A look at “Case Report: Integration between eye movement desensitization and reprocessing and cognitive therapy for autism spectrum disorder. Novel intervention protocol based on case formulation and brief review of literature” by Maria Marino, Mariangela Pezone, Maria Pia Riccio, Raffaele Garotti, Annamaria Scapicchio, Isabel Fernandez and Carmela Bravaccio (2026)
Many autistic people carry trauma, not always from a single dramatic event, but often from years of being misunderstood, overwhelmed, excluded or criticised. Yet trauma therapies were mostly designed with non-autistic people in mind. This Italian case report describes how one therapy team adapted EMDR (eye movement desensitisation and reprocessing, a well-established trauma therapy) for an autistic young woman.
What they describe
The client was a 23-year-old autistic woman, also with a specific learning difficulty and significant social and performance anxiety. She’d been in cognitive therapy since adolescence. That work focused on her anxiety and low mood, harsh self-criticism and beliefs about being defective or unlovable. Alongside this, she was helped to understand her own neurodivergent profile: her sensory needs, how she processes information and how she regulates emotions. Respecting her preference, the team used identity-first language: “autistic person”.
Things shifted after a stressful work trip abroad led to sensory overload, a meltdown and acute anxiety. She found her usual strategies simply didn’t work when emotions were this intense. The therapists suspected older traumatic experiences were fuelling her reaction, so they introduced EMDR.
The adaptations included:
- building safety first, using breathing, body awareness, imagery and mindfulness to bring her back within her “window of tolerance” before any trauma processing;
- careful attention to sensory and processing needs throughout;
- short, structured blocks: four 50-minute EMDR sessions over five weeks, with a week’s break between targets for recovery and reflection, recognising how cognitively, emotionally and sensorially tiring the work was;
- clear explanation of every step of the process in advance.
The authors report that this adapted approach appeared clinically effective.
A grain of glitter ✨
This is a thoughtful and respectful example of adapting therapy for an autistic client, and its attention to sensory load and pacing is spot on. But it’s a single case report, so it can’t tell us whether the approach would work for others, or whether improvement was due to EMDR rather than years of prior therapy, time or other factors. The paper describes outcomes in clinical terms rather than with clear before-and-after measures.
It draws on Polyvagal Theory, which is popular among therapists but contested by many neuroscientists. Several authors are affiliated with EMDR organisations, so they have a professional interest in the approach. And the language swings between affirming (“autistic person”) and deficit-based (“pathogenic patterns”, “the disorder”).
Why this matters
If you’re autistic and carrying trauma, you deserve trauma therapy that’s adapted to you: paced to your energy, mindful of sensory overload, clearly explained and grounded in safety. Approaches like EMDR may be helpful, but the adaptations matter as much as the method. It’s always okay to ask a therapist how they’d tailor trauma work to your neurotype.
Healing isn’t a race. Even the bravest unicorn needs rest stops between the hard bits.