Treatment of psychological trauma caused by workplace violence with EMDR therapy

Workplace violence refers to an event where a person is abused, verbally insulted or threatened in a situation related to their work. According to the national crime victim survey, approximately six percent of Finns experience threats or physical violence at their workplace or in their work duties every year. Workplace violence is more common than usual in nursing and social care professions, as well as security and restaurant professions. Situations of workplace violence increase an employee's risk of developing mental health problems and work burnout, and it has been found to significantly increase dissatisfaction at work as well. Workplace violence should not be taken lightly as part of a certain job description.

The case example for this blog post is a woman in her 30s (whom I'll call Nea here) who works as a schooling assistant for special children. Nea has an education in the field and, in connection with that, she has received training in case of workplace violence situations. Nea wanted to work on a memory at the reception where she had to calm down a child who had tried to harm themselves at work. In the situation, Nea had tried to stop the child by putting her hand in front of them, when the child had grabbed Nea's hand and bit it hard. The situation had subsided with the intervention of other people. The event had caused Nea psychological symptoms and increased caution at work. Her work motivation had significantly decreased and she considered changing her field.

I asked Nea to concentrate on the worst moment in the target memory, which for her was when she realized the child was biting her. I guided her to name the negative thought about herself related to the event in question and the image it represents. Nea said: "I am in danger and unsafe". As an alternative positive cognition to be attached to the target memory, Nea said "I got through it and I'm safe", and before starting the desensitization, its veracity felt on a scale of one to seven a five (1 = feels completely wrong and 7 = feels completely right). The target memory evoked feelings of fear, frustration and anger in Nea at the reception, both mentally and physically, and she felt that the intensity of the feeling of disturbance of the mental image related to the target memory was eight on a scale of 0-10. Her entire body tensed as he remembered it.

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

N1: "The student bangs their head against the wall several times and I make the decision to put a hand in between."


N2: "They have bitten me on the hand. At first I don't feel anything, but then there’s a stinging pain.”

N3: "I am really frustrated and angry.”

N4: "I'm really worried about how bad things have gotten."

N5: "I'm sitting at the doctor's office and I'm not even thinking about whether I need sick leave, but about how to get to work so I don't leave anyone in trouble."

N5: "I'm sitting at the doctor's office and I'm not even thinking about whether I need sick leave, but about how to get to work so I don't leave anyone in trouble."

N6: "I'm back at the workplace and I'm sitting across from that student, and they’re like nothing happened."

N7: "I'm really numb and feeling tired."

N8: "Still the same feeling. Thoughts just go back and forth in the same event."

N9: "My wrist hurts."

N10: "I notice that I'm not angry with that child, even though there are feelings of anger and disappointment on the surface."

N11: "I wonder how that situation happened so quickly. I was warned not to put your hand in front of it. And I still managed to put it in."

N12: "I really feel like a failure."

N13: "Maybe it's also frustrating on behalf of the child."

N14: "I notice how that student bites me."

N15: "My wrist hurts and I'm thinking about what I should have done differently when I shouldn't have been in that situation."

N16: "Somehow I feel like I don't even have the qualifications for those situations."

N17: "Very insecure."

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

N18: "Seven. When the skin was broken and it actually hurt."

N19: "That child is also frustrated."

N20: "My frustration might be because I sensed that child's frustration."

N21: "Somehow I just notice that the child is really restless."

N22: "Of course I'm really nervous."

N23: "Nothing new, same old."

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

N24: "One"

N25: "I have acted wrongly when I have thought of their best."

I make a cognitive intervention and ask Niina "Is it wrong?"

N26: “No.”

N27: "It bothers me that I didn't think about my own safety, only someone else's."

N28: "I have made a quick decision there and tried to resolve the situation."

N29: "It has been a really challenging situation."

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

N30: "Zero, it doesn't bother me anymore."

After neutralizing the target memory, the applicability of positive cognition ("I got through it and I'm safe") to the target memory was checked with Nea, and she judged it to be applicable and wanted to add the thought "I'm capable" to it. She estimates that the positive cognition feels real as seven on a scale of one to seven. Positive cognition was reinforced with two sets, in connection with which Nea gave feedback:

N31: "I have been safe. There has been a colleague and others at close range."

N32: "I have been able to act in the situation. I have made a quick decision."

At the time of finishing, Nea's shoulders and legs were still somewhat tense, and therefore the treatment was ended with a refuge exercise, with which the tension was released.

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