EMDR & Dissociation: Past, Present and Future

Early in the development of EMDR therapy, some clinicians observed that reprocessing more often moved clients presenting with dissociative disorders into dysregulated states rather than toward an expected, adaptive resolution. In recent years, EMDR therapists and trainers have become more broadly aware of the incidence and significance of complex trauma and dissociation. With this shift, many have delved deeper into the dissociative disorders literatures, strived to utilize screening and assessment tools more effectively, and grown increasingly interested to integrate their learnings to reinforce foundational learning and improve treatment outcomes. Current research will inform this discussion, exploring the different frameworks for understanding dissociation, the importance of diagnostic evaluation in Phase I: History Taking, and conceptualization and treatment of dissociative presentations within an EMDR therapy frame. The future of EMDR therapy and dissociation depends on clinicians and trainers integrating a comprehensive standard of care with nuanced conceptual, theoretical, and practical treatment considerations.