EMDR/LOSS Therapy: When the eyes really are windows to

the soul…

By Robert McGowen, MBA, MA, LPC

Robert McGowen, MBA, MA, LPC

Robert McGowen is an EMDR trained therapist and a primary referral source for the LOSS team of Tarrant County (Local Outreach to Suicide Survivors). He provides individual therapy at Mental Health America of Greater Tarrant County. Clients are often able to be seen as soon as seven days after the death occurs. He has seen EMDR therapy help process, not only the specific loss of a loved one, but past incidents of trauma.

Learning Objectives

1. Learn the basics of EMDR therapy as relates to working with suicide survivors.

2. Explore the nuances of working with individuals that have lost a loved one to suicide.

3. Understand how EMDR therapy helps clients process questions that do not have tangible answers.

Definitions

1. EMDR – Eye Movement Desensitization and Reprocessing

2. LOSS – Local Outreach to Suicide Survivors

3. SUDS – Subjective Units of Distress Scale

4. VOC – Validity of Cognition

5. Suicide Survivor – Significant other of person whom died by suicide

Background on EMDR

1. A psychotherapy treatment designed to alleviate distress associated with traumatic memories. (Shapiro, 1989a, 1989b) Shapiro’s (2001)

2. Facilitates accessing the traumatic memory network, so that information processing is enhanced, with new associations forged between traumatic memory and more adaptive memories or information.

3. During EMDR therapy client attends to disturbing material in sequential doses while simultaneously focusing on an external stimulus.

*Taken from http://www.emdr.com/what-is-emdr/

Background Continued…

4. Therapist directed lateral eye movements are the most commonly used external stimulus but other stimuli including hand-tapping and audio stimulation are often used (Shapiro, 1991).

5. After EMDR therapy, distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced.

6. These new associations are thought to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights.

*Taken from http://www.emdr.com/what-is-emdr/

EMDR therapy uses a three pronged protocol:

1. The past events with dysfunctional memories are

processed, forging new associative links with adaptive

information.

2. The current circumstances that elicit distress are

targeted, and internal and external triggers are

desensitized.

3. Imaginal templates of future events are incorporated, to

assist the client in acquiring the skills needed for

adaptive functioning.

*Taken from http://www.emdr.com/what-is-emdr/

Betty

“It was absolutely amazing how quickly I responded [to the tapping technique].” - Betty

Betty

1. Thoughts?

2. Questions this video brings up?

3. What would you do with Betty?

4. How would you approach her at your first session?

5. What would success be with this client?

Background on Betty

1. Saw client 8 days after she found her husband.

2. The couple was at a doctor’s appointment and overheard the doctor saying he was running labs to test for indications of cancer.

3. Husband received a phone call that he needed to start an oral medication.

4. Husband sent his wife a text about the phone call. She responded saying, “It would be okay.”

5. When she got home, she found her husband’s body in the back yard where he shot himself in the head.

What Betty did in Therapy

1. First session client told her story.

2. She cried. I listened.

3. We started with the Calm Place exercise.

4. She processed an image rated 6-7 on SUDS scale.

5. Window of Tolerance

6. Throughout therapy with EMDR she processed: the image of finding her husband, sleeping on his side of the bed, and listening to the radio.

Evan

“I think the biggest thing I took away from [EMDR] after the first day of using it was that you can get over [the trauma]. You can move on and you can get better.”

- Evan

Evan

1. Thoughts?

2. Questions this video brings up?

3. What would you do with Evan?

4. How would you approach him at your first session?

5. What would you call success with this client?

Background on Evan

1. I saw Evan approximately one month after brother’s suicide.

2. He had seen his brother a few times in six years.

3. First session Evan told his story.

4. Client and his brother were having a conversation. Client said to brother “why don’t you just do something about it.” The brother pulled out a gun and shot himself in the head.

5. Client stated that he logically knows that it is not his fault but still asks himself “why it happened?”

What Evan did in Therapy

1. Started with Calm Place exercise

2. Moved to image at 6-7 on disturbance scale

3. Examples of images processed with EMDR:

• Client speaking to his brother just before brother shot himself

• Walking into the funeral home and viewing his brother

• Cleaning up the room

• Flash, gun shot, brother falling and blood

“The thing I found the most intriguing about the therapy technique was that you are actually doing the healing yourself.” - Evan

Case Study #1

Scenario: Jaquelyn is a fifty-five year old woman. She

married her second husband and was married for one year

when he died by suicide. One afternoon Jaquelyn told her

husband that she was going to lie down for a nap. When she

woke up, she began to look for her husband. After

approximately ten minutes, she found him hanging by a belt

in the guest room closet. Jaquelyn called 911.

She is now your client. You know the details above because

she told you them in the first session. You also know that the

loss occurred three weeks prior to your session.

Case Study #1

1. What are your first thoughts about this scenario?

2. What is your plan with this client?

3. What information do you want to know?

4. What would your goal for this session be?

5. When do you think you would introduce EMDR?

6. Would EMDR be useful? Why or why not?

Case Study #2

Sidney is a thirty-nine year old woman, married for nineteen years, and has two children. She was raised by a single mother and is estranged from her father. Her mother was 16 years old when Sidney was born. Sidney’s mother had years of substance abuse. Her mother had been to rehab several times during Sidney’s life and had relapsed after each time. It was Sidney’s nineteenth wedding anniversary, and she threw a party for her friends and family. Sidney’s mother came. At the party, Sidney noticed her mother’s behavior was unusual and became alarmed. Sidney and her mother had an argument at the party but nothing they had not encountered in the past. Sidney’s mother left the party and that evening was found dead from a self-inflicted gunshot wound to the head.

Sidney came to see you six months after her mother’s death. She had not returned to work. She is staying in bed days at a time. She has no known history of depression and is reluctant to seek help for any kind of medication. She reports crying at random times, yelling at strangers, and not getting along with her husband. She says that she “thinks she is going crazy.” She has decided she needs counseling so is asking you for help?

Case Study #2

1. What would you do in this situation?

2. Where would you start?

3. What is your plan?

4. What information do you want to know?

5. What would your goal for this session be?

6. When do you think you would introduce EMDR?

7. Would EMDR be useful? Why or why not?

Key Takeaways from Personal Experience

1. It is key to build a trusting relationship.

2. Suicide is full of questions that do not have answers.

3. Seems to be a difference in the grieving process based on how it is done or who it is.

• Parent, child, spouse, sibling, etc. – each seems to take on a different dynamic.

4. Have EMDR for a couple sessions. Then have a session to debrief processing and discuss new images, memories, or feelings that have come up.

Key Takeaways from Personal Experience Continued…

5. No right or wrong way to grieve. There are healthy and unhealthy ways.

6. Clients need reassurance when his/her emotions are seemingly erratic.

7. Process emotions/thoughts as they come up and also help educate on common emotions.

8. Healing process is not linear.

***As with all forms of therapy, it is a privilege to sit across from someone that has lost a loved one to

suicide.***

Questions???