That being said, when complex psychological concepts weave their way into mainstream culture, their original meaning can get lost in the hullabaloo, and “triggers” are no exception. As our society becomes more comfortable talking about trauma, I think it’s important to understand what triggers are, how and why we get them, and what we can do to manage them when they show up.

Want to learn more? Contact Ellie Mental Health and get connected with a therapist who matches your needs today.

What Are Triggers?

Triggers are anything (a sound, a smell, a place, or even a situation) that brings up a strong emotional reaction tied to past experiences. For people who have experienced trauma, triggers can make it feel like the past is happening all over again, leading to anxiety, panic, or shutting down. Learning to recognize triggers is an important part of healing because it helps people build awareness, develop coping strategies, and regain a sense of control over their emotions.

What Does It Mean to Be Triggered?

When we are triggered, we lose our capacity for rational thought. Our prefrontal cortex (the thinking part of the brain) gets hijacked by our limbic system (the reacting part of the brain) and blocks our ability to effectively problem-solve, listen, advocate for change, or carry on a productive conversation (note: if you are in actual danger, you haven’t been triggered; your limbic system is simply doing its job, which is to keep you safe.)

The Relationship Between Trauma and Triggers

Triggers do not exist in the absence of trauma. So, to understand triggers, you first need to know a little bit about trauma.

For better or for worse, trauma happens to all of us at some point. Not only is trauma inevitable, but it also teaches us how to survive, which is probably why we are wired to react more strongly to the bad stuff that happens to us than we are to the good stuff.

Broadly speaking, here’s how trauma impacts us most of the time: The bad thing (i.e., traumatic event) happens, we have a big negative emotional response, and then once that bad thing is over, the brain processes the experience, gleans the lessons that can be learned from it, and then files it away into our long-term memory. This is what I call Wisdom. It’s why your thrice-divorced grandma is able to give you excellent relationship advice.

Sometimes, however, a bad thing happens to us, we react, the bad thing ends…but we are prevented from processing the experience and learning from it. This can happen for a variety of reasons, some more complex than others. For now, suffice it to say that the bad thing and the big negative emotional response sorta get frozen in time and stored together in the limbic system, becoming unprocessed trauma, or what I call Baggage. Baggage is why my grandma, who was a child during the Great Depression, would furtively stuff leftover pork chops into her purse when we went out to eat, despite having a fully stocked pantry at home.

The Fallout from Unprocessed Trauma

 Ok, so here you are today, with your Wisdom and your Baggage. Sometimes, negative things happen to you, and while you may have some lingering feelings about it, you are able to reach back into your storehouse of wisdom, grab the lessons you have learned from similar experiences in your past, and make your next move accordingly.

Once in a while, however, you may encounter a situation that falls into the Baggage category, and it sends you into an emotional tailspin. In fact, you feel just like you did the very first time something similarly awful happened to you. You may even be aware that your response is totally outsized, given the actual situation, but it doesn’t stop you from freaking out anyway. The reason for this? You have been triggered.

In other words, your triggers are located inside your Baggage.

Types of Triggers

Triggers are deeply personal and can vary widely from person to person based on their experiences and sensitivities. Some triggers are external, like a specific smell, a loud noise, or a familiar location, while others are internal, such as certain thoughts, emotions, or physical sensations. What feels neutral to one person might be overwhelming to another, making it important to recognize individual patterns. Understanding these differences helps people develop personalized coping strategies and regain control over their responses.

Examples of Internal Triggers

Internal triggers come from within, and they are often linked to thoughts or emotions that unconsciously activate unresolved trauma. Since these triggers are internal, they can be harder to identify and may seem to come out of nowhere.

For example, someone who experienced a past abusive relationship might feel an unexpected wave of panic after experiencing a moment of self-doubt or criticism. Even if nothing in their environment is threatening, the familiar feeling of inadequacy may unconsciously resurface memories of past emotional harm. Without recognizing the trigger, they may spiral into distress, reinforcing the emotional pattern. Learning to identify and address internal triggers:

• Fear
• Anxiety
• Stress
• Physical or emotional pain 
• Intrusive thoughts
• Loneliness 
• Abandonment

Examples of External Triggers

External triggers come from the outside world and can include specific sights, sounds, smells, places, or even people that unconsciously activate unresolved trauma. These triggers are often tied to past experiences, making the brain react as if the original event is happening again. Because they’re connected to the environment, external triggers can feel sudden and overwhelming, sometimes catching a person off guard.

For example, someone who was in a car accident might feel a surge of panic when hearing screeching tires, even if they are safe in a parking lot. Their body instinctively reacts to the sound, triggering memories of the crash and the fear they felt in that moment. Without realizing they’ve been triggered, they may experience a racing heart, shallow breathing, or an urge to escape. Recognizing external triggers can help you develop strategies to manage your responses and regain a sense of control.

• Sights
• Sounds
• Smells
• Anniversaries
• News stories
• Music
• Situations

How to Identify Triggers

So how do you know if you’ve been triggered, or if you’re just upset? First and foremost, you need to determine if your emotional response was disproportionate to the situation. For example, it is perfectly reasonable to get upset at someone for making fun of your shoes. But if you take your shoes off and hurtle them at the person’s head, along with every offensive word you can think of, I think we can agree that is a disproportionate emotional response, and it could be a sign that somewhere in the past you have some unprocessed trauma.

To be very clear: getting super upset does not, in and of itself, mean you have been triggered. For example, if you are a woman or person of color, no doubt you’ve been told more than once you are overreacting to a situation simply because you had a stronger reaction than the people around you. It should go without saying that a person of color would probably have a bigger emotional response to a racist remark than a white person would. A woman may have a more negative reaction to a misogynist joke than the men in the room. That does not mean they have been triggered. But if the woman responded to the misogynist joke by setting fire to the joke-teller’s car, that’s your clue she may have been triggered.

How to Deal with Triggers From Trauma

The bottom line is that while you are not responsible for the trauma that happened to you, you are the only one who can do anything about it.

Now for the good news: You can do something about your triggers! You are not at the whim of the people around you! Huzzah! 

One way to help manage your trauma-related triggers is through mood tracking or journaling. There are also several widely used therapeutic interventions to help manage trauma triggers, all of which have a sizable body of research supporting their effectiveness. EMDR, Adaptive Internal Relational Network (AIR) Therapy, Brainspotting, and Trauma-Focused CBT are a few of the most widely used interventions that have a sizable body of research supporting their effectiveness. These tools and therapies can help to get to the root of the issue and get you to feel some relief.

Want to learn more? Contact Ellie Mental Health and get connected with a therapist trained in any of the above modalities.

The post How to Recognize and Manage Trauma Triggers appeared first on Ellie Mental Health, PLLP.

Through years of training and practice, I’ve learned that Dance/Movement Therapy (DMT) is much more than just dancing to feel good. It is a powerful, evidence-based psychotherapy approach that integrates movement to promote emotional, social, cognitive, and physical well-being.

Before diving into what DMT is, let’s start with what it isn’t.

What Dance/Movement Therapy Is NOT

Many misconceptions surround Dance/Movement Therapy. Let’s clear some up:

• Not a Dance Class: Clients do not need to know how to dance or be “good” at dancing to benefit from DMT. It is not about learning dance techniques or choreography.
• Not a Form of Physical Therapy: Although movement is a core element of DMT, its primary focus is psychological and emotional healing, rather than rehabilitation for physical injuries.
• Not Just for Women: There may be a misconception that DMT is only for those who identify as female. However, it is a therapy for all individuals, regardless of gender.
• Not for Everyone: Like any therapeutic approach, DMT may not be the right fit for every client. The best therapy is the one that aligns with a person’s needs and comfort level.

Check out our recent interview with a Dance/Movement Therapist here:

The History and Definition of Dance/Movement Therapy

Dance has been used for healing purposes in cultures around the world for thousands of years. However, modern Dance/Movement Therapy as a psychotherapeutic practice developed in the 20th century.

The Origins of Dance/Movement Therapy

One of the pioneers of DMT, Marian Chace, began using dance as a therapeutic modality in the 1940s and 1950s at St. Elizabeth’s Hospital in Washington, D.C. She later co-founded the American Dance Therapy Association (ADTA) in 1966, helping establish DMT as a recognized field.

According to the American Dance Therapy Association (ADTA), Dance/Movement Therapy is:

“The psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the individual.”

ADTA members have expanded this definition to include:

“The intentional use of dance, creative movement, body awareness, and embodied and spoken communication, facilitated through the therapeutic relationship, to foster healing and wellness for individuals, families, and communities.”

What Can Dance/Movement Therapy Treat?

Simply put, DMT can be utilized to treat anything and everything. Examples include:

• Aging and Dementia
• Autism Spectrum Disorders and Intellectual Disabilities
• Learning Disabilities
• Psychiatric, Emotional and Behavioral Disorders in children
• Stress
• Anxiety
• Mood disorders
• Eating disorders
• Low self-esteem
• Relationship concerns
• Trauma
• OCD

…and so much more! A Dance/Movement Therapist will work with you to determine the best approach for your treatment area and goals.

How Does Dance/Movement Therapy Help with Trauma?

Sometimes it can be difficult to articulate trauma experience through words. The body holds memories. When faced with certain stress triggers, we may experience reactions such as shortness of breath, clenched fists, or the flight/flight/freeze response. DMT offers clients a safe space to express their emotions and process their experiences in an embodied way. Over time, this can help individuals to release these held memories and emotions and gain a sense of control, safety and sense of empowerment in their bodies.

Find an Ellie Dance/Movement Therapist near you.

Where Is Dance/Movement Therapy Used?

Dance/Movement Therapy is used in a variety of settings, including:

• Mental health facilities
• Rehabilitation centers
• Medical settings
• Educational institutions
• Forensic settings
• Nursing homes
• Disease prevention and health promotion programs
• Private practice

DMT can be practiced with people of all ages, backgrounds, and in various formats, including individual, couples, family, and group therapy.

How Does Dance/Movement Therapy Work?

Dance/movement therapists help clients improve self-esteem, body image, communication, relationships, and coping skills. By observing and analyzing movement patterns, therapists can help clients gain deeper insight into their behaviors and emotions.

What Happens in a DMT Session?

A Dance/Movement Therapy session can include:

• Expressive movement with props (scarves, stretch bands, balloons)
• Seated or standing movement activities
• The use of different types of music
• Guided imagery and visualization
• Breathing and meditative relaxation exercises
• The use of metaphor, play, and storytelling
• Individual movement, partner work, or group interactions

The goal is not to perform but to use movement as a tool for self-expression, healing, and personal growth.

The Mind-Body Connection in Dance/Movement Therapy

DMT recognizes that we are not just our minds and not just our bodies, but a combination of the two. What impacts one, affects the other.

By engaging in movement-based therapy, individuals can work through emotions, build resilience, and foster a greater sense of self-awareness.

Is Dance/Movement Therapy Effective?

In a word, Yes. Research in the field has demonstrated that DMT can be effective at decreasing depression, decreasing blood pressure, improving psychological and physical outcomes in cancer patients, addressing trauma, improving balance and communication in older adults, and so much more. To learn more, check out these research articles from ADTA or this article found on the National Institute of Health’s site:

Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update – PMC

Do You Need Dance Experience for Dance/Movement Therapy?

No, you do not need any dance experience to participate in a DMT session. Your therapist will guide you in various forms of moving, that may include movement warmups, use of imagery in movement, and use of props such as scarves or stretch bands, to help you express your emotions and address your treatment goals with focus on the mind-body connection. They will meet you where you are in your therapeutic journey and never push you to engage in a way in which you are not comfortable or physically able to do.

How Does One Become a Dance/Movement Therapist?

There are master’s level programs at select schools throughout the country, as well as alternate route training available. After graduating, therapists can apply for their R-DMT (Registered DMT) or go on to pursue their Board Certification and become a BC-DMT. Continuing Education credits are required every five years. In addition to webinar courses, the ADTA holds a Virtual Spring Summit as well as an annual conference in the Fall, held at different regions of the country each year. This year the ADTA will be holding its 60^th annual conference in Raleigh, N.C. In addition, there are numerous opportunities to become involved through local chapters and national committees. For more information, visit www.adta.org .

Ready to Experience Dance/Movement Therapy?

If you ever have the opportunity to try a Dance/Movement Therapy session, I hope this breakdown has given you a better understanding of what it is—and isn’t. I’ll leave you with a quote from American dancer and choreographer Agnes de Mille:

“The truest expression of a people is in its dances and its music. Bodies never lie.”

To learn about other “non-traditional” forms of therapy, check out these other blogs from Ellie Mental Health:

Art Therapy Techniques, Benefits, and Applications | Ellie Mental Health, PLLP

What is Psychedelic Therapy? | Ellie Mental Health, PLLP

VR Therapy and its Mental Health Benefits | Ellie Mental Health PLLP

Listed to Ellie’s podcast episode about Dance/Movement Therapy on Spotify. Read the transcript below:

Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda. I am a licensed clinical social worker, and I’m here with Shelby. Shelby, do you want to introduce yourself?

Shelby: Hi, I’m Shelby. I’m here at the Ellie Mental Health Clinic in St. Petersburg, Florida. I am a registered intern mental health counselor, but I’m also a registered dance movement therapist. It’s interesting to have both fields and bring that to the table for people.

Miranda: So, with dance movement therapy, is that a specific degree you pursued, or is it training you received after earning your mental health or master’s degree?

Shelby: It’s interesting—the school I attended actually offers a psychology minor. I completed that along with everything else. The full title of my degree is Clinical Mental Health Counseling with a Specialization in Dance Movement Therapy. The school is Lesley University in Cambridge, Massachusetts, and their program combines psychotherapy and dance movement therapy at the master’s level.

It’s a two- or three-year degree, and once you finish, you’re eligible to become a registered dance movement therapist. You just submit your application, log your hours, and then meet your state’s licensure requirements—whether that’s becoming an LMFT, licensed mental health counselor, licensed clinical social worker, or whatever fits your state’s obligations.

Miranda: Which of those programs did you complete, or which licensure are you pursuing at this point?

Shelby: So, I have my license in dance movement therapy. You can either be a registered dance movement therapist (R-DMT) or a board-certified dance movement therapist (BC-DMT). You have to be registered first to move up to board-certified status, which requires more experience.

As a registered dance movement therapist, you can do everything a board-certified therapist can, except for things like conducting official research studies. You can still provide therapy, work with clients, and collaborate in the field. But becoming board-certified is a great next step—it just opens more opportunities.

The track for that is pretty straightforward. If you’ve done enough work within your program, you’ll continue building on that. There are always conventions and networking opportunities happening. I stay connected with my cohort, too—we all grew really close during the program. Now, we’re spread out, each bringing different viewpoints on how to apply this approach to both dance and therapy.

Miranda: That is so cool. I appreciate you walking me through that because, in my mind, it’s similar to art therapy. You can infuse creative techniques into your practice, but unless you’ve completed the specific training, you’re not a registered art therapist.

Similarly, as a licensed clinical social worker, I could incorporate some movement techniques with my clients, but that doesn’t make me a dance movement therapist. That distinction makes sense. How did you get started with this? It sounds amazing.

Shelby: It’s a long story—one with a lot of emotion and depth.

I started dancing when I was a freshman in high school and immediately fell in love with it. I always knew I wanted to combine dance with helping people. For the longest time, I thought that meant working with individuals with physical disabilities. I was especially driven to do that because I have a physical disability myself—I’m hearing impaired.

That was my focus for years. But then, in 2015, I got devastating news—my boyfriend had passed away. It was incredibly difficult. I struggled to verbalize what I was feeling. I was so young, and at the time, I was working on a dance project for class. I couldn’t bring myself to continue with the original focus, so I asked my dance professor if I could change it to help me process my grief. She said yes.

I ended up creating a video that was both a celebration of my boyfriend and our story, but it also portrayed the stages of grief. That project was a turning point for me. Something clicked. I realized there was a profound connection between physical movement and emotional healing, and I knew I wanted to explore it further.

I started researching mind-body connections but couldn’t quite find what I was looking for. Then, one day, dance movement therapy randomly popped up on my Facebook feed. I started diving into it and instantly knew, this is it. This is what I’m meant to do.

From there, I researched schools, programs, and what I needed to make this a career. I went all in. Dance movement therapy became my passion—combining mental health with creative expression. I still have the option to work with individuals with physical disabilities if I want, but the mental health aspect really resonated with me. Using movement to help people heal is so creative and fulfilling—it sparks so much inspiration in me as a therapist.

Miranda: Oh, thank you so much for sharing that. That’s incredible. I love how you recognized the healing power of movement before you even fully understood the therapeutic connection. You were processing your loss through dance without realizing how impactful it was, and now you get to help others do the same. I have chills—that’s so cool.

So, what exactly is dance movement therapy? What does it look like in practice?

Shelby: That’s a great question. When people hear “dance movement therapy,” they often think, Am I signing up for a dance class? But no—it’s not a dance class.

The foundation of dance movement therapy is the belief that movement is our first language. We don’t come out of the womb talking—we move. Even in the womb, there’s movement. It’s how we first communicate our needs.

Dance movement therapy taps into that innate language. It’s not about formal dance styles like ballet or hip-hop. Instead, it’s about exploring each person’s natural movement. What feels authentic to them? When they’re angry, how does their body express it? When they’re sad, how do they physically carry that emotion?

As therapists, we help clients reprocess and reframe emotions through movement. It’s a psychological approach that integrates physical expression into social, cognitive, and emotional healing—just like other forms of psychotherapy, but using the body as a key tool for expression and processing.

Shelby:
It’s just in a nonverbal way, but we also recognize the importance of verbalization. To be able to have that too, because once it processes in the body, they can be like, “Oh, okay, now I can verbalize this a little better.”

There are some dance movement therapists—I like to do this too—who practice a “let’s move, let’s talk, let’s move, let’s talk” approach. Then I have some people who are strictly like, “Hey, I don’t want to do verbal,” and I’m like, “Okay.” We’re just going to do movement for the whole session. It’s about bringing in those dance movement therapy skills and helping them on a therapeutic level during those times.

Miranda:
I have so many questions. This is so cool. Okay, what does your office look like? Do you have space to move?

Shelby:
In my office, I have space for me and one other person. If it goes beyond that, or if the person wants more room, I’ll move us over to the group room so they have more space.

I can also do dance movement therapy via telehealth. It doesn’t have to be in person. If any of my clients are interested in virtual sessions, I just want them to have space where they don’t feel constricted.

Also, dance movement therapy doesn’t have to be done standing. It can be done sitting, lying down, or in any way that makes the client feel comfortable—especially in the beginning when it can feel really vulnerable. Being okay with that can be hard, so I let them take the lead with some guidance. Then, we work on building up rapport and confidence in movement.

It’s fun. It’s interesting. I always do it at the client’s comfort level.

Miranda:
Do most of your clients seek you out specifically for dance movement therapy? Or do they tend to have a background in dance?

Shelby:
I have some clients who reach out specifically for dance movement therapy. They’re like, “We want this. We want a holistic approach,” because essentially, that’s what dance movement therapy is—even though we’re applying psychotherapy skills in the session without people realizing it.

Some people see me for just dance movement therapy. Others want both—they’ll say, “Hey, I want dance movement therapy, but I also want talk therapy.”

Miranda:
Sure.

Shelby:
So, I always have two plans in my head for those clients. If they’re doing talk therapy that day and need to process something, I have a plan for that. If they’re wanting dance movement therapy, I have an ideal movement plan ready.

Some people also reach out to me specifically because they want a body-positive therapist. They trust that, as a dance movement therapist, I’ll be body-positive and affirming. I’m not going to shut anything down or dismiss their experiences, which they may have faced elsewhere.

I help them build self-esteem and become more comfortable in their bodies. It’s about fostering body positivity for themselves.

Miranda:
Oh, that’s so cool. When you’re doing dance movement therapy, I think I know the answer to this, but it’s not like you’re saying, “Alright, we’re going to process your grief now, so these are the movements you do for grief,” right? It’s not that structured—it’s more client-led, with whatever movements feel right for them?

Shelby:
Definitely. It’s based on movements that feel comfortable for them, but as the therapist, I’ll gently challenge them to push further when appropriate.

I create treatment plans with my clients. With dance movement therapy, I’ll ask, “What do you want to focus on? Grief? Trauma? Anxiety? Depression?” Then, we set goals and priorities.

For example, if someone comes to me for trauma, I might have them draw something out. Then I’ll say, “Okay, now let’s move with this. How does this move you?” It gets their creativity flowing and helps them explore what their experience looks and feels like through movement.

It’s their story. It’s like they’re becoming the narrator of their story through movement—expressing what their trauma felt like or what they actually experienced.

I have some clients who’ve suffered from domestic violence. If they were choked or held down, they might show those movements. I know the areas of the body where they’ve suffered, and we can work on processing those experiences through movement.

As the therapist, I’m observing and assessing in the moment—while also helping them process. It’s very client-led, but it can also be structured if they feel more comfortable with that. I always check in and say, “This is your body. This is your movement. How your body moves is different from how mine moves. What does this look like for you?”

Miranda:
I would imagine it’s very different from a dance class. It’s not like you’re teaching them specific dance moves. It’s more about showing how their body processes emotions, right? Asking, “What does that movement look like for you?”

Shelby:
Exactly. I’ll also bring in props if I notice someone is struggling.

If I sense they feel “stuck,” I’ll bring out a bunch of props and say, “What do you gravitate toward?” It helps them express their feelings tactically.

A lot of people choose my dancing scarves—these see-through, colored fabrics. The colors can represent emotions. For example, some people pick orange or yellow for anxiety. It’s interesting to see the connections they make.

As they work with the prop, I’ll ask, “How does this feel for you?” Then, I’ll guide them to incorporate it into their body movements. “Where do you feel this in your body?” It helps with the transition into deeper movement exploration.

Miranda:
That’s awesome. A couple of weeks ago, we did an episode on self-care with a therapist (shoutout to Taylor!) who talked about how she processes stress by dancing after work.

I was so inspired by that. Dance is such a great way to release feelings and move your body—especially for therapists who sit all day. Even just being silly or shaking off stress can be so helpful.

I’m curious, what role does music play? Do you choose the music, or do clients choose their own?

Shelby:
It’s different for all ages. With kids, music is huge, of course.

The type of music matters. For example, if we’re working on grief but the music is really upbeat, the client might shift away from processing and just match the music’s energy. As the therapist, I have to assess: “Have they processed enough and now they need this change, or do we need to refocus and switch the music?”

I have several dance movement therapy playlists. Some people get overwhelmed choosing music, so I’ll offer playlists with different moods. I have grounding music—more mellow, meditative tracks—and more intense emotional music that still includes some grounding elements.

If clients bring their own songs or playlists, I fully support that. I just ask that we’re mindful of explicit lyrics since we share office space with other therapists and clients of all ages.

Miranda:
That makes sense.

Shelby:
If a client’s music has explicit content, I’ll ask them to find a clean version. That way, they still feel validated by their music choice while maintaining a therapeutic environment.

Miranda:
Are clients ever choreographing routines, or is it more free-flowing? Like, do they say, “I’m going to dance to this song next week,” or is it different each time?

Shelby:
It can be either way—there’s so much creativity in dance movement therapy.

I’ll ask clients, “Do you want this to be free-flowing, or do you want it choreographed?” Some want something special and structured, like what I did in my own video. Since I was a dancer, mine was choreographed.

If a client wants to choreograph, I’ll honor that. It can be challenging, so I’ll support them through it. But if they want free-flowing movement, I’ll honor that too. It’s entirely based on their comfort level.

Miranda:
That’s great. I’m assuming you’re moving with them—you’re not just sitting and watching, right?

Shelby:
Exactly. Most of the time, I’m moving with them unless they tell me otherwise. I don’t want them to feel alone or like I’m critiquing them. Moving together helps create connection, and I can still observe and assess while participating alongside them.

I’ll mirror exactly what they’re doing—nice and easy—whatever they feel comfortable with. If they say, “Hey, I’m done,” then we’ll close it out. And I’ll ask, “How did that feel for you? What did you notice, especially with the trauma story?”

When they’re doing that mirroring, it can be really liberating for them to finally have someone who’s reflecting their movements. It’s like saying, “I understand what you’re feeling. I hear your narrative. I’m validating your feelings and moving through this process with you.”

I actually did my dance movement therapy thesis on trauma and how to apply these techniques for different trauma situations. It’s fascinating to use dance movement therapy techniques to help someone rewrite their narrative through movement.

Miranda: Mirroring is such a cool concept. I can see how helpful that would be for people. What are some other techniques you often use with clients that are similar?

Shelby: My go-to technique is something I call a body map.

The body map can be whatever the client wants it to be, but it helps both of us see what’s happening in their body. I don’t typically introduce it in the first or second session. I usually wait until there’s more rapport built. When we do it, they create a body map.

There are two ways to do this, depending on their comfort level. They can either trace their body on a large poster board or use a smaller, printed outline of a human figure. On the map, they label emotions they feel in certain areas or identify triggers, like words or music, that evoke specific sensations.

For example, if they feel anxiety in their hands and I notice their hands shaking during a session, I’ll say, “We talked about this during the body map. This is a trigger. You’re feeling anxious right now. Let’s pause and ground.”

Often, people place sensations in their stomach. I’ll notice that they start slouching or cowering inward, almost as if they’re protecting their stomach. That body language tells me a lot, and the map helps me recognize and respond to it.

I always do another body map when they’re ready for discharge. It gives us a visual representation of any changes. We can look at it together and say, “This is how dance movement therapy helped you.” It’s a tangible way for them to see their progress.

Miranda: That’s such a cool tool. I often have Gina on the podcast—she was my clinical supervisor—and she does EMDR, mostly with kids. She talks about using body maps a lot to help kids identify feelings and where they experience them physically. I love that you incorporate this into dance movement therapy too.

Do you mostly work with kids, or do you see adults as well? What ages do you typically work with?

Shelby: It’s all ages. Dance movement therapy has no restrictions. We can adapt it to fit anyone’s needs.

If I have elderly clients, I tailor the movements for their abilities. I also see younger women, and sometimes younger boys. As they get older, boys are often more hesitant due to the stigma around doing something artistic. But I have worked with some older boys who are willing to challenge that stigma.

Overall, dance movement therapy is completely adaptable. There are no restrictions on mental health diagnoses, age, or physical abilities.

Miranda: That’s so important—and so cool—because I can imagine some people might wonder, “Can I do this if I have mobility restrictions?” It’s great to hear how flexible and inclusive it is.

Do you have certain diagnoses or presenting issues that are your niche or that you prefer to work with?

Shelby: I’m pretty open, but I do tend to see a lot of clients with trauma. This includes sexual assault, physical assault, and childhood trauma.

Everyone knows the book The Body Keeps the Score, but it’s true—your body really does hold onto trauma. I often work with people who feel like they’ve cognitively processed their trauma through talk therapy, but they’re still experiencing lingering physical symptoms. That’s where dance movement therapy helps bridge the gap by connecting the mind and body.

I also work with people processing grief. Grief can make you feel physically weighed down, like you can’t even walk. Through movement, we practice releasing some of those heavy, chained feelings.

I see a lot of clients with anxiety as well. Many of them recognize that their anxiety shows up in their body before it registers in their mind. So, they come to me wanting to learn how to regulate their physical symptoms first, knowing that the cognitive response will follow.

Dance movement therapy is also helpful for people with autism, ADHD, and other neurodevelopmental disorders. When I worked in a facility, I saw a wide range of diagnoses. It really just comes down to whether the person is open to the experience. If they’re hesitant, we explore why. Are they afraid something might surface? Or do they simply feel it’s not their thing? It’s fascinating to see how different people respond.

When I was at the facility, I often ran dance movement therapy groups. People would ask, “Are you doing individual dance movement therapy sessions?” and I’d say, “Yes, but only a few per week.” The group format was more common. We’d choose a topic and work through it together using movement.

Miranda: A dance movement therapy group is such a cool idea—I hadn’t even thought about that! Do you choose the music and topic each week, or how does that work?

Shelby: I always choose the music. When you have a large group, it’s hard to cater to everyone’s preferences. That’s where my playlists come in handy—I have a variety to fit different moods and themes.

I do ask them for topic suggestions, though. Boundaries is a big one that comes up a lot. We work on identifying physical boundaries and building the strength to say “no.”

Anxiety and stress management are also frequent topics, along with depression. Sometimes, the group gets super specific, but I try to keep things broad and relatable so no one feels left out. I want everyone to feel they belong, no matter their experiences.

Miranda: When you choose the music, do you typically go for instrumental or with lyrics?

Shelby: It depends. Sometimes I’ll ask, “Do you prefer lyrics or instrumental?” and go with a majority vote. I remind them they’ll get through the group either way, and to just breathe through it.

Other times, I’ll choose the music myself and have it playing softly before they even enter. It helps set the tone and creates a welcoming atmosphere.

Some dance movement therapists always have music playing beforehand, while others don’t. Personally, I like giving the group the chance to experience some quiet before we start—it gives them more agency. When they get to participate in those little choices, I notice their eyes light up.

I always make sure the lyrics are clean, of course. Lyrics can be powerful. People often resonate with specific verses or chords. That emotional connection adds another layer of processing. It’s not just about the movement—it’s about making meaningful connections between mind and body.

For me, it’s all about being flexible. Everyone has their own preferences, and I want to make sure the group feels accessible and effective for all.

Miranda:
For a therapist who’s listening to this, who might be thinking, I didn’t go to school for dance movement therapy, but I have a client who would probably really benefit from doing some dancing in sessions, how would you recommend they approach that?

Maybe it’s a good opportunity for grounding, or maybe it’s a chance to help release some anxiety. What recommendations would you have for a therapist who just wants to dip their toes into it and help their clients?

Shelby:
Grounding is the easiest one for me. When I was starting in the dance movement therapy world, it was easier for me to grasp. There are so many ways you can help someone ground through movement—whether that’s small or big.

In dance movement therapy, breath is huge. We want to make sure we’re breathing while we’re moving. But also, if you notice someone starting to hyperventilate, it’s important to take that moment to be there with them.

I like to add an extra layer to breathwork. I don’t just say, “Okay, listen to my voice and breathe in and breathe out.” I want clients to feel their breath. So, I’ll have them place their hands where they’re comfortable. If they’re stomach breathers, I’ll have them place their hands on their stomach to feel the rising and falling. If they breathe more through their ribs, I’ll have them place their hands on the sides of their ribs or on the front and back, so they can really feel the breath happening.

Tapping is another great one. It’s not hugely well-known, but guiding clients through tapping on their wrist, temples, or center of their chest can signal the body that it’s okay. It creates a new sensation to focus on, helping them get grounded.

I also use progressive muscle relaxation—tensing and releasing different muscle groups. When people get anxious, their bodies often tense up, especially in the shoulders and neck. Leading them through some gentle stretching or progressive muscle relaxation can help release that tension.

Another technique I use for grounding is guided visualization. I have clients visualize their safe or peaceful place, walking them through the path to get there. Once they’re there, I have them take a few breaths and then start incorporating movement. I’ll guide them to imagine moving in their peaceful place and begin mirroring that movement in their body.

So, while they’re mentally in their safe place, their physical body is also moving, keeping them present. It’s often a lot of flowing arm movements, especially if they’re sitting down. You’ll see gentle, wave-like motions because they’re regulating themselves.

To bring them back, I’ll say something like, “Okay, let’s bring your hands together. Take a deep breath in, let your arms circle out, and then come back into the present moment.” I’ll ask, “How was it to be in the present moment and grounded at the same time?” And clients are often like, “Whoa, what was that?”

For kids, I’ll do something playful, like patty-cake, to shift their focus and bring in some fun. Sometimes, I’ll use a coping and grounding skill sheet with random body movements and have clients try them out. It gets creative and spontaneous, which can be really effective.

One piece of advice I always share: try it on yourself first. If you have an idea for a grounding technique but aren’t sure how it will feel, practice it yourself before doing it with a client. That way, you have a sense of how it might land and feel more comfortable guiding them through it.

Miranda:
Okay, you’ve given so much good advice—this has been such an awesome episode. I really appreciate you coming on and sharing your personal connection to this work, as well as giving such practical tips for how therapists can start incorporating movement into their sessions.

Any last thoughts or anything you feel we’ve missed about dance movement therapy?

Shelby:
It’s an ever-evolving field. Therapy as a whole is always changing—there’s constant research happening. Dance movement therapy has been around for a long time, but it wasn’t always recognized as evidence-based. Now, we’re seeing more and more research proving its effectiveness.

There are dance movement therapists currently working on applying cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) techniques to dance movement therapy sessions. That way, it can be more easily billable through insurance and provide clients with even greater benefits.

Trauma work has always been a big focus for dance movement therapy, but seeing these additional modalities incorporated is exciting. It makes me think, “Ooh, what does this do for the field moving forward?”

Miranda:
Thank you so much again for joining me, Shelby. This has been such an insightful episode, and I really appreciate you sharing your expertise.

And thank you to everyone listening! I hope this conversation was helpful and inspiring. See you next week!

The post What Is Dance/Movement Therapy? Benefits, Myths, and How It Works appeared first on Ellie Mental Health, PLLP.

We’re diving into the origins and mechanisms of Brainspotting: highlighting its focus on allowing clients to process trauma by fixing their gaze on specific spots and the science behind it. This blog also discusses the application of Brainspotting, including self-spotting, and its unique benefits for therapists who often juggle multiple stressors.

The Basics of Brainspotting

Brainspotting is a powerful treatment method developed by Dr. David Grand that helps people access, process, and overcome trauma, negative emotions, and various psychological and physical concerns. Billie explains the origins of Brainspotting:

Billie shares: “Brainspotting was really born out of EMDR. Dr. David Grand discovered Brainspotting during his work as an EMDR therapist… Last fall, I did a talk at a conference here in Oklahoma, where I had a room full of therapists, and I asked who was familiar with this modality. And only three or four people in that room had heard of it. And so, it really is coming on the scene, but it’s coming fast.”

Unlike EMDR, which involves moving the eyes back and forth to process trauma, Brainspotting focuses on finding a single spot where the client feels a strong emotional or physical response and staying there.

Brainspotting is great for anyone struggling with trauma, anxiety, or depression. It’s particularly helpful for people with PTSD or complex trauma, but it can also tackle things like performance anxiety and unresolved conflicts. Basically, it taps into the brain’s natural healing abilities to help you work through tough stuff and find relief.

The Science Behind Brainspotting

The science behind Brainspotting lies in the deep connection between eye position and brain function. Billie elaborates, “Our eyes are essentially just a part of our brain, made of neural cells. They are one of the first organs to develop in utero and come from brain cells… There are six major muscles that are connected to our eyes, and those muscles are connected to all of the pathways of the brain.”

The principle is that by holding the eye gaze at a specific spot, clients can unlock and process deeply held trauma and emotions. This approach differs from traditional talk therapy by integrating the body and mind more holistically.

During a Brainspotting session, a specific eye position, or “brainspot,” is identified—this spot is where the client’s brain holds onto traumatic memories or intense emotions. By maintaining focus on this spot, the therapy leverages the strong neural connections between the eyes and the brain. Additionally, Brainspotting often uses bilateral sound, which mimics the natural processing pathways of REM sleep, to help both hemispheres of the brain work together in processing the trauma. This dual activation facilitates the deep processing and integration of traumatic memories and emotions, offering a more holistic healing approach compared to traditional talk therapy.

Brainspotting in Practice

Billie provides insight into how Brainspotting works in practice:

“It’s going to be a different spot for everybody and even with each person there are going to be different spots, depending on a lot of factors: the different experiences, different emotions, or just different things that we’re working through.”

To find these spots, therapists use their attunement to observe their client’s reflexes, energy shifts, and bodily sensations. The client is then guided to focus on these spots while noticing and verbalizing their emotions and sensations.

The Therapeutic Journey with Brainspotting

During the podcast interview, Billie emphasized the flexibility and personal nature of Brainspotting: “Brainspotting leaves a lot of room for whatever is needed in that moment, which is a little bit different than EMDR… The big phrase that we use in Brainspotting is ‘follow the tail of the comet.’ Follow whatever’s coming up in the room, and that’s where we go.”

This approach allows sessions to be tailored to each individual’s needs, making the process both unique and effective. Billie explains that the emotional intensity of different “spots” can guide the therapy, whether towards grounding or processing through heightened anxiety.

Self-Spotting: Empowering Therapists

An intriguing aspect of Brainspotting is its applicability to use on your self. Billie describes self-spotting as a valuable tool for therapists:

“This has been one of the things that has been most helpful for me in my own processing and my self-care… Typically you’ll use bilateral sound… You can find bilateral sound if you search on Spotify, Apple Music, there’s YouTube videos.”

By finding their own Brainspot and using bilateral sound, therapists can work through any leftover stress or emotional baggage from their sessions. This helps them feel better and be even more effective in their work (because we know this can be really hard work!).

How to Find a Brainspotting Therapist

At Ellie, we make it easy to find the right therapist for you. You can search providers on our website, fill out a contact form, or give us a call. When you’re scheduling your first appointment, be sure to let the client access specialist know that you are looking for a Brainspotting-trained therapist. They’ll confirm the therapist has availability and takes your insurance.

Ready to begin with a Brainspotting-trained therapist? Click the link below to get started.

Another way to find a therapist trained in this modality is by going through the Brainspotting directory. You’ll be able to filter therapists by state and level of training.

Healing from Toxic Work Environments

In this podcast episode, we spent a lot of time talking about how Brainspotting can help therapists deal with the stress from toxic workplaces. Billie opened up about her own experiences in tough work environments, how they really took a toll on her, and how she used Brainspotting to reconnect with herself and set better boundaries.

If you’re dealing with a toxic work environment but not quite ready for Brainspotting, check out our blog post about setting professional boundaries here.

Action Steps for Incorporating Brainspotting into Sessions (for Therapists)

1. Educate Yourself: Start by reading Dr. David Grand’s book “Brainspotting,” which provides a comprehensive overview and practical tools that you can start using immediately with your clients.

2. Attend Trainings: While the book provides a solid foundation, attending official Brainspotting trainings can deepen your understanding and skills. (I just signed up to be trained through brainspotting.com—the website recommended by Billie!)

3. Try Self-Spotting: Begin practicing self-spotting to manage your stress and emotional health. Use bilateral sound and find your Brainspot to process daily stressors and residual work-related trauma.

4. Introduce it to Clients: Gradually incorporate Brainspotting techniques into your practice, observing how your clients respond and adapting as necessary.

5. Network and Support: It can be SO helpful to join consultation groups to talk and learn from other practitioners, especially when you’re just starting out.

In Closing

Brainspotting is a versatile and accessible modality that offers profound benefits for therapists and clients alike. Whether dealing with trauma, stress, or the residuals of a toxic work environment, this practice provides actionable tools for effective emotional and psychological healing. We hope this exploration inspires you to consider integrating Brainspotting into your practice, benefiting both you and your clients on the journey to wellness.

For more resources and in-depth discussions, don’t forget to check out our full podcast episode with Billie Ferguson, LMFT.

The post What Is Brainspotting Therapy? A Comprehensive Guide for Beginners appeared first on Ellie Mental Health, PLLP.

The discussion covers their backgrounds, the education required to become an art therapist, and various techniques and benefits of art therapy. The guests share

• Insights on using art in therapy sessions for both children and adults
• The role of art therapy in treating trauma and anxiety
• Provide practical prompts and methods for therapists looking to incorporate art into their practice.

This episode is a valuable resource for therapists and anyone interested in the power of art therapy. Listen here:

Read the transcript:

Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda Barker. I’m a licensed clinical social worker here at Ellie, and today we’re talking about art therapy. So we have two amazing art therapists on the podcast with us today. Do you two want to go ahead and introduce yourselves? Chelsea, you can go first.

Chelsea: Yes, my name is Chelsea Wire. I’m a licensed professional counselor in Missouri. I’m working out of the new Ellie Wentzville offices just outside of St. Louis.

Kailah: My name is Kailah Tuttle and I am a licensed professional counselor and also a co-clinic director at the Ellie in Ann Arbor, Michigan.

Miranda: Awesome. So how long have you two been practicing as therapists and specifically art therapists?

Chelsea: Hi, Chelsea speaking. I graduated in 2011. Since then, I’ve received a graduate degree art therapy counseling.

Kailah: I’ve been practicing counseling for seven years now, and art therapy specifically for about four years.

Miranda: What’s your graduate degree in?

Kailah: Clinical mental health counseling.

Pathways to Becoming an Art Therapist

The American Art Therapy Association website clearly defines and explains that to be an art therapist, one MUST attend a master’s level program in the field of art therapy, but it’s important to realize that any therapist can incorporate art into their practice.

Kailah:  I know there are kind of some different pathways of how to get there of like we have an intern starting with us who is dual doing both mental health counseling and art therapy.

So you can kind of do them in tandem through graduate work. But I actually did a continuing education program. It was a two year program all online, all different sorts of courses, and it was very trauma informed. So, expressive art therapy is kind of the umbrella that we operate under.

Miranda: That sounds great. So, theoretically, I mean, I’m a social worker, so I could do a could do like a [training] and then and then it sounds like you would receive supervision to and then you could have those additional letters behind your name.

What about if I’m just a regular therapist? Can I do art therapy skills in sessions without being full trained or certified.

Kailah: Absolutely.

Miranda: I mean, that was kind of like a leading question because I mean, yes, I, I do art therapy skills with the kids that I work with and like the college students, but it’s one of those, it’s one of those funny things where it’s like, yes, I like, maybe I’m not a play therapist, but you can do play therapy. Without the additional training, you can’t call yourself an art therapist, but you can use art in therapy.

Kailah: Yes.

Understanding Art Therapy

Miranda: So what is art therapy?

Kailah: Yeah, art therapy is kind of like an extension of therapy and expression to me. So, there’s something about art and expression that gets to somewhere that language can’t. A lot of trauma is pre verbal, so it can be helpful to use other types of therapy modalities for that.

Art just gets to some of those areas that we can’t always through general speaking.

Chelsea: I agree with Kailah. It’s experiential. This helps with problem solving, understanding something that, especially if you don’t have the words for yet that can be creative that you can see, feel.

Miranda: No, that makes sense. I think that when I initially think of art therapy, I think of that one assessment – the house, tree and person assessment. I don’t even know what this assessment is for.

 If you’re not familiar with this assessment, it’s, it’s essentially like you have your client draw a house, a tree, and a, a person, and this assessment says that you can psychoanalyze different things about it. So they might be like, wow, you drew yourself the size of the house. Maybe that means you have a big ego. That’s not really what one of the assessment things is, but that’s kind of the spirit of the assessment that I understand.

So I imagine art therapy is that you sit with your client and you’re like, okay, draw me a picture. And then you kind of psychoanalyze a bunch of it and you’re like, okay, this means you have a bunch of trauma or this means that you don’t have a good relationship with your mom or something.

But, I know there’s more to it, but is, is that a part of art therapy that you do or is that, am I like way off?

Kailah: I don’t really use it as like diagnostic criteria. I think that’s actually pretty discouraged. I think of it as like an extension of like what we’re already doing in therapy of like, it kind of builds concepts or kind of brings things home that we’re already talking about or working on.

I do think that there can be some insight glint. So like, for example, if someone’s like, I really hate this person, and I don’t want them in my life anymore, but then maybe we are doing, a common technique like a safety island where it’s like, bring all your safe people, and then they put this person on the island, then I might say “well before that you said you hate this person,” and just kind of point that out. It just kind of like builds that bridge between that internal world and that external world that they’re expressing.

Art Therapy Techniques and Tools

Miranda: Okay, what is a safety island? It might be something worth talking about but, what is that?

Kailah: Yes, so you can do this in any number of ways I really like it but I have people make this island and it’s like all the things that would bring you safety, so, like if you think of like a calm safe space, like typically I have people go through their senses and say, you know, I see these things and they bring safety or calm.

Miranda: Are you having them draw it, or like paint it?

Kailah: Yeah, you can draw it, you can paint it, you can do it with mix media or however you want. But then, and the waters around it are like those things that are dangerous that they’re trying to like get away from. So like in the waters might be like depression, anxiety, like self harm, like whatever the thing is that they’re trying to create safety from.

Miranda: Oh, I love that. Chelsea, what do you think about kind of the art therapy as a diagnostic thing versus like just kind of a tool that you’re using in therapy? How, how do, how do you use it?

Chelsea: Sure. So really it’s more about what comes up for the client, but what something means. And we can infer some things, you know, like you mentioned the, like the person is as large as the house.

Like, what’s this person like in comparison to this other person that was drawn in the image, or if you were to draw another person, what size might they be, you know, or how might you place them in the space that keeps them more open to how they might interpret.

In regard to diagnostics one that’s good that that I remember learning about in graduate studies with art therapy was it’s called the Levick Emotional and Cognitive Art Therapy Assessment, aka LACATA, and it’s a series of several different drawings that can help give kind of an idea about what themes keep popping up and did something shift between like this drawing or that utilize more so with, with kiddos.

So that one has been good because it’s been reliable and valid within sessions, but in regard to diagnostics to like that can come between session to session and what comes up in that space, you know, any themes, patterns.

Miranda: So do you just kind of leave it super open ended or do you have it more as like directed? In play therapy terms you’ve got like non-directive and directive play. Is it similar with art therapy?

Chelsea: I think so. It kind of depends on the kiddo and your relationship with them thus far. Like, is it their first session? Is it their seventh session?

Have they expressed, “I’m willing to try this” or “I can’t draw,” (and I’m using air quotes in that). That’s something that comes up a lot, especially with adults that I’ve worked with, and so that’s something more to explore, “where did that come from for you, and has that shown up in other areas?”

I might introduce it kind of like, well, “let’s just play,” or “if you’re willing, you know, let’s try this.”

I might say, “this can be, you know, if it’s a canvas or whatever is there, this can be that container,” or you can say, “what does that drawing or that creation look like for you?”

Miranda: I love that. I’m sure you both have clients that come to you that are like, I don’t do art. So what do you do with people who are like “I don’t know. I’m not very creative.”

Kailah: Yeah, I, I think that’s such a, a myth and or misconception in art therapy of like I have to be creative to do art therapy and that’s not true. That’s why I like kind of calling it more like expressive therapy sometimes or talking about expressive interventions because you do not need to be artistic at all.

In fact, I usually find that the more “artistic” people will sometimes be a lot more perfectionistic. They’re like overanalyzing their work or they’re tearing it up or they’re like, this didn’t come out how I wanted when that’s done. It’s kind of the opposite of what you’re supposed to be doing is more like that in the moment expression.

I’m like, I’ve done art therapy with grown men and kiddos. Like, there’s like a wide spectrum who can benefit from this.

If they’re saying this but are for a loss at words, then sometimes I might pull out a piece of paper or a canvas or something, like, “do you think you could kind of like, at least do some like symbols or shapes or colors that it would be?” And they’re like, “Yeah, actually.” So then it’s a little more informal, just based on like whatever’s in the moment.

But sometimes, like if someone’s like, “I’m really struggling with this thing.” We have all these interventions and kind of approaches in mind, but it’s more just finding like what’s that fit in the moment based on the client experience.

Miranda: Maybe it’s our second session. We’ve done the diagnostic assessment and we’re just like, I want to get to know you.

This is going to sound silly, but I do the wordle every single day and it’s like, I have a couple of go-to first wordle words, right? Like audio, pearl, you know, whatever. But but so do you, so in, in therapy or in art therapy, do you have a couple of like, here are my initial like prompts that I like to start out with?

Chelsea: One thing that I’ve done before is I will take a piece of paper. It could be eight and a half by 11 is fine. And I’ll say, you know what I’d like you to share a little bit about you. And I’m going to share with you a little bit about myself too. And I’m going to start on one end of the page.

And you’re going to start on that end of the page. We’re just going to make some, some marks together. You’re going to make marks down there and I’m going to make marks over here in all different colors. That’ll let them pick, you know, markers or oil pastels, they can choose material. And so. They’ll make some marks and I’ll make marks and eventually we’re somewhere in the middle, we’re going to figure out what we’re going to do with that space.

And so to me, that’s like, okay, like that could be like, you know, what might their boundaries be like in that space? Are they having, are they playful? Are they cautious? You know, how do I want to support them on the page in that space? So to me, I’ve found that that’s helpful with meeting clients kind of where they are and they can get to know me a bit too.

And I invite also like, if they want to share more during that time. Or if they want to, if they have any questions about me, you know, I might share about that. So just again, depending on the client about what’s planned for them and what they’re ready for, because we might not talk, we might share a little bit, we might talk a lot.

Kailah: One of my favorite getting to know you activities is creating a name tag – about how you would introduce yourself. And that’s like more than your name, right? So they can like write their name, however they want. And then here are some things about me and I make one as well.

I think that’s another piece of art therapy that’s very important– the co-regulation of doing it with them is very important. You’re not just sitting and staring at them with a clipboard, and making these notes or observing. But when you’re doing it with them, like, you’re being vulnerable with them, and you’re sharing the process of “this is what I’m feeling or noticing,” or “this is what I want to include.”

Miranda: I love that.

Art Therapy for Different Age Groups

Miranda: So, I forget, do both of you work with like kind of all ages or, or do either of you like specialize in kids or adults?

Kailah: Yeah, I work with all ages. I mostly see adults now just because I have my own little one at home. So, I work pretty daytime hours and that tends to be when mostly adults and college students are working and more so needing services. I do see a few kiddos. I started working with kids primarily when I first started therapy, but mostly adults and typically adults with trauma is my thing.

Chelsea: Same answer on my side.

Miranda: Like exactly the same. Oh, that’s so interesting. I can relate. I became a parent for the first time two years ago. I also started initially seeing kids and then I have shifted more to college students and teenagers so I can be home more in the evenings with my kids.

 How does it vary, or like, what are some of the differences between seeing kids in art therapy and seeing adults in art therapy?

Kailah: Kids are naturally a lot more expressive and willing to do playful, kind of like in the moment things.

I’ve never really had to convince a kid to do art therapy. They’re just like, cool, like, here’s some markers, here’s some paper, whatever. They’re a lot more playful. We’ll just kind of go with it. I mean, they’re like very, the kids that I’ve seen are very, like, you can give them any sort of prompt and they’ll just kind of like take it as their own.

I find that adults are a lot more like, wait, “what was I supposed to be doing?” Or like, “what did you want me to do here?” And kids are just like, “Okay, yeah, you give me a general concept, and I’ll just have fun with it.” It’s the imagination potential.

Chelsea: I like how you said that imagination potential. It’s not that adults are not imaginative per se. It’s just that it seems like they’re not as used to doing that on a day-to-day basis, possibly. Like, if it’s not something that they bring into whether it’s like their workplace or at home. And so it’s like they’re going back to, you know, Kind of like, well, what do I know about these materials or what do I know about this?

So yeah, I like using that phrase and shifting it to like, “well, let’s play with these materials” because it kind of helps break that if there’s a perceived barrier. There seems to be less of a sense of like inner critic that comes up with kiddos.

Miranda: That’s a good way to put it. Yeah. I mean, I think that I’m a very creative person.

I like creating things, but as soon as you put me in a room with another adult and the adult is like, “Hey, create this.” I’ll be like, “Ooh, okay. Are you going to psychoanalyze this?” I don’t know, are you going to tell me I, I drew this wrong or something?

What are some of your other, like, favorite go to prompts when you are working with adults or kids? Thanks.

Kailah: Yeah, I really like doing emotion wheels. That’s a good example of how there are really easy ones to implement are going to be things that already there’s kind of like a template for.

Like, these are things that you don’t have to be an art therapist for. You can find these things on Pinterest, Teachers Pay Teachers. There’s all sorts of different resources out there. But anyways, the emotions wheel helps to talk about like how you can feel more than one emotion at once.

So, you draw a general circle and kind of section that off into four pieces or eight pieces or however many feelings that you wanted to include and then just kind of jot down like here are all the emotions that I’m noticing and then how would I represent those in the pieces and you can use that for adults too but it’s just kind of gets at how I can feel insecure and anxious, and I can also be really excited about something, but we have all these different complexities to our emotions and expression gets at that.

Chelsea: Yeah, it’s hard to choose just one to share. One that comes up for me is I call it like a resiliency rock tool. And so you have like river rocks, around the size of you palm.

And then I bring in, pre-cut words from magazines. And I have them hold the rock. It’s like a mindfulness exercise and just noticing the texture, the temperature, maybe the color. And they’re noticing any significant features about the rock. And a lot of times the rock like starts off feeling kind of cool and it warms up in their hand as they’re holding it.

And they’re like starting to feel that weight in their hand. And then I invite them to go through these pre-cut words. And because I found that if I give them a magazine, a lot of people just like end up looking at the magazine versus if there’s pre-cut words and it’s like, okay, it’s all there.

And they can choose what jumps out to them about what has helped them through those (pun intended) rocky, harder, or heavy times. And they might pick out, for example, like maybe recognizing that it was a transition to something different.

And then these are the different things that have helped them keep going, even though it’s been difficult, or a challenge, so to speak. And so then we use Mod Podge and place those on the rock and then it’ll dry clear. And so they have this rock, you know, you can’t dismiss that this has happened.

Yes, this, you had this experience and what helped you through that process. And so they have that reminder there.

Miranda: I love that. Oh my gosh. So actually just keeping on that same kind of, or that same topic.

Art Therapy for Trauma and Anxiety

Miranda: Kailah, you talk about doing. a lot of trauma work within art therapy. I’m assuming you’re not just going, “Hey, paint a picture of the worst thing that’s ever happened to you.”

So what does art therapy look like when you are kind of doing some trauma interventions?

Kailah: So a lot of trauma and how art therapy can get at that at a very basic level is really getting in touch with the body because there’s so much disconnect between internal experience and then so many people are in like a freeze or dissociated or numb state after trauma.

So getting in touch with those bodily emotions is a really common starter. One starter intervention I would do is, body scans. I’m also an EMDR therapist (Link to EMDR blog), so I kind of, like, use both of those about, like, like, how would you represent this in your body?

That’s a really good one where you can just pull up a template of a body and just kind of notice how they’re feeling. If people are having trouble with that, sometimes music can also be a really good cue into that of like, if they have a certain artist that makes them feel some type of way, like putting that artist on and just kind of like, we’re just going to sit here and just kind of jot down what comes up with colors and symbols and just kind of thinking through that internal experience. It’s like we’re trying to proactively get in touch with what’s already there and then make meaning and wisdom out of what we have in our internal landscape.

Chelsea: Yeah, trauma is so much in the body with, you know, muscle tension or just those bodily sensations.

Again, like, it’s nonverbal. It’s what that sensation is. And you brought up EMDR earlier. Another intervention, too, is a bilateral drawing. You can use a larger paper, but like using both hands, you know, right and left together, use different colors or multiple and moving them together in tandem.

You have them create that back and forth. I’ve seen this done standing up or sitting or I’ve seen people lay down on their bellies, even a lot of adults, it seems like they get a lot from that too. It’s not just kids.

Miranda: Very cool. Are there other diagnoses that you feel like are helpful with art therapy?

Kailah: Yeah, I mean, there’s so much, like, I don’t think there’s necessarily a bad place to start, but it’s, if you think about anything where people are, like, struggling with something internally and they’re looking to get it outside of them, like, that’s kind of what I think of with expression.

I mean even like general life stressors, or anxiety is a really good one because there’s just so much floating around in our head, we ruminate and we just like go over and over and over. But sometimes it just takes that, it’s the same thing with therapy, right? Like people will say, Oh, I didn’t even realize that until I just said it out loud.

And you’re like, okay, yeah, like it’s a similar thing of like drawing it out or expressing it through movement or whatever it is. It’s just one another layer to understanding.

Favorite Art Therapy Prompts and Tips

Miranda: Do either of you have a prompt or like something that you’ll do with someone if they’re feeling anxious or if they are needing to process any anxieties.

Chelsea: I’ve asked people to consider if they could create that anxiety through something tangible. I brought up inner critics earlier. It seems like that can be one source of anxiety too. Whenever they make that, whether it’s on paper or you have like random materials, like aluminum foil or yarn, like they’ll create that.

And then if they’re into writing, like I might ask them too, “okay, how could you create that?” It could be like floating in the ocean together side by side. Or it could be like, okay, well, the light shining on this anxiety and maybe the shadows not as big as I thought that it was, you know? You’re creating that that experience outside of ourselves.

So it’s something that is a part of me and isn’t who I am. And then by that, having that tangible creation, okay, now what? What do we want to do with that? And how do you want to navigate that moving forward? It becomes like a, kind of, Holding that space with them.

Kailah: I like doing safe spaces a lot. That’s a good one. I’m just like building your safe space and those elements. Kind of like the safety island idea. I also really like monster making. Like, especially with kiddos. That’s fun.

Like if your anxiety was a monster or a bully, or if the clients likes video games– like a final boss. Like, what would it look like? Like, what kind of details would it have? And then you can kind of get a sense of, it usually gives some insight into what it is that they’re really anxious about. Like, does this monster look like someone?

Or I’ll ask, “does it remind you of an experience from your past?” Because so much of that anxiety is rooted in past experiences of whether it was like, rejection or different types of fears that have happened over time. But just kind of getting in touch with, okay.

I think of like the scene in, there’s a scene in Harry Potter where they like make their fears into something funny, but it’s like, you can draw it out and then you start to look at it and you’re like, actually, like, why does this thing have so much power over me? It’s pretty ridiculous when you think of it.

Miranda: Absolutely. Oh, I love that. Any other things that we feel like we’re missing? I mean, you, you both have given so much good information. What are some of your other like favorite parts about art therapy or things that you think we missed?

Kailah: If you’re looking for a good place to start, like templates, like there’s so many workbooks and art therapy techniques, I love, Pinterest is a really good resource too, I go on there and scroll for techniques all the time. People think “I have to be an art therapist or I have to be creative or have to be this or that.”

And no, it’s just kind of like meeting your client where they’re at. If you already have a client that’s creative, like, or that wants to utilize some art, like that’s, that can be a really good place to start.

And art when I say art, that’s like art and expression is such a broad term. So this is not just drawing and painting. It can be sound making and movement and expression of all different kinds. It can really be anything that’s. Like expression as an extension of the body.

But just, you know, kind of find your element. Like expression can be so large and art therapy makes such a good intersection to other therapeutic techniques, like finding your thing.

And like, if you love CBT or ACT, like there’s so many intersections between these worlds. So just kind of finding like your own rhythm and your own style and just kind of see like, how could I incorporate more expression or how could I help this client really bring this.

Chelsea: Mm hmm. Yeah, I found too especially in my internships and I’ve started to get back into it just recently is that I’m so glad is starting to make some art on my own whether it’s like just a little bit in between sessions or during a break or at the end of the day, just to kind of have my own container, put this in of like, you know, “where have I started?” and “where am I now?” Just to help get it out of, of my own head.

In regard to materials, I’ve seen so many people create so many neat things from various objects too. And then they get to choose what to do with that. One thing that I did learn over time, is that the art and the process belongs to the client, just like, you know, any of their expressive therapy, or even like someone’s experience overall. We can provide that space and it’s you know, but what they create and take with them. That’s for them.

Miranda: I’m curious, do you ever have clients that like create art and then they want to destroy it?

Chelsea: Yeah, and you said the right word “being curious” about it. Depending on what was created, it could be pretty, pretty glaring of like, “okay, I can see why they did destroy it,” whether it represented something I’ve noticed that could bring closure, or it could bring a sense of control over what was created or what they want to do next with that process or insights that were made. Yet really it’s what’s helpful for the client in that space.

Kailah: Yeah, I think it’s all about the intention of destroying it, of like, this is something that I’ve come to terms with, so I want to burn it, burn it, or rip it, or shred it, but, like, that’s very different than, “Oh, this isn’t good enough” and then that, but that creates its own line of conversation of like, “why do you think this isn’t?”

Because no matter what they express, we can do something with it. But yeah, if it’s from like a perfectionism mindset and they’re trying to destroy it, that’s, that kind of leads you into another level of insight too.

Chelsea: Definitely. And depending on too, like where that comes from and what you find out when you’re like being curious and wondering perhaps that could invite maybe transforming it to something new if they would like to.

Final Thoughts and Takeaways

Miranda: Any other last thoughts before we, before we go? This has been such a good introduction to art therapy.

Kailah: I feel like when I think of art, I always think of Miss Frizzle from the Magic School Bus. She is one of my heroines, but she always says, “Take chances, make mistakes and get messy.” And I feel like when we’re talking about art therapy—like what better wisdom to leave you with?

Chelsea: I agree a hundred percent. I would say too, stay curious and you won’t be disappointed. Whether it be a client or therapist.

Miranda: I love that. Awesome. Well, thank you both so much for joining!

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The post Exploring Art Therapy: Techniques, Benefits, and Real-Life Application appeared first on Ellie Mental Health, PLLP.

They discuss the basics of the EMDR process, including the importance of creating a safe space and the various methods of bilateral stimulation used in therapy. They also talk about their personal experiences with EMDR, the different types of traumas it can address, and its application for both children and adults.

Whether you’re a therapist interested in training or someone curious about how EMDR can help, this episode offers valuable insights and practical information.

Read the Transcript:

Miranda (Host): Welcome to the Therapist Thrival Guide. My name is Miranda Barker. I’m a licensed clinical social worker and I’m here with Amber and Gina. Amber, do you want to go ahead and introduce yourself first?

Amber: Yeah, absolutely. My name is Amber. I’m a co clinical director at Ellie Mental Health Ann Arbor in Michigan. I am an LLMSW.

Miranda: What does that mean? LLMSW?

Amber: Limited License Masters of Social Work.

Miranda: Got it. Okay. So in our state, is that the same as like an LGSW?

(Amber nods)

Gina: Gina, take it away. Okay. Hi, I’m Gina. I’m at Ellie, Minnesota at the Mendota Heights location.

I’ve been with Ellie for four years. and I am the director of the Embedded and In Home Therapy team.

Miranda: Awesome. Gina has been on our podcast so many times because she was my clinical supervisor and so she feels like she has to say yes to me whenever I ask her to do things.

What is EMDR?

Miranda: But today we are talking about EMDR and I knew that this was a topic that Gina would want to talk about. This is probably the most requested topic –I mean, people are always messaging me with topic ideas or like putting it in reviews, which if you’re listening to this, please rate and review on your, on your podcast platform.

EMDR just keeps coming up because I think people are so fascinated by it. And I personally don’t know a ton about it. I have had several clients that I have referred over to Gina for EMDR, and so I’m excited to have this episode and talk a little bit more. So yeah, where do we want to get started?

Why don’t we, why don’t we just talk about like, you know, really basics. What does EMDR stand for? What is EMDR?

Gina: EMDR stands for Eye Movement Desensitization Reprocessing. It was developed by Francine Shapiro in the 1980s when she realized that there was a connection between bilateral stimulation, and I’ll go on to explain that, and processing difficult thoughts and memories.

And bilateral stimulation is just sensory experiences on one side of the body and then the other side of the body. that’s simply, very simply put.

Bilateral Stimulation Techniques

Gina: And then EMDR allows a lot of different options. for, bilateral stimulation depending on the client’s preference. The most traditional one that we see, I think in media is the going back and forth, like this with your fingers.

And you’re like, how am I going to do this for like 10 clients all day long without my arm hurting?

Amber: We also did like the butterfly hug, so also like crossing your arms and tapping left and right on your shoulders, which is a great alternative for, again, when you’re on the video screen, sometimes you’re not getting the full bilateral.

So doing the tapping, you’re getting the left, like left, right, left, right, on, virtual sessions.

Gina: Yeah. And I think there’s even like tapping your knees too, like my therapist and I see each other over telehealth. And she can’t tap for me, so I tap my own knees while I’m doing my own processing, right?

And then there’s also, I call them buzzies. Amber, I don’t know what you call them. But they’re little handheld plastic devices that vibrate and you hold one in each hand and it plugs in.

Amber: I have the ones where you can do it from your phone. So you can just be sitting there and your client can hold on to them.

Miranda: So for those of you that are listening or reading and not watching the video, it looks like kind of a remote control or like a guitar pedal or something.

Gina: This is the box that controls everything. These are the devices that you hold in your hands.

Miranda: Oh, they look like something that you’d put on your chest to like, and do “clear!” Yeah, they’re like little, they’re small discs.

Gina: Yeah. And they vibrate. And with this box that Miranda talked about, it’s like a remote, I can control how fast the vibration is and then how intense the vibration is, and then you could also plug in headphones to this and there could be sound.

That’s the other way we do bilateral simulation is sound. and I can control the volume of the sound. So if I have somebody that needs two ways of bilateral stimulation, like that works best for them, we might do the buzzies as these are called. And then we also might do sound and they would wear headphones and the sound would go back and forth.

Miranda: I’ve also seen that there are ways that you can do it with lights. Is there like a, how does it, are light bars?

Gina: (Nods) Some people in Ellie, Minnesota, have light bars and they’re really large. they’re like, Sometimes a foot to two feet to three feet long, and they have little tiny Christmas lights in them, and they, the light will flash quickly from one side to the other.

So then nobody has to move their hands. The client can just stare at the lights going back and forth. And again, you can control those. Like from a remote control with the light bar. The light bar is expensive. It’s probably the most expensive option. We’re talking like 600 to 1, 000 depending on the light bar.

So that’s certainly an option too for somebody who has a heavy caseload of EMDR. A light bar would make a lot of sense.

Miranda: So there are so many different tools to kind of mimic that bilateral stimulation, but could you explain a little bit more about what the bilateral stimulation is or like what is going on with our bodies when that’s, when you’re kind of going from left to right?

Gina: Yes, absolutely.

Understanding Trauma and Memory Processing

Gina: And Amber, please feel free to like interrupt me, if I’m getting anything wrong or if you want to add anything from my understanding of it is when our brain experiences a trauma that overwhelms our brain. Go into fight, flight, or freeze, right, or fawn, and the memory will break up and get stuck in different parts of our brain, right?

So the part of it that wants to tell the story, it’s stuck in that part of the brain. The part of it that is about the senses, as far as like what we saw, what we smelled, what we felt, those are stored in different parts of the brain. and that’s an adaptive way for us to continue to move forward, right?

It’s a little bit of like compartmentalizing is your body’s like, well, I can’t think about this all at once. It’s, it’s going to stay stored in these different parts of the brain. And eventually your brain, like any other structure in your body wants to heal, right? And wants to process and bring those things together.

So EMDR is the idea of briefly thinking about the difficult thing that you experienced or went through while also experiencing the bilateral. stimulation that we just talked about in its various forms. This allows you to integrate all of the different parts of the memory and the experience into one experience and allows you also to create a personal narrative about your own function in the memory or the trauma that happened.

So what I always like to talk about when I talk about EMDR is I cannot change what happened, right? I, I am not going in there and adjusting or changing any memories. What’s most important to me is what you believe about yourself related to this trauma. We call that the negative cognition and the positive cognition, right?

So that’s the language we use to talk about what’s the negative belief that developed after this trauma happened to you. And Amber, I don’t, I don’t, Most commonly actually a client who I just saw yesterday was like, well, this is all I’m helpless. I’m powerless and she was like, that’s all it is. We’re just going to end up doing that one eight times.

And I was like, you know what? I want to tell you that’s probably the most common negative cognition.

Amber: Yes, I agree.

Gina: Everyone is powerless. “I’m helpless.” Or “I don’t have control.” And I’m here to process all 18 versions of that, right? Because in life that happened so much. and so I said, my, like my top three are probably “I’m powerless,” “I should have done something” and “I wasn’t in control” or “I’m not in control.”

 Everybody has versions of those traumas that they get stuck in. and so that’s really the piece that I want to talk to people about is that EMDR can change the way you think about yourself through that trauma that you lived through.

Amber: Yeah. And just speaking off of what Gina said, a way that I also explain it, cause it’s a lot of fancy-dancy terms is, you know, in REM sleep, when we’re sleeping really heavily, our eyes are darting back and forth in our, in our, when we have our eyes closed and stuff.

And oftentimes in REM sleep, we’re processing things like trauma and stuff like that. A way that I prep clients is sometimes when we do talk about heavy things, I’m just like, Hey, just so you know, you might have nightmares about this. You might have dreams about this. You might beat the crap of a person in your dream.

You might get something really clarifying and stuff like that too. And I think that’s important in describing EMDR is again, REM sleep, your eyes are darting back and forth. So your brain is processing that and using the bilateral of your eyes. And so it might help you again, brains are weird when you’re sleeping, The whole thing is weird.

So again, as you’re processing, it might not make complete sense, but you’re still processing as you’re sleeping. So I think of that as a way of like explaining EMDR of while you’re sleeping, your eyes are turning back and forth, you’re processing things. And, you know, like if you beat the crap out of somebody, I’ve had that dream before with my trauma.

What does that mean? I’m trying to get control of this person. I’m trying to, feel like I can communicate my needs and my wants and feel powerful. And I think that’s also a great way to explain that of like, okay, back to what Gina was saying is I feel so hopeless. I feel so powerless. I feel lack of control.

Okay. So what did your nightmare or your dream say about all that? so I think that’s a kind of like a smaller version of explaining all the things

Miranda: It’s kind of like how your brain is already doing this naturally while you’re sleeping and so you are mimicking that and almost forcing it to start to process some of those things by thinking about it.

Gina: Yeah, yeah, yeah. Amber brought up such a good point about the dreaming thing because, when we’re sleeping and we’re downloading our day, right? We’re processing through everything that happens. Some of it’s important. Some of it’s not so much, but the stuff that gets stuck, we end up having those dreams over and over and over again about it until we can work through it.

And that is so much. mimicking the EMDR experience. Not exactly the same, but very, very similar.

Amber: Yes. I think sometimes too, like, of course we have like the cliche of like, maybe go for a walk just to get your mind off of stuff. But actually when you’re taking a walk, the left, right, left, right of your legs also stimulates the bilateral.

So that’s why sometimes too, people find taking a walk really healing in addition to all the nature stuff, stuff like that. But yeah,

Gina: Such a good point. Yeah. The walk and talk. You know when you go for a walk with your friend around the lake and you’re like, Oh my gosh, I feel so much better. Well, that’s because you just talked through all these difficult issues and these things, and you’re moving your body and doing the bilateral. It is an informal version of EMDR, just like running, you know, running would also do that. Hiking would also do that. Like, I always feel like I, you know, went through a therapy session when I go for a walk with my girlfriend.

Miranda: That’s fascinating. Oh my gosh. I’ve never connected that before.

EMDR with Children and Informal Techniques

Amber: Yeah. So, kind of again with informal stuff too. If I have a lot of kiddos on my caseload and they don’t sit with this tapping all that stuff.

They say: “Nope. Absolutely not.” So I’ve used like a drum again, left, right, left, right. Even passing a ball is great for kids, because again, you’re getting the stimulation of left, right, left, right, and stuff like that. So there’s a lot of informal ways that you can actually imitate that, especially with kiddos who can’t sit very still.

Gina: I’m so excited, Amber, that you do EMDR with kids because it’s so needed and there’s not enough people doing it. And I would say I have tucked those little buzzies in their pockets. And they play. Or I tuck those little buzzies in their shoes when we are like running around and they’re playing, you know, house with something like there are ways to build it in so that they can still be mobile and you know, kids are busy, like they’re not going to sit for this.

Anyways, I love that you brought that up that this is not someplace where you just have to sit on a couch and do this. This is something that can move with you too. And now they have wireless buzzies. A lot of people here, even at our office in Mendota have wireless ones. With some you can control it from your phone and they can like be in their pockets or be behind their knees or like wherever they feel good for the person, for the client.That’s really what matters.

Miranda: Absolutely. This is fascinating. Ok, so I know enough about EMDR to know that you don’t just like dive right into EMDR either. There’s somewhat of like a process where you talk about like a safe space so walk me through that.

Starting EMDR Therapy: Safe Spaces and Containers

Gina: Amber, you just went, you’re going to be fresh on all this.

Amber: Okay, ready? Let’s go do all these things. You have to get a background of course, of like, what are we working on? Let’s go through your history. The initial intake session, is typical. Then after that when you’re preparing to actually do EMDR, you have to find that safe space.

There is this idea of a container and a safe space. So the container is, I like to think of something that you can put something away and then you don’t have to visit it until the next time you’re in therapy. I’ve seen people use, Mason jars, pirate chest, mine was Spongebob’s pineapple house.

It should be something that you can lock away and, like, have, like, a physical, like, again, a lock. It can be physical or it can be imaginary. With kids, again, I like to do the, physical thing because they can keep it and we can write little notes of like, what did we talk about today and stuff it in there.

As for adults, for the most part, they can do imaginary containers, but hey, for all means, you can do a physical one too. Like, you could do a physical mason jar, something that you can close and maybe you can keep it with your therapist for a time being. But it can be imaginary too of like, a pirate chest or whatever– something that can close and that you can put away.

So that’s a container part. So as you’re going through your trauma and stuff, it can be hard to leave therapy and leave the stuff at the door. So having that imaginary locking key or whatever it is helps you focus on, okay, I’ve said what I said, this is in therapy. It’s safe. safe. It’s closed. I don’t need to worry about it anymore in my day to day life.

As for the safe place, again, remember that your body is going through the fight or flight thing, even as we’re introducing our trauma to our therapist. So having a safe space, I think in general with EMDR and all, all therapy of having a safe place is very smart. So, that can be somewhere that you’ve experienced before, that can be an imaginary thing, some people find that it’s, in nature and stuff like that, again, somewhere that they visited before, like maybe with Gina, that’d be like a place that she hiked.

That’s a way for you to revisit when you’re feeling a little bit escalated and stuff like that. Okay. My safe place was like a little cabin in the woods with lots and lots of animals and with waterfalls in the back. That’s an imaginary place that’s calming for me. So I know that when I need to visit my safe space, I can visualize there, put myself there.

I feel myself petting all the animals and hearing the waterfall and stuff like that. It calms down my nervous system. So as again, as you’re having to revisit trauma and stuff like that, you have these spaces that you can end the session session in, that you can put stuff away, feel calm, relax.

Miranda: So as a therapist, when you start doing EMDR with a client, you’ll do some like informed consent, you’ll explain that this is what this process is going to look like before we actually start processing. We’re going to talk about a container and safe place or safe space.

And is that like a visualization that you’re guiding them through or something that, or is it just something that you’re kind of introducing and then maybe like the next session you’ll start doing EMDR? Like what is the time frame even look like for this?

Gina: So there’s eight phases of EMDR. The first session is like pre phase one.

It’s really important to realize that. I’ve had a lot of clients come to me who are like, my therapist and I just jumped in to EMDR right away, and I go, what? What?

Informed Consent and Client Autonomy in EMDR

Gina: Miranda, you brought up informed consent. I really want to speak to that for a moment because something that I always, always say in my first EMDR, like meeting the client session is it will get worse before it gets better.

You’re not going to walk out of here and your depression is going to be gone, or you’re going to feel like a million bucks. We’re going to have to trudge through some mud sometimes. I’m going to do my very best to help you to contain it when you leave so that it doesn’t affect other areas of your life, but you will, you can often see a flare up of symptoms, right?

And keep in mind that after an EMDR session, people are tired. Their brain just ran a marathon in 45 minutes, right? So they’re running through all these traumas and thinking about all this stuff, and then we’ve got to wrap it up, and they’ve got to go back to their life. So it’s really important to talk about this.

You’re not going to feel amazing the second session, the third session. This will take time. and that is a really important of informed consent that I really wanted to make sure that we talked about.

Miranda: So what happens if a client is starting the EMDR process, they’ve done some reprocessing and then they’re like, this is too much. Like can they just end? What happens?

Amber: Well, everyone’s entitled to their own type of modality. It might be that, like once we start doing all the tapping and all that stuff, the bilateral, and they might realize too, like it’s too much or feel a little bit cringy doing this.

Everyone’s entitled to find their modality and find a therapist that they enjoy and that they relate to. So it’s totally okay if they get through some stuff and they’re like, yeah, I don’t really like this.

Okay. We can stop. If you need someone else, like if you’re specifically EMDR only again, transferring is totally fine. A client has every right to change whatever they’re doing.

Gina: And we have a consult group here in Mendota Heights just because we have so many providers in Ellie Minnesota that are EMDR trained.

I think we have 24 or 25. So sometimes we all meet together and a common theme is, “We started EMDR and we stopped because the client wants to talk about something else right now.” That’s really, really, really normal because we are touching on hard things, right? That have existed for a very long time. And we’re trying to switch up the homeostasis that this client has been living in.

And that can be very uncomfortable. And so we have lots of clients who are like, “this is too much. This isn’t the right time. I’d like to take a step back.” And I want to honor that. We’re never going to make somebody do EMDR, right?

EMDR is not just EMDR therapy, it’s talk therapy and other things all mixed up into that. because, you know, healing is not a straight line.

Using EMDR for PTSD and Trauma

Miranda: One thing that’s really interesting to me is, and Gina, you’re the one that told me this, but EMDR does not require a complete retelling of your trauma.

Like they don’t need to say it out loud. And I think that some clients really struggle with certain types of therapies that require a complete retelling of their trauma. Why is EMDR different and what can they do instead of talking about their trauma?

Gina: So some people with trauma want to talk and process it out loud and I’m here for that, right? And sometimes they want to talk and process too much, and they want to switch into their intellectual prefrontal cortex brain. And I go, “Ooh, you’re talking too much. Can you just say a sentence about what you experienced and then we can go back in, right?”

And that’s because it makes us more comfortable—to intellectualize it and I explain what’s happening. I can use words. There’s some distance with words from the trauma, but I’m way more interested in how you feel and what’s living in your body.

Miranda: So like going back to a different podcast episode that we’ve did where we talked about the whole brain child, does that mean that when you are doing EMDR, you’re almost like trying to live within the right side of the brain– the emotional side and kind of like not necessarily.

Gina: Yes, exactly.

EMDR Techniques and Phases

Gina: So when you’re in the phase that you’re about to start reprocessing and I have this like worksheet that I have in front of me and I go, “okay, so we’re going to think about the image that is the, the most distressing part of the memory.”

We’re going to think about the negative cognition, which in this example we’ll say is “I’m helpless.” And then we’re going to remember the feeling that you have. Chest pressure is honestly probably the most common one that I hear. Either that or racing hard or sweaty palms or tight muscles. So you’re looking to highlight those three things as you go back into the memory: the cognition, the feeling, and distressing part of the memory.

You need to light up those three parts of the brain. When people get stuck in EMDR and don’t know what to say or don’t know what to do, I go back to how are you feeling and how does your body feel? Because those are the things we’re most separated from. And we feel more comfortable just talking, right?

Miranda: But when you ask those questions, are you asking about how they felt in that trauma or how they’re feeling in this moment in your office?

Gina: In this moment, thinking about that trauma. That’s what I’m asking.

Amber: Yeah. Got it. Yeah. And just to add a little bit onto that too, there are different types of EMDR.

We’re working from the present to the past. and then we’re also dealing with the present right now. So another thing that people are weary of again, is like, I don’t want to talk about my childhood. I don’t want to talk about my mom. I don’t want to talk about my dad. I don’t want to talk about my caregiver.

Nope. Nothing about that. So there’s other ways in EMDR that you can ignore that. So one kind of EMDR—restricted–  doesn’t go into the childhood.

Gina: She’s talking about the AIP, which is the adaptive information processing. It’s the foundation of EMDR. It’s the idea that the memory systems incorporate new memories into old ones as we experience them. And so that’s just a part of the framework of, of EMDR. Yeah.

Miranda: Stop it– So if I’m like thinking about the movie Inside Out and how, like, they have the, the memory world, you guys have both watched this movie, right? Of course.

Amber: We’re therapists. Of course we watch Inside Out.

Miranda: Yes. Exactly. But it’s like in that movie, they have the memory bank where they have all of the rows of like the, the memories that are stored. And then every once in a while they will like have that big hose where they’re sucking up the memories to be recycled.

It’s almost like what you’re talking about where those memories just get recycled into new ones.

Gina: Yes, exactly. Yes, yes, And traumatic memories are processed differently. Right? Because of the overwhelming effects and the overwhelming trauma that we’re experiencing. Our brain is not calm when a trauma happens, right?

So, it’s stored differently and that AIP model helps us to understand that.

Miranda: Okay. I just thought of another question when you said that. Can you do EMDR for, like, pre-verbal traumas?

Gina: Yes. Yeah, there is pre-verbal EMDR.

Miranda: How would that, how would that even work?

Gina: It’s much more, it can be much more based on feelings and body sensations. And there’s a whole, pre-verbal, protocol that you need to use and have to go through before you would offer that to anybody.

Miranda: Okay, so is EMDR only good for trauma?

Gina: Nope.

Miranda: What are some other diagnoses that you would use EMDR for?

Amber: All.

Miranda: Ok, say more, Amber.

Amber: Anything honestly, because I’m thinking about generalized anxiety disorder, everything like I’m scared to do ____. I’m nervous about ____. Are people judging me? Why are you worried about people judging me? You can break down that thought of where that thought came from.

For example– Where did that judgment come from? Is it because somebody judged you for how you drank your coffee in a coffee shop or you believe that they were judging you. That’s a small or minimal example, but you’re having this assumption about yourself, and with EMDR you can explore where did that come from and how we can dive into that.

Borderline is another good one. Why are you having these attachments? Where did that come from? What are the thoughts about these things? anything, anything EMDR.

Gina: Yeah, there’s attachment focused EMDR, with the idea of early childhood neglect and not getting what you needed from your parents and being able to reparent yourself through EMDR.

I’ve used EMDR with a lovely seven year old who struggles with being around people who are sick and a strong fear of vomiting. And she’s doing such great work, at being able to build that tolerance and understand that just because somebody’s sick, that doesn’t mean that I’m going to get sick, or that they’re going to throw up.

So yes, anything with a belief that isn’t serving you can probably be worked on with EMDR.

Miranda: Other parts of EMDR that you like or that you are like, “Oh, we haven’t talked about this aspect of EMDR yet.”

Gina: I think it’s important to talk about the eight phases. The main ones that often get talked about are the prep, right?

The resourcing, which is the, the container and the safe place. and then the reprocessing part, which is really like the meat of what we’re doing. Then there’s also, we do a body check after that. Like, where is this stuff living in you? All of these things, what we’re talking about as far as the memory, the feeling, and the body sensation, they’re all tied together.

And then after we do the reprocessing, after we get to a place where you believe the positive cognition, then we move forward. And in the future you can always go back if you need to reprocess something.

Miranda: How long does EMDR typically take?

Gina: That’s a good question. I mean, it’s really, I don’t know, Amber, I’m curious what you would say.

Amber: Honestly, the answer to all these things is depends on the person. but typically, typically I would say at least, like, maybe, you 12 to 15 sessions, and that’s maybe even being generous again.

And let’s imagine you’re working with this client and you want to make sure that they have enough time to change the negative cognition to a positive cognition. Validity of cognition. So at the end of EMDR a person should be likely to believe that positive cognition about themselves. So let’s say if you’re working with the negative cognition of “I am not in control” then the positive cognition would be “I am in control when I can be.” You don’t want it to be “I am in control” because there is some instances where you’re not in control and that’s okay.

So by the end of EMDR, we want that to be true, which would be a score of seven. So that person should be ending EMDR. It might not get to a seven and that’s okay too, but we want it to increase over time. Bottomline is that we  want our clients to associate with the more positive cognition of “I believe that I can be in control when I can be.”

Gina: And we have Protector Overwatch in Minnesota, where we serve, those that are police officers, firefighters, EMT, first responders, military personnel. And I’ve worked with a few of them on single incident traumas. I’d say with a well resourced person, they can be done in five sessions. But if there’s a bunch of other childhood trauma or a lifetime on a very stressful job where they see trauma after trauma after trauma, then that’s going to take more time.

I think the longer you haven’t talked about the trauma or the longer you’ve experienced it, prolonged chronic trauma, it can take longer to then process it through EMDR. It just depends on the person and the readiness of the person as well.

Training and Certification Process for EMDR

Miranda: If you’re a therapist listening to or reading this, they might be asking, how do I get trained in this? Is it something that I need to do like years of work towards being certified before I can start practicing this? What does this look like?

Gina: Amber just went through it. So I’d love to hear.

Amber: Yeah. So I did my training through EMDR consulting.com. and from there you can do it in the middle of the week or on the weekend.

I did mine on the weekend with George Tab and a hundred percent recommend. It was a three day course I did completely virtual. I believe you get the option to do it in person as well. There are so many of options, but EMDR consulting is the one that I’ve heard the most. If you just google EMDR certification and make sure that you get your CEUs and stuff like that.

You can be certified, and it does not take years. Right now, being that I just finished my trainings, I have a year to get some consultation and after that, I would just have to revisit and talk to the coaches there.

Miranda: But you’re practicing EMDR now, so it’s like you go through the training, you start practicing it,      you’re kind of doing something similar to supervision is what it sounds like, and then, and then at the end of a year, you’re like, all right, I can now call myself certified or what, at what point?

Amber: You have to do a bunch of, courses, which again, I finished all that. I unfortunately have to wait until I’m fully licensed to, to get my certification.

There’s supervision that you need to complete. There’s so many hours that you have to also do EMDR too. Then after that, and again, you have to be fully licensed. to get your full certification. I might be missing some things, Gina.

Gina: No, I think the, Amber’s got it. there’s, they usually, it usually happens in two parts.

Yeah. So sometimes I haven’t ever seen it done all at one time because that would be a ton of information, but usually it’s one long weekend of like 24 to 30 CEUs. And then part two is 24. We don’t want them to be super separated, because otherwise you’ll forget the material. mine, I was working at a lovely non-profit where they offered EMDR at about half the price. I wouldn’t have been able to afford it otherwise, right?

Miranda: Because how much is it to do all of this? How much is the training?

Gina: I think Amber and I are going to say a range. Yes. Anywhere between fourteen and seventeen hundred dollars usually. Split between the two weekends and hopefully paid in a payment plan.

Miranda: Yeah, I mean, that’s really cheaper than somatic experiencing, cheaper than a lot of like cheaper than a lot of modalities out there.

Gina: It is more affordable than some of the trainings out there.

Miranda: Well and gosh, if you’re ending it with so many CEU hours, it’s probably worth it.

Gina: Right, and like Amber was talking about, after you finished part one, part two, they want you to be practicing and working with clients after part one, and they want to see you again for part two, and they want you to be doing the work after that, you need 10 hours of group consultation.

And they’ll set you up with that or advise you or give you options of who you could do the 10 hours with. Once that’s done, you can submit that and become certified. Got it. So you can be called “EMDR trained” if you completed it. If you want to do certification, you have to go through MDREA and send all those materials in and then pay like a yearly fee to continue to be certified.

And then from there, you can become a consultant in training, a consultant, and then a trainer. And there are steps for that along the way that include even getting like letters of recommendation. And then I think to actually work to being a consultant in training, you have to have like 200 clients and at least a certain amount of hours, that you’ve done EMDR.

I think it’s important to have those gatekeeping measures because it needs to be done in a certain way to be effective. In their own practice though, therapists have flexibility. And I think, clinicians who have been doing it for a long time, they have their own ways, right?

Like it all comes back to the bilateral, but they develop their own interesting ways of doing it too that are, can be very effective.

Miranda: okay. I have a question. So, for my personal situation, like, I don’t see, I don’t see a full time caseload of clients. So I don’t know if it would be worth it to, to actually become certified and pay the extra cost and supervision.

Could I just do EMDR training and then, like, start practicing at that point and not ever get fully certified?

Gina: I’ve been doing it for 12 years and I’m EMDR trained. I am not certified.

Because I don’t necessarily see the cost benefit for becoming certified and paying the fee to be an MDREA member and then doing all of that work. I’d like to be a consultant someday though, so I’m probably going to do like the steps for that because I want to train eventually, but no, I’m still trained in the EMDR.

For some people that certification is super important and you do get put onto like Emdrea’s list of certified therapists, which I think is, there’s a lot of benefit in that too.

Regardless, you don’t have to figure that out right away. And it wasn’t within my budget to do that right after I’d gotten trained anyway.

Final Thoughts on EMDR

Miranda: Well, this has been super helpful. Any other last thoughts or things that we feel like we’re missing about EMDR?

Amber: I have been seeing a lot of people inquiring about EMDR. So I think it is one of the up and coming kind of modalities, kind of the buzzword kind of thing.

I think it’s a good investment to get this training. Because are people going to be wanting it too and we’re getting a lot of inquiries for EMDR. So I think it is worth it, especially as that becomes more well known in society today.

Miranda: That’s fascinating to see how clients have become more aware of these modalities. The book, “The Body Keeps the Score” has gotten so popular, even just like non clinicians with people who are just trying to understand themselves, and that book talks about EMDR. I’ve had probably two or three different clients who have read that book and then come to me and been like, I think EMDR would be really helpful.

Gina: Yeah. My first session is always, how did you hear about EMDR? Yeah. Tell me what you know about EMDR. Like give me an idea. And it’s, “my sister did it” or “My best friend did it”–  very, very much word of mouth. They found it super helpful. It changed their life.

And then they get to tell them about their experience and what they saw change in their life. And they want, they want that for themselves as well.

When I was a fresh newbie and was working with people with lots of trauma, I was like, “OMG, how am I going to help them?” Like I had CBT and I had the foundational knowledge of what I learned out of school, but I was like, “I’m going to need something else to be effective here.” And you know, I was considering TF-CBT and brain spotting and ART. There’s so many options now and all of them are worthwhile.

And EMDR was the one that I was drawn to because I felt like it could help the largest group of people and it could be used with adults and kids.

Miranda: Awesome. Well, thank you both so much for joining and we’ll have to have you back again sometime.

Links to Podcast Episodes:

Spotify

Apple

Amazon

YouTube

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If you are feeling suicidal or if you are worried about a loved one, you can call or text the National Suicide Prevention Lifeline at 988

Recognizing the Signs of Suicidal Thoughts and Self Harm

It is important to recognize that suicidal thoughts and self-harm look different for everyone. As a therapist, I’ll ask clients the question, “Is it your intent to want to hurt yourself, make yourself feel something, punish yourself, etc.?”

Suicidal thoughts can be passive or continuously active. A passive suicidal thought could be something as brief as “Wouldn’t it be crazy if I just died right now?” while enjoying a bowl of cereal in the morning. Whereas, active suicidality is “I truly wish I wasn’t alive at this moment” and it is usually met with deeper feelings of sadness, grief, pain, etc.

While talking to someone who is suicidal, it can be tough to recognize the signs. As a loved one, some warning signs that you could look for if you suspect someone is experiencing suicidal ideation is:

• If they are more irritable or sad than normal,
• If they are talking about the future as if it is not obtainable,
• If they are giving away some of their beloved items,
• Withdrawing from others or any special interests of theirs,
• Talking about being a burden or how others may be better off without them

And many more. Please view this list created by the National Institute of Mental Health for a more intensive list:  Suicide Prevention – National Institute of Mental Health (NIMH).

Self-harm also has its own magnitudes. Usually when someone refers to self-harm, it is common for people to picture someone cutting themselves with a sharp object, but self-harm can be more complex than that. Self-harm could be pulling your hair, burning yourself, making yourself work extreme hours, taking EXTREMELY hot showers, etc. These aren’t uncommon, however the question is “why am I doing this? What is the intent?” For most folks, it is to ignore the pain that they are experiencing in their head.

What are Potential Causes of Suicidality?

There’s no perfect answer as to why someone may be experiencing suicidal thoughts or urges to self-harm, however there are common causes that may contribute to why your brain is allowing you to feel and do these things.

Suicidality can come from feeling that there is no other way to cope with stressors. Stressors can be bullying, conflicts arising in various environments, confrontational situations, etc. Of course, some people may experience these situations and not experience suicidal ideation. These differences may be based on how your prefrontal cortex is processing and navigating your emotional and impulsive reactions.  

In a less scientific way, sometimes I explain to clients that even if they feel like they have no reason to be suicidal, sometimes their brain just has fewer “happy chemicals”. Sometimes people think that if they have a good life and have no trauma, it means that they should not be feeling this way, which is simply not true. There are certain chemicals in your brain that lead to happiness, motivation, love, etc. For some folks, those happy chemicals aren’t as plentiful as the average human being. That is why you’ll often hear from professionals that medications and therapy is the best combination to treat majority of mental health conditions.

Some people are worried about taking medication. You know when you’re watching TV and an antidepressant commercial comes on and you hear the fast-talking warnings towards the end that says “may lead to suicidal thoughts” – you might be thinking “well why would I want to take a pill that may increase what I’m already feeling?” That’s valid, because it can be scary, and it is always a risk with any potential medication. The majority of people find relief when they are on medications, and should be monitoring any side effects closely with their prescriber.

Have you ever put on a sweater that looks SO good on the model or a best friend, and then you put it on and it looks NOTHING like how you thought it would? Medications are similar. Medications that work for some people might have a different effect on others. Some of that has to do with your brain chemistry and some has to do with how your body metabolizes and absorbs chemicals. It is can be trial-and-error process finding a medication that works for you and your fancy dancy brain chemicals, and that’s why having a prescriber you trust is important.

Philppe Courtet and Jorge Lopez-Castroman did research on the concern that antidepressants could lead to increased suicides, however they found that suicide is more likely for those who do not take any medications versus those who are on medications.

Suicide Statistics

Here are some statistics regarding who are most likely to be affected by suicide according to information gathered by the CDC in 2021:

• Non-Hispanic American Indian / Alaska Native have the highest rates of suicide with non-Hispanic white individuals following second
• Males are four times more likely to be affected by suicide than women
• People ages 85+ have the highest rates of suicide
• LGBTQIA+ individuals are four times likely to commit suicide than their peers
• Nearly 20% of high schoolers report having serious thoughts about suicide, and 9% admit to a suicide attempt.

What Should I Do If I am Experiencing Suicidal Thoughts?

First things first: You can call or text the National Suicide Prevention Lifeline at 988. If you don’t think you can keep yourself safe in that moment, call 911 or go to your nearest emergency room to get help right away. 

Second, seek professional help from a medical provider or therapist. A therapist can help you manage your suicidal thoughts and also help manage self-harm, especially if you notice it is interfering with your day to day life. If you begin to formulate a plan for your suicide, inpatient hospitalization may be more necessary for you.

The difference between inpatient and outpatient therapy is that outpatient therapy is what you envision as your “typical” therapy, like talk therapy in a therapy office. Inpatient therapy is what the kids call “grippy sock jail”, where you are hospitalized for a period of time to help manage your suicide thoughts and urges. Inpatient hospitalization can be a helpful way to meet peers who are also struggling through group therapy sessions, pausing outside stressors until you have necessary coping skills, and even medication management if necessary. That can help you feel like you’re not alone.

If you’re worried about someone that you love, check out our blog post about how to ask someone about suicide.

As a therapist, some coping skills that I teach my clients that might also be helpful for you too, (but keep in mind that seeing your own therapist and getting your own professional help is going to be the best course of action) may be the TIPP method:

T: Temperature

Temperature is a great resource for suicidal thoughts, and for any other rumination. Temperature is a part of using the senses, which can be great grounding. A tool that is often recommended as part of the temperature idea is to squeeze an ice cube in your hand, have a fan blow cold fan in your face, take a really hot or really cold shower, etc. Your goal is to distract your mind by putting pressure on your body using the senses in a healthy manner. This is similar to the idea of intense exercise. The sweat, soreness, etc., provides a great distraction.

I: Intense exercise

The I stands for intensive exercise; Pushing your body to sweat, be warm, and end up being sore is a way to “feel the burn” but in a constructive manner. The body sensations also adds to the idea that the senses are important in regulating emotions.

P: Paced breathing

Paced breathing is also a great tool for all mental health conditions. You can do box breathing by holding your breath for four seconds, breathing in your nose for four seconds, holding for four, and letting the air out of your mouth for four seconds.

P: Progressive Muscle Relaxation (PMR)

Progressive muscle relaxation means to work your way either up or down your body by squeezing all of your muscles then releasing. This process helps individuals become more aware of and release tension in their muscles, and it can counteract the body’s stress response, leading to reduced feelings of anxiety and improved overall well-being.

Suicide and Self-Harm Prevention Resources

Ellie Mental Health can be a great resource to find a therapist to help manage any suicidal symptoms you are experiencing.

If you are feeling suicidal, you can call or text the National Suicide Prevention Lifeline: 988

You can also chat online here or call the Trevor Project (866) 488-7386.

If you are worried that you can’t keep yourself safe, call 911.

Some books and blogs that may help educate you or others on suicidal thoughts or self-harm:

• Understanding and Responding to Self-Harm: The One Stop Guide: Practical Advice for Anybody Affected by Self-Harm by Allan House
• Reasons to Stay Alive by Matt Haig
• Adolescents and Suicide Prevention: A Guide for Clinicians
• Three Easy Steps to Ask Someone about Suicide
• The Complex Relationship Between Mental Health Medications and Suicidal Thoughts
• A Parents’ Guide: Anxiety and Depression in Children

Other Resources and Sources:

Suicide Prevention – National Institute of Mental Health (NIMH) (nih.gov)

Antidepressants and suicide risk in depression – PMC (nih.gov)

Suicide Data and Statistics | Suicide Prevention | CDC

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What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a terrifying event. You probably associate it with military service people who have been in active combat, but it is by no means limited to that. Survivors of assault and abuse, those who have been in or witnessed a traumatic accident or disaster, and any number of other traumas may be affected and diagnosed. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Traditional treatments include therapy and medication, but not everyone responds to these methods, necessitating the exploration of alternative treatments. Enter Virtual Reality!

How Does VR Work in Treating PTSD at Ellie?

Virtual reality therapy for PTSD involves immersing patients in a computer-generated environment that simulates the traumatic event they experienced. Here’s a breakdown of the process:

• Controlled Exposure: The primary principle behind VR therapy is controlled exposure. By gradually exposing patients to their traumatic memories in a safe environment, they can confront and process their trauma. Over time, this can reduce the power these memories hold over them.
• Customizable Scenarios: VR scenarios are tailored to each patient’s experience. For a survivor of a medical trauma, the scene might be a hospital room, while for someone who survived a car crash, it might be a busy intersection.
• Therapy Combinations: VR therapy can be combined with other trauma-focused therapies, such as EMDR or ART, to offer more comprehensive treatment.

 Benefits of Using VR for PTSD Treatment

• Safety and Control: One of the primary advantages of VR is that it offers a safe environment for patients to confront their traumas. They know they can exit the virtual scenario at any time, giving them a sense of control.
• Higher Engagement: The immersive nature of VR can be more engaging than traditional talk therapy, making patients more likely to participate actively in their treatment.
• Objective Data Collection: With the integration of biofeedback, therapists can collect objective data on a patient’s physiological responses, aiding in the treatment process.
• Flexibility: VR can be adapted to suit the needs of each patient, ensuring a personalized treatment approach.
• Tailored Treatment Approach: At Ellie, we work with our clients to make the treatment specific to what works for them. With Virtual Reality therapy, we can start small and increase intensity or frequency as the treatment progresses. 

Virtual reality is paving the way for innovative treatments in the realm of mental health. For PTSD, it offers a unique approach that combines technology with traditional therapeutic principles. As research continues and technology advances, VR could become a standard treatment for PTSD, offering hope to those who need it most.

If you or someone you know is struggling with PTSD, please seek professional help. This article is informational and should not replace professional advice. At Ellie, we are accepting new Virtual Reality Therapy clients, and also have a variety of other therapies and treatment options that may work for you or your loved one experiencing PTSD.

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When paired with a strong support system and mental health therapies, these medications can do a world of good for you or a loved one in need. But with any psychotropic prescription drug (meaning one that alters your mental state,) there are some undeniably important considerations to understand and discuss with your mental health care providers.

In this article, we’ll get you up to speed on the basics of antipsychotic medications, how they work, potential challenges associated with them, and more. We encourage you to speak with a psychiatrist for more details and to address all your options.

Do you need more information on antipsychotic medications? Reach out to Ellie Mental Health today to learn more.

Types of Antipsychotic Medications

While all antipsychotic medications aim to ease psychosis and closely-related symptoms, they go about doing it in slightly different ways. This has created sort of a dividing line among antipsychotic medications, with options falling into one of two groups–typical antipsychotics and atypical antipsychotics.

● Typical antipsychotics — sometimes called first-generation antipsychotics, these were the first medications used to treat bipolar disorder and generally function by blocking dopamine receptors in the brain. This category of antipsychotic medication includes haloperidol, chlorpromazine, and fluphenazine.

● Atypical antipsychotics represent second-generation antipsychotics that came to market in the 1990s. These medications also block dopamine receptors but have a more complex mechanism of action that also allows for the blocking/regulation of serotonin. This results in controlling a broader range of psychosis-related symptoms, and this dopamine blockade also significantly minimizes the impact of the medications’ effect on muscle stiffness and movement. Common examples of atypical antipsychotics include clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole.

While atypical antipsychotic medications are more commonly prescribed today, typical antipsychotics are still used as a viable treatment option in some cases.

How Do Antipsychotic Medications Work?

As mentioned above, the mechanism for these medications is based on limiting the flow of neurotransmitters (dopamine and serotonin) to the brain. Neurotransmitters are essentially messengers to our brain, and some believe psychotic episodes are caused by an overproduction of dopamine. By limiting the “messages” received, our brains can better regulate and manage these inputs.

Talk therapy can also be coupled with antipsychotic medications to yield good results for patients. Ellie’s Senior Director of Adult Psychiatry, Dr. Suzanne Jasberg, MD, puts it this way: “Therapy is absolutely helpful for people experiencing psychotic symptoms. Multiple modalities are used (from CBTs to supportive therapy, motivational interviewing, and IOPs, to name a few). The old dogma that psychosis patients cannot participate in therapy is absolutely false.”

What are Some of the Pros and Cons of Antipsychotic Medications?

First and foremost, the biggest benefit to a regimen of antipsychotic drugs is the ability to get severe mental illness symptoms of psychosis in check. While it may take some fine-tuning with your healthcare provider to find the ideal dosage and medication for keeping symptoms manageable, the benefits of having a stable baseline are hard to overstate.

“Medication is used to regulate the dopamine system, and a shorter duration of psychosis is associated with a better prognosis. The goal is to eliminate symptoms and return people to their previous functioning and quality of life,” says Jasberg.

It’s important to note that, as with any medication, antipsychotics can come with some side effects. At Ellie, our doctors very carefully monitor the side effects of the medication. We take side effects very seriously and work with patients to maximize patients’ quality of life on a medication. We encourage you to be open and honest with your doctor about your concerns about side effects so they can use the information to make a treatment plan that works for you.

Considerations for Children and Antipsychotic Medications 

The decision to prescribe antipsychotics in a child’s treatment is a complex and often challenging situation for parents. One of the most common indications for the use of antipsychotic medications in children and adolescents is for agitation or aggression associated with autism, however, this is not the only use. It’s important to discuss this option thoroughly and honestly with their healthcare provider.

Another factor to be aware of is that, depending on the child’s age and specific diagnoses, not all antipsychotic medications may be FDA-approved and available. Medications are not studied as robustly in children as compared to adults and therefore fewer carry FDA indications. Your provider may recommend medications that are not FDA-approved but are still routinely and safely used in children with appropriate monitoring.

As in adults, there are potential side effects of these medications for children. For example, weight gain and menstrual irregularities are fairly common and can be particularly challenging for kids undergoing puberty to contend with. We encourage you to speak with your doctor about the options for your child.

How Long Does it Take for Antipsychotic Medications to Work?

Another important consideration with antipsychotic medications is the length of time it takes for patients to see results. While it’d be great to have a sustainable option that’s fully effective in minutes, the reality is most antipsychotics will require weeks or longer to reach their full effectiveness. More acute symptoms may see relief in a few days, but ultimately antipsychotic medications are a long-term effort.

How Long Do You Need to Be on Antipsychotic Medication?

There’s no universal answer to this question, as there are far too many variables from person to person. Your doctor will work with you to create an individualized plan as to how and when to reduce and even eliminate the need for medication.

Dr. Jasberg says, “The goal is to, overtime, reduce and possibly eliminate the medication. The likelihood of a patient being able to taper off of the medication is tied to their consistency in taking the medication early on in their symptom presentation.”

Can I Change Antipsychotic Medications if One isn’t Working?

The short answer is “yes, absolutely.” If your medication isn’t working, you should communicate the details with your doctor so that they can make changes to improve your experience. The more details your doctor has, the better they will be able to tailor your treatment plan to your needs. Depending on which medicines you are changing, your plan will be individualized based on a variety of factors. The goal is to treat and eliminate symptoms as quickly as possible.

Changing antipsychotic medications is a deliberate, individualized process that will need to be overseen by your healthcare provider to avoid triggering a relapse in psychosis symptoms.

Getting on Solid Ground

Psychosis symptoms are a challenging fact of life for many with serious mental health issues like schizophrenia and bipolar disorder, and conditions that may cause acute psychosis. Fortunately, these symptoms can be managed well with medication, and therapy can lead to meaningful progress. 

We encourage you to speak with a psychiatrist sooner rather than later to get you or your loved one back on track to an optimal quality of life! Here at Ellie, we have immediate appointments available for medication management! Connect with a provider.

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Racial trauma, whether experienced firsthand or witnessed from afar, can have profound and lasting effects. According to a 2020 KFF poll, 63% of Black adults and 45% of Hispanic adults report that they have been treated unfairly within the last year because of their race or ethnicity while shopping, going to a restaurant or bar, in dealings with the police, at work, getting healthcare, and a variety of other situations.

When you experience racial trauma, it’s easy to feel helpless or angry at the world around you. However, there is hope for healing. By understanding your trauma, prioritizing your self-care, and exploring options for racial trauma therapy, you can learn how to improve your mental health and build resilience in the face of oppression.

Looking for a safe place to seek help? Reach out to Ellie Mental Health today to learn more.

Racial Trauma Defined

Also referred to as race-based trauma, racial trauma defines a person’s emotional response to a racist or discriminatory act. It is a term that defines the emotional and psychological harm that occurs when someone witnesses, is exposed to news coverage of, or experiences racism.

There are many experiences that can result in racial trauma, including:

• Verbal and physical abuse
• Hate crimes
• Racism in the workplace
• Brutality towards people of color
• Racial discrimination
• Microaggressions
• Stereotypes
• Racial profiling
• Historical trauma
• Institutional racism
• Systematic inequities

Racial Trauma and PTSD

Racism can have a profound impact on your mental health, leading to symptoms similar to those seen in post-traumatic stress disorder, such as:

• Intrusive thoughts or memories of the racist event
• Avoiding triggers of distressing memories or emotions
• Recurring flashbacks and nightmares
• Hyper-vigilance, fear, anger, and anxiety
• Depression or feelings of worthlessness
• Self-blame and social withdrawal

Could You Have PTSD?

It’s important to note that not everyone who has experienced racial trauma will develop these symptoms. For some people, racial trauma PTSD may develop from a single racist event or an accumulation of racist experiences and ongoing stress and anxiety related to racism.

While trauma can have an intense and debilitating effect, healing can take a few days to a couple of months. However, PTSD covers a specific set of severe symptoms that typically begin about three months after the traumatic event and persist for at least a month. You could be diagnosed with PTSD if your symptoms match those listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Does PTSD Go Away on Its Own?

If you suspect you are experiencing PTSD, we highly recommend talking through your experience with mental health professionals who understand and specialize in treating race-based trauma or a trauma-informed therapist. With a healthy healing process, the effects of trauma will lessen with time (even if the memories linger). However, PTSD is caused by the brain struggling to resolve trauma, and symptoms can last for years if left untreated.

In the case of racial trauma, people may develop complex PTSD, which can occur when an individual experiences repeated or prolonged trauma. For instance, someone may have been a victim of racial violence, frequently experience racial discrimination in the workplace, and be exposed to upsetting news events. These events may traumatize the person again and again, further complicating PTSD symptoms and putting the nervous system in a constant high-alert state.

The Impact of Racial Discrimination on Mental Health  

Experiencing racial discrimination can impact many areas of your life and worsen your overall mental health. You may experience low self-esteem, self-worth, and self-perception. The devaluation, stereotypes, and negative judgments others have about your race can make you feel inadequate or inferior.

Self-Doubt

You may start to doubt your abilities, talents, and achievements. You may wonder if you are capable of reaching your goals if you deserve or truly earned your success, or if you have the same opportunities and chances at success as others.

Internalized Negative Beliefs

You may begin to internalize negative beliefs and stereotypes about your race or ethnic group. This can cause you to become hyperaware or even ashamed of your racial identity. You may feel a constant need to prove yourself, have a distorted image of yourself, or feel pressured to overcome biases associated with your race. These feelings can be overwhelming and seem to overshadow every area of your life.

Social Withdrawal

It’s not uncommon for people who’ve experienced racism to feel isolated or like an outsider. You may also look at the world around you and feel helpless, sad, frustrated, and downright enraged at the individuals, systems, and groups that you believe are a part of the issue. You may struggle to trust others or withdraw from society and loved ones.

Anxiety and Fear

Whether you’ve witnessed violent acts against people of your race or have experienced them firsthand, you may become more fearful and feel insecure and unprotected. This can lead to chronic stress and anxiety.

Depression

The impact of racial trauma can lead to depression, disillusionment, and cynicism. When faced with the deep-rooted inequalities and injustices that persist in society, it can challenge your faith in humanity and cause you to believe the world is dark and unjust.

Physical Reactions

Your physical and mental health are closely linked, and race-based trauma can cause bodily symptoms as well. You may experience headaches, stomach pain, trembling, sweating, fatigue, or aches and pains. These issues can become chronic, causing long-term insomnia, difficulties concentrating, or recurring pain.

Activism

While racial trauma leads to many negative emotions, it can also spark activism and spur individuals into action. In the face of racism, you may be spurred to advocate for change, challenge systematic inequalities, and work toward paving the path to a more inclusive and equitable world.

Strategies for Coping and Healing From Race-Based Trauma

Healing from race-based trauma is a personal journey, and it’s important to be patient with yourself during the process and seek support when needed. Your experiences and your reactions to them are valid. Here are some strategies and suggestions for coping with race-based trauma.

Recognize and Validate Your Emotions

You’re likely experiencing a range of emotions, including anger, sadness, frustration, or fear. Practice emotional acceptance by allowing yourself to observe and identify your emotions without judging them and trying to suppress or change them. Remember that you are not wrong for feeling hurt or traumatized. You are not weak or overreacting.

When experiencing negative emotions, your first reaction will likely be to push away the feelings or try to escape. While ignoring difficult feelings may make you feel better in the short term, struggling to accept your emotions can lead to unhealthy coping habits or prolong the healing process.

Practice Self-Care

Self-care can be a powerful tool for healing from racial trauma and counteracting the negative self-talk and internalized racism that often arises from racial trauma. Self-care activities, such as journaling, meditation, or deep breathing exercise, can help you process and regulate your emotions. Exercise is also an effective self-care method that releases endorphins, reduces stress, and provides a healthy outlet for pent-up emotions.

Creative activities, such as painting, writing, or making music, are very personal and calming activities that allow you to express your emotions and create something you’re proud of. You can also engage with others’ art. By reading books, listening to podcasts, or looking at art pieces, you can remember that you’re not alone in how you’re feeling, learn about yourself and the world around you, and build a sense of solidarity and community with others who have had similar experiences.

Additionally, consider finding opportunities to connect with your cultural heritage and engage in activities that celebrate your identity to foster a sense of pride, connection, and resilience.

Learn Healthy Coping Methods

Self-care and coping mechanisms can overlap. The key difference between the two is that self-care is a proactive and ongoing process that nurtures your mental health, while coping methods are specific actions or strategies you use to deal with acute stress, difficult emotions, or traumatic situations. While you should always incorporate self-care into your daily routine, you also need to be aware of how to cope when an internal or external event triggers memories or difficult emotions concerning racial trauma.

People may turn to unhealthy coping mechanisms, such as using substances to minimize emotional pain, escaping into social media, or acting violently toward themselves or others. These methods may provide temporary relief or distraction, but they are detrimental in the long run.

Alternatively, constructive coping mechanisms help you manage stress effectively, navigate challenging emotions, and support your overall well-being. They also can promote problem-solving, address the underlying causes of your distress, foster self-awareness and empowerment, strengthen relationships, and align with your personal values and goals.

Not everyone will benefit from the same coping mechanism, so you will want to take time to explore and find strategies that resonate with you and your situation. A few examples of healthy coping mechanisms can include:

• Physical activities: exercising, doing yoga, going on a hike, gardening, stretching, or martial arts
• Grounding activities: practicing mindfulness, meditating, doing progressive muscle relaxation, and deep breathing
• Social activities: calling a friend, joining a support group, spending time with loved ones, seeking guidance
• Creative activities: creating something physical, writing, journaling, singing, playing an instrument, or drawing
• Healing activities: practicing gratitude, setting boundaries, seeking therapy, reading a self-help book, or completing a workbook

Set Healthy Boundaries

Setting boundaries for yourself and others is an essential part of the healing process for racial trauma. First, you should take time to identify what situations or conversations are distressing to you. Once you have a clear understanding of your triggers, be assertive and clear in communicating these boundaries with others. You may also need to examine your lifestyle and media intake and consider what you need to distance yourself from during this time.

It’s okay to disengage from situations that exacerbate your racial trauma or to remove toxic or racist individuals from your circle. In the first stages of healing from racial trauma, the best course of action may be to minimize your exposure to your triggers, which might mean turning off the TV or walking away from an upsetting conversation.

However, over time and with professional guidance, you may choose to gradually expose yourself to triggers in a controlled and safe environment. This approach can help desensitize and reduce the intensity of your emotional reactions to triggers.

Seeking Racial Trauma Therapy From a Mental Health Professional

There are many professional resources available to help you heal. A therapist, counselor, or other types of mental health professionals can offer specialized guidance and interventions tailored to your needs. They can help you navigate the complex emotions, triggers, and challenges associated with racial trauma while taking into account your unique traits and experiences.

If you feel as if there is no one you can unpack your emotions with, counseling is a safe and judgment-free zone where you can talk about what happened, seek emotional validation, process your emotions, and become equipped with the tools and techniques you need to heal, grow, and address any mental health issues.

Types of Racial Trauma Therapy

When looking for a therapist that can help with racial trauma, consider finding a therapist who specializes in racial trauma or has experience working with diverse populations. Depending on your unique needs, there are several types of therapy approaches that can be effective in addressing racial trauma.

Cognitive Processing Therapy

This type of racial trauma therapy is one of the most frequently used therapeutic approaches for treating race-based trauma. It focuses on helping people understand and challenge their negative thoughts and beliefs that have stemmed from traumatic experiences. Through CPT, you can identify harmful beliefs that lead to self-blame and feelings of worthlessness. Through structured exercises and techniques, you can learn to reframe your thoughts, develop a healthier perspective, and cultivate a sense of empowerment in your life.

Eye-Movement Desensitization and Reprocessing

EMDR is an evidence-based therapeutic method that is often used to help people heal from trauma and PTSD. It involves an eight-phase approach incorporating bilateral stimulation, such as eye movements, while targeting traumatic memories. The goal of this therapy is to help certain areas of the brain (including the amygdala, hippocampus, and prefrontal cortex) resolve unprocessed traumatic memories and resume natural healing.

Trauma-Focused Cognitive Behavioral Therapy

TF-CBT combines two techniques: cognitive behavioral therapy and trauma-focused therapy. By working with a therapist, you can challenge negative thoughts and replace them with more helpful and realistic ones, which is the core of cognitive behavioral therapy. TF-CBT also incorporates exposure therapy, which means gradually facing and processing memories or reminders of the traumatic event in a safe and supportive way. This therapy technique also teaches you coping techniques so you are better equipped to handle the negative effects of racial trauma.

Culturally-Centered Therapy

This therapy approach looks at the intersectionality of mental health and culture by acknowledging and incorporating cultural factors into the therapeutic process. For example, Black women are impacted much differently than Hispanic women by racism. And this therapy emphasizes the impact of racism and discrimination on mental health — and uses culturally sensitive techniques to explore racial identity and promote healing.

Narrative Therapy

Narrative therapy separates people from problems and empowers them to reshape their life stories. With this technique, your therapist will help you to share your story, challenge negative beliefs about yourself and the world around you, and to gain a sense of control over your experiences.

Group Therapy and Support Groups

Community and support can play a big role in your healing journey. By joining a support group, you can find a safe place where can share your experiences and connect with others who have also experienced racial trauma. Group therapy can help you become more comfortable talking about your trauma and can provide lifelong friendships and sources of support.

Empowering Healing and Growth After Racial Trauma

Racial trauma can leave a mark, affecting your emotional well-being, relationships, and overall quality of life. Although racism and discrimination can seem to affect every area of your life, it’s important to recognize the power of resilience and the potential for healing. You possess incredible strength and capacity to overcome adversity, and by seeking support, you can begin to unravel the complexities of racial trauma in your life, learn your true worth and value, and flourish.

Ready to begin your healing journey? Find an Ellie location near you and get started.

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