Holding Space for Yourself: Trauma Stewardship in EMDR Practice

July 24 is International Self-Care Day, the perfect time to remember that EMDR therapists need to hold space for themselves as well as their clients.

Holding Space for Yourself: Trauma Stewardship in EMDR Practice

Guest Blog Post by Danielle Hiestand, Psy.D., LMFT

Slowing down to think about why you pursued a career as a therapist is not something therapists do on a regular basis. Consider taking some time to slow down right now and write down your answers to these questions:

What inspired you to seek EMDR training, develop your skills, and use EMDR therapy with your clients?

What keeps you attending conferences and trainings in the field of EMDR therapy?

Where (if any) is there tension between your values and how you move through your professional life?

These questions speak to therapists’ purpose and their ways of creating meaning in their life. The answers to the questions are specific to the individual and provide a framework for therapist self-care. Both self-care and self-compassion are vital to the well-being of the therapist and the client (Yazici & Özdemir, 2022).

Historically, therapists were not offered specific training on post traumatic stress disorder (PTSD), complex trauma, or trauma treatment while in graduate school. While more evidence-based trauma-informed practices are becoming more well known, there continues to be a deficit in resources for therapists to protect themselves from secondary traumatic stress and burnout (Bentley, 2021). Without proper self-care and protections in place, mental health providers will inevitably be adversely impacted by interactions with trauma survivors and the trauma stories they hear. What does therapist self-care look like in day-to-day life, and how do therapists prevent the negative impacts of trauma exposure? One option is to bring trauma stewardship into their daily practice.

What is trauma stewardship?

Trauma stewardship is when individuals, organizations, and societies attend to the pain or trauma experienced by human beings, animals, plants, and the planet (van Dernoot Lipsky, 2009). Those practicing trauma stewardship understand that, while pain is a part of life, suffering is a personal response to pain. Suffering can initially take the form of a trauma exposure response and over time has the potential to be reshaped as a journey toward change and growth.

Signs a therapist might be struggling in trauma exposure response

Signs of a trauma exposure response in therapists include feeling helpless, hopeless, and believing they can never do enough for their clients. The therapist may approach their work with anger and cynicism, may struggle with empathizing, and eventually may experience the suppression of their own emotions.

Exposure to trauma over time without adequate self-care and protections can lead to therapist burnout and emotional fatigue. This takes the form of diminished creativity, a sense of boredom at work, dismissing the suffering of both themselves and others, chronic exhaustion, deliberate avoidance, and even dissociative moments during sessions with clients (van Dernoot Lipsky, 2009). Some therapists may convince themselves they are the only ones who can help their clients; therefore, they have to keep working long hours, avoid time off, and ignore their own self-care.

Examples of a therapist’s trauma-exposure response in the workplace include:

Denigrating their clients among other therapists.

Missing notes, phone calls, and scheduled appointments.

Distracting from their own emotions with screen time, substances, rumination about their clients, and so forth.

Expecting clients to no-show, arrive late for a session, or not use coping skills discussed in session.

Turning down invitations to socialize with friends, go on vacation, or join consultation groups.

Continuing to work when sick, ill, or obligations to loved ones have increased outside of work hours.

Choosing not to schedule time for activities they previously enjoyed.

The ways to prevent and recover from exposure to trauma are to stay curiously attuned to your own emotions, know your window of tolerance, and maintain a connection to the meaning your work provides you as an EMDR therapist.

Strategies for tending to therapist trauma exposure

As you connect to the reasons you became an EMDR therapist to begin with, consider implementing the following strategies to respond for your own inner experience. Write down the meaning being an EMDR therapist gives you on a sticky note, on your phone, or in a journal and revisit your note weekly. After removing identifying information, save cards, emails, letters, and art from clients in one location that is accessible to remind yourself of the positive impact you have made on others’ lives.

Additionally, practice thoughtful attunement to your own emotions in the present moment while distinguishing those emotions and beliefs that are from the past. Identify your own window of tolerance for listening, empathizing, and being present while someone is sharing a traumatic story. When you are outside your window of tolerance, take the appropriate steps toward self-care and establishing boundaries with yourself, clients, your employer, or your supervisor. Therapist boundaries are both protective and healing as one navigates their workplace.

In the same ways EMDR therapists provide safety, reflection, and co-regulation for their clients, therapists can mirror these supports back to themselves. If the client is going to their well-established calm place, model the strategy by imagining your calm place. Engage in guided breathing exercises with your client. Explore other grounding strategies that can be co-experienced in session. Another supportive tool that offers emotional safety and possibly prevents direct exposure to traumatic material consists of imagining a protective shield. The shield can take any form and be made from any material. Imagine the shield allows for your empathy, groundedness, and compassion to move in one direction through the shield toward the client, while the client’s emotional distress is blocked from moving toward you by your shield. Imagine the client’s emotional distress dissipating in the air or being absorbed by a plant or water. The options and use of imaginary tools such as these are limitless.

Lastly, therapists and clients cannot practice self-care alone. All people are in need of community, connection and support from others. As you navigate trauma exposure from being an EMDR therapist, consider joining or forming a consultation group, meeting up with colleagues for networking and social activities, and attending conferences and therapist retreats. Caring for the self involves seeking out opportunities for co-regulation, learning, and connecting with those who make you feel seen and understood.

Implementing your self-care plan

As you take in these various ideas, write down what resonates with you. Begin to imagine implementing one of these ideas into your weekly or daily routine. To provide yourself accountability, tell someone about your self-care plan. Carve out at least five minutes a day to check in with your own emotions, reactions, and needs. As you increase the time you take care of yourself, know that your clients will benefit too.

Danielle Hiestand PsyD, LMFT, CEDS-C, EMDR Consultant and Facilitator has a private practice in San Diego, California, where she provides telehealth and in-person EMDR therapy. She is a Certified EMDR Therapist, EMDRIA Approved Consultant™ and EMDR Facilitator with Precision EMDR Academy. Dr. Hiestand provides affordable continuing education retreats for mental health providers in serene locations.

References and Resources

Bentley, P. G. (2022). Compassion practice as an antidote for compassion fatigue in the era of COVID‐19. Journal of Humanist Counseling, 61(1), 58-73. https://doi.org/10.1002/johc.12172

Hemphill, P. (2024). What it takes to heal: How transforming ourselves can change the world. Random House.

van Dernoot Lipsky, L. & Burk, C. (2009). Trauma stewardship: An everyday guide to caring for self while caring for others. Berrett-Koehler Publishers, Inc.

Yazici, H. & Özdemi̇, M. (2023). Predictors of secondary traumatic stress in mental health professionals: Trauma history, self-compassion, emotional intelligence. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 41, 162-175. https://doi.org/10.1007/s10942-022-00458-y

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