I’m an EMDR Convert

Call me weird but my niche is trauma. Over the last 25 years I have gotten really good at hearing, discussing all kinds of awful stories from clients. I can hold these stories, and at the end of the day, I go home and live my life as if some spacey force field surrounds me from absorbing the pain into my own heart. Recently however, I decided that I could not be a trauma therapist if I did not know anything about EMDR therapy. The most I remembered from the first time I heard about it (in around 1993) was about watching a pencil eraser go back and forth and somehow people felt better afterwards. It seemed a little like voodoo to me. But after the last 3 months of training, I decided that it’s more like magic.

Real magic, like having my own wand in Diagon Alley with Harry Potter and friends and knowing all the right spells and potions at my disposal. Okay let me qualify this: I am a total newbie. I literally just finished the second weekend at the Maigberger Institute in Boulder, Colorado, with the amazing Barb Maiberger. Barb teaches four groups per month, then follows them up with online meeting consultations. I have had a private practice for a few years and many of my established clients were psyched to try this modality with me and I have been able to witness some amazing things in a short period of time. So before I say more – just what the heck is EMDR therapy, you ask? Well, I am here to tell you, since one of the assignments is to draft an explanation for my clients.

Eye Movement Desensitization and Reprocessing therapy is a modality that can be used with adults, teens and young children. It has been extensively researched and shown to reduce symptoms associated with most kinds of traumas and generally disturbing events and emotions. There are 8 phases that will take place as the client is ready for them.

The treatment will use one or more of the following types of Bilateral/Dual Attention Processing stimulation (BLS). This keeps the client and therapist in the past and the present at the same time: Each client can choose what they prefer: Eye movement by following an object, hand buzzers, tone through headphones, tapping by the therapist or self-tapping.

EMDR Therapy does not erase memories, it merely takes the emotional connection away from an event so that a person can recall and discuss the events without distress or disturbance. Research has also shown that the brain continues to re-process even after the session and well into the future. Clients may experience dreams, flashbacks, emotions and other sensations following the treatments especially after the trauma work begins. This is normal as it shows that your nervous system is doing its work.

Many of you may have heard that in June 2019 the creator of EMDR, Francine Shapiro, passed away at the age of 71. She discovered the properties of her theory quite by accident, as many good ideas come along, and being open to something that the Universe was trying to tell her. As a graduate student in Psychology, she followed up with good old-fashioned inquiry and research and started nothing short of a revolution. People with long term traumatic symptoms – war veterans, crime victims, people with chronic pain got relief! Even after years of traditional therapies, within a few sessions, they were able to think about or talk about their traumas without feeling as though it was happening all over again. Like I said: Magic.

Ok, magic and science. One image that came up in my mind when watching my first demonstration on Day One was the idea of hypnosis. In the movies, we always see some Victorian doctor in a gray suit with a curly mustache swing a big, gold, pocket watch in front of someone’s face until they become sleepy. In this state, the doctor is able to access memories, or implant some suggestion that later comes out unknowingly as a behavior the doctor wanted the patient to complete. Okay, that is pretty creepy and not what the purpose of any legitimate therapy is. But the bilateral stimulation has definitely been known for a while as a powerful method for brain stimulation. Plenty of new science on the brain is out there and practitioners, writers, researchers are clamoring to have the next breakthrough: like plugging our heads into a screen and making images appear. I’m not so sure that is a world I am interested in, as my reality, anyway. I’ll take it as science fiction instead.

I am a convert now. I don’t hear all the stories as much in sessions. I find myself taking deep breaths with my clients, nodding, and saying “go with that,” a lot while observing waves of emotion in my clients through their tears, twitches and relaxation responses. They end their sessions looking like they just came out of a nice dream, stretching and smiling, yet they were fully awake in the room the whole time. I tried it while in training, as we have to do on one another, and discovered that a number of things that used to get me going on an angry rant are no longer bothering me. It is a very peaceful feeling, to be able to let it go. I have studied for 25 years to do play therapy, Cognitive Behavioral Therapy (CBT), Solution Focused Therapy, art therapy, and this is becoming my go-to and I don’t have to give up any of the above! I hope to keep going to get certified, which will take a couple years to do, so until then I will keep practicing, training, and consulting. Advice? Interested therapists should find an EMDRIA approved training, and don't cheap out on this one. There is too much to learn in what might look like a bargain. Potential clients: always look up where your therapist got their training, just in case they did cheap out! 

Does My Child Need a Therapist?

                 I see a lot of posts, memes, blogs about parenting, about how our kids “drive us crazy” or got into trouble at school for some mischief or even for bullying another child. I have friends ask me often if they should take their child to counseling for sometimes “normal” things related to the child’s particular temperament, and sometimes for what is a good catch on the part of the parent. How would you know if your child is having issues beyond what you, as a parent, can help?

                The critical question I am going to ask is, “does the child’s behavior or mood prevail across two or more environments?” If a child is struggling to concentrate in school, misbehaves, can’t stay in their seat and blurts out in class, but is quiet and pleasant at home, sits and reads, then I would think there is some school anxiety vs ADHD (attention deficit hyperactivity disorder). If a child is moving and off task at home and at school, and in a museum and a grocery store, then we might be looking at ADHD. Confused already? That’s why getting answers from a person and not your Google search is important. There is a lot to consider and asking is perfectly reasonable. Children with ADHD don’t always need a therapist, unless some of their adaptive behaviors have become habits and they need help with social skills and parents may need help adapting their own skills to the child who needs a lot of patience. Kids can usually be easily treated with medication that the pediatrician can prescribe (a simple questionnaire should be given to the teacher and an EKG is usually completed first). Be sure to ask a lot of questions – parents need to know everything they can.

                Similarly, the behavior is not only taking place in multiple environments, but is interfering with normal daily tasks. A child who is developing OCD (obsessive-compulsive disorder) will eventually forego pleasurable activities to complete the compulsive behavior they “need” to complete to resolve the worry in their mind. Most people have a superstition or two, but if a child cannot get dressed before going through several perfect renditions of their task, (flipping the light switch, a chant, touching objects in a certain order) there is a problem.

                If you have answered “yes” to either or both of the above questions (2+ environments, interfering with fun), you may need a professional consultation. It does not mean something is “wrong” with your child, or your parenting. Imagine if your child needed a life-saving medical service, and you decided, “no, it’ll be okay without the intervention?” You wouldn’t likely do that, would you? You’d take your child for the appointments until they were cured. Letting an emerging mental illness go untreated is a threat to the child’s future, so it’s better to get help now while their brains are workable. Yes, many of these illnesses also come out as adults, and we can’t always predict it, but kids can learn valuable coping skills to handle stress throughout their lives. And parents don’t always know the best way to manage childhood anxiety, depression, OCD, ADHD. When you love someone as much as you love your child, your emotions get mixed in all too easily.

                Ask your child if they are worried about anything. Tell them you can find someone who can help them feel better. It might not even take very long for relief. A good child therapist can help bring out issues through drawing, through games and help the child identify and verbalize what is worrying them. The therapist can help parents respond more effectively to their child and teach them skills to self-regulate, communicate and listen. Call a therapist, ask the questions, and make the appointment. A wonderful adulthood awaits your child.
ARileyLCSW@live.com. 

The Business of Helping

The past week and a half have been full of learning, mostly about things they just don’t teach us in Graduate school – and how could “they” have? This was 16 years ago, there was barely anything called “the internet” in those days. Things are so different so I have to adapt. I am in a program called Business School Bootcamp – a two week intensive on getting a private practice up and running successfully. Is it all about making gobs of money? No, although it is about value – the value of what I provide and the value a potential client places on getting well. But it’s about finding ways for us to meet – the client who needs my help and the therapist who needs clients, so they can both thrive in the world.

To pat myself on the back, I have done a lot of the things in the lessons already – I did a lot of planning before I went full time. There is more I can do to get my name out there and I am working furiously to do it. So much of it is about technology – just getting search engines to find your website. Researching what people type into a search engine and then matching those words and phrases into the fabric of my website – the part you don’t see, The Code. Dammit, Jim, I’m a therapist not a computer programmer! Ok maybe I am a little now? If you understand that above reference, then you know that I AM a Star Trek fan.  I’m not too old to learn a few things.

So when you, a potential client, looks for someone to pour your soul out to, you type in a search – counselor in Denver area – or something to that effect. A lot of calls and referrals come through Psychology Today and I am grateful for that. This week I actually Googled “PTSD counselor in Commerce City, CO” and my website popped right up. It was a happy moment for me. Once you find your list – how do you know that therapist is going to be right for you? Recently I am getting more Medicaid clients, and I am among very few in my area who accepts it as payment. Right away that puts me on the top of the list of people to call. But I want clients to want to work with me, not just because I take their insurance. I want to have a site that says “I’m your person! I get you, I can really help you, and you’re going to really like working with me because I’m the shiz-net.”

I also chose to be on the Medicaid panels because I see kids in foster care, and all too often families on Medicaid are referred to the county clinics, which are often staffed with new graduates, interns, who are less experienced and over worked. I know because I have been there. I can’t be the best therapist I can be by being overworked, underpaid and having to deal with issues that are harder than I can handle (if I were there ;D). There should be equal access to quality services. Or so I believe. I want these clients to find me so I needed to make it easy to find me. So that’s why you would pick me, or why you would pick someone else. You found a therapist who “speaks” to you through all this media noise. Only I have tried to cut out the noise.

Give me a call and interview me. Then interview someone else. Interview a third person? Why not? This is your healing and your future we are talking about. 

Countertransference

If there is one thing I stress to students and anyone I supervise... it's "get a handle on your own stuff." What does this really mean? I see a lot of posts about behaviors people need to stop doing, for example, complaining or worrying, nail biting.

But first you must be aware that you do these things at all. And most people are NOT because they can be very unconscious. Long before I knew this is what I wanted to do, I went to therapy for a year. I was 17 and I had issues, suffice it to say. I didn't think this therapist was any kind of guru but I learned what I needed to learn and threw away some of his sexist, assuming and occasionally belittling crap about me. I can laugh about it now! I also went to therapy in my 20s because my father was terminally ill but I went for ten years anyway. After I got married and had a baby, I was in marital therapy *surprise!* So I have done some time on the couch, and I think ALL therapists should. Why? Because you need to be aware of your own stuff! I cannot say this enough!

Counter-transference is the therapist's reaction to the client's reaction to them. Or to their story. Last week I saw a couple - only for two sessions. One wanted to work on the marriage, and the other was done with her spouse. I don't really want to see couples, and I was glad when they decided to stop coming. Why? Because I have gotten divorced, and clearly not long ago enough. My mind wandered and I struggled with staying focused on them because I could see all the similar issues. I also have a client who is getting divorced but it's a little easier to manage my feelings with just one person - I tend to align myself with one person vs staying in the middle - I am not a good mediator. Well, it is something I can work on. I have my areas of expertise and I do not have to be an expert in all things.

During my marital counseling time, I found a therapist whom I adored. She was an older lady (we both thought she resembled my mother but she was nothing like my mother as we found out!), French speaking Swiss ex-pat, elegant, and had this uncanny way of using her own counter-transference to work with us (I am sure this was her Institute training but she was gifted). She allowed her feelings to surface based on what each of us said. She used those feelings to respond to the person who was talking and not talking. I loved her and eventually went to see her on my own from time to time.

I once went to a training on counter-transference where we watched some film clips - Ordinary People, and Dead Man Walking are the two I recall the most. Any film with therapy scenes or
difficult issues are good opportunities for therapists to think. If you were sitting across from a sociopath on death row and he started making sexual innuendos - how would you handle that? Watch the movie - she did great. Granted - you'd feel pretty uncomfortable. Angry even - how dare he? Be aware of those things. Narcissistic people will piss you off constantly, be aware of that. Those feelings are telling you something not just about you but about your client.

The California psychiatrist Irving Yalom MD writes great books about therapy - I recommend them. The book "Love's Executioner" is specifically about counter-transference and is a must read on the topic. I have learned more from his books than any class or supervisor. While I was reading his book, "The Gift of Therapy" I got stuck on a chapter and stopped reading it. I mentioned this to a colleague and he asked what the chapter was about because it had triggered something in me... well of course it was something I was having a reaction to - I don't recall at this moment what it was. My point is that these things are all signs that point to our issues and we must listen.

Therapy is a GIFT. Managed care has made it all about billing hours and time limits, sadly, but if you really want to be a good therapist, dig deep into yourself and not only learn about yourself, but learn from your therapist. If you are not learning - find someone else who can be your guru.

Welcome

I recently quit my day job. I have worked full time since 1993, fresh out of college and trying to save the world. Well, not really. I wanted to make a difference, even if it was for one person. I think I managed that. I was a caseworker in Brooklyn for kids in foster care, I was a hospital social worker for the pediatric crime victims unit at Bellevue, I was a therapist for Catholic Charities, I worked in cardiac surgery for a stint at Columbia. When I moved to Denver I knew I wanted to supervise and I loved doing that for 8 years. And then I was done.

I had a make a plan over several months how to transition from "working for the man" to working for myself. My father was self employed for most of my life - what I remember. I thought I could never live like that - not knowing how I was going to pay the bills. But once I started digging around, I realized I had the key already. I worked in Child Welfare, I am a subject matter expert in child welfare, trauma, and therapy. I am also a painter and studied art in a specialized High school and in college as well as going to classes at the Art Student's League of NY. Everyone said, "you should be an art therapist." I thought I needed to go back to school. I was wrong!

I am already a Licensed Clinical Social Worker, and an artist. I had joined a mobile painting party company in the fall for fun - to get out and meet people and "teach" them painting by showing the group how to do a painting from start to finish. Easy right? You'd be amazed at how anxious people would get. They think it's funny when they say "I suck at this," but I was stunned by these reactions. It felt like part of my work was helping people overcome psychological barriers to be able to say, "I am making something nice," instead of being self deprecating. So I started some groups at work, with caseworkers, making mixed media paintings that were meant to reflect who they are and how they cope with their difficult jobs. Amazing art was created!

So I began applying for contracts and to serve Medicaid clients (for child welfare). In talking to people I found that there are few child therapists who really know this population and fewer still who do art therapy, let alone directive, trauma informed play therapy. I am not a playmate, I am a therapist.

While I am still advertising myself as a clinical supervisor (for those who want to consult or get license hours), I still feel the need to make a wider impression, to make that difference for children, for their parents, for people who have been harmed and want to heal. So the blog was born. I don't write it for money or fame, but I am never opposed to money... let's just be honest. Starting out is scary - there's no weekly check that gets mailed out automatically unless I have CLIENTS.

Be sure to check out my website: www.aliceriley.net

thanks for reading!  Comments are welcome - next topic: COUNTERTRANSFERENCE!