Is there a place for EMDR in the treatment of personality disorders?

There is substantial evidence that EMDR is an effective treatment method un posttraumatic stress disorder (PTSD). However, comorbid disorders have to be taken into account when treating PTSD with EMDR. Personality disorders are a frequent comorbid disorder of PTSD, and a high prevalence of childhood traumatization has been found in personality disorders as well. Given this background, the paper to be presented discussed (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations, Problems of therapeutic alliance due to transference phenomena and acting out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e. g., as in dissociative identity disorder) call for a consideration of all ego-sates of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.

Conference

English

Wolfgang Woller

Woller, W. (2004, June). Is there a place for EMDR in the treatment of personality disorders? In complex traumatisation and EMDR (K. Linder, Chair). Symposium conducted at the 5th EMDR Europe Association Conference, Stockholm, Sweden