| Subscribe to Mark's Newsletter |
EMDR AND THE RELATIONAL IMPERATIVE
By Mark Dworkin
For nearly two decades – since its initial introduction to professional circles – Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular among practitioners dealing with trauma. While a number of empirical studies, clinical experience, and published scholarly work have confirmed the efficacy of this therapeutic method in the treatment of trauma and PTSD, there remains a large gap in the literature in this burgeoning area. Most existing material on EMDR concentrates on the theoretical constructs of the method and /or the physical methodology of the treatment, while not recognizing that even evidence-based forms of treatment are practiced by flesh and blood human beings. This book explores an area that has, until now, been left unconsidered.
EMDR and the Relational Imperative: examines the nature of the therapeutic relationship as it pertains to EMDR use in psychotherapy. Mark Dworkin has been in practice as a psychotherapist for over 30 years – specializing in the treatment of PTSD for the last 25 years – and has been working with Dr. Francine Shapiro (founder of the EMDR Institute and the developer of EMDR) since 1995. Mr. Dworkin represents the entire body of research and published work on the relational aspects of EMDR, and has received Dr. Shapiro’s support and guidance in his expansion of the theory and practice of this treatment methodology.
“In this text, Dworkin draws upon his extensive clinical experience, the wisdom gleaned from the burgeoning field of neurobiology, and his understanding of the Adaptive Information Processing model, which guides EMDR, to provide clinicians practicing any form of psychotherapy with a more thorough appreciation of the processes of clinical change and the dynamics of effective therapeutic relationships.” -from the foreword by Francine Shapiro, Ph.D., Senior Research Fellow, Mental Research Institute.
To purchase your copy from Rutledge, just click the icon below to go directly to the item page.
You can also visit Routledge-ny.com , select advanced search then enter ISBN#: 0415950287.
To purchase your copy from Amazon, click the Amazon icon below to go directly to the item page.
You can also visit Amazon.com and input the ISBN#: 0415950287 into the search box then click the red go button.
To Purchase from Mentor Books, please click the icon below to go directly to the item page.
You can also visit Mentorbooks.com and input the ISBN#: 0415950287 into the search box, select Keyword and then Search.
- Call Today for a Private Appointment -
516-731-7611
Dear Mark,
I am remiss to say I have no love for EMDR. While knowing I had no memory of the first 12 years of my life, yet I was raised in a large traditional Italian family which didn’t seem odd compared to other families in our neighborhood. I have 6 siblings. My parents worked hard, we always had food, a clean home, a normal childhood, went to church celebrated holidays, all of it.
Convinced to seek EMDR therapy to learn why I felt I was born at age 12, I spent 3 years in EMDR therapy, weekly at $100 dollars a week. The clinician convinced me to see a psychiatrist to get medication. I did that.
Within those 3 years I attempted suicide twice. EMDR did not bring up memories of anything significant and the antidepressant medication nearly killed me.
I recovered from EMDR when I tossed the antidepressants in the garbage and all I did learn was; the clinician was an irresponsible and dangerous man. EMDR, if it is done properly should last about a month. I read the books.
What I got out of the entire experience is, It cost me a lot of money to find out I had dissociated what ever trauma it was that cost me a childhood, and I also survived it. With that obvious truth, I am in charge now. Blaming my childhood for my issues is passed its sell by date. I have a beautiful life and can live it in spite of a lost childhood and in spite of misfortunes I do remember.
I enjoy your writing,
God Bless
Jo
Dear Jo:
I am sorry to hear about your experience with this EMDR clinician. In order to be good trauma therapist, it is crucial to understand dissociative phenomena. Having no memory for the first 12 years of your life can be very disturbing. While we don’t know each other it sounds like you may suffer from dissociative amnesia. These kinds of events only happen when there are multiple traumas. But you can’t get to them directly by using the active trauma processing phases of EMDR. These are phases three through six, they had named assessment, desensitization, installation, body scan. EMDR is not a method for memory retrieval. It seems to me, by your report, that you therapist did not spend enough time in the first two phases of EMDR.
Phase 1 called history taking and evaluation is designed to facilitate the recognition of conscious traumatic memories that are put on a treatment plan so that you in the clinician can determine what memories you wish to reprocess (meaning release the pain from). Having such a long amnestic time period is a red flag to any seasoned trauma therapist of any stripe.
Phase 2 of EMDR is designed to help the person develop all needed coping and self soothing strategies so that the person is ready to reprocess old traumatic material. Phase 2 can last for a session or two, or up to a year or two. One of the issues that Dr. Shapiro mentions is that a firm therapeutic relationship must be established in order to do trauma work. This doesn’t mean that you like it therapist, or therapist likes you. It means that the two of you have set goals, discussed the tasks each one of you needs to be active in, and by agreeing to both tasks and goals of therapeutic bond begins to develop. One issue that it sounds like you therapist missed was the issue of creating safety for you before starting the active phases of trauma work.
Part of safety means talking things out until memories do start to surface, and/or taking the necessary steps in dealing with someone with a dissociative disorder. There are many strategies, I’ll just mention one. There is a technique called Frasier’s Dissociative Table Technique. This procedure is used to help someone with a dissociative disorder recognize that they have different parts (as we all do). Optimally All of our parts work together, only in this case there are parts that are protecting you from things that have happened during your first 12 years of life. Without creating safety by using those protective parts as allies to help the wounded child part no good work can be done.
It seems to me that EMDR is not the problem. It seems that you’re therapist did not understand how to deal with you dissociative problem. As a result EMDR was misused and you suffered as a result. I’m sorry for your pain. If you ever do decide to try working with the trauma therapist again let me know what part of the country you are in and I will help you find someone who is competent in trauma and memory, as well as any number of different kinds of trauma therapies. While I do think EMDR practiced by someone who understands dissociation is your best bet, somatic experiencing, sensorimotor therapy, internal family systems, structural dissociation therapy, cognitive behavioral therapy, are all reputable forms of treatment. Please remember this above all, it’s the quality of the therapeutic relationship as well as the clinical judgment of the seasoned clinician that will make the difference in any form of therapy.
That is why when I train people in EMDR I spend a good deal of time helping them understand how the therapeutic relationship affects the work in all eight phases. I also spend a good deal of time lecturing on have trauma affects memory, how different kinds of attachment problems may need modifications in the standard methodology, and have different kinds of dissociative disorders need to have a much different approach when thinking through, and using EMDR methodology.
Again I am sorry for your pain, and would be glad to assist you in finding competent help.
Best wishes,
Mark Dworkin LCSW, P. C.