Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy » (New Edition)

Carol Forgash, LCSW, BCD, is a psychotherapist in private practice in Smithtown, New York, specializing in EMDR and ego state therapy. She is an EMDR Institute facilitator and an EMDRIA Approved Consultant.
She presents at psychotherapy conferences and at workshops in the United States and internationally on the integration of EMDR with ego state therapy and psychodynamic treatment, the treatment of complex posttraumatic stress and dissociative disorders, and the treatment of the complex health issues of sexual abuse survivors. She is the board president of EMDR Humanitarian Assistance Programs.

Margaret Copeley, MEd, is a freelance editor specializing in the mental health fields.

EMDRIA has approved this book for a Distance Learning Book Course for 8 EMDRIA credits.

"This book pioneers the integration of EMDR with ego state techniques. and opens new and exciting vistas for the practitioners of each." --From the foreword by John G. Watkins, PhD, founder of ego state therapy

"The editors have gathered many experts in the field who explain in clear informative ways how to expand the clinician's abilities to work with this terribly injured population. This book blends concepts from neurobiology, hypnosis, family systems theory and cognitive therapy to enhance treating this population. It is a well written book that the novice as well as the seasoned clinician can benefit from."

--Mark Dworkin, author of EMDR and the Relational Imperative

"[This book] conveys complex concepts that will be of interest to seasoned therapists... with a clarity that will appeal to the novice as well. This is really a wonderful text with many excellent ideas and I highly recommend it to anyone who treats trauma."

--Sarah Chana Radcliffe, M.Ed.,C.Psych.Assoc.

Author, Raise Your Kids without Raising Your Voice

"I believe that this book is a significant contribution to the fields of psychology and EMDR. It is the first of its kind... anyone who reads this will gain greater confidence in using EMDR and ego state therapy witih highly dissociative and complicated clients."

--Sara G. Gilman, in Journal of EMDR Practice and Research, Volume 3, 2009

"This is a book about polypsychism and trauma. It offers a number of creative syntheses of EMDR with several models of polypsychism. It also surveys and includes many other models of contemporary trauma theory and treatment techniques. The reader will appreciate its enrichment with case examples and very generous bibliographic material. If you are a therapist who works with patients who have been traumatized, you will want this book in your library." --Claire Frederick, MD, Distinguished Consulting Faculty, Saybrook Graduate School and Research Center

"Training in EMDR seems to have spread rapidly among therapists in recent years. In the process, awareness is growing that basic EMDR training may not be adequate to prepare clinicians to effectively treat the many cases of complex trauma and dissociation that are likely to be encountered in general practice. By integrating it with ego state therapy, this book may just serve as a crucial turning point in the development of EMDR by providing a model for productively applying it to the treatment of this important and sizeable clinical population." --Steven N. Gold, PhD, President Elect, APA Division of Trauma

The powerful benefits of EMDR in treating PTSD have been solidly validated. In this groundbreaking new work nine master clinicians show how complex PTSD involving dissociation and other challenging diagnoses can be treated safely and effectively. They stress the careful preparation of clients for EMDR and the inclusion of ego state therapy to target the dissociated ego states that arise in response to severe and prolonged trauma.

Contributors     xi
Foreword   John G. Watkins     xiii
Preface   Carol Forgash   Margaret Copeley     xvii
Acknowledgments     xxi
Integrating EMDR and Ego State Treatment for Clients with Trauma Disorders   Carol Forgash   Jim Knipe     1
Introduction: New Help for Clients with Trauma Disorders     1
A Preliminary Note to Therapists     3
The Nature and Sequelae of Trauma     4
Attachment Disorders and Their Relation to Affect Regulation and Dissociation     6
Dissociation     8
Treatment Goals for Trauma-Disordered Clients     13
Ego State Theory and Therapy     14
Introduction to EMDR     17
The Eight Treatment Phases of EMDR     18
Potential Problems with Using EMDR with Dissociative Clients     21
Unique Challenges of Working with Clients with Complex Trauma     22
Phased Treatment with Combined EMDR and Ego State Therapy     35
Stabilization and Symptom Reduction     36
Trauma Work     48
Resolution     51
The Person of the Therapist Working with Challenging Clients     53
Conclusion     55
She's ComeUndone: A Neurobiological Exploration of Dissociative Disorders   Uri Bergmann     61
The Relationship between Trauma and Dissociation     62
The Evolution of Biological Action Systems     63
Types of Dissociation     65
The Neurobiology of Primary Dissociation     66
The Neurobiology of Secondary Dissociation     75
The Neurobiology of Tertiary Dissociation     82
Dissociation and Medical Illnesses of Unknown Origin     84
Conclusion     84
Combining Hypnosis with EMDR and Ego State Therapy for Ego Strengthening   Maggie Phillips     91
Joyce: Resolving Anxiety through Hypnosis and ECEM     94
Benefits of Adding Hypnosis to EMDR and Ego State Therapy     96
The Importance of Ego Strengthening     98
Introducing Hypnosis to EMDR Clients     101
Sequential Uses of Hypnosis in the Standard EMDR Protocol: An Extended Case Study     102
Conclusion     116
Changing Cognitive Schemas through EMDR and Ego State Therapy   Michael C. Paterson     121
Maintenance of Irrational Beliefs and Behaviors     124
Terrorism and Trauma in Northern Ireland: Police as Victims     126
Margaret: A Case Study of Trauma in Northern Ireland      127
Conclusion     138
Treating Dissociative Identity Disorder with EMDR, Ego State Therapy, and Adjunct Approaches   Sandra Paulsen     141
Talking to Parts     141
The Crux of the Problem and New Treatment Approaches     142
Working with the Dynamics of Dissociative Identity Disorder     144
Technical Challenges of the Treatment     148
ARCHITECTS: A Process for Abreactions     166
Case Studies     169
Conclusion     176
Loving Eyes: Procedures to Therapeutically Reverse Dissociative Processes While Preserving Emotional Safety   Jim Knipe     181
One Foot in the Present, One Foot in the Past     181
EMDR and Dissociation     183
Loving Eyes: Seeing the Traumatized Child     184
Mehmet: Dissociated Affect Due to Childhood Deprivation     188
Veronica: Targeting an Avoidance Defense     193
Enhancing Present Orientation     199
Chris: Dissociative Identity Disorder Resulting from Childhood Sexual Abuse     203
Conclusion     221
Hidden Selves: Treating Dissociation in the Spectrum of Personality Disorders   Uri Bergmann     227
Historical and Contemporary Conceptualizations of Ego States      229
The Definition and Spectrum of Personality Disorders     235
The Treatment of Personality Disorders with EMDR     236
Dissociation: A Developmental Line of Personality     237
Treatment Goals     239
Integrating Ego State Treatment into the Eight-Phase Protocol     240
Case Presentations     247
Conclusion     259
EMDR in Couples Therapy: An Ego State Approach   Barry K. Litt     267
Natalie and Roger: One Couple, Many Selves     267
Introduction: Ego State Theory, EMDR, and Contextual Therapy     269
Contextual Theory: The Relational Self     269
The Interior Life of the Couple     272
Ego State Conflict in Theory and Practice     276
An Integrative Treatment Approach     279
Conclusion     291
The Integration of the Internal Family Systems Model and EMDR   Joanne H. Twombly   Richard C. Schwartz     295
The Untarnished Healing Self     295
The Inner Ecology: Dynamics of the Self and Parts in IFS     296
The Three Primary Categories of Parts     298
IFS Steps to Healing     300
Optimizing the Therapist's Access to the Self     301
Jack: Richard Schwartz Uses IFS to Resolve Rage     302
Using IFS with EMDR     304
Lucy: Joanne Twombly Uses IFS and EMDR to Resolve Memories of Abuse and Neglect     308
Conclusion     310
Applying EMDR and Ego State Therapy in Collaborative Treatment   Carol Forgash     313
Introduction: Reviving Stalled Treatments through Collaborative Therapy     313
Sara: A Stalled Treatment in Need of Repair     314
Offering Specialized EMDR Treatment through Collaborative Therapy     315
A New Experience for Clients: Benefits and Outcomes of Collaborative Therapy     317
Identifying Clients Who May Benefit From EMDR and Ego State Therapy     319
The Challenge of Treating Trauma Survivors     320
Developing a Successful Collaborative Therapy Relationship     321
Case Study     324
Conclusion     339
Appendix     343
Index     347