The cutting must stop: A way out of the stabilisation versus reprocessing paradox with a DID-patient
In this workshop I will discuss and illustrate by video fragments, the steps of trauma reprocessing with a very instable DID patient. The patient was suffering from sudden severe self-cutting that took place outside the patient's own consciousness. It was clear that an Emotional part of the Personality (EP) was tormented by a severe trauma, and in response, acted very aggressively. Because of the great danger of self-harm, which man could become life-threatening, the cutting had to be stopped as soon as possible. Therapist and patient were trapped in the well known paradox: to reprocess the trauma there had to be enough stability, but to create enough stability the trauma had to be solved. It was clear that in this period of her life the patient couldn't bear any trauma reprocessing. This workshop offers a way out of this paradox. I will show how to establish enough safety for all the parts of the personality who are involved, increasing two of the Apparently Normal parts of the Personality (ANP's). For one of the ANP's, safety meant that she didn't have to witness the story about the trauma, she still didn't know. The workshop will demonstrate how to establish a working alliance with the aggressive part (EP) who is indirectly responsible for the severe cutting. Finally, after all these preparations, the trauma reprocessing by using EMDR on this EP can be started. The participants will learn: a. How to work from a Structural Dissociation view. The importance of an active attitude for the therapist, like a film director, in getting in contact and working together with the different parts of the personality, to reach the necessary goal; c. That trauma processing is at least partly possible in absence of the 'main part' of the personality which can contribute to stabilization in order to reprocess the trauma completely. been This workshop provides an opportunity to escape from the ]paradox: reprocessing a trauma requires stability but stability ]requires a reprocessed trauma. It is always thought that for reprocessing a trauma the ONP('s) must be involved, This workshop will show that if only parts of the personality, without the ANP, undergo the reprocessing, it can lead to a remarkable reduction of dangerous symptoms. The completing of the trauma reprocessing with the ANP can be postponed to the moment that the patient feels sufficiently stable.
Original Work Citation
Oppenheim, H.-J. (2010, June). The cutting must stop: A way out of the stabilisation versus reprocessing paradox with a DID-patient. Presentation at the 11th EMDR Europe Association Conference, Hamburg, Germany
“The cutting must stop: A way out of the stabilisation versus reprocessing paradox with a DID-patient,” Francine Shapiro Library, accessed September 27, 2020, https://emdria.omeka.net/items/show/19875.