…And He Cried On My Shoulder

By Deborah Mitnick, LCSW

The following is a report of a recent session that I had with a new client. All details have been altered to preserve confidentiality. The trauma was even more dramatic than the way I’m portraying it here.

The client is a 55-year-old who was referred to me by two psychiatrists. Forty-five years ago, "Henry" witnessed the death of a child-friend of his. His friend was disemboweled in front of his eyes during a school outing at a nature park. Henry has always felt responsible for the accident because he had encouraged his friend to attend the event where the accident took place.

Since that time, Henry has been unable to cry. He has felt guilty all of his life. He has never held a meaningful job. He has multiple allergies to food and to the environment. He suffers from fungal infections, has debilitating physical pains, and many immune system problems. He suffers from bowel problems and daily headaches. He complains of low energy and dissatisfaction with life.

His strongest emotions are shame, guilt, and anger. He rates them all at a Subjective Unit of Distress Scale (SUDS) level of 9, with 10 being the worst it could be. He says that a 10 would mean that he couldn’t cope any more.

He avoids making meaningful relationships and has distanced himself from most of his family and friends. He’s left most of his jobs "in shame."

Henry has been in multiple therapies over the years, starting immediately after the accident. There have been at least six inpatient hospitalizations, at least 13 bilateral treatments with ECT (shock treatments), and multiple medications for depression, anxiety, and mania.

When Henry called me, he told me that he was afraid to remember the event and that he was afraid that he would get overwhelmed during the session and would "go crazy" again. He knew about me for four months before he actually scheduled the appointment. He’s been "afraid to face what needs to be faced."

I met with the client for a "free consultation" for one hour. I told him that my job in the session was to keep him on task. I described my role as that of the secretary for the busy executive. I would keep him organized. I told him that I had some tools that I could use that would provide him with the opportunity to do his own healing. I made it very clear to him that although I could not "cure" him, I would provide the structure and the environment to make it possible for him to find his own positive result. I also reminded him that in my work, there are no guarantees of success and I make no promises of a positive result, although my success-rate is very high.

After this first hour, we agreed to work together. I demonstrated the EFT tapping points and asked the client if he’d want to do his own tapping, or if he’d want me to tap for him. I received his consent to do the tapping for him.

I then conducted a formal and complete psychiatric interview. This helped me assess if the client had the ego-strengths to work through the trauma with the methods that I have to offer him.

When the client mentioned his allergies, his low self-esteem, his difficulties with maintaining meaningful employment, I told him that some of the methods we would be using could be helpful to him in overcoming some of these problems.

Henry said, "This accident is something I’ve never been allowed to talk about. My father wouldn’t let me talk about it at home, so I had to deal with it in my room alone. The sounds and smells haunt me. I’ve had no one to tell about it. My life has been hell since it happened. I guess I should bite the bullet and talk to you about it, but it’s really too painful for me to address. I’m afraid if I start to tell you about it that I will go crazy and get too overwhelmed to continue. I’m afraid I’ll run from your office, screaming and crying, and I’ll never get over this problem."

I decided that we needed to "tap around" the trauma for a while. I asked him what physical symptoms he has that he associates with the trauma. His throat always aches and feels tight. He feels like crying, but never does. We tapped for "this throat emotion" for a SUDS reduction from 8 to 5 =. At that point, he said that it’s hard for him to express emotions about this, but his throat no longer ached or felt tight, yet he was afraid to let go of the tightness. So we tapped for "afraid to get over this tightness emotion."

New aspects began to emerge. He said, "I’m not sure what I saw. I feel responsible for what happened. I had nagged my friend to go on the outing with me."

(Please note: I still have no idea what the details are about this incident. You know as much as I do from this description.)

I decided to start providing him with "re-framing" possibilities. I asked him if he would have free will if someone encouraged him to go on an outing. Would he be "locked into" going, just because someone strongly encouraged him, or nagged him? He looked thoughtful, and said, it would still be his choice. I asked him to remember what he was like at age 10. Would he have been able to say "no" if someone encouraged him to do something and he didn't want to do it? He agreed that he would have been able to say "no" to a friend, even at the age of 10.

We tapped for "this responsibility" and "this guilt." His throat began to feel better. We tapped for "this beating myself up-thing." He reported feeling much more relaxed and "light." He said, "My throat is feeling a lot better. I’m no longer afraid that I won’t be able to swallow."

To continue with the re-frames, I asked, "How old were you at the time of the incident?" He said he was only 10 years old. I said, "How much power does a 10 year old have over another person?" He smiled.

We returned to tapping on "this responsibility" and "this guilt." But this time, my suggested affirmations had to do with, "…I was just a kid…doing the best I could at the time…I’m not responsible for the decisions of others," etc. Every time I do such an affirmation, I ask the person, "Does this ring true for you? I don’t want to put words in your mouth that don’t fit for you." Henry said that all that I had suggested was true for him.

He began to smile (first time in the session). He said, "This feels so much better. It’s affirming to think of it that way. It’s getting less intense in my throat. [He laughed.] It’s now moved up to the roof of my mouth. I can feel it moving up and out!" He rated his throat constriction as a "1" now.

Henry grabbed my hand. He said, "I’ll never forget this moment." He put his head on my shoulder and wept for about five minutes. (Remember, he hasn’t cried for 45 years.) I just held him.

He doesn’t know it, but I cried, too. I felt humbled by the power of the method. I felt thrilled for him that he had trusted himself, and trusted enough in me, to permit the healing to take place. I thought about how simple healing could be, as well as how rapidly it could happen, but at the same time, it can be a profound experience. I also realized that it was not necessary for him to "barrel in" and feel the full pain of the incident. It was also not necessary for me to "understand" exactly what his trauma was.

He opened his eyes, sighed deeply, smiled at me, and closed his eyes. He stayed immobile for over five minutes. He finally said, "I’m forgiving myself. I thank God for bringing me to you. I thank God for revealing this method to me. I realize now that God forgave me a long time ago, but I never forgave myself. Now I can forgive myself."

Henry began to rub the center of his chest. He said, "I’m rubbing in the good feeling. I want to treasure this moment. Thank you for giving me the opportunity to find my voice and say what needed to be said. The balancing you did with the tapping made this possible."

This seemed like the perfect "end-point" of the session, and we stopped.

I still have no idea what happened during the trauma. You know everything that I know. Henry never reviewed the incident. We only "talked around" it. And it resolved.

I spoke to Henry two days after this session. Here’s what he said: "I felt so good on Thursday. I'm so happy that I did that session with you. I've put the accident behind me. I don't have any guilt about that any more. I feel totally relieved about that accident. Now it's behind me. I don’t think about it anymore. I really thank you for that."

This session lasted for 70 minutes.

Deborah Mitnick, LCSW