Dissociative Disorders and Complex Presentations
Tracks
South Hall 2 (A + B) | Room 2
| Saturday, May 31, 2025 |
| 15:45 - 17:15 |
Speaker
Ms. Emmanuelle Vaux-lacroix
Clinical Psychologist - EMDR Europe accredited Trainer
Private Practice - Ecole De Psychologues Praticiens - Université De Lorraine - Ifemdr
Why are we afraid of applying EMDR with Dissociative Identity Disorder?
15:45 - 16:15Abstract
Authors
Emmanuelle Vaux-Lacroix1
1Ecole de Psychologues Praticiens (Paris, France), Université de Lorraine (Metz, France), Private practice (Levallois-Perret, France), Adress : 98 rue Jean Jaurès, 92300 Levallois-Perret France
Dissociative Identity Disorder (DID) concerns at least 1% of the general population [1]. ISSTD is clear on the fact that there are no strict guidelines for these clients; but there are options. Despite EMDR trainers such as Dellucci [2], Gonzalez & Mosquera [3], Hoffmann [4], Knipe [5], Piedfort-Marin, Solomon and Zimmermann who have helped with the use of EMDR with extremely dissociated clients, many still hold a certain fear of working with DID. How can we use the basic protocol with these very complex clients? How do we adapt phases 1 & 2: accepting that we won’t have access to all of phase 1 and that we have to adapt phase 2 [6]? How can we help our clients identify their internal system and then help them use the parts of their personality as a resource?
How can we reprocess traumatic events, whilst taking parts into consideration without them interfering with the work? How can we reprocess with our clients whilst containing, as much as possible, brutal lifts of amnesia? We have developed what we call a sequential approach to reprocess trauma – that is with different groups of parts of the personality and using a titrated approach as to maintain the client within his or her window of tolerance. And finally, what are we afraid of? Difficulty in setting boundaries? Brutal lifts of amnesia? Suicidal attempts? Countertransference? Vicarious trauma?
Learning objectives
1.Adapting phases 1 & 2 for DID patients
2.Applying a sequential approach to phases 3 to 7
3.Feeling more confident to work with clients who suffer from DID
1] Dorahy, M. J., Brand, B. L., Şar, V., Krüger, C., Stavropoulos, P., Martínez-Taboas, A., & Middleton, W. (2014). Dissociative identity disorder: An empirical overview. Australian & New Zealand Journal of Psychiatry, 48(5), 402-417.
[2] Dellucci, H. (in press) La Boite de Vitesse, Molenbeek-Saint-Jean. Satas.
[3] Gonzalez, A & Mosquera, D. (2012) EMDR and dissociation. The progessive approach. Amazon Imprint.
[4] Hofmann, A. (2009). The inverted EMDR standard protocol for unstable complex post-traumatic stress disorder. EMDR scripted protocols. Special populations, 313-328. New York : Springer Publishing Co.
[5] Knipe (2015). EMDR toolbox: Theory and treatment of complex PTSD and dissociation. Springer Publishing Company.
[6] Vaux-Lacroix E. (2022) “Trouble dissociatif de l’identité et psychoéducation » in Binet, E. (ed) Evaluer et prendre en charge le trouble dissociatif de l’identité. Paris. Dunod.
Emmanuelle Vaux-Lacroix1
1Ecole de Psychologues Praticiens (Paris, France), Université de Lorraine (Metz, France), Private practice (Levallois-Perret, France), Adress : 98 rue Jean Jaurès, 92300 Levallois-Perret France
Dissociative Identity Disorder (DID) concerns at least 1% of the general population [1]. ISSTD is clear on the fact that there are no strict guidelines for these clients; but there are options. Despite EMDR trainers such as Dellucci [2], Gonzalez & Mosquera [3], Hoffmann [4], Knipe [5], Piedfort-Marin, Solomon and Zimmermann who have helped with the use of EMDR with extremely dissociated clients, many still hold a certain fear of working with DID. How can we use the basic protocol with these very complex clients? How do we adapt phases 1 & 2: accepting that we won’t have access to all of phase 1 and that we have to adapt phase 2 [6]? How can we help our clients identify their internal system and then help them use the parts of their personality as a resource?
How can we reprocess traumatic events, whilst taking parts into consideration without them interfering with the work? How can we reprocess with our clients whilst containing, as much as possible, brutal lifts of amnesia? We have developed what we call a sequential approach to reprocess trauma – that is with different groups of parts of the personality and using a titrated approach as to maintain the client within his or her window of tolerance. And finally, what are we afraid of? Difficulty in setting boundaries? Brutal lifts of amnesia? Suicidal attempts? Countertransference? Vicarious trauma?
Learning objectives
1.Adapting phases 1 & 2 for DID patients
2.Applying a sequential approach to phases 3 to 7
3.Feeling more confident to work with clients who suffer from DID
1] Dorahy, M. J., Brand, B. L., Şar, V., Krüger, C., Stavropoulos, P., Martínez-Taboas, A., & Middleton, W. (2014). Dissociative identity disorder: An empirical overview. Australian & New Zealand Journal of Psychiatry, 48(5), 402-417.
[2] Dellucci, H. (in press) La Boite de Vitesse, Molenbeek-Saint-Jean. Satas.
[3] Gonzalez, A & Mosquera, D. (2012) EMDR and dissociation. The progessive approach. Amazon Imprint.
[4] Hofmann, A. (2009). The inverted EMDR standard protocol for unstable complex post-traumatic stress disorder. EMDR scripted protocols. Special populations, 313-328. New York : Springer Publishing Co.
[5] Knipe (2015). EMDR toolbox: Theory and treatment of complex PTSD and dissociation. Springer Publishing Company.
[6] Vaux-Lacroix E. (2022) “Trouble dissociatif de l’identité et psychoéducation » in Binet, E. (ed) Evaluer et prendre en charge le trouble dissociatif de l’identité. Paris. Dunod.
Mr. Olivier Piedfort-Marin
EMDR Europe
EMDR in the therapy of complex dissociative disorders presenting pre-verbal dissociative parts: challenges and possibilities
16:15 - 17:15Abstract
Authors
Olivier Piedfort-Marin1
1Institut Romand de Psychotraumatology, Lausanne.Avenue de Montchoisi 21, 1004 Lausanne, Switzerland
Background and aims
Dissociative identity disorder (DID) and partial DID are severe trauma related pathologies characterized by the presence of “two or more distinct personality states (dissociative identities) associated with marked discontinuities in the sense of self and agency. Each personality state includes its own pattern of experiencing, perceiving, conceiving, and relating to self, the body, and the environment” (ICD-11). In some cases, these distinct personality states refer to pre-verbal traumatic experiences and the associated symptomatology is non-verbal, highly emotional, behavioral, and difficult to manage. The communication with non-verbal dissociative parts is a challenge since the use of language is limited. This presentation will focus on the use of EMDR in such complex (partial) DID patients, and aims at opening further possibilities of EMDR with complex dissociative disorders
Methods and results
Video excerpts of sessions will be used to present two cases with nonverbal dissociative parts. Case 1 is a male patient with partial DID whose therapy is completed with important symptoms reduction; the treatment plan and results will be described. Case 2 is the on-going treatment of a severe DID female patient: EMDR is used to decrease the symptomology (switch) related to a pre-verbal dissociative part with lack of object permanency.
Conclusions
The specificity and severity of (partial) DID imposes humility in our expectation towards EMDR for their treatment of these disorders. While EMDR can be limited and hazardous in some cases, it can be useful in other cases and increase the benefits of an integrative psychotherapy.
Learning objectives
-Conceptualize somatoform and non-verbal dissociative symptoms
-Develop communication with non-verbal dissociative parts
-Use EMDR to address non-verbal dissociative symptoms
Olivier Piedfort-Marin1
1Institut Romand de Psychotraumatology, Lausanne.Avenue de Montchoisi 21, 1004 Lausanne, Switzerland
Background and aims
Dissociative identity disorder (DID) and partial DID are severe trauma related pathologies characterized by the presence of “two or more distinct personality states (dissociative identities) associated with marked discontinuities in the sense of self and agency. Each personality state includes its own pattern of experiencing, perceiving, conceiving, and relating to self, the body, and the environment” (ICD-11). In some cases, these distinct personality states refer to pre-verbal traumatic experiences and the associated symptomatology is non-verbal, highly emotional, behavioral, and difficult to manage. The communication with non-verbal dissociative parts is a challenge since the use of language is limited. This presentation will focus on the use of EMDR in such complex (partial) DID patients, and aims at opening further possibilities of EMDR with complex dissociative disorders
Methods and results
Video excerpts of sessions will be used to present two cases with nonverbal dissociative parts. Case 1 is a male patient with partial DID whose therapy is completed with important symptoms reduction; the treatment plan and results will be described. Case 2 is the on-going treatment of a severe DID female patient: EMDR is used to decrease the symptomology (switch) related to a pre-verbal dissociative part with lack of object permanency.
Conclusions
The specificity and severity of (partial) DID imposes humility in our expectation towards EMDR for their treatment of these disorders. While EMDR can be limited and hazardous in some cases, it can be useful in other cases and increase the benefits of an integrative psychotherapy.
Learning objectives
-Conceptualize somatoform and non-verbal dissociative symptoms
-Develop communication with non-verbal dissociative parts
-Use EMDR to address non-verbal dissociative symptoms
