EMDR and structural dissociation

TrailRunner14 · Nov 08, 2016, 03:19 PM

Quote:

Originally Posted by Luce

TR, I found this one, which seems pretty good - especially to share with a counsellor. Follow the links to read more about primary, secondary and tertiary dissociation.

Structural Dissociation

Let us know what your counsellor thinks of it! I think I am going to ask my new T if I can share the link with her too.

And for the more academically minded... Trauma Information Pages, Articles: Ellert Nijenhuis, et al (2004)

Thank you Luce for the links. I like your link better. I'm going to forward both of them to him.

kecanoe · Nov 08, 2016, 11:20 PM

I have DID and have used EMDR with no problems. I found it to be somewhat helpful. I have done it with two ts, both of whom are trained to use it with trauma cases.

They followed a pretty strict protocol which involved doing a lot of "resourcing" before we addressed any issues, and were careful to not let me leave in a dissociative state. One thing I like about EMDR is that I can do it without getting attached to t. And I find getting attached scary.

I also liked that they told me to stop it at any time. That helps with safety for me.

I would suggest you ask about resourcing and try that before targeting any bad memories.

finding_my_way · Nov 09, 2016, 04:42 PM

when it was just becoming popular, i was seeing a therapist who suggested it. but she wasn't quite aware of how dissociated i was and as a result not educated properly on dissociation and EMDR. in addition, she was religious which i asked her to leave out of it. unfortunately, she did not respect that and during maybe the first and last time i did it, it caused a lot of triggering and dissociation because of how she referenced religious stuff as she was asking me to think of a memory. i have no memory of how many times i actually did it though i saw her 10 times.

for that reason, i would be reluctant to try it now with my psychiatrist even though she is way more educated on DID and EMDR...though i would have to guess since my reaction to the one time i tried hypnotherapy with her went out it did that EMDR probably would be about the same no matter what.

i think you have to be pretty stable and have proper support and go really slow with it just in case things go in a direction you don't quite expect.

Luce · Nov 10, 2016, 01:26 AM

Peaches and FindingMyWay, your kinds of personal experiences with EMDR are exactly why the push for training in dissociation as part of EMDR training is happening. It is only through experience they have learned that extra consideration and an adapted approach needs to be taken with dissociative clients. I am sorry you guys essentially became 'guinea pigs'. They just didn't know what they didn't know.

I really do believe that with a skilled and adequately trained EMDR therapist the process might be helpful rather than harmful though.

Yesterday I saw my new t for only the second time and I was so very impressed with her. She broached the topic of DID and structural dissociation and we shared quite a bit about my system and history. I was very surprised at how comfortable I (we) were in disclosing personal info to her. It was because she was knowledgeable, I suppose. She knew what we/she was talking about.
She was also incredibly perceptive and skilled at helping us to stay grounded. She noticed and responded to even very subtle changes in affect and switches etc, and was able to help us stay within the 'window of tolerance' throughout the session. The first time we saw her she taught us a tapping technique for grounding, and she taught us some more techniques yesterday. One of them was tapping to support during the session (like you with the buzzers, Peaches).
Near the end of the session she did a visualization exercise that safely contained everything and left me feeling so peaceful that I was able to leave the session without feeling triggered at all - which has never ever happened before in all my years of therapy.
We haven't discussed EMDR yet, but I recognize the techniques she is teaching me as part of the EMDR preparation phases. She is just so attentive to my dissociative cues and so effective at helping me to ground and refocus that it all feels very, very safe. She seems so intuitive and aware of the need for tolerance and grounding that I think I can trust she would only attempt EMDR with me if she knew it was safe. Somehow I don't think she will even try it for a while yet.

Solnutty · Apr 30, 2017, 11:19 AM

Quote:

Originally Posted by finding_my_way

it's interesting to see that some who do EMDR will do it with people who have DID. my psychiatrist does EMDR but won't do it with me. i think she explained that it can cause more issues with DID...like if there is stuff that comes up out of nowhere and floods me....but it probably also depends on the system and how they function. i would think if/when mine becomes more clear, more is known, etc. that maybe she would consider doing it with me, but she seems to use hypnotherapy/guided meditation over EMDR for DID (or just me maybe)...except we are still just doing talk therapy right now because that was a bit unsafe when we tried.

Yes! I entered therapy for depression and surfacing trauma memories. My therapist at the time started me on EMDR and it took about 3 sessions for my system (which was well hidden, she wouldn't have detected it) to begin to unravel and flood with flashbacks and the associated negative coping mechanisms. Honestly I had life changing epiphanies that I am grateful for, but it is not something I would do again except under extremely controlled circumstances with a T who has practiced the technique with DID individuals specifically and had specialized training. Oh yeah, and who had extensive knowledge of and trust built with every part in the system. EMDR is a powerful tool, so powerful in fact that it must be used with the utmost care with any persons who are dissociative. If you fall into that category do not let your therapist use it until the above conditions are met, and at that point it can truly help. Otherwise you might find your selves falling apart.

Solnutty · Apr 30, 2017, 11:44 AM

Adding to my above post:
My previous T and I did continue to do EMDR on a limited basis. The process revealed several of my parts. Eventually she encouraged me to seek out another therapist specializing in dissociative disorders. I did, and I am so glad that I did. My new T is working on getting to know all of us, teaching grounding techniques, developing trust, and increasing communication and cooperation in the system. We actually look forward to our sessions, and I've been told I am much more stable and happy.
There were some warning signs in the beginning that pointed to a dissociative disorder and should have been an indication that EMDR was not appropriate for me. First, and I mean right from the first session, I was unable to construct a mental "safe place." The effort produced something like a panic attack. (Looking back I was experiencing the emergence of a frightened child part.) Eventualy I was able to, but it took a great deal of work outside of session. Second, my dissociative symptoms skyrocketed post-session. I mentioned flashbacks, and there was also that feeling of being unreal, staring off into space for up to hours at a time, times when I was suddenly unable to speak or think about a topic I was just focusing on, feeling like I was sitting far back inside my head, unexplained body pains and what seemed like random emotions, and more. Also, during sessions I would experience a great deal of looping and dead ends. It was like at the end of each pass I would end up at the same thought or image over and over again. There was one in particular that would show up, and later I figured out this was a protector part that was surfacing to block the association of a group of trauma memories. Thank God too, because I certainly wasn't ready for those and I know I'm still not.

Apr 30, 2017, 11:48 AM

Quote:

Originally Posted by Luce

I am terrified of trying it too! Although I am educating myself about it, because I think it will be able to help me and I really want to try it. I am going to go slowly with it though... and make sure that both my T and I are well prepared before diving into it.

Me too. It seems that we go in a dissociative trance and tune out when approached with something new.

Apr 30, 2017, 11:49 AM

Quote:

Originally Posted by Solnutty

Adding to my above post:
My previous T and I did continue to do EMDR on a limited basis. The process revealed several of my parts. Eventually she encouraged me to seek out another therapist specializing in dissociative disorders. I did, and I am so glad that I did. My new T is working on getting to know all of us, teaching grounding techniques, developing trust, and increasing communication and cooperation in the system. We actually look forward to our sessions, and I've been told I am much more stable and happy.
There were some warning signs in the beginning that pointed to a dissociative disorder and should have been an indication that EMDR was not appropriate for me. First, and I mean right from the first session, I was unable to construct a mental "safe place." The effort produced something like a panic attack. (Looking back I was experiencing the emergence of a frightened child part.) Eventualy I was able to, but it took a great deal of work outside of session. Second, my dissociative symptoms skyrocketed post-session. I mentioned flashbacks, and there was also that feeling of being unreal, staring off into space for up to hours at a time, times when I was suddenly unable to speak or think about a topic I was just focusing on, feeling like I was sitting far back inside my head, unexplained body pains and what seemed like random emotions, and more. Also, during sessions I would experience a great deal of looping and dead ends. It was like at the end of each pass I would end up at the same thought or image over and over again. There was one in particular that would show up, and later I figured out this was a protector part that was surfacing to block the association of a group of trauma memories. Thank God too, because I certainly wasn't ready for those and I know I'm still not.

What is your ultimate goal in therapy? Integration....co-operation?

How long have you been in therapy?

Apr 30, 2017, 11:50 AM

Quote:

Originally Posted by peaches100

My therapist used EMDR with me early in my therapy, before she realized how dissociative I am, and it caused a lot of problems. I couldn't handle the emotional distress that it caused. I got too flooded with pain, either during the EMDR session or in the 1-3 days following an EMDR session. It was a destabilizing experience for me that triggered my issues from childhood of being in painful situations that I couldn't tolerate. I endured several destabilizing episodes of EMDR. The emotional pain was so bad, it left me feeling retraumatized every time!

My t did her best to verbally coach me through these distressing EMDR sessions, but I felt like the pain would destroy me. All I could think and feel was that I was in horrible danger and pain, and I needed somebody to rescue me and protect me. In my case, it would have helped significantly if my t had come over and sat next to me, perhaps even holding my hand so that I would be able to hang onto some realization of her presence and know that I was not actually all alone and in danger. But my t was afraid to touch me because of my past SA in childhood. As a result, it triggered old issues from times I really was in too much pain or danger, and my mom wasn't there for me. It created feelings of fear and deprivation, and damaged our therapy relationship for a time. We finally quit trying to do EMDR.

As time went on, my t started to realize I was dissociative and learned that she should not have done EMDR with me so early without first helping me develop more coping skills and ability to tolerate distress. We have been working on that now for quite awhile. We still aren't ready to try EMDR again. But I sometimes still hold the hand buzzers in my session when we work on things. I think my t believes that it will help me incorporate more of our work with the bilateral stimulation.

Maybe my experience will help guide some of you who haven't tried it yet. I am by no means implying that EMDR is bad or damaging, in and of itself. But be careful that your therapist understands that people who are dissociative need much more preparatory work ahead of time to make sure it will not be too overwhelming for them. Also, if it helps to share my experience, my t has had to learn over and over again that in my sessions, she absolutely must go slow. It does not take much to flood me. Thankfully, I am getting better and being able to tolerate more and more distress without feeling retraumatized. But it has taken a long, long time!

As a child, our family just never talked about emotions or bad things at all, or even acknowledged emotional pain. So I never have learned how to talk about bad or scary feelings, much less work through them in therapy. I've had a hard time even allowing myself to feel things like fear, rejection, need, etc., without being terrified. It takes a long time...

Peaches

This is me....the forgotten parts can stay forgotten.

Solnutty · Apr 30, 2017, 12:22 PM

Quote:

Originally Posted by AlwaysChanging2

What is your ultimate goal in therapy? Integration....co-operation?

How long have you been in therapy?

I've been in therapy for almost a year. At first my goal was integration, but now it's more cooperation. I have about 13 known parts, and a couple of them have already integrated (why that happened so fast is a very long story, I've actually been interacting with several of my parts for years with increasing coconsciousness, but I did not know this as it was my "normal" and I am a writer--thought I was just really quirky and imaginative). I shifted to cooperation as the goal because that's something we can all agree to and I was criticized by some of them for acting like my goals and feelings were the only important ones in the system! Just because I'm the one who goes to work and school doesn't mean I get to decide what's best for everyone. So if any of them decide integration is what they want, great, and if not, we can cooperate for the rest of our life.

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EMDR and structural dissociation

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