Barbara came into the EMDR therapist’s office stricken with grief since her spouse died four years ago. Despite having passed the reasonable amount of time needed to recover from her tragedy, she was still mourning her husband and used gambling as her escape. Barbara was motivated to start treatment when she was forced to face the reality that she gambled away the life insurance she received after her husband’s death and was forced to scale back her life style. The clinician used a genogram to explore Barbra’s family history in addition to the quality of both her interpersonal relationships and marriage. Barbara maintains good relationships with each of her grandchildren; naturally she is closer to some children than others. She is the mother of three successful children who are married with children of their own and successful in their respective professions, her older son is partner in a law firm and handles the legal aspect of the family business; her daughter and son operate different stores in the chain while Barbara learned to operate the family business once her children were grown. Bob taught her to manage the enterprise when he developed a heart condition and feared that one day he would be too disabled to manage the day to day operation. Barbara drafted her daughter who specialized in clothing design and has a trained eye for clothes, as a buyer for the stores and her younger son, the accountant as CFO.
Barbara’s husband, Bob was an extremely successful owner of chain clothing stores and supported his family in style. He was raised in a number of foster homes after his parents’ death when he was 10 until he reached 18. Bob did not elaborate much on the details of his different foster parents, he merely said that they mistreated him and put locks on the refrigerator doors and used the money given to them by the state to subsidize his needs for themselves.
When Bob was 18 he supported himself as a cashier and salesman in a clothing store. He gradually learned the business and became a buyer. He used this knowledge to embark on his own clothing store that was extremely successful and he became very ambitious in creating a large enterprise of chain stores catering to the needs of individual communities. The clinician gently pushed Barbara to discuss the circumstances of her husband being placed into foster care. Both of Bob’s parents died from cancer and his married siblings were engrossed in their family and career refusing to assume the responsibility of raising a teenage child. Bob was very protective of his immediate family and was extremely generous in helping them financially; therapist explored this behavior with Barbara who claimed that his siblings adored Bob. She challenged Barbara regarding Bob’s behavior, was he buying love? What sort of siblings allows their brother to suffer in foster homes?
Following the family history assessment the therapist prepared Barbara for difficult moments of processing with EMDR grounding resourcing. In addition, the clinician provided Barbara with the psychoeducation necessary to understand trauma processing; the left side of the brain is the cerebral cortex dealing with logic that makes rational decisions and the limbic system is the right side of the brain where emotion is stored and where the amygdale, the danger alarm resides. Once the body experiences danger the body stores the alarm cues in the amygdale which will automatically react to any cue that is reminiscent of the danger whose sensations are stored in the five senses. These triggers automatically shut off the cerebral cortex in order to rescue the individual. The person will react in one of two ways, fight/flight or freeze. This preliminary psychoeducation helped Barbara understand her behavior and her marriage.
EMDR helped Barbara face the reality of her “perfect” marriage which was far from perfect. Bob was not a good listener and did not want to hear what bothered her; he would complain that she is always depressed. Furthermore, he was bisexual and had many rendezvous with homosexual men and affairs with women. Barbara felt foolish remaining married to a man who was unfaithful to her. Therefore, the therapist used a pro and con list with a score from one to ten to determine whether she made a wise decision in a world where relationships are disposable. Barbara discovered her husband’s infidelity when she was a young woman with three small children needing support and lacking the marketing skills necessary to adequately provide for her children. She had the luxury of being a stay at home mom, remediating her children when necessary to the extent that their deficit became their asset and they graduated with honors; Barbara rated this advantage a 10/10. Furthermore, he was a good father who really cared about his children and their children felt safe at home with both parents. Statistics indicate that divorce has a drastic negative effect on children’s emotional well being and they are more vulnerable to sexual abuse; they are safest with their family intact. This benefit was also rated 10/10 along with her children being successful in both their private and professional lives was rated a 10/10. The negative side of the equation is that she had an unfaithful husband which she rated a 10/10; however, this concrete pro and con sheet indicated that she was not a fool to remain married to Bob since the pros outweighed the cons.
Therapist proceeded to explore with Barbara her belief that Bob was addicted to sex. Bob was raised in a very precarious condition; he did not have adults protecting him and he most likely had to compromise himself in order to survive. Barbara never considered this possibility which made total sense to her once the clinician suggested that sexual abuse is common in this population and Bob was reticent about life in the foster homes. The psychoeducation regarding the amygdale in the limbic system that is used as an alarm for danger may have been triggered very often and sex was used as an antidote to ward off danger. Another explanation might be that addiction is a flight response which helps the addict dissociates from his/her reality that he is unable to face, Bob’s life was very traumatic and his sex addiction was his escape. Similarly, Barbara used gambling to help her escape the reality of her perfect marriage; it was a means of dissociation. Therapist used a two hand interweave with EMDR; one hand she held Bob, the good father and generous husband who was always at her side and the other hand held Bob, the sex addict. The dual awareness that EMDR provides helped Barbara realize that Bob really loved her; he did not have a permanent mistress, he had sex with strangers. The psychoeducation helped Barbara put her husband’s behavior in its proper perspective and forgive Bob; he was unable to talk about the details of his traumatic childhood with anyone which prevented him from overcoming his trauma. Therefore, he used his addiction which on one hand alleviated his fears since he probably used sex as a bargaining tool in his youth and it helped him dissociate from the demons of his past.
Furthermore, the therapist was able to help Barbara realize that his addiction was a means of dissociation rather than infidelity. Bob trained Barbara to handle the business which he created so that they would be financially secure. In addition, he was a very generous husband and showered her with expensive jewelry, gifts and vacations. The clinician challenged Barbara weather these were demonstrations of love and Barbara acquiesced. This final realization provided Barbara with peace, her husband was traumatized and needed his addiction to survive; despite the nature of the addiction his actions show that he was concerned about her welfare and he had indeed loved her.
These insights were hastened with EMDR which helps the patient maintain a dual awareness of the present while probing into memories of the past. Barbara was in therapy for three years before she entered my office. Her last therapist suggested that she try EMDR since traditional talk therapy did not alleviate her grief, gambling and depression. She needed the dual awareness and psychoeducation of trauma processing to face her demons that prevented her from getting past her grief.
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