Dissociation of the Personality and EMDR Therapy in Complex Trauma-Related Disorders: Applications in Phases 2 and 3 Treatment

Hart, Onno van der; Groenendijk, Mariëtte; González, Anabel; Mosquera, Dolores; Solomon, Roger

doi:10.1891/1933-3196.8.1.33

Cited by 22 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Abgrenzung von einer rein eklektischen Kombination "stabilisierender" und konfrontativer Interventionen versteht sich das Behandlungskonzept als "Destabilisierung im Kontext von Stabilität" [27] Auf der Ebene konkreter Interventionen spielen Überlegungen, wie das traumakonfrontative Vorgehen an die Bedürfnisse von Pa-tientInnen mit komplexer PTBS angepasst werden kann, eine zentrale Rolle. So kommen sowohl Techniken der "skills-assisted exposure" [16] als auch Modifikationen der EMDR-Methode [21] zum Einsatz. Besonderes Augenmerk gilt dabei auch Phobien und Vermeidungsstrategien, die im Vorfeld der Konfrontation des Indextraumas durch spezifische Techniken reduziert werden können.…”

Section: Methodeunclassified

“…Gleichzeitig empfiehlt die Mehrzahl der ExpertInnen heute, das traumafokussierte Vorgehen bei PatientInnen mit komplexer PTBS, komorbider Borderline-Störung oder komplexen dissoziativen Störungen wie der Dissoziativen Identitätsstörung (DIS) oder der nicht näher bezeichneten dissoziativen Störung (DDNOS) [20] mit einem Training der Emotionsregulation zu kombinieren und in der Durchführung anzupassen [13,16,17,21]. Cloitre et al [22] konnten zeigen, dass durch ein derartig angepasstes Vorgehen signifikant bessere Behandlungsergebnisse zu erzielen sind.…”

Section: Zur Rolle Von "Stabilisierung"unclassified

See 1 more Smart Citation

Stationäre Therapie der komplexen PTBS in Folge körperlicher oder sexualisierter Gewalt in der Kindheit: Wirksamkeit und Prädiktoren des Behandlungsverlaufs

Kratzer

Heinz

Schennach

et al. 2018

Psychother Psych Med

View full text Add to dashboard Cite

show abstract

Section: Methodeunclassified

Section: Zur Rolle Von "Stabilisierung"unclassified

Stationäre Therapie der komplexen PTBS in Folge körperlicher oder sexualisierter Gewalt in der Kindheit: Wirksamkeit und Prädiktoren des Behandlungsverlaufs

Kratzer

Heinz

Schennach

et al. 2018

Psychother Psych Med

View full text Add to dashboard Cite

show abstract

“…The ISSTD Task Force for Children and Adolescents has developed guidelines for the assessment and treatment of dissociative symptoms in traumatized children and adolescents. To foster the coherence of self and promote healthy adaptation according to the child or adolescent's ability to enter a relationship and feel safe again in the present (Van der Hart, Groenendijk, Gonzalez, Mosquera, & Solomon, 2014), the guidelines recommend proceeding slowly by titrating therapeutic interventions while maintaining safety, building trust, and using a phased approach (ISSTD, 2004). The three treatment phases of Pierre Janet (as cited in Van der Hart et al, 2005) are History, Assessment, Stabilization, Symptom Reduction, and Skills Building (Phase I); Treatment of Traumatic Memories (Phase II); and Personality Reintegration and Rehabilitation (Phase III).…”

Section: Treatment Of Trauma and Dissociation In Posttraumatic Stress Disordermentioning

confidence: 99%

“…The more complex the trauma is, the less likely that these phases will be applied in order. Backtracking to Phase I is necessary in order that safety and trust are promoted in the clienttherapist relationship (Van der Hart et al, 2014).…”

Section: Treatment Of Trauma and Dissociation In Posttraumatic Stress Disordermentioning

confidence: 99%

Kronos Abuses His Son: A Case Study of Severe Interpersonal Trauma, Dissociation, and Survival in Adolescence

Papanikolopoulos

Konstas²,

Prattos-Spongalides

et al. 2017

J EMDR Prac Res

View full text Add to dashboard Cite

This case study presents case conceptualization, therapeutic intervention, and the subjective and objective therapeutic progress of a 14-year-old adolescent hospitalized with posttraumatic stress disorder (PTSD) following emotional, physical, and sexual abuse by his father. The adaptive information processing (AIP) model that informs eye movement desensitization and reprocessing (EMDR) therapy and the theory of structural dissociation of the personality (TSDP) were used to conceptualize and guide the treatment. Stabilization and orientation to the present were essential to integrate his traumatic memories into a life narrative, and this became a major goal and an outcome of treatment. A single-case AB design was applied in assessing the impact of intervention. The UCLA PTSD Symptom Scale, Strengths and Difficulties Questionnaire—HEL (SDQ-HEL), State-Trait Anxiety Inventory (STAI), and Dissociative Experiences Scale II were administered at 5 different time points to assess changes in the youth’s subjective emotional state and indicated substantial improvement. In addition, objective behavior change (using O’Neill’s Behavior Checklist) was recorded on a daily basis for 7 months and showed a large decrease in the frequency of targeted maladaptive behaviors. The article describes the treatment process which helped the youth to regain a sense of time; establish a coherent sense of self; and maintain adaptive perceptions, emotions, attitudes, and behaviors.

show abstract

“…Different authors have proposed adapting the standard EMDR procedure for the treatment of those severely traumatized patients who are included in the complex trauma and dissociation categories ( Forgash and Copeley, 2008 ; Paulsen, 2009 ; Gonzalez and Mosquera, 2012 ). A recent review of these adaptations based on the theory of structural dissociation of the personality has been proposed by Van der Hart et al (2010 , 2014a , b ). Nevertheless, this area of study lacks systematic research on the use of these EMDR protocols.…”

Section: Introductionmentioning

confidence: 99%

The Progressive Approach to EMDR Group Therapy for Complex Trauma and Dissociation: A Case-Control Study

González-Vázquez

Rodriguez-Lago²,

Seoane-Pillado³

et al. 2018

Front. Psychol.

View full text Add to dashboard Cite

Eye Movement Desensitization and Reprocessing is a psychotherapeutic approach with recognized efficiency in treating post-traumatic stress disorder (PTSD), which is being used and studied in other psychiatric diagnoses partially based on adverse and traumatic life experiences. Nevertheless, there is not enough empirical evidence at the moment to support its usefulness in a diagnosis other than PTSD. It is commonly accepted that the use of EMDR in severely traumatized patients requires an extended stabilization phase. Some authors have proposed integrating both the theory of structural dissociation of the personality and the adaptive information processing model guiding EMDR therapy. One of these proposals is the Progressive Approach. Some of these EMDR procedures will be evaluated in a group therapy format, integrating them along with emotional regulation, dissociation, and trauma-oriented psychoeducational interventions. Patients presenting a history of severe traumatization, mostly early severe and interpersonal trauma, combined with additional significant traumatizing events in adulthood were included. In order to discriminate the specific effect of EMDR procedures, two types of groups were compared: TAU (treatment as usual: psychoeducational intervention only) vs. TAU+EMDR (the same psychoeducational intervention plus EMDR specific procedures). In pre-post comparison, more variables presented positive changes in the group including EMDR procedures. In the TAU+EMDR group, 4 of the 5 measured variables presented significant and positive changes: general health (GHQ), general satisfaction (Schwartz), subjective well-being, and therapy session usefulness assessment. On the contrary, only 2 of the 5 variables in the TAU group showed statistically significant changes: general health (GHQ), and general satisfaction (Schwartz). Regarding post-test inter-group comparison, improvement in subjective well-being was related to belonging to the group that included EMDR procedures, with differences between TAU and TAU+EMDR groups being statistically significant [χ2(1) = 14.226; p < 0.0001]. In the TAU+EMDR group there was not one patient who got worse or did not improve; 100% experienced some improvement. In the TAU group, 70.6% referred some improvement, and 29.4% said to have gotten worse or not improved.

show abstract

Dissociation of the Personality and EMDR Therapy in Complex Trauma-Related Disorders: Applications in Phases 2 and 3 Treatment

Cited by 22 publications

References 23 publications

Stationäre Therapie der komplexen PTBS in Folge körperlicher oder sexualisierter Gewalt in der Kindheit: Wirksamkeit und Prädiktoren des Behandlungsverlaufs

Stationäre Therapie der komplexen PTBS in Folge körperlicher oder sexualisierter Gewalt in der Kindheit: Wirksamkeit und Prädiktoren des Behandlungsverlaufs

Kronos Abuses His Son: A Case Study of Severe Interpersonal Trauma, Dissociation, and Survival in Adolescence

The Progressive Approach to EMDR Group Therapy for Complex Trauma and Dissociation: A Case-Control Study

Contact Info

Product

Resources

About