Integrating control-mastery theory and EMDR in the treatment of attachment-related trauma: Pathogenic beliefs, testing processes, and target selection

This paper proposes a clinical-theoretical integration of Control-Mastery Theory (CMT) and EMDR for the treatment of attachment-related trauma.

Article Abstract

“Attachment-related trauma often develops through repeated relational experiences involving emotional misattunement, role reversal, inconsistent caregiving, and chronic threats to relational security. Such experiences may contribute to pathogenic beliefs concerning dependency, responsibility, emotional expression, and interpersonal safety, while making the identification of clinically meaningful targets for trauma processing particularly complex. This paper proposes a clinical-theoretical integration of Control-Mastery Theory (CMT) and Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of attachment-related trauma. Drawing on the CMT concepts of pathogenic beliefs and testing, we suggest that relational processes within therapy may provide clinically useful information about the beliefs currently organizing the patient’s difficulties. Observation of passive-into-active, transference, and direct tests may help clinicians formulate and refine hypotheses about the relational meanings linking present difficulties to developmental experiences. When integrated with standard AIP-informed history-taking and EMDR target assessment, this information may contribute to the prioritization of candidate attachment-related memories for processing. The paper also introduces the concept of relational readiness as a complementary dimension of EMDR case conceptualization, referring to the extent to which pathogenic relational expectations have become sufficiently observable within the therapeutic relationship to inform target formulation, without replacing established considerations of stabilization, affect tolerance, or readiness for trauma processing. A clinical illustration is presented to demonstrate the proposed sequence from relational testing and disconfirmation to EMDR target formulation and processing. The model is intended as a hypothesis-generating framework rather than an empirically validated treatment protocol, and its incremental clinical value requires systematic investigation.”

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Article Access

Open Access 

Bedeschi, L. & Onofri, M. (2026). Integrating control-mastery theory and EMDR in the treatment of attachment-related trauma: Pathogenic beliefs, testing processes, and target selection. Frontiers in Psychology, 17: 1918050. https://doi.org/10.3389/fpsyg.2026.1918050 (opens in new tab)