Sexual tauma in dsfunctional marriages: Integrating structural therapy and EMDR



Sexual abuse survivor couples who choose to engage in marital therapy often present with problems around attachment, intimacy, infidelity, rage, a sense of entrapment, feelings of betrayal, low self-esteem, powerlessness, codependency, and a need to control or have power. Their individual histories become critical to understanding what type of interventions to implement as these individuals continue to respond to one another in an almost stylized and predictable manner. This chapter describes a treatment approach that combines Structural Family Therapy (SFT) and Eye Movement Desensitization and Reprocessing (EMDR) in marital therapy when one or both partners have a history of childhood sexual abuse. In this approach, the therapist begins with SFT and then shifts to EMDR treatment of the traumatized partner. This shift is to process the survivor's abuse experience so that he or she can come to an adaptive resolution. This sets the stage for the survivor to respond differently to the possible triggers in his or her life as well as in the relationship. Once the EMDR process is complete and the couple participates in joint debriefing of the EMDR intervention, they reengage in the SFT marital sessions while integrating insights and adaptations the trauma survivor has gained from the EMDR work. This approach involves the applications of the EMDR standard protocol. It also uses the core elements of SFT, such as joining, restructuring diffuse and rigid boundaries, relabeling, and enactments.


Book Section




Wilhelmina S. Koedam

Original Work Citation

Koedam, W. S. (2007). Sexual tauma in dsfunctional marriages: Integrating structural therapy and EMDR. In F. Shapiro, F. W. Kaslow, & L. Maxfield (Eds.), Handbook of EMDR and family therapy processes (pp.223-242). Hoboken, NJ: John Wiley & Sons Inc



“Sexual tauma in dsfunctional marriages: Integrating structural therapy and EMDR,” Francine Shapiro Library, accessed January 29, 2022,

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