Joanne Twombly, an author and expert on dissociation and trauma treatment, shares her deep insights on addressing complex PTSD and dissociative disorders. She discusses the integration of EMDR and Internal Family Systems (IFS), highlighting its unique benefits. Joanne emphasizes the importance of relationships in healing and advocates for flexible diagnoses to better support clients. The chat also delves into the complexities of trauma, emotional safety in therapy, and the interconnectivity of one's internal selves, making for a compelling and informative conversation.
Understanding dissociation is essential for therapists, as many lack the necessary training to effectively recognize and treat these disorders.
Integrating EMDR and IFS methodologies can enhance therapeutic approaches, as both offer unique perspectives on managing dissociative symptoms.
Deep dives
The Importance of Understanding Dissociation
Dissociation is a critical aspect of complex PTSD that is often overlooked in therapeutic settings. Many trauma therapists lack adequate training to recognize and address dissociative disorders, leading to ineffective treatments for clients who need specialized care. For instance, one individual mentioned undergoing eight separate therapies without receiving the help needed for their dissociation. This highlights a significant gap in mental health care, underscoring the urgency for therapists to be educated about dissociative symptoms and disorders.
Differing Approaches to EMDR and IFS
The podcast discusses contrasting methodologies between EMDR (Eye Movement Desensitization and Reprocessing) and IFS (Internal Family Systems) when dealing with dissociation. EMDR initially created barriers to engaging with dissociative clients due to concerns about handling such complexities, while IFS's broader perspective may inadvertently lead to oversights in client care. For example, EMDR emphasizes caution around dissociation, advising therapists to refer clients out if signs are present, whereas IFS assumes all parts can be engaged without specific training. This difference demonstrates the need for therapists to integrate knowledge from both approaches to effectively support clients.
Building a Therapeutic Relationship
The therapeutic relationship is crucial for clients dealing with dissociative disorders, and it must be approached with care and sensitivity. Establishing warm, trusting connections can be therapeutic, but too much warmth might trigger fears of manipulation in clients who have experienced trauma. Therefore, therapists should balance emotional expression, acknowledging a range of feelings while ensuring the client feels safe. This nuanced approach helps clients gradually learn to trust their therapist while managing their fears rooted in past experiences.
The Role of Coping Skills in Therapy
Coping skills play a significant role in the treatment of clients with dissociative disorders, although there is debate about their implementation. Some perspectives, particularly in IFS, suggest that emphasizing coping skills can undermine the self-management of clients' internal systems. However, it can be argued that clients need coping mechanisms to manage overwhelming feelings and experiences, as dissociation often prevents them from effectively processing trauma. Attention to these skills empowers clients and contributes to their overall healing process.
It was such an honor to have Joanne Twombly on the podcast! We speak about dissociation, and also about the integration of IFS and EMDR. Joanne wrote the first article with RIchard Schwartz that connected these two models.
She also has written "Trauma and Dissociation Informed Internal Family Systems: How to Successfully Treat Complex PTSD and Dissociative Disorders." This book was transformative for my work. In a clear and interested way, Joanne was able to share necessary information, so that we as therapist are able to better understand how to recognize and help people struggling with dissociation.
There were so many questions to ask, and Joanne was so gracious with her time, that I felt we could divide this conversation into two parts. In a day or two, I will publish the next section, so you can hear part two of our conversation.
I hope you enjoy this conversation as much as I enjoyed having it :)
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