Eye Movement Desensitization and Reprocessing (EMDR) for Shame Related Offense Trauma in a Justice Involved Individual Presenting With Active Suicidality and Self-Harm

A single-case study is presented, which describes the application of EMDR for a justice involved health care worker, presenting with active suicidality and self-harm, within the context of high levels of offense-related shame. “Alex” was a 42-year-old female, serving a prison sentence for Theft. Prior to her offense, Alex was a nurse with an unblemished career. Her offending occurred as a result of her addiction to pain medication. Alex attended 20 treatment sessions, which followed the eight phases of EMDR therapy: (i) history taking; (ii) preparation; (iii) assessment; (iv) desensitization; (v) installation; (vi) body scan; (vii) closure; and (viii) evaluation. Eye Movement Desensitization and Reprocessing (EMDR) has a growing body of evidence for its effectiveness with offense-related trauma; shame-based disorders; and with those presenting with self-harm and suicidality. Given the postulated link between shame and recidivism, it is perplexing that to-date there has been no published research pertaining to the psychological treatment of offense-related shame, specifically. The importance of EMDR case formulation in regard to treatment planning is described. Therapeutic processes and clinical outcome will be discussed. Overall this case-study builds on the existing research base and highlights the utility of EMDR for the treatment of offense-related shame, self-harm and active suicidality.