EMDR & Parts Work

Weaving these two gentle and effective trauma treatments together for healing childhood/complex trauma and dissociation.

In my EMDR basic training, my teacher repeatedly advised those of us working with clients who have childhood trauma/ cPTSD and dissociation to work with parts before going into any specific trauma processing. This preparation work with parts is to make sure that all parts are onboard with the EMDR processing, to hear their thoughts and concerns, and create safety for them before going into a memory.

To review, and if you want to read more I wrote about parts work here. Parts work, also called ego state therapy, inner child work, Internal Family Systems and more has been a core part of Psychotherapy from the jump. Different therapists have expanded upon those theories and created new and updated frameworks to use with clients. In parts work, we acknowledge that our psyche is made up of different parts, instead of a singular self. Some parts hold pain from the past and are called exiles, others keep those younger, feeling parts safe and are called protectors. At the center of these collection of parts is the Self, a core part that holds our most authentic and grounded self.

In therapy, we are always working with all of these parts. Frequently, protectors show up first. They have concerns about us feeling our feelings and processing trauma. Can we handle it? Will it be overwhelming? Will we fall apart if we do? How do we know we can trust you, the therapist? Protectors can show up in the work the same way they keep us safe in our day to day lives: through dissociation, avoidance, minimizing, and sometimes even survival coping like drinking, self harm and more. THIS is exactly why it is so paramount that these protectors are onboard with the work, or at the very least are down to take a step back and give it a try. Remember, these parts are trying to help us by keeping the work at a stalemate! They really believe they are keeping the wounded parts of us safe by not allowing the work to happen.

Recently in my own EMDR, right as I was releasing emotion and an exile of mine was finally being heard through the trauma processing, a protector stepped in and shut the whole thing down. This protector introjected into my moment of feeling and processing to remind me that what I was working on was nothing compared to the stories I have heard from others. "See it isn't so bad!" this protector shouted, jumping in front of my wounded parts who were crying and processing. I stopped crying. I stopped feeling.

In EMDR, we would call this a blocking belief. "Other people have it/ had it worse" is a belief that blocks the processing from happening. It's my defense of minimizing, which I have used my whole life, and it's a fierce protector of mine. I have been kept safe by this protector through some pretty bad situations, that I survived by believing, "it could be worse, other people have it worse". In many ways, the protector is right, someone is always suffering more. Just interpreting this as a blocking belief, and not seeing it as a part, limits the work. This is one of the many ways parts work is so necessary for the EMDR work to happen! Once my therapist and I named this blocking belief as a protector, then we could work with that part so she wouldn't jump in front of our work and my feelings, so I could finally have some lasting relief and fully process.

We all have parts, but we especially have them if we have experienced trauma during childhood. As we form our sense of self in those early years, through attachment and major developmental stages, we are particularly vulnerable to fragmentation of the self in order to survive. Something traumatic or wounding occurs, and we develop an exile. If this part holds what happened to us, then we can compartmentalize that away in order to still attach to our caregivers, do well in school, and build peer relationships. Protectors develop during this years to keep us alive and safe. Dissociation, avoidance, minimizing, people pleasing, over achieving, managing others through codependency, self harm, suicidal thinking and more are all ways to keep those feelings that exile holds at bay. Later in life, when we walk into therapy, wanting things to change, that is only possible if these protective parts are willing to let the work happen. They have kept these feeling parts safe for so long, it's not going to take just walking into the therapy office for them to step aside. While we may have signed up for EMDR, protectors didn't necessarily agree to it. They can step in front of the work through dissociation in a session, turning off the faucet of feelings, not showing up to sessions, and more.

As therapists, it is vital that we hear thoughts, concerns, and questions from these protectors. We also need to make sure exiles know this processing will happen safely, within their window of tolerance. They have kept these memories and feelings safe for so long, it can be terrifying for them to open that box. We may know that EMDR addresses these memories in a way that won't put them out of their window, but these exiles don't know that.

Trauma therapist Janina Fisher who uses both EMDR and parts work with her clients teaches a Safe Place Protocol for beginning this work. She has clients invite their parts to the safe place the client has created in EMDR, or creates a new place with them that is good for a meeting of the parts. Here, protectors, exiles, and anyone else can be fully heard in their feelings and concerns around therapy and trauma processing. This protocol is coupled with the BLS (Bilateral Stimulation) used in EMDR, either eye movements, tapping, or using buzzers. Janina teaches that this work is as important or maybe even more than the trauma processing aspect of EMDR. If the system of parts can feeling more cohesive, protectors feel unburdened from their post, and the client is feeling compassionate towards all parts, this can be just as transformative as closing our an EMDR target. It certainly leads to the work flowing more easily, clients staying present in the room, and coming back for sessions.

If more extreme protectors like or suicidal thinking or behavior is showing up, getting that client to safety through skills groups like DBT and 12 step groups, medication, safety planning, and any higher level of care is necessary before going any further. This is still EMDR! The preparation phase can look different for each client depending on their needs.

It makes all the sense in the world to me to combine two of the most highly effective trauma treatments together in this way so we can work more holistically with our clients, or show up to our own healing with all parts welcome.

To learn more about using parts work & EMDR you can check out the following resources:

EMDR Toolbox by Jim Knipe

EMDRIA for trainings on joining these two modalities can be found here

Information on doing EMDR with me can be found here

Everything I Wish I Had Known About EMDR

There are many things I wish I could tell younger versions of myself. "Don't date her", or "This apartment doesn't get heat in the winter". As a young therapist struggling with the impact of trauma on my own life, I wish I could go to her and show her all that EMDR has to offer. Personally and professionally.

Finding the right type of therapy for yourself as a client or a clinician isn't easy. There is so much out there - it can be hard to sort through all the noise. What is trendy right now may not be the thing that works for you. Many of us go to therapy without specific goals because it's just something we think we should do - something Mychal Denzel Smith wrote about for the NYT Opinion section and talked with me about. A lot of us therapists default to talk therapy only - which absolutely has its benefits and completely changed my life in my early 20's - even though we know our clients need more.

I wish I could show my young therapist self, my coming to terms with my own trauma self, EMDR. EMDR stands for Eye Movement Desensitization and Reprocessing. Don't let some of those big words fool you - it's actually quite simple. Our brain stores traumatic material in the here and now memories, which is why they feel so fresh and triggering. These memories haven't been fully digested by the brain's natural processing routine because in order to keep us safe, our brain thinks it needs to keep this memory right up front. This way, hopefully, it won't happen again. However, it means we don't get to move on, feel safe in the present, or create new beliefs about ourselves to replace the ones from trauma. The eye movements are clinically proven to help trigger that natural memory digestion process. The desensitization happens as the material becomes less disturbing through the reprocessing. Eventually we can say, "yeah that happened to me, and it sucked, but it's in the past". Eventually we can "I don't believe I'm worthless anymore, I truly believe I am worthy of love and respect". Eventually we can think of that time in our lives and not feel our mouth go dry or our hands start to shake.

EMDR has 8 clear and predictable phases. History taking, client preparation, assessment, desensitization, installation, body scan, closure and reevaluation of treatment effect. Rapport and relationship building happen during the history taking and client prep, as well as grounding skills. As a young therapist I was flooded with coping skills. Everyone wanted them, and there were simply too many to choose from. It often felt like I was throwing spaghetti at a wall trying to get something to work. Since myself and clients had so many choices, it felt like none of them were good enough. I often found myself saying in session: "Let's try this! No? What about this! Or this?" In EMDR, there are 3 or 4 clear resources to use for grounding and getting back into the window of tolerance. Container (literally a safe storage place in your mind to put unfinished work, triggers, overwhelming feelings), Safe Place (literally a safe place to go to in your mind and body that makes you feel calm and grounded) and whats called RDI (Resource Development and Installation) where you identify positive memories, relationships, and experiences and use those as grounding tools. All of the above is coupled with the eye movements, or any kind of back and forth of the body (tapping with small buzzers you hold in your hands, butterfly hug with tapping, tapping feet on the ground back and forth, all of this is called BLS aka bilateral stimulation).

The other phases focus on processing the traumatic material. What I wish I had known about EMDR - and what honestly kept me away from it for so long, was that this traumatic material is not just specific trauma memories! EMDR uses what is called a three-pronged protocol. Prong #1 is that classic past trauma memory. Prong #2 are triggers in the here and now. Prong #3 are future fears. EMDR addresses the past, present, and future of trauma. For clients who have a long history of trauma starting in childhood, it can feel way too overwhelming to start in the past. This was my main concern - I really didn't want to only work with specific trauma memories with clients! There is just so much more, we are so much more. Which EMDR addresses with this past, present, future protocol. So much of my work with clients is processing triggers that come up in the here and now, and fears for the future related to their trauma.

These processing phases have somatic, cognitive, and memory based components. You are not just processing traumatic memories and images of triggers or fears, but also where you feel that distress in your body, and the beliefs about self and the world that are attached to that image. I had no idea how holistic EMDR actually is, how it takes into account all aspects of our experience, not just one.

I also didn't realize how easily parts work, also known as ego state therapy or Internal Family Systems can be woven into EMDR, and with clients who have childhood trauma and/or dissociation, how parts should be included work! Parts can be invited to Safe Place for meetings with the whole internal system and to be heard from by the core self. Parts need to be checked in with before any deeper processing begins to make sure everyone is onboard and ready to dig into that memory, trigger, or fear. A huge part of my practice is weaving parts work and EMDR, something else I wish I had known was possible! That EMDR could be used to deepen the work I was already doing with parts.

An EMDR target is any specific memory, trigger, or fear that can be used to process. Targets however can expand to include so many other aspects of what clients come to therapy wanting to address.

As a client, I wish I had known the freedom EMDR had in store for me. How certain memories or beliefs about myself could be so directly targeted and processed. I didn't think the work was for me because my trauma didn't fit a specific narrative that at the time was associated with PTSD. As a therapist, I wish I had known how accessible EMDR is for clients and for me as a therapist in training. How EMDR addresses every aspect of the work I was already doing with clients, how it could've answered the question I asked myself everyday: "I know this client needs more than this, but what?"

I feel like I finally have that answer now.

To learn more about EMDR check out emdria.org

Co-Regulating with Nature & Animals: Creating a Secure Attachment With the World Around You.

When I was a tiny queer child, I had some issues at school, like most of us queer kids do. I didn’t connect or identify with the kids in my grade. I knew there was something different about me, and so did they. A professor of mine in undergrad called queerness, “that thing about you that just doesn’t fit.” A family friend’s kid, who also had that thing that made him “not quite fit”, had just built a chicken coup in their backyard, and I was instantly intrigued. Did you know there are so many breeds of chickens? That they have enormous personalities? That there is nothing more magical than waking up to your first egg, or first hatched chick?

In the years I kept chickens, I had a security in my life. A way of managing any kind of feelings I was having about being different. These chickens served as a transitional attachment as I moved between the liminal spaces of puberty and finding oneself. They greatly improved my mental health, and contributed to my sense of self. I had a job, I had a beating heart to regulate with, I was always welcome.

I have countless clients who look at their animal companions as absolutely vital to their health. These animals are family members, caretakers, reasons to get out of bed in the morning, a reason to stay alive. To go outside. To clean the house.

One of the best parts of having part of my practice remote is getting to meet client’s wonderful animal companions. I can just feel the difference in their nervous systems when their companion is with them. They feel more grounded, calm, secure.

For so many of us, living in this weird late stage of capitalism, we are disconnected for a number of reasons on a daily basis. Emphasis on the individual versus the collective. Working all the time. Living alone during a pandemic. Struggling to find people we can fully be our authentic selves with.

Having these companions creates daily opportunities for co-regulating our nervous systems with living, breathing beings. This isn’t a replacement for human connection, but simply another avenue that is also available to us.

So what if you don’t have an animal companion?

Another story. In my early 20’s I was in a difficult relationship. Weren’t you too? It was very hard for me to regulate in that relationship, and one of the only ways I could fully rest and recharge during that time was to be by the ocean. The waves cresting and falling would lull my nervous system into a deep state of co-regulation and relaxation. I felt such a deep resonance with this enormous natural entity. When the water held me as I floated on my back, I felt an expansive state of ventral vagal deliciousness. The ventral vagal nerve being the part of your nervous system that invites a feeling of safety and connection. You can learn more about that here.

We can co-regulate with most parts of the natural world. We can have a secure attachment to nature, or a specific part of or place in nature. While I never knew how my girlfriend at the time was going to act, I always knew how I would feel with the ocean. I felt secure in my relationship, held, and loved.

It’s different for everyone where they feel the most secure. For some of us it’s an open field, for others a dense forest. For some of us, we live in big cities and have to build relationships with the breeze, sunshine when we can, clouds, plants between the side walk cracks, any tree we can find, and always, birds. The promise of birds is everywhere.

We can always return to a calm place in nature in our mind's eye. Remembering how a place we have visited feels in our body, what it smells like, looks like, feels like. We can hang pictures on our walls of the natural world, which is scientifically proven to ease our bodies.

When we are rushing through our days (because capitalism makes us rush, or makes us feel like we have to rush) we miss these chances for regulation. We only pet our cat for 1 minute instead of a nourishing 20 minute cuddle session. We miss that the goldenrod is blooming on the corner of our block. How delicious the sun feels on our skin and the rain smells on the pavement. It is incredibly recharging to stay at home in our nests, and also, it can be so helpful to make time to really spend long periods of time outside co-regulating with nature.

Some ideas:

Take a page out of How to Do Nothing by Jenny Odell and buy a bird book for your area. You can also download the Merlin Bird ID. Learn the names of the birds on your land and greet them as you start to recognize them.

Practice deep breathing outside. Notice the temperature of the air. How it smells. How it feels entering your nose. Feeling the wind on your skin.

Spend the same amount of time you might spend scrolling on an app or on a TV show giving your animal companion your full 100% attention.

Plan to spend the whole day outside in a calming environment. This could look like a hike, a day by a body of water, at the park on a blanket in the grass, snowshoeing or sledding in the snow. Check in with yourself, how do you feel after this day? How is different or similar to a day spent resting indoors? How does your body feel?

Make a list of all the animals and parts of nature you can connect with and next time you need that co-regulation, return to it.

Learn the name(s) of the tribes whose land you are on here. Research them and what life was like before colonialism. Imagine how that world must of been. Learn what birds and plants are indigenous to where you are and try to find them.

Read Braiding Sweetgrass by Robin Wall Kimmerer.

Ask a stranger if it’s ok if you pet their animal.

Imagine your calm place in nature, or look at pictures of it. Imagine it with your whole body. Notice what happens to your stress levels.