CIPOS in EMDR Therapy: How It Supports Stabilization and Dual Attention

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A Clinical Companion to Understanding CIPOS

If you are searching for CIPOS in EMDR therapy, you are likely working with clients who cannot stay fully inside the standard EMDR protocol without becoming overwhelmed, dissociative, or shut down.

CIPOS, or Constant Installation of Present Orientation and Safety, is not a workaround for poor preparation. It is a sophisticated clinical strategy used by EMDR-trained therapists to maintain dual attention when full reprocessing is not yet tolerable.

This blog is designed to support and expand the foundational understanding of CIPOS outlined in the original EMDR Coach article, while answering the deeper clinical question many therapists are asking: when, why, and how does CIPOS actually help?

What Is CIPOS in EMDR Therapy?

CIPOS in EMDR therapy is an interweave that intentionally keeps one foot in the present while allowing limited contact with traumatic material.

Rather than asking a client to fully access a target memory, the therapist repeatedly installs present-day orientation cues such as:

Current age
Present location
Felt sense of safety now
Awareness that the trauma is over

This happens while bilateral stimulation is used, creating a steady anchor to the present.

CIPOS is especially helpful when:

Clients dissociate quickly
Affect tolerance is limited
Trauma occurred early or repeatedly
The nervous system shifts into shutdown or panic during standard targeting

Why CIPOS Supports Dual Attention

Dual attention is the backbone of EMDR therapy. Without it, reprocessing either floods the client or collapses entirely.

CIPOS works because it:

Reduces demand on the memory network
Strengthens present-moment orientation
Builds capacity gradually instead of forcing access

From a nervous system perspective, CIPOS allows the client to sample traumatic material without losing contact with safety. This keeps the window of tolerance intact and supports integration rather than retraumatization.

When CIPOS Is Clinically Indicated

CIPOS in EMDR therapy is not reserved only for severe dissociation. It is often indicated when you notice subtle signs such as:

Flat affect during reprocessing
Rapid cognitive looping
Somatic freeze responses
Intellectual insight without emotional engagement

In these moments, pushing forward with standard Phase 4 work often leads to stalled processing or increased symptoms between sessions.

CIPOS allows you to stay relationally attuned while adjusting the intensity of the work.

Common Misconceptions About CIPOS

CIPOS is not avoiding trauma

Using CIPOS does not mean the client is not doing EMDR therapy. It means the therapy is being paced appropriately.

CIPOS is not only for dissociative identity presentations

Many complex trauma clients benefit from CIPOS even without a dissociative disorder diagnosis.

CIPOS is not a permanent substitute for reprocessing

CIPOS is a bridge. Over time, many clients can transition into more direct targeting once capacity increases.

Practical Ways Therapists Use CIPOS in Session

Therapists often integrate CIPOS by:

Alternating brief memory contact with present orientation
Installing present safety before distress escalates
Naming the year, location, or age repeatedly during BLS

The key is consistency. CIPOS works through repetition, not intensity.

This is where many therapists feel unsure, especially without consultation support.

How CIPOS Fits Into Ethical EMDR Practice

Ethical EMDR therapy prioritizes client safety, nervous system regulation, and clinical attunement.

CIPOS in EMDR therapy supports this by:

Reducing destabilization
Preventing premature exposure
Supporting client trust in the process

It is not a failure of the protocol. It is a skilled application of it.

Introducing Dana Carretta-Stein

Dana Carretta-Stein is the founder of Peaceful Living Mental Health Counceling, an EMDRIA approved consultant and therapist who specializes in helping clinicians navigate complex trauma, dissociation, and stalled reprocessing.

Her teaching emphasizes: