EMDR and DID

I read posts about EMDR and how it works for DID and trauma. I'm open and interested because I read a lot of good results. I asked my therapist whether this would be good for me, her answer was outspoken and clear. That I should not do EMDR. And that I had to promise her that if I did not continue with her, i will not try it with someone else. I'm going to follow a course at a TRTC (Top Referent Trauma Centrum)
During the intake I have also asked about EMDR and their response was similar. They explained to me that my trauma is complex and that EMDR is not appropriate for me. I come from europe. Do they have different thoughts about EMDR and DID?

only your treatment providers in the netherlands (where the TRTC is located)/europe say whether they have a different standard, treatment options and thoughts about EMDR and DID than another person/another treatment provider/another country...

here in america treatment providers dont always agree/have the same thoughts/opinions about things like treatment options..example I went to a workshop this past summer and the treatment providers were a diverse bunch from every walk of life, all kinds of expertise, options, opinions and more...

American has the freedom to have their own opinions, the freedom to choose their own treatment providers, the freedom to choose what treatments they want to try and what they dont want to try.

my suggestion your treatment providers are the ones treating you, go according to what you and your treatment providers feel is right for you.

I'm reading a book right now about EMDR and trauma. In order to do EMDR with amnesia present, there is a long process to go through, to make sure the client is stable enough to manage the trauma memories, etc. I think you'd need to have someone who is extremely skilled in EMDR and DID both, in order to do this. My T is very highly skilled with EMDR and has no problem working with people who have DID (I'm in Canada). However, there are a list of issues that can happen when the t is not comfortable with the process.

You could end up switching, based on the eye movements, and whoever comes out may not be on board with the treatment. It would have to be explained too all the parts and they would all have to be willing to open up the past. EMDR can bring up memories that aren't being worked with that you didn't know about, it can make trauma seem real. Without someone who really knows what they're doing, you could end up doing what they call 'looping', where the eye movements just keep you locked in a memory. If this happened with someone skilled, they would know different ways to get you out of it. But if you were with someone who wasn't as sure, you could, potentially be retraumatized by the experience.

I don't know where you are in therapy or what memories you would want to work with. They focus a lot in the book on building up distress tolerance skills and other coping skills to be able to help yourself.

Not to scare anyone off. Any kind of therapy, if it's not the right kind for the right person can traumatize them. I was hurt by a counselor a few years ago who had no idea I had so many early traumatic memories, and she caused a lot of damage.

Could you ask your t what would need to change in order for you to benefit, or for some concrete examples as to how your situation does not fit the treatment? Perhaps she has a plan for you, or you have both decided on a certain way to address the memories and adding EMDR wouldn't help you?

I'm lucky with the EMDR because my T explains everything well, is skilled, and also becuase I have no amnesia when I switch, so it is not so complicated to treat.

Let me know what she says, I would be interested!
xoxox
IJ

I'm with innocentjoy!

One of the initial phases (Phase 2) in EMDR involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often what is referred to as "EMDR" which is actually an 8-phase method of psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff, as well as creating strategies if you're triggered in everyday life. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. There is a special EMDR protocol for dissociative disorders and complex PTSD. The treatment of trauma and dissociation with EMDR (or any therapy) requires special/extra training. Be absolutely certain the therapist has specialized training in DD, as well as advanced training in EMDR therapy. Neither EMDR nor any psychotherapy should go digging for memories. Memories are gone - may be buried/held in different parts - for good reasons. It's really a brilliant protection. Always talk with your therapist at the beginning of your work about what you already know is grounding.

In phase 2 you learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you weren’t in the past, during traumatic events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand, or any method of bilateral stimulation that feels okay to you and your parts) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 passes of the lights to ask you to take a deep breath and say just a bit of what you’re noticing, anything different, any changes. (The stimulation should not be kept on continuously, because there are specific procedures that need to be followed to process the memory). The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And your therapist should be experienced in the EMDR techniques that help make it the gentlest and safest way to detoxify bad life experiences and build resources. Your therapist should also be using a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, or, imagine the abuser speaking in a Donald Duck voice... and so forth. There are a lot of these kinds of "interventions" that ease the processing. They are called "cognitive interweaves" that your therapist can use, and that also can help bring your adult self's perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like "are you safe now?" or "who was responsible? and "do you have more choices now?" are all very helpful in moving the processing along.

Grounding exercises are essential. You can use some of the techniques in Dr. Shapiro's new book "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR." Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). The book is an easy read, helps you understand what's "pushing" your feelings and behavior, helps you connect the dots from past experiences to current life. Also gives lots of really helpful ways that are used during EMDR therapy to calm disturbing thoughts and feelings.

For DID, as with any complex PTSD/trauma, the "front-loading" of resources, and a phased treatment plan is essential. Please read the 2011 revision of International Society for the Study of Trauma and Dissociation (ISSTD) guidelines for treating adults with dissociative disorders available for free public download.
Also good to read:
"Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder" by Tracy Alderman
"Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy" by Carol Forgash
There are other kinds of Resource Development strategies that can be used depending on the skill level and experience of your therapist (Google "Resource development and installation" and find articles by Janina Fisher, Debbie Korn, and/or Andrew Leeds, ask about John Omaha's AMST - Affect Management Skills Training, or the Imaginal Nurturing protocol).

I'm a therapist who uses EMDR as my primary psychotherapy treatment and I've also personally had EMDR for anxiety, panic, grief, and “small t” trauma. As a client, EMDR worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR (certified by the EMDR International Association and trained by the EMDR Institute, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, PTSD, anxiety, depression, grief, body image, phobias, distressing memories, and bad dreams, DID, and many other problems. It's a very gentle method with no significant "down-side" so that in the hands of a professional EMDR therapist, there should be no freak-outs or worsening of day-to-day functioning.

In addition to my therapy practice, I roam the web looking for EMDR discussions, try to answer questions about it posted by clients/patients, and respond to the critics out there. It's not a cure-all therapy, however, it really is an extraordinary psychotherapy and its results last. In the hands of a really experienced EMDR therapist, it's the most gentle way of working through disturbing experiences.

I found that information really interesting, and helpful, thanks! The book I am reading through now is called "looking through they eyes of Trauma and dissociation" by Sandra Paulsen. It breaks the EMDR into many different steps, as you are describing.

Again, thanks for the info.
IJ

Thank you very much for this information! I have not had the chance to talk with my T about this, but I certainly do! and also read more about it!

you have good experience with DID and EMDR? I find that interesting!

Again thank you for the information!
Bloem

Mmm...

It's tricky, different things suit different people. EMDR can be very helpful for fast processing of trauma. But it does NOT suit many people with DID. If you dissociate easily any way, you will need a very experienced therapist and as you are probably aware many with DID have serious trauma. I don't want to put you off EMDR because it can be a good way to get through a multitude of trauma and for some people it is good. Good luck with whatever you decide.

I think your t might be worried that you would find someone who would try and do the EMDR very quickly. It can take a long time to get prepared for any of the actual eye movement stuff. It would be very risky to go into it without enough time to prepare, build trust and learn coping skills.

I think the reason it is such a touchy subject is because most people are not qualified to work through the process, and unless they've spent time with you to learn about your situation, especially if they are not schooled in EMDR with dissociative disorders, it can be difficult.

I think the actual therapy would be very helpful to almost anyone dealing with any level of trauma, it's just that those qualified to help through the really difficult stuff are few and far between.

Please let me know what she says about it.
Thanks!
IJ

I want to do emdr but I don't think I have the coping skills I need. I have worked with my t on coping skills but not everyone is there at the time. So when I find myself needing to ground myself I sometimes have no idea of what that is or that I can do that. It all depends who is out. Sometimes someone will say use ice but most times my grounding knowledge isn't present with certain parts. My fear is that when it comes time for me to ground myself the part out won't know how and I will get stuck. We have gotten stuck before and it upsets everyone.

My t has wanted to do emdr with me on "little stuff" like stress for exams and stuff, and we did it once and I almost switched. My t has never talked To me about my alters and I know I've told her about then but I don't know f she remembers. She doesn't seem to want to focus on anything that isn't day to day stress so she was confused when I had to stop for a second and re-focus on being me. She didn't explain any of this to me so I was freaked out was confused as to why it happend.

Thank you for this information. I didn't know there was a correlation. I'm going to talk with her about this maybe when she gets back.

I asked my T about EMDR and why it is not suited (yet). It's not that EMDR is totally impossible for DID, she told me that they also work with EMDR, in the center where I had an intake. It should be well thought about, why it can be used? and whether it will work....so that the client does not again can be 'traumatized'

My T explained that EMDR needs a 'focus' a clearly defined goal / trauma where you will be working on. In my case there is not one but multiple infantile trauma, in that way that it is in various fields. That makes it complex for EMDR. Suppose we focus on CSA with EMDR, it can call up emotions, which are similar for an other trauma. Another part that has to do with that trauma, can get into 'trouble'. Therefore it is at the present not yet suitable for us.

We must first be stable and see who is connected tot which trauma and which intensity. Also because I easily get triggered in everyday life.
For now EMDR is not appropriate for me, but in the future it can change and work.

Bloem

It sounds like you have a good therapist because she took the time to explain why emdr is not the best therapy at this point. I am glad you got your question answered and the entire thread was very informative. Take care.

I'm glad she was able to go into detail. It sounds like she is willing to do the preparation, just not the actual processing yet. I'm glad you have someone who sounds like she completely has your back!
xoxo
IJ