EMDR therapy treatment of psychological trauma caused by intimate partner violence

In Finland, approximately one in three women has experienced physical or sexual violence in a relationship (European Union Agency for Fundamental Rights, 2014). Physical violence can include hitting, strangling, biting, scratching, holding, pushing, obstructing passage or sleep deprivation. Physical violence often starts with a seemingly small act but is apt to escalate over time as it repeats more seriously. Leaving a relationship significantly increases the risk of violence. Every year, around 20 women die in Finland because of intimate partner violence.

Being the target of violence is always a traumatic experience. It causes, among other things, fear, anxiety, insecurity, sleep difficulties, shame, worthlessness, suicidal behavior, and physical symptoms. You should seek help as early as possible if you are exposed to physical violence.

In this blog post, I discuss the recovery of my approximately 45-year-old client (I call her Rita) from psychological symptoms caused by intimate partner violence years ago. The events discussed in EMDR therapy had happened 15 years earlier and they had come back to mind when Rita got into the same social situation with her ex-husband. This activated trauma symptoms in Rita, the most central of which were uncontrollable feelings of anger, difficulty sleeping and states of fear.

The target memory chosen to be worked on included a situation where Rita's husband at the time had come home and started strangling Rita while she was lying in bed sleeping. I asked Ritta to focus on to the worst moment in the target memory, which for her was when she realized she wasn't getting oxygen. I guided her to name the negative thought about herself related to the event in question and the image it represents. Rita said: "I'm dying and I'm responsible". As an alternative positive cognition to be attached to the target memory, Rita said "I'll survive and I'm not responsible", and before starting the desensitization, the truth of it was felt on a scale of one to seven felt two (1 = feels completely wrong and 7 = feels completely right). In the beginning, the target memory evoked feelings of fear, sadness and anxiety in Rita on both the mental and physical levels, and she felt that the intensity of the feeling of disturbing the mental image related to the target memory was ten on a scale of 0-10. Her body shook and she wept profusely as she recalled it.

The bilateral stimulation with a visual stimulus was started when Rita was focusing on the target memory and associating a negative thought about herself with it. Below is described the processing of Rita's mind step by step as the bilateral stimulation (BLS) progresses and lasts approximately 20-30 seconds at a time. To reduce the length of the text, each phase of the bilateral stimulation is not marked, but they are repeated after Rita's feedback, always with relatively the same duration:

R1: "I have my heart in my throat and the other one is just squeezing and I'm waiting for it to stop."

BLS

R2: "It's like a film strip in the eyes. I remember all the other times of violence before that."

R3: "I'm looking forward to it because it turns heads upside down. I can't get it off. I just tried to keep my eyes closed, thinking that if it did, it would stop. I couldn't make a sound; I couldn't say anything."

R4: "I didn't think about anything other than what bad thing I have done that they want to kill me."

R5: "It felt like it was an eternity. Then he just suddenly let go."

R6: "Then I just tried to keep quiet so that I don't start crying and that he doesn't come back. I just kept quiet, hoping he wouldn't come back. Then I heard the front door open, and he left."

R7: "I was in a hell of a hurry to think where I would go. I just went to the child's room; I didn't dare say anything."

R8: “He didn't even say sorry; how can one be so cruel?”

R9: "How can a person be so terribly afraid. I tried to throw up, but I couldn't.

R10: "I looked in the toilet mirror and saw those fingerprints on my neck."

R11: “I somehow... I don't even remember what was going through my head. I was just in the children's room when I knew that it would never tell anyone what he had done."

R12: "In the morning when I woke up, I wonder if I imagined everything. The children wondered why I was sleeping there."

R13: "That moment.. I didn't even remember that moment of relief when that door opened, and I realized that it is possible for me to get out of this situation."

R14: "I looked at myself in that mirror and those fingerprints were visible there. The main thing was the feeling of relief that I was able to think about how to keep the other one away, so that he will never get the chance again."

R15: "The intuitive solution that I didn't oppose it was probably the right solution. I was able to think rationally about what I should do next.

R16: "After all, I was the one who decided what happened after that."

R17: "The thought was just that it was the last fucking trick you did to scare me."

R18: "Oddly enough, I've forgotten what a relief it was to make the decision to protect myself and the children from it. And I will stop protecting that man.”

R19: "I won't settle for anything poor."

R20: "That's when I decided to go to a doctor's visit in the morning, have photos taken of the injuries and create a safe email address to store them in."

R21: "How empowering it was to think that he no longer has power over my life."

R22: "There was no need to worry anymore, I can look ahead. Whatever."

R23: "I realised at that point that now I can let the scenery tear and fall down in peace."

R24: "You probably don’t ever need to be afraid of death anymore when you have survived. You will survive also in the future."

R25: "I feel that nothing really happens to me."

R26: "When I feel his hands on my neck and it squeals... I cover it a bit as if from the outside. I couldn't do anything”.

R27: "When that door opened and the feeling of relief came, I realised that there was no need to be afraid now. The fear of death disappeared."

I ask Rita to return to the target memory and ask how disturbing it is on a scale of 0-10

R28: "It seems radical to say zero, but I could say it because now I remembered things that I didn't remember right after that situation."

After the neutralization of the target memory, the applicability of the positive cognition ("I survived it and I'm not responsible") to the target memory was checked with Rita, and she judged that it was suitable for it. She estimated that the positive cognition feels real on a scale from one to seven as seven. The positive cognition was strengthened with three sets, in connection with which Rita gave feedback:

R29: "I was able to keep my life and I am not responsible."

R30: "I don't give a damn about small things."

R31: "I got the idea that no one can get rid of me that easily."

 

Rita said that she left the shared home with their children the day after the strangulation and she never again found herself in a situation where she would have been alone with her ex-spouse.

In Finland, you can find information about domestic violence and get help on the following pages, for example:

https://mieli.fi/vaikea-elamantilanne/vakivalta/vakivalta-satuttaa/

https://ensijaturvakotienliitto.fi/tukea-ammattilaiselle/perhe-ja-lahisuhdevakivalta/tunnista-vakivalta/

https://vaestoliitonterapia.fi/2020/07/23/pelko-ei-kuulu-rakkauteen/

 

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