Trauma-Focused EMDR Therapy Session Note

Client Name: Sarah Jenkins

Date: 18/05/2024

Preparation Phase Completed: Yes, completed on 04/05/2024 (Calm/Safe Place and Container exercises established).

Presenting Issue or Memory

Image

• Most Disturbing Image: Seeing the oncoming headlights of the truck right before impact during the MVA.
• If No Picture: N/A (specific visual image identified).

Negative Cognition

• Negative Cognition: "I am powerless."

Positive Cognition

• Positive Cognition: "I am safe now and have control."

Validity of Cognition (VoC)

• VoC Rating: 2/7

Emotions

• Emotions Experienced: Terror, helplessness, panic.

SUDs

• SUDs Rating: 8/10

Location of Body Sensation

• Body Sensation: Tightness in the chest and knot in the stomach.

Desensitise

• Desensitisation Process: Bilateral stimulation (BLS) via horizontal eye movements (28 passes per set). Client initially reported heightened chest tightness and auditory recall of screeching tyres. Shifted to remembering waking up in the ambulance. After 6 sets, somatic distress decreased significantly; SUDs reduced to 1/10 ( ecologically valid given ongoing physical physiotherapy).

Processing and Checking for New Channels

• Processing Notes: New channel emerged mid-processing regarding guilt about her sister being in the passenger seat. Addressed via 4 sets of BLS; client spontaneously verbalised, "The truck crossed into my lane, I couldn't have swerved." Channel cleared.

Installation

• Positive Cognition Validation: Client paired original incident with "I am safe now and have control." Initial VoC was 5/7, strengthened to 7/7 after 3 sets of BLS.
• Installation Process: Standard sets of fast horizontal eye movements used to link the positive cognition with the target memory until no further adaptive shifts occurred.

Body Scan

• Body Scan Results: Client held the target memory and PC in mind while scanning the body. Reported minor residual tension in the right shoulder. Completed 2 sets of BLS; tension dissipated completely. Clear body scan achieved.

Procedure for Closing an Incomplete Session

• Incomplete Session Notes: N/A (target memory fully processed to completion).
• Containment Exercise: Brief visualization of her "Safe Place" (Blue Mountains bushwalk) used for 2 mins at session end to ensure baseline grounding prior to departure.

Closure

• Debriefing the Experience: Client expressed relief and noted the memory now feels "distant, like watching an old movie." Advised client that processing may continue post-session and to log any dreams, triggers, or new memories in her TICES log.
• Future Work: Re-evaluate this target at the start of next session. Proceed to the next target on the trauma hierarchy (hospital admission/surgery experience).

Notes

• Observations or Issues for Future Sessions: Client tolerated rapid BLS well with no signs of dissociation. Monitor driving-related avoidance behaviours over the coming week.