EMDR FORUM ARCHIVE, 2000
Re:EMDR with a MDD/PTSD/DID/SRA client (research question--pls HELP!!)
Sandra Paulsen Inobe, PhD · 05/30/01 at 9:05 PM ET
This horror story certainly illustrates the importance of having a therapist trained in working with dissociative conditions. Some of the specific therapist behaviors described in this report are directly out of EMDR training and would not be a problem for a non-dissociative client. Example: some therapists use finger snapping on each side of the head as a form of bilateral stimulation. I don't because I find it to be intrusively close to the client if the client has a complex trauma history. Continuing unless the client uses the preagreed stop signal is right out of EMDR training, but a therapist trained in dissociative conditions can recognize a flashback into a child ego state or alter if s/he sees one! For reasons that continue to escape my understanding, in spite of the fact that EMDR trainings include a warning to screen for an undiagnosed dissociative condition, some therapists still do not do so. Actually, I think I do understand why .... they think that because they haven't seen (or recognized) a dissociative condition, that that means the current client can't be dissociative either, or that perhaps the dissociative client would come in with clear labeling as such on the forehead. Finally, I think people don't realize how destabilizing EMDR can be to a dissociative client. The article I wrote in 1995 for the journal Dissociation will guide therapists in treating a dissociative client, except for the most severe DID clients (and those include those reporting SRA issues). For those clients, the work should be fractionated and planned after much stabilization and containment work has been achieved. My article is available at no charge on my website, which is www.paulsenconsulting.com under Articles for Professionals. It alone is not enough for a therapist not trained in treating dissociation to treat a DID or DID/SRA client. Such a therapist should seek consultation, get to workshops, and join the International Society for hte Study of Dissociation. Sandra Paulsen Inobe, PhD
Certified EMDR Consultant
Fair Oaks, California
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