FAITH-BASED TRAUMA-INFORMED TREATMENT FOR

SEXUAL ADDICTION: A CASE ILLUSTRATION

22-23 April 2017, Shanghai

Tommy LIANG, MSS, MPhil, RSW
Hong Kong

Treating Trauma through EMDR Therapy for Peace

How would it be like when EMDR is integrated with
Inner Healing Prayer in the treatment of sexual
addiction?

Treating Trauma through EMDR Therapy for Peace

 Case notes

I first met Pastor David on 9 March 2016 to work on his addictive

behavior, mainly internet pornography. It became evident very quickly
that his problem has something to do with childhood experience and
we quickly worked towards healing of past memories, desensitizing
present triggers, and consolidating future goals. His personal action
leading to sustained delaying gratification and effective self-control
included effective time management, tapping his yearnings, self-care,
better stress management, connecting to internal resources,
deepening love in caring relationships, and proper self-understanding
and self-acceptance on a regular basis. My last session with him is on
30 May 2016. Throughout the seven individual sessions, I am
satisfied to see his progress and understand his desire to prepare
himself for overseas missionary work.

Treating Trauma through EMDR Therapy for Peace

 “But the Comforter,
even the Holy Spirit,
whom the Father will send in my name,
he shall teach you all things, and bring to your remembrance all
that I said unto you. Peace I leave with you; my peace I give unto you:
not as the world giveth, give I unto you. Let not your heart be
troubled, neither let it be fearful”
(John 14:26-27, ASV).

Treating Trauma through EMDR Therapy for Peace

Faith-based Trauma-informed intervention:
A Christian perspective
The Triune God
GOD THE JESUS HOLY SPIRIT
FATHER THE SON
ASSURES SECURES COMFORTS

STABILIZES TEACHES

REMINDS

Treating Trauma through EMDR Therapy for Peace

 A review of literature

“Inner healing prayer (or healing of memories) is a form of prayer

designed to facilitate the client’s ability to process affectively painful
memories through vividly recalling those memories and asking for the
presence of God to minister in the midst of this pain” (Garzon and
Burkett, 2002, p42)1.

4 major models:
 Healing of memories (Seamands, 1985)2.
 Religion in clinical practice (Tan, 1996)3.
 Restoring the Christian soul (Payne, 1991)4.
 Healing life’s hurts through theophostic prayer (Smith, 2002/2005)5.

Earlier history:
Agnes Sanford (1950s), Francis MacNutt, Ruth Carter Stapleton, and
John and Paula Sandford

Treating Trauma through EMDR Therapy for Peace

American Society of Addiction Medicine definition of addiction:

Addiction is a primary, chronic disease of brain reward, motivation,

memory and related circuitry. Dysfunction in these circuits leads to
characteristic biological, psychological, social and spiritual
manifestations. This is reflected in the individual pursuing reward
and/or relief by substance use and other behaviors. Addiction is
characterized by impairment in behavioral control, craving, diminished
recognition of significant problems with one’s behaviors and
interpersonal relationships, and a dysfunctional emotional response.
Like other chronic diseases, addiction often involves cycles of relapse
and remission. Without treatment or engagement in recovery activities,
addiction is progressive and can result in disability or premature death.

• A NEUROBIOLOGICAL BASIS
• WITH BIO-PSYCHO-SOCIAL-SPIRITUAL ASPECTS
• APPLIED TO NON-SUBSTANCE ADDICTION

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Gale Encyclopaedia of Medicine definition of addiction:

Addiction is a persistent, compulsive dependence on a behaviour

or substance. The term has been partially replaced by the word
dependence for substance abuse. Addiction has been extended,
however, to include mood-altering behaviours or activities. Some
researchers speak of two types of addictions: substance addictions
(for example, alcoholism, drug abuse, and smoking); and process
addictions (for example, gambling, spending, shopping, eating,
and sexual activity). There is a growing recognition that many
addicts, such as polydrug abusers, are addicted to more than one
substance or process.

• PERSISTENT
• COMPULSIVE
• DEPENDENCE
• MOOD-ALTERING ACTIVITIES

Treating Trauma through EMDR Therapy for Peace

 Instinct, desires, and spirituality

Sex drive is seen as a God-given biological instinct that must

be controlled in order to avoid sin (Stanford, 2010)6.

Lust is a distorted version of God-made passion (Tan, 2010)7.

“If we are honest, we all know something about disordered

desires. Most of us know the possibility of forming a false
attachment to someone, looking to them to meet needs that
can never be met by any human…… Ordered – or purified –
desires expand me and connect me to others and the world in
life-enhancing ways. Disordered desires suck me into myself
and rather than adding vitality to life, leach it away (Benner,
2005)8.

Treating Trauma through EMDR Therapy for Peace

 …but each person is tempted when they
are dragged away by their own evil
desire and enticed. Then, after desire
has conceived, it gives birth to sin; and
sin, when it is full-grown, gives birth to
death (James 1:14-15)

…walk by the Spirit, and you will not
gratify the desires of the flesh…But if you
are led by the Spirit, you are not under the
law…But the fruit of the Spirit is love, joy,
peace, forbearance, kindness, goodness,
faithfulness, gentleness and self-control.
Against such things there is no law
(Galatians 5:16,18,22).
These people are grumblers and
complainers, living only to satisfy
their desires. They brag loudly
about themselves, and they flatter
others to get what they want
(Jude 1:16).

Treating Trauma through EMDR Therapy for Peace

The underlying mechanism of addiction
based on the Bible

SIN MOOD
(arelational) (of discontent)
(Adapted from David
Eckman, 2005) 9

DESIRE
(pain-killer /
pleasure-
giver)

CYCLE AGGRAVATED BY RULES & LAW

 Fruit of the Spirit as treatment
LOVE
SELF- (an
internal
CONTROL disposition
of delight
(the ability to control in God
bodily appetites) and
people)
MEEKNESS JOY
(the ability to not (unmistakable
assert one’s right) satisfaction)

(Galatians 5:22-23,
interpreted by David
Eckman, 2005)
PEACE
FAITH (absence of
(the ability to believe) inner turmoil)

LONG-
GOODNESS TEMPERED
(an attitude of wanting to be helpful) NESS
(patience with
KINDNESS people)
(an attitude of wanting to be beneficial)
 CravEx: an EMDR approach to treat addiction
(Hase, 2010) 10

The addiction memory (AM) serves as a useful concept for

obsessive-compulsive craving to be seen in drug addicted
patients (Boening, 2001).

The concept of AM and its importance in relapse occurrence and

maintenance of learned addictive behavior has gained growing
acceptance in the field of addiction research and treatment.

2 types of targets for EMDR concerning addiction memories:

(1) Memories of relapse
(2) Memories of intensive craving

Treating Trauma through EMDR Therapy for Peace

 Reprocessing of the Addiction Memory

The presumably episodic type of AM, its cue reactivity and power
resembles the maladaptive traumatic memory forming the core of PTSD
(van der Kolk, Burbridge, & Suzuki, 1997).

34 patients with chronic dependency, in an inpatient detoxification facility,

were randomly assigned to one of two treatment conditions during a pilot
study: treatment as usual (TAU) or TAU + EMDR. In the TAU + EMDR
group, patients received two sessions of EMDR in order to activate and
reprocess the addiction memory, they focused on the following targets:
memories of intensive craving and memories of relapse. The craving for
alcohol was measured by the OCDS pre, post, and 1 month after
treatment. The TAU + EMDR group showed a significant reduction in
craving post-treatment and 1 month after treatment where TAU did not.
The TAU + EMDR group showed less relapse at the 6-month follow-up.
The results indicate that EMDR might be a useful approach for the
treatment of addiction memory and associated symptoms of craving (Hase,
Schallmayer, & Sack, 2008).

Treating Trauma through EMDR Therapy for Peace

 SESSION 1

GOALS THERAPIST CLIENT ACTION PLAN

Rapport building 1. Expands client’s view of 1. Reports his Start/end the day
his problem by tapping his perception of with 15-minute
yearnings problem as a exercise on regular
2. Explains mechanism of reaction to child basis
addiction and highlights neglect and
Explore client’s Reward himself with
physiological response abuse
understanding of coffee & book after
3. Normalizes human 2. Reports many
his problem and completing ministerial
sexual desire but attempts to stop
his previous task once a week
confronts client’s way of his addictive
coping
coping behavior since 11
4. Discusses client’s year old but
problem in the light of failed
Identify trauma-informed Enjoy family life on
yearnings framework Saturdays as a result
underlying 5. Introduces EMDR of good time
presenting 6. Discusses action plan in management
problem relation to pleasure-
seeking & coping with
Induce hope for Complete DES,
stress
change memory list, &
7. Discusses relapse
current stimuli list
prevention
before next session

Treating Trauma through EMDR Therapy for Peace

 SESSION 2
Outcome from previous session’s intervention:
1. Ability to discern normal sexual desire and craving
2. Ability to complete all action plans except regular 15-minute exercise
3. Ability to realize and tap his yearnings

GOALS THERAPIST CLIENT ACTION PLAN

Review action 1. Evaluates 1. Recalls the memories of Remind himself of the
plans and pre-session losing control over dying frog in a kettle
homework change addiction full of water under
assignments 2. Prepares 2. Recalls the significant life gradual heat
client for events when addiction
Introduce two Turn his crave into
CravEx increased
types of target: love by deepening his
3. Follows 3. Recalls an experience of
relapse & craving love for a newly
Phase 1: intense craving
memories converted friend
History-taking 4. Becomes aware of the
4. Identifies triggers to craving
earliest 5. Identifies both raising up
memory of children and preparation
History taking on craving at 11 for missionary work as Think of the losses he
addiction years old & disturbance to staying may experience when
that of sober losing control as a
relapse at 19 6. Identifies the fears about result of relapse
years old future dangers that may
cause him to relapse

Treating Trauma through EMDR Therapy for Peace

 SESSION 3
Outcome from previous session’s intervention:
1. Ability to discern normal sexual desire and craving
2. Ability to turn craving into love for his newly converted friend
3. Abstinence from addictive behavior

GOALS THERAPIST CLIENT ACTION PLAN

Review 1. Explains 1. Sense of excitement, desire, Remind himself of
action plans EMDR security, pleasure, freedom, and cue word ‘evangelist’
and mechanism achievement identified as a to activate his
homework 2. Installs result of addiction resources on a daily
assignments resources to 2. Memory of wife, video game, basis
meet his basketball game, reading,
Phase 2: Recall his resources
yearnings preaching, caring, teaching
Preparation daily to tap his
resulting identified as resources
yearnings
from containing above senses
addiction 3. Installation of first four
3. Reduces resources done
craving 4. Positive cognition (I’m a
courageous & strong missionary’)
and the above resources
connected & strengthened
5. Cue word ‘evangelist’ identified
6. Intensity of craving reduced
from 2 to 0

Treating Trauma through EMDR Therapy for Peace

 SESSION 4
Outcome from previous session’s intervention:
1. Ability to complete ministerial work and enjoy family life
2. Report of a recent incident of intense craving when he was away from home
3. Report of maintenance of love, which has been sustaining his change

GOALS THERAPIST CLIENT ACTION PLAN

Review Targets a recent 1. Reports Level of Urge as 9 Notice any changes
homework memory for 2. Begins desensitization but not as a result of this
assignments assessment and yet completed session
intervention
Evaluate
coping
capacity
EMDR Regular practice of
phases 3 resources installed in
onward previous session

Treating Trauma through EMDR Therapy for Peace

 SESSION 5
Outcome from previous session’s intervention:
1. Ability to delay gratification by discerning normal sexual desire and craving
2. Ability to turn craving into love for people
3. Abstinence from addictive behavior

GOALS THERAPIST CLIENT ACTION PLAN

Review pre- 1. Introduces 1. Recognizes the need for Take opportunity to
session the idea of capacity for practical concern love
change self- without denying existing
ministering to capacity for vision
enhance 2. Visualizes own achievements
congruence in terms of serving others in
Consolidate Appreciate his
2. Strengths difficult conditions
positive capacity to delay
client’s 3. Becomes aware of the
treatment gratification
positive goal possibility of impact of
goal
using BLS childhood traumatic memories
3. Reprocesses of his mother on his craving
memory of a 4. Reports anger towards his
Continue recent intense mother
reprocessing craving &
the memory identifies
of a recent blocks
intense
craving

Treating Trauma through EMDR Therapy for Peace

 SESSION 6
Outcome from previous session’s intervention:
1. Ability to delay gratification by discerning normal sexual desire and craving
2. Ability to stop playing video games
3. Increased ability for self-control

GOALS THERAPIST CLIENT ACTION PLAN

Review pre- 1. Identifies target Reports God’s acceptance Daily practice of
session memory of 4-5 years and self-acceptance resource connection
change (SUD=9) (SUD=0; VOC=6)
2. Completes Regular experience of
desensitization & love
reprocessing
Identify and Take note of any
reprocess changes as a result of
traumatic 1. Identifies target Reports God’s power and reprocessing
memories in memory of 11 years self-forgiveness (SUD=0;
relation to old (SUD=10) VOC=7)
mother-son 2. Completes
relationship desensitization &
reprocessing

Treating Trauma through EMDR Therapy for Peace

 SESSION 7
Outcome from previous session’s intervention:
1. Sustainability to delay gratification by discerning normal sexual desire and craving
2. Quit playing video games
3. Increased ability for self-control
4. Enhanced communication with mother
GOALS THERAPIST CLIENT ACTION PLAN
Review pre- 1. Identifies and processes Reports Level of Urge Daily practice of
session two triggers: accidental from 3 to 0 (T1); 8 to resource connection
change exposure (T1); relaxation 0 (T2)
without responsibilities
States goal (spiritual Regular experience of
(T2)
health), positive belief love
(“I can do all things
Identify and with God.”), qualities Take note of any
reprocess 2. Identifies and processes (caring people with changes as a result of
present future template enthusiasm & joy) reprocessing
triggers and
future goals Termination (Request
Termination for further session in
3. Facilitates relapse case of need)
prevention in terms of Reminder from a
foreseeing difficult handout on self-care
situation and blocks for ministers

Treating Trauma through EMDR Therapy for Peace

 Discussions and limitations

1. This is an illustration of a 32-year old married pastor who began

masturbation and sexual fantasy since the age of 11 and was first
involved in internet pornography from the age of 16 till the present
treatment.

2. In spite of reporting the experience of love from grandmother (at 4),

teachers (from 8), peers (from 9), and God (from 16), he perceives
himself as emotionally suppressed (from 3), neglected (from 7), upset,
shameful, resentful (from 9), regretting and depressed (from 9),
cowardly (from 13), and abandoned (at 18).

3. Although history-taking is done, frequency, intensity, and duration of

specific addictive behaviors are not identified.

4. Although addiction memories are identified in Phase 2, CravEx Resource

(Hase, 2010, pp473-476) is only used to reduce craving.

To be continued…

Treating Trauma through EMDR Therapy for Peace

5. During Phase 3, when the most recent memory of an intense
craving is targeted and desensitized, blocks are found until the
memory network is expanded, leading to full reprocessing of
childhood traumatic memories. Other memories of craving and
relapse are not targeted.

6. Although help is available in case of need, no follow-up session is

offered after termination.

7. Tapping of yearnings, cost-benefit analysis, and skills training are

adopted along with EMDR protocol.

8. Prayers, metaphors, Scriptures, and hymns are employed

throughout the sessions whenever appropriate to the context.

9. Client reports deep experience of God’s presence and acceptance

in reprocessing, which is beyond his comprehension.

Treating Trauma through EMDR Therapy for Peace

 References
1. Garzon, F., & Burkett, L. (2002). Healing of memories: Models, research, future directions. Journal of
Psychology and Christianity, 21, 42-49.
2. Seamands, D. A. (1985). Healing of memories. Wheaton: Victor Books.
3. Tan, S. Y. (1996). Religion in clinical practice: Implicit and explicit integration. In E. P. Shafranke (Ed.),
Religion and the clinical practice of psychology (pp. 365-387). Washington DC: American Psychological
Association.
4. Payne, L. (1991). Restoring the Christian soul: Overcoming barriers to completion in Christ through
healing prayer. Grand Rapids: Baker Academic.
5. Smith, E. M. (2002/2005). Healing life’s hurts through theophostic prayer. Campbellsville, KY: New
Creation.
6. Stanford, M. S. (2010). The Biology of Sin. Downers Grove, IL: InterVarsity Press.
7. Tan, S. Y. (2010, July). Counseling with all our heart, all our soul, and all our mind. Lecture presented at
the Conference on Wholistic Christian Counseling in Asia 2010, Singapore.
8. Benner, D. (2005). Desiring God’s will. Downers Grove, IL: InterVarsity Press.
9. Eckman, D. (2003). Becoming What God Intended. Harvest House.
10. Hase, M. (2010). CravEx: an EMDR approach to treat substance abuse and addiction. In M. Luber (Ed.),
Eye movement desensitization and reprocessing (EMDR) scripted protocols : special populations (pp.
467-488). New York : Springer Pub. Co.

Treating Trauma through EMDR Therapy for Peace