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Healing the Heart of Trauma & Dissociation, With EMDR & Ego State Therapy
Carol Forgash and Margaret Copeley (Eds.)
New York: Springer Publishing Company LLC,
(www.Springerpub.com) 2008, 347 pp., $40.00 (hardcover)

This review appeared in the American Journal of Clinical Hypnosis
Copyright © 2010 by the American Society of Clinical Hypnosis
53:1, July 2010

Carol Forgash, LCSW, BCD, is a psychotherapist in private practice in New York and is well regarded as an EMDR facilitator. She is an EMDRIA Approved Consultant, and she presents at workshops in the U.S. and internationally on the integration of EMDR with ego state therapy (EST) and psychodynamic treatment, complex PTSD and dissociative disorders. Forgash is a specialist in treating the complex health issues of sexual abuse survivors. Margaret Copeley, M.Ed., is a freelance editor specializing in the mental health fields.

This book consists of ten chapters, all of which have something to offer the therapist who is just beginning to explore trauma and all of its effects on the lives of those who have suffered trauma, from a single incident to repeated,
ongoing trauma since early childhood. There is also something for therapists who are well experienced in treating trauma and dissociation. All of the contributors are specialists in the field of trauma, and perhaps one of the best contributions is the forward by John G. Watkins, one of the founders of ego state therapy, as he gives a brief but thorough explanation of ego state therapy.

From the title of the book one might wonder why it is being included in the
AJCH. Where is the link to hypnosis? Maggie Phillips writes a chapter on Combining Hypnosis with EMDR and Ego State Therapy for Ego Strengthening in which she not only emphasizes the importance of ego state strengthening, but takes the reader through a step by step process for doing so, from introducing hypnosis to the EMDR patient to integration and closure, and she includes a brief case study for illustration.

A chapter by Michael C. Patterson explores the use of EMDR by presenting a case study of a police woman in Northern Ireland which provides another perspective on the use of EMDR from a Schema-Focused Cognitive Therapy approach – another way to look at Ego State Therapy. Jim Knipe presents a chapter on preserving emotional safety while using procedures to process dissociative processes, and Barry Litt presents EMDR as an ego state approach in working with couples.

Several chapters discuss the use of EMDR and EST in treating dissociation and dissociative disorders. There is a chapter by Joanne Twombly and Richard Schwartz that explains the use of the Internal Family Systems (IFS) model to strengthen the effectiveness of EMDR when it does not seem to be working. Although this reviewer’s experience with EMDR has been that EMDR is usually successful, it is also true that it does not always work for every patient. The authors of this chapter explain how, in those cases, IFS can help to enhance or enable EMDR processing.

I have saved my favorite chapter for last. Uri Bergmann gives us a beautifully
readable look at the neurobiology of dissociation and dissociative disorders. We are presently learning so much about the brain and how it works that our model is constantly changing. Bergmann manages to include brain anatomy and physiology, and he links this to the importance of early attachment in a very readable way, making the point that it is the physiological systems that will prove dissociative processes exist, given the nay-sayers and those who would discredit therapists as planting “false memories.”

This is not a “how to” book for those who have not had training in EMDR and/or Ego State Therapy. Forgash stresses the importance of being appropriately trained by the EMDR Institute and EMDRIA approved consultants. EMDR is also not something one can learn from a book, although there are those who have tried, and will continue to try to bypass professional workshops. This book does help to explain why professional training is important for the well-being of our patients, and also for us — professional psychotherapists. This read truly does have something for everyone who works with trauma and dissociative processes.

Reviewed by Cynthia Horacek, M.S.
California Lutheran University, Thousand
Oaks, CA

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Working with patients with complex PTSD and dissociation is a challenging endeavor. Trauma therapists need to continually find resources to broaden their clinical thinking and strategies. EMDR has been research proven as the best approach to trauma treatment. Yet there are survivors of relational trauma who have been so badly damaged by the cruelty of others that they need additional approaches as well. They suffer from inabilities to regulate their affect, their consciousness and self perceptions. Short on trust, these survivors need an even broader approach to their suffering.The editors have gathered many experts in the field who explain in clear informative ways how to expand the clinician's abilities to work with this terribly injured population. This book blends concepts from neurobiology, hypnosis, family systems theory and cognitive therapy to enhance treating this population. It is a well written book that the novice as well as the seasoned clinician can benefit from. As a trauma therapist of 30 years I found myself enriched by the various ideas and strategies presented. The addition of ego state work in combination with EMDR treatment offers hope to therapists who have hard to reach patients.

Mark Dworkin LCSW"
Author: EMDR and the Relational Imperative

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Mental health professionals will really appreciate this informative text. Although it conveys complex concepts that will be of interest to seasoned therapists, it does so with a clarity that will appeal to the novice as well. Case examples, step by step protocols, research findings and comprehensive theoretical explanations deliver the information off the page and into the clinician's office. I bought this text because I practice both EMDR and Ego State Therapy but I have not yet seen a text that addresses both (although there are many books that cover each of these topics separately). I was not disappointed. Dissociation - a common symptom of trauma syndromes - is explained and addressed so that therapists can actually work with the phenomenon instead of pretending it doesn't exist! This is really a wonderful text with many excellent ideas and I highly recommend it to anyone who treats trauma (which means, any psychotherapist or counselor!).

Sarah Chana Radcliffe, M.Ed.,C.Psych.Assoc.
Author: Raise Your Kids without Raising Your Voice

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In the Journal of EMDR Practice and Research: Volume 3, Number 3. 2009
Carol Forgash and Margaret Copeley have created a very important book for clinicians and educators. The topics of trauma and dissociation in and of themselves can be complicated. Forgash and Copeley address dual treatment approach, EMDR and Ego State therapy, for these disorders in an organized, clear and thorough fashion. This book is not a quick read. Packed with useful information, it can be read and re-read. The collective amount of years in the field of these authors is over 200. All of the authors have extensive clinical, teaching and writing experience. It showed! I was most impressed with the seamless integration of the various authors’ chapters with the overall focus of the book. In addition to presenting complex information in an understandable format, the authors also provide practical interventions for readers to implement. The case examples and session transcripts throughout the book create an excellent bridge from theory to practice.

In Chapter One, Forgash and Copeley lay an important foundation for the reader, with an historical review of both EMDR and Ego State Therapy as they relate to Trauma and Dissociation. It also includes theoretical and technical explanations of both modalities. The other chapters include topics about Hypnosis, Personality Disorders, Couples Therapy, Family Systems, Neurobiology of Dissociation, and Collaborative Treatment. Each chapter provides an extensive bibliography. The book offers a definition of terms, which helps provide additional clarity. Standard EMDR protocols are referenced, along with a description of the Adaptive Information Processing Model. Each chapter maintains a strong emphasis on proper preparation and preserving emotional safety for this complex group of clients. Readers will learn how to deal with the pitfalls that occur when treating those who suffer from complex traumas as well as gain an understanding of integrating Ego State Treatment into the Eight-phase EMDR protocol. This unique and comprehensive treatment approach extends EMDR’s reach to a broader population, clients with the most severe trauma-related disorders. This book is so packed with information it can be a challenge to get through. The editors covered many topics. There were times I wanted a chapter to give more examples and tools, before moving on to the next topic.

As a veteran clinician of 25 years, I obtained important information and clarity about the relationship between Trauma and Dissociation. I was able to implement the authors’ suggestions immediately based on my clients’ needs. EMDR trained clinicians will especially benefit in having this as a text to refer to repeatedly. A new therapist will be able to assess their clients in a more thorough way with this important updated information. This book helps therapists build a strong base of knowledge and experience with practical guidelines and easy to use interventions.

I believe this book is a significant contribution to the fields of Psychology and EMDR. It is the first of its kind. It would be an excellent addition to Clinical and Counseling Graduate Programs. The thoughtful presentation of a phased treatment model for Trauma and Dissociation using EMDR and Ego State Therapy gives us hope in bringing healing to a broader range of challenging clients. I believe that anyone who reads this will gain greater confidence in using EMDR and Ego State Therapy with highly dissociative and complicated clients. I applaud this team of clinicians who have helped all of us gain greater insights and skills!

Sara G. Gilman, MFT
Encinitas, CA

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