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Old August 9th, 2005, 10:46 PM
Maria Shine Stewart Maria Shine Stewart is offline
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Location: Cleveland
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Default EMDR with compulsive behavior

I am new to this site, a teacher, and a counseling student. I am wondering if EMDR has been used in the treatment of compulsions (such as eating or cleaning) that clients may do in response to recollection of trauma. I would also like to know if there are recommendations on the number of sessions a practitioner would do to gather history before beginning the use of EMDR. (I suspect the answer to the second question is "it depends"...but I wonder if too much history recall can, itself, prove difficult for clients.) Thank you for any insights.
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Old August 10th, 2005, 01:16 PM
Sandra Paulsen Sandra Paulsen is offline
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Default Re: EMDR with compulsive behavior

It depends, you are right, on the complexity of the case and the strength of the client. It depends on what kind of compulsions. Compulsive eating is a habit that can be done for lots of reasons, including keeping down unresolved emotions. Compulsive cleaning can be part of Obsessive Compulsive Disorder, which is a different breed of cat, has its only treatment strategy needed, namely, exposure and ritual prevention. In both, EMDR can be a part of the treatment plan, though there is no controlled research on this subject, only case reports.

Example: EMDR can be done on the triggers for eating, the beliefs about eating, the emotions that come before, during or after eating, and the consequences of eating, as well as the eating behavior itself. For OCD cleaning, the EMDR can be done on early traumatic or hurtful memories, in combination with ego state therapy to access child parts that are often engaged in the compulsive rituals with child reasoning.

In terms of history, you are right. Some people can't tolerate alot of history taking, because they'll be flooded by traumatic memories. We best do a good history if people can, but an experienced therapist's antennaes will tell her if she is walking into a minefield. That's part of why we do the DES too, to reveal if we are in a minefield without having to blow anything up.

But in between history taking and EMDR for a compulsive client of either kind, if there is a large trauma history, there are many things to do to strengthen, stabiize and contain. If the trauma history is simple and the client is strong, EMDR can often be done early, as long as they do well with safe place, have resources and score low on the DES or other dissociation screening method.
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