When we look at the standard protocol for EMDR we soon realize that it is too difficult for a lot of people with a background of severe abuse. We need more stability to manage trauma work, yet we can’t gain that stability because of our severe trauma symptoms. It can feel like we need to get healed first, so we can tolerate the healing process.
The progressive approach in EMDR offers a way to implement small interventions for resource installation and emotional processing into our stabilization phase. The lines between phases get a bit blurred. That doesn’t mean that stabilization isn’t taken seriously, it is crucial, it just means that there will be small interventions to process the things that hinder us from gaining more stability.
Phase 1 goals for DID treatment like communication and cooperation can be supported with bilateral stimulation as well. It highly depends on the individual system if bilateral stimulation is a tool that can work for you. You need to try this with your specifically trained T and see what happens. I cannot tell you what is good for you but I can share what is theoretically available in the therapists tool box.
Resource installation
Classic
In resource installation bilateral stimulation is used to increase positive feelings or states. It is usually done using slower eye movements or, where that is more practical, tapping or buzzers.
Your T will pay attention to when you feel positive emotions or share about having felt positive emotions, stop the conversation and offer a few sets of bilateral stimulation to see if the feelings can be increased. In theory, this will make it easier to remember and recall that feeling later and creates an anchor in the positive experience.
Connection
Feelings of connection can be increased the same way. So if you have a good moment of deep connection with your T in session or report about a time like that with a safe person in your life your T might offer a few sets of bilateral stimulation to help you feel it more deeply. Strengthening these relational experiences can support our ability for relational regulation and self-soothing when thinking of supportive people.
Safe Place
With a background of severe trauma learning the Safe Place exercise can be difficult. You might be scared of it or unable to imagine safety or the safe place might shift and become dangerous while you practice. Your T might offer bilateral stimulation to process fears or to increase your sense of safety and install the Safe Place in a way that makes it easier to recall it in its pure form when you need it.
Orientation&Grounding
It is not unusual for survivors to live in a fog of dissociation, so that orientation and grounding in the Here and Now is a challenge all by itself. The regular orientation exercises can be enhanced when you use the bilateral stimulation when you are well oriented. Once you can recall that well enough you can work on increasing the physical realization of being in the Here and Now with the support of bilateral stimulation. You are creating a mental anchor in the memory of how it feels, that can make it easier to remember this state and return to it. A skilled T can help you to learn how to tell apart inside reality and outside reality here.
Self-Care
Sometimes there are layers of difficult feelings and beliefs that keep us from proper self-care. Bilateral stimulation can help to process that. It can also be used to process urges that are not healthy for us like the urge to self-harm or to use other unhelpful coping strategies like drinking or taking drugs or eating or however you usually cope. Increasing self-care automatically increases stability.
Emotions
Some difficult emotions can be processed without having to look at the traumatic past where they developed. The focus of processing will be on the present. Your T can also use bilateral stimulation to increase your tolerance for feeling emotions without dissociating them or getting overwhelmed. The ‘Caring for the baby’ procedure asks you to imagine your emotion like a baby that is feeling unwell while bilateral stimulation is applied. You can stay with it in a caring and compassionate way like you would soothe a baby. It can take a while until your emotion calms down, just like a baby might need some time. Using this procedure can help you to manage yourself with more compassion and grace while experiencing emotions, enhancing your window of tolerance.
Reflection
Trauma can hurt our ability for mental processes like reflecting about something without getting sucked into it. Bilateral stimulation can help us to take a step back and reflect on the situation and what is going on inside of us and increase our ability to see the bigger picture from a present perspective. Usually you would do this kind of reflection with your T so they can add ideas or introduce a new point of view.
That way bilateral stimulation can help us to build resources that we need to cope with the more difficult part of the treatment.
EMDR for stabilization in DID or subforms
When we want to approach traumatic memory long-term we don’t just need stability on the outside or in the part that is usually fronting, it is needed within the whole system. We need to take inner connection, communication and cooperation seriously, otherwise any attempt for trauma processing will fail badly. The stabilization phase in DID is a ton of work, but for some systems it can be made easier with EMDR tools.
Phobia of other parts/other phobias
In DID parts are not automatically friends. There is usually a great fear of other parts and the trauma they know, even hearing voices inside can lead people to shut down and dissociate because they can’t handle it. There is usually a lot of avoidance in the ANPs while EPs can often be hostile too. The realization of what is going on is just too big and too scary. Overcoming the phobia of the inner experience and specifically of other parts is the first huge challenge in DID treatment. EMDR is pretty effective in treating fear. So when you are too afraid to even make contact with what is inside, your T might offer bilateral stimulation to process that fear. You don’t have to make contact, you just focus on your fear and see if it changes with a few sets of bilateral stimulation. Getting the intense fear out of the way can be a huge help. Other phobias that can be addressed are the phobia of attachment, traumatic memories, intimacy or change, but that’s for later in the process.
Communication
People with DID who can work well with bilateral stimulation often report that it makes inner communication easier. It is suggested that the activation in the brain affects the different neuro-networks of parts so that there can be connections that are otherwise impossible. When bilateral stimulation is used during a therapy session to support communication between parts it might be more practical to use tapping or buzzers so that the fronting part can focus on the therapist and a ‘group’ conversation. Ts have to be careful because it is impossible to tell which inner connections might be increased and what kind of part might enter the conversation, but this is a good method to reach those that are completely separate otherwise. Some use bilateral stimulation throughout their team meetings to make it easier for everyone to negotiate and take part in problem solving.
Feelings about other parts
Just overcoming the phobia of making contact and having contact with parts doesn’t always change that we have difficult feelings towards our Others. That can be fear or disgust or anger or rejection etc. The ‘Loving Eyes’ procedure in EMDR invites us to look at a specific part while bilateral stimulation is applied and notice how our emotions might change over time. Negative feelings can get processed and result in a change of our inner relationships. It can increase empathy and understanding for each other.
Sharing resources
DID is marked by a separation of memories, emotions and abilities between parts. Some parts might end up with a lot of resources for self-soothing while others carry a lot of difficult emotions. Bilateral stimulation can help us to share our resources with those in the system who need them but don’t have access to them because of the dissociative barriers. The barriers are temporarily lowered. One way your T might guide you to share resources is by drawing little pictures, one of the resource you want to share, the other one of the part who needs it. These pictures then get moved to the left and right side of the table. You T will guide you to look from one picture to the other while holding your head still, creating the bilateral eye movement, while thinking of what the resource feels like and then of the part who needs it, back and forth.
Co-Consciousness
To increase co-consciousness your T might offer bilateral stimulation (more likely tapping) and ask the fronting part and one other part to share the experience. They can introduce neutral or positive stimulation so you can practice experiencing it together while co-conscious and the bilateral stimulation can help you to stay connected.
In the next stage your T might ask you to share neutral or positive information with each other while staying co-conscious, usually by asking questions that demand team work to answer them.
Then your T might invite you to learn how to act together while staying co-conscious and take part in some kind of activity. With every step the feeling of sharing gets installed and becomes more easily available in the future.
This can lead to fast progress in sharing your life and staying together so that amnesia can be reduced and you are generally more oriented and more in control.
Blending and Fusion
These tools are for later in your therapy, after you have worked through important trauma memories. I am adding them here because it helps to see how bilateral stimulation can be used throughout our treatment.
Your T might eventually guide you towards greater levels of connection, where the barriers between parts are dissolved. You can imagine that process while bilateral stimulation is applied and carefully notice how you are feeling, especially in your body. That way any kind of resistance can be detected and processed.
The ‘integrative movie’ procedure is used after fusion with one part or as a whole system. Your T guides you to imagine your whole life and go through it while bilateral stimulation is applied. Whenever something doesn’t feel comfortable your T will stop, help identify where there is still something left to process and keep working with you until it feels right.
While basic resource installation is usually taught in basic EMDR training, the tools for working with DID are not. If you have DID, you need to make sure that your T has specific training to use EMDR for structural dissociation, otherwise you will be in serious danger of retraumatization! How systems react to bilateral stimulation is impossible to predict. For some, too much of the dissociative barriers gets pulled down and they decompensate rapidly. So you need to carefully test it with your T. The basic EMDR protocol should not be applied when there is a known DID diagnosis. There is a different EMDR procedure for that.
These tools sound simple but they are no toys. You cannot try them for yourself at home without taking huge risks hurting yourself, especially if you don’t know how your system responds to bilateral stimulation. Let your T help you to gently explore if bilateral stimulation works for you, then follow your Ts individual instructions to see if you could maybe use it at home after you have collected some experience with it. If bilateral stimulation doesn’t come with extreme side effects your T might agree to let you work on resource installation on your own or use it to help you with therapy homework and inner communication.
In case your T is unaware that there are EMDR tools that are taught specifically for structural dissociation you may want to show them this blog post or point them towards „EMDR and Dissociation“ by Gonzales& Mosquera or a rough summary of the basics in this article.
Leave a Reply