EMDR therapy in the treatment of anxiety caused by appearance pressures related to skating training

Figure skating is often associated with pressures related to both appearance and physique. According to a sports federation survey published last year by the Finnish Figure Skating Association, 53% of 438 skaters had experienced pressure related to their appearance in connection with skating. In recent years, at least Kiira Korpi and Emmi Peltonen have talked about the topic publicly in Finland. This blog post discusses a skater’s experience of sport-related appearance pressures and their impact on a sports career. Here I will call the skater Jutta.

Jutta is a 30-year-old woman who has done very well in skating nationally and internationally. Jutta has applied for EMDR therapy to address the pressures and demands of her skating career on body composition and appearance. Jutta has felt dissatisfied with her appearance her whole life, the effects of which have been reflected in her relationships.

Recently, Jutta’s experiences of finding herself bulky and muscular have been emphasized. She has experienced severe anxiety and despair as a result. In the treatment situation I asked Jutta to slip back in time to memories as early as she could. Memories accompanied by the same bodily experience of dissatisfaction and unworthiness. Jutta described the situation selected as the target memory as follows:

“I’m at the ice rink and we’re practicing jumping. We practiced one after another. The coach had the kind of device with which he assisted in the jumps. However, the coach refused to assist me because he thought that I was too heavy for the individual sport. I remember him telling me I was too big and not letting me practice jumping. I also remember we had these sticker sheets on the wall and a skater always got a sticker after a successful jump. I didn’t get them."  

I asked Jutta to focus on the worst moment of the target memory, which to her were the words of the coach about her being too heavy. I instructed her to name a negative thought about herself related to that event and the image that represented it. Jutta said: “I’m fat.” As an alternative, positive cognition to be associated with the target memory, Jutta chose “I’m pretty normal”. Its veracity felt like a two on a scale of one to seven before starting desensitization (1 = feels completely wrong and 7 = feels completely right). The target memory evoked feelings of anger, sadness, and self-loathing in Jutta, both at the mind and body level, and she felt that the intensity of the disturbance of the image associated with the target memory was a 9 on a scale of 0 to 10. She described her bodily experience as “nauseating”.

Mutual stimulation given with visual stimulus was initiated as Jutta was focusing on the target memory and attaching to it a negative thought of herself. The stepwise processing of Jutta's (J) mind as bilateral stimulation (BLS) progresses and lasts for approximately 20-30 seconds at a time is described below. To reduce the length of the text, not every step of the bilateral stimulation is marked, but they always repeat after feedback given by Juta at relatively the same duration:

 

J1: "It's really lonely."

BLS

J2: “Still the same kind. And there’s this feeling that you’re invisible in all that’s happening.”

J3: "That kind of stuff just feels very unfair when you’re so small."

J4: "Nothing new."

J5: "It just feels really distressing."

J6: "You get this feeling of just wanting to hide or go under the blanket."

J7: "It just spins in the loop."

J8: “Feeling like you might just say screw it and go away. It’s really hard to describe emotions.”

J9: “I jump a little out of the memory. I speak like an adult to that child me.”

J10: "I make kinda like a comforting speech to myself."

J11: "It feels little calmer."

J12: “Uppermost is a kind of irritation because I knew I was really good. And they condemned me because I weighed a few kilograms more than the others... that memory somehow disappears again.”

J13: "I notice I'm starting to jump out of that memory."

Therapist: How disturbing does the event now feel on a scale of 0 to 10?”

J14: “Feels kind of empty. Like 2-3, I notice that my hands are nifty. I can't catch that memory anymore.”

J15: “Maybe I’m bothered by the fact that I wasn’t able to speak or leave. When you are so small, you are content with fate.”

J16: "Nothing new comes to mind, that's it."

J17: "I remember practicing other things while the others jumped."

J18: "Suddenly it occurred to me that I wasn't the only one who wasn't allowed to practice jumping."

J19: “Somehow I’ve always seen a certain picture of me and the coach. Now the whole ice kind of like opened. There were others and they couldn’t practice jumping. They were the ones whose size was also commented on."

J20: “Nothing new. The view is clearer.”

J21: "It calmed down, the whole memory."

J22: "I feel like crying, it feels like a weight was lifted off.”

J23: “As if something had lifted off of the chest, I feel light. It's starting to go away, the whole memory.”

J24: "It just goes away, I can't catch it anymore."

Therapist: "How disturbing does the event now feel on a scale of 0-10?"

J25: “Zero.”

After neutralizing the target memory, Jutta was checked for the suitability of positive cognition (“I am normal”) for the target memory, and she judged it to be suitable and feel real on a scale of one to seven as a 4 to 5. Positive cognition was strengthened, while Jutta was giving feedback:

J26: “It returned back to that bright memory again, the one that was there at the end. And then there were those other skaters.”

J27: “It only gets stronger, the fact that the coach had a focus on those few skaters. You start forgiving yourself for the situation.”

J28: “The truth of the cognition is around 7. That memory is kinda normal.”

J29: “That experience influenced the development of the whole sports for me. I stopped solo skating at the age of six and switched to figure skating, which I still continue. We are the best in Finland in that.”

J30: “As a child, skating is playing! Or at least it should be.”

 

At the time of the incident, Jutta was four years old. She had started skating at the age of three.

 

Additional information:

https://www.stll.fi/wp-content/uploads/sites/4/2021/08/Taitoluistelun_lajikulttuuritutkimus_2021.pdf

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