Emerging from the coffin: Treatment of a masochistic personality disorder

"Dan" was a 48-year old married man who, despite ten years of psychoanalytic treatment, awakened every morning with the image of lying dead in a coffin. This dovetailed with his experience of daily life as devoid of meaning and pleasure. Despite his apparent relentless suffering and preoccupation with death, Dan reported never having been actively suicidal. In fact, his life appeared to be oddly homeostatic. He sought out therapy at the urging of his wife, who was exasperated by his pervasive negativity. This case illustrates the successful use of longer-term EMDR charactered by the multiple sessions and many months to fully reprocess individual protocols. Treatment was completed, with Dan free of coffin fantasies and capable of experiencing hope, joy and purpose for the first time in his life. His positive response, over time, indicates that individuals with characterological defenses can process, albeit incrementally, difficult material and ultimately reach a level of full resolution. Since my success with Dan, I have replicated this startling outcome with numerous clients in periods ranging from 9 to 18 months. This was inconceivable for me in my pre-EMDR days when many years of treatment yielded far more limited results.

Book Section

English

David Grand

Grand, D. (1998). Emerging from the coffin: Treatment of a masochistic personality disorder. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications (1st ed.) (pp. 65-90). New York, NY: W. W. Norton & Co