Reclaim You- The Why’s and How’s of Trauma Therapy
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In this conversation, Sarah and Abby discuss trauma therapy and how it can support ACA's and folks who have experienced complex trauma. They highlight the importance of building a strong therapeutic relationship and developing safety and stabilization as the first step in trauma therapy. They also discuss the use of EMDR (Eye Movement Desensitization and Reprocessing) and parts work (ego state work) as effective modalities in trauma therapy. The conversation emphasizes the role of the nervous system in trauma therapy and the importance of understanding and regulating the body's response to trauma triggers. Overall, the conversation emphasizes the slow and paced approach to trauma therapy for PTSD and CPTSD and the need for patience and compassion in the healing process.
Previous episodes and blogs mentioned in today's episode:
Strategies That Makes Sense For Adult Children of Alcoholics
How Trauma Therapy Can Help Adult Children of Alcoholics Blog
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To learn more about Reclaim Therapy and how to work with a therapist on the team, head to https://www.reclaimtherapy.org.
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Sarah (00:00)
Hey everybody, welcome back to Reclaim You. I'm here today with Abbey and we're gonna be talking all about trauma therapy.
Abby (00:09)
Hi, everyone. Yeah, I'm excited to talk about this.
Sarah (00:12)
Yeah, so we are talking about how trauma therapy can help and maybe some different types of trauma therapy for adult children, alcoholics, and also just anyone who's experienced complex trauma. That's kind of the lens that we're looking through today. So yeah, excited to dive into this and share some more about the cool work that the folks in our practice do.
Abby (00:30)
Yeah.
Yeah, yeah, I'm excited to kind of like outline some of the like what trauma therapy could look like for people who are interested or wondering, you know, if I'm an adult child of an alcoholic or if I've experienced complex trauma, what does that therapy in particular look like? Because it can look so many different ways. And at least at our practice, I think.
Maybe I won't speak for everyone, but we tend to lean on a few different modalities that we find to be really supportive for healing from complex trauma.
Sarah (01:12)
Yeah, yeah, and I'll link to the last episode that we did about trauma and complex trauma and how trauma therapy might help. So I'll link to that so whoever's listening can listen to that as well because that was a really great episode that Abbey really broke a lot of things down. But yeah, let's just talk about trauma therapy in general. How would you define trauma therapy?
Abby (01:39)
Yeah. Yeah. So I'm, I remember in grad school learning about trauma therapy being divided up into three main stages. And I feel like that's sort of the, the way I conceptualize trauma therapy to this day, because it's just a really helpful framework, at least in my mind. trauma therapy, first and foremost, is
heavily reliant on the therapeutic relationship. So before anything, we really prioritize building a strong relationship with the people that we work with. Because ultimately, if we're going to dive into some really challenging stuff, aka trauma, it's not always possible to do that when you don't feel super safe in a relationship. So
That being sort of the foundation of all trauma therapy in my mind, the relationship. And then the three sort of stages, prongs, and again, they may not be perfectly linear, but the way that I think of trauma therapy is the first step is really developing that safety. So again, building a relationship, developing safety, maybe we
talking through stuff that's going on in your life while also building a toolkit of tools to
create a stronger sense of safety and stabilization day to day. And that can take as long as it needs to take. So it's not that one session goes by and it's like, got it, got all my tools in my toolbox and I'm ready to move. Sometimes, more often than not, I would say we are developing safety and stabilization throughout.
a therapy relationship and process, always revisiting it. So that being sort of the first stage, if you will. And then, you know, once we both as therapist, client feel like, okay, there's enough safety and stabilization and our relationship is strong enough to kind of move into that some of that trauma material. That's when we move into like that stage two of processing some of the trauma in a very
gradual way. So it's not that we just rip the bandaid off and go straight there. We talk about it, we plan for it, and we go slow. And then the last stage again, we're kind of weaving in and out of these all the time, is sort of integrating that work into daily life. So from that reprocessing of past trauma, how are we kind of
weaving in some of that new insight, learning, healing work into our day -to -day life. So yeah, kind of a long way of talking about trauma treatment. Is there anything you'd add, Sarah, or change the figure?
Sarah (04:43)
Yeah, no, think that was, yeah, that was really wonderful. I was just thinking as you were talking about, I think I say this on most consult calls that I do. I talk to most people who are coming into the practice talking about why we are a trauma -focused practice. And this goes in alignment with what you were sharing about having a safe relationship and then moving into reprocessing and stabilization, all of those things that.
we really look at the body as a means of healing. So as eating disorder therapists and body image therapists, you know, we have to include the body in that treatment and the body is so imperative in trauma treatment, because the way that trauma is stored in the brain is only access through the body. It's not access through cognition, right? It's not access through words and lots of popular therapies like CBT.
the behavioral therapies, right? They rely heavily on cognition. And we, in our practice, we access trauma through the body, which is the way the body can process trauma. So all of that to say, that's all I have to add.
Abby (05:53)
Yeah, yeah, yeah, I'm picturing again, there's like those three stages in my mind of trauma therapy, safety stabilization, number one, number two, processing the trauma, number three, integrating into life. I can only picture a pyramid here. And then the foundation of the pyramid is the relationship and like the body. So the relationship between client and therapist and your relationship.
Sarah (06:14)
Mm the body.
Abby (06:19)
sort of not only with your body but sort of how the body is showing up in the work and how the body has stored trauma over time. So right alongside the therapy relationship the body is such a foundational piece of trauma work.
Sarah (06:23)
Yeah.
Absolutely, which I feel like can lead us into maybe part of this conversation about polyvagal theory, which I can link to a blog that Abby just wrote about that. But and what it is, it's like the nervous system, right? The nervous system, the body, nervous system is part of the body, right? It's all connected. And trauma therapy relies heavily on like leaning into the nervous system and understanding the nervous system. So maybe it would be helpful to kind of break that down a little bit.
Abby (07:05)
Yeah, yeah, so breaking down polyvagal theory a little bit more on that type of work.
Sarah (07:09)
Yeah. Yeah. Yeah. Because then all the other trauma therapy is kind of like follow suit, right?
Abby (07:17)
Yeah, yeah. So when thinking about the nervous system, which a lot of people are talking about the nervous system these days, which is great. And also we were just talking about it earlier. Like there's this notion of hacking the nervous system, how to hack your nervous system into feeling better. And that's really complicated because there may not be a quick fix hack to feeling better or healing from complex trauma.
Sarah (07:29)
Awesome.
Abby (07:46)
But, you the talk of the nervous system is important because it does highlight just how, you know, at the core of everything, our nervous system is reacting to past experiences, present experience, etc, etc. So I guess to break it down, Polyvagal Theory was developed by Stephen Porges. And if I get any of these details wrong, please jump in, Sarah, but he
Sarah (08:13)
Mm -hmm.
Abby (08:15)
developed this theory of the nervous system that was then broken down into like more easily understandable terms by this clinician Deb Dana. And I really love her work because it helps me understand the more sciency lingo of the nervous system because it can get really sciency, which I love, but it's also confusing. So I guess I'll just like try to share from my own brain what our nervous system
Sarah (08:30)
Understand. Yeah. Yeah.
very sciencey. Yes.
Abby (08:43)
is kind of composed of in the like broadest terms ever. These won't be super sciencey terms today. Our nervous system is kind of broken up and it's certainly not broken up, but it's like broken up in my mind into three sort of mechanisms or parts even, branches. That's a much better term.
Sarah (08:49)
Mm -hmm.
branches.
Abby (09:06)
And the branch of the nervous system that's involved in trauma is the autonomic nervous system, which we can then break down further into the sympathetic nervous system and the parasympathetic nervous system. And yeah, we'll link to the blog that kind of gives more imagery to this because I find it helpful to view it visually when thinking about the nervous system. But
Maybe we'll start with just like when you're in a state of calm, when you're in a state of ease and everything's going relatively well. And even if things aren't going really well, but you're feeling like you can breathe in, breathe out and manage the present stressors with relative ease. You're in a state of ventral vagal activation, which is a fancy word for just you're in your window of tolerance. You're in your, your,
Sarah (09:59)
You're chilling.
Abby (10:00)
you're chilling, you're finding it much easier to regulate even if things go awry. And that is a felt sense in the body. Like you can literally digest food easier. You can breathe more deeply. Your thoughts are clear. You're communicating what's on your heart and mind. And then life happens or you are moving about your day and you might experience
something that perhaps implicitly, not consciously resembles something from your past that was very traumatic or just difficult in general. And that might send you out of your window of tolerance, that ventral vehicle activation where you were just chilling. So when that happens, we either sort of bounce up into a state of
fight flight energy. We've talked about this on a previous podcast too with lots of animals. And then sometimes you get bumped sort of down into what's called dorsal vagal activation where there's that collapse that you might feel fatigued when you're in that place, dissociated, disconnected, can't quite think clearly. So,
opposition to fight flight, is sort of that submit response that we've talked about before. Why am I blanking on the other ones right now? It's just complete collapse, immobilization, fawn. lots of fancy terms for when you're popped out of that chill place because of trauma triggers, whether they're conscious or
Sarah (11:26)
Like fawn, yeah, like clops, yeah.
Abby (11:37)
your nervous system is reacting. So I just said a lot of things and wondering what's standing out to you from the like broad overview of nervous system.
Sarah (11:49)
Yeah, yeah, yeah. And I'll link to lots of links in today's episode to a blog about the window of tolerance, which might help people also visually understand this a little bit more. I'm just kind of visualizing in my mind like a wave. If you're on YouTube, you're saying you go like this, like a little wave of our bodies, our nervous systems want to be regulated. That doesn't mean that dysregulation doesn't happen. But our bodies want to find
Abby (11:54)
Yes.
Sarah (12:17)
a flow, some flow of like feeling activation and coming back down into what feels easy and regulated and maybe spacious. And then maybe some dips down into immobilization, but like coming back up into feeling tolerant of like the present day stuff going on and finding some like regulation again. our nervous systems want to do this, right? But what gets in the way is often trauma or events that happen in our lives.
that keep us like stuck in a state of activation. So it doesn't have a chance to come back down into that place of regulation. So when we were talking about trauma therapy just a few minutes ago, this is the point is to help people reprocess events so that their bodies and their nervous systems can find that ease and flow in, you know, getting activation and coming back down into like deactivation and some just stability there and like, like a little wave like I'm doing with my hand, which you can't see if you're listening.
but up and down and up and down, and even spiking up and then coming back down into like, okay, I'm safe, things are okay. So that feels like the importance of learning about polyvagal theory is that there's a reason behind all of this, a very sciencey reason behind all of this, and that's how we base our treatment is understanding and kind of conceptualizing the nervous system in that way, and what's happening and why it's happening in a body way, maybe not a cognitive way.
Abby (13:42)
Yeah. And I love what you said around like that's really the point of trauma therapy is it's not that our nervous systems will be perfectly regulated all the time. They're not meant to be like they are designed to fluctuate or move up and down that that that ladder really for a reason. If we didn't experience sympathetic activation, we wouldn't be able to protect ourselves in
the face of real threat. If we didn't experience sympathetic activation, we wouldn't be able to do the things we want to do in life. Like there's actually like some components of that activation that are really helpful. It's all helpful, but you know, there's, we're never going to be perfectly regulated. I think trauma therapy is very much about getting
in tune and aware of really what it feels like in our bodies to move into those different spaces sympathetic so hyper arousal hypo arousal ventral vagal chill space yeah chilling to know okay i'm here now and what do i what do i know
Sarah (14:52)
you
Abby (15:00)
about being here. And what do I know about like the environment and space that I'm in, in the present moment so that I can really recognize like, is there a real threat here? Is there a real danger here? Or is my nervous system reacting because of my past? And that discernment or that ability to kind of differentiate
Sarah (15:02)
Mm -hmm.
Yeah.
Abby (15:25)
takes a lot of practice and processing and is often done in the safety of a therapeutic relationship. So yeah, that feels just important to say too.
Sarah (15:37)
Yeah, absolutely, absolutely. And so in even talking about all of this, what feels natural to talk about is like the different types of trauma therapy that we often maybe use in our work, just with the, I guess, with the baseline of what we just shared about the nervous system and including the body in the treatment of trauma. But yeah, what do you lean on? What are your go -tos? Because I know actually
same as mine. what are your go -tos?
Abby (16:09)
you're like, what are your go -tos? Yeah, they're mine too. Exactly. Yeah, our practice does focus on a lot of the same things for a reason. So I tend to lean on, if I think a lot about the work that I do with clients, I tend to lean most heavily on
Sarah (16:13)
Cause I know.
Abby (16:32)
principles from EMDR, eye movement desensitization therapy, and I can talk a little bit more about that.
principles from ego state work. So a version of ego state work is commonly known as internal family systems. Those blend really well together in a lot of ways. And what I like about those two modalities are that the body and the nervous system are just so naturally incorporated into those trauma therapy models. So yeah, would it be helpful to kind of like talk through
what those are.
Sarah (17:07)
Yeah, let's give a bird's eye view of EMDR and parts work. Yeah, that's a great idea.
Abby (17:11)
Yeah. Yeah. So EMDR is a type of trauma therapy that really hones in on those three prongs of trauma therapy that I had talked about before, developing stability and stabilization, a big part of EMDR, eye movement desensitization, reprocessing therapy, which is a
So much of that work is spent in what's called resourcing. So we're developing a lot of internal and external resources to feel that sense of safety and stabilization. And then we move into, again, like that stage two of processing the trauma. And there's a specific way EMDR goes about reprocessing past trauma, and it's through the use of what's called bilateral stimulation. So bilateral stimulation could be bilateral eye
moving your eyes back and forth, left to right. Could be tapping, alternative tapping. We could use sound. So there's many different forms of bilateral stimulation. The reason that EMDR uses that to reprocess trauma is the research believes that it's meant to sort of mimic what's happening in REM sleep. So when we're in that deep sleep state,
it's said that we are reprocessing or just sort of processing material. And so when we're reprocessing trauma with that mechanism, bilateral stimulation in place,
I think one of the more important pieces is it's really allowing us to have one foot in the present while we're putting one foot in the past. We're always doing this reprocessing in a way that is really safe and grounded as humanly possible.
So that's hopefully a bird's eye view. We have a lot of material on our website and more to come. And even this blog that we'll link on EMDR. Anything you'd add about EMDR for, especially like complex trauma, I guess.
Sarah (19:13)
Yeah, you know, and I think I share this in, like I said earlier, with most people that I talk to on the phone about EMDR with our practice in particular, because we do work with folks who have experienced a lot of trauma, so complex trauma. I tell people that we do this for a reason, that we really like to spend a lot of time in the beginning phases of EMDR therapy. So
getting a really solid history of where people are coming from, what they've gone through, even if it's just headlines, right? Like we wanna know like the base of where your symptoms started. So if we look at that from the nervous system perspective, it's like what happened to you and how did your nervous system adapt so that you could survive in the world? So our job is to really like gather this information in a way that feels, you know, slow and safe enough that we can conceptualize with you.
to understand where we're going and why we're going there. It's not just like willy -nilly, we're gonna choose this memory and blow through it and you're gonna be fine, right? We want to be really strategic about what we're doing. So all of that to say, we spend a lot of time getting a history, building a relationship, really focusing on that resourcing phase of therapy where you have lots of tools to navigate your nervous system.
so that when you feel like a trauma trigger or you're experiencing a trauma response, you have tools to come back to the here and now, to some like corner or glimmer of safety, to really work alongside your nervous system to feel more regulation. Because we know that when people are reprocessing trauma, there's likely gonna be some sort of activation that's there. We wanna make sure people are really well equipped to come back to a place that feels okay.
Abby (21:01)
Yeah, yeah, which feels like a perfect segue into what is parts work, ego state work, internal family systems work, because at least for myself, I use a lot of that as preparation or resourcing.
before we would ever move into something like reprocessing trauma with EMDR. And so parts work really is just this idea that we all have many different parts of self. The best movie that represents this is Inside Out, which I haven't seen the second one. I need to see the second one. Okay, yeah. Which I just feel like it's such a good illustration of the just different parts of self and
Sarah (21:23)
Yep. Yep.
-huh. you gotta see it. It's great. Yeah, it's great.
Abby (21:48)
That movie only shows so many parts of that character's self. There's like so much more. But I find it to be a really helpful.
resourcing modality, like it's a modality that allows us to get to know our internal system, like who are the different parts of me? Why are they here? They're here to protect me in some way. What are they protecting me from, perhaps? And it's...
Yeah, we never want to get rid of our parts. A lot of the work is around how can we develop stronger relationships with the parts of us that get activated from trauma triggers or just life stress in general.
And how can we develop more awareness around those different parts so that when they do show up, they're not in the driver's seat right away. Like maybe there's a conversation before they take over or we like practice so much with them. They start to develop more and more trust that they can maybe take a step back and let, you know, let us be in the lead. So all to say, as you were talking about.
our practice spending a lot of time in stabilization and preparation. That's one modality that I really like to use before moving into that processing.
Sarah (23:11)
And I think something that we've talked a lot about in previous episodes, just to kind of, I guess, give maybe a real time example, is like people pleasing, right? So like this people pleasing part of me, right? Like the people pleaser comes out.
quite easily, right? So in my own work, it's been working on acknowledging when that part has kind of like stepped forward and understanding and giving a lot of compassion and grace to myself so that I can make a more like value driven decision in the moment. It's not just all about what feels like sometimes, you know, life or death around, you know, taking care of other people and not myself.
Abby (23:47)
Mm -hmm. Yeah, and you just sparked within me just this thought of a lot of the times when people say things like, I know what I want to change. I know that I don't want to react in this way or people please in this way. I know it's a tendency of mine, but I can't seem to stop it.
That's where I find this sort of combination of modalities to be really helpful, doing some parts where preparing potentially for some EMDR reprocessing. Yeah, yeah, so that just kind of made me think how often I hear that sentiment of like, I know all the things, why can't I just change this behavior or why can't I just?
Sarah (24:29)
I know other things. Right.
Abby (24:33)
change this mindset or this thought pattern. And there's likely really good reason why it's not budging as quickly as you want it to because awareness is wonderful. And it only goes so far then the nervous system comes in, or these parts of us come in to really protect because something else is just stuck. And that's where I find these modalities EMDR parts work. Again, like more of the somatic therapy work.
Sarah (24:52)
Mm
Abby (25:02)
to be really helpful in getting into that stuck place.
Sarah (25:06)
Yeah, yeah, yeah, that's great. Yeah, absolutely. Yeah. Anything else you feel like we should talk about?
Abby (25:14)
Yeah, think, I mean, there's only like one other piece that I may be worth mentioning. This may or may not be a misconception amongst people in the world, but I have heard the question of like, can EMDR treat complex trauma or is it that I just need to have experienced sort of a single incident trauma? And I know we've talked about complex trauma and what that is on a previous podcast,
I guess the short and sweet of it is yes, EMDR can be supportive for the healing of complex trauma. there's just, perhaps it's just that we're really working in that resourcing and stabilization safety phase for as long as we need to. And it just, yeah, yes is the answer.
Sarah (26:02)
Yes is the answer. Absolutely.
Abby (26:03)
There's a longer answer there, for now I'll just say yes. There's applicability there.
Sarah (26:09)
Yeah, absolutely. And I'm thinking just about how it's like, yes, and it's like, it's not going to happen overnight, right? And I think that good trauma therapy is well paced and is slow and really prioritizes, you know, as much safety as possible. So that takes however long it takes, which like, I know, none of us really want to hear that, right? But typically when folks
experienced lots of trauma, complex trauma in their lives, there's a lot that's happened really fast. And so, you know, sometimes we do really need to slam on those brakes and go really, really slow so that their nervous systems, our nervous systems can adapt to something new and something different, which is probably what our nervous system needed way back when.
Abby (27:00)
Yeah, yeah, yeah, the slow is fast. I'm just thinking of all the times that I'm like cooking a meal in the kitchen or something, I'm moving at lightning pace and then have to like go back and pick up things that fell and redo part of the recipe because I forgot something or messed it up, you know, like there's this slow really is fast. And that has been a lesson I'm learning and relearning again and again.
Sarah (27:15)
huh.
Yep.
Over and over. Yeah. -huh. Totally. Yeah. Well, I feel like this was really helpful. Yeah. Anything you want to add to close it
Abby (27:36)
think that's it. Yeah, there'll be more to come on maybe like nervous, I'm planning out a few more blogs on just nervous system stuff. So people can keep an eye out for that.
Sarah (27:40)
for sure.
Yeah, yeah, awesome, awesome, awesome. Well, I'll link to all those blogs that we referenced and spoke about, and even the previous podcasts that we've recorded that I think will really fit in well with what we just talked about. And yeah, excited to dive into more like nervous system stuff with you on future episodes, because like Abby said earlier, there's a lot of talk around hacking nervous systems right now.
I think we don't need to hack anything. Our nervous systems are smart. They know they sometimes need a little support, right? A little support, a little attunement, maybe not so much hacking, but we'll talk more about that later. All right, well thank you Abby.
Abby (28:15)
Yeah.
Yeah. That sounds great.
Thank you.
Sarah (28:32)
Okay everybody, we'll be back next week with another episode, so take good care.
Reclaim Therapy is a group of trauma therapists that provides trauma therapy, therapy for eating disorders, EMDR Therapy and Complex PTSD treatment.
Our team is passionate about helping people reclaim their lives from diet culture, body shame and the impact of trauma.
We would love to support you as you Reclaim YOU and the life that you undeniably deserve.