Authors: Phyllis Annesley, Laura Longdon and Stephanie Hinchliffe, Clinical and Forensic Psychology Service, Rampton Hospital, Nottinghamshire, UK.



This case study presents an Eye Movement Desensitization and Reprocessing (EMDR) intervention for Complex post-traumatic stress disorder (Complex PTSD) with a female patient diagnosed with Emotionally Unstable Personality Disorder who was detained under the Mental Health Act (DH, 2015) within a UK high secure hospital. The therapy included the 8-phase EMDR protocol, the Constant Installation of Present Orientation and Safety (CIPOS; Knipe, 2010) to increase present orientation and emotion regulation, the two handed interweave technique (Shapiro, 2001) to resolve ego state conflicts, and the integration of aspects of Cognitive Analytic Therapy (CAT). Using a single case ABA design to assess the intervention, three self-report measures of trauma symptomatology and dissociation were administered pre- and post-treatment, and at six-month follow-up. Incident data was also collected. Qualitative content analysis of goodbye letters articulated the patient’s and psychologist’s experiences of the therapy. This paper evidences the effectiveness of EMDR combining aspects of CAT within a high secure forensic setting when delivered collaboratively, flexibly, and creatively in greatly reducing complex post-traumatic symptoms and life-threatening self-injury.

Key words: Complex post-traumatic stress disorder, Eye Movement Desensitization and Reprocessing, EMDR; Self-injury, Constant Installation of Present Orientation and Safety, CIPOS, Two handed interweave technique, Cognitive Analytic Therapy.

Vol. 1, Issue 2, 2020