Incorporating EMDR Therapy Into Couples Work
Guest Blog Post by Dr. Monique Thompson, LPC
Tell us a little bit about you, your experience becoming an EMDR therapist, and your experience working with couples.
For nearly 25 years, my clinical work has focused on adult survivors of sexual trauma and couples recovering from infidelity. A few years ago, as I approached a professional milestone, I decided to pursue EMDR training as a way of deepening my work and honoring the longevity of my practice. What I did not anticipate was how quickly EMDR would transform the way I work with couples—particularly those navigating betrayal trauma.
Before integrating EMDR into my practice, I frequently referred clients out for trauma reprocessing. While some followed through, many did not. Barriers such as insurance limitations, discomfort with starting over, or the emotional cost of seeing another provider often prevented clients from accessing EMDR. Even so, when clients did complete EMDR elsewhere, I consistently observed meaningful shifts: greater emotional presence, reduced reactivity, and increased capacity for relational work.
Offering EMDR in-house removed those barriers. More importantly, it allowed trauma work and relational repair to unfold in real time, within the same therapeutic container.
What are some themes that you encounter that typically bring couples into couples therapy?
In couples therapy—especially following infidelity—unresolved trauma often dominates the room. Betrayed partners frequently express a painful refrain: “I can’t get over it.” This is usually accompanied by persistent “why” questions: Why did my partner cheat? Why didn’t I leave? Why does this still affect me years later?
What is often missed, however, is that the partner who cheated is also frequently operating from a dysregulated nervous system. While the injured partner may experience betrayal trauma, the partner who crossed the boundary often presents with a different—but still clinically significant—pattern of stress responses shaped by shame, fear of loss, and attachment threat.
In my work, many partners who have cheated arrive internally panicked about being judged or rejected, mentally rehearsing explanations or defenses, or emotionally shut down as a way of coping. Common negative cognitions may include beliefs such as “I’m a terrible person,” “I’ve ruined everything,” “I have to fix this right now,” or “If I fully take this in, I will collapse.” These internal states can drive defensiveness, minimization, avoidance, over-explaining, or urgency to move on—patterns that interfere with accountability, empathy, and meaningful repair when left unaddressed.
What is one of your favorite things about using EMDR therapy?
For many years, I asked couples to pause decision-making for a set period of time. While couples were often able to delay deciding whether to stay or leave, the path toward that decision was frequently marked by ongoing distress. Trauma remained a constant, heavy presence during this waiting period.
EMDR offers relief in that space. From an Adaptive Information Processing (AIP) perspective, reactions on both sides of a relational rupture reflect experiences that have not yet been adequately integrated, rather than intentional resistance or lack of care. Neurobiological research on attachment and stress suggests that betrayal disrupts systems related to bonding, safety, and reward for both partners (Negash, Carlson, & Linder, 2018; Porges, 2011). As a result, partners may begin to view the work as futile, and therapists may experience sessions as stalled. Clinically, this sense of being “stuck” reflects unresolved trauma rather than therapeutic failure—and it is precisely the point at which trauma-informed intervention is needed.
When trauma remains unaddressed, traditional couples interventions often stall because the nervous system is not yet ready for relational repair. EMDR allows both partners to reduce reactivity, process shame- and fear-based beliefs, and develop the internal steadiness required for accountability, empathy, and sustained engagement.
Clinically, this often shows up as partners being able to remain present during difficult conversations without escalating, shutting down, or rushing toward premature decisions. This shift has been one of the most meaningful changes in my work.
How can EMDR therapy be incorporated into couples therapy? What successes have you seen?
In couples work—particularly following betrayal—unresolved trauma can derail sessions entirely. Partners may leave appointments, refuse to attend, or shut down emotionally when difficult material arises. In these cases, individual EMDR sessions can help partners tolerate distressing content and approach, rather than avoid, relational work.
Establishing a strong therapeutic alliance remains my highest priority in couples therapy. When safety and trust are present, couples are often willing to postpone major decisions long enough to address trauma first. EMDR supports this process by helping clients move out of survival-driven states and into clearer discernment. Importantly, reduced activation does not dictate which decision a couple will make—it simply allows decisions to be made with greater clarity and less reactivity.
One of the earliest and most consistent successes I observed after integrating EMDR into couples work was a noticeable reduction in negative cognitions and an increased capacity for self-regulation when processing highly sensitive material in session. In betrayal work, urgency around decision-making is often the most pressing challenge. Couples frequently arrive seeking an immediate answer to the question, “Should we stay together?” EMDR helps slow this process, creating space for stabilization, reflection, and more grounded engagement. For this reason, EMDR is not optional in my work with betrayal; it is essential.
EMDR can be integrated flexibly and thoughtfully into couples therapy. One approach involves joint sessions in which one partner engages in EMDR while the other remains present as a witness. In some cases, both partners may engage in bilateral stimulation during the same session, provided that containment, pacing, and clinical readiness are carefully assessed.
Experiential EMDR literature suggests that witnessing a partner’s trauma processing can deepen empathy and emotional attunement (Capps, Andrade, & Cade, 2005). Observing trauma resolution firsthand may foster accountability, compassion, and relational repair in ways that conversation alone often cannot.
When conducting joint EMDR sessions, I recommend extended appointments—typically 90 minutes or longer—to allow adequate time for preparation, processing, stabilization, and closure. EMDR can move quickly, and sufficient session length supports both nervous system regulation and relational safety.
In my practice, I have found it most effective to begin with individual EMDR sessions for each partner before introducing joint EMDR work. Individual preparation reduces activation and strengthens internal regulation, making conjoint sessions safer and more productive. Once both partners are more regulated, joint EMDR sessions tend to result in increased emotional stability, improved empathy, and greater capacity for relational repair.
Ethical considerations
EMDR is not a guarantee of relationship recovery. Its purpose is not to preserve relationships at all costs, but to reduce survival-based functioning and support clearer discernment. Improved regulation does not necessarily mean partners will choose to stay together, and therapists must remain attentive to outcome neutrality throughout the process.
Careful assessment of readiness, safety, and clinical stability is required before initiating EMDR within a couples framework. In my practice, each partner completes the preparation and stabilization phases individually before any trauma reprocessing is introduced, ensuring adequate internal regulation and containment before conjoint EMDR work.
What multicultural considerations might EMDR therapists need to keep in mind?
Betrayal is defined not by monogamy versus non-monogamy, but by violation of agreed-upon consent and relational boundaries. Cultural and religious values shape how betrayal and healing are understood. In some cultures, divorce is not an option. In some religions, EMDR may not be a readily accepted approach. Respecting these values and maintaining a strong therapeutic alliance is essential.
Are there any myths you would like to bust about using EMDR therapy with couples?
A common misconception is that behaviors such as defensiveness, shutdown, or withdrawal reflect poor communication or lack of motivation. In many cases, these behaviors are trauma responses rather than characterological traits. EMDR can reduce these trauma-driven responses, allowing traditional approaches—such as Gottman-informed communication work—to be more effective once the nervous system is better regulated.
Another myth is that partners must be referred out for individual trauma therapy before couples work can continue. Many partners present with PTSD-like symptoms, including intrusive thoughts, emotional reactivity, avoidance, and difficulties with emotional regulation and intimacy. Setting aside individual sessions specifically for EMDR, or conducting EMDR within the couples therapy framework, can provide symptom relief that allows partners to remain present and engaged in the relational work.
A further misconception is that EMDR cannot be conducted with both partners present. EMDR can be done with one partner processing while the other bears witness, or with both partners engaging in bilateral stimulation when clinically appropriate and carefully managed (Capps, Andrade, & Cade, 2005).
There is also a belief that EMDR must be practiced in isolation from other therapeutic approaches. In my work, I draw from parts-based concepts informed by Internal Family Systems (IFS), which conceptualizes post-trauma responses as protective internal states organized around unresolved emotional burdens (Schwartz, 1995; Schwartz & Sweezy, 2019). This framework supports stabilization, pacing, and internal awareness, while EMDR remains the primary trauma-processing model.
Across modalities, my task is not to be loyal to a method, but to the person sitting in front of me. The therapeutic relationship and the client’s nervous system readiness guide which tools are most appropriate in any given moment.
What would you like people outside the EMDR community to know?
For me, EMDR training was only the first step. Thoughtfully integrating it into my existing caseload—and experiencing EMDR as a client myself—deepened my understanding of the process and strengthened my clinical effectiveness.
EMDR pairs well with other modalities, including cognitive behavioral therapy, dialectical behavior therapy, and trauma-informed approaches such as Polyvagal Theory and Internal Family Systems, when these approaches support stabilization, preparation, and integration without altering the core EMDR protocol or exceeding the clinician’s scope of training.
When trauma is addressed directly, couples are often able to engage in relational work with greater clarity, compassion, and agency—regardless of the relational outcome they ultimately choose.
Further exploration
Creager, T., & Eason, M. (Hosts). (2025, March 19). 228 | EMDR: How it can help heal infidelity trauma [Audio podcast episode]. In Let’s Talk About Love, Sex & Infidelity. Apple Podcasts. https://podcasts.apple.com/us/podcast/228-emdr-how-it-can-help-heal-infidelity-trauma/id1492757242?i=1000699987102
Dabach, J. (Host). (2025, December 12). Getting out of the burning house: Trauma, infidelity, and EMDR in couples therapy (feat. M. Thompson) [Audio podcast episode]. In The Jon Dabach Show. Apple Podcasts. https://podcasts.apple.com/us/podcast/getting-out-of-the-burning-house-trauma-infidelity/id1668643123?i=1000741008995
Howard, K. (Host). (2023, March 1). EMDR therapy with couples with Dr. Jason Linder, LMFT (Season 2, No. 5). In Let’s Talk EMDR podcast. EMDR International Association. https://www.emdria.org/podcast/emdr-therapy-and-couples/
Dr. Monique Thompson, DHA, LPC-S, is an EMDR-trained therapist with nearly 25 years of experience specializing in trauma recovery, infidelity, and couples work. She has served as Associate Faculty in the College of Social and Behavioral Sciences at the University of Phoenix since 2009, consulted with Southern Methodist University Perkins School of Theology for over 20 years, and has supervised Licensed Professional Counselor interns to independent practice since 2007.
References
Capps, F., Andrade, H., & Cade, R. (2005). EMDR: An approach to healing betrayal wounds in couples counseling. In G. R. Walz & R. K. Yep (Eds.), VISTAS: Compelling perspectives on counseling (pp. 107–110). American Counseling Association.
Negash, S., Carlson, S. H., & Linder, J. N. (2018). Emotionally focused therapy and eye movement desensitization and reprocessing: An integrated treatment to heal the trauma of infidelity. Couple and Family Psychology: Research and Practice, 7(1), 1–15. https://doi.org/10.1037/cfp0000107
Porges, S. W. (2011). The polyvagal theory. W. W. Norton & Company.
Schwartz, R. C. (1995). Internal family systems therapy. Guilford Press.
Schwartz, R. C., & Sweezy, M. (2019). Internal family systems therapy (2nd ed.). Guilford Press.
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