The joint use of EMDR and hypnosis in the treatment of DID, DDNOS and complex PTSD


Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder (PTSD), is currently recognized as a treatable condition. It is considered the paradigmatic dissociative disorder and carries with it extreme posttraumatic symptomatology which lends itself to be an apt target for treatment combining the use of EMDR and hypnosis. Therapists skilled in the treatment of DID and Dissociative Disorder Not otherwise specified (DDNos) have augmented their therapeutic arsenal with the fluent uses of hypnosis for stabilization, affect management, building a safe place and grounding. EMDR, which has come to the forefront of clinical awareness in the last fifteen years, seems well suited for the treatment of trauma, but can be destabilizing. The presenters recommend a protocol, called Wreathing Protocol, for the imbricated use of EMDR and hypnosis in the treatment of not only DID, but also DDNOS and complex chronic PTSD. The Wreathing Protocol is useful to advanced clinicians skilled in both modalities independently. This workshop will explain and illustrate with a clinical vignette the sequential steps of the Wreathing Protocol; it will describe the required contextual treatment frame for its safe use. The presenters will explore the consequences of the premature uses of EMDR and offer planful structured responses to a disequilibrated treatment and a destabilized patient. The clinical implications of the use of the Wreathing Protocol will be discussed. Learning objectives: 1. Name three prohibitions to the use of EMDR in the treatment of dissociative disorders. 2. Exemplify one target symptom of the BASK model of dissociation in the clinical example presented and relate a different one in one of your own patients. 3. Describe a potential multistep Wreathing Protocol sequence from selection of target to resolution of at least one microsymptom in a patient of your choice.






Catherine Fine
Ami Berkowitz

Original Work Citation

Fine, C., & Berkowitz, A. (2008, April). The joint use of EMDR and hypnosis in the treatment of DID, DDNOS and complex PTSD. Presentation at the 1st Bi-Annual European Society for Trauma and Dissociation Conference, Amsterdam, The Netherlands



“The joint use of EMDR and hypnosis in the treatment of DID, DDNOS and complex PTSD,” Francine Shapiro Library, accessed September 27, 2020,

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