I’m writing this in 2021 from a remarkable and privileged viewpoint. As a trauma therapist, I see people completely and profoundly heal from past experiences. I am trained in multiple modern approaches to help clients heal and I am fortunate … Continue reading Why is Actual Healing So Rare?
A Simple and Metaphor-Guided View of Working with Complex Trauma using EMDR Phase One of EMDR therapy is an important part of the recovery process. It is often the point where a new client meets his new therapist. First impressions … Continue reading What’s So Complex about Complex Trauma? Phase One
If I had a talent when I was young, it was going away. Retreating deeper into that space that doesn’t have a name. If I have any talents now, they have grown from what I learned by being alert and … Continue reading Unwanted Embodiment
We are entering a new era of trauma awareness. We are just starting to be able to make visible the central role that trauma plays in human development, physical health, and in relationships of all types. We are recognizing that … Continue reading The Ethics of Not Treating Trauma
That Which Doesn’t Kills Us, Makes Us Stronger –Nietzsche In our age of growing trauma awareness, the resilience movement has a core conceptual problem. Resilience, when it comes to someone who has been traumatized, arrives as a functioning of healing. … Continue reading “That Which Does Not Kill Us” And Related Lies
“Have you ever been emotionally, physically, or sexually abused?” It’s a standard intake question asked tens of thousands of times a day as part of mental health assessments all across the country. At the beginning of my career I asked … Continue reading Dancing Around the Unspeakable at Intake
All memory is individual, unreproducible – it dies with each person. What is called collective memory is not a remembering but a stipulating: that this is important, and this is the story about how it happened, with the pictures that … Continue reading Regarding the Trauma of Others
EMDR Therapy reprocessing involves three central components: you activate a traumatic memory, notice what comes up as you interact with the memory, and you do this while your brain receives a left-right stimulation. Noticing is the bright yellow line in … Continue reading If You Chase It, It Will Run
Noticing is the bright yellow line in the center of the road of EMDR Therapy. A client that struggles or resists noticing is unlikely to move efficiently in the direction of healing. But, noticing sucks for most people with trauma. … Continue reading Bypasses in EMDR Therapy
There is a strange place in post-traumatic growth–after most of the hard work is done–that gratitude may start to settle into. Not gratitude just for having survived it. Or, having recovered from it. Gratitude for having experienced it. That emotion … Continue reading Post-Traumatic Growth
It’s completely normal for life to break your heart. It will happen. We all got here when a bottom fell out and everything that we knew fell out with us into some vast space that we never anticipated inhabiting. And, … Continue reading Disclosure in Trauma Work
In the reprocessing phases of EMDR Therapy, it’s often easier to know that reprocessing is happening than is to know that it is not. As a general rule, you can expect that reprocessing is occurring if the client reports any … Continue reading How to Know if Reprocessing is Happening
Embracing the EMDR Therapy worldview may transform how you do therapy. It may transform or adjust nearly everything that you thought you knew about how people change. However, the structure of the EMDR protocol doesn’t cover your deficits as a … Continue reading EMDR and the Therapeutic Relationship
From the broadest view, EMDR allows stuck memories to connect with and assimilate into adaptive information. This is done by activating the stuck memory, noticing whatever comes up, while receiving one of several forms of bilateral stimulation. Noticing is an … Continue reading Notes on Noticing
Clients will often have performance anxiety related to starting any form of trauma therapy. Many therapists also have performance anxiety about starting EMDR Therapy with their existing clients. What happens if I offer this option to a client and she … Continue reading The Performance Anxiety of New EMDR Therapists
This is a fantastical story. I probably wouldn’t believe you if our situations were reversed and this were your story. Still, let me tell you a little about what I see every day in my work as a mental health … Continue reading What Healing Looks Like
It is wise to be adequately prepared for any journey. Preparation is particularly important with my clients because most have extensive trauma histories spanning decades, many have severe PTSD symptoms, many also have severe and chronic pain (usually from either … Continue reading A Preparation Checklist for EMDR Reprocessing
A flashback is a strong and involuntary sensory replaying of part of a traumatic experience for some people who experience traumatic events. It rapidly takes clients out of the “now” and drops them inside a past traumatic experience. During the … Continue reading Displacing Flashbacks with Visual Grounding
In the broadest view, EMDR facilitates the linkage and assimilation of “stuck” information into existing adaptive information. Part of my initial assessment also explores for the presence of healthy and adaptive information. I’m not very picky about the types of … Continue reading A Simple Overview of Where Blocks Might Happen in EMDR Reprocessing
For many clients, 45-55 minutes is enough of time to reprocess many targets. For others, you will wish for an additional 20 minutes (which you probably will not have). The following strategies seem to be effective at making the most … Continue reading Strategies for Making the Most of 55 Minute EMDR Sessions
I view my role as an EMDR therapist as an assistant navigator in working with clients to reprocess trauma. This can be an elegant metaphor. It suggests that one of the primary purposes of our relationship is movement. What I … Continue reading A Workable Metaphor for the Therapist Role in EMDR
Some clients will experience intense emotions during reprocessing (other clients will reprocess without a lot of intensity). EMDR therapists should be comfortable with a wide range of emotional expression or emotional lack of expression. The purpose of implementing strategies to … Continue reading Some Notes on Abreaction in EMDR
It is not unusual for a client to “go blank” at some point during reprocessing. He may suddenly report, “I don’t know what I’m noticing” or “I don’t feel anything right now.” When noticing “nothing” occurs very early in reprocessing … Continue reading When Reprocessing Starts but “Fizzles” in the First Few Sets
It’s one of the most intense EMDR targets I’ve encountered in working with clients. It’s also one of the most productive. There is often a big loneliness that floods in when doing attachment-focused EMDR. She remembers the awful loneliness of … Continue reading Sitting on the Floor of a Childhood Home
I’ll try to describe what an average traumatic memory reprocessing session using EMDR looks like. During the first few minutes of the session we select the specific memory that the client will initially focus on. I ask the client about thoughts … Continue reading Brief Description of an Average EMDR Session
Being an effective EMDR therapist is a mix of experience and intuition. They’re so closely related that when both are active it’s hard to talk about one without the other. However, it is possible to have a lot of experience … Continue reading The Intersection of Experience and Intuition in EMDR
Trauma breaks things. It fills the pieces with the impulse to flee. It also augers each piece and necklaces them together into what becomes a tight torsioned knot. Nothing can get what it needs with all that restlessness pulling against … Continue reading Estrangement and Recovery
Lord, I’ll take the good. I’ll take the good all day long. This world will give it. Perfect is always on that distant horizon, always almost here. You can swim in good, build your house on top of it, smell … Continue reading Mindful: A Meditation After Recovery
Apologies nearly never do what my clients with developmental trauma hope that they will do. Most of my clients will not get an apology at all, nor anything that approximates any recognition of harm. All that wanting for any form … Continue reading Apologies in Trauma Recovery
Forgiveness is the domain of priests. It’s also centered in the common language of abusers and their apologists. When it comes to trauma, we don’t come to the idea of forgiveness untarnished. There’s absolutely nothing new in the suggestion to … Continue reading Forgiveness in Trauma Recovery
Of course trauma profoundly affects self-esteem. It rips the rug out from under the self. It changes the way our brains work. It changes the way the world looks. The lessons that traumatic experiences teach us related to our own … Continue reading Self-Esteem and EMDR
I have seen enough deep healing to recognize the irony. It’s not until you can heal enough that you no longer need anything from them that you can get what you’ve always needed. Developmental trauma is the other trauma. It’s … Continue reading Healing Developmental Trauma: A Meditation
Traditional talk therapy is a mess. Everyone pretty much knows it, especially therapists. We sit in small rooms all day with people who need to make deep and lasting changes. They rarely do. We hope that our attentive listening and … Continue reading If Therapy is Slowly Killing You, Maybe You Should Do it Differently
It’s ironic that I’m writing this piece to other therapists about the importance and hazards of early breath work in clients with trauma. Breath is about connecting with the inside. Asking someone to notice anything related to the inside can … Continue reading “Deep Breathing Doesn’t Work for Me”
I’ll start with what sucks. People do astonishingly terrible things to other people–unbelievable, unspeakable, and completely messed up things. This happens all the time and on every street. Trauma happens in virtually every family. A fair chunk of trauma is … Continue reading Being an EMDR Trauma Therapist Teaches You a Lot and Most of It Is Good
This is an ongoing list of things I have noticed (or things to remember) about doing EMDR with clients. Much of this will not make much sense if you aren’t EMDR basic trained. I’m only several hundred EMDR sessions in. This list … Continue reading Troubleshooting in Early EMDR Sessions
In community mental health, most of your client’s mood issues are directly related to everything they have survived (to be fair, this is probably true for the rest of us too). Yet, most of them have survived some particularly horrible … Continue reading Psst: You’re Already a Trauma Therapist
The idea that the mind and body already know about healing is incredibly liberating. It frees me from the burdens of excessive doing and allows more intentional being. Suddenly, I don’t have to prescribe, or conjure, or orchestrate. There is … Continue reading Sunshine
I transit the underworld every day in the work I do with severely traumatized clients. If you do this work, it’s helpful to be personally familiar with the terrain. It’s equally important that you have–for the most part–found your own … Continue reading Underworld Railroad
[The seeping box metaphor is one of the most useful trauma metaphors that I have found. Clients seem to understand every part of it intuitively. We continue this metaphor through all parts of safety and reprocessing.] When we’re kids and … Continue reading The Seeping Box Metaphor for Trauma
Many of your clients with extensive trauma with have a history of panic attacks. Those with extensive trauma that do not have panic attacks may have frequent rage episodes instead. Some have both. In community mental health, you are unlikely … Continue reading Working with Clients Prone to Panic Attacks
Your clients with trauma have likely been told throughout their lives that their traumatic experiences did not happen, that their emotional responses are dramatic and unfounded, that the problem is how they are thinking about what happened to them, and … Continue reading Baker’s Dozen of Things Not to Do with Traumatized Clients
The strange part about EMDR is the bilateral (left and right) stimulation. Despite the claims of critics, the bilateral part of EMDR appears to be an essential part of traumatic memory reprocessing using this method. Clients are usually able to … Continue reading Simple Ways to Introduce EMDR to Clients
Traumatic memories are not “normal” memories and do not behave like normal memories. Understanding these differences and finding ways to communicate these differences to clients, is important early work that you can do in your own development as a therapist … Continue reading Understanding Traumatic Memories
At least 90% of what I do at work is trauma work. It takes a while to realize this. It’s just the nature of community mental health. It’s hard to believe at first. I see only Medicaid clients currently and … Continue reading It’s Much Worse Than What You Have in Mind
[From early 2013, several months into my practicum/internship.] So, this is what I’m thinking today. It’s different than last week and I will have a different view on Wednesday evening of next week. “She” refers to most of my client base. … Continue reading Early Reflections During My First Few Months of Community Mental Health Work
I started seeing my first community mental health clients three years ago. On the day that I met my first clients at my internship, I was immediately aware that no part of my graduate education (or my life) prepared me … Continue reading Things Someone Should Have Told Me
EMDR is a therapy to treat traumatic memories. Traumatic memories are not like “normal” memories and do not behave the way other memories behave. Traumatic memories appear to be stored deep in the emotional parts of the brain and accessing … Continue reading Ten Things to Love about EMDR (As A Newly-Trained Therapist)
Go With That 