How is EMDR therapy used to treat dissociative disorders?

Dissociative disorders are among the most complex and counterintuitive psychopathologies.

Indeed, they are able to generate psychological alterations not only of a quantitative type, as is the case, for example, with generalized anxiety, but they also act by introducing qualitative imbalances in the functioning of the mind. In fact, there are cases where they come to 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 currently forms of psychological intervention to treat this type of disorder. Here we will focus on one of them and see how EMDR therapy is used to treat dissociative disorders.

    What are dissociative disorders?

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

    Faced with this, dissociation appears as a barrier dam which slows down the direct influence of the trauma on our consciousness in terms of its capacity to make us suffer, but at the cost of altering the functioning of the latter.

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

    1. Compartmentalisation

    Dissociation receives this name because in it they appear a series of containment barriers that “dissociate” psychological processes and mental elements such as the content of autobiographical memory, Made up of memories of what has happened to us throughout our lives. This prevents mental contents that generate a lot of anxiety, and in particular those related to psychological trauma, from being associated with other mental processes and “infecting” them with this emotional load.

    Thus, dissociative disorders are triggered, in general, by trauma, and constitute a dysfunctional way of dealing with this painful emotional mark that remains in our memory.

    These retaining walls that keep separate contents present in the human mind are expressed in other ways through amnesic barriers in dissociative disorders, that is, memory gaps that go hand in hand with situations in which there is an altered state of consciousness .: The two phenomena complement each other. 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. In dissociative alterations in which horizontal divisions of the state of consciousness predominate, a quantitative change in it occurs, narrowing or reducing – (as in the case of depersonalization), whereas where one or more vertical divisions do not occur are qualitative changes in the state of consciousness, with several states of consciousness passing in parallel, each under its own operating logic: this is the case of dissociative identity disorder. In both cases, it is reflected that there is certain mental content that is “quarantined”, suppressed (quantitatively) to prevent us from being fully aware of it, or from being separated from the rest of the elements that come to us. in consciousness.

    Thus, some authors who have studied specifically dissociative disorders emphasize that in traumatic processes, there is a whole range of more or less complex psychopathological alterations: in the simplest one would find a state of post-traumatic stress, and in the most complex would be dissociative. complex post-traumatic stress disorder and stress.

    2. Avoidance

    As we have seen, dissociation follows the logic of avoiding which produces immediate discomfort, And that in the case of normal post-traumatic stress (in which there is no dissociation) results in moments of flashbacks and a sharp rise in the level of anxiety when the memory of the traumatic occurs. ‘mind.

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

    What is EMDR therapy and how is it used in 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 primarily in the preservation and evocation of memories. It was developed in the late 1980s by researcher Francine Shapiro as a way to treat patients with psychological trauma, although over the years it has proven effective against other psychopathologies.

    EMDR seeks to ensure that, through the memory evocation system, we can intervene in the management of these traumatic memories, to allow them to be approached as content that is not necessarily problematic and likely to be managed. by our capacity for acceptance. and resilience. In this sense, it resembles the systematic desensitization often used to overcome phobias.

    Are you interested in undergoing psychotherapy?

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

    Bibliographical references:

    • American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
    • Dell, PF (2006). Multidimensional Dissociation Inventory (MID): a comprehensive measure of pathological dissociation. J Trauma Dissociation, 7 (2): pages 77-106.
    • Logie, R. (2014). EMDR: More than just therapy for PTSD? The psychologist. 27 (7): pages 512-517.
    • Maldonando RJ and Spiegel, D. (2009). Dissociative disorders. In The American Psychiatric Publishing: Board Review Guide for Psychiatry (22).
    • Shapiro, F. (1989). Effectiveness of the eye movement desensitization procedure in treating traumatic memories. Traumatic Stress Journal. 2 (2): p. 199 – 223.

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