Solving transference and countertransference with dissociative disorders in EMDR

This workshop will focus on transference and countertransference problems and solutions in EMDR with dissociative clients. There will be a short literature review on procedural modifications in dealing with dissociation in EMDR, and transference and countertransference with dissociative patients. Research findings on mirror neurons and embodied simulation will be taught to enhance the participant’s understanding of the neurobiological substrates for attunement and resonance, and for solving transference and countertransference with dissociatives in EMDR when ruptures to relatedness occurs. Identifying and using transference reactions to enhance dual awareness will be demonstrated in history taking. Enhancements in preparation phase will be shown through case example to limit induced transference. Transference and countertransference during the assessment phase will be identified and solutions offered. In the Desensitization phase EMDR processing may induce transference, countertransference, or both (even with procedural modifications). Intersubjective challenges seem to be more intense during phases 1 -4 and 7-8. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session, or during Re-evaluation. Failure or defectiveness parts of the therapist may become activated then as well. Different parts of a dissociative patient may appear with different kinds of transferences during different EMDR phases. These transferences challenge therapist’s abilities to stay attuned. Strategies of attunement to the activated part of the patient will be demonstrated in order to repair or prevent ruptures to the alliance and to understand the nature of the dissociated communication. Bi-directional interactions may activate parts of the patient and therapist without conscious awareness. Strategies to somatically identify and use these countertransferential activations will be taught through experiential exercises so that the therapist may have a more in depth understanding of the dissociative patient’s communications. R/D/I strategies will be reviewed and applied to the therapist to limit countertransference activations. Dealing with dissociative enactments are crucial to identify ruptures to the therapeutic alliance, restore attunement and resonance, uncover dissociative messages that can be used during EMDR processing.. Solutions to the problems that occur during different EMDR phases will be taught using lecture, discussion, case examples, written and experiential exercises so that participants will leave the workshop with additional strategies. Solutions include how to maintain attunement to dissociative parts during transferential activations while enhancing dual awareness; how to identify transference and countertransference problems during phases 1-4 and 7-8 and use them as additional sources of dissociated communications that can be used in EMDR processing ; how to use the Clinician Self Awareness Questionnaire to identify and process countertransference problems ; how to use compartmentalization strategies using R/D/I to limit countertransference activations; how to develop self soothing skills for the therapist’s dissociated parts; how and when to use Relational, Empathic, and Transferential Interweaves during Desensitization; and how to identify moments of enactments, and using EMDR strategies to deepen the EMDR experience .

Conference

English

Mark Dworkin

Dworkin, M. (2009, August). Solving transference and countertransference with dissociative disorders in EMDR. Presentation at the 14th EMDR International Association Conference, Atlanta, GA