Re: Chronic Pain and EMDR

Your question is a good one and you are right in thinking EMDR might assist. Let me address three areas briefly: 1) chronic pain, 2) sexual abuse, and 3) motor vehicle accidents.

1) Chronic Pain. There are special protocols for the use of EMDR in patients with chronic pain. Whether a somatic symptom is entirely psychogenic or partially psychogenic, resolution of the psychological aspects, by using EMDR in combination with other approaches, can be enormously helpful. Often these chronic somatic symptoms are the body "keeping the score" as Bessel van der Kolk has said, neither being able to remember nor forget childhood trauma. In other cases, there may not be a trauma history, but there can be personality or other affective components that contribute to the condition, which can be assisted with EMDR.

2) Sexual Abuse. Sexual abuse is common in chronic pain sufferers. In severe cases, there may be dissociative conditions present, and that's why we always screen for a dissociative condition before doing EMDR. EMDR will trip over dissociative barriers as surely as if they were curbs in the night. There are special protocols for using EMDR in dissociative individuals (see for example my article in the March 95 issue of the journal Dissociation, "The Cautious Use of EMDR in the Dissociative Disorders"). In less-than fully dissociative cases, the usual EMDR protocol will work just fine.

3) Motor Vehicle Accidents (MVAs). MVAs are sometimes readily treated with EMDR depending on how much trauma preceded the MVA. By that I mean that if an individual had a lifetime without a significant trauma history, and adequate parenting, and then gets in an MVA and develops PTSD, that PTSD can be readily treated in very few EMDR sessions (sometimes even a single long session, typically several however). If, however, a person had a history of chronic, inescapable and severe abuse as a child, and then got into the same car accident, an interesting phenomenon occurs. The closets in the mind spring open with the MVA -- closets that had been containing the fear, shame, sadness, rage, and even memory of the child abuse. The feelings are similar enough with the present trauma of the MVA to retrigger the old unresolved material. That individuals course of treatment may be quite lengthy -- work can't begin on the MVA PTSD until basic preparatory work is complete, which can take weeks or months or more. Once prepared, however, the PTSD from both MVA and unresolved childhood abuse can be resolved and new meaning made of the entire experience.

Replies:

Re: Chronic Pain and EMDR and MVA, by marilda, 5/9/00

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