Understanding CIPOS: A Specialized EMDR Technique for Staying Safe and Present
CIPOS—Constant Installation of Present Orientation and Safety—is a specialized technique within EMDR therapy designed to help clients maintain a strong sense of present-moment safety while briefly approaching traumatic material. It is especially useful for dissociative clients and those with complex trauma who become quickly overwhelmed. It was developed by Jim Knipe, described in EMDR Toolbox, Chapter 13: “The CIPOS Procedure”)
If you’re unfamiliar with EMDR therapy, EMDRIA provides an excellent, brief overview here:
https://www.emdria.org/about-emdr-therapy/
Why CIPOS Exists: The Specific Problem It Addresses
In The EMDR Toolbox, Jim Knipe explains that many clients with complex trauma experience overactivation when approaching traumatic memories. This overactivation can lead to dissociation, shutdown, emotional flooding, or a total loss of present orientation.
Knipe emphasizes:
Dissociation inside EMDR therapy is often a symptom of overactivation. Dissociating from the overactivation is not the problem. The problem is the level of activation itself.
For these clients, the issue isn’t that EMDR is inappropriate—it’s that the nervous system cannot tolerate sustained contact with the traumatic memory without losing dual attention.
CIPOS directly addresses this by helping clients:
stay oriented to present safety
experience traumatic material in very small, tolerable chunks
maintain dual awareness of both the present and the past
avoid being overwhelmed by affect or dissociative responses
As Knipe states, trauma work requires distress to come up—but only in “discrete chunks small enough for the client’s current window of tolerance.”
This micro-dose approach to memory activation makes CIPOS one of the most important adjunctive tools for dissociative and complex clients.
The Foundation of CIPOS: Present Orientation & Short-Term Memory
Chapter 13 explains a key principle:
Even when a dissociative client begins to “drop into” traumatic material, short-term memory of present orientation stays available for roughly 2–20 seconds.
CIPOS takes advantage of this window.
Clients are guided to enter the traumatic memory only for a brief period (e.g., 2–10 seconds), after which the therapist immediately calls the client back to full present orientation.
This allows the client to:
touch the trauma
return quickly to safety
build confidence in their ability to stay grounded
maintain dual attention over time
The Back-of-the-Head Scale (BHS): A Core Component
Knipe pairs CIPOS with the Back-of-the-Head Scale, a tool for measuring how oriented the client is to the present moment.
Your slides summarize it:
“The BHS is a way to measure, moment to moment… the extent to which a client is oriented to the safety of the present situation.”
Clients point to where their awareness is located along an imaginary line from:
Fully Present →→→→→ Dissociated
CIPOS is only used when the client is within the dual-attention zone—aware of the safe present while also able to access some traumatic content.
The CIPOS Method: Step-by-Step
(Using Knipe’s language wherever possible + your slide content)
1. Establish strong present orientation and safety
Knipe emphasizes that CIPOS should never begin until the client:
feels safe with the therapist
feels safe in the room
is grounded in present orientation
Your slides echo this:
“Don’t proceed with CIPOS until client feels safe in the office, particularly in terms of the therapeutic relationship (‘the therapist is on my side’).
Strengthen the client’s present orientation.”
This includes orienting to the room, naming details, and confirming readiness.
2. Introduce the Back-of-the-Head Scale (BHS)
The therapist introduces the BHS as a moment-to-moment measure of presence versus dissociation.
Clients identify where they are on the scale before each brief memory dip.
3. Ask the client if they are willing to enter the memory briefly
Knipe provides a clear verbal script, reflected in the slides:
“In a few moments—not yet—but in a few moments, would you be willing to close your eyes and go into that memory for just a few seconds—maybe just 8 seconds? I will keep track of the time.”
Important:
No bilateral stimulation is used here.
The exposure is time-limited and precise.
4. After 2–10 seconds, the therapist immediately calls the client back
The therapist uses firm, repetitive language:
“Come back into the room now.”
This continues until the client’s eyes are open and they are looking around the room.
This is the “installation of present orientation.”
5. Re-establish present orientation & check BHS
The therapist confirms the client is again oriented to the present:
eyes open
back in the room
BHS indicates presence
This reinforces safety and stability.
6. Repeat as needed
Your slides summarize:
“Repeat as needed.”
Each repetition gradually increases the client’s tolerance for traumatic material while maintaining safety.
7. Pair present orientation with brief sets of BLS
Only after the client is able to tolerate brief memory contact while staying present does the therapist begin adding BLS:
“Orientation paired with BLS.”
This strengthens the adult self’s present-safety and dual-attention capacity.
8. Continue to repeat while maintaining dual attention
The loops of:
brief memory contact
immediate present orientation
BLS-supported grounding
continue until the client can reliably remain grounded.
9. Transition to Phase 4 EMDR Desensitization
Only when dual attention is stable does the therapist move to:
“With BLS—Standard EMDR Desensitization Phase 4.”
At this point, the client is ready to process traumatic material without overwhelming dissociation.
Conclusion
CIPOS is one of the most powerful techniques for:
dissociative clients
clients with complex trauma
clients who become easily overwhelmed
clients whose nervous systems cannot yet tolerate full reprocessing
Jim Knipe’s CIPOS procedure (Chapter 13 of The EMDR Toolbox) provides a clear, structured way to help clients experience the trauma without being overwhelmed, while steadily strengthening their ability to stay present, safe, and connected.
