EMDR: List of Positive and Negative Cognitions

One of the objectives of EMDR therapy is to alleviate negative cognition during the desensitization phase, and to replace these negative beliefs with positive cognition during the reprocessing phase. This is in order to, eventually, help PTSD patients (and patients suffering from other mental health conditions) reprocess traumatic memories.

To achieve this, many aspects of the patient's cognition must be stimulated and entrained. Through this guide, we highlight why cognitions are important for EMDR therapy, as well as a list of both negative and positive cognitions to help therapists prompt clients to choose their cognitions during the process.

What is an EMDR Cognition?

A cognition in EMDR therapy can also be referred to as a ‘belief’ – and these beliefs, especially negative, can sometimes be involuntarily reinforced by an individual when they are suffering from a mental health disorder, such as PTSD. However, experiencing negative cognitions can also be a symptom of other conditions, such as anxiety, depression and OCD. It’s possible for all of these mental health disorders to be treated with EMDR therapy, which looks to tackle pairing a negative cognition with a target image and, over time, replacing it with a positive cognition.

List of Negative & Positive Cognitions

Although negative and positive cognitions are typically customized to the individual (i.e., focusing on topics which are specific to their triggers), using a generic list of negative and positive beliefs can be a useful place to start for you and your client to help grasp the process. These are generally split up into four main categories:

• Control/choice
• Safety/vulnerability
• Perfectionism/self-defectiveness
• Responsibility

Negative Cognitions for EMDR

Control/choice

• I do not have control of my life.
• I am weak.
• I am powerless.
• I cannot succeed.
• I will fail.

Safety/vulnerability

• I am in danger.
• I cannot stick up for myself.
• I can’t trust anybody.
• I can’t trust myself.
• I cannot protect myself.

Perfectionism/self-defectiveness

• I should be better.
• I did something wrong.
• I should have done more.
• I should have known better.
• I should be more like X.

Responsibility

• I am not worthy.
• I am stupid.
• I deserve to die.
• I am insignificant.
• I am a bad person.

Positive Cognitions for EMDR

Control/choice

• I am in control of my life.
• I am strong.
• I can succeed.
• I am capable.
• I can handle it.

Safety/vulnerability

• I can trust my judgment.
• I am safe now.
• I can trust myself.
• I can choose who to trust.
• I can take care of myself.

Perfectionism/self-defectiveness

• I did everything that I could.
• I learned from the situation.
• I can’t blame myself for what happened.
• I did my best.
• I don’t need to compare myself to anyone else.

Responsibility

• I deserve to be loved.
• I am worthy.
• I deserve to live.
• I am intelligent.
• I am significant.

Why Cognitions Are Important for EMDR

As part of the EMDR therapy process, both negative and positive cognitions are used as vital tools to the reprocessing element of the procedure. A negative cognition is paired up with a ‘target image’ (which may vary in nature and intensity throughout the procedure) to begin the initial phase of EMDR processing, while a positive cognition is also chosen – whether the client believes in the validity of it or not.

Next, clients are then helped to process information in their trauma memory network ( which the negative cognition is a part of) and taught to integrate it with more adaptive information ( which the positive cognition is apart of). In order to choose the most appropriate cognition, the patient is asked to identify which negative cognition they express when thinking about their trauma – and to quantify their belief in the cognition on a subjective scale.

Meichenbaum and Fitzpatrick, 1993, commented that “later in the reprocessing phase, the patient is requested to replace such negative cognition with a new positive one. This cognition is reinforced through rhythmic movements (paired with bilateral stimulation) and acts as a new narrative content of self-consciousness.”

Unprocessed, or maladaptively processed, experiences can lead to distorted conclusions about the self as these conclusions are based on inaccurate information connected with disturbing effects at the time the experience was encoded. That is why this element of EMDR therapy is necessary for the client to be able to reprocess the feelings and emotions around the trauma in a healthy, safe way with the help of a professional.

For more information on how to become a certified EMDR therapist, or to learn about our range of EMDR courses, speak to a member of our expert team today or browse our online courses.

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EMDR Step-by-Step PLUS: Your Start to Finish Guide to Safe and Successful EMDR Therapy

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