Hi, my name is Destiny. I live with a birth defect called Spina Bifida. It is what I have NOT who I am. That being said, it affects my daily life in many ways including how I show up in the world and how I interact with it. My life is not a script from a made for TV movie. I am often viewed similarly to those "As Seen On TV" infomercials. I know you have seen them. You've probably even brought into some of them yourself. They are often products that fail to meet your expectations from what they were claiming to be in the ads or you get them home and they work amazingly well only to malfunction right after the 30-90 day money-back guarantee runs out!
That is NOT me either but you may have been fooled into thinking either example above is the reality of my life. The current state the world is in with protests and riots over racism has sparked a few heated debates. There has also been huge worldwide news coverage of the entire situation. With media comes creative license and with that comes a whole host of other issues that I will dive into a few of here later.
Recently an article came across my screen and again in my inbox. The article is titled 8 Influential Black Women with Disabilities to Follow. It was published within the time frame of everything going on.
HOLD THE PHONE...RED FLAG!
Black = Minority
Women = Unequal (if not considered a Minority)
Disabilities = Minority
Influential = We are supposed to inspire you to change because "if we can do it with the challenges life throws at us, WHY THE HECK CAN'T YOU?" That's called inspiration porn and can come in many forms, including memes. The disabled person in those cases is never asked so they are not consenting to the creation of the material.
I do not wish to demean anything that the eight women mentioned in the post do to make a living. What the women have accomplished is wonderful but not because of a disability. I do desire to bring light to some of the finer, missed, or overlooked points. All disabled people have many unique gifts and talents. As a disabled person I know we are often seen as a lesser value because we do things differently. What I have a huge problem with is using innocent disabled women as a weapon. It was painfully obvious to me that this was the case. The article might as well have been titled "Proof the US Government Isn't Racist and Doesn't Discriminate." I am a disabled, white woman from Canada and I'm not okay with that!
Disability is defined in two ways. A physical or mental condition that limits a person's movement, senses, or activities. The second is a disadvantage or handicap especially one imposed or recognized by law. How it is defined is problematic. It fails to realize that disability means different things to different people. It also fails to give a clear picture of what a disability looks like. It can't give one because it’s an umbrella term that is viewed as having one meaning. This results in a disabled person having to advocate for themselves proving themselves again and again in a world where nobody believes them. They are left to pave their path in the world largely being fought against and misunderstood.
In the article of all the disabilities mentioned, we have a Harvard law graduate, nurse, clothing designer, and others. Great! anyone with or without a disability can do any of those things. The law graduate doesn't appear to be working within the legal justice system and likely never will. The nurse says she has to fight to do the work of a nurse and not do anything except sit behind a desk because she obviously can do that so she should. She appears to have become slowly disabled over time and was possibly a nurse before becoming disabled. The clothing designer is an amputee, missing a leg. That has nothing to do with her ability to sit behind a sewing machine, at a computer or desk to draw wonderful designs for clothing. When wearing her creations and taking pictures they are cut off so the prosthetic doesn't show! Many of the others are in the entertainment industry and every last one of them is into disability rights, activism, or advocacy of some sort except the nurse. I think you are starting to get the picture here and seeing a pattern. Disability and Sex have something in common...THEY SELL!
The entertainment industry is the area that has the big bucks. The harsh reality is the big bucks don't go far when you are someone living with a disability and have more to cover due to the disability compared to other people. There are models, dancers, and actors that do have disabilities. The big questions...are they working for the same companies as anyone else? Or are they all working with companies that are specifically for those with disabilities even their type of disability? The reality very well may be that they are a model, or they are a dancer or an actor but maybe only had one shot at being either of those things.
When you hear about disabled models and actors on TV what you are most familiar with seeing are able-bodied people posing as or acting the part of a disabled person. (i.e. a wheelchair user) Rarely in any movie do you see someone with a disability playing the part of their disability. The same is true for images for ads to sell products. To a disabled person using an able-bodied person to act like them is very offensive and comes off as very fake. We know what we live with daily isn't anywhere near as good or as bad as what is shown. I know some of the disabled people mentioned in the article, not personally, but from social media. That's what many of them do mostly not model or act.
I mentioned briefly about companies for disabled people. I don't want to mark them as good or bad but I will say this: their existence is discrimination with a friendly face with the focus being on the disability, not the person. It makes able-bodied people look good and seem like great people when they create things like this for a part of society seen as weaker, unimportant, and less than anyone else. Don't subscribe to the images you have seen in the media as what disability is. It's truly not reality or an in-depth view of disability.
There is also a huge problem with mainstream companies using those with disabilities for photo opportunities or campaigning as a way to make themselves or a brand look good. The disabled person is used only because they are disabled and fit an image a company wants to portray. It’s called tokenism. By subscribing and buying into that sort of media you are allowing the people that paint disability in that way the right to do so. It's not only a problem on mainstream media but social media in the form of inspiration porn.
By necessity people with disabilities have to become adaptive and learn ways to navigate the world. This is not because we want to but we have to if we are to survive in a world that wasn't made for us to fit. Our biggest fight is often to have accommodations and modifications met. We are seen as needy, selfish, or as creating DRAMA. You may not always understand some of our needs, that doesn't mean we don't need accommodation or modifications. You don't have the right or ability to determine that.
We are often not heard, seen, or respected as individual human beings capable of things. We are expected to be poster children and spokespeople for our disability. That's the path the world laid out for us. The one that money can be made for their benefit.
Two extremes exist but there is a larger group in the middle who don't desire fame and dread being seen as an object to be pitied than there are people who are in the public eye being viewed as amazing overcomers of their disabilities instead of being accepted as people with them. Just because we are capable of working doesn't mean we are magically not disabled anymore.
If someone has the chance to and wants to pursue a career in entertainment they should be able to no matter if they are disabled or not. Nobody should be placed in a position where they have to sell their disability to earn a living or worthy of the space they take up. It's time we stop all the toxic positivity and inspiration porn that disabled people face. It’s time to embrace the struggle and raw, real human beings we truly are!
My reality as a disabled person is a person who struggles to fit into the two extremes while truly not wanting to be part of either one of them. What my experience is I can best sum up in a quote from Dr. Jamie Marich: "As a society, we tend to celebrate those that perform well hurt and we criticize or even demonize those that ask for help or otherwise show weakness.” For those of us in the middle, we are celebrated for being disabled while criticized and demonized for the same thing.
That's my story and I'm sticking to it.
This last year and a half has been an unending nightmare. I was “outed” as a person with a borderline personality disorder (BPD) by an angry classmate who I had trusted with this information. In the clinical psychology world this can destroy your career. What happens then to a clinical psychologist in training who outs you as a person who has been given a highly stigmatized mental health diagnosis? Nothing.
After what I thought was a minor disagreement, a colleague who has dealt with mental illness themselves and currently works with therapy clients, shared my mental health history and other personal information with other colleagues. Initially, I attempted to have an open discussion with this colleague. After several attempts at confronting this person, they became increasingly abusive. This colleague has since pushed me in the students' lounge, consistently rolled their eyes when I speak in class, shut me out of conversations and given me the silent treatment. Furthermore, they have isolated me and ruined my professional relationship with others in the program. In short, I am being bullied.
BPD is a highly stigmatized diagnosis. Although I do not identify with it and do not consent to this diagnostic assignment, it was given to me as a teenager. I experienced multiple levels of ongoing abuse, neglect and self-harm. These experiences spilled over onto my psychiatric treatment. Due to the many mistreatments and constant dismissal of my experience within the psychiatric community, I now consider myself a recovered psychiatric survivor.
As clinical psychologists we are trained to practice five principal ethical principles: benevolence and nonmaleficence; fidelity and responsibility; integrity; justice; and respect for people’s rights and dignity. Yet, two years into a doctoral clinical psychology program I have heard many horrifying things about people with BPD. The most common label is that “borderlines” are manipulative, needy, irrational, difficult, clingy liars; and incapable of completing graduate school or even undergraduate. Another misconception is that people with self-harm scars must have BPD. Diagnoses are reductionist labels. Although for many people they provide an answer to their troubles, for many others they add to their troubles.
Going back to where I started, I was “outed” without consent. After six months I finally got fed up and told my advisor what was happening. They advised taking meaningful action against this person. A school appointed psychologist told me to “suck it up.” I had done that for many months, wanting to respect this person's need to be angry and tolerating their continued abuse. Only one other colleague knew, but they remained close with the other colleague. I met with the program director, but there was not much they could do due to lack of evidence, and I did not want to disclose further details about my history, partly for fear of additional stigmatization.
I have enough going against me as it is for the clinical psychology field. I am a Latinx woman with little U.S. connection and Spanish as a first language. In addition, I have scars, the result of violence, abuse, self-harm and more. My scars can be seen and judged by anybody who pays close attention, which psychologists are trained to do. For the last year and a half, I have felt powerless. Some colleagues have caught up with the hostility but besides offering moral support have not done anything proactive to help stop the bullying colleague or be an ally.
Some colleagues have expressed that they do not want to fall at odds or be shunned by others, basically end up in the position I am in. What worries me is that not only myself, but our patients, are being put in these positions as well, dehumanized by the very professionals charged with helping them. The clinical psychology field seems to have an us (the healthy ones) versus them (the mentally ill) perspective. The field feeds and exists on the ideal that clinical psychology helps others heal, but in reality, they look suspiciously at those who have been able to heal, survived the system and have a desire to do the same for others. The field exists within the same authoritarian hierarchy as many other systems that perpetrate injustices. At one point a PhD student who disclosed their given diagnosis was told that by sharing that information they had created a “burden” for their colleagues. They mentioned how their mentor and “lab mates” had joked about their given diagnosis and how they felt the need to disclose their given diagnosis in order to make them stop. In addition, a historic lack of all expressions of diversity race, gender, cultures, economics, languages, sexual orientation and psychological experiences permeates the field to the detriment of the patients.
The ethical principles that rule clinical psychology are practiced as long as providers are the sane/normal ones and the patients are crazy and incapable. This has been further demonstrated by research on mental health provider stigma which may also take the form of prejudice and discrimination. For the last year and a half, I have felt isolated, betrayed, powerless and for the most part, defeated. I considered dropping out on multiple occasions. A quick Google search showed that there are not many clinical psychologists with lived experiences who are “out.” This made me wonder, how many of us are living in the shadows, quietly listening to others in our field making deprecating comments about people like us and being marginalized and bullied. Additionally, I wonder how “out” I actually am, how many people know and how will the labeling ultimately affect my career. These thoughts keep me up at night and I have debated many times whether or not to “officially” be out, and at least regain my narrative and speak out. Within our field it seems that labels or given diagnoses place a person within a box, context, or circumstance and the person's personal experience are most often discredited and dismissed.
One thing they could say if I “come out” is “Here she goes, the manipulative needy woman, needing attention,” as psychologists have previously said about individuals with a given diagnosis of BPD. These are the same beliefs that maintain the status quo, that create systematic barriers for individuals with lived experiences to speak out, get help and recover. These are the same mechanisms which perpetuate abuse within our mental health system. The field needs to change, clinical psychologists need to be held accountable for their role in keeping the status quo, and maintaining inequalities. In my opinion, clinical psychologists need to be challenged from the minute training starts, any training.
Individuals with lived experience in mental illness should be at the forefront of this change and leading these conversations, we are the ones who have been through the system. Even if our perspectives of how the mental health system should be revolutionized digress, they matter. Instead the field of clinical psychology, which often promotes healing and recovery, ironically keeps us marginalized as being “unable to recover.” Moreover, from what I know, many schools do not ask that clinical psychologists attend therapy themselves and for that reason many have never been in the patient’s role. Is this not hypocritical and counterintuitive? I am calling my field out for its hypocrisy and continued dismissal of marginalized voices. The field already exists within a Westernized white developed bubble and it is time to put a stop to all of this. Simultaneously, I am calling out my colleagues and future clinical psychologists for their continued participation in these practices. As it is, the clinical psychology field continues to promote and monetize the dehumanization of mentally ill people.
When will the dehumanization of people with lived experiences in mental illness stop?
Do not deny what comes up with your reaction. Reactions aren’t all bad--as some distorted spiritual teachings claim them to be. There are times when they show us where we can no longer accept certain behavior or treatment from another.
Nowadays, many of us are turning towards spirituality and ancient wisdom teachings to enhance our lives and look deeper within. We may have realized that conventional ways are not working so well anymore. Please be aware that it is actually important to learn to engage safely in spiritual practice...who knew?! This way of living should be approached in a balanced way where we can discern what is right for us and what does not serve us.
For the most part, the teachings and teachers are not questioned. Instead they are revered and followed very devoutly. Although it may be seen as “unspiritual” to some, these teachings have to be reviewed or questioned just like anything else. Don’t get me wrong...there are many gifts wrapped in these ancient teachings. There are also many ways that, if practiced to an extreme, these teachings can put you into danger; especially if you are in a vulnerable state or have endured trauma in your life.
What is lacking in many spiritual communities is a healthy balance between respecting our humanness and connecting with our spirit. We need not abandon one for the other. Some people who seek out spirituality are lacking in psychological and emotional awareness, causing them to use the teachings to bypass their humanness in the name of “ego transcendence.” I hate to tell you...but we are stuck with our egos...they are not going anywhere anytime soon!
The ego-mind likes to think and act on our behalf, therefore; it has its own agenda and wants to protect us from our past experiences even though they are not happening in the present. This is understandable and we have to remember that our egos try their best (although limited in their approaches) when they perceive danger in our current environment. Your ego is not “bad” and should not be gotten rid of. Our egos, in fact, allow us to think critically, solve problems, understand interactions, make decisions, discern right from wrong, analyze data and sort through information. If you deny your ego entirely, the workings of your mind can become partially disabled and you may be unable to perform these tasks in any balanced way because you won’t trust your own thoughts and actions. This can be very dangerous!
Even some spiritual teachers, who boast of this transcendence, have the biggest and most destructive egos of all, and ironically, this is all playing out unconsciously...without them even noticing. Or sometimes they are very well aware and simply on a power high. If a teacher is denying the existence of their ego (or thoughts/behaviors/patterns) in an effort to keep their spiritual image, they are also denying their “dark-side”. These parts that are being rejected subconsciously come up and control their life through unconscious behaviors and repeating patterns; even harming others around them who trust them and are wanting to be of service and give of their hearts. Certain spiritual teachers, caught up in their own egos and unconsciously denying their “darkness”, steer us away from expressing a reaction in any way and so we may not recognize the important messages for us that often come along with them.
Let’s talk about “reactions” and the shame that often comes up when daring to allow yourself to actually have them. Overly spiritual people might say that the reaction is just “resistance” to “what is” and that you should “accept things the way they are”. In the case that you are unable to accept “what is”, for any variety of reasons (or are unable to take the spiritual route and you do have a reaction) you may feel shame because you have not practiced the teachings in the best way possible. Or maybe you think that you are not worthy of this spiritual practice because you aren’t doing it right and are getting away from your intention.
Sometimes, it is just not complete to say that you are just in resistance or that you should accept things as they are. There is more for us to see here. In cases of abuse or manipulation, why should we just accept what is? Maybe we should not. Maybe we should speak out for what is right or say those facts that someone who is abusive wouldn’t want to get out. Actually, I think that is exactly what we should do. Because whatever abuse or dysfunction is going on is enabled by us being quiet or just accepting it. The cycle will continue if we spiritualize our reaction to these types of dynamics. This is a case where you can use your ego-mind to discern what is right for you to do...but not if someone has convinced you to believe the ego is all bad and should be thrown to the wolves!
Let’s say you are overwhelmed by your life circumstances and you feel like you are reaching a breaking point. You may have a reaction. In this case, feeling the emotions strongly enough to get into the reaction may actually be healthy for you in order to make a change.
We are taught that reactions come up from unresolved circumstances, in the form of triggers, from our past. When something irritates or angers us, we should:
I agree with this teaching in principle and it has been beneficial to me--increasing my capacity in many areas. However, if you are in an abusive situation, or are constantly pushed too far over your edge of comfort, this teaching can be practiced in a distorted way.
In a spiritual community, we learn that once we have dropped the energy behind the reaction (calmed down) and have the ability to respond...then we can approach the person who triggered us. That is a good plan...except that, at this point, we may have prematurely forgotten about the impact of the abusive person or forgiven them for their actions, even if it was not a forgivable thing that they did. Yes, I said it...some things are unforgivable!
If we spiritualize everything and live in some ethereal realm floating above ourselves, completely detached from our humanness, then we may allow people to treat us in many ways that are not healthy, not conducive to our growth, or even keep us in cycles of trauma. We could be spiritually bypassing our reaction and denying our own feelings about it in an effort to “let go of”, “relax with”, or even “surrender to” it. What we are actually doing, in many cases, is suppressing the reaction. Beware, what you may be “surrendering” to is abuse!
Let’s talk about the messages that accompany reactions.
Maybe you are in a circumstance where you are under a lot of pressure at work and your partner isn’t very supportive (seems to be a common example these days). So, something sets you off and you “flip out” and start screaming at them about how you can’t do this anymore and then realize that you have to make a big change--that is probably accurate. And yet, if you are trying to follow extreme spiritual teachings on reactions then you may think you should just drop it or let it go and wait until you drop the energetic charge and can respond. Here, you stay with the partner; you stay at the job.
This is an alternative: when you lose your temper, allow your reaction to reveal to you that you have to make a big change. Look at it. Investigate: what is it trying to tell you? Question it...let it be there. Be with it. Don’t be afraid...this takes courage.
You know, if you “breathe” enough with it (especially many different times with the same trigger) and it passes, you may just conclude that you are in a reaction based on your “past programming” and you were wrong to think those things. Or maybe you can respond instead when you drop the energetic charge. By that time, you have probably talked yourself out of what you know you need to do...once again. This breathing and acceptance may happen again and again with you believing it is your own internal work to do; giving the other person a pass.
Of course, others shouldn’t be continuously subjected to your reactions. There are ways to express them--or you can learn to listen to yourself before they become so forceful. You should note: if they come up often, you need to take action or you may stay complacent under terrible conditions.
So, what if this big blast of energy in the form of a reaction is informing you that you are to make a change? Oftentimes, it is. Don’t throw out the information it gave you just because it came up the way it did. Don’t walk out of alignment with yourself, your body, and what you know you must do. Yes, by all means you can wait to calm down before you respond, but don’t miss the point! Use your reaction to empower yourself to see the truth of the matter. Reach a place where you are not overtaken by emotions, can act calmly, and discern what is appropriate for you.
Allow taking care of yourself and feeling safe to be your biggest priority. Realize that the reaction arrived for a reason. You may constantly be putting yourself over your edge where you will face anxiety, depression, rage, and shutdown.
In my experience, this is the core of many episodes of anxiety: knowing you should do something and not following your knowledge and intuition to change something in your life. Instead, you may find yourself discarding this information, not listening to yourself, feeling too much fear to do something different, maybe denying what you feel in your body. And so you avoid making a decision, maybe unknowingly justify another’s actions. Sit in what does not serve you. You are crawling in your skin. And you feel awful.
Maybe you KNOW you should get away from your partner who you constantly argue with or leave the abusive job that requires way too much of your energy... and that’s what causes you to be very reactive. Instead of believing you are the problem, realize that you need to create a solution-- and follow through with it. Even if it feels unnatural and impossible because it is not your usual pattern--get some support and go with it!
Don’t throw the baby out with the bathwater. As in, don’t ignore the action that came to you--just because it came in the form of a re-ACTION.
You need not over-spiritualize your humanness. The gift of this life is to experience the richness of your human side, both dark and light, as you connect to your spirit--grounded on this earth.
Oppression and Privilege: An Excerpt from Trauma and the 12 Steps Revised and Expanded Edition (Dr. Jamie Marich)
In 2016 I had the privilege to give an EMDR therapy overview at a conference for treatment providers of color. We didn’t even get to the content on EMDR. I was not surprised, yet was still amazed at how healing the validation of an experience like racism as traumatic was to my students in attendance. I listened to the attendees’ experience, strength, and hope on the traumatic impact of being a person of color in communities and systems that will likely invalidate their experience. The conference taught me that validating the suffering people experience, especially in contexts when it is likely to be ignored or dismissed, is a vital first step in healing trauma. And healing trauma can be a life or death matter to people seeking recovery from addiction.
Consider the concept of negative cognitions that accompany any traumatic experience. In EMDR therapy and various other modalities, we describe negative cognitions as the messages people receive about themselves (e.g., “I am a failure,” “I am permanently damaged,” “No one will ever love me”) or the world (“No one can be trusted,” “I am in danger”) resulting from a traumatic experience. In the fifth edition updated in 2013, even the DSM added the presence of such cognitions as part of the negative alterations in cognitions and mood criterion under the PTSD diagnosis.
My colleague Rajani Venkatraman Levis and her writing partner Laura Siniego introduced the idea of oppressive cognitions in a 2016 book chapter on cultural diversity in EMDR therapy. This construct takes the idea of negative cognitions a step further by recognizing that some of these messages we internalize are rooted in what we learned from others about our race, ethnicity, gender, or sexual identity. Examples of oppressive cognitions can be very specific (e.g., “Dark-skinned women are not beautiful,” “I am a freak for being this way,” “Real men don’t cry,” “I am trash because of where I come from,” “I am an abomination because Jesus says so”) or more generalized (“The world is not a safe place for people like me”). In the words of Melita Travis Johnson, an African-American woman, longtime social worker, and one of my personal mentors, “Oppression complicates--and aggravates—the recovery process.”
These visceral imprints are very real and can be even more impacting when they fester day in and day out. Although many people who have experienced oppression can pinpoint one or two major events in their lives that might qualify for a PTSD diagnosis, it’s the cumulative impact that can be more damaging. A student of color once described her experience of racism to me as “the trauma of a thousand paper cuts.”
At this point, you may dismiss what I’ve presented thus far as irrelevant because these experiences were not so for you. Or you may fear that drawing attention to the dynamics of oppression plays into the idea of terminal uniqueness, or the inclination many folks in recovery have to prove that they had it worse than others. Remember that a core component of trauma-informed care is honoring that just because something was a certain way for you, doesn’t mean it was that way for everyone else. I am not a politician, pundit, sociologist, or diversity specialist, and it’s well beyond the scope of this book for me to get into any debates on the matter. Consider, if you’re familiar with the Big Book of Alcoholics Anonymous, how we are even encouraged to resign from the debating society in order to get well. So I am no longer a debater.
And yet I am a trauma specialist and can testify to the reality of oppression and the various ways it manifests itself as a legitimate form of wounding that needs to be addressed. My hope is that people in recovery who have not been personally affected by oppressive cognitions in any way can honor the struggle of people who have. Even if you have been impacted by oppressive cognitions based on how you grew up, please don’t transpose this wounding onto others by getting into shouting matches about who had it worse. I’ve seen this happen too often in the rooms of recovery, and that is not how we help each other heal.
Alcoholics Anonymous was founded by two well-educated white men of privilege. If you are a white person reading this you may already be getting nervous at the very mention of the word privilege. Privilege doesn’t mean that you don’t have problems or your life hasn’t been hard. A simple way to look at it is that you have not experienced the extra stress of having to navigate life with the added weight of oppression due to race, ethnicity, gender, class, or sexual orientation. Recognizing your privilege means honoring that you may not have to worry about what others face as a daily struggle. This recognition and the personal work that goes along with it are important if you are going to work with others in recovery who are different from you.
Failure to honor the struggle of an individual seeking help pushes more people away from seeking or retaining help than any other factor I’ve observed in my career. Recognize and acknowledge how others experience life—this is the very definition of empathy. If your biases and misconceptions about how people other than you experience the world is getting in the way of your being empathetic, there is likely more work to be done on yourself if you wish to be of optimal service to others. In the brilliant words of Pastor Nadia Bolz-Weber, herself a person in long-term recovery, “Our drug of choice is knowing who we’re better than.”[ii] This hit me like a ton of bricks when I heard her say it out loud. It felt like the answer to why we can get ourselves into a frantic mess as a society, and why we can alienate people in recovery contexts.
If you feel uncomfortable about anything you have read thus far, or anything you read in the sections that follow, remember that discomfort is required for meaningful change. Hopefully you first picked up this book because you want to do better. The sections that follow will go into more of the specifics on how you can. The quest to do better must always include constant inventory and evaluation of ourselves, our biases, and where our own wounds may need healing.
[i] Jamie Marich, Trauma Made Simple: Competencies in Assessment, Treatment and Working with Survivors (Eau Claire, WI: PESI Publishing & Media, 2014), 61.
[ii] Panel discussion at Wild Goose Festival, Hot Springs, NC, July 12, 2019.
From Trauma and the 12 Steps Revised and Expanded Edition: An Inclusive Guide for Recovery, by Dr. Jamie Marich, Published by North Atlantic Books, copyright 2020. Reprinted by permission of publisher.
Defects of Character or Emotional Parts: Using Structural Dissociation to Reframe Step Six by Michael Gargano, LMHC, CASAC-2
“We were entirely ready to have God remove all these defects of character.”
--Alcoholics Anonymous, Step 6
Treatment centers and 12-step communities need to begin normalizing dissociation within the addicted person’s experience. Trauma and dissociation are often left out of the discussion in addiction treatment and recovery worlds. Survivors of abuse, neglect, abandonment, and other traumatic experiences note with consistency and frequency the value of compartmentalization plays in daily life functioning and avoidance of traumatic memories. As an addiction and trauma specialist, I’ve heard countless clients describe how and why it became necessary to stuff events, emotions, sensations, thoughts, actions, and images deep into the catacombs of the psyche. The self that seeks recovery may sometimes feel like a fraud, fake, or not real, as a result. And this can make the phrase defects of character in Step 6 difficult for addicted survivors of trauma to navigate. Looking at Step 6 through the lens of structural dissociation, may offer the field, recovery communities, and people we serve new insight into both trauma-informing and dissociation-informing the steps. What we commonly call defects of character within 12-Step Literature can be more accurately viewed as dissociative parts of self that impede spiritual progress, acceptance, connectedness, healthy relationships, and recovery
A cursory overview of the Theory of Structural Dissociation is needed to help us understand its theoretical and clinical framework. The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization, a ground-breaking book on trauma and dissociation, written by Onno van der Hart, Ellert R.S. Nijenhus, & Kathy Steele, proposes human beings are not born with an integrated personality. Our early formative life experiences shape our personality, thoughts, feelings, and behaviors. In healthy development our caretakers help us to meaningfully integrate and adapt to our environment. Attachment wounds stemming caretakers who could not meet our essential needs, sooth us, and provide us with restorative experiences sets the stage for fragmentation of the self. The discussion presented in this blog will prepare us to draw connections to how structural dissociation relates to 12 Step work and a trauma-informed approach to embracing our dissociative parts. We challenge the notion of character defects as it is traditionally understood in recovery circles as the term defects of character does not align with a trauma-informed approach. This contention is made with full recognition that the steps can and do work for millions, including me. And it’s also time to have this discussion.
The conception of dissociative parts of the personality is not new. The theory of structural dissociation of the personality is a cogent, comprehensive, and concise description of dissociative parts. The theory holds every person has what is commonly referred to as an Apparently Normal Self/Part (ANP). The ANP is the survivor self or the core persona that is seen by others in public, holds a job, raises a family, forms attachments, and does everything that we often ascribe to the executive functioning in our brains. In response to a traumatic event the ANP fragments with the formation of an Emotional Part (EP). The EPs form to protect the ANP from the wounding that has occurred.
The self as EP displays evolutionary defense mechanisms, emotional reactions, and action systems to protect the core self. Action systems guide us to notice and be drawn to stimuli. They restrict our field of consciousness to relevant stimuli and promote certain action tendencies while inhibiting others. For example, when a fire alarm suddenly goes off, the self as EP may signal “Danger, Danger, Danger!” and the action system related to panic may activate. The action system related to rational thought and decision making may be disinhibited. These mechanisms include responses based on flight, fight, freeze, and submission. If a dissociated part is fixated in a particular action system or subsystem, they may be unable to cope or perceive with their situations because their perceptions are colored by the goals, and a restricted field of consciousness will be restricted to stimuli relevant to that subsystem.
I believe Dr. Bob and Bill W.’s vision of step work helps us to heal our structural dissociation. Step Six invites recovery seekers to dig deeply and invite our EPs into their healing journey. Up to this point in our recovery experience we have accepted the nature of our addiction, we took steps to find a new path, embraced a belief that a power greater than ourselves could restore us to sanity, made a searching and fearless inventory, faced our dissociation, and now we are tasked with integration. Bill W.’s commentary on Step Six hones in on the addicted person’s compulsive tendency for self-destruction and annihilation. We work against our instinct for self-preservation. The commentary goes on to describe structural dissociation like language in discussion of how our drives far exceed their usefulness. The founders of Alcoholics Anonymous understood parts of self. Bill W. writes in 12 Steps and 12 Traditions commentary on Step Six: “When our instincts drive us blindly or willfully demand that they supply us with more satisfaction or pleasure than are possible or due us.” He is talking about an EP. Bill recognized EPs operating within recovery seekers more than 80 years ago.
The goal of Step Six is not to eradicate our EPs. Total integration of all dissociative parts of self will not happen overnight. Some parts of self will mature or extinguish. Others will take a lifetime to heal. Parts work, trauma work, and working the steps are circular pursuits. We may need to go through the Steps several times to gain a new way of relating in the world. The wisdom of this Step is we are cautioned to “be content with patient improvement.” It is important to seek proper therapy with someone skilled in dissociation and parts work who can help you understand the emotional parts of your personality. In our parts work some of our parts may not want to work on the spiritual aspects of the program. Some might attempt to destroy the whole system. We did not will these EPs to exist. Our minds fractured in a beautiful way to keep us safe, secure, and protected. However, the actions, thoughts, and impulses of our EPs caused us insurmountable problems as we sought to change old patterns.
Change is difficult. Sometimes we get into a routine and become complacent with our EPs. Take procrastination, for example. By not completing a task on time, one does not have to risk failure. This EP could be protecting us also from people hurting us by seeing our vulnerability. Turning in assignments late or showing up on time for appointments means our EPs remain in control of who gets to see our vulnerable side. Procrastination, like other destructive tendencies, could be an EP part designed to hide reality from us.
Our EPs have secondary gains which make it difficult to heal them. Skillful work in this area will explore the systems and rules at play. We will not be perfect in this work nor do we need to be. In Step Six we work to renegotiate the boundaries with our EPs and the alliances between them. Our work here is to meet our needs in more adaptive ways so our lives as ANP is fuller, richer, and more meaningful.
In my recovery experience I relied heavily on EMDR therapy, sponsorship, and the 12-step recovery meetings and literature to heal my fragmented self. I believed I could be restored to sanity. I trusted my Higher Power would allow me to get where I needed to go in the often hard and emotional trauma work, I set for to complete. I had a mindfulness and yoga practice that helped me settle inward to listen to my emotional parts. I had faith in my therapist who guided me through parts work and trauma reprocessing. I was able to see for the first time how my EPs impinged on my ability to live unchained. My EPs were my minds grasps of relating to a world which no longer existed. We must face facets of our personality which do not paint us in a good light. The Shadow side of the personality we must not fear. Step 6 and parts work are reparative processes. What I have learned is I do not have to live in survival mode any longer. Because of this work I can meet needs without reliance on old compulsive behaviors. I can risk authenticity and vulnerability without fear of rejection.
Sexual addiction and recovery can be controversial constructs. Unlike addictions to chemicals or substances, sex and sexuality are intrinsic facets of healthy human life and development. The goal of recovery from sexual addiction for most people is not to give up sex or the expression of one’s sexuality in its entirety. Rather, the purpose of recovery is to live a fulfilled life embracing a healthier model of sexual expression. Recovery is about setting boundaries and freeing one’s self of the suffering caused by acting out.
Like eating disorders, shopping addiction, and gambling, sex addiction is a process addiction. Process addictions are generally described as behaviors that are habitual and provide the person with an emotional high. The problematic behavior is often repeated to gain an increased high. A negative feedback loop forms wherein the individual cannot stop the behavior despite negative consequences. The origins of these addictions are rooted in trauma. Most people do not wake up one day and say, “Hey I think I’d like to become a sex addict.” Wounds leave their mark. The pain endured over time often becomes unbearable and prompts a form of escapism we see as addiction.
Shame often keeps people from seeking the help so desperately needed to develop healthier lifestyles in their journey for sexual recovery. Sex Addicts Anonymous (SAA) Green Book reminds recovery seekers:
Sexual addiction is not just a bad habit. Nor is it the result of poor self-control, a lack of morals, or a series of mistakes. If it were something we could stop on our own, the negative consequences would be enough to make us stop. Many of us tried to cure ourselves with religious or spiritual practice, moral discipline, or self-improvement. Despite our sincerity and our best efforts, we continued to act out. Our behavior eluded all rational attempts at explanation or correction. We had to face the fact that we had a disease, and that we could not stop the addictive behavior by ourselves (p. 9).
My name is Michael and I am a recovering sex addict, anorexic, and alcoholic. What follows comes from my lived experience as a person in recovery and as a clinician trained in trauma, addiction, and mental health. I work the twelve steps and traditions of Alcoholics Anonymous (AA) and Sex Addicts Anonymous (SAA). I will forever be indebted Eye Movement Desensitization and Reprocessing Therapy (EMDR) and to 12-step recovery programs for the gift of living free from the bondage of addictions.
The spiritual principles, tools, and suggestions contained within 12-step recovery helped me to find a life that was worth living. I learned that I deserved to be recovered, loved, and that I have worth. Recovery and trauma work helped me to thrive and accept who I am, was, and can be. In an earlier piece I wrote about the Step 1: “We admitted we were powerless over alcohol and sex, and that our lives became unmanageable.” The process to admit that I was powerless and that my life had become unmanageable took what felt like a lifetime to achieve. I bought the SAA Green Book and read through the entire text cover to cover in search for the answer of how to remain in sexual recovery.
The first task of this sexual recovery journey started 90 days of abstinence from all sexual behaviors. Let me tell you that it the most difficult thing I ever had to do in my life. I experienced withdrawal symptoms which included body shakes, anxiety, depression, angst, despair, craving, hypersensitivity, suicidal thoughts, and intense dreams. That list does not do justice to my lived experience during that time. It was a miserable experience, and yet a necessary one for recovery in my eyes.
When I joined SAA, I continued to hear a concept called “3 Circles.” It was all everyone talked about in meetings and in literature. In the Fellowship these three circles are how each member defines what is addictive and healthy sexual behavior for themselves. The program is quick to recognize the personal nature of addiction to sex. Not every human being acts out in the same way. For some their addiction is pornography. And for others it may be masturbation, destructive relationships, power and control, romantic obsession, cruising the streets for sexual partners, cybersex, prostitution, cross-dressing, having affairs, and fantasy. The list is endless.
Understanding what is addictive and is healthy requires distance and reflection. That 90-day embargo on sex and thinking or acting on sexual thoughts/desires were critical. The help of incredible trauma-informed sponsorship and therapy also played a major role in my recovery. I recall early in recovery listening to others share first step presentations about their powerlessness and unmanageability. I got into recovery in a Pre-COVID19 world with no local SAA meetings. My only options were telephone meetings all over the country.
Living with an addiction in isolation often drove me to act out. The beauty of phone and video meetings with others was that I could stay connected. I leaned early on in my process that recovery thrives in connectedness. I made several phone meetings part of my routine schedule. I volunteered on calls to read literature. During meetings I spoke up about my struggles and desires for a life built on a firm bedrock of recovery. It did not matter the time of day or hour of night. I made meetings a priority in my life. I stayed for fellowship hour at the end of each call. I exchanged numbers with other recovering sex addicts, and made phone calls during the week to talk about life, recovery, successes, and struggles.
I already received the gift of desperation. I needed something to give me hope in my life. As I called into these meetings, I heard men and women who shared their experience of what it was like, consequences of their acting out, and steps to stay in recovery. I sat and reflected on my own life after each presentation. I saw patterns of what behaviors I could not control. My first SAA sponsor, Adam, was a man who attended these phone meetings. We exchanged contact information and started to work the steps. I owe him a debt of gratitude for helping me to define what sexual recovery would look like for me. We have never met face to face. We conduct step work via email and phone calls. Sponsorship and meetings are my lifelines for connectedness. These are some of the tools in my recovery toolkit:
The Three Circles (diagrammed below) consist of three concentric circles. Each level represents a layer of addiction and recovery. Inner Circle behaviors are ones that cannot be safely practiced and/or controlled (seeking out emotionally unavailable people, pornography, drug use, alcohol use, disordered eating, etc.). Middle circle behaviors are actions, desires or behaviors that may lead to a slip or are risky (using sex to avoid emotions, lying, hiding, justification, etc.). Outer circle behaviors promote recovery (healthy sex based on choice, mutuality, and respect; meetings, sponsor, therapy, family time, staying connected, hobbies, step work, spiritual community time, dating, writing, dancing, creating music, etc.).
The process was a spiritual awakening. For the first time I could see my addiction; it had a name. It was real. It had a list of behaviors and symptoms. Defining healthy sexuality shifted my understanding. The best advice I received from my sponsor was live in the outer circle. What a jewel that insight was. The way I interacted with people and my surroundings changed. I noticed a shift in mind, body, and spirit. I felt alive again.
As a professional and a person in recovery it was important to define my boundaries especially around addiction. I carried intense shame for my addictions. I often felt that I lived a double life. My recovery work centered around integration of all the parts and pieces of myself. I never could be who I was. All the parts of me were cut off. Sexuality was one piece. Intellectual me was another. Emotional side was another. Creativity was lost in the abyss. I felt if I came out about my addictions or my parts of self, I would be shunned from the profession. My recovery integrated into every domain of my life. I turned a new leaf thanks to the program, recovery support systems, and others who have opened the door that I may walked through.
I am who I am. I will not change this inner-knowing for any person or institution. The process of recovery has instilled within me radical acceptance for who I am. I am not alone. Acceptance, I discovered, was key to healing. Once I made a thorough first step and opened the flood gates of the past, I quickly realized the need for trauma work. I could not stay in recovery from sex addiction without resolving the past that impeded on my present life. Spiritual awakening lead me to start EMDR.
I went to see Tom Buckles, LMHC, a former professor and licensed mental health clinician, who offered EMDR treatment. I quickly learned about my dissociative mind and how my parts of self directly influenced my acting out behaviors. Each of my eleven parts represented a wounded piece of my life. These parts were cut off facets of my life. I recall asking each of the parts to work together to help me heal. I believe because of this dissociative trauma work I was able to heal. At each session we completed between 4-5 trauma memories. I continued to see gains in EMDR. I started running, and I never thought I would be the running type. I restarted playing instruments, painting. My relationships with others took on a deeper meaning. I was free! I could remain present.
I have learned that my circles may change over time. In order to move something out of my inner or middle circle it requires an honest and willing conversation with my sponsor, recovery community and close friends whom I trust. My spirituality also plays a key role in helping to keep me on the road. Throughout this journey I have relied on faith to guide me. I turned over everything to the Higher Power of my understanding. I went back to the Roman Catholic Church, made confession, took spiritual direction, restarted mindfulness and yogic Practices, practiced spiritual principles in all my affairs. I remained open to what the universe, other people both inside and outside the fellowship, and my higher power were teaching me. I was an eager student.
The 3 Circles tool evolves with the person. Recovery is not stagnant. As I grew in healthiness and worked on the traumatic events that feed my addictions, sexuality took on a richer meaning for me. Today I am open to the potential in any situation. SAA and EMDR gave me the gift to live in the moment. Both 12-step programming and EMDR allowed me to face what seemed previously impossible. Today I can live a life that I never dreamed was possible. I realize today that sexuality is creativity and a vital life force. I channel that energy for good.
Today, I am a trained EMDR therapist. I get to help others in their quest to heal.
Recovery made this possible.
Painting by Michael Gargano
To read more about Michael and his work click HERE
“We’re all in this together."
It’s the messaging, tagline, hashtag, and well-intentioned sentiment that has been reiterated ad nauseum for the better part of 6 weeks. Apparently, the pandemic has brought us all to a place of Kum-by-ah, harmony laden nirvana, and we are all wrapped in snug and secure in our collective Shangrila. Except I’m calling bullshit.
We are, in fact, NOT all in this together. Sure, we’re all in it; it’s a global pandemic, how could we not be? As for the ‘together’ part? That’s where the phrase morphs from annoying trope to flat out lie. The word indicates that the collective ‘we’ is experiencing the current state of affairs in an equitable way, and this is the furthest thing from reality. When the response to the distress and trauma that is compounding day after day is “we’re all in this together”, there is an unspoken hierarchy being established; a domestic violence survivor held hostage in their home is shamed into silence, having been chastised with this insipid, hollow phrase. It strips away the validity of the individual experience that the trauma of COVID-19 has plunged our worlds into.
For trauma survivors, hearing “we’re all in this together” has become the latest iteration of “why did you stay” or “what were you wearing”. It is being used to minimize, marginalize, and delegitimize reactions and perspectives because it makes other people feel better to be able normalize the abnormal. This way, they do not have to sit in their own discomfort and try to hold space for those that have a different reality-not worse, different-than the one they are currently surviving.
At the very core of this entire reality is trauma. Trauma comes from medical Latin, and the root of the work is Greek for “a wound; a hurt; a defeat”. Here’s the other thing that goes along with trauma-crisis. Crisis comes from the Greek word ‘krisis’, meaning a decisive moment. Trauma has two parts, objective and subjective. We can agree that something has happened, and that our world has been picked up by this giant tantrum-throwing toddler of a virus, and shaken violently while we fly around helplessly, flipping upside down, solid ground yanked out from underneath us, like figures in a snow globe. How this seismic shift in reality is experienced can be, for some of us, a crisis on a daily basis. It is a crisis for parents who had no desire to home school their children; for the cancer patient who now finds themselves in chemotherapy alone; for the elderly who relied on home based services. When you are vulnerable, when you are homeless, when you are trying to serve and protect and maintain law and order, there is nobody else “in this” with you-you have earned the right for your experience to be uniquely yours and for the rest of us to acknowledge it.
We are grieving. As families, and communities; as a nation and as a world we are grieving. Grieving is the internal emotional experience of catastrophic, unexpected, heavy loss, an unexpected burden that is heavy for the soul to bare. Mourning is the external acknowledgment of your grief from the people around you. In a crisis, we go in to self-preservation mode, and while this is a completely expected, primitively driven survival response, we must stop, take a breath, shift out of survival mode, and see those around us. We cannot continue to dilute the relevance of engaging in empathy and holding space for individual lived experiences, despite our own discomfort with reality. Let’s start making the shift from “We’re all in this together” to “I see you in this”, and acknowledge the way we are each operating in our own experience of ‘this’, whatever that may be.
Originally published on Nikki Gordon's personal blog, 21 April 2020.
I grew up tortured by the tenets of fundamentalist Evangelical Christianity, and in my young adulthood, navigated to conservative communities within Catholicism. While some use my background against me, saying that I’m unnecessarily guarded, I believe that proactively healing from the wounds of spiritual abuse these last two decades gives me an uncanny ability to call out rigidity when I see it. Even as a kid being volleyed back and forth between two devout parents in their own right (one Evangelical, one Catholic), I learned to see the merits of both. AND I couldn’t understand why we all seemed to resist seeing the common ground. That included Jews, and Muslims, and Hindus, and Jains, and Buddhists, and all the great wisdom traditions of the planet! To me, our beliefs have a common thread, yet I grew up in contexts where I was told differently. The first time I ever saw the now legendary CoExist symbol was on a billboard when I first visited Sarajevo in 2000. I turned 21 that summer and Bosnia-Hercegovnia, where I would remain to live and teach for the next three years, was still in the throes of recovering from a brutal civil war. Personally, I was struggling to identify my own spiritual path as I sought recovery from addiction. When I saw that billboard, I knew with every fiber in my being that the CoExist symbol was my path. I came to learn it had a name--sanatan dharma—the threads that unite us are the essence of truth and worthy of embracing. The rest is just details.
Resting into this spiritual path serves me well in my personal life, and it’s largely shaped my professional outlook. Which brings this all to eye movement desensitization and reprocessing (EMDR) therapy… An experience with a phenomenally integrative EMDR therapist in 2004 saved my emotional life (when I was two years sober and still struggling with maladaptive dissociation). I received my training in 2005-2006, and jumped in with both feet, regularly offering the therapy to my clients. While working on my doctoral studies, I first attended the EMDR International Association (EMDRIA) annual meeting in 2007. Brazenly, I introduced myself to EMDR founder Dr. Francine Shapiro to thank her for what she created, yet it was at the conference where I would also meet other wonderful people in the EMDR community who would made even more of a difference for me. One of those people was Dr. Sara Gilman from Encinitas, CA, who became my primary consultant throughout the certification process. She also helped me wade through my frustrations around the politics and personalities in the EMDR community that bothered me immensely. Sara was (and still is) a radiant, real human being who truly understood how my mind worked, and she never once tried to change it. She worked with it and helped me fall in love with EMDR even more! A line that she consistently used in our work together, when I struggled with some of the rigidity in the protocols was, “Jamie, this is what the textbook tells you to do. This is what I actually do.”
That guidance from Sara represents a balance that I hope I have also been able to impart as an EMDR clinician, consultant, educator, and training provider. This guidance was the inspiration for my first book that Premiere Education and Media published in 2011, EMDR Made Simple: 4 Approaches to Using EMDR with Every Client. I knew that the book would likely make me a pariah in the EMDR establishment, and at that time I didn’t care. I believe I had something useful to say from my lived experience about how fundamentalism and rigidity benefits no one, especially people like me with complex trauma and dissociation. Even at that point, I would sit in conference presentations and feel like the powers that be who got the microphone on these topics were talking in such intellectual terms about people who need to be treated in a very human way—the way that Sara treated me. As I learned that EMDR therapy can play well with other therapies and approaches in a spirit of integration and modification, I started bristling when people said things like, “Well, that’s not really EMDR,” generally in putting down a savvy modification or adaptation. It reminded me of hearing people at church say things like, “Well, then you’re not really a Christian if you believe, say, or do that (insert any violation of the "rules" here).”
Ouch—why were people connected to a therapeutic modality that I loved, a therapy that helped me to heal from much of that trauma, spouting the same kind of aggression?
I dug in to investigate my reactions that were being elicited, and in 2010 I ended up writing an explanatory model that would become the basis for EMDR Made Simple—something I dubbed “the Four Faces of EMDR.” The idea is based on a teaching of St. Augustine called The Four Voices of God, presented for a modern audience by Fr. Benedict Groschel in the book Spiritual Passages: The Psychology of Spiritual Development. We studied this Augustine teaching in my Catholic graduate program and it was honestly the most important take away for me. People relate to God in one of four primary ways—as truth, as fire/oneness, as beauty, and a goodness. Of course we can have secondary paths of relating (I am fire/oneness first, and beauty second), and we tend to get along the least with the people whose style of relating to God most differs from our own (e.g., for me that’s the “truth” people… the theologians, dogmatic types, and to offer a clinical parallel, the strictly quantitative researchers). Augustine taught that all are different, and all have their place, for God shows up in a variety of ways and forms.
Call me crazy (I truly don’t care, it’s a compliment these days), this idea seemed to fit as it relates to all psychotherapies and the controversies that ensue about model fidelity versus tendencies to innovate and to modify. And from there I proposed “the Four Faces of EMDR:”
I’ve long embraced that all of these faces of EMDR are valuable, and we need all of them in the clinical arena. Since I attempt to be as non-dogmatic as possible, I also agree it’s possible to identify with more than one face. For instance, although primarily Face 2, I have a great deal of Face 4 in me. I consider the Dancing Mindfulness approach to expressive arts therapy that I developed in 2012 to be an extension of my EMDR work and thus Face 4 in many ways. Additionally, a person may see themselves as somewhere between Face 1-2 or between Face 2-3. Although I am Face 2, I can pull out my "Face 1" language and savvy when I need it, especially in offering foundational (basic) trainings or in communicating my ideas to other Face 1 people.
I published this model in an attempt to promote some semblance of unity and cohesion among people who love and are intrigued by the wonders of EMDR therapy. Of course many resented me for it, and many considered me a genius for it… I’ll let you be your own judge of that. I’ve been thinking a great deal about “The Four Faces of EMDR” since the COVID-19 pandemic thrust an entire community of therapists, not just EMDR therapists, into working in telehealth…an area where so few of us are trained and where few research studies exist on best practices. As battles ensued around me over propriety and appropriateness in shifting EMDR therapy to telehealth (e.g., do you let people self-tap or not?, is it ethical to do trauma work online with people who dissociate?, is it prudent to venture into an area where there is so little research?, should we be taking advice on online therapy from people who are in different ideological camps?), the Jamie who wrote EMDR Made Simple ten years ago re-emerged.
I admit, especially since I am now an EMDRIA-approved trainer who has more Face 1 qualities than she used to, I’ve sometime wondered if EMDR Made Simple did more harm than good in helping therapists hone their EMDR craft. I am much less rebellious and a lot more party line as it relates to proper EMDR technique than I was back then. I’ve learned that the technique isn’t the enemy; it’s the attitude and approach that people take to the technique that causes problems. You can use it rigidly, or you can use it artfully. I even wrote two pieces lauding proper technique and explaining how I reconciled with the standard protocol here on this blog. I’ve come to appreciate that much of what I initially interpreted as rigidity in Dr. Shapiro was truly her push to get EMDR therapy validated as evidence-based by the metrics of empirical research. Even though thinking in those terms does not serve me either personally or clinically, I see how it serves our larger community. And in 2018, Springer Publishing—one of the largest publishers of mainstream EMDR material and the publisher of The Journal of EMDR Practice and Research—put out my second EMDR book (EMDR Therapy and Mindfulness for Trauma Focused Care, co-authored with Dr. Stephen Dansiger). Rebel Jamie from 2010-2011 was a bit shocked by that one!
Yet in the week when we switched over to telehealth and I struggled to find resources for my trainees and community—I listened to the different voices and the old Jamie who wrote EMDR Made Simple paid me a visit. I realized that rebel Jamie is who I need to be for myself right now, and how I need to show up for my students and my community. As I declared on a public webinar I did with my friend Mark Brayne on March 22, however you do EMDR in your office and in whatever face you work—transfer that to telehealth. Your confidence in your approach will inevitably translate and we can continue to ease or even end some suffering during this difficult time. There’s plenty of time to debate and even to research when all of this is over. For now, show up for your clients with whatever EMDR face you wear and do your best to honor other EMDR and EMDR-related clinicians who are doing the same.
Adapt - to make suitable for new use or purpose; become adjusted to new conditions (merriam-webster.com)
COVID-19 has brought disruption to everyone’s lives in so many different ways. I never imagined my life and daily routines would be so drastically altered in a week. My kids are at home all day now instead of going to school and will probably finish up the school year interacting with their teacher and classmates through Zoom and being semi-homeschooled by myself and my husband. We can’t go to restaurants or workout at the gym, and a trip to the grocery store feels like a wild goose chase trying to figure out what store stocks when and who will have everything on my list.
My therapy practice has drastically changed as well. Hardly anyone, clinician or client, is in the office, which is normally bustling. We had to shut down our yoga studio, and I haven’t been able to practice in the space that has been my yoga home for years. In just a few days, I had to figure out how to meet with clients remotely in case either one of us is quarantined. Teletherapy never was a platform I wanted to use because of the nature of the trauma work I do, but at this point, it isn’t a choice; it’s a necessity.
In short, everything is turned upside down and what was the norm a week ago, feels like ancient history and who knows if it will go back to that way of life ever again. I spent the last few days grieving and feeling like I was living in crisis mode, trying to make sense of everything and finding a stable footing. I know my family is fortunate; my husband and I both still have our jobs and the ability to work from home, we have our health and endless resources. Our theme for life today is adaptation, and we must find new ways to adjust to these new conditions.
Take time to grieve and have a breakdown. There is so much turmoil and uncertainty now; acknowledging this can help you cope with these feelings. And it’s okay to be sad about the more superficial changes like not being able to stop by Target randomly or having a mid-afternoon cappuccino at Starbucks. Take the time you need to experience and process these feelings.
Be mindful and stay in the present moment. Even with all the stress and chaos happening around us, there are so many positive moments that we could miss. It could be your kids laughing and talking as they are playing Minecraft together or hearing the spring peepers at night. By being mindful and paying attention, we can strengthen the importance of these positive moments.
Limit social media and the news. It’s so easy to get caught up in minute by minute updates in the news and all of the commentary on social media. It’s beneficial to stay informed but do so in small doses to avoid vicarious trauma.
Find control in the things you can. There are so many restrictions being placed on us right now in regard to where we can go and who we can be around. Businesses and restaurants are being told to close, people are losing their jobs, and normal resources are scarce. This can trigger a feeling of not having control, and it is important to find control in the things you can. It may be as simple as setting a time to get up in the morning or when to eat meals. Take the initiative to turn off the news and limit social media and go outside for a walk.
You are not alone. No one on this planet is immune to what is happening right now. In different ways, everyone is affected by this pandemic. My hope is that we, as a global community, find solidarity in this. It is a time to come together and find strength in this shared experience. If you feel that you are the only one overwhelmed, anxious, angry, remember, you are not alone. We are all learning how to adapt, and we are all in this together.
You know it’s over when they let you enter without first scrubbing your hands.
This ends one of two ways. Only one means coming home with the one you love.
Safety precautions are no easier in intensive care, just clearer.
The ventilator, translucent skin, the unsteady beat of the monitors--all scream vulnerability and so, of course, of course you wash and gown and mask. That’s obvious.
The dying parent. The tiny babies. Every cell in your body wants to shield them from danger, even – especially – the invisible danger clinging to you from outside, hitching a ride closer to them. Looking for a way in; their vulnerability an invitation.
They can’t protect themselves.
Protecting them is obvious even when it’s not easy. You respect the barriers marking the threshold between the menace outside and the relative (hoped for, prayed for) safety here, inside.
When you can see blue blood rushing beneath translucent skin, it’s not hard to wash your hands.
The line used to be hard and sharp. Maybe it was imaginary, but it seemed straightforward. Safety is here: danger is there.
Now, the ink has smeared until that line becomes earth, becomes air encircling each of you and what does it mean to be safe now?
Ah, but you know what it means to keep a distance, so that you can protect.
You remember. It’s planted in the marrow of your bones.
How do you love through panes of glass? With a heart beating so hard you’re certain your tiny babies must hear it, too. When you touch them with a gloved hand, is it warm? Do they know it’s you?
Only your voice can touch without danger. The soft lullaby you sing into the incubators when you have to leave them. And the way his heart speeds up when he hears you coming into his hospital room.
On that final morning, they let you in without scrubbing. You touch your father’s hand with yours, unwashed and ungloved, because that line doesn’t matter anymore. It’s how you know it’s over.
All those years before, you got to take your babies home, drawing a new line around them, hard and strong for as long as you possibly could until you cracked it open to take them out. Out there. Unwashed hands and air travel leave them with bronchitis, but they’re stronger now and recover. You gave them time to grow and for their lungs to heal.
And you know it isn’t over.
It’s planted in the marrow of your bones.
And now? Now you will stay away for as long as you must if it means they will be safe.
You will love them again through a pane of glass (or a computer screen) when they are six-thousand miles away instead of in your kitchen, cooking and bickering, where you wish they were (where they’re supposed to be) instead.
You will send your voice through the telephone and hug over a video link and listen through a window for the music you know is out there because the line defining dangerous and safe has shattered, and you will protect them with the distance that you keep because this is what you do when you love.
- Visual Media and Poem by Dr. Mara Tesler Stein
Institute for creative mindfulness
Our work and our mission is to redefine therapy and our conversations are about the art and practice of healing. Blog launched in May 2018 by Dr. Jamie Marich, affiliates, and friends.