A few months ago, my office was visited by a 43-year-old man (I call him Mikko here) who had started playing football at the age of eight. For him, it was a dear hobby for which he spent a lot of time and he also served as a coach for juniors. At the turn of last year, Mikko was found to have a tumor of considerable size and he quickly underwent two surgeries related to it, one of which involved him in life-threatening intensive care. In connection with the treatments, Mikko experienced fear of death, severe pain, wish of death, significant weight loss and muscle atrophy.
Four 60-minute EMDR therapy sessions were reserved for Mikko. Treatment focused on working on the anxiety, fear, and hopelessness caused by his situation. Mikko hoped to use eye movement therapy to find his joy in life and gain perspective on the future. At the last session, Mikko said that he was comfortable with the memories related to getting the diagnosis and the health care that followed. It was decided that the last session would be used for Mikko to process the fact that due to the complications caused by the surgeries it had become clear that he could no longer play football.
In eye movement therapy with Mikko, the phone call that Mikko had received from the surgeon who had operated on him two weeks earlier was chosen as the starting point for the target memory. During that call Mikko was told that his leg would never recover to the way it was before due to the damaged nerve. While answering the phone, Mikko was playing football with his daughter, and just before the call he had thought that he was really looking forward to muscle recovery.
I asked Mikko to focus on to the worst moment of the target memory, which for him was the disappointment he experienced at hearing that he could not continue playing. I instructed him to name a negative thought about himself related to that event and the representative image of it. Mikko said “I am lame and all hope of continuing football is lost”. Mikko chose “I survived it”as an alternative positive cognition to be related to the target memory, and he felt that its truthfulness before starting the desensitization was four on a scale of one to seven (1 = feels completely wrong and 7 = feels completely right). At the appointment, the target memory evoked feelings of sadness and injustice in Mikko, both on the mind and body level, and he felt that the intensity of the mental image’s disturbance related to the target memory was four on a scale of 0 to 10. His legs reacted strongly by twitching at the beginning of the processing.
Bilateral visual stimulation was initiated while Mikko was focusing on the target memory and attaching the negative thought about himself to it. Described below is the stepwise processing of Mikko's (M) mind as the bilateral stimulation (BLS) progresses and lasts approximately 20 to 30 seconds at a time. To reduce the length of the text, each step of the bilateral stimulation is not marked, but they always recur with the relatively same duration after Mikko's response:
M1: “The situation before the phone call. My daughter kicked the ball, I tried to catch it, had no grip at all. I thought I’d recover and my foot would get better and this would end"
M2: "The phone call… The surgeon said that the nerve is gone for sure, my anger rose, and I said that you didn’t tell that before, why do I get to hear this now."
M3: “After the phone call I wondered who to blame. Is it this surgeon or the surgery that failed?”
M4 (crying): “My daughter asks if I’m okay… We start walking home. I tell her that I don’t know if I’m going to recover, and I ask my daughter for a hug.”
M5: “We walk towards home. I apologize to my daughter for not being in the mood to talk. We stay silent.”
M6: “We arrive at home, and I call my wife. My wife says she doesn’t believe it and that she has a feeling that I’ll recover. But I don't feel it.”
M7: "I separated myself from that memory… Others say that muscles recover, but even if I get 50 % of them back, it doesn't mean I can do anything."
M 8: “I returned to the moment before the phone call, it was nice there, a pretty day with my daughter… That phone call then ruined it a bit.""
M 9: “I skipped that phone call, in the post-call state… that grief… a certain state… the losing of hope.”
M 10: “I was in that phone call. The doctor’s voice was not apologetic but correct. That contrast to what I felt was quite big.”
M 11: “I'm not actually in it. I remember the appearance of that surgeon and how they spoke.”
M 12: “On the phone… I just pondered that when I was told which nerves are damaged, everything was supposed to have been able to recover. And suddenly they are broken.”
M 13: “I thanked for the phone call and the information and said that it is better to know than to be uncertain. I tried to smile and remembered the hug that my daughter had given me.”
M 14: "It… on that journey I thought it had been nice, but I couldn’t do sudden movements. I thought that I can do things, but all the sudden moves are out of the game.”
M 15: "It makes me sad that even though I can coach, I can't show all the movements."
M 16: “I think of all sorts of things I can’t do.”
M 17: “I liked to play a one vs. one gimmick game with my daughter, I will miss it the most. I have funny memories of it.”
M 18: “I will move to these senior games of mine and there are those who can’t move.”
M 19: “It’s that… I do… It’s useless to go to games… Going there to stand… The only thing I can do is to pass… I don’t think I’ll continue.”
M 20: “I was supposed to go wrestling today and the intention was to cope there… I haven’t attended the practices. Now there are even more physical challenges.”
I ask him to return to the target memory and ask him what he notices now.
M 21: “I feel like I’ve dealt with it, it doesn’t evoke great emotions.”
M 22: "There is such disbelief and sorrow, when the surgeon said that these legs won’t return as before."
M 23: "I recalled how grateful I was for the surgeon to call, as it was already 7 pm. I thought it was nice that the surgeon uses their own time."
M 24: "I thought it could have been worse… but it was the worst possible news."
M 25: “That… As an outsider watching… That kind of phone call and getting bad news… You have to keep yourself together.”
M 26: “The fact that I have studied the nervous systems. I had a fear of what nerve it was. When the surgeon spoke, the sense of victory was lacking. Funny detail in it.”
I ask him to return to the target memory and ask for its disturbance on a scale of 0 to 10.
M 27: “It’s a sad thing… Maybe one.”
After neutralizing the target memory, Mikko and I checked the suitability of the positive cognition (“I survived it”) to the target memory, and he estimated it to fit and feel real as a six out of a scale of 1 to 7. The positive cognition was strengthened, during which Mikko gave feedback:
M 28: “What you can do about it.”
M 29: “My muscles have been strengthened, and I am able to do more and more things all the time.”
M 30: “There is clearly a possibility that there are new ways to do things.”
M 31: “I think that in wrestling when you get to practice actively, it is a greater victory for yourself that you can wrestle as physically challenged… and a greater humiliation for a friend.”
It took a total of 60 minutes to process the target memory into neutral and attach the positive cognition to it. Afterwards, Mikko described himself as calm and said he was feeling well and had a lighter mind. Finally, he stated: "Even though you aren’t able to, there’s always a chance."