Treating Trauma and Dissociation:
The Integrated Model of Trauma Detox Treatment Protocol
The Trauma Detox Treatment Protocol is an innovative approach to treating trauma and dissociation, integrating the 3 Phases of Trauma Treatment recommended by the International Society of the Study of Trauma and Dissociation (ISST-D) with the 8 modified phases of Eye Movement Desensitization and Reprocessing (EMDR), known as the progressive approach by Dolores Mosquera. This model emphasizes safety and individualization, recognizing that every person's body and mind respond uniquely to trauma.
The 3 Phases of Trauma Treatment
The ISST-D recommends a phased approach to trauma treatment to ensure effective and safe healing. These phases are:
1. Safety and Stabilization: The first phase focuses on establishing safety and stability in the patient's life. This includes creating a safe environment, developing trust between the therapist and client, and teaching coping skills to manage distressing symptoms. The goal is to stabilize the client's emotional and physical state, preparing them for deeper therapeutic work.
2.Trauma Processing: In this phase, clients begin to process their traumatic memories. The therapist uses various techniques to help clients confront and integrate these memories into their current understanding of themselves and their lives. This phase is often intense and requires careful pacing and monitoring to avoid overwhelming the client.
3. Reintegration and Rehabilitation: The final phase focuses on integrating the processed trauma into the client's life, helping them to develop a new sense of self and a new understanding of their experiences. This phase also involves building or rebuilding life skills, relationships, and activities that support the client's recovery and ongoing well-being.
The 8 Phases of EMDR: The Progressive Approach
EMDR is a structured therapeutic approach that involves eight distinct phases, with a slight modification by Dolores Mosquera, emphasizing preparation before history taking:
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Preparation: The therapist explains the EMDR process to the client, establishing a therapeutic alliance and teaching the client self-regulation techniques to manage distress during and between sessions.
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History Taking: The therapist gathers a detailed history of the client's past experiences and current symptoms, identifying targets for EMDR processing.
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Assessment: The therapist and client identify specific traumatic memories and associated negative beliefs. The client rates the distress related to these memories using the Subjective Units of Distress Scale (SUDS) and identifies positive beliefs they would like to adopt.
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Desensitization: The therapist uses bilateral stimulation (eye movements, taps, or tones) to help the client process the traumatic memory, reducing its emotional charge and associated distress.
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Installation: The therapist helps the client strengthen and integrate the positive belief identified in the assessment phase, reinforcing the new, healthier perspective.
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Body Scan: The client scans their body for residual tension or distress related to the processed memory, addressing any remaining physical sensations.
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Closure: The therapist ensures that the client is stabilized at the end of each session, using relaxation techniques and other self-regulation strategies to maintain safety and comfort.
Reevaluation: In subsequent sessions, the therapist assesses the client's progress, revisiting processed memories if necessary, and identifying new targets for EMDR
The Integrated Trauma Detox Treatment Protocol
The Trauma Detox Treatment Protocol combines these structured approaches into a comprehensive model with a foundation of safety and five phases:
1. Rapport: Building a strong therapeutic relationship based on trust, empathy, and understanding. This phase is crucial for establishing the foundation for effective treatment.
2. Regulation: Teaching and reinforcing self-regulation skills to help clients manage their emotional and physical responses to stress and trauma.
3. Reflection: Encouraging clients to reflect on their experiences, emotions, and behaviors, fostering self-awareness and insight.
4. Reprocessing: Utilizing EMDR and other trauma-processing techniques to address and integrate traumatic memories, reducing their impact on the client's present life.
5. Rediscovery: Supporting clients in rediscovering their authentic selves, developing a new sense of purpose, and building healthy relationships with themselves and others.
The Prevalence of Dissociation and the Science of Recovery
Dissociation is a common response to trauma, with a significant percentage of trauma survivors experiencing dissociative symptoms. According to Judith Herman, trauma can fragment the mind, leading to dissociative experiences as a way to cope with overwhelming stress. Frank Anderson emphasizes that understanding and addressing dissociation is critical for effective trauma treatment. Sandra Paulsen highlights the importance of tailored interventions that consider each client's unique experiences and responses to trauma.Research shows that with appropriate treatment, individuals can recover from trauma and dissociation. For instance, studies indicate that up to 90% of clients with dissociative identity disorder (DID) and other dissociative disorders show significant improvement with proper treatment. Therapeutic approaches like the Trauma Detox Treatment Protocol offer structured and individualized paths to healing, helping clients build resilience and achieve long-term recovery.
References
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Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror. Basic Books.
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Anderson, F. (2019). Transcending Trauma: Healing Complex PTSD with Internal Family Systems. Sounds True.
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Paulsen, S. (2009). Looking Through the Eyes of Trauma and Dissociation: An Illustrated Guide for EMDR Therapists and Clients. Bainbridge Institute for Integrative Psychology.
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Brand, B. L., & Loewenstein, R. J. (2010). Dissociative disorders: An overview of assessment, phenomenology, and treatment. Psychiatric Times.