Dissociative Disorder and Complex Presentations II.
Tracks
Congress Hall Auditorium
| Sunday, June 1, 2025 |
| 14:00 - 15:30 |
| AUDITORIUM - Congress Hall |
Speaker
Ms. Anabel Gonzalez
Md. Phd.
Instituto Médico Imaya
Are there good and bad "processors"? The role of the level of traumatizacion, emotional regulation, dissociation and other factors in processing styles
14:00 - 15:00Abstract
Authors
Gonzalez-Vazquez Ana Isabel1,
Ramallo-Machín Alejandra2,
Gómez-Salas,Francisco J.3,
Burgos-Julián, Francisco A.4,
Santed-Germán M.A.5
1Departamento de Psiquiatría, Complexo Hospitalario Universitario de A. Coruña, Xubias de Arriba 1, 15.006, A.Coruña, Spain
2Facultad de Ciencias, Universidade da Coruña (UDC), Campus da Zapateira, 15071 A.Coruña,Spain
3Facultad de Psicología y Logopedia, Universidad de Málaga (UMA), Campus de Teatinos,29010, Spain
4Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid,Spain
5Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid,Spain
Background and Aims
When clinicians describe their cases frequently comment that some patients seem to process more fluent and effectively while others become blocked, do not show changes, present problems to maintain dual attention or to achieve generalization. Our research team have recently published the initial validation of a Processing Styles Scale to operationalize this concept and allow the study of factors influencing the quality of processing. There is also an intense debate in the EMDR field about when some factors as complex trauma, dissociation or emotion dysregulation make necessary a specific and extended preparation phase before accessing traumatic memories and which kind of interventions would be necessary. One of the goals of our line of research is to give light to this debate from a different perspective, that is the analysis of the process within the session and the factors that influence it. From a process analysis perspective in EMDR therapy, clinical observations during the processing of traumatic memories have revealed individual differences among patients
related to the number of spontaneous positive associations, the fluidity of emotional processing, the occurrence of blockages, difficulties with dual attention or the emergence of dissociative symptoms. This preliminary study aims to analyze the possible influence of emotional regulation, dissociation, post-traumatic stress symptoms and other factors on the
quality of memory processing during EMDR therapy using the Processing Difficulties Scale.
Methods
A correlational study will be conducted to analyze the potential relationship between aforementioned factors and trauma processing styles in EMDR therapy.
Results
From the correlational analysis conducted in this preliminary study, it was found that emotion dysregulation, as measured with the DERS, does not appear to be associated with unproductive processing of traumatic memories, which aligns with the perspectives of some authors, such Ad De Jongh. However, certain emotional regulation strategies or processes, such as control, suppression, and difficulties in identifying or describing feelings, do seem to be associated with unproductive processing. Additionally, the number of early traumatic events is linked to greater loss of dual attention
during memory processing and, consequently, with unproductive processing during the session. Finally, regarding dissociation, lower levels of dissociation appear to increase the likelihood of productive memory processing, whereas higher levels of dissociation are associated with greater dual attention loss and, consequently, a higher probability of unproductive processing during the session.
Conclusions
The results of this preliminary study indicate that certain important factors, such as emotional regulation, dissociation, or the level of early traumatization, appear to influence the processing of traumatic memories. This holds significant clinical and research relevance. Investigating which factors may impact memory processing in EMDR therapy is essential for gaining a deeper understanding of the processes that may lead to unproductive processing. Enhancing this understanding could enable the development of specific interventions during Phase 2 of EMDR therapy, as well as during the processing of traumatic memories. This would improve clinical interventions by increasing the effectiveness of the therapy through process analysis from transdiagnostic perspective.
Abstract Topic
This study presents a preliminary analysis of the potential relationship between certain factors and trauma processing styles in EMDR therapy. The Processing Difficulties Scale (PDS) will be used for this purpose.
Learning Objectives
1) To understand the concept of “processing styles” and become familiarized with the Processing Styles Scale to evaluate it
2) To study the role of emotional regulation, dissociation or the level of early traumatization, among other factors, in trauma processing styles during EMDR therapy, with the aim of better understanding the processes that may contribute to unproductive processing.
3) To hypothesize about the development of specific interventions to enhance the overall effectiveness of EMDR therapy based on empirical data.
References
Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R. & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Systematic Reviews, 12, CD003388. DOI:10.1002/ 14651858.CD003388.pub4.
Gratz, K. L. & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41−54. https://DOI.org/10.1023/B:JOBA.0000007455.08539.94 Hogg, B., Gardoki-Souto, I., Valiente-Gómez, A. et al. Psychological trauma as a
transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. Eur Arch Psychiatry Clin Neurosci 273, 397–410 (2023). https://doi.org/10.1007/s00406-022-01495-5.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.https://DOI.org/10.1080/10705519909540118
McLaughlin, K.A., Colich, N.L., Rodman, A.M. et al. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med 18, 96 (2020). https://doi.org/10.1186/s12916-020-01561-6
Nolen-Hoeksema, S., & Watkins, E. R. (2011). A Heuristic for Developing Transdiagnostic Models of Psychopathology: Explaining Multifinality and Divergent Trajectories. Perspectives on Psychological Science, 6(6), 589-
609. https://doi.org/10.1177/1745691611419672
Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18(1), 51- 60. DOI:10.1016/0005-7967(80)90069-8.
Rachman, S. (2001). Emotional processing, with special reference to post-traumatic stress disorder. International Review of Psychiatry, 13, 164-171.
DOI.org/10.1080/09540260120074028.
Ramallo-Machín A, Gómez-Salas FJ, Burgos-Julián F, Santed-Germán MA and GonzalezVazquez AI (2024) Factors influencing quality of processing in EMDR therapy. Front. Psychol. 15:1432886. doi: 10.3389/fpsyg.2024.1432886
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://DOI.org/https://DOI.org/10.18637/jss.v048.i02
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) therapy, third edition: Basic principles, protocols, and procedures. New York: Gilford Press.
Gonzalez-Vazquez Ana Isabel1,
Ramallo-Machín Alejandra2,
Gómez-Salas,Francisco J.3,
Burgos-Julián, Francisco A.4,
Santed-Germán M.A.5
1Departamento de Psiquiatría, Complexo Hospitalario Universitario de A. Coruña, Xubias de Arriba 1, 15.006, A.Coruña, Spain
2Facultad de Ciencias, Universidade da Coruña (UDC), Campus da Zapateira, 15071 A.Coruña,Spain
3Facultad de Psicología y Logopedia, Universidad de Málaga (UMA), Campus de Teatinos,29010, Spain
4Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid,Spain
5Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid,Spain
Background and Aims
When clinicians describe their cases frequently comment that some patients seem to process more fluent and effectively while others become blocked, do not show changes, present problems to maintain dual attention or to achieve generalization. Our research team have recently published the initial validation of a Processing Styles Scale to operationalize this concept and allow the study of factors influencing the quality of processing. There is also an intense debate in the EMDR field about when some factors as complex trauma, dissociation or emotion dysregulation make necessary a specific and extended preparation phase before accessing traumatic memories and which kind of interventions would be necessary. One of the goals of our line of research is to give light to this debate from a different perspective, that is the analysis of the process within the session and the factors that influence it. From a process analysis perspective in EMDR therapy, clinical observations during the processing of traumatic memories have revealed individual differences among patients
related to the number of spontaneous positive associations, the fluidity of emotional processing, the occurrence of blockages, difficulties with dual attention or the emergence of dissociative symptoms. This preliminary study aims to analyze the possible influence of emotional regulation, dissociation, post-traumatic stress symptoms and other factors on the
quality of memory processing during EMDR therapy using the Processing Difficulties Scale.
Methods
A correlational study will be conducted to analyze the potential relationship between aforementioned factors and trauma processing styles in EMDR therapy.
Results
From the correlational analysis conducted in this preliminary study, it was found that emotion dysregulation, as measured with the DERS, does not appear to be associated with unproductive processing of traumatic memories, which aligns with the perspectives of some authors, such Ad De Jongh. However, certain emotional regulation strategies or processes, such as control, suppression, and difficulties in identifying or describing feelings, do seem to be associated with unproductive processing. Additionally, the number of early traumatic events is linked to greater loss of dual attention
during memory processing and, consequently, with unproductive processing during the session. Finally, regarding dissociation, lower levels of dissociation appear to increase the likelihood of productive memory processing, whereas higher levels of dissociation are associated with greater dual attention loss and, consequently, a higher probability of unproductive processing during the session.
Conclusions
The results of this preliminary study indicate that certain important factors, such as emotional regulation, dissociation, or the level of early traumatization, appear to influence the processing of traumatic memories. This holds significant clinical and research relevance. Investigating which factors may impact memory processing in EMDR therapy is essential for gaining a deeper understanding of the processes that may lead to unproductive processing. Enhancing this understanding could enable the development of specific interventions during Phase 2 of EMDR therapy, as well as during the processing of traumatic memories. This would improve clinical interventions by increasing the effectiveness of the therapy through process analysis from transdiagnostic perspective.
Abstract Topic
This study presents a preliminary analysis of the potential relationship between certain factors and trauma processing styles in EMDR therapy. The Processing Difficulties Scale (PDS) will be used for this purpose.
Learning Objectives
1) To understand the concept of “processing styles” and become familiarized with the Processing Styles Scale to evaluate it
2) To study the role of emotional regulation, dissociation or the level of early traumatization, among other factors, in trauma processing styles during EMDR therapy, with the aim of better understanding the processes that may contribute to unproductive processing.
3) To hypothesize about the development of specific interventions to enhance the overall effectiveness of EMDR therapy based on empirical data.
References
Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R. & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Systematic Reviews, 12, CD003388. DOI:10.1002/ 14651858.CD003388.pub4.
Gratz, K. L. & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41−54. https://DOI.org/10.1023/B:JOBA.0000007455.08539.94 Hogg, B., Gardoki-Souto, I., Valiente-Gómez, A. et al. Psychological trauma as a
transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. Eur Arch Psychiatry Clin Neurosci 273, 397–410 (2023). https://doi.org/10.1007/s00406-022-01495-5.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.https://DOI.org/10.1080/10705519909540118
McLaughlin, K.A., Colich, N.L., Rodman, A.M. et al. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med 18, 96 (2020). https://doi.org/10.1186/s12916-020-01561-6
Nolen-Hoeksema, S., & Watkins, E. R. (2011). A Heuristic for Developing Transdiagnostic Models of Psychopathology: Explaining Multifinality and Divergent Trajectories. Perspectives on Psychological Science, 6(6), 589-
609. https://doi.org/10.1177/1745691611419672
Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18(1), 51- 60. DOI:10.1016/0005-7967(80)90069-8.
Rachman, S. (2001). Emotional processing, with special reference to post-traumatic stress disorder. International Review of Psychiatry, 13, 164-171.
DOI.org/10.1080/09540260120074028.
Ramallo-Machín A, Gómez-Salas FJ, Burgos-Julián F, Santed-Germán MA and GonzalezVazquez AI (2024) Factors influencing quality of processing in EMDR therapy. Front. Psychol. 15:1432886. doi: 10.3389/fpsyg.2024.1432886
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://DOI.org/https://DOI.org/10.18637/jss.v048.i02
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) therapy, third edition: Basic principles, protocols, and procedures. New York: Gilford Press.
Mrs. Elena Isola
Psychologist
EMDR Ostia Center
EMDR Therapy in the Treatment of Sexual Dysfunctions: Protocol in Couples Work and Discussion of a Clinical Case
15:00 - 15:30Abstract
Authors
Elena Isola1,
Chiara Abbatelli2
1EMDR Ostia Center, Viale della Vittoria, 5, 00122, Rome, Italy
2B. Mencher LLC Private Practice, 1350 Connecticut Ave NW, Washington, DC 20036, United States
Background and Aims
Treating sexual dysfunctions requires an interdisciplinary approach due to rapid social and cultural changes. EMDR therapy addresses cognitive, emotional, and physical aspects, considering sexual behavior as a “psychosomatic unity.” The aim is to restore “sexual health” as
overall well-being, necessitating comprehensive clinical investigations into biological, hormonal, and psychological components.
Methods
Through the discussion of a clinical case, we aim to define essential guidelines to treat sexual dysfunctions with EMDR, within the framework of attachment theory. An EMDR protocol for couples, both rigorous and flexible, allows customization to the specific needs of individuals and
couples. The integration of EMDR with a systemic perspective combines trauma reprocessing with an analysis of relational contexts in which trauma originated.
Results
The results demonstrate EMDR's innovative and effective role in treating sexual dysfunctions linked to personal histories. EMDR reactivates self-healing mechanisms, offering a novel approach beyond symptom-focused treatments. The holistic integration of biopsychosocial factors into treatment protocols addresses the complex needs of patients and couples.
Conclusions
Patients and couples often experience cycles of intimacy avoidance, problem discussion, and solution-seeking. Restoring confidence in their roles is vital. EMDR therapy helps reprocess early traumatic experiences and negative cognitions, breaking this cycle and enhancing relational
dynamics.
Learning objectives
1. Understand the interdisciplinary approach to treating sexual dysfunctions with EMDR.
2. Apply EMDR protocols in couples therapy within the attachment theory framework.
3. Integrate EMDR with systemic perspectives to address trauma in sexual dysfunction treatment.
Elena Isola1,
Chiara Abbatelli2
1EMDR Ostia Center, Viale della Vittoria, 5, 00122, Rome, Italy
2B. Mencher LLC Private Practice, 1350 Connecticut Ave NW, Washington, DC 20036, United States
Background and Aims
Treating sexual dysfunctions requires an interdisciplinary approach due to rapid social and cultural changes. EMDR therapy addresses cognitive, emotional, and physical aspects, considering sexual behavior as a “psychosomatic unity.” The aim is to restore “sexual health” as
overall well-being, necessitating comprehensive clinical investigations into biological, hormonal, and psychological components.
Methods
Through the discussion of a clinical case, we aim to define essential guidelines to treat sexual dysfunctions with EMDR, within the framework of attachment theory. An EMDR protocol for couples, both rigorous and flexible, allows customization to the specific needs of individuals and
couples. The integration of EMDR with a systemic perspective combines trauma reprocessing with an analysis of relational contexts in which trauma originated.
Results
The results demonstrate EMDR's innovative and effective role in treating sexual dysfunctions linked to personal histories. EMDR reactivates self-healing mechanisms, offering a novel approach beyond symptom-focused treatments. The holistic integration of biopsychosocial factors into treatment protocols addresses the complex needs of patients and couples.
Conclusions
Patients and couples often experience cycles of intimacy avoidance, problem discussion, and solution-seeking. Restoring confidence in their roles is vital. EMDR therapy helps reprocess early traumatic experiences and negative cognitions, breaking this cycle and enhancing relational
dynamics.
Learning objectives
1. Understand the interdisciplinary approach to treating sexual dysfunctions with EMDR.
2. Apply EMDR protocols in couples therapy within the attachment theory framework.
3. Integrate EMDR with systemic perspectives to address trauma in sexual dysfunction treatment.
