Made Simple:
EMDR and Dissociation

In one sentence: Reframe your understanding of dissociation by destigmatizing the experience and learning how to work with it during EMDR therapy.

In one paragraph: Dissociation is commonly misunderstood and pathologized. By embracing it as a normal (and adaptive!) trauma response you can learn how to work with it, and by closely listening to your clients when they dissociate you can create an environment of care and trust, both of which can have a profound impact on your clients’ healing.

Dissociation Is Commonly Misunderstood

EMDR therapists can be hesitant to work with dissociation in EMDR Therapy.

I don’t blame them—after all, many trainers, consultants, and even recognized dissociation experts within the EMDR community can still say things that may scare clinicians, including, but not limited to:

• Don’t let your clients dissociate.
• You can’t do EMDR with someone who has a Dissociative Experiences Scale (DES) score over a certain number.
• You must follow a certain model for “parts work” before you even think about doing EMDR with someone who has a dissociative disorder.

As a long-standing EMDR therapist, consultant, trainer, and author, I decided to come out publicly as a person with dissociative identities in 2018 because I was fed up with the misunderstandings of the dissociative mind being passed off as fact.

I maintain that the best way to work with a client and their system is to listen to them.

In this blog post I will address the three common misconceptions mentioned above from my pluralistic lens as both a person with dissociative identities and as an EMDR trainer. This is my attempt to simplify dissociation—and hopefully help you release some of your fears about this powerful and wondrous gift of the human mind!

That last sentence may surprise you, especially if dissociation has only been framed as something that is pathological. For most of us who carry or have carried a formal dissociative disorder diagnosis, dissociation is a gift—it is a function of several brain systems that allows us to survive and even thrive in unspeakable circumstances.

Dissociation simply means to sever or to divide, and it is something that every human being does at one point or another in life, especially in response to stress and boredom. Daydreaming, zoning out, being here but not here, and even using skills like going to a Calm or Happy Place are all dissociative activities. For those of us who grow up in chronically traumatizing environments we may leverage our tendency to sever or to divide from the present moment more frequently and more intensely, to the point that it becomes just a regular part of life. Dissociation exists to protect and/or to get our needs met.

Some of us develop separate and distinct parts, alters, or aspects of self that help us carry the burden. And even more of us, including many folks who don’t necessarily have a dissociative disorder, can put up walls between the various channels of experiencing life. If you’ve ever described a client as being too much in their head or logic as a protective mechanism from emotions or body sensation—or perhaps you even qualify as someone who meets this description—that is a form of dissociation.

Dissociating During EMDR Therapy

My parts system and I laugh whenever we hear a trainer or consultant say things like, “Don’t let your clients dissociate.” No one is that powerful! If people need to dissociate when overwhelmed they are going to do it. And as EMDR therapists we must recognize what an overwhelming experience EMDR therapy can be, especially the emotional and somatic aspects of it.

Yes, it is very prudent for us as EMDR therapists to work with our clients in Phase 2 on developing a set of skills for grounding, anchoring, or attuning to the present moment and their own internal world if they find themselves drifting off. Yet too often I see many trauma therapists get so obsessed with the concept of grounding that they hold their clients back from going forward unless they can somehow ground perfectly. Many of us will never be able to—there will always be one part that could remain a little floaty as a measure of safety. And this may be okay for the person and their system. While I certainly endorse working extensively with a variety of skills in Phase 2, please don’t make assumptions about how things should be—listen to your clients. If they tell you that letting themselves be a little bit dissociative is the only way that they can approach doing some big work, try it out before you shut them down. Speaking for our own system, we need to be in a light dissociative state in order to do some of our heaviest processing in EMDR therapy.

Take it from long-time EMDR trainer Dr. Curt Rouanzoin, who in his interview for my 2023 book on dissociation stated: “Most of the stuff I’ve learned how to do I’ve learned from my patients! I always tell my colleagues, ‘Find a dissociative client and listen to them. That will make you a good therapist.’”.

I am so grateful that my first EMDR therapist, Janet Thornton, truly listened to me—she not only helped to save my life in her role as my therapist, she modeled what it meant to be a solid EMDR therapist working with the protocol while not letting my dissociative mind scare her. Janet gave me a DES which registered a score well above that “cut-off” of 30 that many talk about in EMDR circles as being a red flag. Yet she used it as a conversation starter that helped her to accurately diagnose me. She helped me develop a collection of resources and not once shamed me for having dissociative experiences or parts. She went with the flow and worked with my parts as they needed to speak within the EMDR protocol. Looking back on my experience of being an EMDR client, the greatest gift that she gave me was to embrace my dissociative mind and adapt the EMDR accordingly. She did not try to force me into any box, nor did she take drastic measures to try to stop my first signs of dissociation. After one of my roughest EMDR sessions, even though she had to go and see another client, she let me lay on the couch of an empty office in her suite and just cry and reorient until I felt safe enough to leave. That small act of care and trust made a profound impact.

Dissociation & Parts Work

Lastly, there is a great deal of buzz in the EMDR community these days about what model works best for parts, and whether or not one should do parts work with a client who dissociates before they even attempt EMDR therapy. This is an issue about which every EMDR trainer and consultant seems to have an opinion, and they are all just that—opinions. Even if their parts model beliefs are based on clinical experience or research, I maintain that the best way to work with a client and their system—whether it be a clinically dissociative system or a simple parts constellation as is conceptualized in Internal Family Systems (IFS) and other forms of therapy—is to listen to them. Get a sense of how they experience parts, aspects, alters, or dimensions of self (yes, let them choose the word/words that work best for them) and adapt accordingly. Part of going with the flow is recognizing that some parts and systems may not even reveal themselves to you as the therapist until you get into the reprocessing phases, which then may send you back to Phase 2 for more preparation and reorienting.

On Seeking Consultation

If all of this sounds overwhelming to you, especially if you are a newer EMDR therapist who is less familiar with dissociation, seek consultation. In vetting potential consultants, really listen for the fear factor when you ask them questions—if they are hyper cautious about dissociation, my general recommendation as a person with lived experience is to seek out someone who does not see dissociation as a dirty word.

---

Curious to learn more? Check out Jamie’s book Dissociation Made Simple: A Stigma-Free Guide to Embracing Your Dissociative Mind and Navigating Life, which blends personal stories with actionable skills and strategies to understand and navigate dissociation as both a client and a clinician.