Eye Movement Desensitization and Reprocessing (EMDR) Therapy as an Intervention for Anger and Aggression in Adolescent: A Comprehensive Case Report

M.H. is a bright and academically talented student who excels in his studies. He was actively involved in school activities and had a close group of friends. However, approximately six months ago, M.H. experienced a traumatic event that significantly impacted his emotional well-being. He witnessed a serious car accident involving a close friend, and since then, he has been struggling with distressing symptoms. M.H. has been experiencing frequent nightmares and intrusive thoughts about the accident, leading to disrupted sleep and difficulties in concentrating on his studies. In addition to the trauma-related symptoms, M.H.’s parents noticed that he became increasingly withdrawn and emotionally reactive after the incident. They observed a notable change in his behavior, with M.H. frequently getting angry and lashing out at his younger brother over minor disagreements. Furthermore, M.H. started expressing excessive worries and self-doubt about his academic performance, despite his consistent high grades. His parents reported that he would often become anxious before exams and assignments, fearing failure and disappointing his parents and teachers.

To assess M.H.’s psychological functioning and gain deeper insights into his presenting complaints, a comprehensive assessment was conducted. The House-Tree-Person (HTP) assessment and Rotter Incomplete Sentences Blank (RISB) were administered. The HTP assessment revealed weak social connectedness, communication skills, imagination, and inner strength. M.H.’s drawings depicted a sense of isolation and vulnerability. He expressed feelings of inadequacy and self-doubt in the post-inquiry questions. The RISB responses indicated a general positive attitude towards family and an interest in cars, dancing, and reading, but also reflected underlying worries and concerns.

Based on the assessment results and M.H.’s history of trauma exposure, a comprehensive case formulation was developed. It was hypothesized that M.H.’s aggressive behavior towards his brother and excessive worries about academic failure were manifestations of unresolved trauma-related distress. The traumatic car accident experience appeared to have triggered emotional dysregulation, leading to difficulties in social connectedness and self-esteem issues. Additionally, M.H.’s inability to process and cope with the trauma might have contributed to his heightened anxiety and anger. Furthermore, the pressure to maintain his academic performance and the fear of failure may be linked to a perfectionistic personality trait, intensifying his distress. The combination of unresolved trauma, anxiety, and perfectionism could be contributing to M.H.’s overall emotional difficulties and maladaptive coping mechanisms.

Considering the significant impact of trauma on M.H.’s emotional well-being and the presence of maladaptive coping strategies, Eye Movement Desensitization and Reprocessing (EMDR) therapy was selected as the intervention to address his presenting complaints and enhance overall psychological functioning. EMDR therapy has demonstrated effectiveness in trauma resolution and has been widely used to treat emotional and behavioural issues in adolescents. EMDR therapy was conducted over eight sessions. The therapist and M.H. collaboratively identified the traumatic memory related to the car accident and explored its emotional and cognitive associations. Bilateral stimulation through eye movements was employed to facilitate the processing and integration of distressing memories and emotions.

Following the completion of EMDR therapy, M.H. exhibited significant improvement in managing his anger and aggression towards his brother. His academic worries reduced, and he reported feeling more confident in his abilities. The post-treatment HTP assessment and RISB responses indicated positive changes in social connectedness and self-esteem.

This case report demonstrates the efficacy of EMDR therapy as an effective intervention for anger and aggression in a traumatized 13-year-old male. The comprehensive case formulation allowed for a deeper understanding of M.H.’s presenting complaints, considering the impact of trauma and perfectionistic tendencies. The findings are consistent with previous research supporting the effectiveness of EMDR in trauma resolution and improving emotional regulation in adolescents [1-3].

EMDR therapy proved to be a valuable intervention for M.H., resulting in a significant reduction in anger and aggression towards his sibling and excessive worry about academic performance. The case report highlights the importance of early intervention and the potential benefits of EMDR therapy in addressing emotional and behavioural challenges in adolescents who have experienced trauma and perfectionistic tendencies. Further research and case studies are needed to establish the broader effectiveness of EMDR as a treatment modality for various psychological issues in young populations.

1. Shapiro F (2001) Eye Movement Desensitization and Reprocessing (EMDR): Basic principles, protocols, and procedures (2^nd ). Guilford Press, USA.
2. Solomon RM, Shapiro F (2008) EMDR and the adaptive information processing model: Integrative treatment and case conceptualization. Clinical Case Studies 7(4): 301-316.
3. Etten MLV, Taylor S (1998) Comparative efficacy of treatments for post-traumatic stress disorder: A meta-analysis. Clinical Psychology & Psychotherapy 5(3): 126-144.