The case covered here is presented with the permission of the person in question, as always in my blogs. This person (I call her Sanna here) came to my office for EMDR therapy with a referral from a psychiatrist for her to be able to address the underlying factors of her sleeping difficulties, recurring nightmares, motoric restlessness, and depression. When she came for treatment, Sanna was a 36-year-old entrepreneur. Already for eight years then, she had had panic attacks and had been hospitalized for them, as well as she had gone through three years of psychotherapy, which she had found useful. Nevertheless, the mental symptoms continued.
Sanna told me she had experienced outsiderness and inferiority from elementary school onwards. She had been a so-called ‘girl with excellent grades’. Sanna’s parents had been absent a lot in her childhood, and she felt like she had spent a lot of time alone. At school, Sanna had felt that she was often left out of her friends’ games, and no one helped her. The teachers were aware of the situation, but in Sanna’s experience, they downplayed it. Sanna had similar experiences during her studies. She was shy and sensitive and often felt that she was not part of the group at all. She had strong fears that no one likes her. At the time of entering treatment, Sanna was living in a relationship, but her relationship was overshadowed by the difficulty of trusting her partner and a constant feeling of being alert. From the treatment, Sanna hoped to get tools to calm herself and some connection between her body and mind. At the start of the treatment, she was assessed to have moderate depression with experience of failure, self-loathing, strong self-criticism, irritability, and crying sensitivity. Sanna also had several typical psychosomatic symptoms caused by bullying, such as sleeping difficulties, headaches, chest pressure, muscle tension and so-called freezing up of the body.
Sanna’s referral consisted of 20 treatments (45 min at a time, some of which were done as 90-minute sessions). EMDR therapy was started by activating the above-mentioned body sensations and anxiety in Sanna. Sanna related a negative cognition of “I am bad and defective” to this experience. I asked her to slide in her mind, that is, to go back in time with that body feeling and negative cognition to the memories and events where this same experience appeared. In her mind, Sanna slid back in time to elementary school and to the situation where she had stood alone in the school yard. She hoped to be able to think of herself “I am good and sufficient”in relation to that memory. On an emotional level, the realness of it felt like a three on a scale of 1 to 7 (feels completely wrong - feels completely real). The target memory evoked feelings of sadness and disappointment in Sanna, and it felt as e.g. tension especially in the facial area. The disturbance of the target memory was 8 out of 10 at the beginning of the treatment. During the first therapy session, the disturbance of the target memory decreased to three, and at the end of the appointment a safe place exercise was performed to calm the body and mind.
At the second therapy session, Sanna said she had had restless dreams during the break. It was obvious that the processing of the bullying memories continued in Sanna’s dreams. She attached experience of outsiderness and defectivity to them more strongly than before. However, the second therapy session was sufficient in reducing the disturbance of the event in the first target memory to zero (not disturbing) and the reality of the positive cognition attached to it increased to five.
At the following therapy sessions, Sanna's bullying memories were processed one at a time. The negative cognition was usually “I am bad, defective” or “I’m not good enough”. The target memories included e.g. events where Sanna had come home from school and cried alone at home as a result of the day's bullying experiences and the situation where she had given a presentation in front of the classroom and the others had giggled at her, as well as the situation where she had sat alone in the classroom and the numerous times she had walked down the school hallway and had been exposed to name-calling and disdain. The emotions evoked by Sanna’s memories were usually sadness, fear, self-loathing, shame, and anger. The disturbance of each target memory before it was desensitized was usually a 7 or 8. After seven therapy sessions with relatively the same content but targeted to different target memories, Sanna said she was feeling more balanced. She felt the reactivity of her body had decreased and she had gained more self-confidence. However, she said that she keeps having dreams with the elements of fear and alertness from time to time.
Then the therapy proceeded to process the difficult and present time disturbing memories related to parental absence. The topic of them was related to very similar subjects as in the memories of bullying: “I am insufficient”, “I am not good enough”, “I am bad” , and the target memories having to do with being alone.
Sanna's therapy was carried out very regularly, with appointments once a week. She was highly motivated to the treatment and worked on subjects well in therapy. All the therapy sessions were carried out remotely via video due to the corona pandemic, we never met face to face. However, I always made sure that Sanna was feeling safe and had a calm space when communicating from home. At the end of the last appointment, I asked Sanna to describe the spectrum of memories we had processed. She told:
“I can see those events further away… I see them as if from afar… I feel calm. I am important and valuable… I have the right to be here and the right to be who I am…
This is the most impressive thing I have ever done.”