​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

The response to COVID-19 is unlike anything I’ve witnessed in my forty years on this planet. Seeing so many events and yes, even whole sporting seasons being suspended, has me wondering if I’m living in some kind of twilight zone. Or in one of the apocalyptic movies that I love so much. While I appreciate the arguments I’ve read about mitigating risk and slowing the spread of the potentially deadly virus, my mixed emotions about everything are boiling over, prompting me to write this piece and share something I want to scream from the rooftops. Why don’t you care this much about risk and contamination when it comes to trauma?

There is so much rhetoric out there, much of it legitimate, about putting the vulnerable at risk by exposing them to the virus. Even though I’ve soldiered on to finish some planned events this week, a concern exists over how people may judge me for potentially putting others at risk. Where is this same level of concern in a country and indeed a world where violence against women and children is the most brutal pandemic of them all? What about the endless stream of brutality and invalidation that developmentally vulnerable children can be exposed to on a daily basis from parents, other family members, teachers or peers? And have you ever stopped to consider the systemic injustices that the poor, underprivileged, and underrepresented minorities in our society have to battle consistently? All of these are a short list of risk factors living in our midst every day that, if left untreated, will tragically blossom into complex post-traumatic stress disorder, addictions, “personality disorders,” dissociative disorders, and cause or complicate a whole host of other physical health conditions like heart disease, hypertension fibromyalgia, or cancer. Read the Adverse Childhood Experiences study and the public health initiatives from that study for a primer if you don’t believe me.

The heart of my teaching as an author and clinical specialist in traumatic stress disorders is that to truly understand the human phenomenon of unhealed trauma and how to treat it, you must break down the word origin. The English word trauma is a direct translation from the Greek word meaning wound. My working definition of trauma is any unhealed wound. You can check out my TEDx talk on the trauma as wound metaphor from 2015 on YouTube for the full teaching. Here are the highlights: understanding how physical wounding, illness, and injury works is the key to understanding all other kinds of trauma—emotional, sexual, spiritual, etc. Think of everything you know about physical wounds. They come in all shapes and sizes. Some may require more urgent care than others or they can be fatal. Whether you are talking about a scrape or a gunshot wound, all wounds need care. Sometimes that care is to wash it out and then give it time and space to breathe, and other times the care needs to be professional. Of course, people with compromised immune systems or other health problems are naturally more vulnerable and professional care may be imperative.

Wounds generally need treated from the outside-in to stabilize, although true healing occurs from the inside-out, over time. Check out the talk if you want even more of the metaphorical parallels between physical and emotional wounding; believe me, I can’t shut up about them. A major point to highlight is that it can feel easier to deal with a physical injury or illness, especially one that is visible like a broken leg or an audible cough. Because they are visible in the realm of the five senses, they are more likely to be validated by others as problematic. And if the risk of a more immediate fatality looms, the concern is generally worse. I argue that this is due to humankind’s overall fear of death and dying, but there’s not enough room in this blog to even begin to go there. Maybe the next one…

Yet if wounds are unseen, like the kind we experience in our hearts, through our emotions, and in our souls, we are more likely to get told things like “get over it,” or “pick yourself up by the bootstraps.” Or my favorite: “You’re triggered all the time! Enough already.” Usually it’s the people who complain about our triggering that are the ones who have done some, if not most of the wounding. Let me be clear—we’ve all hurt other people and we’ve all been hurt by other people. The severity of some wounds may require professional intervention, just like with physical wounding, while other wounds may simply need a little space, time, and tender loving care from another human being like a friend or confidant in order to heal. Having an awareness of how we are wounded and how we’ve wounded others is the key to understanding the risk of contaminating others with the blood of our own unhealed trauma. Hopefully this awareness can inspire willingness to proactively heal ourselves so that we do not contaminate others with our words, actions, behaviors, and the sordid fruit of our own unhealed wounds. Because it is often those we love—our partners, our children, other members of our family, and our friends—that we can harm the most. Until that widespread awareness happens, perhaps we can at least do less harm. In physical healthcare there is a greater sense of awareness that safety measures must be taken to minimize the spread of bodily fluids and pathogens in order to prevent disease. When we heal ourselves emotionally, we engage in similar prevention and initiative for mental health…see the parallel?

There’s another angle for me to share this week, this one much more personal. Like many in the clinical professions, my own struggles with trauma, mental illness, and addiction led me to this work. In recent years I’ve been much more public about my seventeen year journey in recovery from addictions, a dissociative disorder, and bouts of persistent depressive disorder (formerly called dysthymia). Due to reasons having nothing to do with the Corona virus, the last three months have been hell. I’m struggling to date again after an adulthood filled with poor romantic relationship choices resulting from the impact of childhood and adolescent trauma. Just before Christmas, one of my best friends died by suicide and I’m still dealing with a flurry of emotions stemming from his loss. And the mounting pressure of growing a business and becoming a more public figure in my field, I have to admit, is getting to me. I am privileged to have access to the best possible mental health care. I have the most kickass recovery support system in the world, an inner circle of friends that would walk through the fire for me or with me, a daily wellness practice, grounded spirituality, and a solid commitment to self-care. Yet the sheer volume of work and travel, coupled with a growing disconnect from relationships I value, is causing a level of exhaustion unlike anything I’ve ever experienced.

Two weeks ago, I experienced my first significant suicidal impulse in years and earlier this week, it flared up again. There are plenty of factors that keep me protected, yet the reality is that I just want off the fucking merry-go-round. Exhaustion was the main culprit, coupled with a persistent conflict I’ve been feeling over having such success in my professional life while still struggling with interpersonal relationships and my inner world. I hate that the more honest I can get about my suffering, the better that I teach. People draw strength from it, and it can also make me feel like all I was put on this earth for is to teach and to help others. I struggle knowing that so many people see me as someone who inspires them when I still feel like such a train wreck who has been having trouble getting out of bed in the morning on more days than not. On the day of the second major bout, I told my manager and friend that when I meditated and listened to my body, the one word that came up was, “Rest.” I had this overwhelming sense that my body needed a good few weeks to rest and reset herself, in the larger scope of reevaluation I’ve been conducting about my life, my work, and how I spend my time.

Of course, Dr. Jamie the public figure was hesitant to cancel anything—I have commitments and a reputation and a business! Although I have taken time off for my mental health in the past, I feel like I’m in a whole new territory now regarding my schedule and how many people rely on me. I’m not proud to admit this, but I actually said to my manager, “Maybe if I get this Coronavirus thing, I would actually get some rest and nobody would question it.” That was a wakeup call. And when widespread suspensions forced me to cancel my upcoming teaching tour of the UK and Ireland, it was even more of a wakeup call for me that I wasn’t really disappointed. I adore traveling and teaching abroad. And yet my body, mind, and soul needs the rest more. I’ve been granted it due to the risk and contamination precautions around a physical virus, and yes, I feel less guilty taking the time because of this physical manifestation of a disease and its implications for spreading. Yet would people in my work world—the people who book me, the people who come to my trainings, the people who depend on me in my life—have been as compassionate if I needed to rest citing a preventative mental health concern?     

Maybe yes, maybe no.

The bigger problems is that me—Jamie—wasn’t even compassionate enough with herself.

Could this be the result of some healing in me that I still have to let happen? Of course. Yet I also believe it’s the result of societal conditioning that none of us are immune to—this idea that physical health care will always take precedence over mental health care. That the medical model trumps the holistic model. And that what shows up in, on, or through our physical bodies and appearances is more important than what is inside.

Enough of this already.

Let’s connect in a way that honors the physical in a healthy way, yet values that who we really are as people is so much more.

The healing power of human connection rests at the center of my work, and this week I’ve been given multiple personal reminders about how this power is where our hope rests. Nothing is more important to me than human connection, and I want to reestablish this primacy before the endless grind of touring and “being public” makes me resent it. My manager and long-time friend Mary, my best friend Allie, and countless other people in my kickass support village have breathed me back to life this week. Whether in person, on the phone, or even through the sometimes cold medium of text, my people were there for me and I am grateful beyond measure for their time and their love. Allie, who lost her own father to suicide, reminded me that in order to get through this I would have to be fully honest about what I am feeling, especially with the inner circle. I teach this stuff all the time! It’s not lost on me that the teacher can be the most likely to forget, especially when she’s flirting with burnout. In those moments, the healing power of friendship and being rigorously vulnerable helped me to hear my own lesson.

I wasn’t expecting to share this vulnerably with my readership this soon, and yet here it is. With the healing power of human connection a potential casualty on the COVID-19 chopping block, a reminder is in order. If my story as its unfolding this week has done this in some small way, I’m truly glad I shared it.        

After 30 years of working in the field of behavioral health in various capacities, I’m owning the fact that I have dealt with vicarious trauma and PTSD related issues for many years.  While I can joke and discount many of the encounters I’ve had through the years as “part of the job,” I wasn’t counting on was the physical and emotional toll the job really had on me.  Had I heard some of these stories from others, I wouldn’t hesitate to be concerned at the symptoms and events; but for me, I could handle anything.  After a while, I had to discard my cape and realize I was not a superhero with powers to deflect the toxins that had been thrown my way.  As much as I dove in and stayed in the trenches to help people overcome their disturbances, I had to pull myself out of those same trenches to find my own healing. 
 
So, what is vicarious trauma, clinician burnout, compassion fatigue?  Vicarious trauma occurs when we have been exposed to, experienced, witnessed, or listened to other’s experiences of traumatic material, usually over a period of time.  When someone shares their traumatic stories with us in such a way that we can visually experience it with them, we are at risk of activating our own trauma responses.  This leads to what some refer to as “burnout”, but what I call vicarious trauma.  It is being personally traumatized through the eyes of someone else.  Vicarious trauma has a host of signs and symptoms, such as disconnection and/or depersonalization, lack of energy, social withdrawal or isolation, cynicism, despair and hopelessness, sleep and appetite disturbances, disrupted frame of reference, such as an inability to trust our own decisions, minimization, hyper-vigilance, self-loathing, emotional numbness, feeling overwhelmed, intense rage or bouts of crying, anxiety, nightmares, resentments towards others, including clients, feeling unsafe, poor self-care, concentration problems, and feelings of being on an emotional rollercoaster.   This list could go on and sounds in large part like the symptoms of Post-Traumatic Stress Disorder.  They are indeed trauma reactions, even if we did not directly witness the trauma, and have been a large piece of my life for quite a while now.  I’ve worked to gain an understanding of my own vicarious trauma reactions and feel lead to share this with others.  We are not “burned out clinicians” who need to retire; on the contrary, we are wounded healers who understand some things so intensely. Our clients are actually in the best hands they can be in, when we are well ourselves.   
 
When the whole of your work is to help others bear the weight of their souls, the pressure of their pasts, and the anguish of their current situations, it bears on us in a profound way.  We dissociate from our emotions just enough to show compassions and empathy but be still able to cut off from those feelings in order to help clients heal.  We may find ourselves subject to this pendulating force regardless of the situation, including in our own personal lives.
 
I have come to believe in the practice of self-care. For me, it’s more than just compassion and healing – it’s survival.  When I am in a spiral of negative cause and effects related to the vicarious trauma I’ve witnessed, the replay of my own demons, or a combination of the dark side of the world in which we live, I have to have the escape, the outlet, the life that still exists.  Expressions of art, music, prose, or meaningful conversations help me to share that emotional wound.  When I write, my soul unburdens itself without fear of judgement, accusations, or denial.  What I have inside me needs to be expressed from a place of non-judgement or I will not allow it to purge, and, not purging those feelings is disastrous.  It can mean the shutting down of emotional regulation, the disregard for others and myself in a variety of areas, and a general sense of mistrust with the world around me.  I need to have light in the times of darkness, for if the cold dampness is allowed to fester, the beauty within is left to ruin.  Expression is my escape from the center of my mind which I so desperately need at times.  Without the escape, I become tainted and ineffective as a clinician and as a person. And so, my hope in writing about this is that this act of self-expression and owning my experiences with vicarious trauma will help others find an outlet to express their own feelings and experiences.  What is left alone too long no longer serves any purpose, except to destroy. 
 
And so, this writing comes from a state of necessity.  I am now noticing that the depth of the pain of what I hear all day has had a tremendous effect on me over the course of 30 years, and I’m sure other clinicians feel this way as well.  By sharing this experience, I hope we are all able to find the core piece of ourselves that was what started our paths on this journey again.  The times of wanting to cancel clients and take the day off, sleep disturbances, experiences with hyper-vigilance and intrusive thoughts were creeping in again like a familiar, but terrifying, old friend.  The ghosts of those past mentors, clients, clinicians, and eras had been overtaking each other until I no longer heard the words which needed now be spoken, to me or others.  When I can no longer distinguish between clinical appropriateness, my own bias, therapeutic boundaries, and personal fears, it’s time to pull back the reigns and allow some healing to occur.  So, as I offer these perspectives to my colleagues, I should also note how very personal this is for me.  My life’s work in the field of behavioral health has taken different avenues, but I have never lost my desire to be a guide to those who may need a light.  By shedding light on this issue, I hope to find my own light source again in a way that it no longer burns down quite so far. This is how I make amends with my own past mistakes and come to a place of true trauma-informed care, that starts, inevitably, with me. 

They’re doing it for the attention.
It’s a refrain uttered everywhere, as people attempt to explain why troubled adults, adolescents, and children behave the way they do. Overused and indiscriminately applied, doing it for the attention has bothered me since I was a trainee in child psychology. Surely, humans do what they do for a wide range of reasons. And if someone is crying out for attention, don’t they deserve—need—us to notice? To attend?

Instead, seeking attention from others is all too often reviled. It’s dismissed as indulgent, considered a reward for undesirable behavior, a reinforcement of disavowed emotion. So, we stop being curious about others’ internal experiences — disconnecting from what they know, feel, need, want, fear — and, necessarily, we disconnect from our own. Rather than noticing, bringing attention to what’s happening inside no matter how confusing or intense or messy, we learn to turn our attention away. We numb, avoid, put aside. It feels safer to stop noticing. If we don’t give it attention, we can make it disappear or pretend it’s not real.

Not so in the process of EMDR therapy. There, the words, “Just notice,” are the foundational guideposts.

“Just notice,” we therapists say. “Let whatever happens, happen.” We may repeat this mantra countless times a day-- a reflex woven into procedural memory as we support clients dealing with trauma.

Just notice? The mother wonders, just notice what?, as she stands over the warming bed of her two-pound baby in the NICU. She tries desperately, silently, to notice what the nurse is showing her about her newborn baby’s skin tone. What if I never get it? she thinks. What if my ability to notice what’s important is broken?

“…and let whatever happens, happen,” we say, as the newly bereaved parent of a baby who died at birth looks at us with wide eyes.
“Let whatever happens, happen? I can’t just notice. I can’t trust my judgment. Just look at this baby, who my body failed, who I have failed…”

We say these words because we know that the key to healing begins with simply noticing. Pay attention. Be curious, see what happens next.

But it’s a catch-22. Trauma fractures our natural ability to notice. It disrupts our capacity to access that calm curiosity that allows us to stay connected to what’s happening inside. Bringing our attention to pain, even though it’s uncomfortable, seems to be essential to recovery. It’s as if we need people to be healed in order to access the healing.


Fortunately, as in all relational psychotherapy, EMDR therapists offer our attuned presence as scaffolding and support as people begin to turn their attention to their internal world. With EMDR therapy, we provide precisely the sort of nuanced appreciation for the ebb and flow of thought and feeling, somatic sensation, and memory that parents must bring to their babies and that, especially in the face of disruptions on the road to parenthood, can seem both frightening and out of reach.

It goes something like this:
As you bring your attention to yourself, just noticing, I will help you. I will notice with you. I will notice the subtle changes in your skin tone, as your cheeks redden and clear, as the tears rise and fall. I will note your breathing and breathe with you. I will not turn away from your fear or your pain or your anger. My nervous system will listen to the rhythms coming from yours. I will notice and then you can notice, too.

That subtle sensation, that flickering emotion, it all matters. “Notice that,” we say, inviting gentle curiosity, remaining just as engaged and attentive as when tears are flowing. “What are you noticing now?” we ask. So often, language is elusive but the emotion, the emergent shift, is palpable and so we lean in. “Just notice it,” we say, affirming that it exists even when it can’t yet be articulated. “That blossoming warmth? That stab in your chest? Just notice it. And when you do, when you let whatever happens happen, we will notice together. We will know its truth and meaning together.”

This is how we walk with our clients into the process of EMDR therapy where everything they notice, no matter how subtle, counts, not just the sobs or the searing flash of memory. It’s also how we accompany bereaved and traumatized parents into the new world born in the face of perinatal trauma. We notice the shrapnel causing pain and blocking healing. Just as important, we nourish and support the gradual creation of connective tissue that forms the foundation of a new sense of self: as a parent to this baby within the matrix of relationships, within this family.

All of it, every single nuance, counts.
“My baby only spent a few days in the NICU,” said one father to me in response to a call for interviewees for our book. “Are you sure you want our story?” “Our baby died,” whispered another. “Do you really want to interview us?”
It’s a common concern that parents express to therapists. Does it count? Does our experience really matter? Even if my baby is fine now, or if there are no marks on my body to prove that we’ve walked through the fire or no living baby to parent after all we endured? Do I have permission to notice what this means to me, how it actually feels? And if I do notice where it hurts, can I show you? Will you pay attention?
So we sit across from the families who land in our offices-- parents unmoored from what they used to know about themselves, about babies, pregnancies, and the way the world is supposed to work when you’ve followed all the rules, and we pay attention. We notice and most importantly, we trust what they notice. We show them with our engaged, calm presence, staying out of the way but staying.


If we’ve been fortunate to become a parent to a full-term, healthy baby, conceived, gestated, and born without incident, it can be challenging to learn to decipher these signs of dislocation and the consequences. When the road to parenthood has been pitted with earthquakes and storms, parents cannot trust in what once seemed natural and easy. Without that steady sense of “I can figure this out,” or “everything will be okay,” parents feel unmoored and may desperately turn to others to steady themselves.


They often turn to professionals, like us.
And yes, they are doing it for the attention.
And in fact, they benefit when we pay attention-- when we see them as they are, validate their experience of their journey, acknowledge their pain, and accompany them as nonjudgmental witnesses. Our attention is what helps them learn to notice both the obvious and the nuanced and let what happens happen. Our attention is what helps them regain feelings of confidence and competence. Gradually, they begin to believe in themselves as parents, including, “I can learn to read this baby’s cues,” or, “I can trust my sense that something is wrong (or right) with myself or my baby,” or, “My pain counts even though other parents are experiencing a grief and fear I can’t even fathom.” Or even, “I feel love and hope and joy even though strangers glance at my baby and turn away,” or, “I am a loving parent even though my baby died.”


Our attention validates these truths. Noticing them guides our clients to turn their own attention back to their lived experience in all its mess and meaning. Only then can they weave together the strands of their experience, appreciating them all as part of a larger whole.

​In the last two weeks I have suffered three injuries. None of them so terrible that I required major medical intervention, but bad enough to leave me generally pretty bruised and crappy feeling. It was on the heels of some bruised ribs and a fall down the stairs that my partner invited me to attend a woodshop orientation workshop in which we’d be introduced to various saws and machinery and how to use them correctly. You can see where this is going…
 
The second saw in, the instructor casually referenced the availability of a safety mechanism and cavalierly noted that most people find it a nuisance and moved along without showing us how to use it. Naturally, when it came to my turn the saw spit back a piece of wood at me which rocketed into my hip at what felt like 8,000 mph. The pain shot down my leg and my body went tingly then numb. I could barely stand. The instructor and other participant just looked on in silence and moved on to the next machine. My partner, who’d invited me, looked at me with genuine concern and whispered, “are you ok??” I clenched my jaw and nodded and hobbled along behind the group to the next machine where I put on a brave face and completed shaving off an eighth of an inch of a piece of wood on a drum saw. Afterwards, I began to feel overheated and a little faint, so I turned to my fella and said, “I think I’m gonna sit this one out, you stay here!” It was at this point that I exited to the parking lot and proceeded to cry my eyes out. Every part of my body hurt, and I was so tired and overwhelmed there was no way to keep it in. Awhile later, I sent him a kindly text explaining that I was not feeling well and I’d walk back home and for him to enjoy the rest of the workshop. My partner responded in the sanest way possible by immediately calling me, asking where I was and if I was ok. After admitting that I’d been crying in a parking lot by myself, he said rather plainly, “you sitting in a parking lot crying by yourself is more important than me learning to use a band saw. You hide what you’re feeling really well.”
 
He’s not wrong. I grew up in a feelings phobic household. Sure, my parents cared for us and treated us well, but I don’t even need one hand to count the number of times I’ve seen family members cry in front of me. Sadness was treated as a medical problem, rather than a natural emotional response. So many people have it worse! Pull yourself up by your bootstraps! And power through! Were the well-intended mantras of our household. Sadness was something tucked away and saved for the medical professionals. And to be clear, I have dealt with diagnosable depression that has required medical intervention. But I do wonder if the inability to express sadness only compounded those feelings.
 
It wasn’t until the day after my woodworking injury when talking with a friend that I realized how insane my response had been. My natural response had been to save those feelings until I was by myself and walk home on a crippled hip so as not to bother anyone. In that moment I did not believe that my pain and experience might be more important than someone else learning to use a dumb saw. I did not realize that it might be a little out there to suppose I needed to keep it together in front of an instructor who clearly wasn’t interested in my safety, a stranger, and a person who cares deeply about my well-being.
 
These are the lies we tell ourselves: my pain isn’t important, or least not important enough to bother anyone. I cannot show what I’m feeling. It’s better to suffer in silence. No one likes someone who’s always complaining. I cannot look weak. I need to have it together.   It’s always a little funny when I become aware of this stuff, because like hey, it’s literally my job to help people process feelings in a variety of ways. And as much as I write about it, and give talks, and work with others, I’m still a human for whom this exists. Honestly, it kind of makes me feel like a fraud sometimes. I guess that’s the other lie: you’re not good enough.
 
I think it takes most of us awhile before we even realize that some of the beliefs that underpin the way we operate in the world are lies – mostly, we just think this is the way we are, and the way we handle things without subjecting those beliefs to any litmus tests. It usually takes someone else asking me, “how is that serving you?” before I put those beliefs to the test. How does it serve us to buy into these beliefs we have about ourselves, what we deserve, and what we should do? Are these beliefs and the actions that extend from them benefiting us? Or are they hurting us? Do they make my life better? Or worse? I’m going out on a limb here, but in retrospect it seems like deciding to walk home on a busted leg because of the belief that I cannot show my feelings wasn’t making my life any better.
 
But seeing the lie still isn’t always enough for me to do things differently. It’s hard to get away from that initial gut reaction to default into the same old way of doing things. There are a million reasons we find to not do things different. It’s hard. It might not even be better anyway. It will definitely be uncomfortable. These are just a few that I can buy into. I mean if you grow up in a household where crying in front of another person is never experienced, how do you even begin to test out that kind of vulnerability? Truthfully, I’m not sure. But I know this, after I let it all out to someone I care about and whom I trust in return, I went home, was tucked in under some blankets and fed chocolate in front of the TV until I fell asleep. And you know what? I felt better. I’m not always sure I know the answer, but I am fairly sure at this point that if I don’t try being vulnerable with the right people in the moment, I will always end up crying by myself in a parking lot. And at this point, that just isn’t serving me well anymore.

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. 
 

I have had a lot of people reaching out to me lately for some advice and insight on balancing private practice work with parenthood, and more specifically, how to handle parental leave.  In the spirit of developing an open dialogue, I have decided to share my experience in the hope that it may be helpful to others.   For some background, I am an EMDRIA Approved Consultant and Certified Therapist, focused primarily on trauma therapy.  I have been in the field of social work for almost twenty years and started my EMDR therapy journey in 2008.  I am a faculty member with The Institute for Creative Mindfulness, and own a small private practice in Columbus, Ohio where I work with clients of all ages who have experienced some form of trauma or adverse life experiences.  I live with my husband, dog, and beautiful one-year-old daughter. 
 
There are days I feel like I am really succeeding as both a business owner and a mother.  There are other days it seems I am frantically trying to juggle all the pieces of my life, without feeling confident that I am successfully managing any of them.  This has just become part of my personal journey.  Self-care and balance are hard enough concepts when we are solely dealing with being mental health providers in the field.  Add to that a relationship with a partner, and the responsibility of caring for a child, and it’s easy to see how self-care can be pushed to the back burner.  As we preach to our clients though: if we are not taking care of ourselves, we will not be able to care for others.  So here I am, putting on my oxygen mask first and finding ways to balance my sanity, in order to have time and energy to devote to my family and my work.
 
I’ll start off with some of the things to think about as you prepare for taking some leave from work.  Whether you are giving birth, adopting, or your partner is having a baby, there will be a period that you will need to be home with your family. 
 
Things to consider before your leave:
 
1. Think about how and when to tell clients about your baby:  The timing of this is completely your choice.  Some people start telling everyone they know as soon as they get a positive pregnancy test.  Others wait until they are as far along as possible to minimize the risk of having to disclose a lost pregnancy.  Just be sure to think through all of the options before going to one extreme or the other.   If you are pregnant, you cannot assume that your clients won’t notice a growing bump or other symptoms.  This is particularly important when working with trauma survivors; many trauma clients pick up on any small changes.  Their brains have been programmed to attune to others as a form of protection and defense.  So, if you are experiencing extreme fatigue, nausea or other symptoms, you may want to let clients know what is going on so that they don’t form any of their own conclusions.
 
2. Consider that your situation may be triggering for clients:  While you may be bursting at the seams with your exciting news, please keep in mind the impact this could have on your clients.  Some of your clients will be overjoyed for you.  Some clients will immediately start to panic in anticipation of your absence, or even the possibility that you won’t be returning to work at all.  For others, they may have dealt with infertility, had an unplanned pregnancy, had a miscarriage, lost a child, or have a history of terminated pregnancy.  Think about each of your clients carefully and consider how you will deliver your news.
 
3. Decide when to stop taking new clients:  You will need to decide on a reasonable date to ethically stop taking new clients on your caseload knowing that you have an upcoming period of leave.  This time frame should depend on the nature of your populations and scope of practice.  If you have started telling existing clients on your caseload, then you also need to inform potential new clients before they start investing time into coming to see you.  You will also need to consider the type of work that you are doing with clients as you approach your baby’s arrival date.  Be sure to allow ample time to work with your clients on planning their transition.  With some clients, it is not responsible to continue to do trauma processing up until your last day, because of the possibility of destabilization and your inability to be available to support that client.  You also need to consider the possibility that your leave will begin sooner than anticipated.
 
4. Have a plan for coverage while you are on leave: What you do with your cases while you are off is something that you will need to decide with some input from your clients.  Some of your clients will be able to manage a period without attending counseling.  There are some clients that you may think would be able to manage without counseling but will elect to see someone anyway, and vice versa.  Finally, some clients may be required to see a counselor during your leave due to safety reasons.  If you work in a group practice or with colleagues, reach out and see who would be willing to cover your cases while you are on leave.  If you work alone and don’t have many colleagues, reach out in some networking groups to see if anyone is available, or do some of your own research and find some referral sources for your clients.  You can link clients with specific clinicians, or you may provide a list of a few therapists that are available and willing to see them while you are off and leave it up to them to make the contact.
 
5. Clean up your caseload:  I do not recommend leaving any cases open on your caseload while you are on leave.  Complete a discharge summary for each client that outlines your recommendations while you are on leave.  You can always re-open cases when you return to work.  However, this will relieve you of any liability while you are off as well as compensate for any potential delays returning to work or issues that could prevent you from returning to work.  I also recommend creating a form letter that lets clients know that you will be going on leave with general recommendations.  Provide a copy to your clients and keep one in their file.  This can prevent any claims later that you did not provide ample notice or planning.
 
6. Plan how long you intent to be off:  Think about how long you plan to be off and begin financial planning as soon as possible.  If you are in private practice, you may be an independent contractor and not have access to paid time off.  If you plan far enough in advance, there are some short-term disability insurance plans that may fit your needs.  You will need to start paying into the plans before you or your partner are pregnant.  Remember that babies are not always on the same timeline as we are, so consider a window of time that allows for the baby to come earlier or a little later than expected, and consider how you will handle any situations that may require extra time off.  Consider alternative strategies for income to make up for your time off.  If professional development or consultation are within your scope of practice, consider scheduling some trainings before and/or after your leave to bring in some additional income.  Think about hiring someone part-time to supplement your time off (and as an added bonus they can start off by covering some of your cases while they build their own caseload).  In my experience, trainings allowed me to supplement my maternity leave and enabled me to come back to work seeing clients part-time.  I invest about one weekend a month to training, but it allows me to spend more days at home with my daughter overall.  Consultation groups for EMDR therapists have also allowed me to make income in a shorter block of time than seeing a full day of clients.  Balancing a schedule of trauma therapy with consultation and training also facilitates self-care and secondary trauma prevention.
 
7. Identify how you will communicate the start of your leave:  Figure out a plan for how you will communicate that your leave has started.  You may want to pick a date a few days before your baby’s due date as your last day to see clients.  You do not want to be thinking about calling to cancel clients while you or your partner are in labor or arranging plans for the immediate arrival of your child.  If you need to work until your baby comes, create a new voicemail each day that states whether or not you are in the office.  Let your clients know to call the voicemail before heading in for their appointments.  When you start your leave, be sure to change your voicemail and email responses to communicate that your leave has begun, as well as the steps clients should take if they have a clinical need.
 
8. Have a backup plan:  As mentioned earlier, babies do not always follow the plans we have set in our heads.  Some people also fully intend to come back to work but things change while they are home snuggling their new squishy babies.  Be sure you have a strategy for communication of any changes to your schedule to clients that are hoping and planning on coming back to see you when your leave is over.
 
9. Identify how you will communicate your return:  Just like the form letter that you sent to clients to notify them of your upcoming leave, you will want a plan for how to announce that you have returned to the office.  If you have a social media account for your business, you could direct clients to check there and make a post when you have a return date.  You could also send a general announcement to your former client load.
 
10. Establish a plan for working during your leave:  If you plan to do work while you are on leave, I would encourage you to think about how crucial that is.  In my case, I was running a small practice without an office manager, so I didn’t have a choice but to continue to do billing and payroll.  Decide whether any of your tasks can be delegated, and if not, identify specific times in your week to allot to doing work.  You only get parental leave one time with your baby and you want to make the most of it. 
 
Things to consider with your transition back to work: 
 
11. Don’t plan on continuing to work as effectively at home as you do in the office: I thought I would be able to get a lot more work done from home.  As I look back, the time period I probably could have gotten the most work done was the first several weeks of leave when my daughter was mostly sleeping.  However, that was the time I soaked up the most and really bonded with my new baby.  Once they start becoming interactive and eventually mobile, you will need to be more deliberate in delegating a time and space for working in the home.  Fortunately, I have an amazing partner and a lot of family and friends that jump at the chance for some baby time.
 
12. Ease back into your schedule:  Some of you will be itching to get back to work by the time your leave is done, and some of you will be dreading it.  Either way, make sure you plan for a transition back to work.  Not only will you be making the adjustment back to seeing clients and using your brain in a new way again, you will also be adjusting to a new schedule and being away from your baby.  This doesn’t have to mean a very gradual transition, but I don’t recommend planning to see a full day of clients your first day back. 
 
13. Expect to be sleep-deprived:  Sleep deprivation is a real thing.  I know people joked to me about it all the time, but it is the real deal.  I have not slept through the night in almost two years, counting the sleepless nights that started while I was expecting.  I don’t have any good advice here, but I wanted to normalize and validate this for all of you.  You are going to be tired.  There are going to be days you have a full day of intense clients and your child is also teething, has a fever, or just didn’t sleep the night before.  Take care of yourself.  And coffee.  Sweet, sweet coffee.
 
14. Prepare for a range of emotions:  As I mentioned earlier, you are going to experience a lot of emotions as you return to work.  Whatever those emotions are, notice and pay attention to them.  Take care of yourself and your needs.  If you feel you need extra support and you don’t already have a good therapist, find one!  EMDR therapy can work wonders for postpartum depression and anxiety.  There are also some great groups on social media if you are looking for some camaraderie with other working parents, such as “Moms in Private Practice (Mental Health).”
 
15. Think about countertransference:  As trauma therapists, you may find that you experience some new countertransference now that you are a parent.  As a clinician, I validate to my clients that as their own children reach certain developmental stages, they may find themselves newly triggered by their past experiences at those ages.  The same can happen as clinicians.  Hearing about trauma and adverse life experiences your clients experienced as children may feel different to you now that you have your own child.  Just be aware of what you are experiencing, and find someone that you trust and that you can process these feelings with: a coworker, supervisor, consultant or even your own therapist. 
 
16. Establish a self-care plan:  Establish a self-care plan, and don’t minimize it.  As a new parent, I have to schedule time that is set aside for myself.  I make an extra effort to go to bed at a certain time, drink water, and eat healthy meals.  I also schedule purposeful social interaction with other adults.  Identify self-care strategies that are small and some that take more time, and figure out how these can fit into your routine.  If we just assume that it will get done, it won’t.  You need to be purposeful about this.  I have found bullet journaling to be especially effective for tracking my daily, weekly, and monthly goals.
 
17. Prepare for pumping needs:  If you will be breastfeeding, you will need to think about your pumping needs.  Be sure to schedule time for pumping.  Because of the nature of our work, most of us already have a private office, but if not, find out how to establish a private space for pumping.  Kellymom has some great articles for support with pumping at work.
 
18. Re-examine your boundaries:  The biggest change for me since going back to work as a mother has been my boundaries with my schedule.  If you ask any of my colleagues, they will be the first to tell you I used to work a ridiculous schedule.  I was known to see nine or ten clients in a day and work sixty hours a week.  As a new mom and recovering workaholic, I am now forced to say “no” to appointments that are outside of my scheduled week.  Primarily because I would need to arrange additional childcare, but also because it intrudes on my time with my family.  I learned the hard way that coming home right at my daughter’s bedtime to put her to bed didn’t go as smoothly as I planned.  I also know that I cannot allot exactly enough time to drive to pick up my daughter from my last scheduled session.  Sometimes sessions run over, or I need to make a client phone call at the end of the day. 
 
19. Let the guilt go: The first day I went back to work, I definitely cried more than my daughter did.  Looking back now, I’m actually not sure how much she noticed me walking out the door.  At the time, my guilt was at an all-time high, and I had an unrealistic impression of how much my work would affect her.  In reality, she has been able to spend much more time bonding with family members and caregivers and finding ways to develop.  I had to let go of the grief around not getting to see every single thing she did, said, and discovered.  Instead, I make an effort to be fully present when I am with her.  There are going to be things that I don’t get to see, but I try to make up for it by mindfully experiencing the events I am there for.
 
20. Find a new balance: I have to be more purposeful about when I check work email and when I do work from home.  I want to be fully present at work and fully present with my family.  I am definitely not always perfect, but I don’t feel good about my role as a mother when I am trying to do work while simultaneously feeding my daughter lunch, nor do I feel like a great clinician when I am responding to an email while trying to sing Old MacDonald.
 
Final Notes:
I hope that this article has been a useful resource for considering your parental leave, and I hope to hear from many of you with more helpful additions to this conversation.  I have to make a conscious effort every day to try to practice the kind of self-care and balance that I encourage for my clients.  It is my hope that by sharing my experience some of you may be inspired to begin planning for balance in your new journey. 
 
Suzi Rutti, LISW-S
Rutti Counseling & Consultation, LLC
www.suzannerutti.com
https://www.facebook.com/suzanneruttilisws/
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For as long as I can remember, I have adored flowers. Looking at wildflowers in the fields or noticing several varieties alongside houses in my neighborhood are some of the first pictures that come up in my head when I float my memory back. I remember having to ask my mother’s permission before picking them in my own yard or my grandfather’s yard nearby because I once got in trouble for plucking some of the neighbor’s tulips. I’ve only recently started to appreciate the awesomeness that my mother is named Rosie (which she prefers to Rose)—and that literally makes me a flower child!

​I can’t remember when I first received flowers—it was likely when I made my first communion around age seven. I fondly recall getting flowers from my friends and family when I was in my first big stage show at twelve. The confirmation name I chose for myself when I received the sacrament in the Roman Catholic Church is Marie-Therese. I selected the name to honor St. Therese of Lisieux, also called the Little Flower. The first tattoo I got was of a flower (a peace lily on my hip). Even though both of my marriages ended in bitter divorce, I still have several fond memories from both relationships that involve receiving flowers. On a recent pilgrimage to India, one of my drivers—a lovely man named Ratan—climbed a tree to pick me the state flower of Uttrakhand in the foothills of the Himalayas. This gesture had me beaming from ear-to-ear and made me realize just how much I love receiving flowers.
 
So what better way to honor the sacredness that I am than to practice buying myself flowers? We can put so much weight, especially as women, on what it means to receive flowers as a gesture of love or appreciation. But who is to say that for flowers to have such appreciative value, they have to be gifted by someone else?
 
Although I’ve picked flowers for myself over the years, I do not consciously recall buying myself a bouquet of flowers until about two years ago. I purchased a beautiful dozen of pink roses to celebrate my separation from marriage number two and all of the pain it represented. After that marriage ended, I entered into a period of deep inquiry to investigate and ultimately heal the remaining layers of relational trauma that kept me in this loop of unserving relationships. And in my sadhana (spiritual practice), my guides led me back to a favorite poem from which I’ve drawn great strength over the years, After A While by Veronica A. Shofstall. After my first divorce, I wrote a song called “Grace of a Woman” (which became the title track to the last album I recorded in 2012) based on a line from this poem. The repeating line in her poem is “after a while you learn”… During that period in my life, this line most resonated for me:

And you begin to accept your defeat with your head up and your eyes ahead
With  the grace of a woman, not the grief of a child

Clearly that was the lesson my foolish heart needed at the time. Yet with one of the classical definitions of foolish being “slow to learn,” there was still more healing to be done…
 
Within a few weeks after my second husband and I parted ways, I remember standing at the entrance to the grocery store near my home where the florist is located and Veronica’s poem came back to me like a lightning bolt. Specifically the wisdom:

After a while you learn that even sunshine burns if you get too much
So you plant your own garden, and decorate your own soul
Instead of waiting for someone to bring your flowers
​
Thus, as a ceremony representing the new phase of healing that life was bringing me through, I bought myself that bouquet of the most beautiful pink roses. I brought them home, put them in a vase, and all felt right with the world.
 
“I can do this,” I resolved, “I can be okay by myself, as I am.”
 
During the period of initial healing I bought myself flowers regularly to keep reminding myself of this lesson. Truthfully, I fell out of the practice after about six months. I started to feel much better. And then, about a year after the separation, I started seeing someone. Although not to the same extent as in earlier seasons of my life, I noticed some of the same patterns about needing to be wanted pop back up and disturb the peace in my life. Even though I’m slow to learn when it comes to my personal healing, I do learn and I’ve been able to nip much of this potential destruction in the bud.
 
Getting my latest book Process Not Perfection prepared and ready for publication happened alongside me doing some deep therapeutic digging about the remnants of relational trauma. Healing those wounds has proven to be the greatest process of my life. The day that the book officially released, I allowed myself to sit on my couch, breathe, and take it all in. And then the wisdom inherent in Veronica’s poem came back once again—go out and buy yourself flowers. Celebrate you! Celebrate not just all that you’ve accomplished, celebrate the wonder that you are! Indeed, decorate your own soul…
 
We can decorate our soul in a variety of ways along our healing path in ways that are not entangled with attachments to others. Even if you are in a committed relationship, please consider nourishing yourself in this way. Perhaps planting a garden is more your style than buying flowers. Do it. Do whatever is going to help you celebrate your own wonder while cultivating beauty in your life. I am worth it, you are worth it. And perhaps if we deepen into this practice of gifting ourselves with the beauty we deserve, we will indeed spread that healing like wildflowers through this suffering world desperately in need of that colorful energy.  

​In the summer of 2000, I set out on my first proper backpacking tour of Central and Eastern Europe. For six weeks I would be visiting all of these historical places that I studied about for years, and I was ill-prepared! The cheap $20 rolling duffle bag with pieces of things pretending to be straps just would not do, especially on the trains. During my first stop—Prague—I saw how much easier it was for other young travelers to navigate the trains having proper backpacks. So at my next stop—Krakow—I found an outdoor shop and paid $80 for my first real backpack. She was amazing! Blue with black trimming, she was so easy to pack, and so wonderful to carry on the trains. I feel like she opened up the world for me and the possibilities in it even wider. For the next nineteen years, she would literally help me carry the baggage of my life and my transformation.
 
The word “baggage” has taken on an interesting emotional connotation in modern times. My mother always warned me not to date a guy with “baggage.” By the time I got to my mid-thirties, I was brave enough to respond, “Um…mother, I got quite a bit of my own baggage by now.” There’s even a Game Show Network series called Baggage hosted by none other than Jerry Springer where dating show contestants evaluate each other by whether or not they can live with each other’s baggage. And as a trauma therapist I’ve long helped people come to terms with their baggage, a word they often use for the burdens they carry. Sometimes I help them to shed the load that’s weighing them down and other times I help them to make peace with their past and how they carry it. Using the backpacker’s metaphor, sometimes we just need to get a more efficient piece of luggage.
 
Recent events prompted me into some deep introspection about baggage and all of its metaphors and meanings. I am currently on a one-month tour of the U.K., teaching and writing. When I got to the airport, I noticed that one of the last two functional buckles holding my old girl together had cracked and broken. Over the years everything that once made the old girl an ideal backpack went bad—the waist buckle, the chest strap, some chords and zippers. The two back straps were still intact which made her still okay to use. And suddenly that was no longer the case. I checked in at Cleveland for my flight to London. Yet trying to haul a month’s worth of gear into London city from the airport with a broken backpack was exhausting. I gave her one more go as I proceeded up to Scotland last week and the strain wreaked havoc on my shoulder and back. Knowing that there was no way to fix or to replace the buckle, it was time to lay her to rest and get a new pack.
 
I was surprised at how difficult that was for me. I’m not really the type to get attached to material things, yet there I was, attachment sick over literal baggage.
 
“Wow, Buddha would have a field day with this,” I snickered.
 
The old girl was different. She carried me through the healing journey of the second nineteen years that sought to unravel the confusion and pain that tangled me up in the first twenty. Setting out to travel the world was a major component in my recovery for it showed me new perspectives and different energies. When I ended up moving to Europe for three years in November 2000, I carried everything I needed in the old girl. She came with me on every international trip that followed as I connected with these lost pieces of myself.
 
When I walked into the outdoor shop in Inverness, Scotland, I reflected on just how far that 20-year-old girl who walked into a similar shop in Krakow had traveled. Two marriages come and gone, sobriety, a doctorate, seven books written, a successful business established, major mental health relapses healed and still healing, coming out in various ways, a story of transformation still in process… Most importantly, we’ve achieved liberation by connecting to the certainly of who we really are and what we stand for—we are total and yet continually evolving towards wholeness. Traveling, embracing the journey—both literal and metaphorical—brought me these gifts.    
 
And now the time had come to get a more functional, efficient pack for the next nineteen years and beyond. When Mark, the lovely salesman in Inverness, explained all of the features on the state-of-the-art red Osprey pack I was privileged enough to buy, my first response was, “But the pouches on the new pack aren’t like the old one—I liked that feature better!” I chuckled at myself—realizing how it’s so easy for all of us to do that during the change process. Without a doubt my new pack is better for my body, contoured for a larger woman’s back and hips and full of efficient features. This new pack is 15 gallons smaller than the old girl, which will force me to pack more efficiently. That’s probably a good thing! I knew in that moment that as attached as I can get to the things I’ve gotten used to, they may no longer be what serves me the best presently.
 
I’ve learned to travel lighter in the last nineteen years, both literally and metaphorically, and this adjustment certainly helps. I am also a human being struggling to make sense of attachment and heal or release the storylines I carry. In trauma focused therapy, working with attachment is a topic du jour. As an EMDR therapy trainer, I often entertain questions on how well our curriculum can help trainees to work with attachment trauma. While it’s clear that many people with complex trauma were severely wounded in early childhood by the caretakers with whom they should have formed healthy attachment, I’ve never felt that repairing attachment is the entire answer. As a mindfulness-focused EMDR program committed to East-West integration, detachment is just as important. I heartily believe the Buddha’s teaching that attachment or clinging is one of the three main causes of suffering. Yet we are human and healthy attachment is a legitimate need—so how do I reconcile this one, Buddha? Contemplating this question in meditation has taught me that acceptance and letting go are vital to the change process. We can do this at the same time as we grieve the childhood we needed and never received. We can also bring healing to the younger, wounded parts that may still live inside of us, modeling healthy attachment for them. Letting go of the storylines and the attachments that no longer serve us in the present is paramount. Letting go clears the path for healing at all levels.
 
I ended up letting go of the old girl in my hotel room in Scotland with a note for hotel staff to do what they saw fit. It felt appropriate laying her to rest on the international road, especially in a place as magical as Scotland. I was also blessed to stumble upon a teaching from de-cluttering guru Marie Kondo during the days I wrote in Scotland. She advises, “Have gratitude for the things you're discarding. By giving gratitude, you're giving closure to the relationship with that object, and by doing so, it becomes a lot easier to let go.”
 
I don’t think I’ve ever read anything so wise and so applicable for people on any path of recovery. Gratitude is a quality of recovery that directly helps us to let go of unhealthy or unserving attachments, yet in modern times gratitude can become so difficult to practice. We are socialized, especially in the West, to focus on what we don’t have instead of celebrating what we do. Further, practicing gratitude can feel impossible especially when you’ve been so hurt and so wronged by life and the people in it. Hopefully this will not block you from at least giving the practice of gratitude a try in your process of letting go and lightening the load.
 
I thanked the old girl vocally before I left the room that day, and writing this article is a way of publicly offering my thanks. Yes, it’s to an object, yet think of how much this wisdom can also help us let go of the so-called “baggage” from our past that weighs us down—memories, shame-based scripts, unhealthy coping skills, and the impact of wounding relationships. We can thank those things and those people for the role that they played for us at the time. Even the horrible stuff—if you are willing, thank it for its role in bringing you to where you are today, hopefully on the precipice of a major shift in your continued healing and recovery.