EMDR therapy was initially developed to reprocess traumatic experiences, arising predominantly from PTSD, to an adaptive resolution. However, it was quickly discovered that EMDR “can lance dissociative barriers prematurely and cause flooding when the volume of material accessed exceeds the capacity of the client to process the material”. Over the last 30 years, different techniques have been utilised to integrate management of dissociative symptomatology into structured EMDR therapy. More recently, Mosquera has developed the Progressive Approach to describe the principles and techniques guiding interventions in this population.
Patients with complex PTSD frequently present with comorbid dissociative symptoms. Many clinicians consider that for patients in this population, EMDR therapy should be limited to those who have high functioning dissociation, and only after a long preparation phase utilising other treatment modalities. This is now being challenged by clinicians interweaving EMDR Therapy principles into work with “dissociative parts”.
This presentation introduces the basic principles of EMDR therapy and describes adjusting these principles to incorporate reprocessing of phobias of traumatic memories and phobias of dissociative parts. Video tape examples will be presented to demonstrate particular interventions, with particular reference to dissociative hallucinations.
EMDR therapy protocols can be adjusted so that patients with complex PTSD with severe comorbid dissociation can be treated successfully without the need for prolonged stabilisation of dissociative phenomena.