Britta, a Caucasian woman in her fifties, heard of my services working with chronic addiction relapsers, and she was willing to do just about anything to get to the root of her problems. Britta had been in and out of active polysubstance remission for a period of 26 years, achieving almost 10 years of sobriety at one point. However, in the 2 years prior to coming to my counseling practice, Britta has been struggling to maintain more than a couple of weeks of sobriety at a time and was riddled with shame and self-loathing because she was not able to keep herself sober. In addition to meeting criteria for PTSD and polysubstance dependence, Britta was also being treated for bipolar disorder and felt better when she was medication compliant.

Britta and I engaged in 3 to 4 months of stabilization activities, which included helping her get active again with AA and “work the steps” with her sponsor. After hearing the benefits and risks of EMDR, Britta was more than willing to try it, well aware that messages she received in early childhood about herself kept her stuck in self-loathing and self-pity. Like with many a complex client, we could not pinpoint a specific memory as a starting point, since her whole childhood seemed tortured, so I gave her the negative cognitions list, and “I’m not good enough” was clearly her number-one choice. We set up a protocol tracing “I’m not good enough” back to an early childhood memory, but Britta began blocking (i.e., not being able to process) right away, saying, “I can’t do this, I’m not feeling anything.”

When we used some traditional cognitive interweave, or the open-ended questions that are taught by Shapiro (2001) to move along stuck processing, Britta revealed that she can’t feel anything because she’s not allowed to feel. A light bulb went on in my head, and I thought, “Adjust the setup! If Britta really believes she’s not allowed to feel, we must start there.” So, I readjusted the processing setup and had Britta remember the first time she ever got the message “I’m not allowed to feel my emotions.” She also recalled a similar childhood memory, but in this one, her father specifically told her that she was not allowed to cry. We began the processing there, and although she blocked a little at first, the EMDR soon worked like a charm.

We spent about 7 active processing sessions on “I’m not allowed to feel my emotions,” and when we later revisited “I’m not good enough,” it took less than a session to process the remaining material. Clearly, a generalization effect had taken place.  At the time of this writing, Britta had attained 18 months of sobriety, and she indicated that it’s the first time in her recovery process that she does not feel burdened by self-loathing. As a result, she was able to complete all of the steps in her 12-step fellowship, this time in a more thorough manner.

(c) Jamie Marich, 2011