Treatment of a Same-Day Trauma using EMDR & Hypnosis

by Jonathan Marshall, PhD

The Challenge of Treating Recent Trauma

“I’ve just been hit by a car. Please help!” Understandably the caller, Kate, hoped that as a psychologist I would be able to help her with her distress. Unfortunately, we still don’t have conclusive research on how to treat a recent trauma, yet alone an event that occurred only a few hours prior. We were taught to encourage survivors to discuss their experience and “get it out of their system.” The American Psychological Association has since condemned the practice of psychological debriefing, stating it has “no research support” and is “potentially harmful.” Sadly, our lack of clarity around what to do, doesn’t help the 10%-20% of people who go on to experience post-traumatic stress disorder (PTSD).

Faced with this situation, I used a combination of eye movement desensitization and reprocessing (EMDR) and clinical hypnosis. Kate’s initial distress cleared and for the following 11 days since then, she describes herself as thriving. She is free of depressive symptoms [1] and the impact of the accident appears to be minor [2]. I offer this case study to help us consider ways of working with very recent events.

Kate

Kate [3] is an accomplished ultra-athlete and was preparing for a multi-day sporting event. Bruised and cut, she was panicky, agitated, and despairing. The trauma of motor vehicle accidents like Kate’s can leave a person with nightmares, flashbacks, feelings of helplessness, numbness, and avoidance of things that remind them of the accident. These can last days, weeks or much longer. Immediately after her accident, Kate also experienced a sense of humiliation and despair because none of the many onlookers tried to help. While that memory may have been more manageable at another time, in her state of vulnerability, it was a source of considerable distress and increased my concern that her recovery may not be easy. What follows is her description of our two-hour session.

Written by Kate

Yesterday I got hit by a car. I was sent flying across two lanes of oncoming traffic, hit the ground and then my bike landed on me. I was fortunate not to be hit by a second car when I landed. By the time I limped to the sidewalk, the guilty car had sped away, and the pedestrians who had watched the whole scene had resumed their journeys, unconcerned. Though my hands were shaking badly, and my heart was racing, I couldn’t feel any physical pain. I was in shock. I felt so alone and utterly miserable.

When I got home, I wandered aimlessly, unable to focus on anything other than what had just happened. I then realized that my hands and knees were bleeding. But, to my dismay, there was no sensitivity in the wounds. I poked at them and felt nothing at all.

A couple of hours later, I spoke with a psychotherapist, Jonathan. He asked me to go to the emergency room to get medically checked out but I refused. I was too shaken. He then instructed me to follow his fingers, which were moving left and right, whilst I simultaneously recalled the worst moments of the trauma. I let him guide me to the exercise, focusing on both the memory and the moving hand. Something started to happen. The sweeping motion literally acted on the memory and I became gradually emotionally detached from it. Then the physical pain suddenly came, all at once, sharp and intense. It was a bit overwhelming and I rated it a 7 or 8 out of 10. Despite my initial reluctance, I now wanted to go to the emergency room and get pain killers. He then offered to help me reduce my experience of pain using hypnosis to which I agreed.

Jonathan instructed me to roll my eyes in a particular way and then to imagine being in a “special place.” I saw myself pouring a healing ointment on my aching body; an ointment that would convert the pain to tingling. Later I met a “loving and kind” messenger -- an imaginary figure who gave me words of inspiration. After the hypnosis, I felt so hopeful about my recovery, and my pain was only 1 or 2 out of 10. When I poked my wounds, they hurt, but the sharp, shooting pains were gone.

I am not sure how long he worked on me, but the techniques he used went deeply into me. Though intellectually I know what he did was based on science, the whole experience still feels baffling and magical.

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The next day Kate reported having slept deeply and was “overflowing” with energy. She did receive a medical check-up and her physicians explained that while her cuts and bruises needed treatment, she could proceed with her upcoming ultra-sporting event. They also explained that given her injuries, they were surprised she didn’t feel more pain. Since then, she has finished 8 back-to-back marathons with no injury. She writes, “The astonishing part is just how fresh the legs are every morning - no heaviness, no pain.”

The success of Kate’s treatment is in part due to her resources: psychological health prior to the accident, freedom from any debilitating injury due to the accident, innate ability to use hypnosis, and focus on her sporting event which helped her to avoid the destructive rumination that sometimes follows a trauma. So it’s hard to know the value of the EMDR and hypnosis. It’s also too soon to conclude that she will remain free from any psychological impact of the accident. My own formulation is that the eye movement desensitization protocol helped Kate process the immediate psychological effect of the trauma; hence it permitted her to feel the pain that was actually present in her body but was previously blocked due to her being partially dissociated. The hypnosis helped her managed that pain, reduced her sense of isolation, and gave her optimism for her recovery.

As more therapists experiment with combining EMDR and hypnosis, I anticipate we will find they have application in many areas, including the treatment of recent trauma.

 [1] Beck Depression Inventory score = 2

[2] Impact of Events Scale - Revised = 11

[3] “Kate” is a pseudonym. She has read and approved my publishing this article.