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1. Fisher, J. A. (2000, November). Adapting EMDR techniques in the treatment of dysregulated or dissociative patients. Presentation at the International Society for the Study of Dissociation Annual Meeting, San Antonio, Texas.

Language: English

Format: Conference

Abstract:
Since its inception, EMDR [Eye Movement Desensitization and Reprocessing] has been understood by both clinicians and patients as a powerful vehicle for processing traumatic experience but one to be undertaken only when the patient has achieved some degree of stabilization (Shapiro, 1992). In DID and DDNOS patients, that baseline stability is also supposed to include a level of internal communication and consensus that would permit cooperation between parts of self about how to tolerate the memory processing and how to re-stabilize afterward. However, as any clinician who works with this population knows, some dissociative disorder patients never achieve that degree of internal coherence, and some have a long, rocky, tumultuous, exhausting road to travel before they get there. Faced with the DID or DDNOS patient who cannot tolerate affect or associations to traumatic memories; who cannot control switching, get grounded, or resolve internal struggles over power and control; who is unable to manage selfdestructive impulses; who cannot differentiate past and present experience; who is even unable to tolerate Resource Development (Korn & Leeds, 2002) or create a Safe Place inside—is there any way that EMDR can be helpful?

Keywords: Dissociation  Dysregulation  

Accuracy Verified: Yes


2. Holm, O. (2008, November). Attachment and mental representations: Research, theory, and treatment - Sequential use of adult attachment inventory and EMDR to resolve negative cognitions in DDNOS: Six Spanish cases reports. Presentation at the 25th Annual meeting of the International Society for the Study of Trauma and Dissociation, Chicago, IL .

Language: English

Format: Conference

Keywords: Attachment  Adult Attachment Inventory  DDNOS  Negative Cognitions  Research  Spanish  

Accuracy Verified: Yes


3. Goldman, J., & Coane, J. (2010, October). A case of strategic collaboration: Two therapists and one DDNOS patient in end phase treatment. Presenttion at the 27th Annual Meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA.

Language: English

Format: Conference

Abstract:
A colleague, experienced in DID treatment, was invited to collaborate by the primary therapist in the end phase of treatment to facilitate patient movement through the introduction of EMDR. The nature of the collaborative relationship, its influence on transference and countertransference, the contribution of the different genders of the two therapists, as well as issues of launching the patient more fully into adult life as influenced by the collaboration will be explored. The rationale for introducing EMDR as well as its specific contribution will be explicated. The argument for therapeutic collaboration, as related to the patients history and treatment process, will also be addressed.
Participants will be able to : ♦♦ List the indications for initiating adjunctive treatment. ♦♦ assess the effects of collaboration. ♦♦ appraise the treatment trajectory to decide when to bring in another modality.

Keywords: DDNOS  

Accuracy Verified: Yes


4. Forgash, C. A. (2005, June). Deepening EMDR treatment effects across the trauma spectrum: Integrating EMDR and ego state work. Föreningen EMDR Sverige, EMDR Tidningen, 7(2), 6-14.

Language: English

Format: Newsletter

Abstract:
The concepts, interventions, and techniques presented in this workshop are culled from theory and techniques of working with the range of the dissociative disorders). They have proved to be an effective addition to the preparation stage of the EMDR protocol. In other words, they can be used with clients who dissociate under certain conditions but do not have a dissociative disorder Most of the traumatized clients seen for EMDR treatment have a range of dissociative symptoms as well as symptoms of PTSD. This combination of PTSD and a dissociative disorder is often labeled DDNOS. However, people with a more complex variety of PTSD usually have experienced very early and enduring severe physical or sexual abuse (generally perpetrated by a family member), atrocities, war, or severe environmental disruption such as earthquakes. They are more accurately diagnosed with disorders of extreme stress (DESNOS). For these clients, the dissociated neural networks, or dissociative fragmentation, cause serious problems in adult life. The adaptive information processing system is on hold for these dissociated fragments or parts. They are easily triggered by internal or external cues to which they can have extreme reactions, (flashbacks, amnesia, losing time and place, and so forth.) Our goal as therapists is to use EMDR to help clients (and their internal dissociated neural networks or parts) find stability and resources to function adaptively in their present life, and then desensitize and reprocess the dissociated trauma memories and the PTSD symptoms. We aim to help our clients manage their symptoms. It is not our goal to eliminate dissociation, which has been a major survival strategy, but to help the client utilize it with conscious control. It is important to note that attachment issues are an aspect of development that are especially impacted by trauma. The attachment styles of the family pre trauma may have already affected the client in negative ways, impacting the client's resources and responses to trauma. One way to look at this set of problems is to utilize two approaches in the preparation phase of EMDR. These approaches combine the treatment of dissociative symptoms with ego state work and are an essential aspect of treating these clients with EMDR. This work may extend the preparation phase considerably, but will add safety and structure to the trauma processing experiences for these clients.

Keywords: Ego State Therapy  

Accuracy Verified: Yes


5. Paulsen, S. L. (1994, March). Ego state disorders: Dissociative but not multiple. Presentation at the EMDR Network Conference, Sunnyvale, CA.

Language: English

Format: Conference

Abstract:
Conceptual Framework. In Ego State Disorders, moderate levels of dissociation are present for the purpose of isolating overwhelming affect or untenable conflict from conscious awareness. There are parts of the self'which are experienced by the host, -upon discovery, and who experience themselves, as separate. These parts,however, do no have the ability to take complete executive control of the body, or are not as complex and elaborated as in Multiple Personality Disorder, which is called Dissociative Identity Disorder in DSM-N. The closest diagnosis for describing Ego State Disorders in DSA4lV is DDNOS, or Dissociative Disorder Not Otherwise Specified, a miscellaneous category.

Keywords: Dissociation  Ego State Therapy  

Accuracy Verified: Yes


6. Hamilton, C. (1996, November). EMDR applications in the treatment of DID/DDNOS. Symposia presented at the annual meeting of the International Society for the Study of Dissociation, San Francisco, CA.

Language: English

Format: Conference

Keywords: DDNOS  DID  Dissociative Identity Disorder  Symposia  

Accuracy Verified: Yes


7. Twombly, J. H. (2005). EMDR for clients with dissociative identity disorder, DDNOS, and ego states. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 88-120). New York: W W Norton & Co.

Language: English

Format: Book Section

Abstract: U
sing EMDR with clients with dissociative identity disorder (DID) and other dissociative disorders (DDs) requires careful adaptation to allow the unique benefits of EMDR to be used productively, without risking unleashing a flood of traumatic material and destabilizing the client. In this chapter I will discuss adaptations for each stage of treatment for dissociative clients. While I'll focus on work with DID (formerly multiple personality disorder) and dissociative disorder not otherwise specified (DDNOS), the EMDR adaptations and protocols taught in this chapter can be used with people with other DDs and complex PTSD, and in ego-state work. This chapter is divided into three sections, summarizing the treatment of DDs within the three stages of standard phase-oriented trauma treatment. [Text, pp. 88, 90]

Keywords: Adults  Child Abuse  DID  Dissociative Identity Disorder  Hypnotherapy  Psychotherapeutic Processes  Survivors  

Accuracy Verified: Yes


8. Rouanzoin, C. (2006, September). EMDR Master Series – II. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
Dissociation is a normal human process. We all dissociate. Some individuals are so severely and chronically traumatized that, in order to survive, they split their awareness into at least two levels or streams of consciousness - one level being the participant in the abuse drama and the other level being an observer watching as if the abuse was happening to someone close. This defense mechanism, which allows severely abused individuals to survive, can become an obstacle to the reprocessing of their traumatic memories. This presentation will discuss dissociative process from the Accelerated Informational Processing Model of EMDR. It will cover: the implications and complications of clinical treatment with dissociative process; the nature of dissociative process; screening for dissociation and the 'Red Flags' of treatment concerns; the differential diagnoses of dissociation - from dissociation found in diagnostic categories other than Dissociative Disorders (e.g., Mood Disorders, Anxiety Disorders, PTSD) to DDNOS (ego states work) and DID; the use of EMDR in the treatment of dissociation in relation to trauma; therapist attributes that help contribute to the successful treatment of dissociative patients. Participants will be encouraged to share their own insights and difficulties in working with this very traumatized population of individuals.

Keywords: Accelerated Information Processing Model  AIP  DID  Dissociation  

Accuracy Verified: Yes


9. Shapiro, R. (2005). EMDR solutions: Pathways to healing. New York: W W Norton & Co.

Language: English

Format: Book

Abstract:
This book is a manual for doing EMDR with diverse client populations. [Text, P. 3]TOPICS TREATED: The strategic developmental model for EMDR; Integrating resource development strategies into your EMDR practice; EMDR for clients with dissociative identity disorder, DDNOS, and ego states; EMDR processing with dissociative clients: adjunctive use of opioid antagonists; The phantom limb pain protocol; The two-hand interweave; DeTUR, an urge reduction protocol for addictions and dysfunctional behaviors; Targeting positive affect to clear the pain of unrequited love, codependence, avoidance, and procrastination; The reenactment protocol for trauma and trauma-related pain; EMDR with cultural and generational introjects; Exiting the binge-diet cycle; Utilizing EMDR and DBT techniques in trauma and abuse recovery groups; Using EMDR in couples therapy; EMDR with clients with mental disability; Treating anxiety disorders with EMDR; Affect regulation for children through art, play, and storytelling. [Pilots]

Keywords: Anxiety Disorders  Psychotherapeutic Processes  Stressors  Survivors  

Accuracy Verified: Yes


10. Hamilton, C. (1998, November). EMDR use in a patient with DDNOS and psychosis. Symposium at the annual conference of the International Society for the Study of Dissociation in Seattle, Washington.

Language: English

Format: Conference

Keywords: DDNOS  Psychosis  Symposium  

Accuracy Verified: Yes


11. Paulsen, S. (2010, October). EMDR with dissociative clients: 17 secrets. Presentation at the 27th Annual meeting of the International Society for the Study of Trauma and Dissociation, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Unmodified EMDR can harm dissociative clients if it prematurely breaches dissociative barriers overwhelming the client’s capacity and resources. Practitioners must screen for dissociation and use special procedures to safely use EMDR with these clients. The workshop will cover critical guidelines and techniques to pace and troubleshoot EMDR with dissociative clients within the phased treatment model, for clients ranging from DDNOS to DID. Assessment and stabilization are key to preparing clients for trauma work. The workshop offers methods to increase affect tolerance, establish a two-step containment habit, and orient personalities to person place and time. Other topics include: increasing tolerance of body sensation and affect, and enhancing compassion for self and others, directly working with introjects or other “monstrous” shame-laden parts, essential to reducing internal conflict and resistance to therapy. The workshop instructs in specific ego state strategies and imagery to provide sufficient resources, maintain an observing ego. Rooted in the hypnotic tradition, stabilization methods to pace and fractionate the work within EMDR while interspersing trauma work with sessions that consolidate gains. The workshop also describes the conference room method and means to trouble-shoot stuck processing. Finally, the workshop describes the final phases of therapy, skills building, integration and fusion.
Participants will be able to : ♦♦ explain why and when to assess every client for degree of dissociation and choose an appropriate protocol. ♦♦ list six tactics for stabilizing clients, prior to doing EMDR for dissociative clients, to increase rapport, contain affect, orient to present circumstances, reduce inner conflict, and build coping resources. ♦♦ structure EMDR sessions using imagery and ego state interventions for pacing, fractionating and trouble-shooting the work.

Keywords: Dissociation  

Accuracy Verified: Yes


12. International Society for Study of Trauma and Dissociation. (2011, March). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12, 115–187. doi:10.1080/15299732.2011.537247.

Language: English

Format: Journal

Abstract:
The International Society for the Study of Dissociation (ISSD), the former name of the International Society for the Study of Trauma and Dissociation (ISSTD), adopted the Guidelines for Treating Dissociative Identity Disorder (Multiple Personality Disorder) in Adults in 1994. However, the Guidelines must be responsive to developments in the field and require ongoing review. The first revision of the Guidelines was proposed by the ISSD’s Standards of Practice Committee1 and was adopted by the ISSD Executive Council in 1997 after substantial comment from the ISSD membership. The second revision of the Guidelines was requested and approved in 2005 based on the expertise of a task force of expert clinicians and researchers.2 The current revision was undertaken by a new task force3 in 2009 and 2010 after input from an open-ended survey of the membership. The current revision of the Guidelines focuses specifically on the treatment of dissociative identity disorder (DID) and those forms of dissociative disorder not otherwise specified (DDNOS) that are similar to DID. It is intended as a practical guide to the management of adult patients and represents a synthesis of current scientific knowledge and informed clinical practice. There is a separate Guidelines for the Evaluation and Treatment of Dissociative Symptoms in Children and Adolescents (ISSD, 2004) available through the ISSTD and published in the Journal of Trauma & Dissociation. The American Psychiatric Association (2004) has published Practice Guidelines for the Treatment of Patients with Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD), which may be relevant to the treatment of DID.

Keywords: Adults  DID  Dissociation  Dissociative Identity Disorder  Practice Guidelines  Trauma  Treatment  

Accuracy Verified: Yes


13. Twombly, J. H. (2000). Incorporating EMDR and EMDR adaptations into the treatment of clients with dissociative identity disorder. Journal of Trauma and Dissociation, 1(2), 61-81. doi:10.1300/J229v01n02_05.

Language: English

Format: Journal

Abstract:
This paper offers ways to incorporate Eye Movement Desensitization and Reprocessing (EMDR) in the treatment of clients with Dissociative Identity Disorder (DID). Uses of EMDR detailed can be applied to Dissociative Disorder, Not Otherwise Specified (DDNOS) and ego state work. EMDR is a therapeutic method using alternating bilateral stimulation (ABS) that integrates traumatic memories with adaptive reasoning and the patient's own resources, resulting in accelerated information processing and healing. DID is a complex disorder suffered by clients who have often experienced multiple childhood traumas. They live with what Kluft terms a "multiple reality disorder," and describes as living in "...several parallel but incompletely over-lapping constructions of the world and of life experience." An asset with EMDR is that it can accelerate the treatment process. A liability is that its incorrect use can accelerate decompensation for fragile clients, e.g., those with complex trauma histories or DID. This paper offers suggested uses of EMDR and EMDR adaptations to facilitate learning, intervene in multiple reality disorder, decrease some negative transferences, and to provide a protective format for processing traumatic material. [Author Abstract]

Keywords: Dissociative Identity Disorder  Psychotherapeutic Processes  Stressors  Survivors  

Accuracy Verified: Yes


14. Twombly, J. (2004, September). Incorporating EMDR and EMDR adaptations into the treatment of dissociative disorders. Presentation at the annual mmeting of the EMDR International Association, Montreal, Quebec Canada.

Language: English

Format: Conference

Abstract:
This workshop offers ways to incorporate Eye Movement Desensitization and Reprocessing in the treatment of clients with Dissociative Identity Disorder (DID). Dissociative Disorder Not Otherwise Specified (DDNOS) and ego state work. DID and DDNOS are complex disorders suffered by clients who have often experienced multiple childhood traumas. Used carefully. EMDR and EMDR adaptations can accelerate the treatment process. A liability is that its introject use can accelerate decompensation. This workshop offers suggested uses of EMDR and EMDR adaptations to facilitate Stabilization, orientation to the present, decrease some negative transferences and to provide a protective format far processing traumatic material.

Keywords: Dissociative Disorders  

Accuracy Verified: Yes


15. Rouanzoin, C. (2007, September). The integration of EMDR in the treatment of dissociative clients. Presentation at the annual meeting of the EMDR International Association, Dallas, TX.

Language: English

Format: Conference

Abstract:
This workshop will focus on the use of EMDR in the treatment of patients who span the dissociative spectrum. The participants will learn how to understand dissociative process from simple to complex dissociation and how to utilize EMDR in their treatment. This presentation will discuss dissociative process from the Adaptive Information Processing Model of EMDR. It will cover: the implications and complications of clinical treatment with dissociative process; the nature of dissociative process; screening for dissociation and the ‘Red Flags’ of treatment concerns; the differential diagnoses of dissociation – from dissociation found in diagnostic categories other than Dissociative Disorders (e.g., Mood Disorders, Anxiety Disorders, PTSD) to DDNOS (ego states work) and DID; the use of EMDR in the treatment of dissociation in relation to trauma; and therapist attributes that help contribute to the successful treatment of dissociative patients. Participants will be encouraged to share their own insights and difficulties in working with this highly traumatized population of individuals.

Keywords: Dissociation  Dissociative Disorders  

Accuracy Verified: Yes


16. Fine, C.& Berkowitz, A. (2008, April). The joint use of EMDR and hypnosis in the treatment of DID, DDNOS and complex PTSD. Presentation at the 1st bi-annual European Society for Trauma and Dissociation Conference, Amsterdam, The Netherlands.

Language: English

Format: Conference

Abstract:
Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder (PTSD), is currently recognized as a treatable condition. It is considered the paradigmatic dissociative disorder and carries with it extreme posttraumatic symptomatology which lends itself to be an apt target for treatment combining the use of EMDR and hypnosis. Therapists skilled in the treatment of DID and Dissociative Disorder Not otherwise specified (DDNos) have augmented their therapeutic arsenal with the fluent uses of hypnosis for stabilization, affect management, building a safe place and grounding. EMDR, which has come to the forefront of clinical awareness in the last fifteen years, seems well suited for the treatment of trauma, but can be destabilizing. The presenters recommend a protocol, called Wreathing Protocol, for the imbricated use of EMDR and hypnosis in the treatment of not only DID, but also DDNOS and complex chronic PTSD. The Wreathing Protocol is useful to advanced clinicians skilled in both modalities independently. This workshop will explain and illustrate with a clinical vignette the sequential steps of the Wreathing Protocol; it will describe the required contextual treatment frame for its safe use. The presenters will explore the consequences of the premature uses of EMDR and offer planful structured responses to a disequilibrated treatment and a destabilized patient. The clinical implications of the use of the Wreathing Protocol will be discussed. Learning objectives: 1. Name three prohibitions to the use of EMDR in the treatment of dissociative disorders. 2. Exemplify one target symptom of the BASK model of dissociation in the clinical example presented and relate a different one in one of your own patients. 3. Describe a potential multistep Wreathing Protocol sequence from selection of target to resolution of at least one microsymptom in a patient of your choice.

Keywords: Complex PTSD  DDNOS  DID  Dissociative Identity Disorder  Dissociative Disorder Not Otherwise Specified  Hypnosis  

Accuracy Verified: Yes


17. Cohen, A. (2009). Treatment of dissociation with EMDR when war interrupts the process: The integration of EMDR with e-mail therapy. Journal of EMDR Practice and Research, 3(1), 50-56. doi:10.1891/1933-3196.3.1.50.

Language: English

Format: Journal

Abstract:
This article describes the integration of e-mail correspondence with EMDR treatment for a woman with a fear of driving and a diagnosis of dissociative disorder, not otherwise specified (DDNOS). When the client first presented for treatment, her diagnosis was unrecognized, and treatment showed limited success. With recognition of the DDNOS diagnosis, the treatment contract was renegotiated, with the focus of therapy shifting to addressing her dissociative experiences. Therapeutic progress was being made when the course of the treatment was interrupted by war in the north of Israel, and regular meetings became impossible. Communication was maintained by e-mail correspondence. When face-to-face sessions recommenced, the e-mail therapy continued because writing had become a powerful therapeutic tool. Therapy concluded with the successful treatment of both the dissociative disorder and the fear of driving. Cautions regarding the use of e-mail therapy are provided.

Keywords: Dissociative Disorder  Dissociation  E-Mail  Not Otherwise Specified  War  Writing  

Accuracy Verified: Yes


18. Ross, C., & Rouanzoin, C. (2012, October). Uses of EMDR in complex dissociative disorders. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA.

Language: English

Format: Conference

Abstract:
EMDR can be used in the treatment of complex dissociative disorders. Both presenters have been treating dissociative disorders for decades and one is an approved EMDR trainer. This workshop will not include instruction on specific techniques: these can be learned from approved EMDR trainings which require six full days of workshop teaching, assigned readings, and 10 hours of supervision. Instead, the presenters will explain how EMDR is based on a trauma-dissociation model and is therefore highly suited to the treatment of complex dissociative disorders including DID. A brief description of EMDR will be provided, including its 8 phases, of which only one involves eye movements or other forms of bilateral stimulation. EMDR is consistent with three-stage models of trauma therapy: the eye movements are used in stage two, the active working phase of therapy. In EMDR this is called Phase 4. The work in trauma stage one (EMDR phases 1-3), in patients with DID or DDNOS, involves grounding, stabilization, system mapping, building co-consciousness, orientation of parts to the body and the present, and other elements from the dissociative disorders literature. The bilateral stimulation phase of EMDR should not be used until this phase one work is complete, or at least well underway. The presenters will then go on to provide case examples of how EMDR can be used in the psychotherapy of DID, DDNOS and the complex comorbidity that usually accompanies both.
Learning Objectives: Participants will be able to describe how EMDR can be used in complex dissociative disorders. Participants will be able to describe how EMDR is based on a trauma-dissociation model of mental disorders and addictions. Participants will be able to describe the basic feaures of EMDR.

Keywords: Dissociative Disorders  

Accuracy Verified: Yes


19. Knipe, J. (2008, Maart). Using EMDR with dissociative clients: The CIPOS method. Keynote gepresenteerd op het derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.

Language: English

Format: Conference

Abstract:
During this keynote the so called CIPOS procedure will be fully explained which is helpful with clients who are vulnerable to dissociative aabreaction (e.g. DID, DDNOS). This involves first a method for measuring degree of dissociation during a session (the so-called Back-of-the-Head Scale) and then a method for maintaining present orientation during traums processing (the moeht of Constant Installation of Present Orientation and Safety)

Keywords: CIPOS  Dissociation  Keynote  

Accuracy Verified: Yes


20. Fine, C. (2009). The wreathing protocol: The imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder, dissocaitive disorder not otherwise specified, and post-traumatic stress disorder. In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations (pp. 329-347). New York: Springer Publishing Co.

Language: English

Format: Book Section

Keywords: DID  DDNOS  Dissociative Identity Disorder  Dissociative Disorder Not Otherwise Specified  Post-Traumatic Stress Disorder  PTSD  Protocol  

Accuracy Verified: Yes


21. Fine, C. J., & Berkowitz, S. A. (1999, November). Wreathing Protocol: The imbrication of EMDR and hypnosis in the treatment of childhood onset PTSD. Poster presented at the annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.

Language: English

Format: Conference

Abstract:
This paper will describe a “Wreathing” protocol which involves the imbrication of EMDR and hypnosis in the structured treatment of individuals who struggle with complex childhood onset PTSD and/or DDNOS and/or DID. In recent years, Shapiro has succesfully promoted the uses of EMDR in patients who suffer from PTSD with the caveat that dissociative disordered individuals ought not undergo such therapeutic methodology. The current authors have devised a protocol which will be respectful of the structured phase based therapies typically associated with Dissociative Disorders and complex childhood onset PTSD. The “wreathing” protocol will be described as it is systematically joined into a therapy informed by hypnosis and where the patients use EMDR to do the abreactive work. This “wreathing” protocol uses as a foundation for elaboration the BASK model of dissociation where each BASK dimension becomes the starting point from which an abreactive event is initiated and eventually integrated into the main stream of consciousness. Clinical examples will illustrate each therapeutic approach and demonstrate that not only will the EMDR used in this manner not destabilize or decompensate the patient, but more importantly it will better facilitate for the patient the integration of dissociated material.

Keywords: Children  Hypnosis  Poster  Posttraumtic Stress Disorder  PTSD  Wreathing Protocol  

Accuracy Verified: Yes


22. Fine, C., & Berkowitz, A. (2001, January-April). The wreathing protocol: The imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder and other dissociative responses. American Journal of Clinical Hypnosis, 43(3-4), 275-290.

Language: English

Format: Journal

Abstract:
Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder, is currently recognized as a treatable condition. It is considered the paradigmatic dissociative condition and carries with it extreme posttraumatic symptomatology. Therapists skilled in the treatment of DID are typically fluent in the uses of hypnosis for stabilization, affect management, building a safe place, and grounding to name of few [sic]. EMDR, which has come to the forefront of clinical awareness in the last ten years, seems aptly suited for the treatment of trauma, but can be destabilizing. This paper proposes a protocol, called Wreathing Protocol, for the imbricated use of EMDR and hypnosis in the treatment of not only DID (though this will be the primary focus of the paper), but also Dissociative Disorder Not Otherwise Specified (DDNOS) and chronic PTSD. This protocol is useful to advanced clinicians skilled in both modalities independently. The sequential steps of the Wreathing Protocol will be described and illustrated by a clinical vignette on DID. The clinical implications of the use of the Wreathing Protocol will be discussed in DID as well as the chronic post traumatic spectrum. [Author Abstract]

Keywords: Dissociative Identity Disorder  Hypnotherapy  PTSD  Psychotherapeutic Processes  Review  

Accuracy Verified: Yes