In part two of a two part series, Mike returns with guest Julie Roy, for a thoughtful look at trauma and how it can be treated. Using techniques that focus on grounding the body, can begin to ground the mind, so techniques like Eye Movement Desensitization and Reprocessing (EMDR) can assist with dissociative feelings or events. Along the way, they share helpful strategies for managing strong emotions and tuning into the body.

Website: National Library of Medicine / EMDR 2.0

Search: The Body Keeps the Score by Besel van der Kolk

Website: Polyvagal Institute

Website: Cleveland Clinic / What is Acceptance and Commitment Therapy?

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Welcome to A Psycho Delicious Conversation on mental health issues and trends from three local mental health professionals in the greater Lansing area. I'm Michael Stratton, LMSW. And I'm Morgan Bowen, PMHNP. And I'm Melissa Black, PMHNP. And we're here to provide you with a deep dive into the human experience of consciousness and beyond. Our aim is to be educational and entertaining, so just kick back and open your ears and your minds.

Hey, I'm Michael Stratton, lmsw.

And today we have a special episode where Julie Roy, who is a colleague of mine and works in the same suite, is here because Melissa and Morgan are off this week and we've been talking about trauma and complex trauma. And thanks again, Julie, for coming in.

Yeah, thanks again for having me.

And maybe a disclaimer because we're talking about trauma and, you know, I realize that there's the possibility people could get triggered just by thinking about it or hearing examples that we're using.

And also it's always good to have, you know, kind of a like a resource for people that get so severely triggered that they have suicidal thoughts to call. I think 988 is the number for people on a suicide line. That's national and you can do that at any point in time, 24 hours a day.

So the first part, we talked a lot about what trauma is and what EMDR is. And this time we're going to talk more specifically about treatment.

And you talked about how you don't introduce that as an option like right off the start, usually. What's your, I don't know, protocol or what's the mean?

Start EMDR immediately? Yeah, correct. Well, and I, the caveat too is I talked in that last segment that people have an image that EMDR is only the eye movements.

Much of it really needs to be what we call phase two. And practicing so many skills that may not have been learned or have been appropriate to them, especially if there was dissociation to utilize.

So I spend a lot, a lot of time with, like when I went over that DES assessment that we were talking about, that Dissociative Experiences Scale, one thing I forgot to mention is that I have been taught to make that a conversation. And so from the get go, as soon as I'm assessing people, I am looking for what do they need immediately? And we do that.

I mean, I can do that sometimes in an intake, you know, teach containment, you know, as soon as we have talked just a little bit about trauma or I mentioned that I work somatically a lot. And I'll ask them right away to see, you know, can they notice what's going on in their body. And I am watching constantly for body language.

So when you talk about containment, you're talking about kind of peak emotional experiences someone might be having or really distressing emotional experiences and how to work with that in a way that they don't have to either shut down or act out.

Right. Or be feeling it as they leave the room.

You know, it's really important to me, which is hard when I first meet some people, and they have a lot of energy about getting their story out. And, you know, so I try to warn them right away, I'm going to do this a little differently, and I might stop you.

And that's not what people have been taught therapy is about. We're supposed to stay out of the way and let them just talk and talk and talk and talk. And I try to dance back and forth between, you know, is it.

Can I start interjecting some. Some containment here? Yes.

Journey.

The idea of the mental container. Picturing a container.

Okay.

No. So this might be one of those.

New or not that I remember. Go ahead.

Yeah. So this might be something they've added along the way with emdr. So I'm guessing this is a CBT trick.

One of these days I'm going to look at the origin of it. But, you know, so if I say, do you picture things in your head? Can you picture some kind of container?

Now, some people cannot, and I might have to actually show them something like, okay, here's this jar on my table.

Let's say this jar is going to take these feelings that you just brought up so that you don't have to walk out of this room feeling, you know, this distress that you've brought up. So that's what we're going to put in this container.

There's a whole visualization that goes along with it that I won't, you know, demonstrate right now.

But I like it.

I want that to, you know, I want things like that, and I want to check for their ability, you know, to notice things. If we can't notice what's coming up, we are not ready to desensitize anything. Otherwise, we're only talking about it on an intellectual level.

It's re. Traumatizing.

Do you have many people coming to you specifically for emdr or. I mean, are they coming to you through Psychology Today? Are they getting referred by other therapists? What's the.

It's everywhere. Yeah.

Which is so interesting to Me, because I don't know if you hear all these other therapists saying, I can't fill my caseload, I can't fill my caseload. I'm like, how about taking EMDR training? You know?

Yeah, exactly.

Well, and a lot of EMDR training. I would argue, please don't take just the basic training and think you are ready for all of this.

Oh, yeah. I had a therapist, I won't mention their name, but they came in to watch. We had.

We shared a client and they came in to watch EMDR sessions and to see how it was. Next thing I knew, he was doing EMDR two weeks later. And I'm like, yeah, that was not to train.

And that's the other thing I want, you know, people to know there's so much bad therapy, especially EMDR out there.

Yeah.

And that's really frustrating.

Very true.

I would say the majority of the people that come to me these days are also seeking the dissociation. But, yeah, I have a. I have a mix of whether they found me through EMDria. Psychology Today, it seems like less and less.

Psychology Today, like people say, local networking.

And EMDRIA is the EMDR Association.

Basically, yes. And so I don't know if I want to say fortunately or unfortunately, we don't have to be certified through them. I recommend it, sure.

I don't want to be like one of those gatekeeper people about it, but I recommend asking at least if somebody's seeking EMDR therapist, have they done training beyond their basic training at least, you know, are they continuing to get consultation?

Yeah, those.

Those kind of questions, I think are important.

Initially, when I learned how to do it, there were about six of us in the community that knew how to do it. And we would meet in my office, Mike Rogel and Carol Dukat and Jane Rohrabach and there were a couple of others.

And we would bring Bennett Wolper in from Ann Arbor to do supervision with us. And so we did that for several years. And there's a whole story behind that which I'm not going to get into.

And I would imagine pre video conferencing, I mean, how much you all had to work harder to get this kind of training. And so I almost kind of feel like in this day and age, why are people saying they can't access this training? They say it's expensive.

But I will tell you, you will get your, oh, man, your money's worth and your confidence level increase so much.

It's so valuable. I remember the, well, the effects of doing it for myself.

Because it's the other thing that Francine Shapiro said to us when she turned us all loose at the end of our training, the second level. She said, go back to your communities, find an EMDR therapist and power your 10 worst memories, and you will be a different person.

Yeah.

And honest to God, I mean, it was like people were coming up to me and saying, have you lost weight? You know, it was just like they could see, like a physical difference in doing that kind of work. And it was really. It was really great.

And that's such an important point, I think, as therapists in general, is that I think if anybody is in this kind of field and they're struggling with their own situations and they're not addressing that, they're just not going to be confident or effective.

You got to always be looking at yourself.

So I'm glad I came into this later in life after having.

Well, you address things, you become softened. You either become hardened or you become softened or a combination of the two. But you become more humble about. Everybody's got stuff, for sure.

And if you don't deal with your stuff, your stuff will deal with you. You know, you handle it or it'll handle you. So you mentioned phase one and phase two, and it's interesting, that whole idea.

Phase one is like the actual EMDR session itself. Phase two is. How do you work with these.

Yeah, people argue. They need to switch that around.

Yeah, that's great.

It's out of order.

Yeah. Yeah. So you do a lot of phase two work as you're getting ready to do the phase one. Yeah.

And try to inform, because you inevitably get that person then who's like, when are we going to get into emdr? Mdr? Yeah, we are doing it.

It's happening right now.

My. My whole brain is oriented to. To think this way.

You know, I mean, I think that's also another benefit that I did it so early into my career is I only know how to think that way. I don't want to think another way.

So when I'm talking to someone about, you know, isolating a memory and creating like a target memory for what we. What they want to talk about or something that's really been bothering them. And it just.

One thing I like about emdr, it encompasses the whole human experience.

So it's not just think of the memory and get a picture of that memory, almost like it's a postcard that you're going to focus on, but also when you're talking about that, what comes up for you emotionally where are you feeling it in your body? What level of distress do you feel? And then the cognitive piece, which is the thinking piece.

What negative belief are you holding about yourself as a result of that?

And that's what I'm talking about that I am watching for always. All those negatives, always looking for, like, this is the theme. This is the theme. Or.

And especially with complex trauma, we tend to have several themes. And so I'm mentally putting.

And I don't know if I got to tell you that I have a teaching background, so I like to, you know, synthesize, you know, where is this theme going? Where. Where is this story going? And, you know, just keep watching for that fits into that story, and that fits into that story.

You know, and which one do we keep bringing up over and over again?

That's fascinating. So when I talked to you yesterday or the day before, and you were mentioning something about people getting on the ground. So do you.

Do you do more bodywork? Because so much of what I do is we're just.

Were sitting in chairs and we're doing it, and it was fascinating, the idea of someone, like, getting in a pose or a position.

Well, let me qualify and say I would like to get people down on the floor.

Okay. Okay.

They have been conditioned to stay in that chair so much. And I see that, as, you know, our protective barriers, like, I'm safer if I stay on this couch in that move.

But I was trained both in trauma informed mindfulness and yoga, 12 step recovery. Oh. And so when I facilitated.

Did we talk about Kathy Reddington?

Yeah. Yeah, we did. I think we did talk about that. She's a good friend.

Yeah.

So when I worked in residential treatment, I got to do a lot more. I don't know why. At that stage, people were much more open to doing more movement than they are in a typical therapy session.

But so moving into this suite down the hall from you, that was one thing I was very attracted to, is I'm going to keep introducing to people. We can move. We can move while. And that's another thing I've been trained to do with EMDR also. They call that EMDR 2.0.

I don't know if you've heard of that. No. Um, so this is another strategy for dissociation is to be talking while moving. And I think that's another theory with the tappers.

You know, again, it's accessing more of their brain. So I might toss a ball with somebody. You know, we might be stomping or drumming.

And I think I was stressing to you when we talked about it, that some people have been really, that's really good for them. And then other people are just kind of like, you want me to do what?

Well, that's, that's, that's very interesting. I got to check out that EMDR 2.0 working memory text.

Yeah. And I've only had just like, I mean, a couple like really basic trainings in it. I mean, not specific trainings in it, I should say.

I've done trainings that included it.

But it made so much sense to me, you know, because again, I feel like somatically, you know, we, we need the body to communicate what it, what it needs us to know.

One of, one of my early jobs doing psychotherapy was working at Health Central and they did in services. Every week, every Wednesday the doctors would get together and one of the topics was body mind. Is there a connection? Yeah, it was like as a question.

Doctors need to know that. I think they're starting to know that. I'm really excited that NASW just announced that there's going to be a Mind Body certification.

I've gone to some of the, I don't know, meeting work groups, whatever they've had, and that's something I would like to see.

That'd be really interesting. Yeah, yeah, yeah, yeah. There was a therapist in the community that was doing a lot of kind of body movement work.

And I remember, I can't remember this person's name and they're no longer in the community, so I shouldn't even be talking about it. But they would notice a movement that a person would do in a session.

So for instance, if I'm doing this, they would have you exaggerate it and keep doing it and what, what springs up as you're starting to do it and what does it remind you of? And it just go on and on and on.

Yeah, there's a lot of therapists that do that. I mean, they have the whole somatic experiencing trainings. You know, that might be something I might do along the lines, but I tend to seek.

There are EMDR trainings that are yoga based. I've also done that. You know, there, there's a lot of ways to include this kind of into our trainings already.

Yeah. One, one work that we should cite along with Francine Shapiro is Bessel van der Kolk, and he wrote a book called the Body Keeps the Score, which.

I never recommend that clients read.

No, it's dense. It's really dense and triggering and sometimes they want to read it. And sometimes they do.

Interestingly, before I became a therapist, I was told not to read it. And so then anytime somebody tells me not to do something, that's exactly why I will do it.

Oppositional defiant.

Yes,.

I'll keep that.

You're telling me not to read that.

Down the street, I'm going to say, make sure you don't lock the doors.

I'm not that bad. I just get a touch sometimes.

Well, anyway, especially when it comes to books.

You're going to tell me not to read a book? I'm going to read that book.

But he talked about how trauma is stored inside the body. Or as I've heard yoga instructors describe. Kathy Reddington even uses this line, your issues are in your tissues.

And I would experience that doing a yoga class.

Yeah.

Just like, why am I so sad?

I don't know why people dispute it. There's a huge fight. A fight, I guess I want to call it. I guess it's been going on for a long time. Against. If you're familiar with polyvagal theory.

Yeah.

Check that. That argument out.

What are they saying about polyvagal?

Well, again, they're trying to dispute it. When it's. Again, I don't have the training and smarts to explain it, but it's out there. You can find the argument.

Google. P O L Y V A G.

A L. P O L, Y, V, A G A L. Yes. Yeah.

Okay. I was right.

Or pvt. And one of the best explanations of why it works, along with what you just said.

Another person I've done trainings with on a yoga basis who also does emdr is Ariel Schwartz. And so she wrote a substack explaining, again, like, that felt sense. Like, you. You just said you can notice.

I mean, and I see it in my clients, like, if. If I can get them to do something, you know, when there's been a lot of dissociation present, and I can get them to do some movement.

Oops, here comes the feelings.

Yeah.

And that's why they don't want to do it.

Yep. Yeah, sure.

And I get that, you know, so I'm. I'm very cognizant of. I'm not pushing. We'll do it when you feel like you. You can.

So I'm. So I'm guessing that you have a. Your own yoga practice that you do or.

I do do. How often.

How often do you do yoga?

Daily?

Daily.

Yeah.

That's great. I do it once.

Yoga and meditation have been a part of my life, luckily for a really long time. It's kind of funny. Like they were in my life long before so many other pieces needed to be in my life to utilize them correctly.

Yeah, that's great. Yeah. I. Yoga, I mean, it really helps you with balance. It helps you, and I do think it helps you emotionally and.

Yeah, and I have chronic pain.

Dalian, do you do yoga? I do not do it on the regular. I have been known to try it every so often, but I have been back in the habit of doing meditation once again.

So that's good. And that's been very helpful. It is helpful, isn't it? Yeah, yeah, yeah. I'm starting to notice it.

A lot of the times when I'm talking to people, I become a little bit more aware like I used to be, and. Yeah, that's good to return. I'm glad to be back. I was remembering. I'm glad you're back too. This is not connected to trauma necessarily or.

Well, it kind of is. I just had this memory the other day of a training that I'd gone through for act acceptance and commitment therapy and the exercise.

This ties in more with meditation, but it was take your brain for a walk.

And in this, what you had to do is pair up with someone else in the training and go for a walk for five minutes and say out loud everything that was in your brain and just do that for five minutes. And then you'd switch and they would do it and you'd listen to them. And then the third part of it was you do it alone.

And what would happen was that your thoughts went from, like, two dimensions to three dimensions. You just became the observer of your thoughts. It was so interesting. And it carried on where it's like, why am I thinking that now?

Why is that the memory that bubbles up when I'm driving and in that semi dissociative state, but where other things are kind of floating up. So anyway. But the idea of floatbacks, is that something that you were trained in with EMDR as well?

I am, and I don't utilize that as much. Again, with complex trauma. Okay, maybe some people. We will get there eventually.

Sometimes it just kind of happens naturally and they're, you know, they've done enough work despite the dissociation. It just depends.

So the theory, as I understood it, was that the brain, the body knows how to heal itself and the brain knows how to heal itself. And that if you. The example they used, if you cut the back of your left hand, you don't have to think. White blood cells go to back of left hand.

Coagulate form scab. You don't have to consciously do that. It goes where it knows where to go. It knows how to heal.

And once you start this process, the brain will go to where it needs to go. So it may be now I'm noticing something in my body, or now I'm noticing this memory, and it may be connected.

And you just keep following it and following it and following it until it feels like, okay, there's no more distress there. And then you go back to that original memory again and start again and see where the level of distress is.

And has it gone down, has it gone up, where's it been, that kind of thing.

And I'm watching people in session again with this high level of dissociation. Can they do that? Yeah, and some can. I'm not going to judge anybody who can't.

And I'm not going to assume that somebody that has a high level of dissociation can't either. I work very, very flexibly.

You know, I wasn't going to tell this story, but now I am going to tell this story that when our group was first doing it, the group first knew how to do EMDR in this community. And Mike Rogel actually was the force behind this. He said, we should let people know that this therapy is.

And he brainstormed the idea of like, let's get the newspaper, let's put it in the Lansing State Journal that we're all going to give away several sessions of EMDR for people. And all of a sudden there was a flood of letters that came in for people that wanted therapy. And so we all took it.

And what we found was that everybody who responded had very high levels of very complex trauma. So wasn't people that were had.

Yeah, it just been an accident or something.

Super easy life. Yeah, it was just like, I remember one person walking into the. I'm going to forget what it was exactly.

But they said, you should know that I'm on medication. Is this a problem? And I said, what's the medication? They said, well, it's Thorazine and methadone.

I think it was like, oh, this is probably more complex. Like right off the bat, just hearing those two kinds of medications, like, that's probably a lot of stuff going on for you.

And they were turning people away at first, you know, with complex trauma and saying, you know, don't help them, don't help them. And so I'm so grateful to the people that have come forth and said, no, there's ways to help them. You just have to be a little different, you know?

Yeah. Well, what else have we got? I guess that's it. Julie, thanks so much. Julie. Roy, thanks for having me.

I was going to say guest artist, guest therapist here.

You do not want me to sing or perform.

Thank you. Thank you. I did bring my ukulele today. If you guys want to drive in, say it. We'll try it.

A Psycho Delicious Conversation is meant for educational and entertainment purposes only. It is no substitute for therapy and should not be treated as such. If you feel a need for real therapy, you should consult your local provider, Google “therapy” or “therapists” in your area. Check with community mental health or a suicide hotline if you are feeling suicidal. Mike, Morgan and Melissa welcome your questions, feedback or dilemmas. Feel free to send your emails to psych.deelish@gmail.com that's P S Y C H dot D E E L I S H at Gmail dot com. The views expressed on this podcast are solely the opinions of Mike Stratton, Morgan Bowen and Melissa Black and do not reflect the views or opinions of any site broadcasting this podcast. Replication of this podcast without written permission is strictly prohibited.