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CLINICAL Q&A How to Use Fraser's Dissociative Table Technique To CLINICAL Q&A How to Use Fraser’s Dissociative Table Technique to Access and Work With Emotional Parts of the Personality Kathleen M. Martin Rochester, NY This Clinical Q&A article responds to a question about what process to use to access and identify ego states when working with complex trauma. The procedure for implementing Fraser’s Dissociative Table Technique is explained and detailed in 8 clearly defined steps. The author builds on Fraser’s original in- structions and adds several innovations for use by EMDR therapists. Tips on implementing this technique are given. The article then concludes with a session transcript to illustrate the use of this powerful tool. Keywords: eye movement desensitization and reprocessing (EMDR); emotional part of the personality (EP); apparently normal part of the personality (ANP); dissociative table; meeting place Question: I have read about the importance of working a must-have tool for clinicians working with complex with ego states when working with complex trauma. trauma. It is a tool that needs to be used within the Is there a process that is best used to identify ego larger framework of a phase-oriented approach to the states? If so, what is this process and how do I use it? treatment of complex trauma and dissociation. The use of this tool requires that the clinician is knowl- ANSWER: edgeable in the treatment of dissociative disorders (Fraser, 1991, 2003; Paulsen, 2009). If you are new to Identifying and working with emotional parts (EPs; working with internal parts of the personality and dis- van der Hart, Nijenhuis, & Steele, 2006) of the per- sociation, it is essential that you receive training and sonality is essential when working with complex consultation from a clinician experienced with this trauma and dissociation. EPs of the personality are technique as well as the diagnosis and treatment of like isolated neural networks carrying the maladap- dissociative disorders. Using this technique too soon tively stored information. These EPs live in “trauma with some clients with significant dissociative disor- time.” When they are activated, they experience the ders, particularly dissociative identity disorder, can be affect, negative cognitions, behaviors, thought pro- problematic. Getting good supervision while working cesses, action urges, and so forth, which are stored in with this population cannot be emphasized enough. the unhealed traumas and typically are not correctly There are eight steps to this technique. I will detail time oriented early in treatment. These EPs contrib- these steps with specific instructions and give you tips ute to the client’s instability and repetition of the mal- on implementing them. adaptive behaviors and self-beliefs. Gaining access, The most common place an eye movement de- identifying, communicating and working with these sensitization and reprocessing (EMDR) clinician will parts are necessary in preparation for effective trauma introduce Fraser’s dissociative table technique is in reprocessing. Phase 2 of the EMDR standard protocol. In this prepa- An easy yet profound way to identify these parts of ration phase for trauma reprocessing, the dissociative the personality is a process called Fraser’s Dissociative table helps stabilize the client by organizing and mak- Table Technique (Fraser 1991, 2003). This technique is ing sense of the internal experience. As parts of the Journal of EMDR Practice and Research, Volume 6, Number 4, 2012 179 © 2012 EMDR International Association http://dx.doi.org/10.1891/1933-3196.6.4.179 personality are accessed and identified, the work to of me feels sad and another part feels mad” or “On help them understand their roles, functions, interre- one hand I want this but on the other hand I want lationships, and so forth helps the adult part of the that.” This does not mean you have multiple person- personality (apparently normal part or ANP; van der alities. It just means you have conflicting internal ex- Hart et al., 2006) gain more understanding and com- periences. It will be helpful to identify these various passion for these EPs. Time-orientation techniques factions of yourself to help us resolve the issues you are frequently used at the table, which contributes to want to resolve. Are you willing to give it a try? more stabilization. This preparation work at the dis- Step 2: Establish that your client can visualize sociative table makes Phase 4 trauma reprocessing go Fraser states that people who cannot visualize cannot more efficiently. do this technique (personal communication, G. A. If the table was not introduced in Phase 2, some- Fraser, October 30, 2009). Most people are visual- times it will be introduced when Phase 4 trauma izers but you will come across a few who aren’t. If reprocessing has been hijacked by an emotional part you have already developed and installed safe place, outside the window of tolerance. No integration of you know your client is a visualizer so this step is traumatic material can happen when the client is hy- complete. If you have not installed safe place or poaroused or hyperaroused. Gaining access to the other imagining skills to calm and stabilize, take the emotional part(s) under this condition can help the time to do this. If your client cannot visualize, you clinician assess the situation and work directly with must alter the rest of this technique by eliminating the part(s) who needs the stabilization work before all instructions to visualize and replace them with returning to the trauma reprocessing. instructions to list the various aspects of self. Once the table has been introduced, it can be used to help close down incomplete sessions and to check Step 3: Get your client in a calm state in with the internal experience at the beginning of Fraser did not list this as a separate step in his articles the next session. The table can be a place to negoti- (Fraser, 1991, 2003). He only explained the previous ate among the parts regarding what will be worked step to assess that your client can visualize by using on in the session, what parts need to be present for imagination to calm. If successful, then the client that work, and identify necessary stabilization needs. entered a calm state. EMDR clinicians are trained For example, a common question that is asked at the in the EMDR Basic Training to administer the safe table before returning to Phase 4 trauma reprocessing place technique in Phase 2 of the EMDR standard is, “What will be helpful for you to remember that protocol (Shapiro, 2001). Therefore, EMDR clini- this is a memory that we are working on and it is not cians develop and install a safe place with their happening now?” clients early in treatment. I recommend this is done The dissociative table is an 8-step process. Here are before considering the dissociative table with a cli- the steps: ent. Clinicians need to know their client can calm and get themselves out of disturbance to help them Step 1: Psychoeducation and introduction assess when the client is ready for the dissociative To start, educate the client on the process. The intro- table. This also establishes that the client can visual- duction can normalize the fact that people have ize, thus completing Step 2 of Fraser’s dissociative “parts.” This does not mean that people with parts table technique. So, when it is time to do the disso- have a significant dissociative disorder. Do not ciative table, Step 2 has already been accomplished. make the mistake of diagnosing someone with a But it is still necessary to get your client into a calm significant dissociative disorder if parts are identified state so I have added this as a separate step. Simply in this process. This is not a screening tool for dis- ask your client to go to the safe place imagery, take sociation; this is a tool to identify and communicate a few calming breaths or use another calming skill with unhealed fragments of self that are still locked the client likes. An internal calm state decreases the in “trauma time.” adult part’s (ANP) resistance to the EPs and increas- A typical script to educate and introduce the client to es the EPs’ willingness to participate and become the process is present. If the client is activated into dysfunction- we need to find a way to communicate with all the ally stored material, this technique will be harder to various aspects of you. Everyone has “parts” or implement as fewer parts may be willing to come “ facets” of self. These parts vie for airtime and con- to the table. You will have to work to deactivate tribute to the conflicting feelings and chronic struggles the distress before you can return to identifying that you have. You’ve heard the language: “One part the parts. 180 Journal of EMDR Practice and Research, Volume 6, Number 4, 2012 Martin Step 4: Develop the table/meeting place imagery develop a separate image to keep safe place imagery Fraser uses instructions to develop imagery of an available for calming. internal table. The instructions are Step 6: Instruct the adult part of self to enter the now I’d like you to leave your calm place and imagine imagery and take his or her place a room with a table in it. This room is pleasant where Ask the adult part of self to imagine going into the no harm can come to you. The table in this room is room and take his or her place at the table. A typical a special table. It can be as big or small as you need, script is with just the right number of chairs.
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