First responders spend their careers working in and around their communities to protect the safety and welfare of citizens. They experience daily personal and professional exposure to traumatic incidents. Enter EMDR therapy and EMDR-certified therapists like Kate Pieper, MFT. She has spent most of her 30-year counseling career working with firefighters, EMTs, paramedics, and police officers. Learn more about how EMDR therapy helps this population, what kind of education, experience, and cultural relevancy a therapist must have before treatment, and how EMDR helps first responders with their post-traumatic stress injury (PTSI).
- Emotional Survival for Law Enforcement Officers: A Guide for Officers and Their Families by Kevin M. Gilmartin, Ph.D.
- EMDR Therapy with First Responders, Go With That Magazine, December 2018
- EMDR for First Responders and Protective Services Personnel EMDRIA Online Community Special Interest Group
- Focal Point Blog
- EMDRIA Practice Resources
- EMDRIA Online EMDR Therapy Resources
- EMDRIA’s Find an EMDR Therapist Directory lists more than 14,000 EMDR therapists.
- Follow @EMDRIA on Twitter. Connect with EMDRIA on Facebook or subscribe to our YouTube Channel.
- EMDRIA Online Membership Communities for EMDR Therapists
Musical soundtrack, Acoustic Motivation 11290, supplied royalty-free by Pixabay.
Produced by Kim Howard, CAE.
Kim Howard 00:04
Welcome to the Let’s Talk EMDR podcast brought to you by the EMDR International Association or EMDRIA. I am your host, Kim Howard. In this episode, we are talking with EMDR, certified therapist and consultant, Kate Pieper, about EMDR therapy and first responders. Kate is located in Auburn, California. Let’s get started. Today we are speaking with EMDR certified therapists and consultant Kate Pieper, about EMDR therapy with first responders. Thank you, Kate, for being here, we are so happy that you said yes.
Kate Pieper 00:32
Yeah, I’m very excited to be here and to talk about my favorite population and like favorite tool in using with my population.
Kim Howard 00:44
That’s awesome, we’re excited to have you. So tell us a little bit about your journey to become an EMDR therapist.
Kate Pieper 00:50
So I became an EMDR therapist in I believe it was 2000. I was first trained by Francine Shapiro, I’m so excited about that. And when I got training, of course, I saw how powerful it was. And then I started going to get my own EMDR therapy done. And I would say that’s when I experienced the power of EMDR. And how it changed my life in a way that cognitive behavioral therapy, and I’m a fan of Satir and attachment. And all of those different types of modalities didn’t have the impact that EMDR therapy had on me personally, as a therapist. So I became a complete advocate of EMDR.
Kim Howard 01:45
Well, we’re happy to hear that. I mean, we talked about this on podcast, and I’ve seen it written in other places, as well as that, you know, you guys, you guys have to kind of figure out what works best for your client, right? You have to customize your approach. And it might be a little bit of this, a lot of that and, and you have to manage that. And so you kind of have to figure out what works best in this situation. And we like to think if EMDR therapy, but you know, we’re a little biased. And so if somebody comes up and says, Well, we’re going to use CBT and EMDR therapy, or we’re going to use EMDR therapy and something else, then that’s okay, as long as it works for the client and helps them heal. That’s what matters ultimately.
Kate Pieper 02:23
Right. Yeah, yeah, definitely.
Kim Howard 02:26
What is your favorite part of working with EMDR and first responders?
Kate Pieper 02:30
My favorite part of working with first responders and EMDR… So I think my favorite part with working with first responders is and using EMDR is how quickly their symptoms are mitigated. And when I see first responders, I usually see detectives or deputies, or law enforcement or firefighters or EMS. And they’re the ones who don’t reach out for help, because it’s just part of the job. They may have been experiencing symptoms for years and just consider it part of a job of the job. I love it when they come in to see me because their whack-a-moles at night have just become too intense, and they can’t keep it down. And I love to be able to do EMDR. And in two sessions, all of a sudden they’re able to sleep. And all of a sudden they can’t they can’t even picture that image that they’ve been having on a at least weekly basis on at or a nightly basis. They can’t picture that image. I love just how quickly it mitigates the symptoms.
Kim Howard 03:45
Yeah, that’s great. And, you know, people who, who work in that kind of career path is, to me always absolutely astounding, that the work that they do, you know, basically saving other people and protecting other people and the images and the mental anguish that they go through in their work shift. I just, I imagine it’s just horrible. I mean, not everything I think is horrible when you’re in that line of work, but I think a lot of it is and so thank goodness that there is a therapy that can help them manage that because that is so much for a human to take in.
Kate Pieper 04:26
No, it is but the first responders are really designed specifically, you know, like, in most like with CHP [California Highway Patrol] or law enforcement, they they take the psych eval, and so they’re actually designed they have the personality to be able to walk into the tragedy walk into people’s worst days of their lives and and not have it impact them as deeply as it would impact other people. And, and also you know when you talk about first response Under, they’re constantly being trained. So their amygdala, their hippocampus is being lit up. And they’re constantly trained for their executive functioning to take control of the situation. So, So Kim, I find that working with first responders there with EMDR. It’s so effective. I wanted to study their brains to see why is it exactly that it’s so effective with them and it works so efficiently.
Kim Howard 05:31
Absolutely. Well, on that note, what successes have you seen using EMDR therapy with first responders?
Kate Pieper 05:38
A multitude of successes, I would say one of the successes that I hold very dear, is a first responder that who was trapped in a building. And he would actually, actually the protocols of firefighting changed because he was trapped in a building, and he was burned, very seriously burned. And I loved the fact that even though he was successful in his life, and he went on to, to be promoted, when he came to see me and we did the EMDR, then the intrusive nightmares left him, and he experienced a freedom that he had never experienced before. And they anxiety went away. I think one instance that I can share is I had a CHP officer that he had, like about 20 years on the job. And, and early in his career, he had the privilege and the honor of holding the hand of a young child as a young child passed away. So for when he had seen me for about 16 years, 1617 years, he would periodically have that dream of that young child and feeling guilty. false guilt, we know that it’s false guilt, that he felt false guilt about that he couldn’t save that child’s life. And when we did EMDR, we did EMDR, because he was having behavioral symptoms of having a career in law enforcement for 20 years. And one of the things that we targeted was that young child, it was so amazing, because we did the EMDR. And then the next week, he came in to see me and he’s like, ‘Kate, I keep trying to bring up the image, I keep trying to bring up the image, I can’t even remember the child’s face. And even when I talk about it with my wife, I don’t feel anything anymore. I don’t feel anxiety, I don’t, I don’t feel dread.’ And instead, he was able to recognize what an honor it was to be that kind and loving person as that child passed away. And he gave that child comfort in a way that no one else could have. And so rather than feeling the guilt, and the trauma of not being able to do something more for the child, he was able to recognize the honor that he had in being able to comfort the child. So I mean, it’s things like that, that I love working with first responders and helping them to recognize their heroic things that they’ve done that they don’t even consider heroic. It’s just part of the job.
Kim Howard 08:32
Yep. Yeah, yeah. My sister was a she retired from Washington, D.C., Fire Rescue, she was a paramedic. And yeah, they’re very stoic about the work that they do in terms of, ‘Oh, it’s just part of the job. You know, I see this, that and the other all day long during my shift are all night long.’ And they just sort of act like it’s not a big deal. And the rest of us, you know, regular folks who do regular work, we’d be like, Oh, how do you deal with that? But yeah, you’re right. They, they just kind of take it in stride. But you know, like you said, they they test people before they hire them so that they have the right fit for the staff.
Kate Pieper 09:13
The right personality. And I think, you know, one of the questions, Kim, that you gave me on the complexities of difficulties in dealing with doing EMDR with first responders is that a lot of times they’re brought into therapy, and they’re being accused of being a narcissist. And this isn’t necessarily saralee EMDR related. It’s more first responder related in that they’re not necessarily narcissist. They wouldn’t be in your office. If they were narcissist. They might come across as narcissistic because things aren’t impacting them as much as it would impact somebody that isn’t a first responder. And so somebody who doesn’t understand That might not recognize that their emotional hypervigilance roller coaster. When they come down off of shift, they actually experience a low cortisol a low adrenaline, you know, they’ve crashed, and they look like, quote unquote there give a damn as busted and it’s actually their body is resetting and getting ready to go back on to shift. So I think anyone who’s working with first responders has to recognize and integrate that emotional hypervigilance roller coaster into the into the treatment plan. If you don’t do that, as a clinician, I think you might create a hurdle in the therapy. That is unnecessary.
Kim Howard 10:48
Great answer. It’s a good segue to the next question, which is, are there any myths I would like to bust about EMDR therapy with first responders?
Kate Pieper 10:57
I think one of the myths is that there’s just too much trauma, that 20 years or 30 years of a career in doing EMDR is just too much that they’re never going to come out of it. And I haven’t found that to be true at all. In my work with first responders, I do think that it takes a certain clinician to be able to do the work with first responders, I teach a course on working with first responders. And for instance, when I was talking to one of my colleagues who does great work with individuals who have been abused as children in the with EMDR, she does great work. But when I was talking to her about one of the incidents that I was working with consulting, and talking with her about one of the incidents that I was working with my first responders, she started to tear up. And you can’t do that, as a clinician who is working with first responders, the tragedies that they hear the multiple level of tragedies with children and with multi-casualty incidents or with friends or colleagues that have been had a line of duty death, you have to be the type of therapist who has done your own work, and is able to give hope immediately to your clients and recognize that, you know, stick with me for the next six months. And we’re gonna get you through this. And we’re going to reduce that PTSI. So I think that that’s one of the myths is thinking that anybody can meet with first responders. That’s not accurate, you have to have the fortitude, I guess, the emotional fortitude, to be able to meet with first responders and hear their story and not react to it. But to offer them the hope that they might think they’re never going to get better. And you as a clinician know, they are going to get better.
Kim Howard 13:01
I would make a terrible therapist then…I mean,
Kate Pieper 13:05
For first responders….
Kim Howard 13:06
I have read in the magazine, because I’m the editor of the magazine. And I have also been in sessions at our conferences. And most recently, the Summit and I have heard some stories and seen some clips. And I just think,’Oh my goodness. I would never be able to keep a straight face. If I were on the opposite side of that desk with somebody. I just, I couldn’t do it.’ So thank goodness that there are people who can do that kind of work. So thank you.
Kate Pieper 13:30
Yeah, well, you’re welcome. I consider it a great honor. And I also do critical incident stress debriefing for law enforcement and for firefighters. So I hear the details of the events from multiple viewpoints. I do that in my practice. And then when I do critical incident debriefing, of course, I hear that so I’m just designed to do that to do this work.
Kim Howard 13:58
Yeah, that’s great. Now, you did mention a specific complexity. But there are others complexities or difficulties with using EMDR therapy for this population that you want to talk about?
Kate Pieper 14:08
Scheduling is really important, recognizing that if that if that law enforcement officer has to go back on shift, you want to make sure that you’re doing it at that you’re scheduling your EMDR for that firefighter that you’re scheduling your EMDR 18 to 24 hours after they’ve come off shift so that their bodies and minds are back in that reset from the emotional hypervigilance rollercoaster. And that’s a term that Kevin Gilmartin uses in his book, ‘Emotional Survival of Law Enforcement Officers.’ So you want to make sure that you’re scheduling it in such a way that they are 18 to 24 hours off of their shift and then also in such a way that they have time to reset the or they go back on to shift. Because it’s not like you’re working with somebody who is no longer exposed to the trauma, you’re working with somebody who is driving past that incident where that incident happened on a regular basis, or is going to have to do CPR or is hat going to have to pull someone over, or is going to have to get into, into an incident with someone on a regular basis. So I think recognizing, recognizing their job is really going to be very important and doing the trauma work in a way that respects what they have to do.
Kim Howard 15:44
It’s great advice. Thank you. How do you practice cultural humility as an EMDR therapist?
Kate Pieper 15:49
I listen to their experience. So the thing that I love about being a therapist, if I don’t know anything, I don’t know anything about that person, regardless of the color of their skin. Regardless of who they’re attracted to sexually. I don’t know anything. I don’t know what anger means. I don’t know what attraction means. For me, I am constantly learning from my clients. I’ve been a therapist now for 30 years. And there is not one time that I have not learned from the person sitting across from me. So regardless of what ethnicity they are, or they they tell me that they are or their sexual orientation, I am learning from them. And I am learning from their experiences. I would say that that’s the number one way. And then the number two way is just recognizing and giving the person across from me permission to let me know that I may say something that’s going to offend them. Or I may not knowingly offend them. And I want them to teach me and I want them to have the experience of me respecting and recognizing and being teachable by their experience of who they are. Yeah. So regardless, I mean, I might meet see law enforcement officers, but I’m not going to see law enforcement officers that fit into this little box. All right, I’m going to see law enforcement officers who some of them, that’s their identity, and some of them, that’s just how they make their living. And the same goes with firefighters and paramedics. So I’m just constantly learning from my clients. That’s exciting to me, that is just constantly exciting to me.
Kim Howard 17:46
Yeah, absolutely. Absolutely. Do you have a favorite free EMDR related resource that you would suggest either for the public or other EMDR therapists?
Kate Pieper 17:57
So I am really partial to giving people tools to use outside of the EMDR session. I appreciate the fact I just, I just had training with Ad [de Jongh] and Suzy [Matthijssen] in the EMDR 2.0. We might disagree on this. But I love the fact that I can tell my clients, hey, go on Spotify, download bilateral music, use this to go to your calm place. So if you find yourself in an in a 16-hour shift, and you’re feeling agitated, go to that bilateral music, play that music for five minutes, and go to your calm place and allow your whole body to relax and be in that calm place. I find that that is a gift to give to my clients who are experiencing trauma on a regular basis. And my clients who are going into the hyper vigilance mode on a regular basis. That’s one of my favorite resources. I think also parents of young children, could you use that on a regular basis?
Kim Howard 19:14
Yeah, I remember those days. My kids were 25 and 22, now.
Kate Pieper 19:18
Yeah, I’m the mother of four. Yes. So I think that that’s invaluable that like just put on your headphones and go to your calm place.
Kim Howard 19:30
Because if you have children, you’re going to need that at some point in your life, at least once.
Kate Pieper 19:34
Absolutely going to need that. Yeah.
Kim Howard 19:37
More so when you have teenagers, but that’s another story.
Kate Pieper 19:40
Kim Howard 19:41
Yeah. What would you like people outside of the EMDR community to know about EMDR with first responders?
Kate Pieper 19:49
I would like them to know that. If they’re like, let’s say I’m talking to somebody who’s married to a first responder I would like them to know that their first responder is experiencing trauma on a regular basis, they have things in their head, that they will not discuss with you as being a family member. They won’t talk about it, because that’s their job, and they don’t want to bring their job home. And they’re experiencing trauma, real trauma on a regular basis. So when you see them start to experiencing anxiety, more often than not, or start to increase on the alcohol, or increase on the food, or start to isolate, or start to get more irritable than not, that’s a time as a family member of a first responder to say, Hey, I think I looked up on emdria.org. And I found this therapist who specializes in working with first responders and practices EMDR. And I think maybe, like seven sessions with them. And it might, I’m told that it might help to reset them. That’s what I would want the general public to No, I actually believe that every first responders should have an EMDR therapist in their back pocket, hypothetically, but their card and be able to call that EMDR therapist and say, I just got done with this critical incident, or I just have this really hard call. And can I come in to see you, I need to reset, or my wife tells me I love it when somebody comes in to see me and I say So what brings you here. And they’re like, my partner said, I’m too irritable. So I need to come and see you. And I’m like, Good, great, let’s help. Let’s help get that trauma out of your system and get you back to that person that you were before you took on this career of 20 years running into danger, or running into, you know, being with people on their, the worst days of their lives. And there you are, and you’re showing up and you’re doing your best. And most first responders are so professional. It’s an honor for them to be with us on our worst days of our lives.
Kim Howard 22:20
Wow. It’s a great testimonial.
Kate Pieper 22:21
I’m kind of passionate about first responders.
Kim Howard 22:24
Yeah, no, I like it. I think it’s fantastic. And I am so glad that there are therapists like you who work with people like that, who need it that population. I mean, like we said earlier that those jobs are, there are there can be good days, but I suspect that there are more bad days, and there are good days, right. And even if there are just average days where nothing really dramatic happens. Just the fact that you are have to be hyper vigilant because of the nature of what you do for a living you are always quote unquote, on right? Even when you’re off shift, you might get called in, they might need you whatever, whatever. And so I mean, I just remember, you know, I used to live outside of Washington, D.C., and I worked six miles from the Pentagon on 9/11. Right. And as we were fully as we were all fleeing the city, because we were scared because our country was under attack. First responders from all surrounding counties were flooding into Northern Virginia where the Pentagon is and so you know, you just look at that and you think, wow, the few right the select people who who do that for a living. So they even even if they’re quote unquote, off duty, they might be called up and you might have to go in and so they’re always on so thank you all for doing that kind of work with it and helping them live. Live a life that’s happier for them hopefully and more mentally well.
Kate Pieper 23:53
Yeah. And for their loved ones. I think. I think there’s a myth also that the divorce rate is higher for law enforcement and firefighters. Now the divorce rate is actually lower for law enforcement officers. And if you think about that, you think about law enforcement and firefighters, how loyal they are first responders and how loyal they are and how they’re willing to stick in there and stand in the fire. Figuratively speaking, but sometimes literally speaking. So if we do EMDR with the first responder, we are helping their whole family to be more content and to be to be happy to be able to hold on to the happy in their lives. I think that’s part of the reason why I love the work that I do. And I’m so thankful that EMDR is a tool that just turbocharges the whole process of giving people back their lives. Yeah.
Kim Howard 24:52
Do you also work with first responder families or strictly first responders?
Kate Pieper 24:57
I work with their families also I work with of couples a lot, who one of the partners is a first responder. And that work I love because when I do that, of course, when you do EMDR with one person, you’re actually changing the dance step, you know, for the couple. And oftentimes the partner has compassion fatigue, and they might have vicarious trauma from the first responder. So a lot of times I’m doing EMDR on both people in the couple, and helping them to move on through the tragedy.
Kim Howard 25:36
And that’s good, because you’re not just helping the first responder, but you’re helping if they’re a family unit or a couple unit, you’re helping them strengthen that relationship. Yeah. Which eventually just helps everybody all around, right?
Kate Pieper 25:49
Oh, I’ll share with you. There was one family that I helped the officer was in an officer involved shooting. And it was very, it was tragic. I helped him of course, but he was doing really pretty well. But the fallout on the children was very significant. So in doing EMDR, with the children, I was able to help them to recognize that they didn’t need to be afraid that dad was going to get involved in that every day of his career, and able to mitigate the anxiety that they felt about what dad was facing every day in his career. So I consider that a privilege just to help them to enjoy dad and enjoy the life that they were living and have them move on from the vicarious trauma of Daddy was involved in an officer involved shooting.
Kim Howard 26:49
That’s great. Thank you. Thank you for sharing that. Kate, if you weren’t an EMDR therapist, what would you be?
Kate Pieper 26:58
A hang glider, or a triathlete or painter, or a mountain climber.
Kim Howard 27:07
Wow. those are great answers. I haven’t gotten any of those before. hang glider. I didn’t even know that was a thing. Oh, yeah, I wouldn’t be like a career path thing. So
Kate Pieper 27:17
yeah, sure. An adventure. I would love it. Yeah, I do triathlons on at least a yearly basis, I’ll do a triathlon. But yeah, I’d love that to be my career just painting and taking pictures and enjoying life.
Kim Howard 27:35
What kind of painting do you like to do? Do you like oils? If you like watercolors?
Kate Pieper 27:42
I like acrylic; I like acrylic. And I like the fact that when you take a pay I’m, I’m a novice in it. But I like the fact that when you take painting lessons, then you start to see the world differently. You know, you look at a mountain and you see all of the you see the shadows and you see the different shades in the mountain, then you you automatically my mind automatically goes to how could I blend? And how could I, I could paint that. That’s, you know, that takes it back to EMDR. Because when you’re talking about first responders, when they have compassion fatigue, or they have PTSI, their lives have become black and white and monochrome. And when you’re doing EMDR, you’re slowly letting them see the colors in life and you’re slowly letting them open up and see that there’s all different colors in life that they haven’t been experiencing, because they’ve been tucking away the sadness, and the shock and the grief that they feel. And so I love. I love my work.
Kim Howard 28:51
That’s great. Yeah. Is there anything else you’d like to add?
Kate Pieper 28:55
Don’t meet with first responders, please, unless you’re willing to become culturally competent. You could be the best EMDR therapist that there is on the block. But if you’re not culturally competent to meet with that law enforcement officer, that paramedic that, that firefighter, you have to become culturally competent, in order to meet with them and and as well as military, you just have to become culturally competent. And I would encourage you to take some courses, do a ride along with law enforcement officer, visit a firehouse, read some books, but don’t just think that you can work with first responders and not become culturally competent about their lives.
Kim Howard 29:46
Good for the end of the podcast. Thanks. Thanks, Kim.
Kate Pieper 29:49
Thanks for having me.
Kim Howard 29:50
This has been the Let’s Talk EMDR podcast with our guests Kate Piper. Visit www.emdria.org for more information about you EMDR therapy or to use our Find an EMDR Therapist Directory with a 14,000 therapists available. Our award winning blog focal point, offers information on EMDR and is open resource. Thank you for listening.
EMDR International Association
Copyright © 2023 EMDR International Association
Howard, K. (Host). (2023, July 15). EMDR Therapy and First Responders with Kate Pieper, MFT (Season 2, No. 14) [Audio podcast episode]. In Let’s Talk EMDR podcast. EMDR International Association. https://www.emdria.org/letstalkemdrpodcast/
EMDR Therapists, General/Public
Let's Talk EMDR podcast