Science & practice: Attachment, dissociation and EMDR

EMDR is a powerful integrative psychotherapeutic intervention. However, in the case of disrupted attachment and significant dissociative symptoms EMDR can be destabilizing if used early on in treatment. That is, fragmentation of self and dissociative symptoms commonly interfere with information processing, thus barring the integration and resolution of the traumatic experience through EMDR. Dissociation interferes with clients sense of their own body, their ability to experience emotion, their capacity for emotional regulation and their sense of self. Addressing dissociative symptoms prior to proceeding with EMDR treatment is essential for positive treatment outcomes.
A neurobiological model is described that guides therapeutic interventions and integrates diverse approaches that include not only EMDR and relevant target selection, but also mindfulness, body therapy approaches, ego-state interventions, sensory integration, as well as neurobiologically based interventions. Such interventions can be used both in the preparation phase but can also form useful interweaves during EMDR information processing.

Using a neurobiologically informed approach, the case is made for the use of somatic and ego-state interventions when dissociation is a significant part of the clinical presentation. Specific focus is on different ego-state and body therapy interventions to increase awareness of the self and ones body. Body therapy and somatic interventions are distinguished from other psychotherapeutic interventions in that they are expressed in markedly slowed-down time, in order to give clients ample time to experience the felt sense of their bodies. Similarly ego-state work can be utilized to titrate information processing, as well as provide clients with internal resources that aid in enhanced information processing.

Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment. The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect. Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment. The workshop also will discuss innovative use of opioid antagonists in the treatment of dissociative symptoms with a particular focus on EMDR.

Learning Objectives: Attendees will gain knowledge about possible underlying neurobiological processes with regard to attachment, dissociation and adaptive information processing and how this relates to EMDR treatment. Participants will learn how to effectively integrate different somatic and ego-state interventions in the treatment of attachment and trauma related syndromes and dissociative disorders, as well as how to enhance information processing during the EMDR treatment. The workshop will teach specific interventions intended to stabilize clients, create safety, help the client stay connected or get reconnected and therefore minimize dissociative symptoms and their effect.

Conference

English

Ulrich Lanius

Lanius, U. (2012, October). Science & practice: Attachment, dissociation and EMDR. Presentation at the International Society for the Study of Trauma and Dissociation 29th Annual International Conference, Long Beach, CA