Pure Gold – An EMDR case cameo from Northern Ireland
Dr Paul W Miller
December 2004
Chief Editor’s Introduction: We are grateful to Paul Miller for a “golden” opportunity to view his creative imagery work! - SEB
I’m just writing this as we approach St Patrick’s Day and with it the symbolism of the Shamrock. The story goes that St Patrick used it to explain the doctrine of the Trinity to the Irish. He took something they were familiar with and used it to explain something profound. In therapy we can often harness the power of the iconic when working in the area of resource installation or when the client becomes stuck and we introduce a cognitive interweave. I want to share such a case cameo with you.

I was working with a woman with a past history of repeated sexual abuse as a child. She was receiving EMDR as part of her inpatient therapy. Although she had been in hospital before and had been treated using other methods in the past there had been little improvement. She met all criteria for PTSD and the intrusive images and nightmares were problematic. Towards the completion of one of her sessions she disclosed that in addition to the flashback images she was also having olfactory flashbacks; the smell of her abuser on her hand. This had been present for years; she managed the smell by wiping her hands constantly with baby wipes, but found no relief. She was very distressed by this symptom and felt ashamed of it, a feeling that led to her not disclosing it earlier in therapy.

Using the EMDR technique with eye movements I tapped into her iconic understanding of the purity of gold. In previous sessions we had already successfully processed the self-blame and guilt that she had about the abuse. Now I asked her to imagine that the hand she could smell now was made from gold that had some impurities in it. I asked her to imagine unscrewing the metal hand and melting it in a crucible. She could see the impurities being burned away in the purifying process. Then she imagined casting a new hand and screwing it back on again. We did this three times. After each occasion she smelled the hand and the smell of her abuser had decreased; on the last occasion she burst out laughing with a broad smile. When I asked her what she could smell she said, “baby wipes”. She no longer has olfactory flashbacks of this sort.

Background
Dr Paul W. Miller MB BCh BAO DMH MRCPsych is a consultant psychiatrist and European Accredited EMDR Consultant Practitioner in Northern Ireland.

He can be contacted at: paul.miller@bigfoot.com