Looking Through the Eyes Workshop

Bainbridge Institute for Integrative Psychology

Bainbridge Island, Washington

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"Looking Through the Eyes: EMDR & Ego State Therapy Across the Dissociative Continuum"

About the Workshop

This workshop describes how to work with dissociative clients in the phased approach recommended by the Treatment Guidelines of the International Society for the Study of Trauma and Dissociation, to which Dr. Paulsen contributed for the Third Revision. Sandra is a Fellow of that society. That phased approach emphasizes stabilization and containment before conducting EMDR, and then using a measured approach to pace the use of EMDR for maximal safety for dissociative clients.

Limitations of the Standard EMDR Protocol

Although EMDR is efficacious in the treatment of PTSD, for dissociative clients, the standard protocol of EMDR is not appropriate and can cause serious clinical setbacks. This is because EMDR can lance dissociative barriers prematurely and cause flooding, when the volume of material accessed exceeds the capacity of the client to process the material. Additionally, when EMDR clinicians are untrained to screen for and recognize dissociation, and are unaware that special procedures are necessary for the safe and effective use of EMDR with dissociative clients, the risk is compounded. The middle of an EMDR session is no time to discover an undiagnosed dissociative disorder, to discover that dissociative disorders really exist, or to try to establish rapport with alter personalities disoriented as to time, person, and place.

Content

Dr. Paulsen will review key assessment issues to which EMDR practitioners should be alert. Additionally, the workshop will elaborate on the key phase of stabilization, before ever conducting EMDR for a dissociative client. It will describe ways to increase affect tolerance, (employ somatic resourcing, and other somatic methods, for the second workshop), reconfigure ego states, use a two-step containment strategy for traumatic material and for ego states. A key focus is on working directly with perpetrator introjects or other “monstrous” disowned or shameful parts, to minimize resistance and internal conflict. Leading edge methods for resetting affective circuits and clearing very early attachment trauma will be touched upon.

The workshop will highlight how, once readiness for EMDR has been achieved, a clinician can use relevant ego state strategies and imagery to ensure that the client’s self system is engaged and informed about the process, has sufficient internal resources to process through traumatic material while maintaining dual-attention awareness. The workshop draws on hypnotic tradition for strategies for pacing and fractionating trauma work, and allowing consolidation of gains and synthesis between pieces of work. Dissociative table (conference room) methods are discussed in the context of use within and outside of EMDR. Ego state, (somatic, for the second workshop) and Imaginal Interweaves are suggested for “looping” or stuck EMDR processes. Pseudoseizures, headaches, and mutism are also discussed in terms of ego state work within EMDR. Finally, we’ll touch on EMDR-assisted skills building, integration and fusion methods in the later stages of the work.

LEARNING OBJECTIVES

Partipants will be able to:

1. Explain why and when to assess every client for degree of dissociation prior to doing EMDR and choose an appropriate protocol.

2. Utilize a phased approach to therapy, including EMDR when and where appropriate, for complex dissociative clients.

3. List six tactics for stabilizing clients, prior to doing EMDR for dissociative clients to increase rapport, increase soma tolerance, contain affect, orient to present circumstances, reduce inner conflict, and build coping resources.

4. Prepare for EMDR processing using ego state and other methods to clarify roles and plan the work.

5. Structure EMDR sessions using imagery, ego state interventions (and somatic methods, for the second workshop) for pacing, fractionating and trouble shooting the work.

6. For the somatic version of the workshop, list several somatic interventions to assist with various phases work with dissociative clients.

"Dr. Sandra Paulsen was the first clinician to identify the need to pre-test for dissociative disorders in candidates for EMDR therapy. Her continued investigations in this area are a contribution to all practicing clinicians."

Francine Shapiro, PhD Originator of EMDR

"Dr. Sandra Paulsen has made significant contributions to the development of a comprehensive EMDR treatment of dissociative clients. She writes and presents in a manner both accessible and scholarly. I highly recommend her workshops."

Carol Forgash, CSW, Author "Healing the Heart of

Trauma with EMDR and Ego State Therapy"

PRESENTER:

Dr. Sandra Paulsen has spoken, written and consulted on the power, benefits and risks of the combination of EMDR and ego state therapy since 1992. She is author of the 2009 book, “Looking Through the Eyes of Trauma and Dissociation: An Illustrated Guide for EMDR Therapists and Clients,” co-author of The Embodied Self: The Neurobiology and Treatment of Trauma and Dissociation,” by Lanius, Paulsen, and Corrigan (in press) and several book chapters. She is a fellow of the ISST&D, was invited Master Series Lecturer for the EMDRIA conference in Montreal in 2004 and is an EMDRIA Certified Consultant. She was a contributor to the 2010 Revision of the ISST&D Treatment Guidelines as well as to the EMDR Task Force on Dissociation the basic EMDR text. She is currently teaching three workshops around the world: Looking Through the Eyes (on ego state therapy and EMDR), the Embodied Self (EMDR and somatic therapy) and When There Are No Words (EMDR for early trauma and neglect). She lives in the woods on Bainbridge Island, Washington.