BLS: Practical Considerations for Therapists
BLS: Practical Considerations for Therapists
As you guide clients through EMDR therapy, remember these key points about BLS:
Safety First:
Ensure clients feel safe and grounded before introducing BLS. Use Phase 2 preparation to build resources like a calm place or container, so clients can manage any distress that arises. Remember that in Phase 2, BLS is provided in short sets so as not to awaken trauma networks. Tapping is a lower dose than eye movements, and is often used with phase 2 coping strategies.
Individualized Approach:
Adapt the type, speed, and duration of BLS to meet your client’s needs. Some clients may respond better to tactile or auditory stimulation rather than eye movements. You can also adjust the length of a BLS set, depending on what the client can tolerate or needs in the moment.
Low tech: Utilize our bodies for BLS. This can be generated by the therapist or client. For example, the therapist’s arm movements to facilitate eye movements. Or the client can generate eye movements by looking back and forth between two points. Clients tapping their hands on their own legs, arms, or chest (modified butterfly hugs), or engaging in larger arm movements as they tap can keep them more in their body and grounded. They may also feel more in control and have a sense of agency.
Higher tech: Utilize tactile tappers that vibrate back and forth, or light bars for eye movements. There are several apps that can be used for telehealth or in your office that may be more economical than purchasing a system. In addition, sometimes video game controllers can be used with an app to provide tactile BLS.
Facilitate Dual Awareness during Reprocessing Phases:
‘Visit’ the memory — Encourage clients to maintain "one foot in the present and one foot in the past." This dual awareness helps them stay in their window of tolerance while processing the memory. It is as if we are visiting the photo in a photo album, rather than walking into the memory as if it is happening now.
Metaphors — Use metaphors to create distance from traumatic material. We typically use a train metaphor (imagine sitting on a train and watching it pass by like scenery) or screen metaphor (contain the traumatic content on a screen, with a magic remote control to do what is needed — zoom in or out, make is less or more colourful, press ‘pause’ or ‘play’).
Shorter BLS sets — Shorter sets can be used to restrict processing to the target and not allow all the associations, from all the traumatic memory networks, to open at once.
Longer BLS sets — To enable abreactions to flow through from beginning, to middle, to end. Think of it as travelling through a mountain tunnel that is collapsing. Speed up and keep moving! Remember that an abreaction is not the same as a flashback, or reliving, but is the release of pent up emotions that have been stuck for a long time. Hold space for the client and provide the safety to feel what the client needs to feel to release the emotions, while maintaining dual awareness. “It’s okay to feel … I’m with you.”
Trust the Process:
EMDR often leads clients to unexpected but relevant associations. Allow their brain to guide the process, trusting that it will access what needs to be addressed.
Monitor and Adjust:
Watch for signs of hyper- or hypo-arousal. Change BLS mechanics (speed, direction, type of BLS) and tax working memory. Use interweaves for stuck cognitions, emotions, or body sensations to keep clients within their window of tolerance. Make sure to match the interweave to the level of information processing where the client is currently stuck.
Empowering Your Clients Through EMDR
When clients understand how EMDR therapy and BLS work, they’re often more willing to engage in the process. Here’s how you might explain it to them:
"Think of your brain like a file cabinet." Some memories get misfiled or scattered during distressing events, staying raw and unprocessed. BLS helps you locate, process, organize, and refile these memories so they don’t feel overwhelming anymore.
"Your brain already knows how to heal." BLS simply helps unlock that natural healing process, allowing you to connect the dots and find relief.
"You’re in control." EMDR is not about reliving the pain but about gently revisiting it in a way that helps you move forward. Make sure that your client understands that they can provide feedback to you. They can ask for a BLS set to be shorter or longer, or to change the type of BLS (e.g., from eye movements to tapping). Provide your clients with the opportunity for agency and choices as you hold space for them to access what they need to access to process and heal.
As a therapist, you play a crucial role in creating the safety and structure clients need to engage in this transformative work. By guiding them with skill, compassion, and a clear understanding of the process, you can help clients untangle the roots of their distress and create a healthier, more adaptive future.
I strongly encourage EMDR therapists to connect with a community of therapists, review the 8 phases regularly, attend workshops and engage in professional development. The structure of the 3-prongs, 8 phases, and the Adaptive Information Processing (AIP) model provides you with a structure that holds both you and your client, while staying true to the foundation of EMDR Therapy and the research base.