| eBook |

Modulation for EMDR:
Applications in Phases 1-8

Phase 1
Phase 2
Phase 3
Phase 4
Phase 5
Phase 6
Phase 7
Phase 8

Neuro-auricular Modulation and Electrodermal Activity: An Overview

Neuro-auricular modulation is the alteration of nerve activity through targeted stimulation (i.e. using manual stimulation, transcutaneous electrical nerve stimulation, a needle, or a low-level therapeutic laser). This non-invasive form of neuromodulation is applied to the outer ear with the goal of helping regulate (restore balance) physiological and psychological function. Targets are identified by imbalances in electrodermal activity (EDA) on the microsystem of the outer ear.

EDA is understood as an objective measure of patho-physiological/-psychological disturbance.[1-15] By assessing EDA on the auricular microsystem — the most representative somatotopic projection of neural reflex zones as recognized by the World Health Organization[16] — therapists can efficiently identify, measure, and compare the relative importance of physical and psychological disturbances.[17-28] These disturbances can then be regulated with neuro-auricular modulation.[24-28] The effectiveness of which, in turn, can again be measured by EDA.
Using EDA and neuro-auricular modulation, therapists can resolve 3 key challenges in therapy with greater insight, objective measure, and confidence:

  1. Move Beyond Defense Mechanisms | Whether general resistance to therapy, a lack of necessary dual attention, or even sever dissociation, EDA measures of disruption help the therapist target specific physiological and psychological neural states requiring attention. These dysregulated neural states can then be modulated to support rebalancing and self-regulation.
  2. Insight for More Precise Targeting | Using EDA as an objective measure of the relative importance of underlying issues, therapists can use the auricular microsystem as a dynamic window to the brain to support more precise targeting.
  3. Bypass blocks for improved processing | Neuro-auricular modulation can activate the same mechanisms of action activated by bilateral stimulation (BLS) without the need for pre-frontal cortex involvement.

Description of Integration: Using Auricular Methods Alongside EMDR

Auricular Methods are founded in the medical approach that uses the microsystem of the ear for clinical assessment, based on electrodermal activity (EDA), as well as for treatment of mind and body via neuro-auricular modulation[17-28] — and is used in the advanced practice of Auricular Medicine by over 20,000 medical doctors in Germany, Switzerland and Austria alone, especially in cases of therapy resistance.[26-27] Neuro-auricular modulation techniques (e.g. Auricular Methods) are not meant to change, or replace, any aspect of EMDR practice. Rather, they are presented as an adjunct tool to be used independently yet alongside an EMDR session.

The concept underlying EDA and neuro-auricular modulation for assessment and treatment is based in the central nervous system being at the core of the regulation of energy homeostasis,[29] and that healthy energy homeostasis can become disturbed or blocked by disrupted neural states.[17-28] These concepts align with the Adaptive Information Processing (AIP) model and the use of EMDR to unblock the disrupted neural states of “dysfunctional stored experience.”[32-33] In fact, owing to it basis in the mechanisms of action of bilateral stimulation (BLS), EMDR can also be considered a means of neuromodulation. Neuro-auricular modulation and EMDR share neurological mechanisms of action,[18, 30] however the former does so without the need for pre-frontal cortex involvement — which is why auricular neuromodulation is so effective in priming the autonomic nervous system to receive therapy, even when the challenge of defense mechanisms would otherwise prevent it. And, all the while, the use of clinical devices to measure EDA remains an underutilized opportunity in the field of psychotherapy.

This eBook means to introduce use cases for the application of Auricular Methods without changing any aspect of the 8-phase EMDR approach — just as Auricular Methods are used to improve, but not necessarily change, clinical outcomes in many other fields of practice across healthcare and medical research.


Auricular Methods can be used in phase 1, and even prior to phase 1, to help...
  • improve client insight
  • show immediate relevant understanding 
  • build trust & rapport

An assessment of the ears of the client by a therapist with simple training in the auricular microsystem (see resources below) offers immediate insights to the dynamic and current brain mapping of the client (as projected onto the microsystem of the ear). This understanding of specific active neural states, and imbalances, has the distinct benefit of quickly and effectively identifying very specific somatic and emotional issues — especially those beyond the consciousness or willingness of the client to address. This immediate connection through understanding of the client is effective in establishing and quickly building trust and rapport in the therapist-client relationship.


In phase 3, Auricular Methods can be used to address challenges related to...
• target identification
• targeting precision
• priming related neural pathways
The use of EDA on the auricular microsystem in the assessment phase supports improved insight to address EMDR challenges related to target identification and targeting precision. For target identification in the assessment pahse, EDA and neuro-auricular modulation can be very helpful. Active neural reflex zones on the auricular microsystem help guide assessment. Targets that may otherwise remain “hidden” can be brought into discussion through testing of reflex zones on the ear.[25-27] Active reflex zones on the ear can support the precision and relative importance of the most effective targets. Neuro-auricular modulation of the related reflex zones helps to prime the nervous system, either by bringing up related memories or by rebalancing related neural imbalances. EDA provides insights into neural states that may influence the client's ability to experience adaptive information processing in active EMDR. Therapists can note active points identified on the client's ear by EDA to assist in treatment planning and its alignment with the adaptive information processing model. 


In phase 2, Auricular Methods can be used to address challenges related to...
  • regulation & dual attention
  • defense mechanisms
  • resistance to therapy

The use of EDA on the auricular microsystem in the preparation phase supports improved insight to address EMDR challenges related to defense mechanisms (i.e. regulation, dual attention, client resistance to therapy, or even severe dissociation). When it is determined in phase 2 that dual attention is not sufficient enough to begin EMDR, EDA helps identify disturbances to pinpoint specific neural states for neuro-auricular modulation, whereby the neuro-auricular modulation has the benefit of activating the same mechanisms of action found to facilitate associative memory processing and restoration of dual attention through EMDR,[30-31] without the risks of proceeding with EMDR when dissociation is detected, or the possible multi-session delays otherwise needed to help clients regulate enough to start with EMDR therapy. Neuro-auricular modulation helps prime the nervous system and balance mind and body to help move beyond defense mechanisms — whether from resistance in cognitive therapy or dissociation.


In phase 5, Auricular Methods can be used to address challenges related to...
  • overcoming persistent defense mechanisms
  • processing

Given that Auricular Methods have been applied at the appropriate times when needed — to guide treatment planning, support assessment insights, move beyond defense mechanisms and facilitate processing — the effects of the auricular neuromodulation naturally support phase 5 (installation) because neuro-auricular modulation of active points is in effect a treatment of related conditions (neural states) requiring activation to move beyond the “block.”


In phase 4, Auricular Methods can be used to address challenges related to...
  • looping in BLS
  • clients being “stuck” in processing
  • SUDs not decreasing

The use of EDA on the auricular microsystem in the assessment phase supports improved insight to address EMDR challenges related to looping in BLS, client’s being “stuck” in processing, and/or Subjective Units of Disturbance (SUDs) not decreasing. If, for example, a client begins looping in BLS sets, or is unable to report a decrease in SUDs, then EDA can pinpoint active reflex zones for neuro-auricular modulation to help facilitate processing without the need for pre-frontal cortex involvement. Neuro-auricular modulation assists the therapist to side-step the need for cognitive interviews while aiding an autonomic shift in the client, often quickly bringing clients back to processing and re-engaging the path to adaptive information processing. The ability to access this non-cognitive approach has the major benefit of avoiding the possibility of an otherwise incompleted session. EDA, in essence, can be used as a measure of objective units of disturbance (OUD). Although this measure may or may not have a direct relationship to the SUD measure, it provides an additional point of reference.

Body Scan

In phase 6, Auricular Methods can be used to support...
  • somatic associations
  • somatic release

As in phase 4, neuro-auricular modulation can support processing in phase 6 for further release. For example, previously treated ear points may become active again, and/or can be stimulated to bring neural states closer to homeostasis.

The use of EDA can help put an objective measure on the findings of the body scan. Therapists can check the somatic associations on the auricular microsystem and record the measure for comparison with measurements taken during the assessment phase, identify psychosomatic shifts, and apply auricular neuromodulation to further lower EDA.


In phase 8, Auricular Methods can be used for...
  • measurement of outcomes
  • supporting documentation
  • guidance for next steps

A record of the active points involved at the beginning of each session, and their relative EDA (or even tenderness based on a pain numerical rating scale/NRS as presented in CIAM training), provides therapists with additional reference for reevaluation.


In phase 7, Auricular Methods can be used to support...
  • final release
  • mind-body connection
  • neural balance

As in phase 6, neuro-auricular modulation can support processing toward final release and neutral state — especially if there is any lingering agitation or stress. During the closure phase, auricular neuromodulation is especially helpful since, again, it bypasses the need for any pre-frontal cortex involvement.

The use of the auricular microsystem offers clients the opportunity to experience a mind/body connection that is very helpful during closure. Often, when therapists use the auricular microsystem, clients express surprise at the connections between their body and mind, and the plasticity of their nervous system. The experience of this discovery provides a strong sense of hope, and supports a state of balance and safety necessary for closure.
Wonderful work! The EMDR portion of Accessing the Somatic and Emotional Experience is immediately useful and applicable to my EMDR practice.”
Dr. Timothy Rowe, MD
Psychiatrist and Director of Psychiatric Services at St. Christopher’s Inn Addiction Treatment & Recovery Community
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Auricular Methods in Psychology

How to Access the Somatic & Emotional Experience Mapped by the Brain

In this course (1 of 4 in the EMDR bundle) you will discover one of the best tools available to every therapist, the ear! The auricular microsystem is a window to the brain that dynamically presents disrupted neural states. In this course you will learn to read the ear and apply neuromodulation to help restore neurofunctional flow. 
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Neuro-auricular Modulation for EMDR

Move Beyond
Defense Mechanisms

While EMDR is among the main treatments for clients with issues ranging from lack of sufficient dual attention to dissociation,[34-38] these issues remain challenges facing the EMDR therapist.[39-43] Using neuro-auricular methods, therapists can bypass pre-frontal cortex involvement and facilitate the restoration of dual attention and self-regulation[17,19,27,28,44-47] — all while avoiding the risks of proceeding with EMDR when a client is not ready.
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Neuro-auricular Modulation for EMDR

Gain Insight for Target Identification & Priority

Even without cognitive input from the client, active points on the microsystem of the ear, especially limbic system and pain memory points,[27] can be helpful in offering clues to useful targets.
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Neuro-auricular Modulation for EMDR:

Support Processing

In some cases, the client simply is “blocked,” in a “processing loop,” or “resistant” during BLS — no decrease in SUDs. Neuro-auricular modulation helps move beyond client defense mechanisms or other blocks without the need for pre-frontal cortex. It activates the mechanisms of action to support engagement, plasticity, healing and processing.[48-52]

CIAM introduces neuro-auricular modulation
at  EMDRIA Conference

The EMDR International Association (EMDRIA), whose membership practices Eye Movement Desensitization Reprocessing (EMDR), represents leadership in the field of psychology — especially in psychology’s shift from purely cognitive to incorporated somatic approaches. The association comprises forward-thinking professionals in the field of psychology who understand the improvement of psychotherapy outcomes through skilled use of multi-modal approaches.

At the EMDRIA 2021 Virtual Conference, the Canadian Institute of Auricular Medicine (CIAM) shared opportunity for discussion, consultation, and Q&A on neuro-auricular modulation techniques to prime the nervous system to be able to receive therapy. Techniques that also provide objective measures of neural disturbance with insight on the specific neural states that will benefit from modulation — all to help move complex cases forward when preparation, targeting, or processing have otherwise become “stuck.”

EMDRIA attendees amazed!

I am going to start training right away.”

This makes so much sense!”

I have used auricular methods before
and now plan to learn more.”

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See neuro-auricular modulation for EMDR
in actual psychotherapy practice

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How to access the somatic and emotional experience mapped by the brain

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Thank you! We will email on the days these discussions go live — see you soon!
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