Cultic Studies Review, Vol. 8, No. 2, 2009, Page 23
approximately 2 years, with minimal benefit. Susan described the previous therapists as
―understanding very little about cults,‖ and they apparently ―didn‘t address any of the real
issues I was dealing with.‖ She had a brief voluntary inpatient hospital admission following a
suicide gesture in which she ingested pills. She had also been prescribed antidepressants for
a total of 3 years with little or no benefit. Susan had been homeschooled, which is common
among JWs and her marriage was, for all intents and purposes, an arranged one. JWs are
discouraged from attending college, especially if doing so involves being away from the
congregation so she had no career other than that of homemaker. All her friends,
associates, and family members were Witnesses, and she experienced an ―us versus them‖
socialization most of her life.
Before her initial treatment session with me, Susan completed the Beck Depression
Inventory-II (BDI-II) (Beck, Steer, &Brown, 1996). Her total score was 28,7 which indicates
high moderate depression. She completed the Subjective Units of Distress Scale (SUDS),8
as well as the Validity of Cognition (VOC)9 scales typically used in EMDR (Montgomery &
Ayllon, 1994). She also completed the Impact of Event Scale (IES)10 prior to treatment
(Horowitz, Wilmer, &Alvarez, 1979).
According to DSM-IV-TR (2000), Susan could clearly be diagnosed with a Major Depressive
Disorder, Recurrent, Moderate: 296.32 she could also qualify for a diagnosis of Post
Traumatic Stress Disorder: 309.81.
In terms of Singer‘s symptoms relevant to Post Cult Trauma Syndrome (PCTS), Susan
checked off the following: sense of loss depression and suicidal thoughts fear that not
obeying the cult‘s wishes will result in God‘s wrath or loss of salvation alienation from
family and friends sense of isolation, loneliness due to being surrounded by people who
have no basis for understanding cult life scrupulosity, excessive rigidity about rules of
minor importance panic disproportionate to one‘s circumstances confusion about right and
wrong sexual conflicts and unwarranted guilt (10 out of 13 items on the list). I used
Singer‘s criteria to determine the focus of treatment.
Because the behavioral targets of my intervention were occurring frequently enough to be
measured regularly, I rated Susan‘s symptoms at the beginning of each session via the
aforementioned methods.
Method
This study utilized an AB design in which I recorded a single baseline (A) and then
implemented a treatment (B). Following the baseline measurement, I recorded three
intervention measurements and three follow-ups, over a period of 2 months. I conducted
one additional follow-up session 1 year after the last treatment session. It is not unusual for
EMDR to work so rapidly that the actual intervention phase covers only a few sessions.
EMDR protocol is as follows:
1. Specific Instructions: Explaining how EMDR works.
2. Presenting Issue or Memory: Identifying the most salient/upsetting thing the patient
can recall relevant to the presenting problem.
3. Picture: Asking the patient, ―What picture (mental image) represents the worst part
of the incident?‖
4. Negative Cognition (NC): Having the patient come up with an ―I‖ statement in the
present tense—a presently held, negative, self-referenced belief. (A list of examples
can be supplied, from which the patient can choose, such as ―I don‘t deserve love I
am a bad person I am not in control or I cannot trust anyone.‖)
approximately 2 years, with minimal benefit. Susan described the previous therapists as
―understanding very little about cults,‖ and they apparently ―didn‘t address any of the real
issues I was dealing with.‖ She had a brief voluntary inpatient hospital admission following a
suicide gesture in which she ingested pills. She had also been prescribed antidepressants for
a total of 3 years with little or no benefit. Susan had been homeschooled, which is common
among JWs and her marriage was, for all intents and purposes, an arranged one. JWs are
discouraged from attending college, especially if doing so involves being away from the
congregation so she had no career other than that of homemaker. All her friends,
associates, and family members were Witnesses, and she experienced an ―us versus them‖
socialization most of her life.
Before her initial treatment session with me, Susan completed the Beck Depression
Inventory-II (BDI-II) (Beck, Steer, &Brown, 1996). Her total score was 28,7 which indicates
high moderate depression. She completed the Subjective Units of Distress Scale (SUDS),8
as well as the Validity of Cognition (VOC)9 scales typically used in EMDR (Montgomery &
Ayllon, 1994). She also completed the Impact of Event Scale (IES)10 prior to treatment
(Horowitz, Wilmer, &Alvarez, 1979).
According to DSM-IV-TR (2000), Susan could clearly be diagnosed with a Major Depressive
Disorder, Recurrent, Moderate: 296.32 she could also qualify for a diagnosis of Post
Traumatic Stress Disorder: 309.81.
In terms of Singer‘s symptoms relevant to Post Cult Trauma Syndrome (PCTS), Susan
checked off the following: sense of loss depression and suicidal thoughts fear that not
obeying the cult‘s wishes will result in God‘s wrath or loss of salvation alienation from
family and friends sense of isolation, loneliness due to being surrounded by people who
have no basis for understanding cult life scrupulosity, excessive rigidity about rules of
minor importance panic disproportionate to one‘s circumstances confusion about right and
wrong sexual conflicts and unwarranted guilt (10 out of 13 items on the list). I used
Singer‘s criteria to determine the focus of treatment.
Because the behavioral targets of my intervention were occurring frequently enough to be
measured regularly, I rated Susan‘s symptoms at the beginning of each session via the
aforementioned methods.
Method
This study utilized an AB design in which I recorded a single baseline (A) and then
implemented a treatment (B). Following the baseline measurement, I recorded three
intervention measurements and three follow-ups, over a period of 2 months. I conducted
one additional follow-up session 1 year after the last treatment session. It is not unusual for
EMDR to work so rapidly that the actual intervention phase covers only a few sessions.
EMDR protocol is as follows:
1. Specific Instructions: Explaining how EMDR works.
2. Presenting Issue or Memory: Identifying the most salient/upsetting thing the patient
can recall relevant to the presenting problem.
3. Picture: Asking the patient, ―What picture (mental image) represents the worst part
of the incident?‖
4. Negative Cognition (NC): Having the patient come up with an ―I‖ statement in the
present tense—a presently held, negative, self-referenced belief. (A list of examples
can be supplied, from which the patient can choose, such as ―I don‘t deserve love I
am a bad person I am not in control or I cannot trust anyone.‖)
