Trauma, Mental Health and Addictions

Parham : It says we’re live. I’m going to take its word for it Ms Sara, What’s up everyone? It is Saturday, February 12th of 2022. Like I say every week I’m getting used to saying that. It’s going to take another month or so to get familiar and comfortable with saying 2022. It still feels weird but long story short, it is here, it is family education and support group with myself, Parham and my wonderful guest today, Ms Sara Rotunno aka the Sarapist. What’s up Tony? Tony’s giving shout outs already, he’s ready to go at 9am! What’s up, Hi Tony! Really grateful to be here with a guest today because I like to provide education to all those who watch, that is not only relevant to where they are in their recovery journey but also can help them with gaining insight, understanding and awareness of how various things impact individuals throughout their lifespan development, one of those things being trauma. You got one of your friends (I think), gave you a shout out too, Sara already.

Sara : Hi Jori! You know it’s weird – I normally can see the comments but now being backstage I can’t see anything so I don’t know what’s going on.

Parham : I’ll make sure that you don’t feel left out. There’s a lot of people saying what’s up, there’s a lot of people saying hi and on the side over there where it says comments (By the way Sara, there is a little side thing that you can click on – you can probably see the comments)

Sara : Okay, okay.

Parham : Let me do a quick introduction of myself, then I’m going to introduce my guest and then from there we’ll get into the conversation today. So my name is Parham. I’m one of the people that helps manage the Buckeye Recovery Network and every single week, I’m here at 10 a.m Pacific Standard Time, providing some free family education and support to anyone who is interested and wants to hear and listen. All these talks are always shareable – you can share them with whoever you want. I try to do different things: educate on mental health addictions, substance abuse, anxiety, depression, communication, boundaries, a little bit of everything in between. One of the topics that I tend to talk about is the topic of trauma and by doing so one of the most important things that I wanted to do was to bring someone who is not only a trauma-informed clinician but also a licensed professional clinical counselor who is also trained in specialty with trauma and various modalities that comes with that. And that happens to be Ms Sara, so Sara go ahead do a little introduction of yourself and we’ll take it from there.

Sara : Thanks Parham. So I am a licensed professional clinical counselor which is just a fancy way of saying a licensed therapist. I have my master’s in clinical forensic psychology so essentially wherever law and psychology intersect is where my focus is and so trauma happens to fall very heavily in that space as well as substance abuse and addiction.

Parham : Right on, and I’ll give a little shameless plug. Sarapist has been working at Buckeye Recovery Network for her fifth year – she’s going into her fifth year now – I think October will be a full five going into six. So I’ve had the privilege of working side by side with Sara during all that time and been able to watch firsthand how she shows up for the profession, how she shows up for individuals that she gets to work with and how she shows up for the different staff members we have at Buckeye. And I could say Sara, from watching from a distance and close and far, whatever you want to call it, I could probably say that you suit up and show up at a very high level and you’re wonderful at what you do and you’re wonderful the way you impact others so I’m grateful personally that you took out some time on your Saturday morning to provide some education to those who are watching. And just so you know, the audience here – they’re committed, they’re faithful, they’ve been here for a couple years now watching this every Saturday. So I’m sure that they’re also grateful that you’re here. Yeah, Tony even said you’re one of the best in the business. I take the best to be me but yeah there you go. We got a lot of family members I think saying what’s up, you got some people saying hi, so let’s get into it. Are you ready Sara?

Sara : I’m ready.

Parham : So today we are talking about trauma – there is a movement that is long overdue, that being trauma-informed care and looking at every human being that comes and sits in front of us through the lens of what they have experienced, what they’ve gone through, the traumas they’ve endured, so I want you – from your perspective Sara – being someone that has a kind of a specialty in trauma, in your personal professional opinion what is considered trauma?

Sara : I’m glad that you talked about studying and looking at trauma being long overdue because there’s this well-known psychologist – his name was Peter Levine – and he talks about how trauma is one of the most ignored and belittled and misunderstood causes of human suffering. So if you think about a kid in school when they’re not feeling well and they call their parents, they say, “I have a stomachache or I’m throwing up,” the parent will come and immediately pick them up but when it comes to mental health – anxiety, depression, those things – it’s not treated the same – people take a different approach. When we start looking at mental health the same way we do physical health, we’ll see a significant shift in human suffering and the treatment of it. So if you were to look at trauma and specifically the diagnostic criteria (that would be the DSM of what therapists and psychologists use in order to diagnose someone trauma) is when someone directly experiences or they witness a near-death experience or a serious injury or sexual violence, whether I directly experience it or I see someone – if I’m a first responder if I am in a car accident and I see someone else get hurt – that’s what the diagnostic criteria of what trauma entails. But the way I look at trauma is very body based – so anytime we go into an altered state of consciousness is when we experience trauma. So a way that I can explain that is if I use my hands and this is our brain, we have two different parts of our brain – this is the frontal lobe and when our frontal lobe is working we’re well functioning, we’re thinking clearly, we have access to our emotions. Hopefully for everyone watching this right now their frontal lobe is working and they’re in a calm and collected state. When we experience a traumatic incident our lid flips and our amygdala which is a different part of our brain, which is the fight-or-flight part of our brain gets activated. Both of these can’t work at the same time so anytime we go into that altered state of consciousness that’s essentially when we’re experiencing a traumatic incident.

Parham : Absolutely, I mean wow, thank you for that true psycho education of trauma and how it actually impacts the brain of an individual. Let’s follow with what you just said right now when it comes to traumatic events – so let’s say something traumatic happens to someone how does that individual respond? At the level of the brain, why do they go from the prefrontal cortex to the midbrain (let’s call it) – is that a form of survival? Is that a form of adaptation? Is it a coping skill? Why do individuals do that and what’s the benefit of doing that for them when they leave the prefrontal cortex?

Sara : You said it perfectly – it is an adaptation and it’s a coping skill and it’s what our bodies naturally do to survive. So if a bear walked in the room right now you wouldn’t be like, “Okay, I need to do this and then I need to do this and I need to do this,” – your brain just takes over and it survives and it just does what it has to do to survive. And if anyone takes anything away from this talk, what I would hope they take away is that it’s not necessarily about the event itself that happens but it’s about the nervous system’s response to the event. Like you and I, Parham, could be in a gas station and someone walks in with a gun and my nervous system takes off and yours doesn’t – I could think about that event for the rest of my life and you would never think about it again. So we experienced the same exact event but our nervous systems responded differently.

Parham : Yeah absolutely, and I do like that individuality of it because I’ve always been on record saying two people can – if we have two identical plates that we bought from Ikea and we drop them from a distance they’re going to have completely different break patterns. Why does that happen? It’s one of those great mysteries. So two people can experience the same traumatic event that could lead to the same trauma and one of them responds differently than the other. Sometimes there’s no rhyme or reason for that – it’s just the individuality of human beings. The part that I really value and respect what you just said and just shared has to do with the fact that it’s a coping and an adaptation. So you named off a few traumatic events that could be considered trauma based on the literature and stuff like that. I want to go ahead and do a refresher for anyone watching – you know I’m a big passionate believer of adverse childhood experiences and how they impact an individual’s lifespan development at the level of the mind, body, spirit, soul and all that kind of stuff. So what are those adverse childhood experiences? I’m gonna share that real quick and then we’ll get on to the next thing because I want you to (after I’m done sharing these) to share how these events impact an individual and why do they impact an individual? The adverse childhood experiences (this was a study that came from a guy named Vincent Felitti) and the origin of his work actually came from working with individuals that came through obesity clinics. So there were these individuals that came through obesity clinics and no matter what he did, whether it was education, whether it was medication, whether it was change in lifestyle, diet, nutrition, whatever it was, these individuals were unable to, after a period of time, lose the weight, maintain the weight loss. So he knew there’s something else going on and he started to explore into the world of trauma to see what have these individuals experienced in their life that they’re unable to adapt, to just cope with or utilize these tools that are being given to them. He created this list called the adverse childhood experiences and there were eight of them and I’m going to go through some of them. Did you ever experience any type of physical/sexual abuse? Did you ever experience any type of psychological abuse? Did you ever experience any type of neglect or abandonment? Did you ever watch (this is really important because you were just talking about it – it doesn’t have to be firsthand it could be secondhand) – did you ever watch physical abuse, like domestic violence in the home? So mom and dad having physical altercations? Did one of your primary caregivers go to prison? Were they mentally ill? Were they addicted to substances? Was there divorce or separation in their life? He tracked these from the ages of zero to 18 and what he found without any shadow of a doubt was individuals who experience adverse childhood experiences were impaired later on in various areas in life. So tell us – at the level of the brain when someone experiences physical abuse (let’s just go with that one because that’s the most common one that people think of when they talk about trauma), how does that change the brain? Why does the brain change? And how does that change or impact the individual’s life?

Sara : There have been a lot of studies that show a scan of a traumatized brain versus a brain that’s never experienced trauma and they look significantly different. I can give an example – usually I show a video when I talk about trauma, of impalas in Africa. There’s an impala and this lion comes up and has the impala by the throat and the impala is about to die and it’s very traumatic to watch – it’s not fun. But you see that the impala plays dead and then the lion is essentially over the impala because it doesn’t want to eat something dead. So the impala lays there for a while and then as the lion walks away it starts viciously shaking. Anyone that’s watching this, if you’re interested you can pull up youtube and just put impala in. It shakes and shakes and violently shakes like you’ve never seen, and then it gets up and walks away. So what happens is that all of that energy that comes up when we’re in survival mode, animals have learned how to deal with that and get rid of that excess energy, but as humans we haven’t. We don’t know why but we think it’s because humans are frightened of the intensity of survival energy so they just don’t deal with it so it ends up getting stored in our body. So if you think about depression, anxiety, and other mental disorders, there are some mental disorders that (don’t always but can) go away on their own. Trauma is one of the very few that does not go away on its own unless it’s addressed because it’s stored in your body.

Parham : That’s a perfect example and I actually will check out that video. I have a feeling it’s going to be traumatic to watch but I do believe that we have a lot of similarities with mother nature and all the animals in the animal kingdom so it’d be kind of cool to watch that. So the question I have here is – I mean we work in the front lines – wait there’s a good question that popped up right here. Let’s see, I’m going to pull it up. Hossein says, “Can the nerve system of a human being reverse the events of trauma internally through the process of recovery?”

Sara : Do you want me to answer that? Okay. So our brains have something called neuroplasticity which is like the ability to adapt and heal, so as long as you are in a safe therapeutic environment and are willing to address those traumatic events you do have the ability to adapt back.

Parham : That’s perfect and thank you for giving the glimmer of hope because I do believe that also, Hossein. The brain is a beautiful thing and healing the brain and healing trauma is a beautiful thing, and not only have Sara and I seen this with countless human beings over the course of our careers, but I wouldn’t be having this talk on trauma and sharing later on we’re gonna talk about what treatment looks like in different modalities for it and stuff like that, if I didn’t believe that there is hope for individuals to experience trauma. Great question! If anybody else has questions feel free to ask – I’ll put them up and Sara does a wonderful job answering them. Working in the field of mental health and addictions is it safe to say Sara, that rarely do we come across those who have not experienced first-hand or second-hand, some type of trauma or traumatic event?

Sara : Yeah, “rarely” is absolutely the appropriate word to use for it.

Parham : Yeah, so I want everyone to hear that it’s “rarely.” So when someone says they didn’t experience anything in their life, sometimes individuals think that trauma is only the overt things, the obvious things. Just because I didn’t get abused physically by someone doesn’t mean I didn’t experience trauma. Trauma sometimes could be things that should have happened in life that never happened – there are things in life that should have happened through the lifespan development of a person that never ever happened. Jim has a question here – thank you for the question – so he said, “Is there a timeframe to overcoming trauma symptoms?”

Sara : I like that question. There’s different types of trauma we can experience. Single incident trauma: let’s say someone has never experienced a traumatic event in their life and they get into a car accident and it’s very distressing for them – treating that trauma is generally going to be a little bit quicker than treating complex trauma for someone who’s grown up in a home with abuse, with substance abuse, with sexual abuse, something like that. There’s not a specific timeframe. When I treat trauma some people will move through it in two to three to five sessions, but for some people it takes two to three to five months.

Parham : Perfect answer, and thank you for not giving a timeframe. I know Jim, why you’re asking, because there’s people that sit in groups like yours and Jim, as most of you know, is a certified counselor with many many years of experience, and a lot of times people say, “Well, how long do I have to work on myself? How long is this going to take for me to get better? How long is that going to take?” Well, for one person, like Sara said it might be a shorter period of time and for some people she said a couple of months. I would oppose that to say maybe sometimes even a couple years. When you’re dealing with complex post-traumatic disorder and you’re talking about complex trauma that happened throughout your lifespan development growing up, it is practically impossible to say that person is going to heal in 30-60-90 days. I want everyone to know that if you or your loved one is struggling from trauma when you come into the recovery process, just because you’re in a recovery program for 30-60-90 days, six months, nine months, that kind of stuff, does not mean that all of the symptomology – all of the signs and symptoms – of the trauma you’ve experienced is going to be diminished, reduced, gone during that recovery. Sometimes it’s long term, so we said it’s “rarely.” Oh, Tony asked a question here: “Is it possible to never remember the trauma or recognize that trauma ever happened, and if so how can that be overcome?” Good question – by the way Tony.

Sara : This is why I love our counselors at Buckeye – they ask really good questions. So absolutely, that’s very common – there’s actually a diagnosis called dissociative amnesia and a lot of the times that’s when people don’t have memory from their childhood or from events in their life and a lot of the time that’s because they’ve experienced traumatic incidents. I know later in the talk we’ll talk a little bit about treating trauma but when you’re doing EMDR or a different modality that looks at addressing it, a lot of the time suppressed memories come up. If I’m working with a client they’re like, “Oh my gosh, I did not remember this happened until this moment,” but that’s our body trying to survive, and our body trying to keep us safe is stuffing it so far down that we don’t have access to those memories.

Parham : There’s something you taught me I think a while ago Sara that you said – it’s the same question that Tony just asked – it kind of came up because I’ve had individuals say they don’t remember anything and you said sometimes trauma is so suppressed and it’s so unconscious. For example, if you experienced a traumatic event with somebody that was wearing yellow or something like that at the time it happened and then later on you’re just going through a grocery store you’re going through somewhere and you see someone that’s wearing yellow, without knowing why that’s causing a trigger or why it’s causing discomfort, any of that kind of stuff, it’s the association that all of a sudden hits. So can you talk about that a little bit from a more professional perspective than I did right there?

Sara : You did it really professionally. There’s something we have called neural networks. The example that you were using was: there was someone who was going on a ski trip to Mammoth for the weekend and they had stopped at a gas station. When they stopped at a gas station someone in (I think) a blue hoodie robbed them at gunpoint. And they went on with their trip, they went snowboarding and they came back and one day they were in college and they were sitting in their lecture hall with 300 people and out of nowhere they had a serious panic attack and they didn’t know why. It wasn’t until about a month later when they were doing EMDR that they were able to make the connection that someone in their classroom was wearing a blue hoodie and that the person that had robbed them was wearing a blue hoodie. Our brains have these neural networks that are able to link these experiences sometimes without us even consciously knowing. A lot of times when we have our clients, when we’re in a group, or when we’re around them, and they get activated and they can’t explain why, there’s sometimes a very very very legitimate reason for it – we just don’t know consciously why.

Parham : Oh thank you, that was a much more professional explanation than mine by the way, Sarapist! I’ve been on the record saying this one too before and I’ve learned this from somewhere but one of the possible outcomes of trauma is addictions and I’m going to share my perspective why that is and just add to it if you want. So when someone experiences trauma (Sara did a really good job talking about how that impacts the brain of an individual), it impacts the brain of an individual talking about the prefrontal cortex which is the CEO of the brain, which is the decision maker of the brain. When they experience trauma sometimes there’s no healthy decisions being made – there’s a lot of impulsivity, there’s a lot of risky behavior, all that kind of stuff, so it impacts the brain which leads to increased anxiety, increased depression, increased PTSD symptoms, all that kind of stuff which leads to having social impairments. So when a child is going through trauma they’re not rolling up to school saying, “Hey kids, I just want to go play.” They might be isolating, they might be not socializing, they might be pulling away from society, they might be stuck in their own head if you will. When all that’s happening to an individual what they do is they seek out either behaviors, or seek out substances, or seek out something to help them regulate that discomfort. So when someone’s experienced a lot of trauma and they have significant amounts of anxiety for example, and the first time that they consume alcohol or take a benzodiazepine or take some opiates and all of that anxiety all of a sudden magically disappears and goes away, they’ve learned how to cope and adapt with something that they did not know how to cope and adapt, with a substance that’s highly addictive. Now, when you’re consuming and using something that is highly addictive for dealing with symptoms left over from trauma it is easy to see how this perfect storm can get created and something like substance addiction or behavior addiction can exist. Based on that kind of platform or just the foundation that is laid is that what you see happens from your personal experience working with individuals? And how does addiction become a product of trauma from your perspective?

Sara : You explained it really well – it’s gonna be hard to piggy off that one. As we talked about trauma stored in the body and our bodies go with us everywhere that we go, how can it not impact an individual? There’s never really a time where it’s not impacting us in some way. When people talk about their inability to sleep when that’s supposed to be one of the most peaceful times of our lives but we experience trauma – we have difficulty sleeping if a bear walked into the room right? Now you wouldn’t be like, “Oh I’m really hungry” – that’s like the last thought that you would have because our body goes into fight or flight. And when we do that the first thing that really goes is our digestive system when we’re in fight or flight. A lot of the time after people experience trauma they remain in fight or flight for a while and they lose their appetite. So you’re losing your sleep, you’re losing your appetite, you’re impacting your hypervigilance, your ability to be calm in a restaurant isn’t really there, you’re always looking at the door, you’re always ready, so it kind of impacts us as a whole all the time.

Parham : Yeah 100%, that’s wonderful even if you are echoing what I said there. I just want individuals watching this to know that it’s not just my personal opinion. This is someone who works intimately with traumas, educated in trauma, uses trauma healing modalities in her personal practice that’s also saying what I’ve been saying here on a weekly basis. That’s what I want everyone to get educated on – to know that it’s real – these situations and circumstances she’s talking about are not just stuff that Sara’s read in textbooks or in classrooms or in trainings. These are human beings, maybe your sons, maybe your daughters, maybe your friends, maybe your neighbors, grandkids, that have sat down and shared how traumatic events have impacted them psychologically, mentally, emotionally, physically long after the trauma was over. And they’ve adapted any way they can to survive now, one of those outcomes potentially being addiction. So now that someone is at a place like Buckeye Recovery Network or any other facility that’s providing mental health and addiction treatment services to those they serve, in your perspective what are the best practices for the treatment of that trauma? It’s okay to talk in general terms, it’s okay to talk about aftercare, front-end care, whatever you want to talk about, there’s no right and wrong – I just want you to say when you assess somebody and you notice that they’ve experienced a lot of trauma what are the next steps from there?

Sara : I remembered what I wanted to say before so I want to answer that really quickly. In terms of how trauma impacts the body and abusing substances, one of the best things that I’ve read when I was reading about adverse childhood experiences (which is what you spoke on before) was when the guy said I no longer want it to be called addiction – I want it to be called ritualized compulsive comfort seeking. That’s what it is. Your body does not feel calm or comfortable until you use a substance and it brings you back to that place so I think that’s really important for people to hear because it’s a more compassionate lens to look at substance abuse and addiction and then in terms of what trauma treatment looks like. There are a lot of different ways to approach treating trauma and sometimes in the field they call it top down or bottom up. Top down would mean a very cognitive approach to it which is trying to shift the way that we think, the way that we look at things, our perspective. I really do like top-down approaches for some things but I personally don’t love it for trauma because how many times have people experienced a traumatic event and they think through and they think through and they try and shift their perspective and nothing really happens or those symptoms that they’re experiencing are still there. That’s because it’s a body-based experience. The bottom up approach is focusing on the body and so any type of somatic approach (there’s a lot of evidence-based research of how effective that is) – EMDR is a really popular one, somatic experiencing and brain spotting are the three that I’ve seen have been really really effective with treating trauma.

Parham : Yeah and also there’s a time component here that’s very important. So if you’re watching this and you are in the front stages, early stages of maybe getting off of a substance, or you’re a family member and your loved one has just got into treatment or just got into detoxing and that whole front end of treatment I want you to know that it is not always either recommended or even appropriate to dive into the trauma too soon. Can you just share real quick because I do want to establish some type of a timeline here even though timelines are subjective. In the early stages when someone’s getting off their drug of choice or behaviors, of addictive behaviors, why is going into the trauma too early kind of a high-risk intervention?

Sara : It can be pretty high risk because a lot of the times when someone’s in those stages they don’t have the skills and tools to be able to maintain their sobriety. When I talk about treating trauma the way that I talk about it is (I’m sure most of people on here, especially any of my friends that are watching, have watched Grey’s Anatomy or one of those medical shows) where someone comes in with an infection and they’re like, “We have to cut your arm to save the rest of your body,” that’s sort of what treating trauma looks like, where it’s a very very intense pain as you’re moving through it, but for a lifetime of relief hopefully. And so for someone to have the ability to be able to self-regulate when all of those distressing memories come back up is really really important. Sometimes that takes time. Another part to it is if you have a relationship and trust and rapport with your therapist, because some therapists will try and start doing some type of trauma work and they’ve known the person for an hour or two and they’re like, “Tell me about your deepest traumas,” and if you’ve experienced trauma you probably have some level of trust issues and you’re not going to open up to that person, so it ends up being not effective. And then there are actually a few other different criterias where sometimes it’s not appropriate for some people. If someone is a victim of some sort of crime – sexual abuse, sexual assault, and they’re in a court case, sometimes EMDR is not recommended because it says that it can alter your mind or your perspective. They don’t really recommend it until after the court case. Or if it is a woman that is pregnant or a soon-to-be mother they say that doing the EMDR work can be really distressing on the baby, so they recommend until after. If someone’s taking benzos it calms our nervous system so it’ll treat it while you’re on the benzos but as soon as you’re off it goes right back up. So there are like some factors that go into place to deem if someone’s appropriate for that type of treatment but if they are and it’s done correctly and there’s a lot of safety and rapport developed and coping skills it’s a very very effective treatment modality.

Parham : Yeah 100% – we are going to talk about EMDR – a little bit deeper dive right now – but I just want everyone to hear what you said there because there’s a lot of family members that might be watching this and they know their loved ones have gone through trauma so maybe there was a really traumatic divorce in their life or maybe there was psychological/physical/sexual abuse that they’ve become aware of in their loved one’s life or maybe they experienced a lot of catastrophes like people that go through natural disasters and all that kind of stuff and and lose previous identities of self and have to rebuild again, or maybe there was a lot of immigrant trauma, there’s a lot of different things that can happen in people’s lives that could be traumatic events. When the family member wants their loved one to deal with their trauma right off the bat – dealing with trauma is absolutely the right thing to do and it’s necessary for long-term abstinence and recovery – however it could be the right treatment at the wrong time. So it is important to work with a trained licensed clinician to identify when that individual has the coping skills, the ability to regulate their emotions without their drug or behavior of choice. Because as soon as someone gets dysregulated about talking about something that’s very traumatic to them their first move if they’re a substance user is not going to be, “Oh let me just go home and sit down and journal.” It’s going to be, “Let me go home and drink some alcohol and bring my emotions down.” It’s not going to be, “Let me go and talk to my sponsor or my support group about what I’m feeling right now.” It’s going to be, “Let me go hit up my previous drug dealer and see if I can get some Xanax. It’s not going to be, “Let me go breathe and meditate and do progressive muscle relaxation.” It’s gonna be, “Let me go eat a bunch of food that I know I shouldn’t be eating right now. Let me go act out impulsively potentially with dating partners, with meeting people” – codependency all that kind of stuff. So people act out in ways to soothe themselves if they don’t have coping skills. One of the components of proper treatment is to be able to first, before diving into the trauma, make sure the individual is learning how to regulate their emotions, self-regulate their emotions, learning coping skills, learning how to ask for help, working on their trust issues. Once all that has been in place it creates a perfect foundation and a beautiful platform in a healing environment for the trauma work to begin. That’s kind of what the beauty of aftercare is in my opinion. Because people that come to us, individuals who come to us, have hopefully already been stabilized, hopefully already learned some coping skills (and that’s not everybody that comes to us by the way), and then we can get to that work. Once we get into that EMDR work, which is something that I know you do at Buckeye Recovery Network for multiple individuals, I’ve seen firsthand (and I’m not just making this up – this isn’t a sales pitch my friends), I’ve seen firsthand, people who experience significant traumatic injuries, like accidents that have plagued them their entire life – 20 or 30 years – through the process of 10 – 12 weeks of EMDR the individual has freed themselves from the association of that car accident, in the way they perceive that trauma and it’s changed their entire freaking life. So can you give us an EMDR 101? Imagine you’re talking to people that have no idea what EMDR is. And when Sara’s talking everyone, I really want you to listen because if you know your loved one has experienced some type of trauma I strongly suggest you listen to what Sara has to say. If they’re not in treatment and they’re just doing therapy or you want them to go to therapy search on things like Psychology Today to find an EMDR specialist therapist because I know it works. I can’t say it works for everyone but I know it works for a significant number of people that go through the treatment. But Sara, tell us what the heck EMDR is, how does it benefit the individual, what does it look like, whatever you want – you’re the expert here – it’s your expertise – I’m gonna shut up. I know it’s a hard time for me to be quiet and listen but I love listening to you so I’m going to shut up and listen and take the stage.

Sara : So EMDR is Eye Movement Desensitization and Reprocessing which I know sounds like a lot and it also sounds very intimidating. But when you’re going through it it’s a very simple process. So what happens is EMDR uses something called bilateral stimulation – what it does is – you know how we talked about trauma with our amygdala gets stuck in your body and it gets stored in your body it bypasses the part of your brain where trauma gets stuck, allows you to activate your prefrontal cortex which is where we can think and we can feel and we can process things, so it accesses this part of your brain so that you can reprocess the trauma. What happens is – there’s different ways that different therapists use bilateral stimulation and it was originally called Eye Movement Desensitization and Reprocessing because the eye movements where they would start, where they would have your finger like this and you’d have to follow your finger back and forth. So if you think about REM sleep, when you’re sleeping your eyes are going like this and they essentially just recreated that. When you’re sleeping you’re dreaming and you’re reprocessing everything from the day before, so it’s kind of like revamping that when you’re awake. But it’s evolved since then and the way I do it personally is: I have these two tappers that clients hold and they buzz left and they buzz right and they buzz left and they buzz right and that activates stimulation. So as the bilateral stimulation is going the client reprocesses the memory. They could do it with their eyes closed or they can do it with their eyes open. They can talk or they cannot talk – it’s really whatever they prefer. But the cool part of it is, if you don’t feel comfortable you don’t have to say a word the entire time you reprocess the memory. Let’s say when you think of the distressing memory – let’s say mine was someone breaking into my house when I start the EMDR – if I’m at a 10 out of 10 I reprocess all parts of the memory that I need to until it gets to a zero out of ten. What happens is you don’t forget that the traumatic incident happened but you no longer have the same body reactions to it. So when you experience a trauma and when you have PTSD a lot of the times people have nightmares, they have flashbacks, they have negative beliefs about the world, and it works to clear all of those for you. It’s really really fascinating to see the toll that trauma takes on people and what their life can look like after it’s properly processed.

Parham : Yeah real quick, because I just want people to understand the gravity of what Sara just said right now – I remember vividly there was an individual who had a significant car accident and after the first or second session working with Sara this individual was really dysregulated, really emotional because they had just re-lived and walked through and reprocessed the trauma they’ve been suppressing and burying and drowning with alcohol and behaviors and all that stuff. Due to their trust in the system and the process, and their commitment to go through the entire treatment episode of 10 to 12 sessions, I’ll never forget this – the very last day they were done they sat in my office and they were smiling, they were laughing, they were joking. It wasn’t fake or insincere – it was the fact that they felt like they were free from that emotion, that psychological physical emotion, the physical experience that they had inside their body once and for all. My friends, it’s not like this gimmicky thing. Once you’re able to go through the process and really altering the brain and getting access to your prefrontal cortex, it’s a freeing feeling. So continue with what you’re saying right there, but I just wanted to share to say that – what she’s saying in practical application – I’ve seen the before and after, not just once or twice. Man, I’ve seen the before and after so many times and it’s a really beautiful experience to see. So continue on, sorry.

Sara : Yeah I know. I’m glad that you talked about how it changes someone’s not personality but how they show up, because something else that EMDR can do is help with cognitions. Cognitions are essentially beliefs that we have about ourselves or the world. So if you think about a lot of women, men, whoever, who have experienced sexual abuse or sexual assault a lot of the time they hold on to this belief of, “It was my fault. I could have done something differently. What did I do wrong?” And when you experience trauma because of the way that your brain processes it you’re very limited to other perspectives. So if anyone on this talk has ever been in New York or Pennsylvania or wherever, when it’s snowing and you have this really small hole you’re trying to look through as you’re driving – that’s kind of your perspective as you see trauma – it’s very limited. And the EMDR kind of works to clear the entire windshield and see the whole picture. I’ve seen people’s perspective on what they’ve been through completely shift. We’re in the middle of it – they open their eyes like, “Wait a minute, I didn’t deserve that, I didn’t do anything. That was not my fault,” and it really helps to alleviate some of the pain that we’re experiencing and the negative beliefs we have about ourselves or the world, that of course develop after we experience something really really painful.

Parham : I actually want you to take a minute or two to share about what kind of traumatic experiences, what type of symptoms have people come to you with that they wanted to use EMDR for? Let us know what EMDR is beneficial for. You talked a little bit about the single case trauma like the car accident for example, or the complex trauma for example, but what do you have in regards to who would benefit from EMDR treatment? Let’s call it that.

Sara : A lot of people with a diagnosis of PTSD would benefit from EMDR – people that have experienced physical abuse, sexual abuse, emotional abuse, who have witnessed crimes or been a part of crimes, first responders a lot of times. In the addiction space, a lot of people who are using are exposed to a lot of death and a lot of loss and a lot of grief – it’s very effective for that. I’m trying to think about what else – so there’s things called big T and little t, that I think is important for people to know. Big Ts are the big traumas that we’re talking about, like sexual assault, physical assault, but then there’s little ts which are the smaller things we experience in life that are like our dog dying, or being bullied in school. Repeated exposure to those little t’s have the same type of impact on your body that the big Ts do. So it’s essentially any time your body enters that altered state where it’s not processed and it just doesn’t feel good when you think about it, EMDR can work to alleviate some of that pain.

Parham : That’s awesome, thank you for sharing that. In closing, I guess the reason why I wanted Sara to come here and graciously give us her time on a Saturday was because I believe in the value and the importance of taking head-on, addressing trauma in order to help people free themselves of the constraints of the past. Because a lot of trauma happened then and there, meaning not in this present moment. However the then and there continues to impact the present moment and when the present moment is impacted, guess what it also does my friends? It alters the future. So the future begins to look like the past. When you deal with people that are coming through treatment programs they’ll tell you the past year of my life, the past five years of my life, the past 10 years of my life has been the same damn thing – it’s like Groundhog Day – same [ __ ], different day. And a lot of the reasons behind the same [ __ ] different day is unresolved and unprocessed trauma. Unresolved and unprocessed trauma continues to make the future look like the past and if that’s something that you don’t want anymore in life, if you want to free yourself from this, from the chains of the past, then looking at the appropriate time with the appropriate provider and the appropriate clinician to deal with and address trauma is something that I would say is necessary for long-term success in the recovery world. So Sara, I think what you brought here today was expertise at a level that I honestly don’t have. I know you keep saying I do have it but I’m not a trauma specialist kind of the way you are. I’m just a passionate guy that likes talking about recovery but you brought a different angle and I would love for you to be able to find time in your busy schedule once in a while on Saturdays to come in here. We don’t have to talk about trauma every time – you’re well versed in all things recovery, in health, in general overall health, so if you want you’re always welcome to come back here. Love to have you here. And if anybody has any questions right now while Sara’s here, we’re wrapping up, feel free to type your questions in the bottom before we get off. I’ll do my best to answer them, have Sara answer them. I do know there’s quite a few people watching – feel free to share what you want. Sara, what was this like for you to be able to have this platform, to be able to share what you know? There’s a couple people – just so you know Sara – like for example, Eileen here has been here for two years straight – I mean she’s a big advocate of us and in our program – just says, “This information is so powerful,” and it really is powerful because what’s common knowledge to you and me Sara, is not common knowledge to the general public, it really isn’t. Society doesn’t know the impact of trauma. They just think, “Oh it happens to everyone, it’s just a part of life, it is what it is, just deal with it and move on all,” that kind of stuff, when there are ways to treat it and to heal from it and to move forward. So any final words you got about this experience, about anything else you want to talk about feel free to.

Sara : Thank you for having me on, it was really enjoyable to talk. I think it’s important to spread awareness and education because like you talked about, people say it’s a part of life, we just move on from it, it’s not that big of a deal, but to bring awareness to the fact of how it can be incredibly debilitating to so many people and how it can shift and impact so many different aspects of their life. So I am grateful for the opportunity to bring awareness to that and to talk about the importance of treating it, looking at it, approaching it compassionately for family members, so thank you for this experience and this opportunity.

Parham : And the last thing I got here: the lens of trauma informed care – what the lens does is, it allows us to view people through the lens of compassion and allows us to view people as not who they are in the present moment but all of the life experiences that they’ve had, that’s shaped who they are in the present moment. I’ll tell you this – sometimes people that have experienced a lot of trauma make it really really difficult and a challenge to be able to connect with them and to be able to just wrap around them and give them the support they need because they’re so terrified of connection and they have so many trust issues. I will say this – those who are the hardest to love are the ones who need it the most, those who are the hardest to love are the ones who need it the most. I think my mom said something down here for you too, let’s see what you said: “Thank you, great professional information from the well knowledgeable, young and beautiful therapist.” Hey, I don’t think she’s talking about me – Mom, are you talking about me or are you talking about her? Okay, I think she’s talking about you because she said young in there. But long story short, appreciate you Sara, thank you so much. I hope you have a wonderful weekend and to everyone else, please, please, please, please, please share this video with anyone because I promise you there are individuals that will greatly benefit from this and need to hear this because it will give them hope that just because they experienced something in the past doesn’t mean they can’t heal from it in the future. And the final message is, “You are not your trauma.” Okay, I’ll see you Sara, take care.