How is EMDR therapy used to treat dissociative disorders?

Dissociative disorders are part of the most complex and counterintuitive psychopathologies.

This is so because they are capable of generating psychological alterations not only quantitative, as occurs for example with the generalized anxiety, but also act by introducing qualitative imbalances 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 currently forms of psychological intervention that allow treating these kinds of disorders. Here we will focus on one of them and see how EMDR therapy is used to treat dissociative disorders.

• Related article: "Dissociative Disorders: Types, Symptoms, and Causes"

What are dissociative disorders?

Dissociative disorders present an interesting diversity in the way they express themselves, but they all have in common that appear through psychological trauma

. Trauma is made up of memories and lives associated with experiences that can make us suffer emotionally and that threaten to upset our emotional balance even years after the event that triggered.

Faced with this, dissociation appears as a containment dam that stops the direct influence of trauma on our consciousness in terms of its ability to make us suffer, but at the price of altering the functioning of this last.

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

1. Compartmentalization

Dissociation receives that name because in it appear a series of containment barriers that "dissociate" psychological processes and mental elements such as the contents of autobiographical memory, composed of memories of what has happened to us throughout our lives. This allows to avoid that the mental contents that generate us a lot of anxiety, and specifically the linked to psychological trauma, are associated with the rest of mental processes and "infect" them with that burden emotional.

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

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

For example, Van der Hart's theory of structural dissociation points out that dissociation has two axes in terms of states of consciousness: one vertical and the other horizontal. In dissociative alterations in which horizontal splits predominate in the state of consciousness, there is a quantitative change in it, narrowing or decreasing (as in the case of depersonalization), while where there is one or more vertical splits, qualitative changes appear in the state of consciousness, with several states of consciousness that run in parallel, each one under its own operating logics: this is the case of Identity Disorder Dissociative. In both cases, it is stated that there are certain mental contents that remain "in quarantine", 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 us consciousness.

Thus, some authors who have specifically studied 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 we would find the Post Traumatic Stress Disorder, and the most complex would include dissociative disorders and complex post-traumatic stress.

2. Avoidance

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

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

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 mainly involved in the preservation and recall 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 been shown to be effective against other psychopathologies.

Through EMDR, the aim is to make that, through the memory evocation system, we can intervene in the management of these traumatic memories, allow them to be addressed as content that is not necessarily problematic and susceptible to be managed through our ability to accept and resilience. In this sense, it resembles the systematic desensitization used many times to overcome phobias.

Are you interested in attending psychotherapy?

If you want professional help to overcome psychological problems related or not to trauma, please contact us. On Psychotools 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.
• Damn R.J. & Spiegel, D. (2009). Dissociative Disorders. In 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.