Definition
Dissociation — including depersonalization, derealization, and identity fragmentation — requires specific assessment and pacing when EMDR is being considered. Some patients need substantial stabilization before any processing.
Why it matters
Ignoring dissociation and proceeding directly to processing can be actively harmful.
The Science
Screening instruments exist and are considered standard practice. Dissociative disorders require modified protocols and, sometimes, longer preparation.
The NSI Perspective
NSI takes dissociation seriously. It is often adaptive before it is a diagnosis, and it deserves care that respects both.
Clinical Implications
Structured screening (DES-II, MID) should be part of intake for any trauma treatment.
Practical Application
If you dissociate, disclose it. Good clinicians will use the information to protect you.
References
- 1.International Society for the Study of Trauma and Dissociation. J Trauma Dissociation. 2011;12(2):115–187.