What is Eye Movement Desensitization and Reprocessing (EMDR)?
EMDR (Eye Movement Desensitization and Reprocessing) therapy is a psychotherapeutic approach developed by Francine Shapiro in the late 1980s to treat complex trauma and distressing memories, such as those associated with Post-Traumatic Stress Disorder (PTSD). The therapeutic approach is based on the adaptive information processing model, which suggests that traumatic memories can become “stuck” in the brain in their original distressing form. It is an evidenced-based, phase-oriented treatment that focuses on symptom reduction and holistic healing.
During EMDR therapy, the client focuses on the memories of traumatic events while simultaneously engaging in bilateral stimulation. This is typically accomplished through guided eye movements from side to side, but sometimes through alternating taps or auditory tones. These exercises appear to help the brain process these memories similarly to how REM sleep processes daily experiences, allowing the memories to become less emotionally charged and better integrated into the person’s broader life narrative.
Dissociation during EMDR sessions can occur, particularly for trauma survivors. When a client dissociates, they may experience a disconnection from their present surroundings or body sensations as a protective mechanism against overwhelming emotions. Signs of dissociation might include a blank stare, feeling foggy or distant, or reporting that they “left” their body during the session.
For this reason, EMDR therapists are trained to establish safety protocols and grounding techniques before beginning the bilateral stimulation. They carefully monitor clients for signs of dissociation and may pause processing to help the client return to the present moment using grounding exercises. Some EMDR therapists use modified protocols specifically designed for clients prone to dissociation, emphasizing resource development and gradually increasing the client’s capacity to tolerate intensified emotions while remaining present.
To learn more about EMDR therapy and how it may benefit your healing journey, please contact Balanced Mind of New York for a free, 15-minute consultation.
Understanding Dissociation
Dissociation exists on a spectrum ranging from common, everyday experiences to clinically significant symptoms that can significantly impact one’s functioning. At its core, dissociation is a disconnection or detachment from one’s thoughts, feelings, surroundings, or sense of identity, which is a psychological mechanism that helps protect individuals from overwhelming stress or trauma. Dissociative episodes are temporary periods of disconnection that many people experience occasionally, such as daydreaming, “zoning out” while driving a familiar route, or feeling detached during highly stressful situations. These episodes are typically brief and don’t significantly interfere with daily life.
In contrast, dissociative disorders represent more persistent and disruptive patterns that meet specific diagnostic criteria. These disorders include Dissociative Identity Disorder, Dissociative Amnesia, and Depersonalization/Derealization Disorder. They involve chronic dissociative symptoms that cause significant distress and impairment in social, occupational, or other important areas of functioning. Understanding this distinction between dissociation experienced in everyday life and symptoms that are indicative of a complex dissociative disorder is crucial for proper assessment, diagnosis, and treatment of dissociative experiences.
Somatoform Dissociative Symptoms
Somatoform dissociative symptoms refer to physical manifestations of psychological distress that occur without an identifiable medical cause. These somatic symptoms arise from a disconnection between the mind and body, often triggered by trauma or severe stress. Individuals experiencing somatoform dissociation may report symptoms such as numbness, paralysis, non-epileptic seizures, chronic pain, or sensory disturbances (e.g., vision or hearing impairment) that do not align with medical explanations. These symptoms serve as a way for the body to express unresolved emotional distress, often outside the person’s conscious awareness. Treatment typically involves trauma-informed therapies, such as EMDR, to help reintegrate mind-body awareness and resolve underlying psychological conflicts.
Dissociative Disorders
Dissociative disorders are a group of psychological conditions characterized by disruptions or breakdowns in memory, awareness, identity, or perception. These disorders typically develop as a protective mechanism in response to chronic traumatization, particularly severe childhood trauma or abuse. The dissociation serves as a way for the individual to mentally escape overwhelming experiences by disconnecting from their thoughts, feelings, surroundings, or even their sense of self.
Eye Movement Desensitization and Reprocessing (EMDR) therapy can be beneficial for treating dissociative disorders because it directly addresses the unprocessed traumatic memories that often underlie these conditions. By facilitating adaptive information processing through bilateral stimulation, EMDR therapists help integrate fragmented traumatic memories into a coherent narrative. However, EMDR sessions must be modified when working with dissociative clients, typically including a longer stabilization phase, careful pacing, and additional grounding techniques. The therapy allows for processing traumatic experiences while maintaining dual awareness (being present while accessing past experiences), which can help individuals with dissociative disorders develop greater integration and coherence in their sense of self and personal history.
Dissociative Identity Disorder (DID)
Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is characterized by the presence of two or more distinct personality states or experiential identities that recurrently take control of a person’s behavior. These identity states may have different names, characteristics, mannerisms, and ways of relating to the world. Individuals with DID often experience gaps in autobiographical memory for important personal information and everyday events, not merely ordinary forgetfulness.
DID is strongly associated with severe childhood trauma, particularly repeated physical or sexual abuse, while personality is still forming. Treatment typically involves a phase-oriented progressive approach focusing on safety and stabilization, trauma processing, and integration or resolution of the dissociated identities. The goal is not necessarily to eliminate all identities but to promote communication, cooperation, and functional harmony among them throughout the healing journey.
Dissociative Amnesia
Dissociative Amnesia involves an inability to recall important autobiographical information, usually of a traumatic or stressful nature, that cannot be explained by ordinary forgetfulness. The memory gaps are typically inconsistent with the person’s age and development and exceed normal forgetting. Several subtypes exist, including localized amnesia (inability to recall events during a specific time period), selective amnesia (inability to recall specific aspects of an event), and generalized amnesia (complete loss of identity and life history).
The most dramatic form of Dissociative Amnesia is dissociative fugue, where a person suddenly travels away from home or work, assumes a new identity, and has no memory of their previous life. Dissociative Amnesia is often triggered by overwhelming stress or trauma, serving as a protective mechanism when memories or experiences are too painful to integrate into conscious awareness. In addition to EMDR therapy, medication may be prescribed by a physician or psychiatrist to address symptoms of comorbid anxiety or depression.
Depersonalization-Derealization Disorder (DDD)
Depersonalization-Derealization Disorder (DDD) is characterized by persistent or recurrent experiences of feeling detached from one’s mental processes or body (depersonalization) and/or a sense that one’s surroundings are unreal, dreamlike, or foggy (derealization). Unlike in psychotic disorders, reality testing remains intact. Individuals with DDD are aware that their experiences are perceptual distortions rather than reality. Common descriptions include feeling like an outside observer of one’s thoughts or body, feeling emotionally numb, or perceiving the world as artificial or lifeless. These experiences cause significant distress and impairment in functioning.
DDD can be triggered by severe stress, trauma, anxiety, or substance use, but may also occur without an identifiable trigger. Treatment typically involves psychotherapy approaches that address underlying anxiety and trauma, such as EMDR therapy, mindfulness practices, and grounding techniques to help individuals reconnect with their bodies and surroundings.
Can I Develop a Dissociative Disorder from EMDR Therapy?
No, although there may be some minor side effects to EMDR therapy, someone cannot develop a dissociative disorder from properly conducted EMDR therapy. EMDR therapy is designed to help process traumatic memories and reduce their emotional impact, not create new mental health disorders. Trained EMDR therapists assess clients for dissociative tendencies before beginning treatment and modify protocols accordingly for those who already experience dissociation.
During EMDR, some clients may temporarily experience increased dissociative symptoms as they process traumatic material, but this is typically a manifestation of pre-existing tendencies rather than the development of a new disorder. Importantly, EMDR includes specific safeguards like establishing a “safe place,” using resource installation techniques, and careful titration of trauma exposure to manage emotional activation.
If a client begins to dissociate during a session, the EMDR therapist should immediately pause processing, help ground the client, and potentially adjust the approach. Rather than causing dissociative disorders, EMDR when properly administered with appropriate preparation and monitoring can actually help reduce dissociative symptoms by processing the underlying trauma that contributes to dissociation.
Choosing an EMDR Therapist
When choosing an EMDR therapist who can manage dissociation during sessions, it is essential to find a professional with specialized training in both EMDR and dissociation. Look for a therapist who has completed advanced EMDR training focused on complex trauma and dissociative disorders, such as the EMDR International Association (EMDRIA)-approved courses on dissociation. Experience with structural dissociation theory, parts work (e.g., Internal Family Systems or Ego State Therapy), and grounding techniques is also crucial. A well-qualified EMDR therapist, such as the psychotherapists at Balanced Mind of New York, will conduct a thorough assessment to identify dissociative tendencies before starting EMDR therapy and will tailor the treatment plan to ensure a safe and gradual approach.
Additionally, the EMDR therapist should prioritize stabilization and resourcing before trauma processing. This means they should incorporate strategies like containment, grounding exercises, and co-regulation techniques to help clients stay present. During EMDR sessions, they should be skilled in recognizing signs of dissociation, such as depersonalization, derealization, or memory gaps, and know how to gently guide clients back to a regulated state. Seeking a therapist who fosters a collaborative and trauma-sensitive environment will help ensure that EMDR is both effective and safe for individuals with dissociative symptoms.
How Do I Pay For EMDR Therapy?
At Balanced Mind of New York, we offer multiple payment options to fit your needs and budget.
In-Network Insurance Provider: Balanced Mind of New York is proud to be an in-network provider for clients covered by Aetna insurance plans.
Out-of-Network Insurance Provider: For all other insurances, we provide superbills for reimbursement. We will contact your insurance company to confirm your eligibility and benefits, including the reimbursement rate for each session. We will also guide you through the process of sending superbills to your insurance.
If you have an out-of-network plan, any reimbursements will be sent directly to you from your insurance provider. Insurance typically reimburses 50-80% of the fee, but note that each policy is different.
Self-Payment Options: If no insurance coverage is available, clients may choose to pay for services out of their own pocket. If you need to pay out of pocket, we offer a sliding scale as part of our commitment to providing affordable care.
We accept Visa, MasterCard, Discover, American Express, and HSA/FSA cards.
Contact Balanced Mind of New York to learn more about your payment options and take the next step toward a healthier you.
