EMDR Therapy for Survivors of Domestic Violence: A Trauma-Informed Approach

October is Domestic Violence Awareness Month, a time to raise awareness around domestic violence (DV), also known as intimate partner violence (IPV), and provide support to those affected by DV/IPV. We asked Vanessa Vaughter, LCSW to tell us more about EMDR therapy and domestic violence.

EMDR Therapy for Survivors of Domestic Violence: A Trauma-Informed Approach

Guest Blog Post by Vanessa Vaughter, LCSW-S

Tell us a little bit about you, your experience becoming an EMDR therapist, and your experience working with domestic violence/intimate partner violence.

My first job after completing my social work master’s degree was with a domestic violence agency in Plano, Texas. It was my job to go into the community and educate teens, parents, and whoever would listen about teen dating violence prevention. It wasn’t long before I was asked to see individual teens for therapy, then, due to the overwhelming need for help, I was asked to take on a few adult clients. Having experienced EMDR therapy myself 10 years before, related to a workplace trauma, I knew it would be an effective way to help our clients.

Can you help us understand a little bit about intimate partner violence and its impact? How prevalent is IPV, and what signs might an EMDR therapist look for that might indicate this is happening?

It is important when quoting statistics to remember that intimate partner violence (IPV) is chronically under-reported. People do not report for a plethora of reasons. That said, worldwide, a woman is killed every 11 minutes; in the United States, three women die a day at the hands of those who say they love them. While men certainly are victims of IPV, 85 percent of victims in the U.S. are women, and every nine seconds, a female American citizen is beaten by an intimate partner. IPV results in nearly 1,300 deaths every year in the United States. In addition, Glass et al. (2009) found: “Prior non-fatal strangulation was associated with greater than six-fold odds of becoming an attempted homicide, and over seven-fold odds of becoming a completed homicide…Non-fatal strangulation [is] an important risk factor for homicide of women.”

With each death comes the pain, grief, and trauma of those who loved the one who died. With each beating, one must consider the risk in staying vs. leaving. A woman is 75 percent more likely to be killed if she leaves than if she stays. And if she leaves, where will she go? Who will take care of her pet? If she has a son over the age of 14, and in some places over 10, he will not be able to stay with her in an emergency shelter, even if she can find one that has beds available. Those who identify as transgender or queer are also victims and sometimes perpetrators. These survivors are even less likely to report due to fear of not being believed or of being ridiculed for who they are, rather than receiving help for what happened to them.

How can EMDR therapy help someone who has experienced intimate partner violence? What successes have you seen?

EMDR has been one of the most effective and efficient psychotherapy approaches I have seen when working with survivors of IPV. The Adaptive Information Processing (AIP) model provides the understanding that with EMDR therapy, a client can reduce emotional and physiological responses but also allow a client’s view of themselves to shift. When a client’s brain can release a neural network that was created with the trauma of IPV, the client who emerges has a whole new perspective. When the neurons that have fired together repeatedly are activated, it allows the client’s negative belief of “I am worthless” to become a felt sense of “I am valuable,” and everything changes.

Over the years, I have had the privilege of witnessing many adolescents and adults experience this shift. A client with two girls was referred to me for EMDR. Her husband had repeatedly physically, emotionally, and sexually abused her, strangling her on two occasions (Glass et al., 2009). She described the “worst one” when, just before losing consciousness, she saw her daughters watching. She left, divorced, and was then stalked by him for a few years. The client had a loving, healthy childhood, which allowed us to focus exclusively on the IPV. After a few months of treatment, she was able to get a new job, begin new hobbies, make friends, and her girls attended a month-long sleep-away camp while she felt safe enough to stay home alone. She credits EMDR therapy with her newfound sense of self and ability to be present for her girls. (Case shared with client’s permission.)

Are there cautionary measures you would like to mention regarding the use of EMDR therapy with survivors of domestic violence?

The number one concern when working with survivors of IPV is their physical safety. When someone experiences IPV, physical and/or sexual abuse may occur only occasionally, but the terror of it happening again is a lived experience every moment of every day. These folks live in a constant state of fear, their nervous system constantly on high alert, some to the point of shutdown.

If a clinician is working with someone who is still in the relationship, it is helpful to begin working with incidents that occurred in the past, perhaps at the hands of a different abuser. As the client gains a greater sense of self, they become better able to make well-thought-out decisions about their future. One woman was in a violent relationship, had two elementary-aged boys, and there was no room in the area shelters. With EMDR therapy, she gained an internal sense of strength, which allowed her to strategically plan her escape. Once out of the dangerous situation, we continued to reprocess more recent abuses. During that time, she got a new job, and in our last session, she reported she had bought a house in an area with good schools where she and her boys were safe.

It should be noted that history-taking is critical, not because the client needs to remember and describe every incident of abuse, but to learn the age at which the client first experienced abuse or neglect. Adults whose abuse history began in early childhood will often require a longer period of preparation to ensure the ability to remain in the window of tolerance. The Developmental Needs Meet Strategy (DNMS), created by Shirley Jean Schmidt, was helpful for me. I have found it to be life-giving to clients and invaluable to me in helping them heal.

Are there any myths you’d like to bust about using EMDR therapy and intimate partner violence?

Myth: “IPV is an anger problem.” Bust: It is about one person’s need to feel power and control over another (Domestic Abuse Intervention Programs, n.d.).

Myth: “Go to couples counseling to work things out.” Bust: Couples therapy is never appropriate when there is IPV in the relationship. The solution to end IPV lies in helping the abusers understand their need for control over the victim, heal from their trauma, and learn new skills. Batterer Intervention and Prevention Program (BIPP) groups are evidence-based treatment groups to assist in that work (National Center on Domestic and Sexual Violence, n.d.).

Myth: “Their relationship is none of my business.” Bust: IPV impacts not only the victim, perpetrator, their children, families, and friends – it impacts our schools, faith communities, workplace, social circles and economy. According to Peterson et al., (2018), “The estimated intimate partner violence lifetime cost was $103,767 per female victim and $23,414 per male victim,… This estimate included $2.1 trillion in medical costs, $1.3 trillion in lost productivity among victims and perpetrators, $73 billion in criminal justice activities, and $62 billion in other costs, including victim property loss or damage. Government sources pay an estimated $1.3 trillion of the lifetime economic burden.”

What multicultural considerations might EMDR therapists need to keep in mind regarding EMDR therapy and this type of violence?

Cultural humility is particularly important when one is currently in a violent relationship. To tell someone to “just leave” dismisses important realities. I worked with a woman who had immigrated with her husband from India. They settled in Texas, near folks from their home region in India who became their community. When she came for counseling, she had already divorced and was living alone. She was patient with my ignorance. I will never forget how I felt as the powerful reality of what she had lost sank in. Yes, she escaped the violence, but she also left behind her life – friends would no longer associate with her, she was no longer able to attend temple worship, and she feared her family in India would also be shunned socially and economically. Patriarchy is a reality in most cultures, including America, yet it manifests in unique ways with various levels of impact. Do not assume because someone is of a particular culture, religion, or even gender that you understand the risks they take to leave. Ask them – they are the experts on their lives.

Do you have any favorite free resources that you would suggest to EMDR therapists interested in learning more about using EMDR and domestic violence?

In session: https://www.theduluthmodel.org/wheels

Teen dating violence: www.loveisrespect.org

Shelters/local services: www.thehotline.org

Staff/Community education: “In Her Shoes” https://wscadv.org/training-kits/in-her-shoes (not free, but powerful)

What would you like people outside the EMDR community to know about this topic?

Never assume it is best for the victim to “just get out,” nor is it advisable to simply “pray harder, stay longer.”
When someone trusts you enough to share their situation, believe them, and then ask how you can help.
Be there for them; yet hold your boundaries. On average, a woman leaves seven times before she leaves for good.

Anything else you’d like to add?

There is hope. There is help. Whether the violence was in the past or is currently happening, EMDR therapy can help both the victim and the perpetrator (not together, of course!) when navigated with care, therapeutic attunement, and fidelity to the AIP model/EMDR protocol.

This is not one person’s problem–it is on each of us to change the culture of power & control often perpetrated by emotional, physical, cultural, and communal violence. Get educated. Get involved.

Vanessa Vaughter, LCSW-S, is an EMDRIA Approved Trainer,™ Consultant, and EMDRIA Certified Therapist™ working at The Center for Integrative Counseling and Psychology. Passionate about EMDR’s impact, she specializes in trauma therapy, having worked with survivors of intimate partner violence and underserved communities. She holds master’s degrees from Duke University and UT Arlington.

References

Domestic Abuse Intervention Programs. (n.d.). Wheels – Domestic Abuse Intervention Programs. https://www.theduluthmodel.org/wheels/

Emory University School of Medicine. (n.d.). Domestic violence/intimate partner violence facts. https://med.emory.edu/departments/psychiatry/nia/resources/domestic_violence.html

Glass, N., Laughon, K., Campbell, J., Wolf Chair, A. D., Block, C. R., Hanson, G., Sharps, P. W., & Taliaferro, E. (2009). Non-fatal strangulation is an important risk factor for homicide of women. Journal of Emergency Medicine, 35(3), 329-335. https://doi.org/10.1016/j.jemermed.2007.02.065

Jean Schmidt, S. (2022, September 11). Preparing dysregulated, dissociative, attachment-wounded clients for EMDR [Online Course]. EMDR International Association. https://www.pathlms.com/emdria/courses/60450

love is respect. (n.d.). Healthy relationships for young adults. https://www.loveisrespect.org/

National Center on Domestic and Sexual Violence. (n.d.). Battering intervention. https://www.ncdsv.org/battering-intervention1.html

Peterson, C., Kearns, M. C., McIntosh, W. L., Estefan, L. F., Nicolaidis, C., McCollister, K. E., Gordon, A., & Florence, C. (2018). Lifetime economic burden of intimate partner violence among U.S. Adults. American Journal of Preventative Medicine, 55(4), 433-444. https://doi.org/10.1016/j.amepre.2018.04.049