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As eye movement desensitization and reprocessing (EMDR) has been increasingly applied in complex trauma-related disorders, including complex dissociative disorders, and trauma-related borderline personality disorder, EMDR practice may benefit from theories developed to account for the dissociative nature of these disorders, such as the theory of structural dissociation of the personality (TSDP). TSDP postulates that the personality of traumatized individuals is unduly divided in two basic types of dissociative subsystems or parts. One type involves dissociative parts primarily mediated by daily life action systems or motivational systems. The other type involves dissociative parts, fixated in traumatic memories, primarily mediated by the defense action system. The more severe and chronic the traumatization, the more dissociative parts can be expected to exist. This article presents the basics of TSDP, and a second article will provide guidelines for the treatment of complex trauma-related disorders based on this theory.
Keywords: dissociation; structural dissociation of the personality; dissociative disorders; EMDR (eye movement desensitization and reprocessing); integration; phase-oriented treatment
Eye movement desensitization and reproce ssing (EMDR) is an effective and empirically supported integrative psychotherapeutic approach for treatment of posttraumatic stress disorder (PTSD) and thus of traumatic memories (Bisson & Andrew, 2007; Foa, Keane, Friedman, & Cohen, 2009; Shapiro, 1995, 2001). Traumatic memories are sensorimotor, emotional experiences that relate to traumatizing events that survivors have not or not sufficiently integrated in their personality, that is, the dynamic biopsychosocial system that determines their characteristic mental and behavioral actions (cf., Allport, 1961; Van der Hart, Nijenhuis, & Steele, 2006).
EMDR is guided by the Adaptive Information Processing (AIP) model, which is highly applicable in the treatment of a wide range of disorders (Shapiro, 1995, 2001; Solomon & Shapiro, 2008). Initially steered by a Dissociative Disorders Task Force (Fine et al., 1995), EMDR is increasingly included in the treatment of complex trauma-related disorders. Such disorders include complex PTSD, trauma-related borderline personality disorder, dissociative identity disorder (DID), and dissociative disorder not otherwise specifi ed (DDNOS)-type 1 (clinical presentations similar to DID that fail to meet the full criteria for this disorder; American Psychiatric Association [APA], 1994, p. 490), that is, the most common form of dissociative disorder encountered in clinical practice (e.g., Johnson, Cohen, Kasen, & Brook, 2006; Sar, Akyüz, & Dog¢an, 2007). EMDR can...