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CHAPTER SEVEN: Jane: EMDR and psychotherapy with a traumatized and abused woman

Mollon, Phil Karnac Books ePub

Jane was a thirty-five-year-old Dutch woman with a background of drug abuse and chaotic relationships involving violence from men. For a brief period her three young children had been taken into care, but were now living with her again. She had managed to establish a more settled way of life, free of drugs, but was still troubled by traumatic events of the past during the time when she lived in a crime-ridden area of Amsterdam. She felt fearful much of the time, and showed continuing symptoms of PTSD. Her childhood had involved some sexual abuse by her brother. She had felt close to her mother, but perceived her as needy and neglectful. Her relationship with her father had been distant, and her parents had separated when she was aged fifteen. Jane had undergone counselling previously, with some benefit. We agreed to proceed with a few sessions of EMDR, focused initially on the sexual abuse by her brother.

Overall narrative revealed by EMDR

Although the ensuing narrative is not simple and linear, the overall story of Jane’s life emerges very clearly in these ten EMDR sessions. Thus, she felt neglected and unprotected as a child, desperately wanting her mother’s love, yet experiencing her mother as manipulative and “flighty”. She experienced her father as violent and frightening. Her brother sexually abused her. Further abuse and trauma occurred in sexual relationships in her teens. She became cynical and promiscuous. Her emotional pain and traumatic stress were blocked with extensive use of alcohol and drugs. Rage at her mother is a recurrent theme in the EMDR sessions. She also manages to report (more directly than she ever had before, apparently) specific episodes of abuse and trauma—experiencing relief as the emotions are abreacted through the eye movements. Her awareness of the defensive function of her drug and alcohol abuse becomes clearer as a result of the EMDR.

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CHAPTER EIGHT: Brief case illustrations

Mollon, Phil Karnac Books ePub

A wide variety of cases are described in the following pages, including rape trauma, phobia, depression and low selfesteem, sexual difficulties, the aftermath of divorce, obsessive-compulsive disorder, fetishism, and self-harm. Most involve the use of EMDR, some combine EMDR and EFT, and two are based entirely around EFT. The style of work does not always follow the original protocols for EMDR1 (Shapiro, 2002a) or for EFT (as taught by Gary Craig, www.emofree.com), whereby the various elements of a trauma are accessed and desensitized until the subjective units of disturbance (SUDs) are reduced to zero. Instead, the EMDR is used as a general facilitation of free association and emotion-processing. It is used both to explore and to process the emerging emotions and psychodynamic conflicts. At times the emotional details and core psychodynamics elicited by EMDR are then “tapped” using EFT in order to bring about a more complete resolution. In every instance the content provided by the therapist is minimal. These methods facilitate the client’s own healing process and require skill but little interpretative content from the therapist. Indeed anything more than an occasional interpretation from the therapist would obstruct the client’s process. Perhaps partly because of this facilitating but unobtrusive stance from the therapist, phenomena of transference, while not absent, are not prominent and, certainly, transference is not the vehicle of treatment.

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Chapter Six: Principles of Psychotherapy with ADHD

Mollon, Phil Karnac Books ePub

In pondering the principles of psychotherapy with this client group, it may be helpful first to explore some basic psychoanalytic considerations. Whilst cognitive–behavioural therapy (CBT) is generally assumed to be the most appropriate therapy for people with ADHD (Philipsen, 2012), a broadly psychoanalytically informed approach, taking account of ego functioning more generally (Bellak et al., 1973; Blanck, 1966; Blanck & Blanck, 1974, 1979; Hurry, 1998; Mollon, 1979), has much to offer as an encompassing framework and can take us more deeply into core aspects.

In his final account of psychoanalysis, Freud (1940a) summarised the therapeutic task as one of assisting a weak ego:

The ego is weakened by the internal conflict and we must go to its help. The position is like that in a civil war which has to be decided by the assistance of an ally from outside. The analytic physician and the patient's weakened ego, basing themselves on the real external world, have to band themselves together into a party against the enemies, the instinctual demands of the id and conscientious demands of the super-ego. (p. 173)

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CHAPTER THREE: What happens during an EMDR session?

Mollon, Phil Karnac Books ePub

C linicians who are familiar only with conventional (psycho-analytically derived) verbal psychotherapy may experience difficulty in grasping what takes place during eye movement desensitization and reprocessing (or the procedurally similar methods of “energy psychology”). Those from a behavioural or cognitive background may be misled by the word “desensitization” in the name; this may give the impression that EMDR is a variant of behavioural desensitization therapy, which indeed initially it was. Although Francine Shapiro, a cognitive-behavioural clinical psychologist and originator of EMDR, first developed the method as a treatment for post traumatic stress disorder, she soon found that much more than desensitization was occurring and that the method revealed much about aspects of the structure of the mind and its processing of emotional information. Ironically, what began as a quasi-behavioural treatment for anxiety took Shapiro back to phenomena that Freud had been exploring a hundred years previously—particularly free association, the unconscious, networks of memory, the layering of traumatic experience, the representation of trauma in the body, and the importance of intrapsychic processing. She also discovered something new and astonishing—that given a little help, the mind has its own natural healing process. This feature of the mind is quite at odds with assumptions that have been prevalent in many areas of psychoanalysis; e.g. that the minds of many patients are in the grip of destructive and anti-developmental forces. What EMDR reveals is that the apparently destructive dynamics and organizations of the mind are functioning as defences against unbearable pain and anxiety.1

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Chapter Ten: Subtle Energetic Aspects of ADHD: Reversed and Scrambled Energy Fields and Yin–yang Imbalance

Mollon, Phil Karnac Books ePub

In writing of “subtle energetic aspects”, I am referring both to the energies of meridians and chakras (and related areas of bioenergetic anatomy and function), and also the way the person's energy is experienced by others.17 The person with ADHD will not only feel “driven mad” by their own energy, but may also have a disturbing and aversive effect on others.

There are several ways in which the more outward “discharging”—or “yang”—forms of ADHD are disturbing to others. First, the person may appear to be “going on and on”, in a very repetitive and irritating way, seemingly unable to set an issue aside and move on. Indeed, the person with ADHD might appear to be continually fuelling their own state of agitation, as if “working themselves up” into an ever-increasing frenzy of fury or other negative emotion. He or she might appear like “a dog with a bone”, never letting go, once having clamped their emotional teeth into an issue.

The psychotherapist listening to such a person might initially try to follow and explore the nature and origins of the particular state of distress the client is presenting. This will often prove to be a fruitless exercise, although this will not immediately be apparent. On trying to make links back to the emotional state of the previous session, the client might seem to have little persisting memory or awareness of this, having subsequently moved on to another preoccupation. It might take some time before the psychotherapist realises that the consistent theme is that something is always bothering and irritating the client, but its content may vary. Exploration of the psychodynamics is rarely, on its own, particularly helpful, although it might initially appear to be. The problem is not essentially one of psychodynamics. It is to do with a brain state and an associated energy state.

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