- desensitisation
- installation
- body scan
- closure
- re-evaluation
NICE recommends that EMDR for PTSD should be based on a validated manual, delivered by trained practitioners with ongoing supervision and include appropriate preparation and strategies for managing distress.
That evidence base belongs primarily to established EMDR treatment rather than specifically proving that one attachment adaptation is superior to another.
What About Complex PTSD and Developmental Trauma?
People who have experienced repeated childhood abuse, neglect, frightening caregiving or other prolonged traumatic experiences may sometimes present differently from someone seeking treatment after a single traumatic event.
There may be difficulties involving:
- emotional regulation
- dissociation
- trust
- relationships
- negative beliefs about the self
- shame
- multiple interconnected traumatic memories
NICE recognises that people with PTSD and additional complex needs may require more time to develop trust and to address difficulties such as dissociation, emotional dysregulation and interpersonal problems before or alongside trauma-focused work.
That provides a sound clinical reason for adapting the pace and preparation of EMDR without needing to suggest that every person with complex trauma requires one particular branded form of EMDR.
Does Attachment Trauma Always Come from Childhood?
No.
Early caregiving relationships can be important, but significant relational trauma can also occur later in life.
Examples may include:
- domestic abuse
- coercive or controlling relationships
- betrayal
- bereavement or traumatic loss
- relationship violence
- other experiences in which trust and safety have been significantly disrupted
Therapy should therefore consider the person’s actual history rather than assuming that every present-day difficulty must originate in childhood attachment.
Which Approach Is Right for You?
You do not necessarily need to decide between Attachment-Focused and attachment-informed EMDR before contacting a therapist.
More useful questions may be:
- Is the therapist appropriately trained in EMDR?
- Do they have experience with the difficulties I am seeking help with?
- How do they assess readiness for trauma processing?
- How do they work if I become overwhelmed or dissociate?
- How much preparation might I need before processing memories?
- How do they adapt EMDR for complex or repeated trauma?
- Do I feel sufficiently comfortable and understood when speaking with them?
The name attached to an approach matters less than whether the therapist can explain clearly what they are doing, why they are doing it and how it fits your particular needs.
Working with Attachment-Informed EMDR
Philip works with adults whose present difficulties may be connected with traumatic, distressing or difficult relational experiences.
Where attachment history is relevant, it can form part of understanding the person’s wider experience rather than treating isolated symptoms without context.
EMDR can then be adapted in pace and preparation according to the client’s needs while remaining grounded in the broader EMDR treatment framework.
Philip may also draw on Internal Family Systems therapy where this offers a useful way of understanding protective responses and internal conflict.
Exploring EMDR Therapy
If you are considering EMDR for trauma, childhood experiences or long-standing relational difficulties, you can learn more about Philip Bruce’s approach to EMDR therapy.
If you are unsure whether standard EMDR, an attachment-informed approach or another form of therapy would be appropriate, you can contact Philip for an initial consultation.
