1. Cessation of deliberate self harm following eye movement desensitisation and reprocessing (EMDR). McLaughlin, DF., McGowan, IW., Paterson, MC., Miller, PW. PRESENTED BY Dr Derek McLaughlin

2. HOW DID I FIND MYSELF HERE  Twenty something years as a MH nurse  Worked extensively in alcohol and drugs as a CMHN  University of Ulster 2001  Keen to keep clinical active  Completed level 1&2 EMDR training at TMR Health professionals  Continue to practice at TMR

3. HISTORY  I met Natalie for the first time in TMR during Jan 2007 she was 18  History showed a normal uneventful and happy life up until the age of 14 at this point bullying occurred at school  This led to reduced mood and self harm in the form of cutting with one incident of tying a scarf around her neck

4. HISTORY  GP prescribed an anti depressant and referred her to CAMHS services  Natalie attended CAMHS this was effective until discharge  Shortly after discharge, stopped medication, alcohol intake increased, cutting returned

5. HISTORY  GP referred to TMR while waiting for AMH contact  Took full history and began to establish a therapeutic relationship  I asked why she cut, as all behaviour makes sense  Natalie cut to reduce tension and anger  Scale 0-10, cut at 8

6. INTERVENTION  Pre loaded with an anger rating of 5 or 6  I could not predict the future, who would be rude to her  To move forward we had to go back  She identified two issues from her past that would still upset her and so I explain EMDR

7. EMDR PROTOCOL  History  Preparation  Assessment  Desensitisation  Installation  Body Scan  Closure  Re-evaluation

8. INTERVENTION  We completed all the preparation  Natalie choose to use clicks as her preferred form of bi- lateral stimulation  Two issues or targets were addressed, the first rated as 6/10 SUDs, and the second 7/10 SUDs  Both targets moved forward well and the SUDs for each were at 0, calm, relaxed and contained

9. OUTCOME  Natalie returned the following week and reported no self harm and she was happy with this  Present coping, tears  She was discharged shortly after this  I had contacted her in June 2008 and she had not self harmed for over 13 months  Natalie was fully Involved in the preparation of the paper, but did not want her name as an author on the paper

10. NATALIE’S CONCLUSION  " [I] never thought I would ever reach the stage of being completely happy with myself! Took some work, but got there in the end".

11. WHERE TO FROM HERE  Team has prepared proposal for funding a mixed methods study.  Very positive feedback but not funded.  Looking into other areas of funding.

12. PAPER AVAILABLE AT  http://www.casesjournal.com/content/1/1/177