How is EMDR therapy used to treat dissociative disorders?

This is how EMDR therapy is used to manage dissociative problems.

Dissociative disorders are among the most complex and counter-intuitive psychopathologies.

This is because they are capable of generating psychological alterations not only of a quantitative type, as occurs for example with generalized anxiety, but they also act by introducing imbalances of a qualitative type in the functioning of the mind. In fact, there are cases in which they radically fragment the functioning of memory and consciousness: the most striking case is that of Dissociative Identity Disorder, popularly known as multiple personality.

Fortunately, there are now forms of psychological intervention that can be used to treat this type of disorder. Here we will focus on one of them and we will see how EMDR therapy is used in treating dissociative disorders.

What are dissociative disorders?

Dissociative disorders present an interesting diversity in the way they express themselves, but all of them have in common that they they appear through psychological trauma. Trauma is composed of memories and memories associated with experiences that can make us suffer emotionally and that threaten to alter our emotional balance even years after the event that triggered it.

In the face of this, dissociation appears as a dike of containment that stops the direct influence of trauma on our consciousness in terms of its capacity to make us suffer, but at the price of altering the functioning of the latter.

Two of the aspects that help to better understand dissociative disorders are their relationship with avoidant traits, on the one hand, and the compartmentalization of memories and psychological processes, on the other.

Compartmentalization

Dissociation is so called because it involves a series of containment barriers that a series of containment barriers that "dissociate" psychological processes and mental elements such as, for example, the contents of autobiographical memory, composed of memories of what we have experienced.composed of memories of what has been happening to us throughout our lives. This allows to avoid that the mental contents that generate us a lot of anxiety, and specifically those linked to the psychological trauma, are associated to the rest of mental processes and "infect" them with that emotional load.

Thus, dissociative disorders are generally triggered by traumatization, and constitute a dysfunctional way of dealing with that painful emotional mark that has remained in our memory.

These retaining walls that keep apart contents present in the human mind are expressed among other ways by amnesic barriers in dissociative disorders, i.e., memory gaps that go hand in hand with situations in which there is an altered state of consciousness: both phenomena complement each other.

For example, Van der Hart's theory of structural dissociation points out that dissociation has two axes in terms of states of consciousness: a vertical and a horizontal one. In dissociative disorders in which horizontal splits in the state of consciousness predominate, there is a quantitative change in the state of consciousness, narrowing or reducing it (as in the case of depersonalization), while where there are one or more vertical splits, qualitative changes appear in the state of consciousness, with several states of consciousness running in parallel, each under its own logics of functioning: this is the case of Dissociative Identity Disorder. In both cases it is shown that there are certain mental contents that are "quarantined", being repressed (quantitatively) to prevent us from being fully aware of them, or being separated from the root of the rest of the elements that come to our consciousness.

Thus, some authors who have devoted themselves to the specific study of dissociative disorders point out that in the processes of traumatization there is a whole range of more or less complex psychopathological alterations: in the simplest ones we would find Post Traumatic Stress Disorder, and in the more complex ones we would find dissociative disorders and complex posttraumatic stress.

2. Avoidance

As we have seen, dissociation obeys the logic of avoidance of that which produces immediate discomfort.In the case of normal post-traumatic stress (in which there is no dissociation), this is expressed in moments of flashbacks and a high rise in the level of anxiety when the memory of the traumatic event comes to mind.

Thus, dissociative disorders can be understood as a series of avoidance patterns that we have internalized, to the point that this is not so much expressed through our interaction with the environment as through our interaction with our own thoughts and memories.

What is EMDR therapy and how is it used for dissociative disorders?

EMDR therapy is a form of psychotherapeutic intervention that seeks to produce a persistent change in the connectivity between specific areas of the brain involved in dissociative disorders. specific areas of the brain involved primarily in the preservation and recall of memories.. It was developed in the late 1980s by researcher Francine Shapiro as a way of treating patients with psychological trauma, although over the years it has proven effective for other psychopathologies.

Through EMDR, the aim is to make it possible to intervene in the management of these traumatic memories through the memory evocation system, so that they can be approached as a content that is not necessarily problematic and can be managed through our capacity for acceptance and resilience. In this sense, it is similar to the systematic desensitization often used to overcome phobias.

Are you interested in psychotherapy?

If you would like professional help to overcome psychological problems related or not to trauma, please contact us. At Psicotools we have been offering psychotherapeutic support to people of all ages for years. You can find us both in our psychology center located in Barcelona (Vallcarca) and in our online therapy sessions by video call. On this page are our contact details.

Bibliographic references:

• American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Dell, P.F. (2006). The multidimensional inventory of dissociation (MID): A comprehensive measure of pathological dissociation. J Trauma dissociation, 7 (2): pp. 77 - 106.
• Logie, R. (2014). EMDR - more than just a therapy for PTSD?. The Psychologist. 27(7): pp. 512 - 517.
• Maldonando R.J. & Spiegel, D. (2009). Dissociative Disorders. En The American Psychiatric Publishing: Board Review Guide for Psychiatry (22).
• Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress. 2(2): pp. 199 - 223.