Private Practitioner D. Michael Coy, MA, LCSW, LICSW Bremerton, Washington, United States
Abstract The EMDR therapy and dissociative disorders literatures have established that ego state interventions can be both helpful and frequently necessary to achieve stabilization/containment, adaptive resolution of traumatic experience, and integration of treatment gains. Of particular concern in the treatment of persons with complex trauma and dissociative disorders are persecutory ego states such as ‘perpetrator introjects.’ Perpetrator introjects are born out of experiences of neglect/abuse and subjectively serve, among other things, as a buffer against realization of the intensity and inescapability of the harm. However, this buffering is usually achieved in ways that are paradoxical, mirroring the original harm rather than actual safety. The harm that can result from these states’ activity poses particular challenges for, and thus requires special attention, in treatment.
The literature reflects work perpetrator introjects that focuses upon orienting them to present realities, persuading them to ‘stand down’ or reconsider/realign how they protect, and helping other states feel less afraid of them. However, many of these interventions also present conceptual and/or practical issues that can make it difficult to achieve or maintain treatment gains with some clients who present with more complex trauma and severe dissociation. This presentation will begin with a discussion of the development of perpetrator introjects, as well as their function within and impacts upon a self-system. Existing approaches to working with perpetrator introjects and similar states will be discussed and examined. In the second half of the presentation, the focus will pivot toward elaborating the Id Protocol, a novel, yet effective, integrative EMDR therapy approach developed by the author, which permanently ‘unbinds’ perpetrator introjects from the traumatic material in which they are seemingly, inexorably bound. The protocol will be described across EMDR’s eight phases, with precautions for its use and modifications of the standard EMDR treatment protocol highlighted. A case example will illustrate its phase-by-phase employment.
Learning Objectives:
At the conclusion of this session participants will be able to:
Summarize the hypothesized phenomena underlying the development of a perpetrator introject
Name at least one ‘parts’-informed therapy and one integration-facilitating mechanism used to work with perpetrator-identifying self-states
Describe two reasons that mapping a client’s self-system early in treatment may be helpful
Identify at least two precautions for employing the Introject Decathexis protocol
Enumerate the six components of the Introject Decathexis protocol