Integrating Polyvagal Theory (PVT) and EMDR: A Guide to Healing

Integrating Polyvagal Theory (PVT) and EMDR: A Guide to Healing

Rebecca Kase has created a free download for you: Understanding the Nervous System: a Practical Guide to Polyvagal Theory.


The intersection of Polyvagal Theory and Eye Movement Desensitization and Reprocessing (EMDR) presents a fascinating and powerful approach to therapy, yet the practical integration of these two cutting-edge models has remained an uncharted territory, until now. As a seasoned EMDR therapist and Licensed Clinical Social Worker who delved into Polyvagal Theory in 2018, I have personally witnessed the transformative synergy between these approaches. This is exactly what led me to build a bridge for my fellow EMDR therapy practitioners, yearning for a more robust and compassionate approach for applying the 8 phases of EMDR and bilateral stimulation. I felt called to write Polyvagal Informed EMDR: A Neuro-Informed Approach to Healing, (Published in 2023, Rebecca Kase) to offer a bridge between these two practical models and to better use the knowledge of neurobiology as a guide in the trauma recovery and healing journey.


In this blog, we will explore the seamless integration of Polyvagal Theory and EMDR, shedding light on how clinicians can leverage this dynamic combination for enhanced client stabilization and more effective memory reprocessing, delivered through a warm, and safe therapeutic relationship.


The Unexplored Symbiosis:

Polyvagal Theory and EMDR individually offer profound insights into the workings of the nervous system and avenues for therapeutic intervention. However, the integration of these models has not been explicitly defined prior to the publication of my book in 2023. Many therapists trained in one model or the other find themselves questioning how to merge these two approaches seamlessly. In my journey, I initially faced challenges in finding the bridge between Polyvagal Theory and EMDR Therapy. Questions like, “Which phases align best with polyvagal theory?” and “Can I practice both simultaneously?” echoed through my consultations. 


My Personal Exploration:

Trained in EMDR Therapy in 2006, I became captivated by Polyvagal Theory in 2018. Intuitively sensing their potential synergy, I began experimenting with integrating these two models. While the initial integration posed challenges, the breakthrough came during a seemingly mundane trip to a grocery store in Colorado in 2020. A sudden loud noise triggered a cascade of memories, showcasing the simultaneous application of Polyvagal Theory and Adaptive Information Processing (AIP) from EMDR with bilateral stimulation. This eye-opening experience marked a turning point, demonstrating the profound overlap and potential for integration between the two models.


The Ice Cream Aisle Epiphany:

Years ago, as I was seeking the how’s and why’s of bridging these two models, I had an epiphany in the ice cream aisle of my local grocery store. In the midst of shopping for a sweet treat, a startling noise triggered my neuroception, the body’s internal surveillance system as described in Polyvagal Theory. I noticed my neuroception perk up at the sound of a loud “pop”, which led to my body preparing me for potential danger with hard wired stress responses. This sympathetic activation also triggered my memory networks, as my mind began replaying memories of gun violence, as the sounds of gunshots mirrored the “pop” I had heard in the grocery aisle. This process mirrored Eye Movement Desensitization and Reprocessing’s focus on memory network activation. I quickly determined that there was no danger, and used skills inspired by Polyvagal Theory and EMDR to get back to a state of emotional regulation. 


This vivid ice cream aisle experience exemplified the concurrent application of Polyvagal Theory and AIP, showcasing their interconnectedness. The autonomic nervous system (described in Polyvagal Theory) and AIP (described in EMDR) are in a constant dance and at the heart of healing and trauma recovery process. It was a moment that taught me that you don’t just think your memories, you feel your memories. And that process happens because of the relationship between memory storage and autonomic processes. 


Polyvagal informed EMDR:

The integration of Polyvagal Theory and Adaptive Information Processing (AIP) is the focus of what I call Polyvagal Informed EMDR (PV-EMDR). This framework holds profound and immense implications for clinical practice. Recognizing the interdependence of the autonomic nervous system and memory storage, PV-EMDR aligns the eight phases of EMDR while integrating correlates of the autonomic nervous system. The PV-EMDR approach views the nervous system as the primary mechanism for assessment, intervention, and outcomes. Practicing PV-EMDR is a neuro-informed and comprehensive approach to healing, as it places the therapist’s focus on the functioning of the nervous system, allowing the clinician to recognize symptoms as neurophysiological correlates. 


In simple terms, it’s all about biology and how your nervous system is functioning. 


Fundamental principles of PV-EMDR include:

  • understanding the role of the vagus nerve in mediating autonomic processes
  • the bidirectional relationship between the autonomic and central nervous systems
  • the necessity of autonomic resiliency for health and wellness


Using the PV-EMDR approach, memories are not only stored in memory networks but are also experienced through the autonomic nervous system. This nuanced understanding allows EMDR clinicians to engage with therapy more dynamically, moving beyond scripted protocols to fluidly adapt clinical interventions based on the client’s neurobiology of trauma. I find the integration of Polyvagal Theory within Eye Movement Desensitization and Reprocessing to be a way to supercharge the model. It makes you a better EMDR therapist, a more attuned therapist, and it decreases the confusion of determining whether or not your client is ready for reprocessing targets. 


Implications for the EMDR therapist:

For therapists, the integration of Polyvagal Theory and EMDR can significantly enhance client transformation and outcomes. Learning this model allows you to better case conceptualize and determine client readiness. Using my Preparation Hierarchy model described in my book gives you, the therapist, a clear pathway to preparing clients for reprocessing and successful treatment planning interventions to help a client get to those crucial EMDR therapy phases. It also emphasizes the importance of the relationship within the EMDR model, something that has historically been lacking and poorly described, and how to be attuned without getting in the way of reprocessing.


A Holistic Approach to Healing:

Both Polyvagal Theory and EMDR provide frameworks for conceptualization and powerful pathways to healing. Their integration encourages a holistic approach that focuses on both branches of the nervous system. While Polyvagal Theory identifies neuroception as the primary means of information processing, EMDR emphasizes the adaptive information processing model. Recognizing the complex yet interconnected ways the nervous system processes and integrates information lies at the core of this integrative approach.



In the realm of advanced therapeutic approaches, Polyvagal-informed EMDR (PV-EMDR) stands out as a transformative methodology. This integration shifts the clinician’s focus from diagnoses to adaptation, from pathology to the intelligence of the nervous system. PV-EMDR represents an advanced, neuro-informed approach, placing the nervous system responses at the forefront of assessment, diagnosis, and successful treatment. As therapists, our ultimate goal is to understand and support the adaptive nature of the nervous system, recognizing that clients seek therapy sessions due to dysregulated nervous systems rather than specific diagnoses or symptoms. Embracing the integration of Polyvagal Theory and EMDR opens new horizons for advanced healing and transformation in clinical therapeutic practice.

 – Rebecca Kase

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