Treating Shame with EMDR: Practical Strategies for Therapists

Guest Blog Post by Skye Ross, LCSW

Shame is a heightened emotional experience. Our behavioral and cognitive responses to shame can be similar to traumatic experiences, yet neuroscience research suggests that shame occurs within a unique neural network (Piretti et al., 2023; Davis, 2019). Experts in psychological shame suggest that shame develops along with our social awareness in our early attachment experiences (Gilbert, 1998; Schore, 1998; Tantam, 1998; Parnell, 2013). Early experiences in childhood, particularly with caregivers, inform whether someone feels valued and loved, which in turn leads to either positive self-beliefs (positive cognitions or PCs) or negative self-beliefs (negative cognitions, or NCs) (Parnell, 2013). As we now know, “the body keeps the score” and those early moments and self-beliefs can become associated with harmful experiences through our somatic, emotional, and cognitive responses (van der Kolk, 2014; Shapiro, 2018). When our current state does not match societal, familial, or personal expectations, it creates a moral injury and shame response (Piretti et al., 2023). Targeting the earliest experiences of shame and the associated negative cognitions can bring robust relief. 

The behaviors most often associated with shame are self-isolating, angry outbursts, over-apologizing, shutdown, hiding or trying to keep one’s shame a secret, and using substances to dissociate from the sensations and thoughts associated with shame (Gilbert, 1998). In the therapy room, these behaviors might be categorized under depressive, anxious, disordered substance use, and traumatized diagnostic presentations. The article below offers suggestions for attuning to shame experiences and reprocessing shame-related clusters with EMDR therapy.  The suggestions made here apply to phases one through four; phases five through eight proceed without alteration. 

Targeting shame through phases 1-4

Phase 1: History taking and treatment planning

Strong history taking and rapport-building are important to assessing whether your client lives with shame. Throughout the history taking process, remaining attuned to the client is imperative in processing shame. Keltner and Harker (1998) identify behaviors to draw clients’ attention as they indicate shame is present in the room. These include a client’s gaze shifting away, frowning, physical collapse (bent posture, shoulders hunched), and silence or verbal statements related to failure, negative self-evaluation, apologizing, or trying to leave. Staying present and attuned to a client who is feeling shame supports new attachment experiences (Parnell, 2013). 

Bring in language and concepts that are specific to EMDR during this phase. For example, as you notice a client discuss their history and hear things related to negative cognitions (NCs) or other beliefs about themself, ask how they saw themself at that time or how they think of themself looking back now. Reflect what you are hearing and how that might be processed with EMDR. This also offers an opportunity to provide some psychoeducation around trauma, shame, memory consolidation, and the adaptive information processing (AIP) model. 

Complete symptom-based treatment planning for shame memory clusters (Lombardo, 2012). To develop your treatment plan, either start with a recent event and complete a floatback or something recent or clearly symptom-inducing (in this case, shame-associated) and floatback. Effective verbiage for identifying earlier experiences within a cluster can come from the floatback developed by William Zangwill (Young, Zangwill, & Behary, 2002), in which you ask your client to “let your mind float back to an earlier time you had similar thoughts, feelings, or bodily sensations and tell me what comes up for you” (Young, Zangwill, & Behary, 2002, p 17). Another option is to ask repetitively about earlier times the NC and somatic experiences were felt to activate the neural network (Trauma Therapist Institute, 2025). These methods both help to identify touchstone memories associated with a cluster and potential targets to move into later. 

Phase 2: Preparation

Preparation to support shame processing incorporates resource development and installation (RDI) specifically related to skills or attributes they wish they had in moments of shame (Korn & Leeds, 2002; Young, Zangwill, & Behary, 2002) or may involve attachment-focused resourcing to experientially correct an insecure attachment (Parnell, 2013). 

As shame often first develops in early childhood (Gilbert, 1998; Schore, 1998; Tantam, 1998), it is useful to develop resources by identifying a time your client felt connected to a caregiver or developing an “ideal caregiver” resource (Parnell, 2013). This builds a felt sense of what secure attachment feels like in your client’s body and offers an installation of positive self-beliefs (positive cognitions/PCs) associated with a secure attachment figure. Having a strong, attachment-resource offers a somatic experience that feels opposite to negative, shameful experiences and more aligned with what the client would rather believe about themself. You can also use the present therapeutic alignment and connection as an adaptive attachment resource. 

If your client easily falls into shameful NCs and somatic experiences, RDI for a skill or positive cognition that they wish they had can be a useful tool (Korn & Leeds, 2002). This offers a powerful opportunity to connect to adaptive information based on the client’s own experiences. 

Phase 3: Assessment

In EMDR phase 3, the therapist can target shame either by floating back from a recent event or from a shaming experience that stands out in the patient’s past. Both internal shame experiences and shame-based behavioral responses offer material to target through EMDR (Greenwald & Harder, 1998). 

Zangwill offers common negative cognitions associated with the defectiveness/shame schema and their counterparts (Zangwill, 2023). The most common include: “I am bad/evil; I am defective/worthless; I am different (less than); I am selfish; I am unlovable; I am lacking.” Angela Kennedy (2014) suggests using the language “What words go best with that experience that expresses your inner critic and deepest hidden fears?” to develop the NC in the client’s own words. She offers the verbiage, “When you bring up that picture (or feeling state), what would your compassionate self say about the idea, remembering to use a supportive tone of voice toward yourself?” to support developing the PC. 

As you develop the target for EMDR, it is important to remember that early experiences may be preverbal or may not involve complex-enough language to resonate with an NC. In this case, you might notice that your client is struggling to identify a present NC that feels true to the experience. When this happens, target feeling states may be more helpful than fleshing out the NC. These target feeling states are seen as symptom clusters. You might draw from the installed resources from phase two to identify the positive cognition, as you have already laid the groundwork for the brain to integrate this adaptively. 

Phase 4: Reprocessing

In this phase, the therapist will choose interweaves that support desensitization and reprocessing and bring in adaptive information. EMDR therapists’ other training informs which interweaves they select. For example, a schema therapist will choose interweaves based on the defectiveness/shame schema, while a somatic therapist will offer interweaves that bring attention to and release sensations in the body. Attachment-focused adjustments, as recommended by Laurel Parnell (2013), can also support processing shame specifically. 

Phases 5 to 8 continue as in the standard EMDR protocol.  

The importance of attuning to shame in EMDR therapy

Some contemporary research indicates that it is just as important to be shame-sensitive as it is to be trauma-informed (Dolezal & Gibson, 2022). EMDR therapists can effectively target shame with the standard protocol and consider integrating other modalities and therapeutic approaches. As EMDR practitioners are well aware, frequent slights, particularly in childhood, can lead to internalized negative beliefs about oneself. While shame may stem from what therapists categorize as consistent “little t traumas,” our clients do not always resonate with calling these experiences traumatic. Targeting shame with EMDR therapy opens doors to offer relief to more clients. 

From insights to practice

Shame is both relational and neurobiological. EMDR therapy and compassion-and-attachment-focused interventions can support clients to reprocess their entrenched self-beliefs and feelings of shame.  

Dive deeper into the research on shame with the resources below, including the compilation edited by Paul Gilbert and Bernice Andrews’s book Shame (1998). This book offers therapists a more comprehensive understanding of how shame develops, how to notice it in the therapy room, and how to respond to it effectively. Gilbert went on to develop Compassion-Focused Psychotherapy to address shame specifically, and further training on this modality, or reading his book, will offer additional insights that EMDR therapists may integrate into their EMDR practice. It is also recommended that therapists seeking to address shame take EMDRIA-approved advanced trainings in compassion-focused EMDR, attachment-focused EMDR, and integrating EMDR and somatic therapy and/or schema therapy. 

Developing your knowledge, skills, and expertise with an approach that deepens your somatic attunement allows you to more confidently treat patients presenting with shame. 

 

Skye Ross is an EMDRIA Certified Therapist™ and a consultant-in-training. Her experience spans practice with people experiencing addiction, chronic illness, perinatal mental health disorders, and complex PTSD in community mental health, criminal court, and private practice. 

 

References 

Davis, S. (2019). The neuroscience of shame. CPTSD Foundation, accessed 8/31/2025: https://cptsdfoundation.org/2019/04/11/the-neuroscience-of-shame/ 

Dolezal, L. & Gibson, M. (2022). Beyond a trauma-informed approach and towards shame-sensitive practice. Humanities and Social Sciences Communications, 9: 214. https://doi.org/10.1057/s41599-022-01227-z 

Gilbert, P. (1998). What is shame? Some core issues and controversies. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 3-38). Oxford University Press. 

Gilbert, P., & Andrews, B. (Eds.). (1998). Shame: Interpersonal behavior, psychopathology, and culture. Oxford University Press.  

Gilbert, P. & McGuire, M. T. (1998). Shame, status, and social roles: Psychobiology and evolution. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 99-125). Oxford University Press. 

Gilbert, P., & Simos, G. (Eds.). (2022). Compassion focused therapy: Clinical practice and applications. Routledge.  

Greenwald, D. F. & Harder, D. W. (1998). Domains of shame: Evolutionary, cultural, and psychotherapeutic aspects. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 225-245). Oxford University Press. 

Keltner, D. & Harker, L. (1998). The forms and functions of the nonverbal signal of shame. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 78-). Oxford University Press. 

Kennedy, A. (2014). Compassion-focused EMDR. Journal of EMDR Practice and Research, 8(3), 135-146. https://doi.org/10.1891/1933-3196.8.3.135 

Korn, D. L. & Leeds, A. M. (2002). Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex post-traumatic stress disorder. Journal of Clinical Psychology, 58(12), 1465-1487. https://doi.org/10.1002/jclp.10099  

Lombardo, M. (2012). Clinical Q & A. EMDR target timeline. Journal of EMDR Practice and Research, 6(1), 37-46. https://doi.org/10.1891/1933-3196.6.1.37  

Parnell, L. (2013). Attachment-focused EMDR: Healing relational trauma. W.W. Norton & Company. 

Piretti, L., Pappaianni, E., Garbin, C., Rumiati, R.I., Job, R, & Grecucci, A. (2023). The neural signatures of shame, embarrassment, and guilt: A voxel-based meta-analysis on functional neuroimaging studies. Brain Science, 13(4), 559. https://doi.org/10.3390/brainsci13040559  

Schore, A. N. (1998) Early Shame Experiences and Infant Brain Development. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 57-77). Oxford University Press. 

Shapiro, F. (2018). Eye movement desensitization and reprocessing therapy: Basic principles, protocols, and procedures (3rd ed.). The Guilford Press. 

Tantam, D. (1998). The Emotional Disorders of Shame. In A. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 161-175). Oxford University Press. 

Trauma Therapist Institute. (2025). EMDR target sequence plans made easy: Navigating target sequences. Accessed 10/5/25: https://www.traumatherapistinstitute.com/blog/EMDR-Target-Sequence-Plans-Made-Easy-Navigating-Target-Sequences 

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking. 

Young, J., Zangwill, W., and Behary, W. (2002). Combining EMDR and schema- focused therapy: The whole may be greater than the sum of the parts. In F. Shapiro (Ed.), EMDR as an integrative psychotherapy approach (pp. 181-208). American Psychological Association. 

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Date
January 16, 2026

Contributor(s)
Skye Ross

Topics
Attachment

Practice & Methods
Your EMDR Practice

Audience
EMDR Therapists

Language
English

Content Type
Blog/Blog Post

Access Type
Open Access

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