Re:Thank you and further questions

This is a hard question to answer. For one thing, since you are using the word "we" to refer to yourself, I deduce that you might be dissociative, but I don't want to go diagnosing anybody in this forum, as I obviously have no where near enough information to do so.

I'll make a couple more general comments about dissociative clients and EMDR here though.

If a client knows s/he is dissociative, s/he can ask the therapist what training and experience that therapist has in treating dissociation, and specifically, in doing EMDR for dissociative clients. There is very little training available in this subject, and no credentially process per se. I wrote an article on the subject, so has Catherine Fine in Philadelphia and Joanne Twombly in Massachusetts. Many clinicians consult with us by telephone to acquire appropriate skills and to have a second opinion on tricky cases.

Many clients who are dissociative don't know that they are dissociative (since the whole point of being dissociative is to keep unbearable truths/secrets from the self and the world. So the client doesn't know to ask, and if therapists aren't trained in dissociation, and know how to recognize it, both can jump in to EMDR prematurely.

That's why I've been on a bandwagon since 1992 insisting that EMDR therapists always screen each and every client for a dissociative condition, using the DES or some other method, so they know whether to delay using EMDR.

For a dissociative client, there are a lot of steps, including stabilization, containment, ego strengthening and then fractionating (breaking into pieces) the trauma work. Various methods can be used to make the intensity of the work tolerable.

At the same time, there is no doubt that the work is painful for dissociative clients, because it is no longer possible to not know the truth of the history - or some piece of it anyway. (disclaimer: information accessed in EMDR is subject to all the same sources of inadvertent error as is any other human cognitive process).

That's my best answer for now.

Sandra Paulsen Inobe, PhD Fair Oaks, CA

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