Dissociation is when the brain’s defenses decide to mess with our sense of present awareness and orientation. A dissociative state can be experienced in several different ways however the main concern while participating in EMDR processing is the sense of losing control in the present moment. Whether that loss of control comes from “spacing out” or by experiencing a sense of emotional overwhelm from newly-emerging traumatic material, we can take measures to make sure dissociation does not interrupt the therapeutic process.
Therefore, the following resource is provide so that both therapist and client and know when the client is drifting into a state of derealization—or, when the client is losing the felt sense of reality and safety in the present situation.
The Back of The Head Scale
Think of a line that starts about 15 inches in front of your face and runs to the back of your head.
For our purposes we will use the point on the line farthest from your face to represent that you are completely aware of being present with me here in our therapeutic space. In this state you can easily listen to what I am saying, and you are not distracted by any other thoughts. You are completely present.
Now, we are going to use the other end of the line—the end at the back of your head indicate you are so distracted by disturbing thoughts, feelings, or memory pictures that you feel like you are somewhere else. Your eyes may be open but your thoughts and your awareness are completely focused on another time, place, or experience.
While we engage in processing I may check in with you from time to time and have you indicate with your finger where on this imaginary line you are.
As a rule of thumb it is necessary for you to be able to point to a position at least 3 inches or so in front of your face in order for effective trauma-focused work to proceed.
Comments