The wicked stepmother, the frog, and EMDR

I write with reference to Pauline Collier's article in the February 2023 edition. I was a student on the Birmingham MSc Clinical Psychology course between 1970 and '72. It was a life changing experience for me and has given me a profession, for which I am most grateful and still practice at the age of nearly 75. The course was pre-eminently behavioural, second only to the Maudsley in reputation, and was one of the larger courses at the time, consisting of about 10 men and two women. I never participated in any aversion therapy at any time although I did observe it happening, most notably when I observed my placement supervisor at the time show me how to do aversion therapy on an alcoholic nun by attaching her to a car battery. I am not sure whether it worked or not, but I most certainly did not like it and never used such techniques myself.

The point of my writing is to describe my amazement at how the insights I am gaining from using Eye Movement Desensitisation and Reprocessing (EMDR) to treat some of the most complex psychological conditions now explain some of my experiences all those years ago.

This was before Cognitive Behaviour Therapy, and before I had any inklings about the role of trauma at all. On placement in a psychiatric hospital outpatient department, I am referred a lady with a frog phobia. I took the usual history and although there were tantalising difficulties in her history, including being imprisoned because she took the blame for something someone else had done, there was nothing I could discover to do with frogs that could explain her crippling phobia. She refused to go out of her house in case she might meet a frog. She had received treatment from a psychiatrist who had used desensitisation, including to pictures of dinosaurs, and (for some reason…) this had not worked. I was stumped.

Turning to the textbooks and my lecture notes, I discovered that there was Systematic Desensitisation and there was Flooding. I explained to my patient that there was the slow way or the quick way. Because previous treatments hadn't worked and she was desperate, she insisted she wanted the quick way. Obviously, I needed a frog.

I went to the Biology Department of Birmingham University and they lent me one. My next stage was to prepare her for treatment, which involved explaining the rules and making sure that I had her complete consent. I obtained permission from my placement supervisor to go ahead and did so as thoroughly as I could without having any idea as to how it would actually go.

The day of treatment came and I sat in a room with my client, having put my frog in a glass tank in another room covered over with a sheet. I explained that we would go into the presence of the frog but on no account could she leave, because escaping would just make it all worse.

I was explaining this to her as my supervisor walked past showing a number of visitors around the Department. 'This is Mr Pike preparing a client for treatment' and they were all duly impressed, I believe. They moved on down the corridor and I took my client into the treatment room, sat her about 6 foot away from the glass tank and took the sheet off. She screamed at the top of her voice for about 15 minutes, just sitting there watching a frog sitting there in the tank watching her.

Like a good practitioner-scientist I asked her for her rating of fear every five minutes – 10, 10, 10, as if it wasn't obvious. And then she collapsed in on herself, stopped screaming and said 'I know what it is now'. My supervisor, also having no idea of what was going to happen, later said she had had to explain to her startled visitors that it was sometimes normal for intense emotion to take place in therapy!

My client then explained that the memories had come back of being a little girl when her mother had died and her father had remarried. They had an outside toilet and one night she was sitting on the toilet with the door open for light when a frog jumped onto the path in front of her. She banged on the wall for her father to come out and rescue her, but instead her stepmother came out and told her not to be so bloody stupid. Her stepmother then interfered in her relationship with her father at every turn, including preventing her from going to her father when he was dying in hospital.

Realising this, she knew it was the stepmother not the frog that was the problem. I repeated a behavioural test of her holding the frog a week later to make sure that the result was holding up and, of course, she had absolutely no problem doing so. She knew it was nothing to do with frogs. I had taken a textbook treatment which I had never seen performed, applied it to a client by the book, it worked brilliantly. And yet when I went back to my course supervisor and excitedly reported that the problem was the wicked stepmother, he said he did not believe it, turned his back on me and walked away.

So, I never got to discuss it with him at all. Such are the blinkers we can put on ourselves when we believe we are right and cannot tolerate any evidence to the contrary. When I look back at my life, it is a repeating pattern that I do something successfully off my own bat and then, afterwards, have people tell me that a) you can't do that and b) it won't work. Ho-hum… perhaps I need therapy for help with this problem.

Now, using EMDR, it has really become quite easy (after well over 10,000 hours helping people solve their problems, of course) to get to traumatic images, which – when made conscious – weirdly dissolve the problem completely. Not in every case, obviously, that would be too much to ask, but the mechanism of ACEs, trauma and resolving psychological problems is now part of our everyday narrative.

I would just say that I do not regard EMDR as a talking therapy where insight solves the problem. You do not need insight to solve a problem, but the mind will solve it for you and give you the insight if you set it up right and do not escape. EMDR is a desensitisation technique, after all. This effect is maximised if you do so completely voluntarily and you trust the therapist to keep you safe.

So, one of my axioms now is that 'there is nothing more psychodynamic than a good behavioural technique'. The prerequisite, though, is the therapist's ability to tolerate the distress of the client and not do anything about it. Scary or what. This might make a good discussion point regarding a theory of mind.

David Pike