Sources support the clinical framework and contextual cautions, not the effectiveness of individual metaphors. All URLs were checked during manuscript preparation in October 2026; access limitations are described in the accompanying audit.
[1] Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press. Source
[2] EMDR Europe Practice Committee. (2019). EMDR Europe accredited practitioner competency based framework: Algorithm version (D. Farrell, Version 4, DF30092019). Source
[3] EMDR Institute. (n.d.). What is EMDR therapy? Source
[4] University College London. (n.d.). EMDR therapy: Domain 5 [Competence framework]. Source
[5] American College of Obstetricians and Gynecologists, & Society for Maternal-Fetal Medicine. (2020, March). Management of stillbirth (Obstetric Care Consensus No. 10). Source
[6] American College of Obstetricians and Gynecologists. (2024, September). Early pregnancy loss (FAQ090; reviewed April 2025). Source
[7] American Psychiatric Association. (n.d.). Prolonged grief disorder. Retrieved October 28, 2026. Source
[8] Centers for Disease Control and Prevention. (2026, May 26). Risk and protective factors for suicide. Source
[9] National Institute on Drug Abuse. (n.d.). Words matter: Terms to use and avoid when talking about addiction [NIDAMED handout]. Retrieved October 28, 2026. Source
[10] World Health Organization. (2026, May 8). Child maltreatment. Source
[11] American Psychological Association. (1995, August 1). Questions and answers about memories of childhood abuse [Archived page]. Source
[12] World Health Organization. (2017, October 13). Responding to children and adolescents who have been sexually abused: WHO clinical guidelines. Source
[13] Centers for Disease Control and Prevention. (2025, December 17). About sexual violence. Source
[14] World Health Organization. (2014, October 8). Health care for women subjected to intimate partner violence or sexual violence: A clinical handbook (WHO/RHR/14.26). Source
[15] Möller, A., Söndergaard, H. P., & Helström, L. (2017). Tonic immobility during sexual assault—A common reaction predicting post-traumatic stress disorder and severe depression. Acta Obstetricia et Gynecologica Scandinavica, 96(8), 932–938. https://doi.org/10.1111/aogs.13174 Source
[16] Centers for Disease Control and Prevention. (2026, August 19). About intimate partner violence. Source
[17] Centers for Disease Control and Prevention. (2025, September 8). NISVS frequently asked questions. Source
[18] EMDR International Association. (n.d.). Language of EMDR. Source
[19] World Health Organization. (2013). Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. Source
[20] International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115–187. https://doi.org/10.1080/15299732.2011.537247 Source
[21] National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Symptoms and causes of erectile dysfunction. Source
[22] National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Diagnosis of erectile dysfunction. Source
[23] Brymer, M., Jacobs, A., Layne, C., Pynoos, R., Ruzek, J., Steinberg, A., Vernberg, E., & Watson, P. (2006). Psychological first aid: Field operations guide (2nd ed.). National Child Traumatic Stress Network and National Center for PTSD. Source
[24] National Institute for Health and Care Excellence. (2018). Post-traumatic stress disorder (NICE Guideline NG116): Recommendations. Source
[25] American College of Obstetricians and Gynecologists. (2021). Caring for patients who have experienced trauma: ACOG Committee Opinion, Number 825. Obstetrics & Gynecology, 137(4), e94–e99. Source
[26] National Child Traumatic Stress Network. (n.d.). Medical trauma. Source
[27] World Health Organization. (2023, March 7). Disability. Source
[28] Centers for Disease Control and Prevention. (2024, October 28). Bullying. Youth Violence Prevention. Source
[29] U.S. Department of Veterans Affairs, National Center for PTSD. (n.d.). Race, culture, and PTSD. AboutFace. Source
[30] Norman, S. B., & Maguen, S. (2026, September). Moral injury. U.S. Department of Veterans Affairs, National Center for PTSD. Source
[31] U.S. Department of Veterans Affairs, National Center for PTSD. (2026, October). Moral injury and PTSD. Source
[32] Watson, P., Norman, S. B., Maguen, S., & Hamblen, J. (n.d.). Moral injury in health care workers. U.S. Department of Veterans Affairs, National Center for PTSD. Source
[33] American Psychiatric Association. (n.d.). DSM-5-TR Cultural Formulation Interview. Source
[34] Substance Abuse and Mental Health Services Administration. (2023). Practical guide for implementing a trauma-informed approach (Publication No. PEP23-06-05-005). Source
[35] International Society for the Study of Trauma and Dissociation. (n.d.). EMDR therapy training. Source
[36] National Institute for Health and Care Excellence. (2005). Obsessive-compulsive disorder and body dysmorphic disorder: Treatment (Clinical guideline CG31), recommendations. Source
[37] Marsden, Z., Lovell, K., Blore, D., Ali, S., and Delgadillo, J. (2018). A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder. Clinical Psychology and Psychotherapy, 25(1), e10–e18. Source
[38] National Institute for Health and Care Excellence. (2014). Psychosis and schizophrenia in adults: prevention and management. CG178. Recommendations. Source
[39] National Institute for Health and Care Excellence. (2014, updated 2025). Bipolar disorder: assessment and management. CG185. Recommendations. Source
[40] National Institute for Health and Care Excellence. (2022). Self-harm: assessment, management and preventing recurrence. NG225. Recommendations. Source
[41] National Institute for Health and Care Excellence. (2009). Borderline personality disorder: recognition and management. CG78. Recommendations. Source
[42] National Institute for Health and Care Excellence. (2017, updated 2020). Eating disorders: recognition and treatment. NG69. Recommendations. Source
[43] Haft, S. M., Rauch, S. A. M., Rothbaum, B. O., and Sherrill, A. M. (2026). Exposure-based treatment for co-occurring posttraumatic stress disorder and obsessive compulsive disorder in veterans: The feasibility of massed models. Journal of Traumatic Stress, 39(1), 75–85. Source