However, clinical experience with such often chronically traumatized patients has taught therapists that modifications of the EMDR standard treatment protocol should be included when the goal is to integrate their traumatic memories, or else these patients are at risk of decompensation (e.g., Forgash & Copeley, 2007 Gelinas, 2003). 490), that is, the most common form of dissociative disorder encountered in clinical practice (e.g., Johnson, Cohen, Kasen, & Brook, 2006 S ̧ar, Akyüz, & Dog ̆an, 2007).ĮMDR can be used in these patient populations in advancing coping skills and integrating traumatic memories (e.g., Forgash & Knipe, 2007 Gelinas, 2003 Lazrove & Fine, 1996 Oppenheim, Ten Broeke, & De Jongh, 2008 Paulsen, 1995, 2007 Twombly, 2005 Young, 1994). Such disorders include complex PTSD, trauma-related borderline personality disorder, dissociative identity disorder (DID), and dissociative disorder not otherwise specified (DDNOS)-type 1 (clinical presentations similar to DID that fail to meet the full criteria for this disorder American Psychiatric Association, 1994, p. Initially steered by a Dissociative Disorders Task Force (Fine et al., 1995), EMDR is increasingly included in the treatment of complex trauma-related disorders. Traumatic memories are sensorimotor, emotional experiences that relate to traumatizing events that survivors have not or not sufficiently integrated in their personality, that is, the dynamic biopsychosocial system that determines their characteristic mental and behavioral actions (cf., Allport, 1961 Van der Hart, Nijenhuis, & Steele, 2006).ĮMDR is guided by the Adaptive Information Processing (AIP) model, which is highly applicable in the treatment of a wide range of disorders (Shapiro, 1995, 2001 Solomon & Shapiro, 2008). Keywords: dissociation structural dissociation of the personality dissociative disorders EMDR (eye movement desensitization and reprocessing) integration phase-oriented treatmentĮye movement desensitization and reprocessing (EMDR) is an effective and empirically supported integrative psychotherapeutic approach for treatment of posttraumatic stress disorder (PTSD) and thus of traumatic memories (Bisson & Andrew, 2007 Foa, Keane, Friedman, & Cohen, 2009 Shapiro, 1995, 2001).

This article presents the basics of TSDP, and a second article will provide guidelines for the treatment of complex trauma-related disorders based on this theory.

The more severe and chronic the traumatization, the more dissociative parts can be expected to exist. The other type involves dissociative parts, fixated in traumatic memories, primarily mediated by the defense action system. One type involves dissociative parts primarily mediated by daily life action systems or motivational systems. TSDP postulates that the personality of traumatized individuals is unduly divided in two basic types of dissociative subsystems or parts. Mental Health Care Drenthe, Assen, The Netherlandsīuffalo Center for Trauma and Loss, Buffalo, New YorkĪs eye movement desensitization and reprocessing (EMDR) has been increasingly applied in complex trauma-related disorders, including complex dissociative disorders, and trauma-related borderline personality disorder, EMDR practice may benefit from theories developed to account for the dissociative nature of these disorders, such as the theory of structural dissociation of the personality (TSDP). Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerationsĭepartment of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands

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