Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
This presentation has been updated to include recent literature relevant to assessment of structural dissociation, the newly updated MID Analysis v5.0, and the Interpretive Manual, 3rd Edition.
Since the development of EMDR therapy in the early 1990s, a large body of research has shown that it is efficacious for PTSD. Clinicians and researchers have found positive treatment effects beyond PTSD for more complicated conditions. Unfortunately, clinicians soon discovered that EMDR seemed to move complex trauma patients into dysregulated states rather than towards the expected, adaptive resolution of targeted traumatic memories. Stories of uncontrolled abreactions, the unplanned emergence of self-states, and subsequent destabilization leading to major setbacks or harm prompted some clinicians to dismiss EMDR as a viable treatment option for persons with dissociative features. Although some advanced EMDR trainings and publications address these complexities, ‘basic’ EMDR therapy trainings historically have not. Therapists new to EMDR gain a powerful tool, yet they are frequently caught unprepared to recognize dissociative features, conceptualize treatment in terms of dissociation, or modify treatment when dissociative symptoms pose a treatment challenge.
The Multidimensional Inventory of Dissociation (MID) has thus become a valuable assessment tool for trauma-focused clinicians--and EMDR practitioners in particular--both to determine the presence of pathological dissociation and to develop more fine-grained interventions for preparation and successful trauma accessing/reprocessing. The MID is a 218-item, self-administered instrument with 168 dissociation items and 50 validity items developed by Paul F. Dell, PhD (2006, 2011). The MID reliably differentiates and offers diagnostic impressions for Posttraumatic Stress Disorder; Posttraumatic Stress Disorder, Dissociative Subtype; Other Specified Dissociative Disorder (DSM-5); Dissociative Disorder Not Otherwise Specified (DSM-IV); Dissociative Identity Disorder; Functional Neurological Symptom Disorder; and, Borderline Personality Disorder. Participants will learn to administer and score the MID; navigate the MID Analysis to enter data, interpret results, and conduct a follow-up interview; and begin to understand how the information offered up by the MID Report may influence treatment. Implications for stabilization and potential markers for readiness for trauma accessing in an EMDR therapy frame will be offered. MID documents (including the new MID Analysis v5.0 and Interpretive Manual, 3rd Edition) are available without charge to mental health professionals and researchers at www.mid-assessment.com.