Kim Howard 00:05
Welcome to the Let’s Talk EMDR Podcast brought to you by the EMDR international association or EMDRIA. I am your host Kim Howard, April of Sexual Assault Awareness Month. In this episode we are talking with EMDR certified therapist and consultant Kristina Anderson. Kristina is located in Kirkland, Washington, where she specializes in providing EMDR therapy for sexual assault and abuse clients. Let’s get started. Today we are speaking with EMDR therapist and your consultant and virtual trainer Kristina Anderson, about EMDR therapy and sexual trauma. Thank you, Kristina for being here today. We are so happy that you said yes.

Kristina Anderson 00:42
yeah, I’m looking forward to sharing my experiences. I think it will hopefully help some EMDR therapists who are working with sexual assault survivors.

Kim Howard 00:51
Yeah, absolutely. So tell us a little bit about your journey to becoming an EMDR therapist.

Kristina Anderson 00:56
Yeah, so currently, just to kind of give some background on who I am. So currently, I’m an EMDR therapist for a nonprofit organization. And I work in Everett, Washington, aimed at helping sexual assault survivors and secondary victims process their trauma. I work with these clients one on one as well as create and facilitate support groups for survivors, non offending parents and caregivers of assaulted survivors. And I work with high schoolers as well. So I’ve been doing this work since 2016. So for the last seven years, which is crazy. And I’m also a trauma supervisor certified through the Institute on Violence, Abuse and Trauma. So I that to assist with case consultations regarding childhood trauma and sexual assault trauma. So that’s a lot.

Kim Howard 01:40
That is a lot.

Kristina Anderson 01:41
A lot of stuff.

Kim Howard 01:42
Yeah.

Kristina Anderson 01:43
Yeah. So I definitely got into this work, just my undergrad was in women’s studies. So one of my favorite courses was the Violence Against Women just because I had no idea how prevalent that was. And one of my internships was at the Center Against Rape and Domestic Ciolence in Corvallis, Oregon. And when I got hired on as a part-time staff member, I actually worked with survivors as a shelter advocate. So while it was kind of staying the night, making sure things were good, I got to hear some of their stories. And it was so empowering to kind of figure out like what had happened, where they are now like what’s going on, and kind of what their plans were for the future. And just being able to sit there and listen to those stories was so impactful for me, but also for them, just having somebody to listen to them and not judge them. So I really got into that work around like 2010 really just being a shelter advocate at this organization. When I went to graduate school, I had another opportunity to work for an organization that centered around like violence and sexual assault trauma. And so I did that. And that was amazing. And while I was at my graduate program, the wonderful Katie Murray came in from hap, and she was able to kind of talk with us about how incredible EMDR therapy is, and especially how, you know, half the humanitarian assistance program is able to help with processing trauma for you know, real world disasters, and kind of connecting those pieces of this is what I want to do as a therapist is work with, you know, victims of assault and violence. And I want to help them process their trauma that just seemed to click for me. And when I attended the the first training, which was October 2016, that just sealed the deal for me. I was like, ‘Oh, this isn’t hypnosis. This is actual, like real life scientific magic.’ And I absolutely have enjoyed EMDR since then there’s not a day that goes by that I do not use it with a client.

Kim Howard 03:44
That’s that’s a great testimony. That’s yeah, that’s great that somebody introduced you to it. Because I, I feel like that’s how a lot of therapists come to EMDR through somebody that they know, professionally, whether it was of course they were taking a class or taking or maybe a conference they’ve recommended, you know, we’re attending and they were like, ‘Oh, what is this? I can tell, tell me more about this, you know.’ And that’s how they come into it. So we’re glad that you found it. And I’m sure that the people who have been your clients have been very happy that you’ve found it as well. So they Yeah, from their trauma. So thank you for all that you do. Yeah, that’s wonderful.

Kristina Anderson 04:24
It is literal, actual magic. And I think it’s really interesting when I tried to describe it to my clients of like, this is what EMDR is, a lot of them are like, I don’t think it’s that efficient, or I’ve tried every other type of therapy. This isn’t gonna work as well as you say it’s going to and then Bada bing, bada boom it is.

Kim Howard 04:43
Yeah. Yeah, yeah. And then they’re singing your praises.

Kristina Anderson 04:48
Yep. And then they go around, they’re like, everyone needs EMDR.

Kim Howard 04:52
Everyone kind of does actually.

Kristina Anderson 04:54
Absolutely, definitely.

Kim Howard 04:56
So what is your favorite part of working with EMDR and sexual trauma?

Kristina Anderson 05:00
What I definitely enjoy about it is, you know, just being able to see how the mind and the body separate when that trauma occurs, and then how EMDR kind of puts those pieces back together, especially, you know, being that sexual assault is really unique that it impacts our mind, our body, our spirit, our emotions, all at the same time. EMDR is a perfect fit for it, because it really helps, you know, just kind of solidify, you are a holistic being who had something fragment you and now we get to sort of put you back together with your help with your brains help, I’m just moving my fingers. And I think also really being able to recognize patterns or factors that increase someone’s chances of being assaulted. So that prevention work can then be implemented. So one of the things that I’ve really noticed working with sexual assault survivors is that they have absolutely had some sort of childhood experience or some sort of adverse effects happen to them, where that kind of leads them down this path of my automatic trauma response is fawning or people pleasing. And that is typically how they end up in a situation where the assault occurs. It’s not that they did something crazy or did something irresponsible or whatever, it’s typically that they had some sort of past experience that then led them to being unfortunately a victim to this. And so what I think of is, you know, the freezing or the fawning trauma response. I’m going to mention that a little bit later on with the questions. But I mean, that is so important to talk about, because that is what happens, like when people are assaulted,

Kim Howard 06:34
Right, we talked, you touched on this a little bit earlier. And whenever you read about or watch any kind of news reports, whether the it’s a television show, or it’s a legitimate news report, and they talk to victims of sexual trauma, they, most of the time, they will say, ‘It was like I wasn’t there, right, my mind completely dissociated with what was happening to me physically, you know, where I was hovering over my body, and I was watching it happen, but I couldn’t do anything to prevent it.’ And so it’s good that you touched on, on how all of that works against the person when it’s happening, and post when it happened. But then how EMDR therapy, cycled through all of that and brings it all together. And so that person can heal.

Kristina Anderson 07:19
Absolutely.

Kim Howard 07:21
So what successes have you seen using EMDR therapy for sexual trauma?

Kristina Anderson 07:25
Yeah, so Kim, oh, my gosh, many…

Kim Howard 07:29
Great.

Kristina Anderson 07:29
But this is going where I’m like, How much time do you have? Yeah, so I think the number one thing is just reclaiming their voice. So you know, especially with the desensitization piece, right? So desensitizing them to the trauma, whether that actually looks like full blown EMDR or just EMD really desensitizing them to that trauma, and getting them grounded in that present moment is huge. So that is like one of the biggest successes I’ve seen is to be able to get my clients to feel safe, when they are actually safe, so safe in their body. And especially with their body, right, it’s reforming a new relationship. So something happened to their body, where their actual, like penetration happened when the sexual assault occurred is completely irrelevant. Something that they didn’t want to have happen to their body happened to their body, and it’s rebuilding that relationship with their body. So not fighting their body, not punishing their body, not ignoring or disconnecting from their body, that sort of facilitating, like your body is a part of you, and you need to celebrate it is huge. So that’s one of the biggest things that I’ve seen in EMDR. And what makes sort of this therapy really successful, also realizing that they are not their trauma, that the trauma that happened is completely separate from them, they just are coping with that and integrating that. That is a huge thing, and that they’re not to blame for their trauma. Another thing that I’ve really seen sort of as a successful story of EMDR. And how it works with these clients is having that aha moment, when they realize that people go out and drink alcohol, people go out and they dress crazy, or they don’t wear anything at all. And that has nothing to do with predicting if sexual assault is going to occur or not, has nothing to do with it. Right? People can go out and have drinks, people can go out and be crazy. They can make you know, quote unquote, poor choices, if you will, there is absolutely no correlation between that and being assaulted. And so one of the things that I find super powerful about EMDR is the reprocessing, right, the reprocessing that negative cognition that I am responsible, I am to blame. This happened to me. It’s like no, the only thing that you did is you happen to be there. You happen to be in that situation and the offender offended you. That is what happened. Right? So those aha moments of oh, I guess I wasn’t actually responsible for that, or I guess I am safe in my body. Those are huge, absolutely huge.

Kim Howard 09:46
Are there any myths that you would like to bust about EMDR therapy and sexual trauma?

Kristina Anderson 09:50
So this one might seem pretty obvious, but I’m just going to say it because the stories that I’ve heard from my clients coming to me for specialized sexual assault therapy is pretty astounding. mean. So please don’t blame the survivor for the assault occurring. Like, I’m just gonna go ahead and put that out there. Please don’t do that. This doesn’t look like overt blame what this can look like as a therapist who is working with somebody who’s been assaulted, it can also look like questioning them about their choices or trying to get more detail about things that are not really relevant to their healing. So one of the things I find really important about talking about victim blaming, is are you victim blaming, because you’re actually blaming the victim for the assault occurring? Or are you victim blaming, because you are scared that the assault can actually happen to anyone, and you are trying to make up excuses as to what that person must have been doing specifically, in order for them to be assaulted? Right? Oh, you must have been going out and drinking and doing something crazy, because I would never do that. And therefore I’m safe, right?

Kim Howard 10:53
And you shouldn’t be out walking at 4 a.m. when it’s dark, and blah, blah, blah.

Kristina Anderson 10:57
Oh, you didn’t have your keys in between your fingers, and you weren’t ready to stab someone? So that’s clearly why that happened. And it’s like, no, that has nothing to do with it. Right. So I think really just being super mindful that victim blaming can come out in a myriad of ways. It doesn’t just have to be overt blaming. So just being extremely mindful as a therapist of how you ask survivors questions, because the myth is, is that victim blaming can actually take on many different forms. So I think that that’s definitely one of the things is just please don’t blame the survivor. Even if you are not out loud, saying like, it’s your fault. Like, just be really mindful of that and be mindful of your past experiences. Because yeah, if you were trying to make excuses as to why the assault occurred, that is victim blaming, I mean, that truly is.

Kim Howard 11:44
And you’re not putting the blame, we’re live, which is because I was on the perpetrator and not the victim.

Kristina Anderson 11:50
Exactly. 100%. Exactly. And I think a second myth would be that you don’t need to be a sexual assault therapist to help your client process trauma related to sexual assault. Some of the clients that come to our organization, they are on our waiting list, and they say, ‘Well, the therapist that I’m currently seeing now doesn’t want to talk about my sexual assault trauma, or doesn’t feel comfortable in that area.’ And yes, while having specialized training in sexual assault is extremely helpful for knowing how to navigate that, you don’t absolutely have to be a specific sexual assault therapist to touch on that subject. There are many things that you could do to be helpful in processing it just supporting and validating and being empathetic, like there are not a whole lot of things that you have to do or feel like you should do as a therapist to unpack all of this sexual assault trauma. So that is kind of just what I wanted to say about that. Because the prevalence is so huge that I mean, in my personal and professional opinion, sexual assault happens to at least 25 percent of people, at least, if not more, the statistic is one in six, but it’s more.

Kim Howard 12:58
I can’t remember it, because it was a few years ago, when they come out with these studies, you know, because my daughter just graduated from college about a year and a half ago. And so that’s always on your mind when you send away a child anywhere in an environment like that. And excuse me, an adult child, and the statistics for college students who get sexually assaulted are just astounding.

Kristina Anderson 13:22
It’s crazy.

Kim Howard 13:22
You know, and I’m like, you guys, you’re there for class. The you know, this is that it just really blows my mind. You know? And so yeah, it happens a lot more. Because, you know, a lot of people don’t report it, right?

Kristina Anderson 13:36
And I will definitely be touching on that. That cycle for sure. Yeah. Because there are both pros and cons for reporting. And I think that that’s really important to talk about, but absolutely right. It’s like, how are we to know that places are safe? And again, it goes back to we don’t, unfortunately, we don’t know, if people are safe. We want to inherently believe that people are good and that they are trying their best, right?

Kim Howard 14:00
But you can trust them.

Kristina Anderson 14:02
Yep, you can unconditionally trust people. They’re gonna you know, they’re not going to hurt you. And I think the really sad truth is that we just don’t know, we just really don’t know.

Kim Howard 14:12
You don’t absolutely don’t. Yeah, yeah, absolutely don’t. Yeah. So are there any well, this is a loaded question. Are there any specific complexities or difficulties with using EMDR therapy for sexual trauma?

Kristina Anderson 14:25
Yes, the answer is yes. The short answer is yes. So I think one of the most complex things that a lot of EMDR therapists may or may not understand is that when you ask a sexual assault survivor, if they feel safe in their body, or if they feel safe right now, even though objectively maybe nothing unsafe is happening around them. They might say, no, they might say no, I don’t really feel safe. And it’s it’s not that your office doesn’t feel safe or the environment that they’re in doesn’t feel safe, they don’t feel safe in their body. And so, one of the complexities really is how do we figure out How to establish a calm safe present, versus a calm safe space. So the difference on that is, you know, if they’re in your office, make your office, the calm, safe presence, you know, make that the present moment that they need to be grounded in and where they need to come back to at the end of every session, just because if they don’t feel safe in their body, they’re not going to feel safe with you, they’re not going to feel safe, you know, where they’re having their therapy, if it’s online, or whatever. So that I think is a huge thing, spending extra time on developing what a calm, safe present looks like, and having them ground themselves in that present moment and feeling safe in their body? Absolutely. I would say, a second thing would be screening for dissociation. So whether you as a therapist, you could have all the training in the world on dissociation, right? But I think that dissociation really happens, like when they’re not in our office, it could absolutely be that they’re dissociating an office. Absolutely. But I think a huge piece is really screening for dissociation, no matter how they present in your office. So I have found that when I screened for dissociation, like it is very prevalent, like they are often especially after an assault, but even if they have had, you know, some sort of adverse childhood experience happened to them, like dissociation is extremely prevalent. And that’s the thing that is kind of getting them through life. So figuring out how to screen for that, what that looks like, providing psychoeducation for your client on that. All of that is very, very important, because it’s going to impact how they process things with EMDR. If they are checking out if they’re dissociating, if they’re having out of body experiences, all of that stuff is going to process or impact how they’re processing. So that is huge thing screen for dissociation. Because that’s going to make things very complex if you do not. And also, while you are talking about dissociation with them, have them in between sessions make note of what it feels like to dissociate in their body or from their body, what it feels like to bring themselves back into their body, and what are the most effective grounding techniques that they can use. Because oftentimes, like those are going to be the grounding techniques that they need to use in session with you, especially after processing the thing that makes them dissociate. So that would just be one of the most complex things is just dissociation. I think with a lot of clients, but especially with sexual assault survivors, the next thing I would say that is complex would be that therapist EMDR therapists are afraid to jump right into processing the sexual assault trauma. I want to say that I think that there are many factors that that kind of dictate if it will be extremely retriggering. Like it’s triggering as we think it’s going to be, or if it’s going to be fine. So a couple of those factors are, you know, the nature of the assault. So how, how violent was it? What happened? What was the the level of physical, emotional, or mental or sexual violence that was used? What was the age that they were when they were first assaulted, So how old were they when they were first assaulted, that is going to be really big, and also a predictor of dissociation, the younger they are, the more dissociated they’re going to be because their brain was not able to compartmentalize and process what happened to them. The number of assaults that they’ve had in their lifetime is going to be huge. If they are coming to you, as a client, who is maybe let’s say, an adult, has never experienced a sexual assault in their lifetime, and then experienced an assault when they come to you processing that that trauma may or may not be as re triggering, as somebody who’s experienced a childhood sexual assault had that sort of repressed for many years, and then is now finding that it’s coming up, and they want to work through that. So that’s a huge thing as well, just how old were they when that assault occurred, the number of assaults that they have had in their lifetime is also going to dictate that is this, again, the first assault is this one of many, that is also absolutely going to be sort of determining if it’s going to be re triggering for them. If they have had any other assaults at all in their lifetime or any other abuse in their lifetime. This is where the ACES comes in handy. The adverse childhood experiences questionnaire, or scale, this is where this comes in handy. Is screening out for that figuring out, did you process that through therapy or by other means? Or is that kind of impacting how you’re not or processing the trauma right now, also, the support or help they received directly after the assault is not something that they received at all. Because if they received no support after their sexual assault experience, chances are it’s going to be very retriggering when you bring it up in therapy or when you process it with EMDR. But if they felt pretty supported, if they felt like no actually, like I feel really supported, they feel validated and I feel empathized with, then bringing that up in therapy with the MDR is not going to be as retriggering as if they had absolutely no support at all. I think something else too is the relationship with the offender. That is a huge piece, basically 99 percent of all offenses realistically, probably 95. But I’m gonna say I’m gonna say almost 100 perent of all offenses occur where the offender is someone that the survivor previously knows, if not knows very well. So when that happens, typically that result In self blame for the survivor, guilt, untrusting of self and a lot of internal locus of control issues. Whereas if the offender was a stranger, that sometimes were mostly results in fear, untrusting of the world, an external locus of control issues, they don’t know what’s going to happen in the world around them versus I am the problem, there’s something wrong with me, I create all of the bad things that happened to me. Another thing too, the last thing would be their current support system. So when they leave your therapy office, do they have support to go to or are you their only support, if that’s the case, ending EMDR sessions is going to be really hard for them if you are the only person who believes them or trust them, and can provide that ongoing support throughout the week when they are not in your office. So those are things, it’s a lot of things. But those are all things to consider when you are wanting to unpack the trauma with them. And kind of a predictor on how retriggering it might be. So that would kind of just be my guidelines and experiences.

Kim Howard 21:02
Those are great guidelines. Thank you.

Kristina Anderson 21:04
Yeah, absolutely.

Kim Howard 21:05
So how do you practice cultural humility as an EMDR therapist?

Kristina Anderson 21:09
Yeah. So first off, super love that this question is even asked, love that. For those who cannot see me, I am a a white, able-bodied female who has had the privilege of having education and a career that I love. So these are things that I absolutely keep in mind, as I go into my sessions, like I am coming from a completely different background. And I have privileges that I acknowledge, I make no assumptions about anybody’s identity, or parts of their identity, or what they choose to talk about with me in session, what they choose to hold dear to them, what they choose to reject. Those are all things that nobody should make assumptions about. And I especially don’t. And so I really encourage and empower my clients to tell their stories, they are the expert of their own lives, tell me what is important to you. And if there’s something that we haven’t touched on, or that, you know, you’re you’re finding that I am just unaware of, make that known to me, like truly, like, I want to know you as a whole, for my organization to what I really, really enjoy about working for Providence Intervention Center for Assault and Abuse in Everett, is in response to George Floyd in 2020. We created the equity inclusion and accountability workgroup. And we did an overhaul of all of our materials, everything that like we internally use as providers and things that we externally get out to clients. And it was phenomenal, like the things that we came up with and things that we were like, or that is outdated, the things that we were able to see and recreate and reconstruct were incredible. Like, for example, we created a phone tree that made it a little bit more easily, easily accessible to actually get to where you wanted to call and the services that you wanted to receive, we created or implemented TTY options for folks who are hearing disabled, we reconstructed our website and our brochure with more inclusive language, gender-affirming care, non-discriminatory services and more inclusive pictures that were more ambiguous not outlying like, you know, thin friends and family like hopping over a lake to signify health. It was like, you know, cans and reaching for, you know, trees and things like that; so more symbolic. This is what healing looks like versus this is, this is who healing looks like. We also created a client feedback survey to encourage the voices and populations to give their feedback on what services or what needs we were not providing or meeting and to see what we were doing well. So that’s always good to know. So getting community voices, I think was huge, huge for us. And that has been continuously changing the services that we provide to be more geared towards people who really, really need them.

Kim Howard 23:46
Yeah, that’s great. I worked in associations for a long time. And I presented before at conferences about magazines, and publishing, and communications and all of those things. And we talk about those things. And we talked about surveys, because you know, quite frankly, when you have an organization, you have to ask members or your customers, if you’re a business, how are we doing right? But I always tell people, if you don’t want to know the answers, don’t ask the questions, because you need to be ready to make the changes when those that feedback comes in, right? And you need to look be able to look at those trends and figure out what you did really, really well and keep doing it and what you need to improve on and how are you going to fix that? So anybody out there who’s working in an agency like you are, it’s good that you’ve also do that kind of as a not a follow up, but as part of your package. When you’re working with clients, this is just how we do it. We ask you what we do well and what we don’t do well and then we make changes with it. So thank you guys for doing that.

Kristina Anderson 24:42
Yeah, I love that right about like, you better be You better be willing and able to make those changes.

Kim Howard 24:48
Yeah, you have to be prepared because I mean, luckily, I mean, members will tell you the truth. I mean, they will tell you the truth about whatever you’ve asked them about some new program you’ve created or some direction you want I go or how the magazine is doing or whatever. And so they will tell you. So you have to just you have to kind of have put on a little bit thicker skin and be prepared because it might not be positive all the time. And then how are you going to? Are you going to adjust your, your future approach? So?

Kristina Anderson 25:15
Absolutely well, and I mean with statistics, so I also have a couple like statistics to read, because I think that it’s really important to know, the populations that are truly impacted the most by sexual assault violence and sexual assault trauma, the most at risk, people of being sexually assaulted are women of color, immigrant women, LGBTQIA plus women and disabled women. So the fact that we did you know, we were finding that all of our brochures had, you know, white families on them, and like, we’re just totally not accessible, not in different languages. I mean, it was just like, who are we trying to reach here? And why are we not doing something about the people who are actually at the most risk? That was something that I just thought was really wonderful about the organization that was willing to open up and actually do that. But at the same time, like there are absolutely still stigmas around receiving care for the these kinds of things. And so, you know, there’s still so much work to be done.

Kim Howard 26:13
There is an I feel like, it is extremely unfortunate that George George Floyd had to happen at all. Oh, absolutely. But I I honestly believe that, and I have seen it with organizations that because of what happened with him, people have made changes, and have they have become more aware. And I don’t know if there’s a silver lining to anything like that. That just tragic. That would be it is that people have finally opened their eyes is sort of removed the scales and said, Hey, this is a problem that we have, not in just this country, but in a lot of countries. And here’s how we’re going to make some changes to press forward with us.

Kristina Anderson 26:49
Absolutely. Like that was the final thing, which is so sad to say, like, that was the final thing to be like, hey, so So are we going to make those changes now? Because they needed to be made before. But I think that now’s a great time to do that.

Kim Howard 27:04
Yeah, absolutely. So do you have a favorite free EMDR related resource that you would suggest either for the public or other EMDR therapists?

Kristina Anderson 27:13
Yeah. So for clients all the time I use the emdria.org. All the time that What is EMDR? all the time. Like, go watch this video. If you have any questions, let me know. Yeah, that’s I love it. That just what is the EMDR page is fantastic. And honestly, I mean, there is so much weirdness in terms of like other EMDR resources that are not actually EMDR that I kind of forbid my clients to Google EMDR because I’m like, you will come up with the weirdest things. And it’s not going to be reliable. And like, this is what I think is really, really reliable. So if you have any questions, or you want to know, stick within this website, yeah. Yeah. So for my clients, that is the resource I absolutely give them. And then for EMDR therapists, so I mean, obviously, if you’re an EMDRIA member, right, like you can download, like those toolkits, and you can download brochures and things like that. But you know, for actual free websites, there is EMDR Consulting, they have free training materials, they have templates that therapists can use for EMDR for their clients. And it’s all very, I mean, it’s all very, very helpful, and it’s all free, which is wonderful. Another thing too, just for therapists in general therapistaid.com has been like my Savior as a community mental health therapist forever. They have amazing worksheets and handouts and things. And they’re all super, I mean, they’re super big font, which is wonderful. But they’re also just, they’re organized in such a way that it is it’s visually stimulating. So it’s not like you’re giving your client this like handout on here’s 1,000 words about whatever it is interactive, it has pictures, it has diagrams. So therapistaid.com is absolutely one of the best websites I’ve ever used. And then just in terms of sexual assault survivors, so if you’re a therapist, whether you’re EMDR therapist or not, but if you’re a therapist, looking for more resources on sexual assault, trauma, or trainings or things like that, or if you have a client who has been sexually assaulted, and you want to refer them to website where they can get more support rainn.org. Incredible. That stands for the Rape, Abuse, Incest National Network. And then for male survivors: So male survivors are of the minority of folks who are assaulted, but they still are assaulted. Nonetheless, male survivors, the website is the number 1insix.org. And that stands for one in six males are assaulted, that is an incredible resource and also with support groups and things like that. So males, at least my personal experience and professional experience working with meals, the support groups are absolutely amazing. And also there is so much stigma around that that they are if you talk with a male who’s been you know, assaulted, it’s either I absolutely want a support group because I wa