Solving transference and counter-transference with dissociative disorders in EMDR

This workshop will focus on the types of transference and counter-transference that arise in EMDR with dissociative clients and teach solutions. Procedural modifications have been the focus in dealing with pathological dissociation in EMDR treatment. Separately, transference and counter-transference with dissociative patients have been written about extensively by experts in the dissociation field. Research findings about the effects of mirror neurons and embedded simulation on the inter-subjective field of patient and therapist have also been published. Strategies for dealing with these transference and counter-transference in EMDR treatment have received little attention even though this population has intense transference, and can activate intense counter-transference. These issues may begin during an evaluation of the presenting problems. Strategies for identifying and using transference to enhance dual awareness during history taking will be demonstrated. An elongated preparation phase to develop enough trust and stabilization before exploring traumatic memories can limit induced transference. Different parts of a dissociative patient may have different kinds of transferences. These transferences may cause the patient to withdraw, cling or attack; affecting the therapist’s abilities to stay attuned and focused on the work in different phases of EMDR. Strategies of attunement to the activated part of the client will be demonstrated in order to repair or prevent ruptures of attunement. Interactions are bi-directional, and different (transferential) parts may activate dissociative parts of the therapist. Strategies to somatically identify and use these counter-transferential activations in the therapist will be taught through body based awarenesses. R/D/I strategies can be used to limit countertransference to remain grounded and attuned. Transference and counter-transference during the assessment phase will be identified and solutions presented. During the Desensitization phase under-accessing or over-accessing target memories; abreaction vs. vehement emotions will be discussed as unacknowledged dissociative moments with indications for inducing transference, counter-transference, or both. Decisions need be made collaboratively whether to process or contain these events. Understanding and dealing with dilemmas of dissociative enactments are crucial to keeping the healing process going. These inter-subjective issues may be most intense during the first four phases, but some problems may continue into Installation and the Body Scan. Problems and solutions during Incomplete Closure and the Re-evaluation phases will be given. Activated parts in the patient may cling or be angry with the therapist at the end of an EMDR session. Failure or defectiveness parts of the therapist may become activated as well. Solutions to these issues that occur during different phases will be taught so that participants will leave the workshop with additional strategies to use with their dissociative patients. Attunement to dissociative parts, identifying transference and counter-transference binds; The Clinician Self Awareness Questionnaire ; Compartmentalization; use of self soothing skills; using Relational, Empathic, and Transferential Interweaves; identifying moments of projective identification and enactments, and then to use them to deepen EMDR will be taught, as well as innovative inter-subjective strategies . Case examples and awareness exercises will used throughout the workshop to facilitate intellectual and experiential learning.

Conference

English

Mark Dworkin

Dworkin, M. (2010, March). Solving transference and counter-transference with dissociative disorders in EMDR. Presentation (M. Paterson, Chair) at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland