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Dissociation and Trauma: EMDR Therapy as a Tool for Integration and Wholeness

Jul 24, 2023 | 0 comments

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The information provided here is not intended to be a substitute for professional health and mental health care or consultation. Individuals who believe they may require or benefit from treatment should seek the advice of a psychologist or other licensed mental health professional.

Very Good Counseling is a private practice of licensed mental health therapists who specialize in EMDR.  We provide online mental health services to individuals throughout the State of Florida,  and in-person at our office in Fort Myers, FL. For more information, contact us.

by: <a href="https://vg-counseling.com/elena-engle-fort-myers/" target="_blank">Elena Engle, LMHC-S, EMDRIA-approved EMDR Consultant</a>

by: Elena Engle, LMHC-S, EMDRIA-approved EMDR Consultant

Because We Believe You Matter

Elena founded Very Good Counseling in 2021. As a therapist, she finds that specializing in EMDR therapy elevates her abilities to help individuals with trauma, PTSD, anxiety, and depression. Passionate about freeing people from years of negative thoughts and destructive habits, Elena is committed to helping individuals find liberation from their past, embracing their truest selves.

“The attempt to escape from pain is what creates more pain.”
― Gabor Maté

Alternative Title: Unlocking Integration and Wholeness: EMDR Therapy’s Role in Healing Dissociation and Trauma

Dissociation, a psychological phenomenon characterized by a detachment from one’s thoughts, feelings, and surroundings, often stems from the profound impact of trauma. Trauma can leave individuals fragmented, leading to an array of dissociative experiences that disrupt their sense of self and daily functioning.

However, there is a therapeutic approach that offers hope for integration and wholeness: Eye Movement Desensitization and Reprocessing (EMDR) therapy. In this article, we will explore the intricate relationship between dissociation and trauma, delve into the principles of EMDR therapy, and examine how this evidence-based modality can facilitate healing and integration.

Dr. Francine Shapiro, the developer of Eye Movement Desensitization and Reprocessing (EMDR) therapy, underscored the significance of dealing with dissociation in a therapeutic context (Shapiro, 2001). Dissociation, where an individual disconnects from their thoughts, feelings, memories, or sense of identity, is often found in people who have undergone significant trauma.

In the EMDR therapeutic process, recognizing and addressing dissociation is of paramount importance. Shapiro proposed a phased treatment approach, particularly for individuals who exhibit high levels of dissociation or are diagnosed with Dissociative Disorders (Shapiro, 2001).

The initial phase encompasses history taking, client preparation for trauma processing, and the enhancement of stabilization. Therapists use techniques such as safe or calm place visualization to assist clients in managing dissociative responses.

Shapiro warned that progressing into trauma processing (Phases 3-6 of EMDR) before adequately stabilizing a client might intensify dissociative symptoms (Shapiro, 2001). Rather, she advocated for therapists to focus on enlarging the client’s window of tolerance, their ability to handle and incorporate distressing material without becoming overwhelmed or shutting down, i.e., dissociating (Shapiro, 2014).

Furthermore, Shapiro emphasized the necessity of recognizing and working with different parts of the self in clients who exhibit significant dissociation, which is consistent with theories and approaches from the field of Structural Dissociation (van der Hart, Nijenhuis, & Steele, 2006).

Understanding Dissociation

To comprehend the intricate nature of dissociation, we must explore its different types and how they manifest in individuals. Depersonalization, characterized by a sense of detachment from oneself, and derealization, where the external world feels unreal or distorted, are common experiences of dissociation.

Additionally, dissociative amnesia may cause individuals to have gaps in their memories, selectively forgetting traumatic events or significant aspects of their lives.

Dissociation serves as a coping mechanism in response to trauma, allowing individuals to escape overwhelming emotions and protect themselves from further harm. It acts as a psychological defense, creating distance from distressing experiences.

However, the long-term effects of dissociation on mental health can be detrimental, resulting in difficulties with memory, emotional regulation, and overall well-being.

Trauma and Dissociation

The connection between trauma and dissociation is profound. Childhood trauma, such as physical or sexual abuse, neglect, or exposure to violence, can significantly impact an individual’s development, leading to dissociative disorders.

Complex trauma, typically experienced over an extended period, can also contribute to dissociation. The cumulative effects of multiple traumas can fragment one’s sense of self, memory, and perception of reality.

Examples of the connection between trauma and dissociation:

  1. Childhood trauma: A person who experienced physical abuse as a child may develop dissociative disorders, such as dissociative identity disorder (DID), as a result of the severe and prolonged trauma endured. The trauma disrupts their sense of self, leading to fragmented identities and memory gaps.
  2. Sexual abuse: Survivors of sexual abuse may exhibit dissociative symptoms, such as depersonalization and derealization, where they feel detached from their own body or perceive the world as unreal. Dissociation serves as a defense mechanism to escape the overwhelming emotions associated with the traumatic experience.
  3. Neglect: Children who experience neglect, such as consistent emotional unavailability or a lack of basic care, may develop dissociative tendencies as a way to detach from the pain of abandonment and unmet needs. Dissociation helps them cope with the emotional deprivation and creates psychological distance from the neglectful experiences.
  4. Exposure to violence: Individuals who witnessed or were victims of violence, such as domestic violence or community violence, can develop dissociative symptoms. The exposure to such traumatic events overwhelms their ability to process the experiences, leading to dissociation as a means to protect themselves from the distress.

Individuals who have experienced trauma may display dissociative symptoms, including a fragmented sense of self, wherein different parts of their identity feel disconnected and incoherent. Disrupted memory and perception are also common, as traumatic experiences may be stored as fragmented fragments rather than integrated narratives.

Examples of dissociative symptoms in individuals who have experienced trauma:

  1. Fragmented sense of self: A person who suffered childhood abuse may struggle with a fragmented sense of self, feeling as though different parts of their identity are disconnected or contradictory. They may experience internal conflicts, shifting beliefs, and a lack of continuity in their self-perception.
  2. Disrupted memory: Traumatic experiences can disrupt the normal functioning of memory. For example, a survivor of a car accident may have fragmented memories of the event, with certain details vividly recalled while others remain elusive or completely forgotten. Trauma-related dissociation hinders the integration of memories into a coherent narrative.
  3. Perception of reality: Trauma can distort an individual’s perception of reality. For instance, a combat veteran who experienced intense warfare may struggle with derealization, where the external world feels surreal or distorted. They may feel disconnected from their surroundings, as if living in a dream or alternate reality.
  4. Fragmented fragments: Traumatic experiences can be stored as fragmented fragments in memory rather than integrated narratives. For instance, a survivor of a physical assault may recall disjointed sensory details, such as sounds, smells, or visual flashes, without a clear chronological sequence. The dissociative response to trauma can result in fragmented memories that are difficult to piece together into a cohesive story.

These examples illustrate the profound impact of trauma on dissociation and how dissociative symptoms manifest in individuals who have experienced traumatic events.

EMDR Therapy: An Overview

EMDR therapy, a comprehensive and evidence-based approach, offers a pathway towards healing trauma-related dissociation. Eye Movement Desensitization and Reprocessing, the full name of EMDR, involves bilateral stimulation, such as eye movements, sounds, or taps, to facilitate the reprocessing of traumatic memories and promote adaptive information processing.

At its core, EMDR therapy operates based on two fundamental principles. Firstly, dual attention stimulation, achieved through bilateral stimulation, helps individuals simultaneously focus on traumatic memories while engaging in the present moment.

This process facilitates the integration of fragmented memories and emotions. Secondly, the reprocessing of traumatic memories involves accessing and reprocessing distressing experiences, leading to their transformation into more adaptive and resolved narratives.

EMDR Therapy for Dissociation and Trauma

Research and clinical evidence have shown the effectiveness of EMDR therapy in treating dissociation and trauma-related symptoms. Case studies and controlled studies have demonstrated the positive impact of EMDR therapy on integrating dissociated parts and reducing dissociative symptoms.

The process of EMDR therapy involves several distinct phases. Initially, preparation and assessment are essential, ensuring that individuals are equipped with the necessary coping skills to manage potential emotional intensity.

Desensitization and reprocessing follow, during which the therapist guides the client in accessing and reprocessing traumatic memories. Installation and body scan phases help strengthen positive beliefs and facilitate a sense of safety within the body. Finally, closure and reevaluation ensure that the treatment progress is consolidated.

While EMDR therapy has shown great promise, it is crucial to address potential challenges that may arise when working with dissociation. Stabilization techniques, aimed at strengthening emotional regulation and grounding skills, play a vital role in creating a safe therapeutic environment.

Resource development and installation further enhance a client’s resilience and ability to self-soothe during challenging moments.

In EMDR therapy, when working with clients experiencing dissociation, we often begin with stabilization techniques. This might include grounding skills such as “mindful breathing” where the client focuses on their breath, inhaling and exhaling slowly, helping them to stay present and grounded in the moment.

This technique is regularly used by clients dealing with dissociative symptoms as it aids in interrupting the process of dissociation and brings the client back to the present moment.

Resource Development and Installation (RDI) is another method used to bolster a client’s resilience and self-soothing abilities. In RDI, clients identify internal resources – positive memories, comforting images, or supportive figures in their lives – and strengthen these through visualization and positive reinforcement, creating a mental “toolkit” they can tap into during challenging moments.

For instance, a client who finds comfort in the memory of their childhood pet might use this as a resource. The therapist would guide the client to visualize and focus on this positive memory, reinforcing it to the point where the client can easily recall this memory when feeling distressed or overwhelmed.

Another example could be a client who feels empowered by a specific place – a tranquil beach or a quiet forest. The therapist and client would work together to build this place in the client’s mind, allowing them to “visit” this place during moments of anxiety or distress.

By integrating these techniques into their therapeutic approach, EMDR therapists can support clients in managing dissociation effectively and safely, paving the way for successful trauma processing and recovery.

Benefits and Limitations of EMDR Therapy

The advantages of EMDR therapy for dissociation and trauma are significant. Clients often experience rapid and lasting results, as the therapy targets the root causes of their symptoms. By addressing the underlying trauma, EMDR therapy offers a comprehensive approach to healing, promoting integration and wholeness in individuals’ lives.

However, it is important to consider certain limitations when utilizing EMDR therapy. Not all individuals may be suitable candidates for this treatment modality, particularly those with severe dissociative disorders or conditions that impair their ability to engage in the therapy process. Additionally, EMDR therapy can evoke intense emotional experiences, necessitating careful titration and pacing to ensure the client’s well-being.

Integrating EMDR Therapy with Other Modalities

To augment the benefits of EMDR therapy, it can be integrated with other therapeutic modalities. Mindfulness-based practices, such as meditation and body awareness, complement EMDR therapy by cultivating present-moment awareness and self-compassion. Somatic experience, a body-centered approach to trauma healing, can also enhance the efficacy of EMDR therapy by addressing physiological manifestations of trauma.

Collaborative treatment is crucial, particularly when working with complex trauma and dissociation. A trauma-informed team comprising therapists, psychiatrists, and other healthcare professionals can provide comprehensive care. Coordinated treatment planning ensures that different modalities work synergistically to address the unique needs of individuals on their healing journey.

EMDR Therapy: Empowering Healing and Integration

The power of EMDR therapy lies in its ability to empower clients to reclaim their lives and well-being. Through the reprocessing of traumatic memories and the integration of dissociated parts, individuals can find healing, meaning, and a renewed sense of self.

Case examples illustrate the transformative potential of EMDR therapy. Clients who have struggled with dissociation and trauma-related symptoms have experienced profound shifts in their lives, reclaiming their identities, and reconnecting with their innate resilience.

The therapeutic relationship, built on trust, compassion, and expertise, plays a pivotal role in supporting clients through their healing journey.

As stated above, dissociation and trauma often go hand in hand, resulting in fragmented experiences and disrupted functioning. EMDR therapy offers a path toward integration and wholeness by targeting the underlying traumatic memories and promoting adaptive information processing.

With its evidence-based approach, EMDR therapy has shown promise in treating dissociation and trauma-related symptoms, facilitating the healing and integration necessary for individuals to reclaim their lives. Seeking professional help and embarking on this therapeutic journey hold the potential for hope, transformation, and the restoration of a sense of wholeness.

Learn more

References:

Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures (2nd ed.). New York: Guilford Press. (https://psycnet.apa.org/record/2001-05049-000)

Shapiro, F. (2014). The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences. The Permanente Journal, 18(1), 71–77. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/)

van der Hart, O., Nijenhuis, E. R., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. New York: W.W. Norton & Company. (https://www.researchgate.net/publication/321969600_The_Haunted_Self_Structural_Dissociation_and_the_Treatment_of_Chronic_Traumatization)

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