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Understanding Trauma-Related Dissociation of the Personality and Phase-Oriented Treatment, including EMDR Treatment, of Complex Posttraumatic Disorders

Length: 2 Day workshop (6 hrs. per day)

There is currently consensus that the EMDR standard protocol needs to be modified for repeatedly traumatized clients, such as clients with complex postraumatic and dissociative disorders, as it may destabilize them. Therefore, therapists need to understand the dissociative personality structures that exist in these clients, as well as their needs and capabilities during treatment, including EMDR procedures. Dissociation is not an epi-phenomenon of traumatic experience but rather its major feature. Based on an integrative failure, dissociation involves a division of the survivor’s personality, that is, of the dynamic biopsychosocial system as a whole that determines his or her characteristic mental and behavioral actions, into two or more insufficiently integrated subsystems. Some of these subsystems exert functions related to daily life, and others to dealing with overwhelming threat. The more severe the traumatization, the more dissociative parts - involving more complex trauma-related disorders - can be expected to exist. Dissociative parts have psychobiological boundaries that are maintained, to a large degree, by different trauma-related phobias, which need to be systematically resolved in phase-oriented treatment. Participants will become acquainted with the key concepts of structural dissociation of the personality and their implications for diagnosis and phase-oriented treatment, including EMDR therapy. This involves ways of relating dissociative symptoms to the underlying dissociation of the personality; recognizing dissociative interferences to therapeutic progress, identifying targets such as the dissociation-maintaining phobias and working with dissociative parts and their interrelationships. In all this the role of EMDR interventions during the respective treatment phases will be highlighted.

Learning Objectives

By the end of Day 1 participants will be able to:

  1. Understand trauma-related dissociation as, primarily, an integrative failure and, secondarily, as a coping strategy or defense
  2. Understand how different dissociative parts are mediated by daily life action systems (ANPs) and those mediated by defense action systems, stuck in trauma-time (EPs)
  3. Identify positive and negative, psychoform and somatoform dissociative symptoms
  4. Understand how various phobias maintain the dissociation of the personality and, within the context of phase-oriented treatment, constitute targets for therapeutic interventions
  5. Regard problems and symptoms of dissociative clients from a systems perspective
  6. Work with therapeutic approaches that call upon clients’ imaginative capacity.

 

Program

9.00 am – 10.30 am, Round 1:  Introduction; Understanding trauma-related dissociation of the personality as integrative failure; understanding integrative capacity/mental level 

10.30 am – 10.45 am: Coffee break

10.45 am  - 12.15 pm, Round 2:  Continued: Distinguishing dissociative parts of the personality mediated by daily life action (motivational) systems and those mediated by the defense action system and stuck in trauma-time; identifying their manifestations in positive and negative dissociative symptoms;  principles of  phase-oriented treatment, which is described as (1) stabilization, symptom-reduction, and skills training; (2) treatment of traumatic memories; and (3) personality (re)integration and rehabilitation (start)

12.15 pm - 1: 00 pm:  Lunch

1.00 pm - 2:30 pm, Round 3:  Principles of  phase-oriented treatment; in particular overcoming the various phobias that maintain dissociation of the personality, and thus prevent integration and interfere with adaptive functioning; with an emphasis on overcoming the phobia of dissociative parts (continued)

2:30 pm - 2:45 pm: Coffee break

2:45 pm - 4:15 pm, Round 4:  Continuation of (a systems approach to) working with dissociative parts, fostering acceptance and collaboration among dissociative parts; the use of approaches that call upon the client’s imaginative capacities

 

Day 2, April 22, 2017 - Denise J. Gelinas, PhD, with Onno van der Hart, PhD

EMDR Therapy of Complex Posttraumatic Disorders Informed by the Theory of Structural Dissociation of the Personality

Learning Objectives

By the completion of Day 2, participants will be able to:

  1. Identify the relationship between clients’ integrative capacities and their ability to productively use different EMDR processing procedures
  2. Provide at least two key elements to enhance preparation for EMDR processing phases
  3. Use different processing formats to avoid or repair over-accessing and overwhelm
  4. Recognize and intervene with dissociative interferences during EMDR phases
  5. Identify guidelines and use several techniques for working with dissociative parts of the personality
  6. Recognize and be able to use some interventions with the phobias of structural dissociation of the personality 

Program

9:00 – 10:30 am, Round 1: Complex posttraumatic disorders: Managing ‘ovewhelm’ during EMDR processing phases: Introduction; ‘overwhelm and mental level in EMDR processing; BLS, processing protocols and target choices adapted to the complex posttraumatic disorders to avoid and/or repair over-accessing

10:30 am– 10:45 am: Coffee Break

10:45 am – 12:15 pm, Round 2: Working with dissociative under-accessing across EMDR phases – “vanishing acts”: Problematic EMDR encounters with dissociative symptoms; fundamental therapeutic stance re dissociation; 3-Step method and specific interventions for working with negative dissociative interference during processing phases; beginning to work with phobias of SDP

12:15 pm – 1:00 pm: Lunch

1:00 pm – 2:30 pm, Round 3: Working with dissociative parts in EMDR to avoid “hijacking”: Activation of parts as   positive dissociative interference in EMDR; fundamental therapeutic stance re parts; General 3-Step Method for working with ANPs and EPs, including Conference Room, across EMDR phases: issues of autonomy, elaboration, ANP consciousness of parts; parts and Blocking Beliefs

2:30 pm – 2:45: Coffee Break

2:45 pm – 4:15 pm, Round 4: Working with the phobias of Structural Dissociation of the Personality in EMDR -stepped method; comprehensive, pervasive set of dissociative interferences; recognition of overt and subtle phobias of SD; phobias and Blocking Beliefs; use of integrative General Stepped Method, including BLS, for working with phobias of SDP 

Presenters:

Onno van der Hart, PhD, is a psychologist, adult psychotherapist in private practice, trained family therapist and researcher; he is  Emeritus Professor of Psychopathology of Chronic Traumatization at the  Department of Clinical and Health Psychology at Utrecht University, the Netherlands. He is a scholar in Pierre Janet Studies. [Both nationally and internationally, he is a clinical consultant on diagnosis and treatment of complex trauma-related disorders and he presents lectures and workshops on complex PTSD, dissociative disorders, phase-oriented treatment of chronic traumatization.] Apart from having co-authored The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization (Norton, 2006), with Suzette Boon and Kathy Steele, he wrote Coping with Trauma-related Dissociation: Skills Training for Patients and Therapists (Norton, 2011), and with Kathy Steele and Suzette Boon, Treating Trauma-related Dissociation: A Practical, Integrative Approach (Norton, 2017). 

Denise J. Gelinas, PhD, specializes in treating complex posttraumatic disorders, integrating   knowledge from the trauma field with EMDR therapy. She is the author of The Persisting Negative Effects of Incest, which first identified the link between incestuous abuse and PTSD. In 2003 she authored Integrating EMDR into Phase-Oriented Treatment for Trauma, and was a co-author of the ISST&D’s Guidelines for Treating Dissociative Identity Disorder in Adults (2005 and 2011 editions). She serves on the Editorial Boards of the Journal of EMDR and the Journal of Trauma & Dissociation. She has presented at over 200 conferences and held numerous teaching and clinical appointments. 

Dr. Gelinas was an EMDR Institute Specialty Presenter on Dissociation, is an EMDRIA Approved Consultant, an Institute and HAP/TR Facilitator and HAP/TR Trainer. Dr. Gelinas conducts her private practice in Northampton, MA, treating clients and consulting, individually or in co-lead groups, to clinicians engaged in similar work.

Note: The content and application of this training material is for EMDR trained clinicians only. Viewing is for registered participants only. No recordings or other distribution of the materials without the presenter and sponsor’s permission is allowed.



Course Materials

  • Please Download & Print! - Day 1 Quiz
  • Please Download & Print! - Day 2 Quiz