How Childhood Trauma Shapes Who We Become and What Clinicians Want to Know

[00:00:00] But this child's story was so powerful because it was a kid that had been referred to the second
[00:00:06] therapist, and it never talked about his sexual abuse. And he was an elementary school kid,
[00:00:11] and he gets to the second therapist that was doing the treatment that, or providing the
[00:00:15] treatment that I train in, trauma focused, going to behavioral therapy, for example. And
[00:00:18] he, and the therapist said, Oh, did you ever talk about, you know, the sexual abuse,
[00:00:23] the sexual abuse with your last therapist? And the little kid was like, and
[00:00:28] the therapist said, Oh, why not? And the little kid said, Oh, she wasn't ready. And I always think
[00:00:32] like, I don't want to be that person, that adult that's not ready to help a kid with recovery
[00:00:38] and to take it out of the dark. Hey there, and welcome to the Heal With Grace podcast.
[00:00:43] I'm your host, Grace Secker, and I'm a holistic licensed therapist and nervous system coach
[00:00:48] who believes that the chronic and often unseen symptoms you're living with are a sign of
[00:00:54] something deeper going on, a sign that your nervous system needs attention. In each episode,
[00:01:00] I'll share the science behind the most common chronic health disorders, plus holistic tips
[00:01:05] using mental, physical and spiritual practices. You'll hear what I've learned in my journey
[00:01:09] and the true stories from our trusted guests. So you can feel less alone in your experience
[00:01:15] and give yourself grace, no matter what you're going through. So without further ado,
[00:01:19] settle in and get cozy. It's time to heal with grace.
[00:01:23] Hi, Monica. Thank you so much for coming on the podcast. I'm excited for today's episode.
[00:01:29] We have not had a specialist in trauma and researcher come on, and I think it's going
[00:01:34] to be really helpful for people. I'm so excited to be here, Grace.
[00:01:38] Yeah, I will let you introduce yourself. Okay, that's great.
[00:01:42] Tell everyone about who you are and what you do. Okay, well, Monica Fitzgerald,
[00:01:50] I'm a licensed clinical psychologist, and I work at the University of Colorado and Boulder,
[00:01:57] and I'm in an Institute of Behavioral Science. There's a lot of words, but I direct the Center
[00:02:01] for Resilience and Well-Being. And so I'm a clinical psychologist and also a senior research
[00:02:06] associate. So we do a lot of applied training and consultation, and we develop interventions
[00:02:13] and prevention programs, and we evaluate them. And they're all trauma-informed or trauma
[00:02:17] responsive programs for schools, for parents, and for children, teen, and families that are
[00:02:24] trauma-impacted. And so, yeah. So I wear a lot of hats. I have a lot of roles. So it's very
[00:02:30] applied and also always evaluating what we're doing to make sure it has a positive impact.
[00:02:36] It sounds like a lot of different experience, and not only yourself, you know, implementing,
[00:02:41] but also figuring out what does work best and how to approach it. And yeah.
[00:02:47] Yeah. And there's a lot that's not known. But I would say one of my hats is really
[00:02:51] with trauma and trauma expertise. But my lived experience as a mom, I have three kids and we
[00:02:57] have a blended family. I also really have carried that experience to inform my clinical work,
[00:03:03] my research questions, my training, because especially one of our daughters has experienced
[00:03:08] a lot of medical trauma since early. And so walking that walk as, yes, a trauma expert
[00:03:13] and a clinician, but also a parent has been really powerful. And so we do a lot of work to
[00:03:17] support parents, but also adults that are trusted adults for young people as well.
[00:03:23] Yeah. I can only imagine. I mean, our lived experience is very much to shape our work,
[00:03:28] especially in psychology. Any kind of field service oriented field, right? If you have
[00:03:33] that lived experience, it makes you so much better at what you do because you have that
[00:03:37] lens. Yeah. Yes. Yes. So I think that actually this is helpful because although
[00:03:44] children do not listen to this, obviously parents do. And so much of the time people that come to
[00:03:50] me end up saying, I've heard that, you know, chronic symptoms can be a result of trauma,
[00:03:55] but I don't really understand if I've had it or if trauma even applies to me, right?
[00:03:59] Like I had a fine childhood or people are obviously like, yeah, I know I had these
[00:04:04] things, but I still don't understand how, what did that do? Yeah. Right? Yeah. So can you even just
[00:04:10] help us with kind of a basic understanding of childhood trauma development? Yeah. Yeah. So there
[00:04:17] are different working definitions, but kind of combining some that I think land are around
[00:04:23] when we think about traumatic events, you can kind of, I'll describe it in a few different
[00:04:27] ways. They can be described as intense, frightening, dangerous or violent events
[00:04:32] that either threaten or cause harm to a child's physical, mental, emotional or spiritual well-being
[00:04:41] and overwhelm their ability to cope. It's very subjective and that you can see kind of this
[00:04:48] wide range, right? And this can be exposure to any kind of incident event. It can be single event,
[00:04:54] ongoing events, multiple events or situations that cause significant fear activation,
[00:05:00] perceived threat of serious harm, actual, physical injury, but it doesn't always have to
[00:05:05] have actual. It can also be perceived threat to a person that you love or your caregiver.
[00:05:10] And so that widens this experience because it can, it can be direct experience, but also
[00:05:15] indirect and witnessing. And so, yes, it can include actual death or sexual violence or
[00:05:21] child abuse and, but that piece about witnessing violence or someone else being harmed or you
[00:05:28] feeling as a young person or even into adulthood, completely overwhelmed by that experience.
[00:05:34] And it can even be involved in learning of an event that occurred to a close family member
[00:05:39] or close friend. And that's why with youth, think about when mass violence or school shootings
[00:05:44] happen, we advise the educators and school folks and the parents to reduce the exposure
[00:05:50] because the more that you see becomes exposure. So it can be learning about
[00:05:55] something, your family being harmed in a violent way or something happening as well.
[00:05:59] So I know that there can be a wide range of events and sometimes in the field, there's
[00:06:06] kind of a broader conceptualization that sometimes is used and it's called the three E's.
[00:06:11] Have you ever heard of that? I think so. Okay. So the first E is the actual event.
[00:06:16] So the E is the event. So the circumstances are the events that I just kind of described
[00:06:20] that might have actual or extreme threat, actual or extreme direct threat or threat of harm,
[00:06:26] psychological harm, feels overwhelming and dangers your wellbeing. So that's one piece of it.
[00:06:31] But then the next E is really important. And that is the experience. And that is the individual's
[00:06:41] characteristics of the person and the context. You could be with your sibling experiencing
[00:06:44] something and yet you, your experience individually is really different. Your reaction is,
[00:06:49] and that's why we don't assume when families come in that have experienced trauma that
[00:06:53] one kid is the same as the next in their response or the parents. And so I do think that experience
[00:06:59] is really important. And yes, there are some, in the research, there are some characteristics
[00:07:03] like earlier age, you know, associated with your impact, but was it on purpose or was it
[00:07:08] accidental? So these are some of the qualities. Who didn't? Was it a caregiver? Was it someone
[00:07:14] that was be ordinarily in the role to protect a young child or you? Or sometimes you're protecting
[00:07:20] you or sometimes harming you? So this is where that experience and was this, you know, just one
[00:07:28] single event or many chronically bad events? And chronic or complex traumas oftentimes, I know
[00:07:34] there's a lot here that is thought about as more ongoing pervasive exposure to trauma and
[00:07:41] that's very interpersonal nature. And so oftentimes you think about caregivers and people that are in
[00:07:47] those roles that supposed to be protecting kids or other adults. Was there, this is another
[00:07:52] important one, was there support after the event? So these are some of the qualities. So we have the
[00:07:57] event, we have the experience of the event, and then we also have the effects. So there can be
[00:08:02] immediate effects. And that's more of immediate acute chronic, you know, stress like all of us
[00:08:07] if we've been in a car accident, we don't want to be in the car, you know, get in the car right away,
[00:08:11] we might have nightmares, we might have disrupted sleep, we might have a very normal
[00:08:15] acute stress response. But then there can be more, you know, prolonged responses. And that's
[00:08:20] where we start thinking about post-traumatic stress development. But also there can be
[00:08:24] delayed onset of symptoms. So a lot of people don't recognize always the connection between
[00:08:31] the events and the effects. And so if we think about the effects varying by the subjective
[00:08:38] experience of the person, but also the age, the developmental level and mental, yes, previous
[00:08:43] also mental and physical health. But we do know that supportive adults are the most important,
[00:08:48] most powerful resilience factors that mitigate impact. So you can also sometimes be surprised
[00:08:53] someone's doing so well. And oftentimes if you ask them what their resources were,
[00:08:57] or their resilience factors there, if they had some supportive adults, maybe they weren't
[00:09:02] all of the adults that were supportive, but that really helps with impact. The last thing I would
[00:09:08] say with the three E's is meaning. Meaning assigned to the event and that can shift over time.
[00:09:15] So I don't want to say too much, but is that helpful just for- Yeah, so the objective part
[00:09:22] and the meaning part, I want to explore a little bit more. Okay. Mainly the idea that like two people
[00:09:28] could go through the same thing. Yes. One person's nervous system respond or registers as trauma or
[00:09:35] difficult to move through and the other doesn't. What, how does that work? And yeah, what's that
[00:09:41] piece about? Well, there's not exactly, you know, like a clear answer of how that works because
[00:09:47] we have like the cycle, like the biology, that, you know, even with neurodiversity, all the pieces
[00:09:52] of that, that person, you know, so I would just say in different styles and personality styles,
[00:09:58] you can sometimes have, you know, more introvert or extroverted kids, extroverted kids, for example,
[00:10:04] I was working with two siblings that were impacted by a lot of domestic violence.
[00:10:08] And one sibling would go towards it and the event, not that that's, you know,
[00:10:12] great response, but would try to do something to get to, to make it change and that, you know,
[00:10:18] put them in danger. This year would go and totally hide and internalize and do what would be a flight
[00:10:26] response, which we understand, or a freeze response. And so you have these different nervous system
[00:10:31] responses that are also happening real time that all makes sense. You might have, and you
[00:10:36] might see that other response from a fight, fight, freeze, and then fawn response, you know, of actually
[00:10:42] trying to appease the vendor or the person doing harm. And so if you think about the personality
[00:10:48] styles and different kids and siblings and families too, that can also interact to affect how their
[00:10:54] nervous systems, you know, is dangerous. Do I have any perceived control? And there is a little
[00:10:59] bit of research in women and adulthood that does look at some of the factors that are associated
[00:11:05] with development of post-traumatic stress disorder. And, you know, I think many people ask why women
[00:11:12] have higher rates, you know, disproportionately higher rates of PTSD when their trauma impacted.
[00:11:18] And so there's a lot there to say, but is that helpful a little bit to your question?
[00:11:24] Yeah. And the meaning making around it. Yeah.
[00:11:27] Maybe also a child and or adult, right? How does that change depending on the
[00:11:33] meaning we make of it? Or how does it impact us based on that?
[00:11:36] You know, okay. So I just say each family and child is different. And that's why we learn. We don't
[00:11:43] assume that because of their these circumstances, and that's part of the work of working effectively
[00:11:49] with children and families is learning about how they feel, how they think about it, what,
[00:11:53] at the time and now, where they are now. But when you, you do see when there's an
[00:12:01] internalization of blame or shame around, you know, like this is happening to me because
[00:12:05] I'm a bad person. I did something bad. I'm wrong. I'm broken. I'm not worthy. My
[00:12:12] parent is hurting me because I just mess everything up. That is an internalization
[00:12:17] that, you know, and can be associated with other like I need to do better. I need to be more
[00:12:21] perfect. I need to be, you know, more worthy, do these things to be more worthy. But when
[00:12:26] things happen, you assign meaning. Like, what does this mean about me? What does this mean
[00:12:31] about others? And what does this mean about the world and social contract? You know,
[00:12:35] do I generalize that no one's safe? Everyone hurts you. Or that's this guy. And, you know,
[00:12:40] for example, in that situation, the brother kind of externalized more and he said,
[00:12:45] my mom's boyfriend who was in the domestic violence situation and he would go towards
[00:12:50] and try to protect his mom, his sister would hide. He said, this guy is a loser. Like
[00:12:54] he's a bad guy. He wasn't saying, hey, I'm a bad kid or my mom, but every kid is also different.
[00:13:02] So yeah, I don't know if that's helpful.
[00:13:06] Yeah, it is. Well, first of all, it's just doesn't talked about unless you're in the field
[00:13:12] and do this work, but it's just not shared as much. And so people don't understand it.
[00:13:18] And also, I think that's just a very important piece to when
[00:13:24] in nervous system dysregulation and chronic pain and chronic illness, there, yes, there is
[00:13:30] a lot of talk around how trauma has impacted you and how you probably have some sort of trauma
[00:13:35] in your life. But also there's a there's a percentage or certain amount of people who just
[00:13:39] don't register with that. So then they feel kind of like, well, maybe this isn't for me.
[00:13:44] Right. Because I don't have these big trauma.
[00:13:48] I appreciate you said that, Grace, because there was kind of a wave. There've been different
[00:13:52] waves in this field over the last number of decades. And one was about big teas and little teas,
[00:13:57] you know, like things that count. And it doesn't really make sense because what we've learned
[00:14:02] to is the small teas what used to people would say, well, this is a small tea. This
[00:14:07] doesn't really have a big nervous system response or traumatic, you know, when you look at
[00:14:12] the big teas and little teas, they can have a similar impact on the stress response system,
[00:14:18] especially if they're ongoing and what people talk about microaggressions. So when you think
[00:14:24] about systemic racism and oppression on the daily navigating, you can't kind of take that out of
[00:14:30] the whole picture to because you're not safe, you don't feel safe, nor you don't want the
[00:14:34] alarm system to just be turned off. And that's embedded in a lot of other structural inequities.
[00:14:41] And why they expanded the ACEs, the adverse childhood experiences beyond just the 10
[00:14:47] to more of the systemic issues and then environmental issues.
[00:14:51] There's so much to say, Grace. I'm sorry. No, don't want to overwhelm.
[00:14:56] This is really helpful. This is like coming from you is really important. And thank you for
[00:15:01] saying the big team little tea. I know that we have, I thought we've moved away from it,
[00:15:05] but not everyone has. So anyway, it's helpful. So thank you. Yeah. And I can even resonate with
[00:15:12] that. I've had a couple of big tea traumas that people would say, yes, that is, you know, a big
[00:15:15] event trauma. And I did have some resources around it. So I actually, yes, it impacted me.
[00:15:23] And at the same time, I think all the other little things that built up over time were
[00:15:29] more impactful now that I know myself more and I know my nervous system.
[00:15:34] Yeah. That cumulative impact, that's not to be minimized. And that's the lens we need to have
[00:15:39] when we're serving for the providers that you're training and things like that.
[00:15:43] And to not bring, if we have a brain, we have a bias, but we need to pause there.
[00:15:46] And you might have a little bit of information, but just really pause there to learn about
[00:15:52] the experience of that person. And can you speak to maybe some of the examples of what
[00:15:57] we might say are more, like you mentioned the microaggressions, right? But even
[00:16:01] then growing up, what would be something that would kind of be, you wouldn't pick it out.
[00:16:06] It would be something underneath the surface, maybe around emotional needs or in general,
[00:16:09] the way that we set up. Yeah.
[00:16:14] Well, I mean, and if we think about, sometimes people say, well, what are those microaggressions?
[00:16:17] And if you think about these, it relates to, because it's like these brief, they can become
[00:16:21] place, these verbal behavioral environmental little indignities, you know, whether they're
[00:16:27] intentional or unintentional. And so they really communicate like hostile or undermining or derogatory
[00:16:32] or negative slights or little insults. So you think about how many things can be said to you
[00:16:37] about why don't you understand that? What's wrong with you? You know, do it better. Like,
[00:16:41] even those things, like somebody's wrong with me, you know, they can be very harmful,
[00:16:46] hurtful, you know, oftentimes when they're also kind of targeted at a certain group,
[00:16:52] you know, a marginalized group as well, and mixed with also racism, you know, and oppression. So,
[00:16:58] so, so, you know, young people that are continually questioned, that's a dumb question,
[00:17:04] like even a criticized questioned, you know, minimize. So that's invalidation,
[00:17:10] you know, that wasn't that big of a deal. You're questioning your experience in the
[00:17:15] world all the time. You know, if you feel like you're always messing up, that's why a lot
[00:17:20] of kids that are physically abused and emotionally abused, because emotional abuse overlaps with all
[00:17:25] the different types of abuse, but and words can even hurt more than the physical actions. What,
[00:17:30] when we ask kids about what really has an impact on them, a lot of times it's what has been said,
[00:17:35] you know, well, we never wanted to have you in the first place, or your mom is such a,
[00:17:39] you know, when making insults and slights against a parent, if the parents are separated,
[00:17:44] like, these things can really hurt. And I always talk about the metaphorical backpack and kids
[00:17:49] are walking around with those, you know, but it's questioning and like they're worth and also
[00:17:56] there's like a invalidation of their experience and they're annoying. And so why would you trust
[00:18:02] yourself later, you know, so which you, you work with so many of those, these patterns too,
[00:18:08] that are associated with neuroplastic conditions and chronic pain, like, oh my gosh, people
[00:18:13] need so much compassion and tenderness and understanding of what's going on, because
[00:18:18] it makes sense that you doubt yourself if you were doubted by all the primary caregivers that
[00:18:23] really were important to you or sometimes celebrated in these situations or totally
[00:18:28] unpredictable settings. So this, that's really hard for kids. I really know what's coming.
[00:18:36] Yes, that's really helpful. We see a lot of, yeah, I don't fully trust in itself or
[00:18:42] always critical of ourselves, right? Or have to be perfect to be worthy, which they don't
[00:18:48] realize that narrative yet until this work. But yeah, and yeah, yes, yes. And why I think
[00:18:56] I started this and I'm sorry I didn't end the the physically abused kids will say, you know,
[00:19:01] when you ask them, you know, why do you think your ex parent, you know, hit you abused you
[00:19:06] physically when you're doing psycho education. And they're like, Oh, I'm a bad kid. Because
[00:19:11] they've entered like I've been told, you know, it's it's me actually. And so that's part of the process
[00:19:18] too. Yeah. And parents are that are engaging and more punitive or harsh or inconsistent parenting
[00:19:26] or more authoritarian parent like they don't even know that they are kind of planting all these
[00:19:31] seeds of doubt in their kids and nervous system response, you know, before I became a nation,
[00:19:37] this chronic pain and illness I was an eating disorder therapist. And so now I also overlap
[00:19:43] a lot of that. And they go very hand in hand often. And the personality characteristics of
[00:19:50] someone is very similar in terms of self worth, no self worth or self esteem. And usually we
[00:19:56] uncover there was some sort of either parental figure or mentor someone that they learned
[00:20:03] those tactics from and usually it was the criticizing, right? Like you should be wearing
[00:20:08] that or eating too much or right, like you shouldn't be X, Y and Z. And they'll point it out. But then
[00:20:17] oftentimes, they'll also be like, I mean, I don't know that was just, yeah, that was just like
[00:20:22] that. That was just their experience. So that's also really from a trap, like with the trauma
[00:20:28] lens for any provider is understanding why that makes sense to that response. Because sometimes
[00:20:34] you're like, why aren't you putting this together and then fully validating yourself? It's like,
[00:20:38] yeah, you know, yeah, it just doesn't happen like that. And you have so many instances
[00:20:45] that are creating like a mountain of evidence that informs how your your schema, your, you
[00:20:51] know, internal working model of how you see yourself and others, you know, and that's
[00:20:55] also part of your attachment system, you know, and attack. So there's a lot there,
[00:21:00] but really just more simply is like, why would I believe that just with one connection point?
[00:21:06] So that's where it's like having that like patience and understanding, especially with
[00:21:11] complex trauma and where it's ongoing and during recurrent and oftentimes in interpersonal
[00:21:16] relationships, it's not like the car accident that happened here or the mountain accident,
[00:21:20] you know, it's really over time. There's so many instances and no, it's like data, but you know,
[00:21:27] that that has informed how they've decided as their identity, you know, doing identity development
[00:21:34] and form their belief about themselves and others and their habitual patterns that it's like,
[00:21:39] it's not overnight and the themes kind of cluster. So that's why in the trauma work,
[00:21:44] you're really helping to lean in to address those dreams related to, you know,
[00:21:48] self-worth or power or intimacy, you know, control and this same and these overlap.
[00:21:57] But that makes sense. Okay. So, you know, those connection points are important that you're saying
[00:22:06] and yet they take a minute. Yeah, you know, yeah. Or what is the other evidence to
[00:22:14] for the contrary? And so, and that has to, you know, that's all the work you're doing.
[00:22:20] So I want to make this make sense for everyone. There's lots of clinicians that listen to this,
[00:22:26] lots of therapists. So let's speak to them for a second. If you're listening to a client who's
[00:22:30] saying, well, I don't really know why or I mean, yeah, my mom was kind of critical and would
[00:22:37] like say things about my body sometimes, which I guess didn't feel good, but I don't know,
[00:22:41] that's just like is what it is. Or that's just how it was then. You know, I'm not sure how to
[00:22:47] make a difference. First and foremost, like, why do they just say that? Why are they saying,
[00:22:54] why are they not? Because the clinician's like, um, hello, that is harmful. You know, they're
[00:22:59] not saying it, but they're like, oh, it was harmful, right? You mean, the clinician's having a
[00:23:05] response, let me make sure I understand. The clinician's having a response. So why isn't
[00:23:08] this landing with them of saying that's harmful? And you think about, oh gosh, that's a great question,
[00:23:17] Grace. There's a lot of elements to that when you're growing up and around a person that also
[00:23:25] you're seeking approval and attention. And so it's not also an automatic response to throw
[00:23:32] them under the bus. Like, oh yeah, that was completely harmful and they should have never
[00:23:36] done that. Okay. Some kids say that. Like I said, you know, when the young boy said,
[00:23:42] my mom's boyfriend is a mean and harmful person, right? Versus we're really bad kids or my mom is
[00:23:47] not a good partner or something. That's external attribution versus internal. I think that when
[00:23:52] you see that like, oh yeah, you're making connections that harmful. So what would have
[00:23:57] been helpful for you to hear from your mom or from someone around you? There are a lot
[00:24:04] of different ways to go because if we're trying to build, I always like for clinicians that I train,
[00:24:10] like, where are we trying? Where are we aiming to go? I'd like for my clinician, I'm really uncomfortable
[00:24:14] with my client believing that like, well, this is okay. So my natural response is to say, and this
[00:24:21] is what step one is like, what's your natural response? Well, because I want to say, oh my
[00:24:25] gosh, that wasn't okay. That was wrong. That was harmful. That really ingrained this, you
[00:24:30] started questioning yourself. They want to say that. So the person would ultimately feel validated,
[00:24:35] understood, and also claim what they, you know, they're worse than all these. But if I want to arrive
[00:24:42] there to this more balanced, healthy way of thinking about myself and others or even the
[00:24:47] situation, okay, so stay with me here. I need to help the person arrive there on their own.
[00:24:54] So that's where we use a lot of these strategies around cognitive
[00:24:59] processing and restructuring to help them arrive there. We need to know where we're going.
[00:25:04] So what would a healthy, positive, affirming alternative statement be in that situation?
[00:25:10] What would you say? That kind of would be saying, yeah, to themselves instead of that other thing.
[00:25:17] That's hard because some people are, they're like, well, I don't know. I don't feel any other
[00:25:21] difference in myself, right? I don't feel right. They wouldn't. But I'm saying from you as the
[00:25:26] clinician, what would you like to, like if we're trying to arrive, you know, and I do this because
[00:25:32] it's like steps on a bridge. I think about you have an unhealthy, problematic or problematic,
[00:25:38] unhealthy, you know, not helpful cognition about yourself and others in the world. It doesn't
[00:25:44] feel good to let someone just sit there because it affects how they feel and they live their
[00:25:47] life and their behaviors. So I'm trying to help this person to maybe move a little closer to a
[00:25:53] more balanced, healthy perspective on themselves, others and the situation. So I just also need
[00:25:59] myself. This is getting very provider-specific, like clinician strategy. What would it sound like?
[00:26:05] And then there are these incredible strategies, very specific strategies clinically, to help
[00:26:11] them arrive closer there on their own because that's the only way it's going to land and
[00:26:16] sit. So if you think about that client you brought up, what might it sound like if she arrived at a more
[00:26:22] authentic, positive, affirming statement to herself? So I have clinicians do that in this
[00:26:27] trial work. They say, you know, instead of the kid saying, I was beat up and I was harmed
[00:26:32] because I'm a bad kid, well, what would you like them? Well, you know, I'd like them to say,
[00:26:38] parents, responsibilities, keep their kids safe, even if their kids make mistakes, you know,
[00:26:43] or mess up. There are other alternative ways. Kids deserve, you know, they need to know where I'm
[00:26:47] going. And then I won't go into the strategies, but to help clinician help a person to do that
[00:26:56] journey work there. And that can be in moments in therapy or take a number of sessions.
[00:27:02] Yeah. And I think that's also really helpful for, you know, the person experiencing this
[00:27:09] and going through it in therapy to understand that it is a journey in this process. And it is
[00:27:16] a journey of helping you yourself arrive to that new understanding and cognition, right? Because
[00:27:23] that is, that's the way, I mean, honestly, that's so much of my body work, because people give so
[00:27:29] much of their power over to other types of treatments and things that they're trying to
[00:27:34] help fix them. Even when I first became a therapist, right, people will come in and be like,
[00:27:39] okay, here's this, like, fix me, you know, tell me what to do. And I have to re-organize for a second,
[00:27:45] but this can work with pain and illness, right? They're like, just tell me, I want to get over
[00:27:49] this. And yes, there are skills and tools. And at the same time, it has to come from in here.
[00:27:55] And we have to arrive there on our own. Yeah. And I think your, you know, your remark about,
[00:28:01] they don't have that alternative statement at the ready pulling out of their pocket that's positive.
[00:28:06] That's what we do have to help them to generate those. And, and, you know, we're using some
[00:28:11] kind of questions, open into questions and even psycho education. And what does it look like?
[00:28:15] And asking, what are parents' jobs, you know, to help their kids when they're struggling with
[00:28:19] something? We're asking some of that, what are we to sound like? What would your best friend
[00:28:25] tell you if you told, you know, if you said this, well, she said my mom, you know,
[00:28:29] she would, if you told her your mom said this to you, she'd be like, well, your mom,
[00:28:34] I won't go and say the rest of it. But sometimes they've even taken in other information about what
[00:28:40] others have said, but they haven't landed on it. It's, it's a little bit of a process,
[00:28:47] but it's also like a key element of trauma focused treatment that is also associated with
[00:28:52] the gains and reduction gains in therapy, but reductions in PTSD. So they're trauma related
[00:28:59] cognitions mediate the response and treatment. So if you can target those so critical for healing,
[00:29:06] explain that one more time. Okay, so yeah, so when you notice these themes coming up that are
[00:29:11] kind of trauma related around, you know, trust, safety, shame, malintent, like just the themes
[00:29:19] that come up, you say, Oh, those are really affecting causing impact. You want to focus on those,
[00:29:26] not shy away from that. And that is sometimes an area that doesn't feel comfortable for a clinician,
[00:29:31] nor do they sometimes feel like they have the tools, like I have, you know, tools to really
[00:29:36] help someone to land there. And the more they keep just telling them what, how they should think
[00:29:41] their client, you know, more positively, well meaning, well meaning clinicians,
[00:29:46] they're like, well, why aren't they getting it? Right. And so yeah, so the point is that the
[00:29:52] research shows that trauma related cognitions are associated with trauma related impacts. And so
[00:29:58] you have to address those. So what happens in our, in our brains and bodies that it takes on
[00:30:04] that trauma, right, that might encode it and make meaning of it in a certain way.
[00:30:08] You made me think of a statement that a question that Dr. Dave Clark talks about,
[00:30:14] I think in his book about hoping someone understand if they've had ACEs or not. And
[00:30:18] usually this is their response. He asks, if someone else would have gone, had the same
[00:30:23] childhood you had, how would you think about that? Like what would you say? Or would you say that
[00:30:28] there was anything impactful about that? Right. And sometimes people can switch it. Sometimes
[00:30:33] I don't know if it's every single time, but sometimes they can look at it from that
[00:30:37] standpoint of if my friend went through that, I would think that maybe that wasn't great,
[00:30:43] you know, or that was hard because you're shifting. Yeah, the perspective. Because if I'm
[00:30:48] sitting here, I mean, I might even give my best friend, why I brought up the best friend
[00:30:52] roleplay, which we talked about like, what would you, or that question, what would you
[00:30:55] say to your best friend that said, you know, X, Y and Z, it's like, I might even have
[00:31:01] great advice for them, but I'm not applying it to myself. And that's why learning
[00:31:07] about the subjective experience and what's underneath why they are, you know,
[00:31:14] they're holding that shame, that blame, you know, not letting themselves out of it, for say,
[00:31:19] when we make responsibility pies, we draw the pie, we list how, who is responsible,
[00:31:26] any of the people that's responsible for the trauma, and we help flush out every,
[00:31:30] and then we draw and we say, how much of the pie do you give them? Or how much
[00:31:34] of the pie do you give the babysitter? How many, how much do you give to your
[00:31:37] mother? How much do you give to the offender? How much do you give yourself, and you take
[00:31:41] a look at it and then you unwrap, you kind of unpack it. Ah, thank you. You know, and if
[00:31:48] sometimes they'll have a really big slice of the pie that's them, and understanding that,
[00:31:53] even after they've gotten psychoeducation, and, you know, like parents' jobs are or child abuse,
[00:31:59] you know, like protection laws or all these things, they can have lots of information.
[00:32:04] The key is to be with that and get underneath it and understand, why do you give so much the pie to
[00:32:11] that, you know, this much the pie that found her? Okay. You know, the person that hurt you. Why,
[00:32:15] and you explore that, and then why do you, in a non-judgmental, like, you know, instead of being,
[00:32:19] like, you're giving yourself all that pie, you don't have any of the responsibility,
[00:32:23] I could jump there, I'm not. It's like, why do you give yourself so much the pie? I want
[00:32:27] to learn and understand that. Okay. Nice. And then we're going to work on that because
[00:32:33] when we do the cognitive processing and emotional processing around those,
[00:32:37] the responsibility in this case, we, what we notice is we notice
[00:32:43] that part of the pie, given responsibility itself. I have visual pies that I'm showing all
[00:32:49] the time in my trainings. It's so powerful, but it takes a little bit of that intentionality
[00:32:55] of looking, understanding. Why might it make sense that they're giving themselves this much? Well,
[00:33:01] what we do in trauma-focused treatment at Core Component is also learning about their experience
[00:33:05] and actually learning about what they experience is talking about what happened.
[00:33:12] And that is walking through, stepping into the scene or scenes that are most causing the most
[00:33:18] impact and not being alone with it. There's that Mr. Rogers quote or something, what's
[00:33:24] what's mentionable is manageable. But it really is like, we take it out of the closet,
[00:33:28] you know, the dark closet and, and we're like, okay. And you know, because some people say,
[00:33:33] why would you want to talk about that? And that's, you know, put them through it again.
[00:33:37] They've already survived this. Let's respect them, you know, that. And we're with them.
[00:33:41] And we're going to learn about more about what that experience was like for them,
[00:33:45] so that we can actually be effective targeting why they are holding up playing.
[00:33:50] And so that's the part of the therapy we call in, at least one of the models I train in,
[00:33:56] it's called the trauma narrative or it's imaginal exposure or it's stepping in and telling your story.
[00:34:03] Yeah. And then it could be usually more effective.
[00:34:07] Some people will also come and say, well, I've heard that opening up my trauma will
[00:34:13] re-traumatize me and I don't know if I want to go there, how I do that, right?
[00:34:18] So what you just said is actually so important in, in that of recognizing that first and foremost,
[00:34:23] we don't even know how it infected you. Maybe we just don't know yet. Let's,
[00:34:27] let's get to know it. Let's explore what that meant to you and how you experienced it.
[00:34:31] Yeah. So I heard that's a very common.
[00:34:35] Yeah. You just named and labeled a very common reaction and a fear and a concern
[00:34:40] of clinicians doing this trauma focused work and doing the exposure or the imaginal
[00:34:44] exposure or trauma narrative work. And you know, I remember, I love this story because this is a kid
[00:34:51] that taught about this in just an anecdotal way, but then there's also research supporting that
[00:34:57] talking directly about the trauma actually does not cause more trauma symptoms.
[00:35:02] And that's really important. Trauma assessment measures, there's not the data
[00:35:06] showing that that does harm. And actually, when you learn more, if you learn about aces,
[00:35:12] it's not just about, oh, count up your score. That's what I'm not about that in the aces.
[00:35:16] It's about also how many positive childhood experiences you do have. Let's also
[00:35:20] balance that because those are also important in buffering. So let's hold both of those positive
[00:35:26] experiences are just as important as these. So we're holding these things together,
[00:35:30] but we're not saying, oh yeah, now you're at increased risk of X, Y and Z.
[00:35:35] I think coming back to this idea of, yeah, could I harm? Like this is a well-mean
[00:35:40] clinician. Could I harm someone by going there? No. If you're doing it in a grounded, sensitive,
[00:35:47] kind of controlled, tight-traded way, right? You're not flooding them. And so we build a container.
[00:35:53] But this child's story was so powerful because it was a kid that had been referred to the second
[00:35:59] therapist, and it never talked about his sexual abuse. And he was an elementary school kid,
[00:36:04] and he gets to the second therapist that was providing the treatment that I trained in.
[00:36:07] Trauma Focus is going to be here about therapy, for example. And the therapist said,
[00:36:11] oh, did you ever talk about the sexual abuse with your last therapist? And the little kid was like,
[00:36:17] and the therapist said, oh, well, why not? And the little kid said, oh, she wasn't ready. And I
[00:36:23] always think like, I don't want to be that person, that adult that's not ready to help a
[00:36:28] kid with recovery and to take it out of the dark. So if that's not your style or if that
[00:36:33] that's what I love to support clinicians that are kind of nervous about this kind of work,
[00:36:39] to support them to be able to hold that and see how powerful it is for healing.
[00:36:47] I mean, like you just said, taking it out of the dark closet,
[00:36:51] that makes a lot of sense to me, right? And you can organize it. It's not just for anxiety
[00:36:57] desensitization because why do we do that kind of work? Well, we are rewiring the brain around
[00:37:04] safety because you have all these highways to the danger associated with the memories.
[00:37:09] And how can we train our brains to know that those memories, and it's not making these memories
[00:37:15] happy. They're just reconnecting them that you're not in danger when you have the memories.
[00:37:23] They can't harm you anymore. And yet, and so we're attenuating that response. We're rebuilding
[00:37:29] connections to them and rewiring, but we're also contextualizing, making meaning. We're organizing.
[00:37:37] So if you think of taking everything out of the closet and then you also are organizing because
[00:37:42] sometimes people are so romant and they're experiencing that they haven't, there's no file
[00:37:49] to put it in and put it in the file folder and it keeps popping up.
[00:37:53] That's exactly what, the same thing with emotions, which can also be traumatic as well, right?
[00:37:58] Nicole Sachs talks about, which I talk about the emotional reservoir that we have,
[00:38:02] the lot of repressed emotions, right? Stay in the reservoir and stay pushed down and then end
[00:38:07] up overflowing, which then your brain sends danger signals to your body. And that's the same
[00:38:12] with, with these experiences with memories of, okay, let's bring them out, work with them,
[00:38:17] reorganize them so they're not dangerous to the brain anymore and the nervous system, right?
[00:38:21] And so then that relieves the pressure of pain and illness. So it's exactly what you're saying,
[00:38:26] which I love that you said that. And I think the message I'm getting, which I hope people are
[00:38:30] getting through this too, is that it's, it's not dangerous to go there. It's not dangerous
[00:38:34] to be with your trauma. You can reorganize it, you can reintegrate it. How do you explain
[00:38:39] that? What happens when you do that? Well, you're desensitizing, right? The anxiety
[00:38:44] that is associated with it. So you are reducing the anxiety. You talked about the
[00:38:48] emotions. The emotions that to the system don't feel safe, right? That, that fear, anxiety, shame,
[00:38:54] whatever is attached to it, right? That, and so that is just with, with regard to paired
[00:39:00] conditioning or our good old conditioning, we're, we're teaching about how this, these are
[00:39:05] associated. And so these emotions might build dangers, but they're actually, you know,
[00:39:10] they're, they can't harm us, but we can't work with them if we can't look at them. Just like,
[00:39:14] you know, I was recently training in Japan and they still love Harry Potter. I don't know,
[00:39:19] they have Harry Potter like museums, everything. But I just kept thinking about Harry Potter,
[00:39:24] because Harry Potter is the only one to like turn and face and say Voldemort or turn around
[00:39:30] and actually say it out loud. And that takes the power and the danger out of Voldemort.
[00:39:36] You can deal with them, right? And I mean, maybe that's a very old reference, but
[00:39:40] Stranger Things had a great example too. They went into a memory, these two kids and they pause
[00:39:45] and they go underground and one of the little girls pauses and the other, you know, older one says,
[00:39:51] remember, memory cannot harm you. We're in a memory. And she's like, I don't know if you
[00:39:56] watched that, but very powerful examples that help us to also reassure us even as providers,
[00:40:03] we have to be reassured and remember the why. So I always go back to why, you know, and
[00:40:08] you're also helping with mastery around these emotions. So you're helping to reduce avoidance
[00:40:17] to another key element of why we do this. So we reduce fear and anxiety and overwhelm associated
[00:40:23] with the trauma, the memories, or the reminders, and then we reduce avoidance. So now I'm not
[00:40:29] afraid to think about it, push it down, repress it as you're saying, or avoid people, places,
[00:40:34] and things that remind me of it. And then I'm also able to put it in its place,
[00:40:39] contextualize, organize, make meaning. Yep, which is what we do with pain when you're afraid of
[00:40:46] sitting in the car for three hours because something might hurt you, right? We reorganize it.
[00:40:51] We unattach from the idea that this thing is going to be harmful to your body.
[00:40:56] Yes, because we avoid, right? It's the avoidance of it. Yes, avoidance usually pushes it
[00:41:02] away and then makes it harder to be with the anxiety associated with trauma, emotions, actions.
[00:41:08] Yeah. Yes. Amazing. Okay, we could probably go for a long time on it. I want to ask one last
[00:41:15] question. So based on everything that we've talked about, what would you say to someone who is
[00:41:21] starting to understand and connect the dots around trauma for themselves?
[00:41:25] I would just say that we're not built to do this alone. So it's really important not to just go at
[00:41:34] this alone. If I was stronger, I can overcome it. It's really to be done in community and with those
[00:41:40] that can hold us. So if that's about those friends and family or others that feel like
[00:41:47] you can connect with and finding a therapist and our counselor, and it's really important
[00:41:53] for you to know that nothing that you bring at your experience is too much for a well-trained
[00:42:00] therapist that deals with trauma. So if you meet a therapist, it seems completely overwhelmed
[00:42:04] by your experiences and it's probably not the best fit because we have such helpful approaches
[00:42:11] to supporting you as that person fully. I think that's a great, I'm glad that you said it,
[00:42:17] because I mean, most people listening to this have had many experiences more in the medical field.
[00:42:23] Well, therapy to realm of not understanding their story and it feeling overwhelmed because
[00:42:28] they're the ones that don't make sense and their pain and their illness and there's a lot with
[00:42:32] their story. And so I guarantee you, there's plenty of people are sitting listening to this
[00:42:36] thinking, yeah, I've had that experience. I've had that experience of I really fully recognized
[00:42:43] yeah, I overwhelm you. And so then it made me stop sharing as much in the beginning
[00:42:50] to kind of test out like I saw myself ask you that being like, all right, I'm going to share these
[00:42:54] few things, see how I do that. And so I think it's, I'm glad you said that.
[00:43:01] Yeah, there's enough room and space for the whole you and all of your experience that you
[00:43:06] bring. And I always like to celebrate like the resilience and people that have been like the
[00:43:12] great strength that you have and that's not highlighted somewhat sometimes, you know,
[00:43:18] it's just like what's wrong or what's weak. And so no, that's, that's to be really
[00:43:23] celebrated this ability to persist and adapt in the face of a lot of challenges and but not alone.
[00:43:29] Not alone. Yeah, amazing grace. Thank you so much. Thank you. Tell us, I'll link everything
[00:43:38] obviously below in the show notes, but tell us how people can find you and you just started a
[00:43:42] private practice, right? I did. Yes, yes, yes, we did resilient families therapy. And then we have
[00:43:49] also a clinic that we started at the university as well. And we have, yeah, I'll share all the
[00:43:56] things. So amazing. Be happy for folks to contact me and learn more and share more. Amazing.
[00:44:05] If this podcast means something to you, it would mean so much to me if you could do
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