Month: March 2018

Two of the skills I often use with clients are Eye Movement Desensitization and Reprocessing (EMDR) and Ego State Therapy. Clients are typically resistant to recognizing that the way they cope with their environment continues to be the result of how they learned to cope in the home as children. I do a lot of work with clients with severe dissociative disorders, which typically means they experienced significant childhood trauma and have very little trust. I have found ego state therapy to be the most effective method for working with those clients. Everyone dissociates to some degree. For most of us we become detached from our surroundings if we are reading a good book or watching an enthralling movie. That is one end of the dissociative spectrum. Those who have a dissociative disorder are at the other end of the spectrum and will have a more complete separation of ego states that gives them as sense of being fragmented. I have found that being able to work within the ego state arena I am able to much more quickly and effectively address the issues of the client. The initial objective in the work is containment of the parts with integration of the egos states the final objective. When this occurs life requires much less effort. It is no longer necessary to filter out all of the information coming in when they are trying to make a decision or response to stimuli.

The clients that move forward in therapy the fastest are typically those who have weak defenses. Those who have stronger defenses take longer, but are more resilient. This is one of the reasons I typically see quick success in clients with high anxiety. They have not learned coping skills to repress the emotional and physical responses to stressors. Those who have strong defenses are able to repress and contain negative emotions and feelings, allowing them to be able to focus on their professional, social, and personal goals. However, this has a negative impact on their bodies and emotional regulation. In therapy clients who have strong defenses must allow them  to come down to access their response to negative stimuli in their lives. This has to be done slowly to maintain their ability to function at a high level in their professional and personal lives and at the same time allow them to experience the risk of being vulnerable. I view it as the difference between creating a sculpture out of soft clay or stone. They clay is much easier to work with and quick change occurs. With stone it has to begin to crack and fracture before it’s form begins to change. Change is much more evident in those who have not been hardened by their environment. The therapeutic work involves identifying changing emotions, physical feelings or sensations and the cognitive thoughts that occur. By connecting these different aspects of self  our perception of the world changes. The end result is the same, being comfortable in a much larger environment.

Often, the first time I get a new client is when they are in despair, feeling trapped and having lost hope. It may occur because of a relationship, job they are in, a manager they work for, because of a mistake they have made, or some other event they have no control over. The primary task is to restore a sense of self outside of the situation and seeing the potential for change. This is done by identifying what is most important (long term goals), recognizing they are separate from the event and that the situation does not contain them. When getting a sense of hope occurs it is evident during the session. They are then able to separate themselves from the event or situation that creates the sense of being trapped and allows them to feel safe in the present and see other possibilities .