The case: treating Jared through eye movement desensitization and reprocessing therapy.

Eye movement desensitization and reprocessing (EMDR) therapy is an integrative eight-phase psychotherapy approach that directly addresses the experiential contributors of both health and dysfunction. EMDR is guided by the adaptive information processing (AIP) model, which posits that psychological disorders not organically based (e.g., through injury, toxicity, genetic defect) are caused by unprocessed memories stored in the brain (Shapiro, 2001). These memories contain the emotions, physical sensations, and beliefs that were experienced at the time the event was encoded. Current situations can activate these memories, causing the person to re-experience the stored information that colors current perceptions and drives dysfunctional behaviors. The focus of treatment in EMDR therapy is the direct processing of these experiences, which causes a transmutation of emotions, beliefs, and somatic responses from dysfunction to health. The previously debilitating experiences become the basis of resilience and strength. While this formulation is clearly applicable to posttraumatic stress disorder (PTSD), the AIP model guides the clinician to evaluate the entire clinical picture for a full range of adverse life experiences that may contribute to current clinical problems. Recent research has supported this conceptualization, indicating that ubiquitous disturbing “life experiences” can cause even more symptoms of PTSD than full-blown trauma (Mol et al., 2005). Therefore, while Jared has a specific trauma history that must be addressed, other potential experiential contributors to his wide range of symptoms need to be thoroughly assessed. The first phase of EMDR therapy involves taking a comprehensive history to identify: (a) the past experiences related to the presenting symptoms, (b) the current situations that elicit disturbance and (c) the skills and behaviors needed for adaptive future functioning. In Jared’s case, specific techniques would be used to trace his current symptoms to the unprocessed memories that form the basis of his pathology (Shapiro, 2001). For instance, EMDR therapy has successfully treated body dysmorphic disorder, and the causes have been found to be as innocuous as passing insensitive remarks made by a friend (Brown et al., 1997). The memory of the remarks is directly targeted and processed with EMDR. Likewise, research has recently indicated that EMDR therapy processing can result in the elimination of auditory hallucinations in those suffering from psychosis (van den Berg & van der Gaag, 2012). Hence, the specific event(s) forging the basis of Jared’s problems, including the hallucination of his mother’s voice, would be identified and processed. Jared’s history would suggest significant symptoms arising from his dysfunctional childhood: Mother was profoundly dangerous and Father didn’t “notice. ” Unprocessed memories of these childhood experiences would generally incorporate affects that can be verbalized by negative beliefs that fall into the categories of “responsibility,” “safety,” and “power/control/choices. ” Jared demonstrates all three in his symptom profile. The rape by a male teacher in adolescence would simply confirm his lack of safety in the world, and would also likely be experienced as “his fault. ” From an AIP perspective, all of those combined experiences would be expected to lead Jared to negative, self-referencing beliefs such as “I don’t matter,” “I’m powerless,” “I’m not safe,” and “I’m rotten to the core. ” In addition to his pervasive trauma history, his negative