How to manage disassociation in EMDR?

[Roland]

I had my first EMDR session last week. Towards the end, I got overwhelmed and shut down. I was crying and nonverbal. But then the following days I was not myself, I felt like my body wasn't mine, had somatic flashbacks, and wasn't comfortable having sex until 3 or 4 days later (my trauma I'm processing is about child sexual abuse).

Today I had a therapy appointment and my therapist said that wasn't a typical response and I should have gotten better not worse. She said maybe I have a more sensitive amygdala and am more in the freeze mode. I said yes I have PTSD and you just described PTSD. I pushed back and said no this is normal, it gets worse before it gets better and encouraged her to read online how people with freeze mode disassociation PTSD with extensive childhood trauma react to PTSD and she was like oh yeah it's probably disassociation. So she did the DES (dissociative experience scale) and I scored a 36 and she said I needed to be under 30 to do EMDR. She also said online wasn't necessarily reality but she seems to be treating any client with EMDR instead of treating specifically clients with PTSD because how have none of her clients reacted like some with PTSD from ongoing child abuse??? Children almost always end up in chronic freeze mode because they can't escape or fight a parent.

I'm frustrated because I would rather just move forward with EMDR and trust the process. But I also see the point of managing the dissociation so the EMDR is actually effective.

But I also don't see this is as simple as "do grounding exercises to stay present" because freeze mode and dissociating is so automatic for me. Sure I can lower my responses to the DES scale but as soon as shit gets tough I'm going to shut down because that's what I do.

What do you think of this? If you're a heavy freeze mode person how was it managed during EMDR? Can you really stop yourself from dissociating?

 

[arfie]

i can't speak to the EMDR angle since i've never done it, but, in general, i have found it far more effective to work with my symptoms than to fight them. yes, i want to alleviate those symptoms, such as dissociation, but they offer important guidance during the healing process. dissociation, in particular, often tells me i am trying too hard and need to ease up a bit.

 

[Friday]

EMDR relies on a certain level of disassociation, in order to work.
It ALSO relies upon being able to snap one’s self back present.
Get the RHYTHM of the two? You’re golden. But it takes some time to learn, much less master.
Like any dance.

 

[Roland]

EMDR relies on a certain level of disassociation, in order to work.
It ALSO relies upon being able to snap one’s self back present.
Get the RHYTHM of the two? You’re golden. But it takes some time to learn, much less master.
Like any dance.

How to manage disassociation?

When therapists tell me to focus on senses etc it just seems like it's missing the whole of it. Disassociation and freeze is so automatic for me, I don't think chewing gum will stop me from doing it. So idk. I just don't see myself not doing it.

 

[Susan Jane]

Today I had a therapy appointment and my therapist said that wasn't a typical response and I should have gotten better not worse. She said maybe I have a more sensitive amygdala and am more in the freeze mode.

My T says it can get worse before better, and that is typical . Guess they disagree. Disassociating is part of the puzzle and it is scary. I guess you have to decide if the EMDR is helping and is it worth going through the hell of disassociating

 

[Roland]

My T says it can get worse before better, and that is typical . Guess they disagree. Disassociating is part of the puzzle and it is scary. I guess you have to decide if the EMDR is helping and is it worth going through the hell of disassociating

I'm puzzled too. I'm doing too ask if her client base actually has PTSD (and if so, is it "like mine" chronic childhood preverbal abuse. Of course I have freeze and disassociative tendencies). Or did she forget I had PTSD?

I'm concerned she would use EMDR for people that don't have PTSD in general. I don't see any research that it works as a one size fits all treatment.

 

[LeiaFlower]

EMDR is usually geared towards clients with PTSD. It’s odd that the DES wasn’t done prior towards the start of the actual EMDR. Did you mention PTSD and dissociation during intake or brought it prior, and she forgot?

As for the high dissociation, I was told the same thing when I wanted to start EMDR. That was back in 2023, and my freeze response is still present but the dissociation has decreased significantly. I end up finding a therapist that utilized somatic techniques which has helped a lot with both dissociation and freeze response. Learning the basics of grounding is still helpful tool to have. Once you find techniques that are helpful, it’ll combat the automatic response for your body to dissociate. It also depends on you’re in hyper arousal vs hypo arousal, for me dissociation will happen in either state so it’s about noticing my feelings/body and basing my grounding techniques off of that.

It honestly is about time, if your body and mind isn’t ready for EMDR forcing it while you’re in a dissociative state will be counterproductive or further traumatic. Have you also looked into IFS? It has been helpful for me in connecting with my younger parts/self so I feel more comfortable in therapy and rely on supports besides dissociation.

Unsure if this all makes sense lol sometimes I jump around a lot and forget to fully explain things.

 

[Roland]

EMDR is usually geared towards clients with PTSD. It’s odd that the DES wasn’t done prior towards the start of the actual EMDR. Did you mention PTSD and dissociation during intake or brought it prior, and she forgot?

As for the high dissociation, I was told the same thing when I wanted to start EMDR. That was back in 2023, and my freeze response is still present but the dissociation has decreased significantly. I end up finding a therapist that utilized somatic techniques which has helped a lot with both dissociation and freeze response. Learning the basics of grounding is still helpful tool to have. Once you find techniques that are helpful, it’ll combat the automatic response for your body to dissociate. It also depends on you’re in hyper arousal vs hypo arousal, for me dissociation will happen in either state so it’s about noticing my feelings/body and basing my grounding techniques off of that.

It honestly is about time, if your body and mind isn’t ready for EMDR forcing it while you’re in a dissociative state will be counterproductive or further traumatic. Have you also looked into IFS? It has been helpful for me in connecting with my younger parts/self so I feel more comfortable in therapy and rely on supports besides dissociation.

Unsure if this all makes sense lol sometimes I jump around a lot and forget to fully explain things.

No worries it makes sense.

I was very thorough in filling out her intake forms, I sent her my psychological evaluation, and we discussed my trauma history in depth. Yet, she seemed surprised that I had disassociation. I forwarded my psychological evaluation document to her again because she hasn't read it. Maybe she forgot though, therapists are human.

I'll look into the difference between hypoarousal and hyperarousal. I don't know much about that other than my hunch as to what it means.

I would love to do ifs since I have very separate parts (structural disassociation). I don't remember if my therapist is trained in it though. (I prioritized EMDR over ifs when looking for a therapist).

I'll ask her more about techniques to reduce disassociation and bring up the somatic exercises idea.

 

[Roland]

EMDR is usually geared towards clients with PTSD. It’s odd that the DES wasn’t done prior towards the start of the actual EMDR. Did you mention PTSD and dissociation during intake or brought it prior, and she forgot?

As for the high dissociation, I was told the same thing when I wanted to start EMDR. That was back in 2023, and my freeze response is still present but the dissociation has decreased significantly. I end up finding a therapist that utilized somatic techniques which has helped a lot with both dissociation and freeze response. Learning the basics of grounding is still helpful tool to have. Once you find techniques that are helpful, it’ll combat the automatic response for your body to dissociate. It also depends on you’re in hyper arousal vs hypo arousal, for me dissociation will happen in either state so it’s about noticing my feelings/body and basing my grounding techniques off of that.

It honestly is about time, if your body and mind isn’t ready for EMDR forcing it while you’re in a dissociative state will be counterproductive or further traumatic. Have you also looked into IFS? It has been helpful for me in connecting with my younger parts/self so I feel more comfortable in therapy and rely on supports besides dissociation.

Unsure if this all makes sense lol sometimes I jump around a lot and forget to fully explain things.

Based on this information: Hypoarousal vs. Hyperarousal | How to Identify Nervous System States

I would describe my post-emdr existence as hypoaroused. I was shut down. I was calm. My body didn't feel like mine, and at times I didn't feel safe in my body. But I was not panicking or restless or flight or fight at all.

But then based on this one I'm confused again: The Window of Tolerance and PTSD – PTSD UK

I think I experience both at different times.

 

[Roland]

Update: still puzzled why it was weird to my therapist that I felt bad after EMDR.

But we had a session today and she is fully trained and qualified for treating PTSD with EMDR. She just didn't know that I disassociate a lot. In part because she's yet to read my psychological evaluation.

But she did say we can try again with EMDR if I feel good about it while also trying to do more grounding and coping skills *resourcing*.