Working with Preverbal Trauma in EMDR Therapy

Working with Preverbal Trauma in EMDR Therapy Guest Blog Post by Deborah Del Vecchio-Scully, LPC, LMHC, BCN, DCMHS One of the more nuanced challenges in Eye Movement Desensitization and Reprocessing (EMDR) therapy involves working with clients who present clear trauma-related symptoms but have little or no explicit memory of adverse experiences. My clients have shared an awareness of “something disturbing” without an explicit memory. These clients frequently report chronic anxiety, attachment disturbances, somatic symptoms, affect dysregulation, relational difficulties, or persistent negative self-beliefs without a narrative to explain their distress. In these types of cases, clinicians may be encountering the effects of preverbal trauma. As our understanding of developmental trauma, attachment, and implicit memory continues to evolve, EMDR therapists are increasingly called upon to conceptualize trauma beyond explicit episodic memory and recognize how early adverse experiences may be encoded within the central nervous system and somatic experience. Preverbal trauma Preverbal trauma includes overwhelming or distressing experiences that occur during conception, pregnancy, infancy, and early childhood—before children have the words to describe their experiences or the ability to consciously remember them. Although these experiences may not be recalled as memories, they can become deeply embedded within the nervous system and continue to influence emotional, relational, and physiological functioning throughout life. Individuals may experience emotional, relational, or physiological challenges later in life without a clear understanding of their origins. Abuse and neglect are commonly associated with preverbal trauma; however, preverbal trauma can also result from circumstances beyond a parent’s control. Experiences such as premature birth requiring neonatal intensive care (NICU) hospitalization, separation from a primary caregiver shortly after birth, medically complicated or traumatic deliveries, maternal health complications, limited parental leave, postpartum depression or anxiety, and adoption may all disrupt early attachment and regulation. While these experiences are not inherently traumatic, they can become overwhelming for an infant’s developing nervous system, particularly when they involve prolonged stress, separation, or reduced opportunities for consistent co-regulation and attunement. Research in developmental neuroscience suggests that early experiences are encoded primarily through implicit memory systems, including sensory, emotional, procedural, and somatic channels. These experiences contribute to the formation of internal working models of self, others, and the world long before language becomes available to organize experience into narrative form (Siegel, 2020; Steele, 2020). As a trauma researcher, Dr. Bessel van der Kolk has noted that traumatic experiences are often remembered not as stories but as sensations, emotional states, physiological responses, and behavioral patterns. Even before birth, the developing brain and nervous system are actively responding to sensory experiences, laying out the foundation for how we perceive, process, and interact with the world. When one’s earliest experiences aren’t healthy or safe, preverbal trauma emerges. For many clients, the body becomes the primary container of early experience (van der Kolk, 2014). From an Adaptive Information Processing (AIP) perspective, these early experiences may remain maladaptively stored within memory networks, continuing to influence present functioning despite the absence of conscious recall. In many ways, preverbal trauma may be the unknown touchstone for clients with complex post-traumatic stress disorder (C-PTSD). Developmental trauma, attachment, and the emergence of Self The intersection of attachment theory and EMDR therapy provides a useful framework for understanding preverbal trauma. Simply stated, when the psychological wound is attachment-based, it is preverbal. Understanding how early relational experiences shape nervous system development, the development of a secure sense of self, and the unfolding of self-organization across the lifespan is vital to identify preverbal trauma. When caregivers are consistently attuned, responsive, and able to support co-regulation, the developing child is more likely to internalize a felt sense of safety and form secure attachment patterns that support emotional flexibility and regulation (Perry & Winfrey, 2021; Steele, 2020; Schwartz, 2020). In contrast, experiences of chronic mis-attunement, emotional neglect, caregiver dysregulation, or early separation can interrupt these foundational processes. Over time, these early relational disruptions may contribute to difficulties in maintaining a sense of internal and external safety and can shape how the nervous system organizes around stress and connection. Clinically, these early patterns often present as: Persistent states of hyperarousal or hypoarousal Enduring experiences of shame or negative self-perception Fear of abandonment or difficulty with trust in relationships Over-extending or under-extending trust, particularly in romantic relationships Challenges with emotional regulation and affect integration Patterns of relational withdrawal or anxious dependency Somatic distress or body-based symptoms of dysregulation Negative self-referencing beliefs A chronic or underlying sense of unsafety Importantly, these symptoms may not be linked to a specific remembered event. Instead, they may represent adaptations to repeated developmental experiences encoded during the earliest stages of development, before experiences could be organized into language, narrative, or conscious memory . EMDR treatment considerations: treating preverbal trauma is much more than a protocol The AIP model offers a valuable lens through which to understand preverbal trauma. When adaptive integration is disrupted in utero, infancy, and early childhood, experiences may become stored in state-dependent memory networks that continue to exert influence throughout the lifespan. These experiences occur long before a child can tell their story, yet they may continue to shape how the nervous system responds to safety, connection, and stress throughout life. Modification of the EMDR standard protocol is required with an emphasis on somatic symptoms, movement impulses, nonverbal fragments or images, and dissociation . Somatic floatback technique can be used as an alternate to traditional floatback (Schwartz, 2020; The Art and Science of EMDR, 2024 ). Phase 1: Client history taking Incorporate a purposeful examination of the client’s earliest experiences integrating all senses. The important modification in Phase 1 can be the use of a somatic floatback without the use of an affect scan or traditional floatback. This helps to develop a new way of listening and attending to the client’s experience by integrating somatic and sensory content. Observing the body: What do you see? Hearing: Noticing tone of voice, pitch, volume Content: Sensation or disturbance without known memory Sensory: Touch, smell, startle reaction Some questions to explore include: What were the circumstances of conception, pregnancy, and birth? What were the circumstances of the client’s first year of life? What is the client’s earliest memory? Does the client express distress without linking to a memory? Are there gaps in memory from childhood? Was the client adopted, in an orphanage, or in the foster system? Is the client dissociative? Are the client’s current relationships stable and healthy? Phase 2: Preparation and stabilization Clients with significant developmental trauma histories may demonstrate limited distress tolerance, fragmented self-states, attachment sensitivities, or autonomic nervous system dysregulation. Consequently, treatment frequently involves a slower pace and greater attention to therapeutic attunement than is typically required. Clinical interventions may include: Resource Development and Installation (RDI) Attachment-focused resourcing Somatic tracking and interoceptive awareness Ego state interventions Developmental repair strategies Phase 3: Assessment Implicit targets emerge through current triggers, recurring body sensations, emotional states, dreams, attachment themes, or implicit beliefs rather than explicit memories. When processing occurs, clients often report shifts in longstanding emotional patterns, reductions in somatic distress, increased self-compassion, and a greater sense of internal safety—even when no specific childhood memory is accessed. Phase 4: Desensitization Reprocessing implicit memory requires a focus on somatic and sensory experience only. While there are different approaches, the one common theme is reprocessing somatic symptoms (The Art and Science of EMDR, 2024 ; Grof & Bennett, 1992 ; Paulsen & O’Shea, 2017 ; and Schwartz , 2021 ). Clients are supported in setting aside their thoughts to focus on their felt sense. Connected disturbance is reprocessed. Healing beyond narrative memory One of the most important clinical lessons in treating preverbal trauma is recognizing that healing does not require conscious recollection. The absence of explicit memory should not be mistaken for the absence of trauma. Nor should it be viewed as a barrier to adaptive resolution. The body always remembers what the mind cannot communicate. We must assist clients in accessing information beyond their thinking and knowing minds. This process does not include a search for preverbal memories. Some clients may access explicit memory, but most often that doesn’t occur, and such a search may contribute to distress and dysregulation. EMDR therapy offers a framework for accessing and processing the emotional, somatic, and procedural manifestations of maladaptively stored experiences. Through careful attention to implicit memory networks, attachment dynamics, and nervous system regulation, therapists can support clients in resolving developmental wounds that originated before words were available. Many clients seeking treatment for anxiety, trauma, relational challenges, and emotional dysregulation may be carrying the effects of developmental experiences that exist beyond conscious recall. Through EMDR therapy and other neurobiologically informed interventions, clinicians can help clients move toward greater integration, resilience, and adaptive functioning across the lifespan. As our field continues to integrate findings from attachment research, interpersonal neurobiology, and trauma neuroscience, EMDR remains uniquely positioned to facilitate healing at the intersection of mind, body, and relational experience. Deb Del Vecchio-Scully, LPC, LMHC, BCN, DCMHS, is a nationally recognized expert in the treatment of trauma and holds diplomat status as a clinical mental health specialist in trauma counseling. She is Board Certified in Neurofeedback and is a certified yoga therapist. Del Vecchio-Scully is an EMDRIA Approved Consultant™ and an EMDRIA continuing education provider offering training and consultation on preverbal trauma, attachment, communal trauma, and childhood trauma. She served as the Newtown Clinical Recovery Leader following the Sandy Hook School shooting, which formed a foundation for treating complex PTSD, attachment and preverbal trauma. References Grof, S., & Bennett, H. (1992). The holotropic mind. HarperOne Mondays With Moshe. (2025, April 29). April Steele imaginal nurturing. YouTube. https://www.youtube.com/watch?v=6mBcq2GLGe0 Paulsen, S. & O’Shea, K. (2017). When there are no words: Repairing early trauma and neglect from the attachment period with EMDR. Createspace Independent Publishing Platform. Perry, B. (n.d.). Dr. Bruce Perry video playlist. YouTube. https://www.youtube.com/playlist?list=PLODOKY7Si1Srt4ue0Bdd8V-5tMVIoonZI Perry, B., & Winfrey, O. (2021). What happened to you? Conversations on trauma, resilience and healing. Flatiron Books. Schwartz, A. (2021). The complex PTSD workbook: A mind-body approach to regaining emotional control and becoming whole. Callisto. Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing Therapy: Basic Principles, Protocols, and Procedures (3 rd ed.). The Guilford Press. Siegel, D. J. (2020). The developing mind: How relationships and the brain interact to shape who we are. The Guilford Press. The Art and Science of EMDR. (2024, Sep 24). EMDR beyond the basics: Preverbal trauma & EMDR with Deb Del Scully. YouTube . https://www.youtube.com/watch?v=3nI6Fr0j1Hs van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books. 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