Bonus Episode: Lessons From Over 7,000 Trauma Therapy Sessions

After more than 7,000 trauma therapy sessions with hundreds of clients, some things have genuinely surprised me. How much the brain wants to heal. How wrong our cultural picture of trauma is. How the quiet experiences, the emotional neglect, the feeling unimportant, do far more damage than we give them credit for.

And one lesson that might be the most freeing of all: not everything is that deep.

This is the final episode of Season 1. Thank you for being here, I’ll see you next season!

• Read the Transcript

  Hello and welcome to the Trauma Nerd Podcast bonus episode. I meant to only do 11 episodes, but like I mentioned last time, I get ideas and then I want to follow through with them. So today is the bonus episode.

  This one's a little different because I don't really have a script. I just have a few things I wanted to talk about, because I want to share what I have learned after over 7,000 trauma therapy sessions.

  I sometimes say I've done over 7,000 EMDR sessions, which I technically have. But I actually think saying it's only EMDR is selling myself short, because the larger umbrella has been EMDR, but there are other therapies that have been incorporated within that. I've done internal family systems, imagery rescripting with schema therapy concepts, ego state therapy, and DNMS by Shirley Schmidt, the needs meeting protocol. All these different trauma therapies and healing approaches, all within the scope of the EMDR protocol.

  So I'm going to share what I've learned. I don't have a script, I'm just talking, so if it's a bit messy, I apologise.

  One thing that has struck me through my experience with the hundreds of people I've worked with is how much your brain wants to heal.

  A lot of qualified people in the health sphere talk about how well our body self-heals. In EMDR we sometimes use the analogy that if you cut yourself, you don't need to sit there and tell your skin cells how to heal the cut. It just does it. Your body knows what to do.

  My experience is that EMDR is exactly like that. For some people it's more complicated, for different reasons that are a whole other podcast. But it is entirely possible, and for many people this is exactly what happens, that you will attend an EMDR session to process a traumatic memory, and literally all you will do is follow fingers, or tapping, or a dot on a screen, and with very little further intervention, your brain will process that memory.

  You will think about it afterwards and go: it's a bad thing that happened. I know it's a bad thing. I feel very sad that it happened to me. But I don't feel it in my body. I'm not distressed by it. The past feels like the past.

  It will just happen. And throughout my career it has actually shocked me at times. I have sat there thinking, no way, I'm going to have to pull out the big guns for this one. And then I don't have to do very much at all.

  Setting it up requires knowledge, expertise, and experience: knowing what memory to pick, knowing how to set it up effectively. The better you get at that, the more likely it is to go smoothly. But it has truly astonished me how easily your brain will heal in the right circumstances, given the right conditions. Your brain doesn't need to be told how to heal. It knows what to do.

  It's made me view humanity, the human spirit, and our makeup very differently to before I started EMDR.

  I think society's general idea of what is trauma and what isn't trauma is wrong. So many people are surprised by this: I would say 90% of the trauma I work with is emotional neglect and emotional abuse.

  People expect someone like me to be predominantly working with the more stereotypical traumatic events. Sexual violence, physical abuse, being the victim of a crime, horrific accidents. Those things do come up, absolutely. But it's maybe 15% of what I work with. The overwhelming majority is emotional neglect and emotional abuse.

  People often come to trauma therapy with a suspicion that their past is involved, and usually they're right. But it's often the case that people come with a problem, maybe people pleasing, maybe being really mean to themselves in their heads, maybe social anxiety or low confidence, and they'll cherry-pick things from their history that look bad. The logical brain trying to create cause-and-effect links between the past and the present.

  It's often incorrect. In EMDR, when we develop the links, we use the body. We detect where the body is taking us. The logical mind doesn't think the same way the emotional brain does. They operate differently. So what is a link logically is often not accurate.

  When people come in with preconceived ideas, sometimes they're right, but I find most of the time it's either wrong, or not the full story. Me doing my job properly, I will always confirm those links. But I also don't want to waste people's time processing a memory that isn't the actual problem.

  Those stereotypical traumas, we call them the capital T traumas. The big events, the ones we think about when we think PTSD. Natural disasters, victims of crime.

  But more often than not, it's actually the lowercase t traumas that are quieter. They're smaller, but they are so, so meaningful.

  There's a study I find really interesting. A facility in the Netherlands called PsyTrek has been extremely influential in the trauma world and particularly the EMDR world. In 2020, they did a study on 97 people whose primary diagnosis was a personality disorder, about a quarter diagnosed with borderline personality disorder. These people were really struggling. But they excluded anybody who met criteria for PTSD. So no capital T trauma presentations.

  After just five sessions of EMDR targeting memories of things like emotional neglect and emotional abuse, experiences that do not tick the boxes of a formal PTSD diagnosis, the therapy worked, and their symptoms significantly improved.

  This is a really good illustration that the way we stereotypically think about trauma is not quite right. We under-emphasise the incredible importance of emotional neglect and emotional abuse, and we overemphasise other things.

  To give some examples: emotional neglect and emotional abuse fits experiences like feeling rejected as a child, feeling ignored, feeling abandoned, being treated in ways that leave you feeling unimportant and worthless. We do not give enough attention to those things.

  Trauma is my world. It's all I do. But I think I got to a point in my career where I was looking for trauma to the point where I was creating it in some cases. I'd meet a client and put my binoculars on: where's the trauma? Let's find it. Let's make it up if it's not there.

  I had been trained in a way that everything means something. You've overreacted? What's it linked to? What happened in your past?

  The biggest thing I've learned: it's not always that deep. Not everything means something. Not everything is about your past. To assume that everything you notice and feel and think is related to something in your past is just blatantly incorrect, and it's going to drive you crazy, because you'll start digging into your past trying to create a problem where there might not be one.

  Not to say there's not a problem. But it might not be your past that's the problem. It's a very reductionist approach that everything is trauma. It's not true. I've learned that very clearly through my work.

  The wellness space and social media are terrible for this. Everything means something. What does it mean? Let's find the problem. It's just not always that deep. Sometimes it is, of course. I would not have a job if it wasn't. But I don't make assumptions. I want the truth. Because if we assume your past is the problem and fixate on that, and it's not there, what a waste of your time. And we're ignoring the actual problem while we do it.

  I find this fascinating. There's an irony about trauma: it is both exceptionally complex and astonishingly simple.

  There are a limited number of ways things can go wrong in your brain. There's a pattern to it. There is a structure to how things get stuck, and that's why, in trauma-focused therapies, when someone tells me their story, I can usually figure out where things have gone wrong within an hour or two. Not because I'm a genius. Because there is a pattern to how things go wrong.

  There is an architecture to how trauma occurs and how it's healed. It's predictable. There is a general structure to the way your brain processes a memory, to the point where I can detect a problem with processing within a minute of it happening, because it's not following the structure it should.

  Make of that what you will, but I'm sure you'll understand why I get a bit bigger-picture about it. The problem occurs in a structured way and the healing occurs in a structured way, and it's all malleable and workable. It's quite incredible.

  I'm constantly humbled. Every EMDR session, I sit there thinking, this feels like a miracle every time. It's not, though. It's scientific. It's all in the research. But it's like witnessing childbirth. It happens every second of every day, and it never ceases to be miraculous when you witness it.

  I think that's it for my bonus episode. I hope you found it interesting.

  This is the end of my first season. Thank you so much if you've listened. It means so much to me. I've got some really exciting stuff coming, some other projects in tow. Subscribe to the mailing list so you get updates.

  I'll leave you there, and I will talk to you soon.