Estados de ego e o EMDR em quadros dissociativos Ego states and EMDR in dissociative frames
Description
O objetivo da oficina é abordar como os processos de dissociação consciente de papéis ou estados de ego podem ser utilizados para potencializar a reintegração psíquica dos pacientes dissociativos. Pacientes dissociativos sempre foram um dos grandes temores dos terapeutas em EMDR para o uso da fase 3 em diante. Geralmente esses quadros requerem um grande tempo de preparação além de um manejo mais avançado e interventivo durante o reprocessamento. Entretanto, entre pacientes com alto grau dissociativo é comum encontrarmos pessoas com grande fragilidade psíquica, acesso a um pobre histórico de recursos, uma grande dificuldade em se expressar, perceber e nomear seus sentimentos além de grande dificuldade em relatar seus traumas. Então, como avançar no protocolo de EMDR com pessoas tão fragilizadas e que quase não nos dão dicas do conteúdo de seus traumas? Alguns critérios hipotéticos auxiliam a instrumentalizar tanto o profissional quanto o paciente a enfrentarem o reprocessamento. Primeiramente, (a) se diante de uma história de traumas intensos a pessoa sobreviveu e chegou até você, é porque ela tem recursos importantes, mesmo que tenha dificuldade de acessá-los. Um desses recursos é o próprio quadro dissociativo que a protege da intensidade dos traumas e possibilita a vida “apesar de...”. (b) Se essas partes estão tão distantes uma da outra, é porque elas tiveram um motivo para isso, mas talvez esse motivo já esteja no passado, e hoje podemos caminhar para uma conversa. (c) Sendo todos esses papéis ou egos são partes do eu, certamente eles querem algo de positivo para esse eu, mesmo que aparentemente seja difícil perceber isso. Essas hipóteses ou crenças positivas a respeito do paciente devem ser checadas com dados de realidade para que possam ser fortalecidas, mas, mais do que isso, é fundamental que elas "transpirem por todos os poros do corpo do terapeuta". Identificados os estados de ego presentes no evento traumático parece ser mais fácil seguir com a etapa do reprocessamento de deforma menos interventiva, principalmente quando não se tem o conteúdo do evento em questão. Obviamente que todo esse processo deve levar todo o tempo necessário e seguido de todos os cuidados que a aplicação do EMDR demanda.
The goal of the workshop is to discuss how the processes of conscious dissociation of roles or ego states can be used to enhance the reintegration of the psychic dissociative patients. Dissociative patients have always been one of the great fears of EMDR therapists for use in phase 3 onwards. Generally these paintings require a great preparation time plus a more advanced and interventional management during reprocessing. However, among patients with high dissociative is common to find people with great fragility psychic, poor access to a historical resource, a great difficulty in expressing themselves, perceive and name their feelings besides great difficulty in reporting their trauma. So, how to advance the EMDR protocol with people so fragile and hardly give us hints of the contents of their trauma? Some hypothetical criteria help to equip both the professional and the patient to face the reprocessing. First, (a) in front of a history of severe trauma the person survived and came to you, it is because it has important features, even if you have difficulty accessing them. One of these features is the very dissociative disorder that protects the intensity of the trauma and allows life "although ...". (B) If these parties are so far apart, it's because they had a reason for that, but maybe that reason is already in the past, and today we can walk into a conversation. (C) Since all these roles and egos are part of me, surely they want something positive to me, although apparently it is difficult to realize this. These positive beliefs or assumptions about the patient be checked against data from reality so that they can be strengthened, but more than that, it is crucial that they "transpire from every pore of the body of the therapist." Identified ego states present at the traumatic event seems to be easier to follow with step of reprocessing deforms less interventionist, especially when you do not have the content of the event in question. Obviously, this entire process should take all the time necessary and followed by all care that the application of EMDR demand.
The goal of the workshop is to discuss how the processes of conscious dissociation of roles or ego states can be used to enhance the reintegration of the psychic dissociative patients. Dissociative patients have always been one of the great fears of EMDR therapists for use in phase 3 onwards. Generally these paintings require a great preparation time plus a more advanced and interventional management during reprocessing. However, among patients with high dissociative is common to find people with great fragility psychic, poor access to a historical resource, a great difficulty in expressing themselves, perceive and name their feelings besides great difficulty in reporting their trauma. So, how to advance the EMDR protocol with people so fragile and hardly give us hints of the contents of their trauma? Some hypothetical criteria help to equip both the professional and the patient to face the reprocessing. First, (a) in front of a history of severe trauma the person survived and came to you, it is because it has important features, even if you have difficulty accessing them. One of these features is the very dissociative disorder that protects the intensity of the trauma and allows life "although ...". (B) If these parties are so far apart, it's because they had a reason for that, but maybe that reason is already in the past, and today we can walk into a conversation. (C) Since all these roles and egos are part of me, surely they want something positive to me, although apparently it is difficult to realize this. These positive beliefs or assumptions about the patient be checked against data from reality so that they can be strengthened, but more than that, it is crucial that they "transpire from every pore of the body of the therapist." Identified ego states present at the traumatic event seems to be easier to follow with step of reprocessing deforms less interventionist, especially when you do not have the content of the event in question. Obviously, this entire process should take all the time necessary and followed by all care that the application of EMDR demand.
Format
Conference
Language
Portuguese
Original Work Citation
Gabarra, D. O. (2012, November). [Ego states and EMDR in dissociative frames]. Presentation at the 2nd EMDR Brazilian Congress, Brasilia, Brazil. Portuguese
Citation
“Estados de ego e o EMDR em quadros dissociativos Ego states and EMDR in dissociative frames,” Francine Shapiro Library, accessed May 5, 2024, https://francineshapirolibrary.omeka.net/items/show/21828.