Your other questions

Yes, generally, EMDR always integrates or associates information that has been not-associated, or dissociated, whether or not a formal dissociative disorder is present. That's why clients with undiagnosed dissociative disorders have stormy EMDR's if the therapist fails to screen for a dissociative condition -- the EMDR associates material no matter where it is held, unless resistance and defenses (like alters or just ego states) pop up to stop it. The elements which can be integrated in any client during EMDR include knowledge, affect, body sensations, and memory/control of ones own behavior.

In EMDR for DID, if four parts were present at the time of the trauma, the work needs to be collaboratively planned ahead of time. All the parts involved need to agree on how to proceed, and other parts may agree to be present as resources. In all likelihood, fractionation will be necessary, in which the memory is processed in bite size pieces. So not only do all four parts not process at the same time, but one part may only do a small piece of the work, in order to make it manageable. The memory can be broken down by channel for some clients, so they process sounds but not smells or pictures during a particular sessions, with the rest saved for other sessions. For other clients, the intensity of the experience can be titrated or fractionated by means of imagery such as seeing the image in black and white on a small screen, far away in the minds eye, or by using a control panel in the minds eye, that has a n intensity control knob or a stop switch. Some clients can have alters blend so that a 9 year old part gives strength to a three year old. And so on. Richard Kluft MD and Catherine Fine PhD have published in this area, and the hypnosis field has a number of similar devices to help manage it. I don't use formal hypnosis per se, with trance induction. I use a conference room approach, as described by George Fraser, in combination with an ego state approach, in which I work with and mediate between parts in the minds eye. No switching required.

The only protocol I know on this subject is that taught in my two day workshop, though Catherine Fine and another author whose name escapes me now have published an article on Imbrication of Hypnosis and EMDR, which means interweaving. Also, Maggie Phillips talks about braiding the two together. In my workshop I describe it in terms of a protocol per se. But that has not yet been published since the article I did in 1995 for the journal Dissociation. That article does not sufficiently address fractionation and stabilization. It is however available at www.paulsenconsulting.com under Articles for Professionals. In combination with stabilization, containment, and fractionation procedures, it is still a valuable procedure.

Replies:

Re:Your other questions, by another client, 07/13/02 Re:Your other questions, by Sandra Paulsen Inobe, PhD, 07/14/02 Re:Your other questions, by another client, 07/14/02

| Behavior OnLine Home Page | Disclaimer |

Copyright © 1996-2004 Behavior OnLine, Inc. All rights reserved.