Stumbling into Dissociation with EMDR Therapy

The relationship between the fields of EMDR therapy and dissociative disorders has been fraught since the earliest reports of undiagnosed dissociative clients decompensating after reprocessing. Subsequently, the potential risks of using EMDR therapy received significant attention in literature and conference presentations throughout the 1990s and into the early 2000s. Since then, attention has been devoted almost exclusively to modifying standard EMDR therapy to accommodate and treat dissociative symptoms and disorders. Despite the emphasis placed upon discernment and treatment of dissociation in the EMDR therapy field over the past 35 years, there has been a near-absence of attention given to ethical considerations specific to EMDR therapy and dissociation. This chapter examines the practical challenges encountered by an example EMDR therapist, including the mixed messages about treating dissociation to which EMDR practitioners are beholden, and follows their process of resolving an ethical dilemma when they encounter a client with a complex history.