Parental Leave and Parenthood in Private Practice: 20 Ways to be Trauma-Informed by Suzanne Rutti, LISW-S
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.
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
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.
Hello, my name is Marnie and I have a question: What is in a name? It’s a question I’ve been pondering lately. Our parents decide what to call us before our voices can be heard. These names usually have some sort of significance for them and I remember school assignments on the discovery of name meanings. Our birthnames become our labels. In a world full of labels, our birthnames end up as our number one label we strive to fulfill.
We try to fit into these names. Take into account the name lists that float around Facebook. Being able to find our names on Coke bottles. Our names mean something to us. However, what if we don’t identify with our birthname? It becomes this scratching walls that is suffocating.
You see, I have a speech impediment from childhood trauma and it impacts my processing (mental stutters) and my ability to pronounce anything with a “R.” “R’s” can go to Hell for all I care. And of all the “R” sounds that could possibly exist, my birthname has one of the hardest configurations of that godforsaken sound.
There have been many speech therapy sessions spent on pronouncing my name. Many. Over time, I developed a sense of shame and embarrassment. My number one label, my number one identifier, and I can’t say it. When out and about with friends and family, it intuitively became a thing that they’d pronounce my name for me. I don’t know if they perceived my shoulders dropping in, my split-second hesitation, whenever anyone asked, “What’s your name?” My voice would get caught in my throat and I’d shrink into myself. “Just call me, M.”
It got worse when people asked where my accent was from. From as far back as I can remember to when I was 26, every day I was asked where my accent was from. When I was younger, I would tell people I moved around a lot. It wasn’t until I was 23 that the internalized shame branched off into anger and I dreaded every interaction with new people.
“Where’s your accent from?”
“It’s a speech impediment.”
Whenever I dropped that bombshell, people would begin to squirm. How does one come back from that? This moment is the opportunity I take to remove myself from the conversation. I remember a couple of times when people would learn about my speech impediment and the fact I couldn’t say my name, they kept trying to pressure me into speaking. Into saying my name.
Oh man, I felt small and that shame bubble only got bigger. Each interaction, I shrunk a bit more. It’s not to say I didn’t like my name, but I didn’t feel comfortable with it. There were points when I mentioned it to my family and was met with various responses, “but your name is pretty,” “It’s a good name,” “I like it.” All responses kept me quiet. However, that need to identify with something else, that need to change my name, followed me around.
This past year, the urge to change my name has only gotten stronger. If anyone read my last blog, know I have a pretty strong intuition. It wasn’t until a recent drive down to an Expressive Arts retreat that I felt comfortable playing with another name. “Tell them to use, Peyton,” bounced around my skull until I shared with road trip buddies to use it for the remainder of the trip together. Thankfully, they took it well and supported it. The entire trip I responded to Peyton like it had always been my name. We also realized it sounds like “painting,” which is something I am passionate about. It felt like coming home.
It dawned on me that my speech impediment has become my identity. Who I’d interact with, how I interact, how I presented myself, all revolved around my speech. I put myself in a corner over time and lost my voice in the process. Picking a name for myself has helped me find my voice I previously locked away. A sort of reclaiming a piece of myself.
So, what’s in a name? For me, everything. My birthname has kept me stuck in a loop of “I’m defective,” because I don’t speak like everybody else. It created this identity of something being wrong with me. A reminder of my trauma history. A reminder of feeling small and powerless. A name is a powerful thing, and everyone should have the opportunity to express who they are, even if it’s a name change. It’s how we introduce ourselves to the world, to people, to ourselves. It can keep us in a box or set us free.
So, hello, my name is Peyton.
Peyton Cram LPC, LCDC III (pronouns They, Them, Theirs) is a Dancing Mindfulness Facilitator, EMDR Therapist, Expressive Arts Therapist, artist, and life-long learner. They received their MSEd in Clinical Mental Health Counseling at Youngstown State University and is currently the Outpatient Program Supervisor at Valor Recovery Centers. Peyton is also a Reiki lvl 2.
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.”
I support and believe Christine Blasey Ford and I am in awe of her courage to come forward and speak her truth. It has not been an easy thing to do and she has re-lived her trauma and experienced more trauma. She has been sent death threats and has had to leave her home. I want her to know I honor her and her story and as a result felt compelled to write this.
Since Christine has come forward with her story of being sexually assaulted by Brett Kavanaugh, there have been a lot of questions and comments. As a sexual assault survivor myself and a trauma therapist who has worked with dozens of sexual assault survivors, I would like to try and answer some of the questions that I have heard and even been asked directly.
Question #1- Why didn’t she tell anyone at the time this incident occurred?
She was 15 years old, scared and having a trauma reaction. Many assaults occur by people who are known to the victim. Sometimes the perpetrator threatens to harm the person if they tell anyone. Many young survivors are afraid if they tell a parent they will get in “trouble”. Many victims are blamed with statements such as “you shouldn’t have been at that party”, “you shouldn’t have been drinking”, “your flirting brought this on”, “the way you dressed caused this”, “he’s a good boy, you must be mistaken”, “you are a slut, whore, etc”. These are just a few of the things that are said to victims. Many victims/survivors are afraid no one will believe them. That was her worst fear coming forward now, I’m sure. Not only did many people not believe her, some people made death threats against her and her family. Now, wouldn’t that be a reason some people may not come forward?
Secondly, a typical trauma reaction is to shut down and try and forget about what happened. But no one ever forgets. Sometimes the event is packed away in the recesses of the mind and resurfaces years later when current events occur that trigger the body and mind. I’ve personally had the experience of early childhood sexual abuse by a known perpetrator that I only remembered after undergoing somatic body work by a trusted friend. My body knew for a long time that something had occurred as I would have atypical reactions to hearing about childhood sexual abuse. For years I had suicidal thoughts and no idea where they were coming from. Once the memories surfaced, I was not surprised and it confirmed for me a lot of things I had felt over the years. My memories were validated by others in my family when I shared them. I went through some intense therapy for several years after this and to this day from time to time have to do some healing work. Since the “#Metoo” movement began, I and other survivors, have been triggered a lot. How do we speak our truth? Where do I speak my truth? Will speaking my truth help someone else? Will I make myself too vulnerable in speaking my truth? Will my family support me in speaking my truth?
Question #2-One of the other questions people have had is “how can she be sure it was him?”, “maybe her memory is wrong."
These incidents are recorded in the brain. When they occur with someone who is known to the victim, they remember who it was, the voice, the smell, the face, all of it. Sometimes, a survivor will dissociate during the incident, which is when the mind separates from the body as a way to cope and survive the trauma. However, the mind is still present and recording the experience.
I have experienced other types of sexual assault. Once, three boys in the neighborhood dragged me into the woods with two of them holding my arms back and the other one fondling me. My “fight” response kicked in and I kicked the one touching me in the groin and was able to get away. I still remember his name and face. I never told anyone. This happened again with a few boys on the front lawn of his house. I remember who it was and I never told. Other incidents of boys grabbing my breasts, calling me names, smacking/pinching my rear end, all occurred multiple times. The only incident I ever told anyone about was when I was 15 years old: While riding my bike, a guy in a gold Camaro stopped and asked for directions. When I got closer to the car I saw he was masturbating. I took off on my bike and rode home with my heart pounding. I remembered the type of car, as it was distinctive. I told my mom and we did call the police to report what happened. I don’t know if he was ever caught.
Of all the incidents I experienced, except for that one, I knew who the perpetrator was. Survivors remember, even when it is hard to acknowledge that it was someone known to them.
Question # 3-Well….what is sexual assault really?
As I’ve shared with my daughter, sexual assault can range from name calling, leering at a woman’s body and making sexual comments, to incest and rape. There are many types of assault under this umbrella, such as fondling, oral sex, forcing someone to watch porn and/or strip, etc. The primary elements are that it is unwanted, unsolicited, there is a power differential, and the victim feels extremely unsafe and threatened. I’ve had women share with me that their fathers, step-fathers, grandfathers, etc. have made sexual comments on their bodies, have looked them up and down and smiled, and have made sexual comments about other women in front of them, and all of this was unwanted, unsolicited, and made them feel extremely uncomfortable and threatened. This is sexual assault. I’ve had women share that they have been fondled over their clothes by uncles, step-fathers, brothers, cousins, neighbors, friends of parents, etc., and that is sexual assault. I’ve had women share that they have been sexually abused (fondled, raped, forced to do sexual acts while being watched, etc.) by fathers, mothers, grandparents, coaches, priests, ministers, boyfriends, husbands, teachers, etc., and that is sexual assault. Some of these incidents were one time and many of them continued over months and years.
In the last year or so women and men are finding the courage to share their stories of sexual assault, abuse and trauma. This is the beginning of finding more ways to heal and hold perpetrators accountable. Education is key in changing the way people understand sexual abuse and trauma. We need more open dialogue on this and movement to change statute of limitations for survivors.
I am using my voice and sharing my story for my own healing and in hopes that others will find the courage to share theirs as that is a big part of the healing process.
Rita Lampe is a licensed clinical social worker working in a holistic therapy center where she is also able to provide Reiki and Energy Medicine sessions as part of her practice. She is a graduate of the EMDR therapy training program offered by the Institute for Creative Mindfulness.
I have experienced significant trauma recovery as a direct result of my training at Gracie University in Torrance, California. My goal is to start a discussion on the psychological benefits I’ve experienced and how it might benefit other trauma survivors as well. I am a survivor of childhood bullying. I am also a survivor of 18+ years of severe complex trauma (neglect, emotional, physical and sexual abuses) at the hands of my family and strangers. As a result, I have a history of somatic trauma and triggers around touch, men, women, and assault scenarios.
I began Gracie Jiu-Jitsu Training in August of 2016 through the Women Empowered (WE) Program. Discovering this program, carefully crafted by women and men focused on trauma-informed empowerment and prevention, has been an incredible gift on my journey towards healing. After 2 years of training, I am both a pink belt and blue belt in Master Cycle. The following is an outline of the clinical benefits I experienced as a result of this training as they connect with core attitudes of mindfulness.
I have learned at Gracie to quiet my inner critic. I tend to be a very self-critical, excellence driven person and it took many months of allowing space for imperfection to learn to laugh at myself, shrug it off and keep going. The instructors are skilled in working with the perfectionistic student. They are encouraging and positive throughout. For example, an instructor would never tell you “you’re doing it wrong”, but instead praise what is right and make small adjustments, always conscious not to overwhelm a student with too many instructions. This was exactly what I needed to stay motivated and feel a sense of mastery developing throughout the process.
Patience / Persistence
Patience is of tremendous value at Gracie and a significant challenge for me. The teachers continually emphasize that the techniques are complex and many times counterintuitive. There simply is no jiu-jitsu without patience and persistence. Instructors often remark that is fantastic if a new student gets 25% on the first try of a technique. The benefits of the skills I get at Gracie extend outside those walls. A pronounced example for me is driving. I have always been an aggressive driver speeding, weaving, and wanting people to get out of my way. On difficult days, I find myself falling into old habits of speeding all the way to class at Gracie. As I am leaving their parking lot, driving home, I find myself more patient, waiting my turn, not pushing, not hurrying and letting people in whenever I get a chance.
Willingness / Beginner’s Mind
Instructors model a humanistic approach in their teaching, regularly sharing personal trials and errors on their journeys of learning jiu-jitsu. They model how to stay motivated and keep coming back. For the novice, a sense of curiosity and readiness to learn from a place of not knowing is nurtured. Many techniques are counterintuitive and require proper training to conceptualize. The clinch move is an excellent example. If someone attempts to punch you, you move towards them rather than away. To this day, my clinch sometimes needs work when I’m not concentrating as I instinctively don’t want to move myself towards the attacker.
Most techniques in jiu-jitsu require a high level of trust. Allowing someone to put their hands on your neck can push a trauma survivor out of their comfort zone. At Gracie they instruct participants to only put hands on shoulders to begin with and then as they advance, to put hands on throats, and eventually pressure. This helps the person desensitize to any associated discomfort and build trust. In addition, safety is a priority. When teaching a technique, they always emphasize how to keep your training partner safe. Extensive time is spent on how to break falls and accomplish training goals while preventing injury. Instructors and assistants circulate the room at all times, checking everyone’s safety and techniques. Newer participants are paired up with seasoned trainees to help newer students with the technique and also set the structure of safety (moving slowly, tapping early, frequent communication, continued verbalizations of safety tips throughout practicing, etc.). It has been a significant corrective experience for me to have many women and men take careful consideration of my safety while training.
When I try too hard and train too hard, my body lets me know immediately. Instructors are quick to encourage taking care of your body. They emphasize that sitting and watching is sometimes better than participating. I was once told “Take breaks from jiu-jitsu before it breaks you.” I find it difficult to take breaks because as a trauma survivor, feeling powerful is intoxicating.
I have had to learn at Gracie to accept my limitations. I train with men that are much bigger and stronger than me. When I master techniques, their size and strength doesn’t matter anymore. However, as a result of this difference, I have had to accept the reality that I need to know the techniques better than these men to accomplish control and safety. I have successfully executed the double leg takedown on a 250 pound man. I also managed to keep control of a 250 pound man in side mount control. I have had to accept the limitations of my age and strength, but in doing so I have also learned how to manage my limitations effectively.
Letting Go / Attunement
Having fun while making mistakes has been another corrective experience. Much of my abuse was centered on punishment for academic mistakes. To train in jiu-jitsu is to make 1000’s of mistakes and have fun while doing it. Newcomers to Master Cycle joke often that all they are trying to do is stay safe or just breathe. One of Gracie Jiu-Jitsu principles involves a concept of going with the flow. Once you have become fixated on accomplishing a particular submission, you inevitably create an opening for the attacker to defend against and even roll to an advantage. “Position before submission” is a concept that involves letting go of potential submissions in order to stay fluid and attuned so you can respond to what is given to you. Some of the best jiu-jitsu I have watched seems more like a dance than combat.
Friendliness / Gentleness
Smiles, hand shakes, and laughter set the tone at Gracie. Gentleness and consideration of your partner is emphasized every step of the way. Keeping each other safe and happily learning is a top priority and a great deal of time is spent making sure that trainees treat each other with respect and care. If any student is too aggressive or not assisting their partner in the “Gracie” encouraging way, they are quickly addressed and asked to leave if the problem persists. I will never forget my first partner - a young instructor from Mississippi showing me the “trap and roll” technique. He performed this technique with speed and precision while carefully cradling my shoulder and moving me in a way that protected me from muscle strain or injury. I am so grateful that he set the stage for me to know and feel how easy, fun and gentle the learning process could be.
Non-Reactivity / Confidence
As a trauma survivor, trigger reactivity has caused significant impairment in my life. When I first thought of testing for my Pink Belt, I knew that most candidates tested with Eve Torres Gracie, the female director of WE. I was concerned that in the reflex testing portion, where you are approached with a variety of attacks to which you must instinctively respond, that I would be triggered and might actually punch Eve. I came to understand that if I was still in a space of this type of reactivity, I was not ready to test.
As I continued my training, I instinctively put myself with the stronger partners in Women Empowered in order to push myself outside my comfort zone. As the weeks passed and I was feeling more confident with my skills, I scheduled a “pre-test” with a Alex Ueda. I felt very comfortable with this instructor and I did well. He explained that had it been a real test, I would have passed. Around the same time, I had noticed that whenever I was called upon to demonstrate a technique with Rener Gracie (Eve’s husband), I became reactive. I was not listening to his words, I moved too quickly and wanted to get as far away from him as fast as I could. It was odd because I admire his teaching, his gentleness, his encouragement and everything that Eve and Rener had created. But when he came anywhere near me, I got tense. After examining my thoughts, I remembered an ad for their gym about 20 years ago, and at that time decided it was not a safe place for me. I realized that in that ad, Rener looked like an attacker from my childhood.
I searched for the Facebook page of this attacker and it all came flooding back as I looked at his photo. I felt my body tense up, get nauseous, chest and stomach tight and breath being held. I reached out to Eve to share my discovery. She expressed gratitude that I entrusted her with my experience and that they had many trauma survivors over the years participate. She shared her experience that everyone responds to trauma differently and that they valued learning what would help me best (less contact with Rener, more, same). Her response was healing, validating and assuring that I was safe in this space. I felt so safe with her support that I asked if I might actually test with Rener as I knew it would be a true test for me of my abilities when triggered. Rener said yes.
From the time he entered the room for the test, I became 14 years old all over again. In a small room, door closed with Rener between me and the door, Rener calmly and slowly explained everything step by step. He encouraged me. It was not a surprise to me that I performed worse with Rener than I had performed with Alex. There were a couple very basic skills that flew straight out of my head when Rener put his hands around my neck. However, I was a triggered “14 year old” with a brand new set of skills and I passed the test. Since then I have had ample time to strengthen the reflexes of the few techniques in which I froze.
The thrill of passing with Rener was an enormous confidence booster. However what happened after the test was really remarkable. I opened up my attackers Facebook page again. Now as I looked at it, my body was calm. There was no reaction, no nausea, no chest tightening. I felt peaceful and I said out loud, “You are not a threat to me anymore, and I forgive you.” After years of therapy to recover from trauma, my logical mind knew I was safe but my body had to catch up.
The “victim” becomes a warrior at Gracie. It’s the complete opposite of the trauma suffered. I particularly like that almost all of the training emphasizes control over your attacker without submitting or hurting them. I can still remain compassionate and kind while strong in relationship to my attacker. I don’t have to become them (angry, aggressive, violent) to defend myself.
The scattered pieces of myself in my trauma narrative forgot about the warrior that I am (my strengths, my coping skills). This unique opportunity to grow in a safe and supportive environment allowed me to remember my true self and put myself back together. My whole body has learned to operate with calmness and fluidity to accomplish my jujitsu goals and heal the memory. It’s a challenge to express the full extent of gratitude for this program and what it has done for both my clients and me personally. I wish every trauma survivor would have the experience of profound healing that I have had at Gracie University. It has been, and continues to be, a spiritual jiu-jitsu journey for me.
Fighting Dissociation Phobia and Coming Out as a Professional with a Dissociative Disorder (Dr. Jamie Marich)
To access original piece with full comments published on 5-18-18, go to:
As you read the title of this article, I am somewhat scared about how you are judging me…judging us. If your information about dissociative disorders—or what the general public may still call “multiple personalities” - is from the movies (e.g., Split, Sybil, Primal Fear), we assure you, what you’ve learned about us is inaccurate. When I say dissociative disorder, it’s not lost on us that many of you reference these portrayals and maybe even assume that a deeply disturbed, murderous “alter” will pop out and get you. Or that, like in Primal Fear, our struggles are all an act to get us off the hook for bad behavior. What saddens me the most is the level of phobic responses to dissociation that we witness from other professionals in our helping fields—mental health and addiction recovery—even from those who claim to specialize in trauma treatments like EMDR therapy. Terms like Islamophobia, homophobia, and transphobia are now regularly used in public discourse. We assure you, dissociation phobia is a real thing and needs to be added to the list.
Every week we hear of or directly encounter stories like these:
This is a short list composed only of clinical examples. We can fill an entire book of tales on how family, friends, and the public are quick to label us crazy or defective when, in reality, the dissociative mind is one of the most beautiful constructs of creation.
Our minds are prismatic, multi-dimensional, and capable of solving problems that empirical science and its numeric precision can’t even begin to figure out. Many of us are extremely high functioning, creative, intelligent, and capable of bringing about real change in the suffering world because most of us can instantly respect and evaluate multiple sides of a story. Yes, we can be plagued by deep suffering and distress that can impair daily living, especially when triggered, invalidated, or negated. When we’re given the tools for healing—which must start with having our own experiences validated and our existence affirmed—the power of our post-traumatic growth may stun you.
The first client with dissociative identify disorder (DID) I ever treated with EMDR therapy expressed, “People fear what they don’t understand,” in attempting to explain his dissociation, an adaptive response to unspeakable early childhood abuse. Our own experience amends this statement slightly, “People fear what they can’t understand.”
The next phase of my work as a public figure in my field is to do my best to help you understand. It’s scary—we’ve been “out” as a recovering addict throughout our career and in recent years we’ve been fully out in all areas of our life as a bisexual woman. Being out as dissociative isn’t exactly a newsflash if you’ve followed my work closely over the years (I reference it in both of my books on EMDR therapy and disclosed my full diagnosis in an article with Psyched last year). However, coming out this boldly (to the level of using singular we pronouns…did you notice the fluctuation between I and we?) feels like the riskiest step I’ve/we’ve ever taken as a professional and a public figure.
We can hear our colleagues now—which include other writers and trainers in the field—snickering behind our back or in some cases in front of it. They have the potential to write me off as a crazy, unstable, untreated girl who loves the attention. Trust me, we’ve considered the reality that others may try to discredit us and we are remarkably okay with that; it shows just how significant of a phobia we are addressing. We fear that in the current political climate where such a fear of the other abounds, we’ll either be dismissed or targeted for how we interact with the world. A side effect of my dissociative mind has been a fierce love of diversity and pluralism, to the point where even our own liberal friends fear us for combating the cut-and-dry, us vs. them labeling that abounds in these modern times. Loved ones have even threatened or attempted to use my dissociation and its complications against me/us, threatening to expose how bad it can get to make me seem less credible.
I was diagnosed with Dissociative Disorder, NOS (now Unspecified Dissociative Disorder) in 2004 and I am one criterion away from qualifying for a full Dissociative Identity Disorder diagnosis (I have never been and am not amnesic about the experiences of my parts). Although dissociation was a mixed blessing of a survival response and a paralysis in my earlier life, the growth I’ve experienced through being properly diagnosed and treated has helped me to embrace how my mind works instead of resent it. You may be puzzled as to why I can be so candid about something that seems, on the surface, so dramatic. Here is the truth bomb—we all dissociate and we all have parts that compromise our internal worlds. I can come out so freely now because I’ve come to learn that I am not that much different from the rest of you.
Understanding how you personally dissociate and how your parts work is an important first step in understanding what those of us who surpass the clinical threshold experience. Are you ready for this? This may feel a bit daunting if you’ve never looked at it before.
Know Your Dissociation Profile
Have you ever daydreamed?
Have you ever drifted off or zoned out a little, especially when you were feeling distressed or bored?
Do you dive in to Netflix binges to numb out from life or imbibe in intoxicants, especially as a method of escape?
To overstate what may seem obvious, we all have. If you are a therapist, have you ever led your clients through a guided imagery exercise like the Calm Safe Place, prompting them to visualize “somewhere else” to relax? Yup—you’ve deliberately elicited dissociation, albeit a form that is adaptive for many. There’s a chance you may even like and make use of such an exercise yourself.
For those of us who dissociate regularly and tend to cross more clinically significant lines, the response to shut down or escape in our own minds developed early and became a bit more ingrained. It can be more difficult to come back to the present moment, especially if what we’re coming back to is highly distressing. Yet with the tools of recovery and wellness, especially those skills that can be learned in the realm of grounding and embodiment, we can.
As a kid, one of the abusive figures in my life routinely said, “Jamie looks like she’s been beaned in the head with a fastball.” Probably because I was daydreaming so hard to tune him out! My vivid imagination took me to some pretty incredible places and the hope I drew from these places made real life slightly more bearable. As I transitioned into adulthood, I experienced significant difficulties distinguishing fantasy from reality, which made coping with alcohol and pills (more tangibly dissociative methods) appealing. If these themes resonate with any aspect of your personal experience, you are well on your way to understanding our experience.
Many teachers describe dissociation as a continuum phenomenon. We all dissociate, some more than others, and the experience may manifest differently at different times depending upon the nature and intensity of stressors. Although the continuum is a good start if you can wrap your mind around this description, for me the idea is too linear. I prefer to think of dissociation as prismatic. Light flows through a prism to reflect a series of colors—the more angles on a prism, the more dramatically light splits as it comes through—resulting in fascinatingly complex and stunningly beautiful patterns and fragments. For a prism to be a prism, at least two angles made of material transparent to the wavelengths of light for which they are designed must exist. Some folks have two angles, others have hundreds. The more intense the light (which can be cast as a metaphor for life stressors in this case), the more radiant the reflection. For those of us who have learned how the angles of our prism serve us under stress, radiant is a great adjective. Prior to learning how they work, the dispersion of light can feel blinding and confusing, to us and to others in our lives. Hence, shutting down the prism altogether can become more appealing. When you notice us go offline in our affect, this could be what’s happening for us.
In discussing dissociation and its various expressions, it’s useful to discuss parts. Although the word “alters” may still be used in context around DID, parts has become a more widely accepted and less shaming term; particularly because even the most conservative, set-in-their-ways reader of this article can identify two or more of their own internal parts.
Do you ever reference having an inner child?
Do you ever see yourself as being one person at home and one person at work?
Are you calm overall yet notice certain things can trigger a rage response in you, like the Hulk popping out of Bruce Banner?
Congratulations—you have parts!
The same parts or internal experiences that shape the theater of your life are similar to what we experience. Ours just may be a tad more fragmented, to the degree that we’ve given them names, numbers, or colors in assigning their roles. Our parts regularly dialogue with each other and fight with each other, just like the discord that you may witness between family and friends. These parts generally developed at different times in our life journeys in response to traumas and other stressors to keep us safe and protected. Some of these parts may still show up as more pronounced when certain situations or triggers wreak havoc in our systems. When parts and their characteristics show up as more pronounced, if you are a therapist or loved one, it does little good to think in terms of, “What’s wrong? What’s happening?” Instead, try “What are you being protected from right now? How is this part protecting you?”
Many of our parts can be quite delightful and even serve us in our public lives and others have the potential to create more problems for us in terms of acting out or shutting us down. Telling those parts to shut up or go away is generally not helpful. They need to be heard. Moreover, placating any one part or even our whole systems with platitudes like, “You’re in a safe place” is generally not productive either. Listen to the part or the series of parts that are most activated and ask them what they need to experience more safety in any given moment. Yes, if you are a therapist some of the parts may scare you or cause you grief. That doesn’t mean that we love or value our parts any less or that integrating these parts into some homogenous alloy is the best solution. Even the parts that we tend to hate or resent for causing us more grief in our adult lives can serve a purpose and resent, maybe even more than the others, this suggestion of classic integration.
Think of the common metaphor of the melting pot that gets used to describe the American nation—i.e., these disparate nationalities coming together, melting down to emerge as “American.” This metaphor has been challenged by many scholars and thinkers because it suggests there is such a thing as an ideal American. Instead, the tossed salad or a pot of stew is proposed as a better metaphor because all the different parts or ingredients contribute to making a tasty whole. With clients who can seem more affected by certain parts reacting to stressors, get to know the composition of the stew or the salad and what it tastes like (or could taste like) when the ideal blend and preparation of ingredients are achieved. If one day there are more tomatoes (for example) than usual, there is likely a reason for it…and don’t assume that the excess tomatoes just need to be cut out. They may be meeting a nutritional need, metaphorically speaking.
The metaphors for understanding parts and how they interplay are various. Explore which ones may work to describe your experience and help clients to determine which ones may work for them. Some like to use versions of a conference or kitchen table, a van, a house, or even a bundle of balloons. My preferred metaphor for my dissociative experience can be explained through Dorothy in The Wizard of Oz. Besides my presenting self (Dorothy), I have three distinctive parts of various ages who serve roles like the Scarecrow, the Tin Man, and the Cowardly Lion. There is also an older, sage/crone part who has more of a spiritual, ethereal presence within me like Glinda the Good Witch. (If you are a fan of Wicked, yes, this sage/crone part is a mixture of Glinda and Elphaba.) Dorothy needed all of them to tap into the vital truth and learning of the story: “You’ve had the answer in you all along.” Dorothy needed all of them to get home.
All of us who dissociate to the level that may cause you to be scared of us are just searching for that yellow brick road that will take us home.
Will you shame us on our quest?
Or will you help us?
If your answer is the latter, thank you for taking the first step by reading this article. May you keep journeying on in your desire to understand your clients, which happens by first learning more about yourselves.
Photograph by Dr. Jamie Marich (March, 2018: Dubai, UAE)
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.