Suit Individual Preferences
Her desired positive cognitions were: "I've come so far and built so much up that he destroyed," and "I have the ability to please." She rated the believability of the positive cognition at a 4 (1-7) and her SUDS was a 9 (10 being the highest). She felt the disturbance all over her body. Interestingly, in these 2 sessions using EMDR within trance, she felt comforted by the diagonal saccades and responded very quickly to them, moving the SUDS from a 9 to a 7 to a 5 to finally a 1. When we installed the positive cognitions, she felt the statements still "fit" and rated them on a scale of 1 to 7 (7 being completely true, 1 completely false) at a "6+". In reviewing my own notes, it is still quite startling to see the almost utter absence of tic behavior subsequent to the combined hypnosis/EMDR sessions. Subsequent sessions focused more on issues of control, anger management, negotiating long-term intimate relationships, and work. She has since become successful in business, has married, and has in every way demonstrated a full recovery. In the 10 years since the combined hypnosis/EMDR intervention, she has had almost no tic activity despite the stress of career changes, marriage, and moving (twice). Her progress continues and she comes in for a session once in a while to brainstorm on one issue or another. She always closes the door behind her.
When hypnosis is used for ego strengthening and EMDR for both continued ego strengthening and uncoupling, they can offer clinicians a formidable toolbox for both generating and therapeutically utilizing those "unexpected responses." It occurred to me in preparing this case that JJ had made her subtle request for EMDR in the initial stages of her therapy if only I had been listening more attentively. Her unconscious references to "tracks," "channels," "blocking," were all terminology used to describe and metaphorically explain the EMDR process by Shapiro herself (1995). Also of great interest, and perhaps worthy of further study, is how only in the EMDR sessions were the incidents involving early childhood sexual abuse and her later humiliation by her ex-boyfriend disclosed. This author wonders whether the more structured process of EMDR was what allowed for this revelation. While I had naturally assumed that the right-sided tic was a function of the physical trauma, it seemed to have been interlocked with more complex psychological and sexual trauma.
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