I found this blog post, Screening for DID and more… by Bonnie Mikelson helpful in understanding how EMDR and dissociation are related.

This list from the article, especially numbers 8 and 9,  seems particularly useful in what I’m dealing with in my own work and self-education and also in doing EMDR trainings with other therapists:

1) It has been established that one shouldn’t do EMDR with any client without first ruling out the presence of a dissociative disorder, but,

2) Many EMDR clinicians continue to have the erroneous belief that they can tell who is and isn’t dissociative as if dissociative disorders are floridly manifest. They only use the DES-II on clients whom they already suspect are dissociative, missing a great many of the non-florid dissociative diagnoses, plus,

3) The instrument most recommended in EMDR training, the DES-II, has false negatives and does not purport to be a diagnostic instrument but only a screening device. However,

4) The SCID-D, the diagnostic device put forward to be the gold standard for assessment of the dissociative disorders, is not intuitively graspable and requires that a clinician be trained in its administration and scoring, and moreover, be educated somewhat in dissociative disorders, but,

5) Most EMDR clinicians are not at all trained and experienced with dissociative disorders, and have been taught in graduate school that their occurrence is rare or non-existent. Those clinicians often only have a paradigm shift regarding the presence of dissociation the hard way, such as…

6) Since many EMDR clinicians use EMDR a great deal in their practices, they run the risk of uncovering numerous dissociative clients in the middle of an EMDR that is either eruptive or looping, which risks…

7) The client may have a suicidal crisis requiring hospitalization, stop therapy, experience a therapeutic rupture, or refuse trauma work of any kind.

8) At this juncture many EMDR clinicians turn ashen, shrivel up, and abandon EMDR altogether for the safer and tamer tools. This happens without their ever having had the needed paradigm shift about dissociation and avoidance being the bedrock of many disorders, and association being a good part of their cure, to oversimplify a complicated story. Moreover,

9) Most new EMDR clinicians are slugging their way through the Adaptive Information Processing paradigm shift already, undertaking extensive and expensive training and consultation required for safe and effective EMDR use. Training in dissociation is competing with that for hypnosis, somatic, or other therapies. In that case,

10) If dissociation seems like the caboose of the train, not its engine, training in the treatment of dissociation a low priority on a scarce training budget. THE SCID-D vs. MID Some time ago Rick Kluft opined that Marlene Steinberg’s SCID-D is the gold standard for the diagnosis of dissociative disorders rather than Paul Dell’s MID. I agree with Dr Kluft that the SCID-D has a relatively longer and certainly a distinguished history in the dissociation field, whereas the MID is a recent comer. However, the SCID-D is a lengthy diagnostic interview, involving exploring for some hours the particular symptoms that represent the DSM criteria for diagnosing each of the dissociative disorders. In contrast, the MID is a questionnaire.

Screening for DID and More…

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