Thematic Client History in EMDR Therapy is something that you may have been doing all along, especially if you work from a more intuitive or relational place. However, in the protocol-driven culture that can surround EMDR Therapy, many new EMDR therapists get the message–either implicitly or explicitly–that if they don’t have a precise, systematized way to take client history in EMDR or any other therapy, then they are not doing it correctly. In this piece, I’d like to share some insights that some of you might find liberating in your quest to find your own clinical identity as an EMDR therapist while explaining Thematic Client History, my approach to teaching Phase 1 Client History in my own basic training program. Although I’ve primarily written this article for EMDR therapists, you may find it useful if you are in any profession that uses measures or scales that you find to be overwhelming or impractical.
Like many EMDR therapists of my generation, I was trained on asking a client for their ten best memories and ten worst memories in order to determine points of resourcing/preparation (Phase 2) and then eventually identify targets to take through reprocessing (Phases 3-6). The roadblock I ran into is that many people had trouble identifying even one “good,” memory. Moreover, listing 10 horrible memories caused many of the people I served, especially those with complex trauma, to crumble. Of course my trainers taught me other important things to cover in history, like doing a Dissociative Experiences Scales (DES) and getting the bigger contextual picture around the client and their presenting issues. And then I started to wonder if getting that contextual picture and listening for the themes in it could be the best way to approach EMDR Therapy client history?
Indeed, this is what my first EMDR Therapist, Janet Thornton, did with me when I first presented for EMDR in 2004 (about a year and a half prior to my own training). In talking to me in a very general way, Janet knew that my trauma was complex. Through a combination of learning this context and taking a DES, she accurately diagnosed me with what was, at the time, Dissociative Disorder, Not Otherwise Specified. Yet when it came time for target selection she simply gave me the standard-issue Dr. Shapiro Negative Cognitions list and asked me to check off anything on the list that still applied to me. I must have marked about 20 negative cognitions, or beliefs. Then she asked me to go back over them and indicate which three stung the worst. I still remember that “I’m unlovable” was my top pick, and that represented the first place that we worked to set up a target for reprocessing. When it came time to set up the target, she used a variation of the Floatback technique, which some of us today might better understand as bridging. It was a simple strategy of, “Notice what I’m unloveable brings up for you, body, mind and soul, and let it take you back to the first time you ever believed that, or got that message.”
After my initial frustrations with the ten worst memories/ten best memories strategy, I began working in a way very similar to how Janet worked with me. And then when I began my Ph.D. studies shortly thereafter, being drawn to the phenomenological approaches of Edmund Husserl (1959-1938) as my philosophical and qualitative research identity, it dawned on me that I was embracing a thematic approach to client history. One of the characteristics of phenomenology, as described by Husserl, is that the human experience cannot be quantified. So taking inventories, adding them up, and getting averages, like we do on the DES and many other scales, is not the best way to learn about a person’s lived experience of any given phenomenon. And yes, we originally get the exact phrase lived experience from the work of Husserl. The phrase is not just something that you see on social media or in advocacy spaces.
Once we talk to a person, read their writing, or even look at their visual artwork, we can get a sense of what themes are most present. If the word theme isn’t immediately resonant for you, you can think about themes as topics, patterns, subjects of discussion, or areas of focus. The simplest possible way I’ve come up with for explaining theme to my trainees is encouraging them to ask a question like, “What does this seem to really be about for you?” in conversationally exploring any presenting issue with a client. Once we have a sense of the theme (or topic or pattern, etc.), we can then turn to the negative cognitions list like my original therapist did to see which negative cognitions are most connected to the themes that are emerging in initial exploration of the presenting issue.
I encourage my trainees to see that you’ve been dealing with themes all along whether you realize it or not. If you are listening for patterns when a person first presents, you are already doing thematic client history. When your therapy participants make jokes or observations, which they often will, like, “I have mommy issues” (or daddy issues), or “I am a magnet for abusive partners”… those are themes to explore. If a person comments about the heaviness of being someone who cares in the volatile political landscape that is 2026, or they are experiencing a sense of heaviness at what feels like the end of humanity, those are also themes. How can you use those as what our siblings in the Internal Family Systems (IFS) movement call trailheads for leading you to a series of treatment goals and, eventually, EMDR Therapy targets?
Another way that you have been working with the theme all along, perhaps without even realizing it, is when you reference Elisabeth Kübler-Ross’ five “stages” of grief, which originally came out of her work qualitatively investigating patients who themselves were dying. What you know as denial, anger, bargaining, depression, and acceptance were never meant to be neat, clean, linear stages. I’ve long argued that our field’s obsession with stage models and having step-by-step certainty turned them into a stage model. Kübler-Ross was a phenomenologist and first identified denial, anger, bargaining, depression, and acceptance as themes. Even in her book On Grief and Grieving: Finding the Meaning of Grieving Through the Five Stages of Loss (2005), she states, “The five stages – denial, anger, bargaining, depression, and acceptance – are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief.”
It may help you to think of themes, in an EMDR Client History sense, as tools to help our therapy participants frame and identify what they may be feeling. And from there we can “floatback,” bridge, or otherwise take history around the source of those feelings. Moreover, you do not have to start with the first or the worst if the client is indicating that they are not prepared to go there. You can get recent history, which can be telling in and of itself. And follows the idea that you can work in any of the prongs of the Shapiro’s Three-Pronged Protocol–past, present, or future–especially with more complex cases. History can also include determining those memories, incidents, or even cognitions that are not as high impact or are even framed by the therapy participant as more positive or adaptive. Starting there might even be safer than going for the most daunting themes right away. That is a clinical decision making point that you and your therapy participant can collaboratively determine.
I have long found thematic approaches to be more useful than working purely chronologically with people, which many EMDR therapists do in order to honor Shapiro’s teachings about working with touchstone memories yielding the greatest impact for generalization in the work. While on one hand I can appreciate that drive to go early in order to get to the root of something, years of clinical practice working with complex trauma and dissociation and navigating my own has shown me that working chronologically is often not practical. If you have therapy participants who struggle with keeping a timeline, or if they have a tendency to get tangential in recounting their history, you may understand this phenomenon as well.
And there is a good reason for that. Even a cursory understanding of the limbic system informs us that when memories are linked with high levels of activation, they are not organized. And the limbic system, especially the amygdala, does not work on the same rational sense of time that our neocortex does. So the same phenomenon that makes it difficult for people to feel like what happened to them fifty years ago is still happening today is what can interfere with chronological history-taking.
When I teach, I’ve long teased that I am much more an English teacher (my first profession) and a writer than I am a scientist in how I teach EMDR and trauma therapy. So I will end this piece by turning to what I know better than the brain: the practice of writing, specifically, memoir writing. Natalie Goldberg, author of Writing Down the Bones: Freeing the Writer Within (1986), is widely regarded a pioneer in teaching that anyone can write by approaching it as a practice. Goldberg defines memoir as “a study of how memory works…. Memory doesn’t remember chronologically…we remember in flashes.”
Comedian Molly Shannon put it even more simply in her 2022 memoir, Hello Molly!: “Chronology is overrated.”
From my chair as both an EMDR Therapist-Trainer and as a memoirist, I heartily concur.
Want to learn more about Thematic Client History with Dr. Jamie? Check out her upcoming course, Thematic Client History in EMDR Therapy: Enhancing Your Clinical Effectiveness with Complex Trauma taking place ONLINE November 19, 2026. Can be taken as a stand-alone course or as a 2-day course bundle along with The Forgotten Phase: Making the Most Out of Phase 8 Re-Evaluation in EMDR Therapy. We offer sliding scale pricing on each course or if registering for the Bundle. Click HERE for more information.
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