I am having a very difficult time getting into the fullness of Christmas spirit this year, still very sad that this will be your first Christmas without us. I’m sitting on the couch right now, smiling so widely as I think about hanging out here on Christmas night in 2017. I was going through my divorce and knew it would be a rough one, and you took great care to make sure that we would have fun that evening—eating my mother’s leftovers, lots of desserts, singing songs, and indulging me in my holiday tradition, a viewing of Meet Me in St. Louis. Although not a Christmas movie in a classic sense, I always admired the Christmas story line in the film and Judy Garland’s performance of Have Yourself a Merry Little Christmas as the pinnacle of Judy at her loveliest. I weep whenever I take in that performance, thinking about how tragically she died and how bitterly the sting of addiction and unhealed trauma affected her. You held me that night as I cried; it never bothered you that I cry so much. Then (since it was your first time watching the film) you grew shocked as, shortly after the song ended, you saw young Tootie take a baseball bat and destroy the snowmen out of her own rage about the family move. “Wellll,” you said in your tenor of commentary, “That certainly changes the meaning of Have Yourself a Merry Little Christmas for me!”
This memory is everything I love about our friendship—deep laughs, deep tears, and the intimacy of shared experience. I wish we could have had even more of these moments, or that I could have more fully savored the ones we did share. Because of your struggles, somewhere deep inside, I feared that we would lose you young, and yet the reality is that more years is not a guarantee for any of us. When I was scrolling through Facebook on the day we cleaned out your apartment, I came across a meme with a quote from Kurt Vonnegut: “Enjoy the little things in life because one day you’ll look back and realize they were the big things.”
So many little things that I would love to experience again—comparing our rough days back at YSU over dinner at Christman Dining Hall, road trips in my car singing at the tops of our lungs, time spent dancing mindfully—especially receiving your beautiful teaching at your 2018 facilitator training using a bagpipe version of Amazing Grace to get us more viscerally attuned to our breath. Our last formal Dancing Mindfulness experience together included bringing you to Mill Creek Park where I taught a class at the end of August, then I drove you around the west side of Youngstown to show you my sites—the house I grew up in as a kid, my high school, the first place that sold me cigarettes underage. As much time as we spent in a car together before, something inside told me to show you those places, and you wittily called our drive the “Dancing Mindfulness Founder’s Day Tour.” We sang the Sunset Boulevard soundtrack all the way back to Warren, particularly relishing in “As If We’ve Never Said Goodbye.” You bought me better Valentine’s gifts than any straight male I ever actually dated, gifts that usually involved sparkle, glitter, or flowers. Gifts that evidenced how well you knew me. Waking up to your awesome messages and Bitmojis when I was on the road training, encouraging me to keep taking care of myself while working my brand of magic, as you named it. You often called me “tender trainer” in these messages and that is one of the loveliest compliments I ever received. The two of us exchanging boy talk, which usually consisted of you making many points about how I was shortchanging myself. The two of us dancing to Jesus on the Mainline at the Krisha Das kirtan/concert just after your 40th birthday. When we sat down for the final meditation, you kissed your hands and then kissed my feet, as this is a common sign of respect one shows their teachers in India. I cried at the meaning of the gesture and cried even more deeply when you said, “I just wanted to touch Maharajji’s foot.”
Maharajji… the term of endearment for our beloved Neem Karoli Baba; the great Indian saint who left the body in 1973, the teacher of Ram Dass, was the subject of many conversations between us. As kids who grew up largely tortured by Christianity yet still fascinated by all aspects of spirituality, the teachings of Ram Dass and Maharajji were balm for both of our souls. We reveled at what it meant to walk each other home, long seeing each other as guardian angels brought into each others’ lives. We marveled at the simplicity of Neem Karoli Baba’s teachings, namely that if you want to see God, love people. When I helped to clean out your apartment a few days ago, chills overcame me when I saw a card on your fridge; I sent it to you this summer while you were incarcerated. I forgot that I wrote this Maharajji teaching on the inside: “Love is the most powerful medicine. Meditate like Christ. He lost himself in love.”
Jason, this is who you really were and still are in your eternal state. You are a sweet, precious wave who returned to the ocean of eternal love. You understood that this love is who Jesus really is, and the miracle of in the Incarnation that we celebrate this Christmas season is that God shows up in human form. Not just in Jesus, in all of us. I am so sorry that the shame gremlins you could never quite shake kept you from knowing the fullness of this truth in your lifetime, as desperately as you sought this truth. When you told me this Fall that after all of these years you still experienced such great shame about being a gay man, I wanted to just wrap you up in Maharajji’s blanket and tell you how perfect and beautiful you are, exactly as God made you. I did my best to convey that with my voice and hope that in your eternal state, you now realize the truth. I see you and Maharajji hanging out together in Kainchi, chanting to Ram and sharing the love of God with everyone who comes to see you. Ram Dass is now there with you, I'm sure. After I visited Kainchi earlier this year, I so desperately wanted to take you to India with me some day and am sorry we will never have a chance to visit there together in this lifetime. Yet I smile when I see you there with Maharajji and our beloved Ram Dass now.
Because you are universal, unchanging, and timeless my sweet friend, I also hear you singing Have Yourself a Merry Little Christmas with Judy Garland in stunning harmony, reaching me like a lullaby in these very difficult days. I promise you, Jason, that I will carry out your wish of making more music. I cherish the beautiful compliment I received when you said, “I’m glad you didn’t go to music school. They would have squashed out the natural organicity of your voice.” Maestro, I was and am truly honored that you regard my spirit so highly, and vow that I will never let anyone squash out this natural me that you loved so much. I promise that I will cherish these little moments of friendship, grace, and wonder in my life even more and never let my working drive override them again. I know you worried about my tendency to overwork and you, more than perhaps anyone, knew how hard it’s been for me to balance my public life and my private, inner world. You love/d Jamie, Dr. Jamie, and Pragya with equal force and in doing so you’ve laid a path for how I can better love all of me too. The other night when I talked to you in prayer, you told me to keep listening to Journey Blind, my song that you loved so much and that we had the chance to perform together.
And speaking of music and moments… that night in the church when we rehearsed Journey Blind in preparation for your show in February 2018; for me that memory rings on as the fusion of art, friendship and love. I’m so glad we were able to receive that on video (yay for Facebook Live and me being a champion networker). I adored that experience even more than us singing it at the show for it is the very essence of being in process, the glory of art as experience. May I create more moments like this with people in my life as long as I remain in this body. For if I were to die tomorrow, it wouldn’t matter how many books I wrote, how many courses I taught, how big my company got, or how many people knew my name… these moments, these Journey Blind rehearsals on a cold Wednesday night at a church in Warren, OH is what I would cherish the most. Thank you my sweet Jason, beloved member of my family of choice, for helping me to finally and fully realize it.
With love forever,
Addiction is a dissociative response. Sounds like common sense, right? For many years we’ve operated in our practices fueled by this assumption. As individuals in personal recovery, the link between unhealed trauma/dissociation and addiction has been blatantly obvious. Even when we share our work with people on developing this new model of Addiction as Dissociation, we are met with a great deal of, “Well yeah, obviously.”
Yet the reality is that no contention in the literature has been directly made addressing this link… until now. The connection between unhealed trauma and addiction has been well asserted, with giants in the field like Gabor Mate, Bessel van der Kolk, and many others speaking to this link. What about dissociation? Dissociation comes from the Latin word meaning to sever. When an experience or a moment becomes too overwhelming for a person’s system to handle, we have a tendency to sever from that present moment, or from our core self. Dissociation is a very normal response of the brainstem that can activate when we are met with overwhelming distress. Dissociation can be adaptive (e.g., spiritual pursuits, proper use of guided imagery, daydreaming, the Netflix binge when you need to decompress) or maladaptive. When the manifestations of dissociation are maladaptive, they are likely to cause functional impairment. The various signs and symptoms of addictive responses can be examples of this phenomenon. Moreover, maladaptive manifestations of dissociation result when traumatic experiences or stressful events have not been processed and reconsolidated.
Both of us have been working very hard in 2019 to scour the literature and create a model that we are now calling Addiction as Dissociation. Regardless of your adopted stance on addiction (e.g., a disease, a response to trauma) or whether you even like the word (i.e., you may prefer behavioral compulsivity), this model will likely be relevant to your practice. We’ve prepared a table version of the model that you can examine in this blog. You are welcome to share it and we also value your comments on what resonates and what may still need refinement. Our scholarly paper that fully supports the contentions and flow of the model is currently under review and we will keep you posted about the more formal debut of this model to the world.
The study of subjectivity is broadly concerned with what it means to be an experiencing subject in the world. When I touch the book, “I” am the subject doing unto an object, namely “the book.” This subjective “I” touches the book, reads the book, has the book fall on her head, absorbs the ideas in the book, discusses them with another human being. So, when studying subjectivity, we ask questions about who I am, how I experience the world, and what gives me meaning as a being in the world. It invites us to think about the way in which we relate to the world around us and how we understand our place in it.
There is a long tradition of western philosophy that talks about how we can never really know the things external to us. Sure, I may touch the book, but my sense perception filtered through my brain is all I really have access to. I could be living in the Matrix and the book may not even be real. The outside world is of course experienced, but in some ways, it is always a bit of a mystery. This tradition presupposes that subjects and objects are fundamentally distinct – that I can never know the “truth” of the external world. They suggest that the subject, that I, am reducible to my brain’s processing power of figuring out the external world.
This has always struck me a very disconnected an unsatisfying way to look at my place in the world. The few memories I do have of my childhood are characterized by that feeling of disconnectedness and inability to make contact with the “external world.” Like many, my adolescence was characterized by a chronic striving to “fit in” with the popular kids, with the ever-present anxiety that accompanied a lack of knowing what they really thought about me. Even now, I have very few memories of my childhood before the age of fourteen, which incidentally coincides with the age at which I discovered the ability of alcohol and drugs to manufacture a sense of connectedness to the world – a pastime which would temporarily cure that sense of longing, but ultimately exacerbate the feelings of disconnect and loneliness. Even as an adult I have few belongings that suggest I even existed more than a few years ago. And so, with a lack of history in terms of geographic location, memory and material possessions, save for the ephemeral sense of disconnect from the world around me, I stumbled into this philosophical tradition that reified every negative cognition and somatic discomfort about my lack of fitting into this world.
But there’s another way to think about our place in the world. Maybe we aren’t just minds functioning as detached observers. Part of what it means to be human is to have experiences in the world. To both contribute to shaping the world and to be shaped by it. To bring an amalgamation of life experiences to bear in our interactions with it. Everything we know, we know from a place that has been informed by a geographic, historic, and cultural context that we bring to the table when making sense of a situation or experience. Such an approach to understanding the subject or self means that we are fundamentally evolving, unfolding and growing with each encounter in the world. We are part of the world, connected intimately to it, and it is part of us.
So, what does this mean for the kid with no memories and a chronic sense of isolation from the world? What has it meant for the girl from nowhere? It means the way I understood myself has shifted over time away from the desire to figure out what others think of me and how I can access the inaccessible. Treating the world like an object to be figured out or analyzed as means to manufacturing a sense of connection with it, somehow only puts greater distance there. But in embracing my own unfolding story and honoring oneself as an evolving, growing, and emerging creature responding to the world around her, rather than trying to figure it out, has paradoxically resulted in a deeper sense of connection and intimacy in relationships and with the world at large. The ironic twist here, is that in my experience when I let go of striving to figure it all out and instead am mindful of my own experiences and responses to the world, I actually somehow become part of it rather than a detached observer.
Moreover, if in every interaction with the world I bring with me a history of experiences that help me to make sense of those interactions, then I also bring those experiences with me as I look back at my past. This means I get to look back at a childhood and adolescence that I don’t fully comprehend, that is missing large pieces, and characterized by a sense of not belonging with the wisdom of experiences and memories acquired later in life. For the girl from nowhere, understanding myself in hindsight with the full weight of the experiences I do have, means I get to weave together a new story and claim that history for myself – to rewrite my own narrative.
There is one last important consequence that results from understanding subjectivity as evolving in response to a world with which we are intimately related and in communion. An intimate connection with and sense of belonging to requires responsibility. If we are connected with the world and therefore one another, we are responsible for both validating one another’s unique experiences and histories and challenging one another to continue to grow and evolve. It is not enough to simply honor from whence we’ve come. Comfort with self, community and other, means we must continue to submit to new experiences that challenge us to discard old ideas that are no longer productive and avoid becoming stagnant.
Understanding subjectivity as the embrace of one’s unfolding story in response to the world about her sounds lovely. yet even as I write this, I am keenly aware that I don’t always live in this space of communion with the world. I would be lying if I said I never gave a damn about what you thought about me, or how even this piece of writing might be received. I want you to like it. I hope you do. But it’s not something I can figure out how to make happen. Even with the full recognition that my striving only feeds my discomfort, I readily admit I still fall into these patterns, defaulting to my analytic brain. I have a choice today about how I want to engage the world, and it’s not always an easy one as I slip into old ways of thinking. So if you see me on the street, feel free to remind me that my own history, experiences, and insights are worth honoring or perhaps need challenged so that I might continue to grow and feel a little more comfortable in this world, and I’ll try to do the same for you.
If there was a category in my high school yearbook for “Most Likely to Become a Junkie,” I would not have been a contender. Indeed, I was voted “Class Brain.” And none of my smarts could prevent me from developing an addiction problem on top of an already budding mental illness. I spent the Fall of 2000 in a state of suicidal use, not caring whether I’d ever wake up. Even as I tried to get sober and well shortly after turning 21, I didn’t think I’d make it past 24.
These period of days from July 4-July 8 are quite celebratory. Most everyone in the U.S. is in a festive place on July 4th, my belly button birthday is July 6th, and my sobriety anniversary is July 8th. This year I turn 40, a momentous occasion for me who once believed I couldn’t ever survive this long. And I celebrate 17 years of sobriety. At the start of these special days, my spirit was somewhat dampened when I saw a friend post a “joke” from a parody account set up to represent an Ohio municipality. The post apologized to members of the city for having a scaled-back fireworks display this year, due to the fact that they’ve spent so much money on Narcan. And they “thanked the junkies” for ruining everyone’s freedom celebration.
I have a very crude sense of humor and I am not a person who easily offends. And this “joke” infuriates me in a way I struggle to put into words. Whenever you talk shit about alcoholics or addicts due to your own ignorance, misinformation, resentments, or unhealed wounds, you are also talking shit about me and scores of people that I love. There are many others who would look at me and the life I’ve built today and say, “But Jamie, you’re different.”
I’m really not.
Yes, I am successful by every conventional American definition of the word.
That’s because recovery defines my lifestyle today.
And it began in a place where I was just as desperate as any other “junkie” who may need revived in the back of an ambulance.
People who meet me now or only knew a very public version of me as a child can have difficulty attuning to this reality. A few years ago after marriage equality became the law of the land, I attended my first same-sex wedding in my hometown. The ceremony was beautiful. I cried through most of it, not ever believing I would see this in my lifetime. And my illusions of liberal paradise were short-lived. I was seated randomly with one of the groom’s family members. He came around at the beginning of the reception and introduced me, “Dr. Jamie Marich,” to everyone at the table. He gushed about how accomplished I was, that I was an author, and everyone at the table seemed impressed.
Towards the end of the meal, the opiate crisis came up as a topic of conversation. One of the family members stated quite bluntly what a travesty it was that we wasted so much money on Narcan, especially for frequent fliers.
“They should just let the junkies die already.”
Of course this was not the first time I’d heard talk like this. A few years prior at an extended family event, I heard someone opining that the government should euthanize people who fail treatment after three tries. And yet this was at a gay wedding, where most in attendance seemed to be tolerant.
My stomach churned, unable to finish my meal, realizing just how much of a stigma problem we still have on our hands. I found myself in that familiar position of freeze, wanting to say so much, yet fearing danger if I did. I wanted to ask that guy, “What if it was your child in the back of that ambulance,” or challenge him with, “And what issue is happening in your life that you’re failing to address? I’m sure your stuff is causing harm to those you love, just maybe in a different way? Have you ever considered that scapegoating addicts may help you feel better about yourself and the role that people like you play in perpetuating a trauma epidemic that people take opiates for?”
At one point the mother of the person making the comment said to me, “I’m sorry if this is upsetting you, this isn’t the best dinner conversation.”
In fairness, the mother, a nurse, challenged her son and also seemed put off by his comments.
“What’s upsetting to me,” I finally managed through that pain of freeze, “Is that I am a person with 15 years in recovery. Alcohol and opiates. And I could very well have been one of the junkies you’re talking about.”
Everyone seemed embarrassed and tried shifting the conversation to congratulating me on my recovery and how “well I had done.”
I’m just glad I had the chance to start somewhere.
I never needed Narcan or professional assistance to come out of an overdose or withdrawal, but I was getting close to the point where I could have. And many people in my network of recovery today, including sponsees who are working to make a difference in the world, required professional assistance for their lives to be saved. Yes, some of them had to go through the system of care multiple times before they got it. And I’m so glad they did. Because many parts of the medical and care system (however flawed they may be) did not give up on them, they eventually learned not to give up on themselves. A person I interviewed for my dissertation research was pronounced dead on arrival twice during overdoses, and would go through twenty-six rounds of professional treatment. And she eventually got access to the proper trauma-focused treatment that she required, later going on to make a big difference in her community.
Every day I get to see what happens when we don’t give up on people. Many people who work for me or with me are in long-term recovery. As a professional serving people at all levels of recovery from addiction and mental illness, I am privileged to behold miracles and know that recovery is possible. I know that it can be frustrating—for as many recovery stories as I witness, I see just as many people struggling to get it. And I’ve known way too many people who have died far too young. If you are a first responder, work in the hospitals, or in criminal justice, seeing the consequences of addiction play out in full living color, I realize that you may be jaded. It’s not easy trying to deal with people who are in the grips of it. I invite any of you to come and hang out with people like me some time. See what happens farther down the road when people get well.
I also recognize that an addict or alcoholic may have caused great pain in your life and this can be a hardening experience. I am the first to admit the damage that we can cause in the lives of others around us, and I realize that no apology can ever begin to heal those wounds. For those of us who make it through, we do our best to make amends through changed behavior. And please realize that even those of us in recovery have been impacted by the consequences of others’ addictions. I’ve been married to two people in active addiction. The son of my recovery sponsor was killed by a drunk driver. And although there has been pain to wade through, we’ve both chosen to be part of the solution, which first and foremost means being present for people who need recovery.
There’s always a fear when we advocate for these compassionate approaches to recovery that such softness will only give people more excuses. So let me share the piece of direction that changed my life which, I believe, embraces the delicate balance between validating and challenging people. When Janet, my first recovery sponsor, heard the story of my life and the progression of my disease she said, “Jamie, after everything you’ve been through, it’s no wonder you became addicted. What are you going to do about it now?”
People only respond to challenge and direction when they have first been validated and humanized. It’s not the other way around. Shame fuels the progression of addiction, and the comments and jokes on social media—no matter how innocuous they seem to you—are part of the problem. Intoning the wisdom of Anais Nin, shame is the lie that someone told you about yourself. For most of us, that starts with unhealed trauma and escalates by contact with others who would have us believe the lie. We say in the treatment field that guilt is when you feel bad about the things that you do, and shame is when you believe that you are those bad things. Shame teaches that those messages of defectiveness define you.
I’m grateful that I hung around long enough to learn the difference. And I’m even more grateful that I met people along the way who helped me to uncover a deeper truth about who I really am. For as much professional therapy as I’ve received and as much time as I spend growing in my spiritual practice, I am further grateful that I can still acknowledge my vulnerability. I am only human. If I stop taking care of myself, the chance is very real that I could be in the back of an ambulance, even after seventeen years in recovery, for reasons connected to my addiction and mental health.
To the people that will inevitably need revived from an overdose somewhere in the world today, I send you my love, my empathy, and if you want them, my prayers.
We are not separate.
I was sitting in front of a client one afternoon as she talked to me about the rape she had experienced a few months ago. As the tears streamed down her face, I began to feel my hands shake, not that she could see, but enough that I definitely noticed. She continued in details of what happened and I remember floating to the top of the room. As she cried, I could only observe her and watch without feeling as I had left my body and floated above myself. I could see my clipboard, writing nothing, see the steaming coffee beside me, hear her sobs and comments; what I could not do was feel anything…until I came back inside myself. The session was concluding and I was able to offer some superficial comfort as I escorted her to the door. When I closed the door behind her, I could see the bathroom door as I opened it. I saw my best friend standing there with another male friend of ours as they had this coy look on their faces. I recall thinking I was in trouble but did not seem able to react until they began to pull me along, down the hall, and into the bedroom. Once I was thrown to the bed and my clothes were being torn off, I could feel the tears on my cheeks, just like my clients. I slowly started to float above this scene and watched in horror. When I noticed I was still in my office and I was staring at the door, I came back to the present awareness, went to my desk chair and wept. I knew it was time to reach out for help. I could not control these memories, these feelings any longer.
I reached out to a colleague who was an EMDR therapist. She agreed to see me to help with anxiety issues I was having from work. My agenda was to be able to trust her enough to share this secret and work through it, but I remember being terrified to talk about it. The longer I met with her, however, the more comfortable I became and it did not take too long before I was able to tell her about the experience. That was hard enough, but as I sat in her office, I wondered how I would ever be able to release all the pain of the rape. How do you even begin to talk about this? How do you let go of this? How can you possibly ever trust again? Be whole again? She was very patient with me and, as I could, I began to share what happened with her. I was able to ask some of the questions I had been thinking and she began to tell me what she thought would help.
She introduced to me a procedure known as EMDR therapy. She explained that EMDR works to help resolve traumas and she talked about what we would actually “do” while in sessions. She said I would watch a light bar, following the light with my eyes, and this would begin to let these emotions process in my brain. I thought it was weird and probably would not work, but desperate for healing, I agreed to try. We talked about some of the negative beliefs I had about myself as a result of the sexual assault and how it had altered the way I see myself. I would have flashbacks and nightmares often and we talked about these as well. We took things slowly, as I could not handle too much at a time. She knew that and while pushing me somewhat, she also respected the boundaries, the lines I could not yet cross.
During the sessions, I watched the light bar and also wore headphones, which sounded a rotating “beep” back and forth in unison with the light. With both these forms of bilateral stimulation being conducted, I would picture things in my mind, feel what was going on in my body, and notice what memories or thoughts would come. Often a lot of emotion came out, sometimes I was not sure about what. This was all part of the process. We would target in on a belief due to a situation and then would let me “process” that, meaning I would watch the light, listen to the beeps and notice what happened in my body and mind. It only took a few times to realize something was happening with this process. I was beginning to deal with my past.
We continued to use this therapy to help process other areas of my life as well. Some of the other situations involved other sexual traumas I had not recalled with this great a detail. Although I was having these memories surface, I felt safe knowing we were working through this together.
I cannot say I enjoyed the therapy and remember many times leaving her office emotionally drained; yet I knew I was healing slowly. I recall one of the scariest times of the processing was when she had me hold the picture I was seeing of the rape in my mind and watch the light to begin to process this. Immediately I began to feel anxious as I pictured the scene. Although there was fear, what I realized was I was having these feelings anyway, but it was different this time. I could begin to feel myself releasing some of the pain through this process. I could feel some of the anxiety go from inside my soul. I was tearful as I followed this light and at times would sob. What was important to me, however, was that these images were beginning to change. I was able to see the incidents and not float away; I could stay inside myself and feel what I had pushed down for the first time in years. I was allowing myself to heal. Through the pain of the trauma, I was being led down a safe avenue to process this with the care and safety of my therapist right there, guiding me. I did not have to be alone in these memories anymore.
Sharing the story of the rape was one of the hardest things I ever had to do. To let someone else in to see my pain, shame, embarrassment, anger, and vulnerability was like an ache I had never before felt. But as my therapist always said, in order for true healing to happen, someone has to witness your grief. Until we can share that pain with another person, we will never truly be free of it. This made all the sense in the world to me as I had carried that grief around for years. Being free of it used to just be an unobtainable thought, but now through EMDR therapy, I could see real hope.
As I mentioned previously, I also began to recall with more memories and details a few other incidents that occurred in my childhood. Had I not been doing the bilateral stimulation that EMDR utilizes, I do not think I would have been able to recall some of the specifics that made all the pieces come together. I was able to remember what happened to me in that day care, in that school office and in that neighbor’s home. I was also able to share these experiences with my therapist and we worked through these as well. When I say working through it, it does not mean just forgetting and moving on. With EMDR, I was able to feel the emotions I had pushed down in regards to these events and begin to let the emotions go. It was as if all the years of pain came up and passed through me again. However, in order to be able to truly integrate this as part of me, this had to occur. I never knew what “processing it” meant until I discovered the EMDR journey. It was like a life saver to me. I was able to be free of the pain, not just pushing it away. I could recall the memories, but allow them to stay in the past where they belonged. I did not have to let them hurt me anymore in my present life. I could be free.
Not So Much of a Rebel: Making Peace with the Standard EMDR Protocol by Jamie Marich, Ph.D., LPCC-S, LICDC-CS, REAT, RYT-200
When EMDR clinicians learn that one of my specialties is addiction, I usually get asked, “Which protocol do you use? FSAP? DeTUR?”
I’m often met with surprised looks when I respond, “I use the standard protocol mixed with good common sense about how addiction works, which informs my preparation approach. I don’t find any of the specialty protocols particularly useful.”
I realize you may be gasping right now since, in EMDR circles, lots of buzz can be heard about the specialty protocols and methods that EMDR practitioners are developing. I participate in several Facebook EMDR groups and almost every day I read a question to the tune of, “What protocol do you use for addiction?,” “What about dissociation?,” or, “Is there a specialty protocol for condition x, y, z?”
So many times I have bluntly responded, “Um, the standard protocol mixed with clinical judgment about preparation needs and how to use appropriate interweaves.”
One of the reasons I decided to write this piece is so that I can cogently share my position as an EMDR therapy trainer, author, long-time clinician, and notorious EMDR therapy rebel. What’s funny is that when I wrote EMDR Made Simple in 2011 I called out many problems that I saw with party line EMDR. Yet as I’ve matured as a person, a clinician, and a trainer, I’ve realized that maybe I’m not so much of a rebel after all. For me, the standard protocol really is where it’s at. Learn the standard protocol well within the context of the client’s goals for treatment and know where to point the targeting sequences, and you really have all you need to do successful EMDR with a wide variety of presentations. The adaptive information processing model will guide you, as will the larger breadth and depth of what we as trauma-focused clinicians are learning about the importance of embodied, somatically-informed affect regulation skills.
In this piece I further explore my position by explaining my approach as a trainer to client context and adequate preparation. Then I explore my thematic perspective on client history, which allows me to direct the standard protocol in the direction it needs to go in order to work with a particular client presentation. Finally, I look at where interweaves and modifications may be appropriate depending on the complexity of the case involved. Since addiction and dissociation are my two main specialties in EMDR therapy (and the two main conditions for which I have been personally treated), I will draw on several case conceptualization strategies for these special populations.
One of the first pieces of wisdom I internalized from reading Dr. Shapiro’s early works is not to do EMDR with a client you wouldn’t normally feel comfortable treating anyway. In my interpretation, this means that the task falls on us as clinicians to learn more about a particular condition that may be stumping us as a general best practice. One of my biggest concerns with the rising popularity of addiction protocols is that well-intentioned EMDR clinicians who know little about addiction are simply pulling out the protocols and hoping for the best. When this happens absent the larger knowledge about the various models of addiction, the interplay between trauma and addiction, and the impact of the stages of change, inadequate care can be delivered. In one of her first books Shapiro wrote that “addiction should not be treated in a vacuum,” (Shapiro & Forrest, 1997) yet I fear this is what happens when EMDR therapists just pull out one of the specialty protocols without educating themselves more on the intricacies of addiction first. The same applies for dissociation and dissociative disorders, or any other specialty presentations that may puzzle you—start by reading up or furthering your continuing education on the generalities of that population and their needs.
Adequate preparation in EMDR therapy involves much more than just doing one Calm Safe Place exercise. Although I train the skill in my program, I discuss its limitations, and it’s one of only many strategies that I teach. While the classic skills of Calm Safe Place (which often involves changing up the descriptive adjectives to meet the client’s needs), Light Stream and Container are still very useful, they can all be very visually biased if not modified. Furthermore, to truly help a client manage affect, tolerate distress and be prepared for what may arise during trauma reprocessing (Phases 3-6), we must explore other skills.
In our program, we teach a wide variety of mindfulness strategies in a trauma-focused way (i.e., allow for modifications, emphasize not just reading the skills out of the book, rather, having a personal practice yourself as a clinician and teach from that experience). Mindfulness strategies can include traditional sitting meditation, moving meditations, mindful exploration of the expressive arts, and learning how to turn all activities of daily living into chances to practice present-moment awareness. Teaching a client breathing strategies and body scanning skills in a trauma-focused way is also imperative. Existing skills or approaches that you utilize in other modalities like dialectical behavior therapy, 12-step facilitation, or yoga can all be very helpful in teaching principles of lifestyle change and grounding. In the spirit of true trauma-focused care, the needs will vary from client-to-client depending on their existing experience with such skills and the intricacies of their presentation. I’ve learned that the more complex the client, attending to preparation in this total matter is more helpful than any specialty protocol just slapped into the treatment process. You can visit a comprehensive library of these skills and watch how I use trauma-focused language in apply them by visiting the resource site Trauma Made Simple by clicking HERE.
And no, I cannot give you a script about how many of these skills you’ll need and in what dosage. That is where clinical judgment and having done your own personal work comes in to make you as effective as possible. Personal work with these skills is important so that you know what it means to modify and adapt skills for your optimal benefit, which puts you in a better position to do this with clients. While scripts can help us build our skills, a practice that most adult learners need and that I endorse, scripts can rarely help you apply them in the absence of practice and context. To intone the wisdom of Jennifer Emch, one of my program graduates and director of Ubuntu Wellness in Chardon, OH, “Life isn’t scripted and neither are people.”
In addition to understanding the imperative of trauma-focused and enhanced preparation in EMDR therapy, we must also consider as EMDR therapists that taking a chronological history is not the best way to go. Although I agree with Shapiro’s essential position that targeting the earliest memories first is ideal for getting to the root of any given problem, due to the nature of how complex traumatic memories are stored in the limbic brain, taking a chronological client history may be impossible. Or at very least, impractical. Most clients I’ve worked with over the years cannot track a chronology, have blanked out significant pieces of time, or get very tangential when we try to take a conventional history due to the disorganization in the limbic system. When I was trained many years ago I learned the 10 best memories and 10 worst memories method for taking client history, and I’ve also found this ineffective. The most effective approach to holistic client history taking I’ve found over the years, and the approach I teach in my program, is to discover potential targets thematically. Let’s use an addiction-specific example.
For many clients new to a recovery process, there is a willingness to do EMDR therapy reprocessing and yet there may be insufficient affect tolerance to go to the earliest instances of abuse or trauma. For optimizing engagement, you may be better suited to work with their goals for recovery first, while respecting the trauma history that led to the problem in the first place. Many individuals struggling to get better, regardless of their specific goals, carry a negative belief like, “I cannot deal with my feelings without alcohol (or other drugs/behaviors). That is a negative belief that can be “floated back” using questions like, “Thinking back over the course of your whole life, when is the first time you got the message that I cannot deal with my feelings without alcohol.” You can also ask the question for the worst or most recent. What you get from the client all represent potential areas that you can target. Might these targeting sequences link in to earlier, more impacting traumatic experiences? Of course. Yet targeting them this manner is, in my experience, a kinder, gentler way to go and helps them to see the relevant connection of the EMDR work to what may be their biggest issue of concern in therapy. To see some examples of how I conduct client history in a thematic way, please visit the video demonstrations section of the Institute for Creative Mindfulness website by clicking HERE.
One of the wisest pieces of direction I received in my rather traditional basic training many years ago is that the greater the degree of complexity in the case, the more level of interweave you will need. I feel that learning the principles of cognitive interweaves (as described by Shapiro in her texts and further elucidated by other great minds in the EMDR community) is essential to doing EMDR with addiction, dissociation, and other special situations that may throw you for a loop. Yes, the classic directive in EMDR therapy is to stay out of the way as much as possible. Yet I was delighted to see Shapiro (2018) use the phrase proactive measures so much in the third edition of her text. To me, solid interweaves work as a plunger of sorts. When the flow of reprocessing is clogged, we can apply good open-ended questions, gentle pieces of encouragement or psychoeducation, and mindful or somatic techniques to get the flow going again. Although I teach a list of common interweaves in my program and Shapiro offers some solid examples of them in her text, the best interweaves are the ones that you develop through constant practice of EMDR and working with consultation to hone your craft.
Sometimes we can get nervous talking to consultants or other EMDR therapists about modifications, fearing that we’ll get “called out” on deviating from protocol. Yet consider how all of these specialty protocols that we can get so excited about in the scripted books or special trainings are really just twists and turns on the standard protocol anyway. They are proactive measures. One final modification tip that I can offer from my clinical experience on working with complex issues like addiction and dissociation related to the part of the standard protocol where we are asked to get an image (or worst part) from the client. I’ve always liked the language of worst part because it recognizes that some memories, especially pre-verbal ones, may not be stored with an image. With folks who may not have sufficient affect tolerance to handle going to the “worst part,” yet who have done all they can with preparation skills, you may be better suited to ask, “What part of this target memory are you willing to work on today?” Then proceed with the standard protocol from there. This may make reprocessing more digestible for the client in the spirit of EMDR therapy Phase 2.5. Yes, you will likely have to go back later and check to see if there is an image or worst part in a separate targeting sequence in order to achieve completion of the target in a technical sense. Yet consider how this modification may be more tolerable for individuals.
If you are the type of adult learner who needs more of a scripted protocol to learn new information, that is more than okay. I know that as a trainer I could not survive without using scripts with my students. And yet there comes a point in your development as an EMDR clinician when you must realize that the scripts are just modifications. These specialty protocols we can all get excited about are just very necessary modifications. No, modification is not a dirty word as long as you are able to clinically justify why you are making the modification or, in the case of Phase 2 preparation, enhancements. Doing this well and in the most trauma-focused manner will eventually involve you moving away from scripts and other peoples’ protocols and working to hone your own clinical common sense.
Shapiro, F., & Forrest, M. (1997). EMDR: The breakthrough “eye movement” therapy for overcoming stress, anxiety, and trauma. New York: Basic Books.
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing therapy: Basic principles, protocols, and procedures, 3rd ed. New York: The Guilford Press.
Sometime in the sixth grade, I first heard philosopher Soren Kierkegaard’s wisdom, “Once you label me, you negate me.” I wish I could tell you that my exposure to this teaching happened while I was attending some kind of summer symposium for gifted children. But alas, I heard it folded into a joke by Mike Myers’ character Wayne Campbell in the 1992 comedy Wayne’s World. Because Wayne’s World is one of my favorite films and I watch it several times a year, I am often reminded of Kierkegaard’s teaching and am challenged to ponder its layers of meaning. As a woman in long-term recovery who works with others in recovery, and as an out bisexual woman who serves as an LGBT+ advocate, I often handle questions about what it means to label or be labeled versus what it me mean to define or identify. Moreover, discussions rage around me and within me about whether or not we place too much stock in identifying in a certain way or calling ourselves certain things. Do labels or identifiers help to advance recovery and advocacy, or do they keep us stuck in unhelpful pigeon holes? Do labels really negate us, and does it make it any better if we swap out label with the word identifier? And on a spiritual level, does the practice of labeling or identifying keep us cut off from the essence of our true nature?
Let’s begin by looking at the distinction between labeling and identifying, for exploring this distinction sets a foundation to answer these very important questions.
“I don’t like to label things,” is a line I’ve heard from many people around me, from wishy-washy people I’ve tried to date to employers who have been non-committal about issues like job descriptions, expectations, contracts, and titles. Just about every woman I’ve worked with or known has been hurt in some way by a potential partner saying they don’t want to put a label on something, when it is really just an excuse to buy time or not commit. Yet I have also experienced very deep friendships that can be hard to specifically label or define because the feelings and roles involved don’t fit into any kind of a neat box. And I’ve also accepted work gigs that seem to defy the gravity of definitions and labels. On any given day it’s hard to describe exactly what I “do.” In fact, it’s a bit of a running joke in my family as my brother has long asked me, “What do you do?,” and my stepson often asks, “So Jamie, how many jobs exactly do you have? I count nine.” In my view I only have one job, yet it’s composed of so many facets and segments I can understand where it would feel confusing to people who don’t get it.
So an argument to be made for labels is that in many contexts, they can keep people safe (especially in work settings and in certain interpersonal relationships) and minimize confusion. Labels can work very much like boundaries and expectations in this sense, so it may feel better to many to call it a definition. Yet we’ve all run into cases where once somebody gets labeled as something, especially in a binary context, it creates a limiting and maybe even discriminatory tone. In this day and age, we only have to look to how political affiliations have divided us to see how this plays out. Many Democrats don’t trust Republicans, especially if they find out they are supporter of President Trump, and immediately shut them down as people as a result. The opposite can also happen, as I know many people (especially those who knew me when I was younger and more traditionally religious) don’t want to hear what I have to say because I’m now rather liberal. The devil’s advocate response I’ve heard, especially from others in the LGBT+ community, is that knowing if someone voted for Trump or not is a sign, a mark that helps them know if they’re really safe with that person. Although I heavily relate to this sentiment and even experienced a great deal of it myself after the 2016 election, for me it is not that black-and-white.
The issue of labeling comes up quite a bit in the recovery and LGBT+ communities in which I live and work. My Trauma and the Twelve Steps work is brilliant to some because it is integrative. Yet my perspective confuses many because even though trauma-focused in my orientation, I still introduce myself in appropriate contexts as, “Hi! My name is Jamie, and I’m an alcoholic and addict in long term recovery.” For me, this is an identifier and not a label. And it is my choice to identify publicly in this way, which makes it very powerful for me. Saying this identifier out loud keeps me grounded in the reality of my story, and I take great pride in being able to introduce myself in this way. Where it can feel like a label, in a negative sense, is when people judge me by this identifier, or if I completely define myself by this identifier. For me, identifying opens up possibilities where labeling connotes being limited by the way in which I identify (or by the way others try to identify or label me).
I recently put the question out to my hivemind on social media and there seemed to be a general consensus that identifying has a much more positive connotation in the English language than labeling. Another common theme is that labeling is more likely to come from without whereas identifying is something that is very personal to the individual doing the identifying—it comes with within. Skeptics or critics may roll their eyes at me when I say things like, “I am an openly bisexual woman in long-term recovery from addiction and dissociation.”
More PC bull crap. Why does everyone need to label themselves? Or be special?
I offer this response: Being open an honest about these things has allowed me to heal and be able to say and claim other parts of my identify like I am a deeply spiritual person, proud of my Eastern European ancestry, and I live each day to the fullest, enjoying life as much as I can and helping and serving others who my Higher Power sees fit to put into my path. I am a yogi, a seeker, a lover, a mystic, a sister, a daughter, a surrogate mother, a friend, a teacher, and author, a guide, a movie lover, an expressive artist… Shall I go on?
I can celebrate the fullness of my human identity because I’ve learned to be honest about my story and what it has meant to shaping my identity. Robert Ackerman, the teacher and recovery writer, said in a 2015 talk: “You cannot expect yourself to become a fully functioning individual (physically, emotionally, spiritually) if you deny a part of yourself. The key is integrating all of who you are.” I felt like he was talking directly to me, and in the months following this message circumstances allowed me to come out fully (not just to my close friends and colleagues) about my bisexual identity. Doing so was a game changer not just for my mental health, but for feeling more authentic and genuine in my professional work. I feel now that no one can label me, and if they do so pejoratively, it’s lost any power to affect me.
The yogic perspectives and teachings from other spiritual paths may offer a slightly different angle to the challenge. Teachers I’ve studied with contend, “As soon as you say I am…, then you are limiting yourself. Because you are really your soul and the pureness of consciousness.” In fact, in many yoga settings, it’s common to introduce yourself by saying, “I’m called Pragya,” instead of “I am Pragya.” Even saying things like “I am anxious” can be discouraged because you are identifying yourself with your anxiety.” It may be preferred to say “I have anxiety.”
Ever the bridge builder, my feelings are that both perspectives are true. I know that when I look at the bigger picture and my Divine essence, it is very limiting to label or to identifying myself in any way. Who I really am exists at a soul level that cannot be damaged or affected by anything on this plane. Yet I also live on the human plane for the time being and to know who I am in this body, a knowing that is empowered by the ways in which I identify, helps me to thrive while I’m here. Knowing the communities to which I belong and where I stand in work or relational contexts is important. Important, yes; everything, no. Like many answers to existential questions answered through the yogic perspective, the key is to not be attached. Freeing myself from the grip of attachment—to outcome, to definitions, to identifiers, to labels, to anything is the key to health and happiness. And this detachment I practice while also being honest about what matters to me is what allows me to be fully human and fully Divine, dancing as One between the worlds.
As a trauma and addiction clinician and a person in long-term recovery from my addictions, I recognize my, and the clients I serve, need to answer the question “what is addiction?” I find that most people struggle with making sense of addiction initially because it is often paradoxical but when I share my perspective on addiction, people readily and agreeably understand. So, this led me to the question of “Can Addiction be Made Simple?” In my quest to answer this rather large question for myself, (before heeding Dr. Jamie Marich’s warning in her chapter “The Addiction Imperative” from Trauma Made Simple (2014) that she has seen many people go down as a result of chasing this answer), I found that simplifying addiction through philosophical understandings and reframing the psychological symptoms of addiction through a trauma-informed perspective offered the answer that addiction is a series of stuck memories i.e., trauma. As a result of this finding, it is clear to me that addiction and trauma are inseparable because they are a part of the same process.
As I began to better understand trauma and how the memory systems work in the brain and mind, I saw addiction present itself in a way that was relatable. I believe the journey I took to answer this question and the conclusions I have drawn will help others define addiction for themselves but also provide insight into how we conceptualize, categorize, and diagnose mental health disorders.
From a philosophical point of view, the question of “what is addiction?” revisits the age-old question, “Is the essence of human nature good or bad?” In the ever-telling pursuit of truth, the answer lies in the journey as the philosopher sits patiently and waits to have you quantify two extremes. “Who is asking the question?” the philosopher asks while waiting to observe a spark of enlightenment. Any two extremes exist in contrast to one another; hence they are a part of the same process. For example, night and day are relative to the observer and the truth of the answer lies in timing of the question. Pain and pleasure, an obvious example of opposites, are understood by reference to one another. This is illustrated in the Taoist concept of Mutual Arising and the Buddhist concept of Dependent Origination (Watts, 1975). Both of these concepts imply that you cannot have one without the other - if one ceases to exist, so does the other i.e., existence and non-existence must co-exist.
Here we enter into the paradox of addiction. What feels good is actually bad. The addicted person’s “choice” to pursue a course of action that is ultimately harmful isn’t logical! The person who is addicted and the outside observer understand addiction from different perspectives. Both understandings are right since the context of each perspective is important for shaping the ways in which we come to define, know, and treat addiction: The person who is in an addicted state is much more feeling or emotionally oriented, while the outside observer is more focused on the illogical nature of the outcomes. These are often the result of short-term vs. long-term thinking, hence adding to the dualistic nature of opposites.
Addiction’s Paradox in the Brain
These two perspectives come from different sides of the brain. The left side of the brain houses logical processes that use verbal language and the right brain houses emotional processes that use non-verbal communication (Siegel & Bryson, 2011). The different sides of the brain speak two different languages and represent the argument of “choice or disease.” The choice argument, associated with the logical or left side of the brain, is correct in saying that there is a choice in any behavior. But I had to ask myself, where does the brain get the information to make those choices? The answer lies in memory systems, which include our unconscious reptilian brain. The reptilian brain has one mode and primary function: survive by any means necessary and is only interested in short-term outcomes. Survival needs include staying alive in dangerous situations (pain) as well as ensuring that procreation happens (pleasure). The fact that pleasure is a survival need means that pleasure is a main motivator for addictive behaviors.
Survival mode fluctuates due to environmental stresses and stimuli, but also it is not alone in processing information. There are higher levels of brain functioning like decision-making processes that take place in the neo-cortex and mid-brain and with which the survival brain must communicate. However, when the survival brain is activated, it dominates the higher levels of functioning by controlling the information through regulation of the blood flow in preparation for fight, flight, freeze, or appease when a perceived danger or opportunity for pleasure is present. So, the innate drive to survive is what informs our decision-making process or “choice”, particularly when confronted with danger or our need to satiate with pleasure to ensure procreation.
So what are the physical and psychological symptoms of addiction (pleasure)? Intrusive reminders, dreams about the experience, mood irregularities based on whether or not the pleasurable experience is going to happen, strong emotions related to everything, and distorted beliefs about anything and everything… “Wait a moment, trauma, is that you? It is like I am looking in the mirror and it is me but not me.” “Yes. It is me, trauma. I have been hiding in addictive behaviors.” So, trauma and addiction are a part of the same process and that is why I say that addiction is trauma (in its positive form and relative to the observer). Conversely, I can also say that trauma is addiction but will have to save that twist until the end.
In order to see how addiction is traumatic, we have to see beyond the idea that addiction is a choice (which ultimately implies fault and produces the stigma of addiction) and the disease argument. These are not the only options. If we attempt to observe addictive behavior without the “addiction is a choice or disease” framework, what is happening? The body is being injected with poison, smoke is in the lungs, neurological systems are being physically stressed by being overloaded and flooded with neurotransmitters, or one is drowning oneself with something flammable – the survival of the organism is being threatened and it likes it. The body remembers experiences like chicken pox or environmental toxins because it might have to defend itself again, just like it remembers the addictive behavior and the effects of the behavior as means of survival. In this sense the body is practical and functional in performing this neutral action and as Deb Dana (2018) points out, the autonomic nervous system does not calculate “good or bad” it just performs its obligation to survival. With respect to understanding addiction as a disease, we must see how addiction behaviors produce trauma in the organism and create traumatic memory. At a symptoms level, active addiction is more reflective of Acute Stress Disorder (ASD) or Post-Traumatic Stress (PTSD), which boils down to unresolved traumatic memories (Shapiro; 2001, ver der Kolk, 2014; Ecker, Ticic, & Hulley, 2012).
Body and mind meet when memory is formed or accessed. Both the body and the mind access memories to guide their decision-making process and when these experiences are referenced; this is what informs the decision-making process. There are different types of memory and they perform different tasks with different responsibilities to help us get through the day. What in our understanding is not based on memory? Genetics, language, and the entire universe are all series of events, remembrances, and links in a chain connecting the present moment to the past. Both trauma and addiction create stress in the body and mind. Positive stress is still stress. Biological symptoms of addiction speak to withdrawal, cravings, and triggers but these can be understood as physical manifestations of PTSD symptoms because bodily operations and responses are a form of memory. Yet if there is a disconnect between the higher and lower functioning’s of the brain or the lateral exchange of logical and emotional content then there is going to be dysfunction. So, fundamentally addiction should be understood as a manifestation of PTSD. Moreover, Addiction and trauma can be understood as two poles on the spectrum of dissociation
Dissociation is the Relationship Between Addiction and Trauma
Van der Hart, Nijenhuis, and Steele (2006) cite Pierre Janet’s early observations from 1887 that dissociation is a “division of the personality or of consciousness” and that these include “systems of ideas and functions that constitute personality (2006).” In essence, dissociation is the process of disconnecting from the conscious or present moment due to a stress and acts as a defense mechanism for the “personality.” Both addictive behaviors and occurrences of trauma induce dissociation due to the impact on the state of consciousness that occurs during the response or act. The types of events and frequency ranges from a single incident to way too many to count, so they can be seen as on a spectrum as well. Ross (2013) sees PTSD as on a dissociation spectrum but does not identify addiction as on the spectrum of trauma-related dissociation. Yet Ross and others miss the point that the body is neutral when a toxin, which creates a trauma, invades the body, mind, and memory system. To include addiction on this spectrum, even if it is induced-dissociation (which I think that there is more to it then just that), means that we have a fuller picture of our pathology and of human behaviors like self-harm, sexualized behaviors, all forms of abuse, dependent issues, obsessive-compulsion, suicidal ideation, eating disorders, perfectionism, entitlement, abuses of power, and personality disorders.
I propose, as Ross suggests (2013), that trauma is really on a dissociative spectrum but I would also like to include addiction-induced dissociation because the impact is similar on the psyche i.e., Dr. Jekyll and Mr. Hyde as different aspects or parts of the personality emerge when under the influence. All addictive behaviors mimic existing states in the body and mind (Inaba & Cohen, 2007) and so dissociative states are going to be produced in addictive behaviors. This is why I believe that we should be focusing on trauma and dissociation when understanding, treating, or making addiction simple enough to understand.
Traumatology has provided a roadmap for categorizing mental health disorders. I feel that a better understanding addiction would lead to a similar understanding, i.e. would create more space for trans-diagnostic treatments. Over the past two decades, Traumatology and Trauma-Informed Care has greatly increased our understanding of trauma but has not identified one core ingredient as its cause. We still must ask, under what conditions do most traumas occur? I would suggest that our addictions (being in a state of trying to satiate unmet survival needs via harmful behaviors) are an answer to that question. Here we can see the intimate relationship between trauma and addiction, wherein addiction is a function of trauma, and the core ingredient of trauma can be understood in terms of addiction. This is why our human drama unfolds the way it does. We become addicted to our stories and our stories become addicting and create the traumas from which we can heal. At its core, our addictions are wants labeled as needs. The results of trying to get our mislabeled needs met, we creates trauma. Our addictions are traumatizing to society and culture and represent a major disconnection between our logical and our emotional world.
To make addiction simple, we simply need to look at it as if it were a trauma because they are a part of the same process. To redefine addiction in this light we see that it is the relationship between trauma and addiction that needs to be defined and determined whether or not it is healthy for ourselves. When we define addiction accurately and categorize it appropriately we find that it is traumatic and produce ASD/PTSD symptoms and dissociation. Luckily we have effective treatments for addressing both, we just need more clinicians experienced in treating all three.
Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. New York, NY: W.W. Norton & Company.
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. New York, NY: Routledge.
Inaba, D., & Cohen, W. (2007). Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs. Sixth Edition, Medford, OR: CNS Publications, Inc.
Lanius, U., Paulsen, S., & Corrigan, F. (2014). Neurobiology and treatment of traumatic dissociation: Toward an embodied self. New York, NY: Springer Publishing Company.
Marich, J. (2014). Trauma made simple: Competencies in assessment, treatment and working with survivors. Eau Claire, WI: Pesi Publishing & Media.
Ross, C. (2013). Structural dissociation: A proposed modification of the theory. Richardson, TX: Manitou Communications, Inc.
Siegel, D., & Bryson, T. P. (2011). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing mind. New York, NY: Bantam Books Trade Paperbacks.
Shapiro, F. (2001). Eye movement desensitization and reprocessing (EMDR): Basic principles, protocols, and procedures. New York, NY: Guilford Press.
Watts, A. (1975). Tao: The watercourse way. New York, NY: Pantheon Book.
Adam O'Brien LMHC, CASAC (EMDRIA Approved Consultant through ICM) - is a Licensed Mental Health Counselor and Credentialed Alcohol and Substance Abuse Counselor in New York State. He is in the certification process to become a Certified Expressive Arts Therapist with Dr. Jamie Marich. Located in Chatham (Albany/Hudson area) where he maintains a private practice. In his writings, he is actively seeking to destroy the stigma of addiction.
One of the great blessings of my life is to have a Jewish mother and a Jewish family in Squirrel Hill. When I heard the news of last week’s massacre at Tree of Life Synagogue in Squirrel Hill (the hub of Jewish life in Pittsburgh, Pennsylvania), I was in Montana leading a clinical training in EMDR therapy, the trauma modality that brought Sharon Saul—my Jewish mother—and I together. Although the news revealed to me that the synagogue attacked was not Sharon’s, it is in close proximity to her home in a community that is very tightly knit. Until I was able to get to Squirrel Hill myself on Tuesday morning and give Sharon a hug, something was unsettled within me. Although Sharon and I remained in touch via text and telephone after she turned hers back on following Shabbat, seeing her was the balm my soul needed. In our communications, she relayed the multiple messages defining the vigils and prayers she attended: The answer to combating all of this hatred is to fight the darkness with light, and to increase our acts of goodness and kindness.
The connection that Sharon and I share is an example of how two very different people can unite in a spirit of goodness and kindness, which is why I feel led (with Sharon’s blessing) to share our story. On Thursday night we sat in her home, a place that's become a haven to me over the years when I offer trainings in Squirrel Hill (about an hour and a half from my home base in Ohio). We were both awestruck by the workings of HaShem in bringing us together. HaShem is a Hebrew name for G-d (literally meaning "The Name") that I’ve come to use in many of my references to Divine presence. Our friendship is, of course, a beautiful Institute for Creative Mindfulness story which is why I’m posting it on our blog. I hope others may also draw some inspiration from our message and our story.
I first met Sharon in Monroeville, Pennsylvania sometime in 2013. I was still working the national circuit for PESI, an educational company, teaching general trainings on trauma-informed care. In this 2-day course, presenting a live clinical demonstration in eye movement desensitization and reprocessing (EMDR), my method of choice for treating trauma-related concerns, was part of the syllabus. As I did dozens of times before and have done hundreds of time since in my teaching, I asked for a willing volunteer for the demonstration, inviting them to come up and see me over break for screening. This lovely, traditionally dressed woman raised her hand immediately. During our screening, as we talked about her background and the issue she’d like to work on, Sharon revealed that she is an Orthodox Jew. Although she seemed to be connecting to what I taught in the course, I experienced a bit of an internal struggle, wondering if someone so traditional would respond to what I had to offer. I’d long identified as rainbow flag-waving tattooed rebel dismissive of most things connected to organized religion or anything traditional. Yet something inside told me immediately that I loved this woman and her willingness, and I was delighted when Sharon responded so well to her work in the demonstration.
Afterwards, in amazement, Sharon declared, “I have to learn this!”
She went on to explain her frustration that every EMDR training she ever found took place over the weekend which would not work for her as an Orthodox Jew. Specifically, Sharon is a Hassidic Jew in the Chabad-Lubavitch movement with a strict adherence to Shabbat observance. Training over a weekend just wasn’t an option for her, even though other folks from religious traditions have missed weekend services before to come to trainings. Sharon began traveling to Ohio to learn from me as I developed my initial training models and ideas around teaching EMDR therapy, expressing only gratitude that she was able to engage in this study during the week and in a mindfully delivered, intuitive way that matched up with her almost forty years of experience as a hypnotherapist. The more she studied and consulted with me, the more I began to trust her as a clinician and to truly love her as a person. The questions she asked helped me to grow as a clinician, and I developed an even deeper sense of wonder about Jewish faith and traditions.
In 2015 when I became officially approved by the EMDR International Association to offer basic trainings in EMDR therapy, Sharon immediately courted me to come to Squirrel Hill where she practiced and lived. She said something like, “I can get you every Orthodox therapist in Pittsburgh to come to the training if you can offer it during the week.”
When one of Sharon’s colleagues first met me, I got the once over, punctuated with the commentary of, “You’re the Jamie, Sharon’s teacher? You’re so young!”
Although I’ve gotten my fair share of the “you’re so young,” comments throughout my career, this one did not impact me with any insult. Rather, it helped me to understand why I respect Sharon so much. She is constantly willing to learn something new, especially from those of us in the younger generations. I watch how her grandchildren teach her new ways of seeing the world, and I hope that I can emulate this spirit of hers to constantly be a learner as I grow up into the example she is setting. And although I started as her teacher, it’s safe to say that we have both been each others’ teachers as our friendship has grown.
Coming to Squirrel Hill to train was a good fit for all of us—for Sharon’s community of clinicians in the neighborhood and for the growing Institute for Creative Mindfulness wanting to establish a base in Pittsburgh. When I visited Squirrel Hill for the first time, some tears filled my eyes. There are moments here when I feel like I’m in Eastern Europe, where I spent a great deal of late teens and early twenties studying and working, primarily in my ancestral homelands of Croatia and Bosnia. There’s just something about the vibe of Squirrel Hill and its Jewish soul, beautifully blended with other cultural influences in the container of Pittsburgh, its own cultural wonder, the visceral epicenter of our region’s heartiness. Something magical happens here at this area around the intersection of Forbes and Murray Avenues. In the past three years I’ve adored working with the people of Squirrel Hill and I enjoy spending time here with both friends and Sharon’s family. Sharon has always taken great care to assure that a guest bedroom in her home that is set up to accommodate her large family for holidays is always ready for me when I come to town. I typically stay in one of the basement guest rooms and sleeping down there feels like I’m in a warm cave being blanketed by an entire house that’s full of tradition and love. I’ve said for several years now that Squirrel Hill is truly my second home.
Sharon has seven children and a slew of grandchildren (I can never keep count). I’ve had the privilege to get to know many of them and their spouses, including one of her sons who is now a budding therapist and has trained with me. I attended the wedding of her youngest son and considered it the greatest honor ever when Sharon began caring for me in a way that led her to declare, “I’m sorry, I can’t turn off the Jewish mother in me.” The first time is when we were leaving her house in Squirrel Hill—it was a rainy morning and we were crossing the street to my parked car, on our way to the training site. A car came unexpectedly whizzing down her street and she brought out the infamous “mom arm” to protect me. Later that year, Sharon and I roomed together at the EMDR International Association conference in Minneapolis. While I’ve enjoyed a wide array of roommate experiences as I’ve traveled for work over the years, Sharon’s attention to detail in making sure I didn’t forget things and that I had a sounding board for things going on at the conference warmed my heart. She once again said something like, “I can’t turn off the Jewish mother,” and I thought to myself, “Nor do I want you to.”
My entire life I’ve struggled with feeling accepted by the people closest to me, especially in my family of origin, because my beliefs and way of being in the world is so different from their traditional (Christian) views. Sharon’s acceptance of me, even as a religious woman, includes a full embrace of my soul and my questions, even when we disagree on certain approaches to life, faith, and identity. While I wish that more devout people from all faith traditions would learn from Sharon’s example of acceptance, knowing her gives me hope that the healing power of what St. Benedict called radical hospitality is possible. Sharon’s willingness to bring me around her family and feel the warmth of their friendliness and the candidness of their interactions with me—even though they are all religious and I am more of a liberal hippie, “spiritual but not religious” type makes me know in my bones that we all have more in common than not. Knowing Sharon Saul and having her as my Jewish Ima (mother) is nothing less than a corrective experience in attachment. And it’s restored my faith that getting to spend substantial time with people from faiths and cultures other than our own is a big part of the answer to bringing about the healing of the world.
So, it’s little wonder that I wanted Sharon to join our Institute for Creative Mindfulness team as both a consultant and a facilitator as soon as she was eligible. In the midst of this Squirrel Hill tragedy she referred to EMDR therapy as “God’s tool for healing,” and I cannot disagree! She is a fabulous educator and mentor and serves our EMDR trainees well. Sharon is responsible for building enthusiasm about EMDR therapy in Squirrel Hill, working very hard to find us good spaces to train during the week. So many of the therapists we have trained here are now on the front lines of working with the community this week and will be in the coming weeks as the people of this neighborhood seek answers and healing.
But even if Sharon didn’t work with me in this professional capacity, I would still want her to me my friend… and of course, my Jewish mother. Even in the midst of debriefing her own experience of this week’s tragedy with me, Sharon still offered me spiritually on point advice about my own love life and my career path, as any attuned mother would. As we sat together the other night in our moment of awe at the Divine dance that brought our lives together, it dawned on me that a friendship like ours and everything it represents is the answer to the madness in which we find ourselves in this modern world. This isn’t something, even as a writer, that I can put elegant syllables together to explain. I simply challenge you to experience it if HaShem ever gives you the chance, because HaShem will.
In her infinite, faith-filled, maternal wisdom Sharon declared, “HaShem, you have a view of the bigger picture. I trust you when I can only see the parts of that bigger tapestry.”
Sharon and I both had the opportunity to do trauma response work this week in Squirrel Hill and were amazed at how this tragedy is bringing other things to the surface for people that have long needed healed. This poses, once more, the age old question: Is tragedy’s hidden gift the sparking potential it holds to stir us into action, first within ourselves and then in our communities? The idea of changing the world can feel overwhelming and impossible, especially with the hopelessness and hatred that seemingly paralyzes our existence. Perhaps the real answer is to heal ourselves and then make a difference on a one-on-one relational level, as Sharon and I have done with each other. When the small pearls of these healings and interactions string together, we create a valuable and beautiful force that will transform the world.
After working together today at the Jewish Community Center here in Squirrel Hill Sharon continued with her teaching for me that began the night before on the importance of the bigger picture: “It just feels like the redemption really is at hand and all of us good people doing all the good we can and all the healing we can it’s our job to just tip it. It feels like we’re almost, almost, almost there.”
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.