EMDR Therapy and Self-Harm

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March is Self-Harm Awareness Month. Self-harm is often overlooked because it carries an uncomfortable stigma, however, it is not uncommon. Self-harm can be overcome with treatment, as you can see from many of the EMDR therapist testimonials below. The American Psychological Association article ‘Who Self Injures‘ points to research indicating that self-harm behaviors take place most often in adolescents and young adults, and individuals who identify with sexual minority status are more at risk of self-harming. Quite simply, “self-harm means hurting yourself on purpose” as the National Alliance on Mental Illness states. Many self-harm or Non-Suicidal Self-Injury (NSSI) behaviors, although deliberate, are not considered suicidal behaviors, but have been linked to suicidal thoughts over time. For many of those who self-harm, the harming behavior is a way to find relief from emotional pain or numbness. The emotional distress that might cause self-harm is often traced back to a traumatic or tragic event, which can be treated with EMDR therapy. Ways to help someone who self-harms: stay calm, avoid anger and blame, ask simple non-judgmental questions to get a better understanding of the person’s point of view, take responses seriously, collaborate to find the best way to ease distress and find help, and respect the need for privacy in recovery.

We asked EMDRIA members and EMDR therapists this question. Here are their answers.

“How has EMDR therapy helped you to work with clients who self-harm?”

“I have used EMDR as a mode of therapy for almost 15 years now. It is one of the most powerful tools I have in my skill set. Some complex trauma cases can get very challenging if one does not know how to deal with the deeper issues that cause the urge to self-harm. I have time and time again integrated Parts work (using this as a form of extended interweave) in my EMDR therapy and have found it powerfully effective in the area of self-harm. Using Bi-lateral stimulation with self-harming parts while engaging with them has brought down the urge and eventually completely healed that aspect of distress in clients.” *** Stella Bhagwat, Ph.D., EMDRIA Approved Consultant

“I have an adolescent female with complex PTSD who on a daily basis would severely self-harm in response to flashbacks. She often was in a dissociative state when self-harming occurred which made it nearly impossible to control or use any CBT or DBT skills. It wasn’t until we began twice a week EMDR processing along with Ego State work that she has been completely freed from self-harming for almost a year now even in spite of continued dissociation. EMDR has definitely saved her life and improved the quality of life for herself and her family.” ***Laura Braziel, MMFT, LPC, LMFT

“One way that EMDR has helped clients who self-harm is allowing them to feel their emotions without feeling overwhelmed. Most clients self-harm when they have shut down their emotions in an effort to survive but after a while, the numbness becomes deafening and unbearable so they cut to feel. Using EMDR, the cycle is broken and they can feel all their emotions without the need to shut down which reduces their likelihood of self-harm.” ***Mrs. Deshane Gutierrez Lopez, Registered Clinical Psychologist and EMDR Trained

“Usually I work on the bad body feelings that trigger the client for self-harm, which is usually by float back with that body feeling as a somatic bridge will take the client to an earliest worst memories.” ***Mohamad Haidar, CTC manager, EMDR therapist

“EMDR therapy has helped with clients who self-harm by assisting them in understanding the discrepancy in self-harm helping them versus it hurting them. They learn that when they are already hurting it makes no sense to hurt themselves rather they need to take care of themselves. They realize when hurting, they should do something that creates joy rather than pain. Identifying the target memories, the triggered responses, and then connecting other memories and responses to find the overall theme and belief about oneself as a result of identifying them, allows them to modify what they think and feel about them in the future. Once they’ve modified those responses, they can regulate their future responses.” *** Amy S Horne, LCMHC, LCASA, CIMHP, MFT

“I have found the DeTUR protocol, developed by the late Dr. Popky, helpful for reducing the incidence of self-harm among several of my clients. Along with training in DBT skills, the Desensitization of Triggers and Urges process helps identify environmental and internal sources of activation. The subsequent EMDR processing reduces the intensity of urge sufficiently that clients are able to access more effective strategies for grounding and resourcing such that they are able to avoid the problem behavior.” *** David Llewellyn, MA, LMHC, CASAT, CMAT, DBT, EFT, & EMDR trained

“My self-harm clients have found peace and understanding through EMDR that defuses reactive emotional states, provides more choices for self-regulation and hope for the future. Rather than standing on the edge with blinders on, they are able to sit in the middle and look around.” ***Susan Lloyd, MA, LCSW, CFRC

“EMDR therapy has helped in my work with self-harming clients by desensitizing the memories and triggers that lead to the self-harm.” ***Colette Lord, Ph.D.

“As a recipient of EMDR Therapy with a history of self-injury, being able to use EMDR Therapy to address my triggering cognition for self-harm, I am stupid, has made all of the difference in my recovery. For me, self-injury was traditionally a method employed to punish myself. I no longer have to do that today and even when a fleeting urge may come, it quickly passes. This gift is one of the fruits of EMDR Therapy in my life, and it’s been a delight to share that gift forward with my clients.” *** Dr. Jamie Marich (Certified EMDR Therapist, Approved Consultant, and Trainer)

“EMDR therapy has helped in my work with clients who self-harm because it gives me a map as well as a tangible way to help. Talk therapy is helpful, but being able to utilize EMDR to figure out triggers as well as the power of Future Rehearsal has been incredibly helpful and gives the clients a greater sense of control as well as hope. EMDR seems to instill hope into the very core of people.” ***Amy Orlovich, LCPC, EMDR Certified

“EMDR has helped many clients reconnect with their bodies, become more comfortable feeling their somatic responses, and decrease the intense desire to self-harm.” ***Marie Paddock, LPC, NCC, EMDR

“EMDR has helped unlock and dig through the underlying stressors and traumas that contribute to utilizing self-harm as a coping strategy. As a result, client’s I work with are able to sort through the stuff they’re dealing with, which may reduce the need to self-harm, and thus cultivate more adaptive ways to deal with their emotions.” ***Kyle Poon, R. Psychologist

“I would say the breadth and depth of my work with clients have surpassed my work with clients through talk therapy. The client’s processing goes deeper and the positive change is more profound.” ***Charlaine Robinson, MA, RCC, Certified EMDRIA Therapist

“When it comes to using EMDR therapy for my clients with a history of self-harming, I love the components of stabilization and rapport building. Prior to learning EMDR, a common way I dealt with clients who self-harm was to spend time assessing and doing primarily cognitive interventions. CBT has its place in our work, but prior to getting into any trauma-related information, I often work with clients on regulation skills. Resources such as safe place (or safe enough, etc.) & other ways to regulate the nervous system have resulted in positive experiences in therapy and a willingness to continue EMDR Therapy.” ***Jordanna L. Saunders, MC, LPC, NCC, CEAP, Certified EMDR Therapist & Consultant in Training

“That’s a loaded question, EMDR therapy is similar but not the same to traditional ways of supporting clients utilizing our healing practices. Be authentically present, supportive, and teach the client that the triggering event is no longer happening and to notice the pain and let it go. Due to the complex complicated past and current history of Native American/First Nation/Metis/Inuit clients, I ensure safety is utmost along with adapted stabilization techniques based on the clients’ cultural background. Practice containment strategies with the client. Important to ensure the client has a strong wrap-around collaborative support; youth worker, caseworker, supportive stabilized relatives, Elders, knowledge keepers, and friends, along with land-based connections. A safety plan is essential when working with clients. Once the client demonstrates an ability to stabilize and regulate will start with an EMD to process the triggering event one at a time to ensure no flooding due to the complex complicated history. Sometimes, we need to be aware of persecutory parts that could be contributing to self-harm and if so, tuck those parts in at the end of each session. Each client presents with unique histories and it’s important to slow the process down, develop a sufficient safe enough trusting relationship with your client.” *** Shelley Spear Chief, MSW, RCSW, Certified EMDR Consultant

“In working with clients who tend to self-harm in order to avoid certain feelings or as a way to ground themselves when dissociating, self-harming behaviors are often connected to traumatic life experiences and triggers. I have seen EMDR be effective in helping the clients learn how to self-soothe and emotionally regulate in a healthy manner by providing them with stabilization skills that provide relief until the urge to self-harm dissipates. I’ve noticed that individuals begin to build more self-confidence when they recognize that they have the power within to learn healthy skills and grow in self-awareness.” ***Stephanie Stathas, MS, LPC, NCC, CIT

“I use EMDR with a client who has self-harmed for 50+ years. We have processed the childhood and adult memories that created feelings of powerlessness, insignificance, and an inability to recognize that she had any rights, or the capacity to make her own healthy choices. Numerous times daily, the client was triggered into intense rages which resulted in serious self-harming episodes. When the client began therapy three years ago, she was self-harming 10+ times/day and was experiencing suicidal ideation. EMDR has given the client relief from the intense rage that precedes her self-harming episodes. She is now able to access a physical sense of calm and peace, and ‘freedom’ from the shame she felt as a result of the self-harming behaviors. She knows now that she has choices and uses this self-awareness to make positive changes in her life. Her self-harming episodes have been nearly extinguished. She feels that EMDR therapy has saved her life. ” ***Linda Thorpe, LCSW

“Integrating Ego States with EMDR has drastically decreased self-harm in the teens I work with through providing them with normalization and alternative perspective. EMDR offered quick alleviation of symptoms underlying the self-harm.” ***Danyale Weems, LCSW, CCTP, RPTS

“I work with young people in residential treatment. Almost all of the young people that I work with have a history of self-harm and complex trauma. The correlation is almost exact. I have found EMDR incredibly useful when working with these fantastic young people, who have often bounced around treatment services with little benefit. Many are exhausted at the thought of narrating the story and have little interest in talk therapy. The resourcing and simplicity of grounding in EMDR is such a powerful experience for these young people. Simply slowing down the process by accessing a toolbox is a start in the stabilization of chronically impulsive behaviors and escalating emotional dysregulation. Being able to ‘do’ or be an active participant in the treatment process is something that feels rather critical in the management of self-harm. My interest in the Neuroscience of Mental Health followed on from my EMDR training and I am now just about to begin an MSc in Neuroscience and Mental Health at Kings College, London. I have my EMDR training to thank for that as well 🙂” ***Fiona Yassin, NCP, IEADP

Resources

American Psychological Association. (2015, July/August). Who self-injures? Monitor on Psychology. www.apa.org/monitor/2015/07-08/who-self-injures

Annesley, P., Alabi, A., & Longdon, L. (2019). The EMDR DeTUR protocol for the treatment of self-injury in a patient with severe personality disorder: a case report. Journal of Criminological Research, Policy, and Practice, 5(1), 27-38. https://doi.org/10.1108/JCRPP-11-2018-0034

EMDRIA Library. Self Harm. https://www.emdria.org/library/?refinementList%5Btopic%5D%5B0%5D=Self-Harm%2FSuicidality

McLaughlin, D. F., McGowan, I. W., Paterson, M. C., & Miller, P. W. (2008). Cessation of deliberate self-harm following eye movement desensitisation and reprocessing: A case report. BMC Cases Journal, 177. Open access: https://doi.org/10.1186/1757-1626-1-177

Mosquera, D., & Ross, C. A. (2016). Application of EMDR therapy to self-harming behaviors. Journal of EMDR Practice and Research, 10(2), 119-128. Open access: http://dx.doi.org/10.1891/1933-3196.10.2.119

NAMI. Self-harm. www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm

Serani, D. (2022, March 1). March is self-injury awareness month. Psychology Today. www.psychologytoday.com/us/blog/two-takes-depression/202203/march-is-self-injury-awareness-month

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