Kim Howard 00:03
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 honor of February marking Black History Month we are interviewing black EMDR therapists. In this episode we are talking with EMDR certified therapist Ava Hart. Ava is located in Middletown, Connecticut, where she specializes in providing EMDR therapy for birth trauma and pregnancy loss. Let’s get started. Today we are speaking with EMDR certified therapist Ava Hart about EMDR therapy and birth trauma and pregnancy loss among Black women. Thank you, Ava for being here today. We are so happy that you said yes.

Ava Hart 00:43
Well, thank you, Kim, I appreciate I appreciate the offer. And I’m excited to be here with you today to talk about this important topic.

Kim Howard 00:49
We are excited to have you. So tell us a little bit about your journey to becoming an EMDR therapist.

ava 00:56
Well, I started my my social work career as a supervisor and I supervise programs in home programs such as early headstart positive parenting program, and then they typically use psycho educational type materials. And so it wasn’t in terms of in terms of the clinical work, it wasn’t heavy in clinical work. And so as I transitioned to my clinical practice, in private practice, my biggest concern was that I wouldn’t have the tools to deal with the big T traumas. That was that was something that I was extremely worried about, and and also being isolated from the community, as I transitioned to EMDR, and was, you know, trained and then certified. I’ve learned, I’ve learned that this is such a huge community that I do not feel isolated. And I certainly feel equipped with the tools to help people with those with the past and present traumas that they’re experiencing.

Kim Howard 01:51
That’s great. That’s a great story. I’m glad that you you pursued that. And I like to hear people’s stories about how they, they found EMDR therapy, and everybody’s coming from a different experience or a different connection. And now we’re all here together. So that’s fantastic. Thank you.

02:08
Kim, there were there would be times when I would, I would be sitting with a client and they’d be talking about something really significant. That has happened, a big past trauma that has happened. And and I’d feel lost at times in talk therapy can be very effective. But what I had, what I was hearing from my clients is that they would feel good immediately following the session, and maybe a day after. But then all of those old feelings, images, memories would come back as well as the anxiety and depression. And so it just didn’t stick. And so I’ve I’ve learned that with EMDR. That is not the case. And so I’ve I’m sold, I’m sold on EMDR.

Kim Howard 02:50
That’s great. That’s great for our listeners to hear. Anybody who might be interested in adding EMDR therapy to their practice, or is curious about it from a client perspective, to know that it does indeed work. And I’ve said this before, on this podcast, I run our social media accounts. And I hear probably once a week, somebody will say EMDR therapy changed my life. Or even, you know, EMDR therapy saved my life. And so you hear that kind of testimony from people who are putting it out there and you’re like, wow, this really does work. And it’s it’s good to get that feedback. And I mean, we we as professionals know that it works, but it’s good when other people who aren’t necessarily connected to our community yet, have experienced it and says yes, this, this doesn’t work for me. So that’s wonderful. I agree. So let’s talk about why we’re here today. What is your favorite part of working with EMDR and birth trauma and pregnancy loss?

Ava Hart 03:42
So, I would say built building trust, building trust with an extremely vulnerable population is is so huge, and for me and important. And so, in terms of using EMDR, I would say the resourcing component is key. And building that trust sitting with with a client and helping them identify their strengths, and all of the potential present and past resources that are available to them. And using this SafeSpace exercise and validating validating how how people are feeling people are feeling and thinking about when they’re at their best. So validating that yes, those those are so validation and supporting individuals with their, with their, with their perceived strengths. Right, and just acknowledging that, that they have protective factors, and that there are internal resources that are accessible with a little support.

Kim Howard 04:43
Yeah, I mean, I have two children on my own who are now adults. And I remember I mean, I had a very I was very lucky I had a very healthy pregnancy I had what I would consider a normal pregnancy and a normal healthy delivery of both of my children and it’s but it’s… you’re right, it’s extremely vulnerable time for a woman. And if they’ve had any past experiences or past traumas with either trying to get pregnant or miscarriage losses, or if they happen to be on the second or third child, and they had a traumatic experience during the birthing process or in labor and delivery, you know, going back in and doing it all over again, I would presume it’s just really very stressful for them. And so I’m so glad that there are counselors and therapists out there who can help them because they really are vulnerable. You’re right, that’s, you know, I think next to children and babies are probably and elderly people. I think that’s the next segment of our population that’s extremely vulnerable during that time when they’re trying to give life and so I’m very grateful that there are therapists out there who do what you do. Thank you. So according to the Kaiser Family Foundation report from November 1, 2022, titled ‘Racial Disparities in Maternal and Infant Health,’ approximately 700 women die in the U.S. each year, as a result of pregnancy or its complications. Black women have pregnancy related mortality rates that are three times higher than white women. This terrifying statistic would make any potential mom to be worried. What successes have you seen using EMDR therapy with birth trauma and pregnancy loss?

Ava Hart 06:24
That’s a great question, Kim. So one thing that I didn’t mention in my, my introduction is that I’m also certified with Postpartum Support International. So I have a certification in perinatal mood and anxiety disorders. So that with my EMDR. And plus, I am a Black woman, it gives me…I have a specialty I have several specialties that that allow me to work with, with a very specific population. I won’t talk about the challenges just yet, because you didn’t ask about that you asked about what’s going well, and so remember that people, pregnant women like this is supposed to be the happiest time of their life, right? They see these shows, they see pictures of babies, they’re excited about setting up the nursery, you know, and then like, it’s just supposed to be the most wonderful time. However, it some people have feelings of sadness or depression, they have concerns about, about anxiety about what what’s going to happen during the delivery, some people have concerns about the past past trauma, and the impact on their parenting. And so for for women of color, particularly African American women. The biggest concern about these thoughts is that who do you share them with, which is why I mentioned trust before, because not only are these statistics true, but also women of color are more likely to be referred to Child Protective Services. And so that’s a big fear for a lot of women that are experiencing some sort of post, you know, we go away from using postpartum depression because it doesn’t, it doesn’t include everything. So we say perinatal mood and anxiety disorder. So a lot of women that are experiencing such a disorder are often fearful of being judged of possibly losing their children because of some of their, their thoughts, intrusive thoughts, the depression and fear that maybe they’re not connecting with their with their baby. And so there’s a lot of a lot of challenges during a time that’s supposed to be the happiest, happiest time of their lives. And so one thing that that I appreciate about, about doing this work is, like I said, being able to build the trust, but also being able to talk with my clients and their providers about the benefits of EMDR therapy, and that and that it does reduce isolation, it does reduce stress, it reduces post traumatic stress disorder symptoms and fears and and also less intrusive thoughts, because those are the scariest for, for women that that are pregnant or having a new baby.

Kim Howard 09:02
Yeah, there was the recent news story and I can’t remember the woman’s name. It just happened within the last week or so. She tried to take her own life after she murdered her three children, the youngest was still an infant, and she was a nurse. So this is someone in the medical profession, who is got access to what we think is all that she needs, right? And she she she helps people for a living and is in the medical profession. And here she is struggling with postpartum depression and and just didn’t know where to go and didn’t know how to solve the problem. And that poor woman and those poor children, you know, her husband so…. If somebody like that in the medical community has issues and is struggling, then the mere mortals who have regular jobs and aren’t in the medical community are struggling as well. And so it’s good that we are talking about this to let women out there who are either pregnant or thinking about being pregnant, know that there are resources available for them to help manage that.

Ava Hart 09:04
Kim, thank you for sharing that. And I hadn’t heard that particular story, but I gotta tell you, I’ve heard plenty of them. And unfortunately, the things that are the, excuse me, the stories that gain the most traction in the news are of these types of stories where, you know, babies don’t survive. And it sounds like maybe that nurse was experiencing psychosis. Right, some sort of person was part of psychosis. And so and there’s a difference between anxiety depression and psychosis. Right. But but but they’re nobody’s reporting on ‘Oh, this mother is extremely anxious about, you know, about delivering a baby are extremely anxious that something awful is gonna happen to her one month old.’ And that is actually the most common, right? We know, anxiety disorders are the most common. It’s no different for the perinatal period. And so my hope is that we in this community are able to educate people on on like I said, that umbrella that, you know, the mood and anxiety disorders, and it’s not just psychosis, and educate the community on use the use of EMDR to reduce anxiety and depression so that we don’t get to that point we don’t we never see psychosis, right, like, so intervention, intervening early is key. And that requires time access screening, and some of those can be challenges for, you know, for providers, particularly, you know, obstetricians OBGYN, like they often have a small window of opportunity to meet with their clients. And so I know they do their best in term in terms of screening. But then there’s afterward, right? There’s, there’s after the babies are born, those first appointments to the pediatricians office, are they screening for perinatal mood and anxiety disorder? Are they checking for depression? I think some are, but I can’t say with competence, that all are using that practice.

Kim Howard 11:57
That’s correct. They’re not all, all practicing that I can tell you. After the birth of our, our second child, my mother-in-law stayed with us for a couple of weeks. And we had moved when, right about three weeks before my daughter was born. And we had to we were in a new state with a new set of doctors, we did go back to – we live in an area where we could go back to the old state to have her delivered. But after that post pregnancy care, and we were in the doctor’s office, and she was checking out my daughter and asking how things were and looking at her and waiting to do all the things and we left the appointment and my mother-in-law looked at me and said, ‘You know, she never asked you once how you were doing!’ And I didn’t even pick up on that. I mean, you know, you’re here you are, you’re you’ve already been through this once you think you can handle it again, because you go I have one, this is the second one. I’ve already been through this. But you know, you’re frazzled, and you’re exhausted from sleep, and you’re the only one feeding the baby maybe if you’re nursing, and you’re trying to do all the things to keep up with your house, and you’ve got other children involved. And and I was like, ‘Oh, yeah, she never did ask me how I was doing.’ You know. And so there’s, there’s this awareness that needs to happen among the medical community. You know, nobody gives you a class on parenting, they give you a couple of books, it says, “What to Expect When You’re Expecting” and then and then “What to Expect the First Year,’ but there’s this whole gap between what happened after you leave the hospital. But this new baby that we’re not educated on, quite frankly, and so it’s I don’t know what the solution is, other than educating us more, but it’s hard. It’s a hard, tough time, and that a medical community should check on new moms a lot more than they I think they do. So

Ava Hart 13:31
I agree with you, Kim. And so the one thing that I didn’t mention was was loss, right. So when whenever I’m working with, with a person who’s experienced the loss of a baby, and anxiety tends to be the most present symptom and, and of course, cup, right, that starts with fear. And typically, it typically shows up with with folks that wish to become a mom again, or wish to become pregnant again, they’re often fearful of another loss, they still, you know, still have have vivid memories of the event that occurred, or the the, you know, the events or the specific situations or the specific images and memories surrounding the loss. And so, there’s a lot of work there because we’re dealing with the past, right? So we’re dealing with what’s happened, while also supporting that, that woman with her present and our future goals to become to become pregnant again, without without the fear because we know that you know, stress is it also well not also stress has a huge impact. It has a huge impact on on one’s health. And it is no different during pregnancy. And so the goal is to of course reduce that. And EMDR has definitely has a way of like I said using the resources or resources and opportunities and safe space and other tools. that we may have access to, such as books or resources on the internet to educate participants or clients before they actually receive services can be extremely helpful. So I like to educate clients by providing them with maybe some video on ‘What is EMDR?’ Well, how is it gonna affect you, of course, I have a consent form that says, hey, you may have some vivid dreams or memories afterwards. And so I’d like to to provide folks with as much information so that we can have success.

Kim Howard 15:29
Yes, absolutely. So are there any myths that you would like to bust about EMDR therapy and birth trauma and pregnancy loss?

Ava Hart 15:37
Sure. So I had actually, I was actually, I had read an article not that long ago, that was written by EMDRIA. Whereas Bethany Warren, she’s an LCSW. I’m not sure if you’re familiar with that, where she was interviewed and asked, she talked about the myths that EMDR must end if a client becomes pregnant, or during the treatment or, and the first trimester. And she talked about the fact that no, that is not true. Of course, we want to maintain that connection. And keep keep, keep it going for the reasons that I mentioned before reducing distress, PTSD symptoms, fear, to sit thoughts, but also the most important thing is the benefits are higher than the risk. And so what we’re learning with this population, and is that people have been fearful to treat pregnant women and women that have had recent losses, because quite frankly, there are a lot of myths, folks have been fearful of psychotropic medications, which I think has been changing over the years, especially in any event that a woman is experiencing psychosis, psychotropic medication is something that is often used. But EMDR EMDR is definitely beneficial. And even during first trimester or or any trimester for that matter. And when working with a client who becomes pregnant, as long as there’s a good connection, and they’re having progress there. But she’s been making progress. I certainly don’t see any need to end that treatment at all.

Kim Howard 17:05
That’s good to know. Thank you. So you touched on this a little bit, but I’ll ask the question, in case there’s anything else you want to add. Are there any specific complexities or difficulties with using EMDR for this population?

Ava Hart 17:15
Well, yeah, so in particular, with with African American population access, and, and so not just access to treatment, but access to treatment by a clinician who was of color. Right, people often look for clinicians that may have similar backgrounds. And, and so like I mentioned earlier, like my specialties are not eight not really common to have someone trained in perinatal mood and anxiety or disorders and EMDR. So that’s, that’s, you know, a niche. However, there are plenty of EMDR therapists. And so I’ve had women of color asked, you know, is it appropriate for me to meet with a with a non black clinician to do EMDR? And I always say, absolutely. The benefits outweigh the risks? Absolutely. Because some therapy is certainly better than none. And you are talking about trained or certified clinicians that know they know what they’re doing. And sure, that might be some, you know, some cultural pieces that may be missed at times. But something is certainly better than nothing. Time is really important. What I found with with this population, most of the women that I work with work, they have jobs, and they’re pregnant, right? So they’re having, or they had a recent loss. So they’re experiencing trauma, but still have to work. Right. And so a lot of them don’t have jobs like me where they could just take time off. Or, you know, I don’t have to call a boss to say I need I need to go see my therapist. And so there are there are issues with people having the time to actually attend therapy. One thing the pandemic did for us is it did open up some opportunities, so telehealth right was never a thing before it is now. So since then I’ve my client base of African American women has increased.

Kim Howard 19:09
That’s great.

Ava Hart 19:10
That’s amazing.

Kim Howard 19:11
Yeah, that’s wonderful news.

Ava Hart 19:12
It is amazing. And so I feel as though that’s been, you know, that’s been one thing that’s helped in in one area of progress by natural resources or another limitation. So what also what I’ve seen because I do my own billing, and so what I see is that a lot of times, these women in data from vulnerable population often have to select an insurance policy that has the it was at the higher higher deductible, right? And so what that what that does is that then forces them to pay more out of pocket. Right? And so we’re talking about a group of folks that not only have, you know, have experienced racism, racial trauma, poverty, community violence, and all a whole host of issues. But now we’re going to ask them to pay a whole lot of money to get this treatment that they’re not even fully confident will will be will benefit them. Right. You know. So those are some of the some of the difficulties or complexities that I’ve seen in my practice.

Kim Howard 20:17
That’s a great answer. Thank you. Thank you. Which leads us to the next question. How do you practice cultural humility as an EMDR? Therapist?

Ava Hart 20:25
Oh, that is a great question. So um, and you know, I don’t know if I’ve, I don’t know if you knew that I actually developed a clinical workshop called, Trauma Bonded Sisters for Black Women.

Kim Howard 20:34
No, I didn’t know that. Yeah, yep. Yep. It’s awesome.

Ava Hart 20:37
Yeah, it’s been awesome. But I’ve learned a lot from it. And I’ve learned a lot about myself. And so in terms of cultural humility, I would say, the most important thing is knowing one’s self one’s biases, like in recognizing that your background, the environment and the things that you’ve that you’ve learned from your environment, that they impact, not only you, but they impact the people that you are with on a daily basis. And so knowing yourself, recognizing that not only do you bring this to the table, right, and we always use the term like meet people where they’re at, right, so meeting meeting them with that, but that also requires their set of biases, maybe about the profession, maybe about this type of treatment, maybe about about me as a as a black woman clinician, right. And so, one of the issues, I think, is that people often think, just because we look like we are alike, and that is not the case. So you must know that you may have a set of experiences, but the person that sits in front of you who may be the same of the same race may have completely different experiences. They may be they may be from Jamaica, they may be from Ghana, like just because we are brown doesn’t necessarily mean that we’ve had similar experiences. And so knowing one’s biases, knowings ones, like I said, own background, and and just recognizing that everybody brings something different to the table, and it all impacts the work.

Kim Howard 22:06
That’s a fantastic answer. Thank you. And I think that’s the first time in the podcast, that someone’s answered it that way. I like that. I mean, I like how you talk about people, I’ve talked about knowing who you are before, but I like how you talk about don’t assume because someone is the same color as you that you’re having the same experience of them. I mean, that’s a really great perspective to remember for all of us to remember, you know, and so that’s a great point. Thank you.

Ava Hart 22:31
You’re welcome.

Kim Howard 22:31
So do you happen to have a favorite free EMDR related resource that you would suggest either for the public or other EMDR therapists?

Ava Hart 22:39
The one thing that I use often is just that little, that brief EMDR video that you can just type in EMDR video, I just type an EMDR Video for kids, and it’s just a animated video that can be really helpful. It’s short, it’s maybe a two, two minute long video if I wanted to explain what EMDR is to a child and family, but also RK EMDR Consulting is, is a firm, they offer free hand handouts, PDFs, on treatment on what to say on brochures, tip sheets, Safe Space PDFs. So RK EMDR Consulting, okay, I personally don’t have a free resource. But I’ve I’ve written a children’s book on using EMDR with children of color is called, ‘The Calm before the Storm: When Bad Things Happen.’

Kim Howard 23:30
Oh, that’s great.

Ava Hart 23:31
Yeah. And so the way I use that is I, well, I actually use it, I give it away, because I can do that as my practice, right? So I get to buy to potential clients who have children that need EMDR therapy. And, and that’s, that can be a resource, particularly if we’re working with children of color. Because we often see that we don’t see children of color in a lot of these resources.

Kim Howard 23:54
That’s great. What would you like people outside of the EMDR community to know about EMDR therapy and birth trauma and pregnancy loss?

Ava Hart 24:01
So you know what, I think I’m just going to be a broken record and say, treatment is extremely effective. And what I’d like for people to know is that we need early intervention we need we need screening, we need screening early on, and often assessment, we need to know what’s happening in the environment for these women and these vulnerable communities and populations, and intervening. So education in terms of intervention, we need to educate our providers around the treatment modality around EMDR so that they are able to make appropriate referrals, or just make referrals in general just make the Referrals Out decide whether they’re appropriate or not. So just getting them in the door is the most important thing as far as I’m concerned.

Kim Howard 24:51
Great reminder that we all need to work together as a community to make it happen, right? Yep. If you were not an EMDR therapist, what would you be?

Ava Hart 24:58
Okay, my my honest answer answers I would be feeling somewhat helpless, somewhat hopeless, as I was before, to be perfectly honest. I know, I know, if you want to we can we can we can redo that, but, but I’m being completely honest. Before EMDR I often felt as though I wasn’t giving people exactly what they needed. Right? So we can do, like I said before talk therapy is very effective. But people leave, and it doesn’t stick. Right. And so I often felt frustrated, frustrated that I am not able to actually give folks what they need. And in terms of like sustainability, right, like it, it works for a little bit, but it does, but it doesn’t. It doesn’t. It’s not sustainable. Right. And so, my true, my honest answer is I would continue to be frustrated and feeling just as hopeless as the people that I serve.

Kim Howard 25:50
Oh, no.

Ava Hart 25:51
I know. I know. I know. That’s, that’s a terrible answer.

Kim Howard 25:54
No, no, no, it’s a good answer. It’s an honest answer. I just thought it would, you would come up with something fun, like, ‘Oh, I’d be a backup singer.’ Or some people are like, ‘Oh, no, some people like if I couldn’t be a therapist, I would have been somebody said a cruise director one time.

Ava Hart 26:08
Ok.

Kim Howard 26:08
I mean, just kind of fun. Interesting. You can say whatever you want, but you were very serious about that. And I appreciate that.

Ava Hart 26:15
Kim, it if makes you feel better, I was a clown for kids birthday parties in my former life.

Kim Howard 26:19
Really? Did you like that work?

Ava Hart 26:22
Well, the magic tricks sometimes were a flop. Some kids are afraid of clowns.

Kim Howard 26:28
They are! I never knew that. My sister used to, well she still may collect them. But she collected clowns. I never thought anything about it until years later, when people like, ‘I think clowns are freaky.’ Why? Cause you can’t see their face. I’m like, ‘Ah, never thought about that.’ Like because they’re covered in paint or makeup and you can’t really see who they are. And I’m like, Oh, I can I guess they’re gonna understand people’s fear.

Ava Hart 26:51
I’m a much better EMDR therapist than I was a clown.

Kim Howard 26:53
That’s good. I’m glad.

Ava Hart 26:54
However, I have had had people say this EMDR is like magic.

Kim Howard 27:02
Oh, well there you go.

Ava Hart 27:03
Exactly.

Kim Howard 27:04
Now you’re the magic EMDR therapist,like the Magic School Bus like you could run a whole series of that. Is there anything else you’d like to add Ava?

Ava Hart 27:13
No, but just thank you. Thank you so much for giving me this opportunity to speak with you and with your listeners today. I’m extremely grateful for this time. And and I hope I’ve been able to provide some information or resources or guidance for any any folks out there doing the work.

Kim Howard 27:30
You provide us some great information and resources. So I think our listeners will be very happy. Thank you for thank you for your time today.

Ava Hart 27:37
Alrightly. It’s great to talk with you Kim.

Kim Howard 27:39
This has been the Let’s Talk EMDR Podcast with our guest Ava Hart. Visit www.emdria.org for more information about EMDR therapy, or to use our Find an EMDR Therapist Directory with more than 14,000 therapists available. Our award-winning blog, Focal Point offers information on EMDR and is an open resource. Thank you for listening.