Kim Howard 00:04
Welcome to the Let’s Talk EMDR podcast brought to you by the EMDR International Association or EMDRIA. I’m your host Kim Howard. In this episode we are talking with EMDR certified therapist, consultant and trainer, Michael Coy about EMDR, complex trauma, and dissociation. Michael is located in Bremerton, Washington. Let’s get started. Today we are speaking with EMDR certified therapist and consultant D. Michael Coy about EMDR therapy for complex trauma and dissociation. Thank you, Michael, for being here. today. We are so happy that you said yes.

Michael Coy 00:37
I’m so appreciative of the invitation. It’s a pleasure to be here.

Kim Howard 00:40
So Michael, tell us a little bit about your journey to becoming an EMDR therapist.

Michael Coy 00:45
So I was an EMDR recipient before I was an EMDR trained therapist. In 2007, I started my first official job as a social worker, my first professional gig in a residential treatment center. Working with severely abused and neglected adolescent wards of the state. It’s probably an understatement to say it was really activating for me, because my own teenage years were really rough. And within a handful of weeks of starting this job, I had a panic attack in my office. I wasn’t with a client, thankfully. But it was after having had a session with a client. And I immediately said, ‘This is not good. Right? This is my first job out of grad school, I need to figure this out.’ So I went and found a therapist. I’ve didn’t know anything about EMDR. I wasn’t even looking for that, because I didn’t know it existed. I found somebody that attended my alma mater, University of Chicago social work school, that was kind of because I figured at least I know where they came from. Right. And I got into to see this person. And in the first couple of sessions, after doing some initial history taking, or at least what I came to understand was history taking, she said, ‘I’m trained in this therapy called EMDR. And I think it could be helpful for you.’ And sent me, and mind you, this is 2007. So at this point, I didn’t know any of this history at the time. But at this point, even the way that EMDR was trained was in flux. So this was still I don’t want to call it the Wild West, but in a way it still kind of was. So there wasn’t a ton online. There wasn’t really read it in the way that it is there wasn’t anything. So I just looked at what I could find EMDRIA’s website existed at the time. So I said, ‘Yes, let’s do this.’ And it changed my life. Now, I learned an awful lot about myself as a result of doing trauma processing because prior to that I been in therapy before but it always been exclusively, either cognitive behavioral therapy, or more insight oriented therapy, like psychodynamic psychotherapy, which is how I was trained. But at some point, after a year or so I said I need to get trained in this. And it coincided with me beginning to dabble in private practice work a little bit. So I got trained in 2011. And then I guess I was off to the races. So I’ve never really I mean, I’ve looked back out of curiosity, but post training, I’ve just kind of continued to grow and learn over these years. And now I’m involved in training other people.

Kim Howard 03:57
That’s an excellent story. And I I’ve said this before on this podcast, and I’ve said it in conversations with other staff, people that I work with and other members, what you guys do for a living, taking on other people’s, mostly a horrific life events, taking them into your brain and into your psyche. I would presume even if you had quote unquote, a regular upbringing or non-traumatic upbringing, would be traumatic enough. And so if you’ve had something in your history, on top of all that, oh, my goodness, you all have to have some kind of outlet for your stress and to be able to continue to do your work because you want to help people heal. And so you have to have whatever however you define self care and if that includes therapy, that if you put that under that umbrella, you have to do those things because I can’t imagine doing this work five days a week or six days a week or however much you work and then not doing anything about what you’re learning in session to infer that you can you can maintain your, your sanity, for lack of a better term, you know, I would presume that it’s crucial to get that kind of work done.

Michael Coy 05:10
I would say, undoubtedly, yes. And the last number of years, in particular have been quite fraught. I’ve seen with everything going on, clients have been activated and say clients, because we are our clients, we’re just sitting in a different chair. Alright, I am not better or different than any of my clients. Because, again, I have been a client too, I’ve continued to do my own work, because if I don’t actually run the risk of doing harm, you know, blind spots, take all kinds of forms.

Kim Howard 05:50
What is your favorite part of working with EMDR?

Michael Coy 05:53
Hmm, I don’t know that I have one favorite. And there are different dimensions, there are the right bank brain reasons. And then there are the left brain reasons. The left brain reasons are I really enjoy the conceptualization, like trying to understand how a and b and c might fit together. And then dealing with the problem solving of how do I use EMDR with this person, in this situation, in this particular context, you know, the bigger context maybe of where they are in their life, and so on, working around challenges, and barriers, potentially to using EMDR. In some situations, in my case, because of my specialty, a lot of situations. The more right brained is the journey along the way, you know, the train metaphor of, you know, the train moving down the track to its destination that we use in EMDR therapy, there’s this process of kind of being a passenger along I mean, the I’m the navigator, so to speak. I’m also kind of a passenger sitting next to my client, as we’re going down the track. And there’s a lot of right brained or right brain, sort of the emotional communication that occurs in the process. And a lot of that has nothing to do with EMDR. It’s about mirror neurons firing just between two people, it’s attunement. And that’s maybe the most enriching aspect is developing the attunement with a client and sometimes feeling what they feel or in some way experiencing what they’re experiencing, and even things like along the way in processing, no matter how complex the issue is, there’s this point at which I frequently see like the train turns the corner, and you know that you’re closer to the destination than the start of your trip. And it just has a feeling to it for me. So there’s it doesn’t mean it’s always going to be a direct route to the destination after that, but I really liked that. Additionally, because of my specialty, I specialize in working with complex people with complex trauma, dissociation, dissociation/dissociative disorders. And there are distinctions, I often can’t use standard protocol, with at least some modification. So working to understand how most effectively to employ EMDR therapy methods with my clients is an ongoing and always interesting process. It’s pretty gratifying process.

Kim Howard 08:40
That’s good to know, I have said this before. But I believe that being a mental health professional is really, it’s it’s all based in science, what mental health professionals do, right, there’s data to back it up. There’s research, there’s theories that have been implemented and watched over the decades. But it really is sort of an art form, right? You as the as the practitioner have to figure out what’s going to work best for this client and every client is different, may have all bring in some similar issues that they’re having. But they all come from a different perspective on that. And then you have to figure out, Okay, what’s going to work with this person? And is this the right path. And so it’s this balance between? These are the things I know that work scientifically, and these are the books of Hamlet, I’m going to implement it in an art form way. And so there’s a lot happening in your chair, so to speak.

Michael Coy 09:31
And, yeah, there is something that I found. I learned this in grad school. This far is the art versus the science. It’s not art versus science. It’s art and science. They can be merged, they are merged. Yeah. Music is all science. It’s all mathematics. So I studied as a I studied voice and music composition in undergrad. So I tend to think of my work very creatively, but also technique clay. So, there’s a lot of not knowing this in this work, which is challenging. Especially I think, sometimes for some people who use EMDR therapy, because there’s a lot we need to know, developing a targeting sequence, et cetera, et cetera, et cetera. And knowing a protocol to use or a technique. And it’s not always like that. I mentioned a moment ago that I learned in grad school, I distinctly remember in grad school with one of my psychodynamic psychotherapy professors, saying, I just want tools. Why do all of these authors not talk about interventions, they talk about frame of mind and conceptualization and understanding, my professor who was a psychoanalyst just shook his head. And he had a slight smile on his face, I was very frustrated. I so appreciate that now, in a way that I couldn’t possibly have back then, I need to not know and we’re all like black boxes, you cannot know another person’s mind. You can’t know that everything that’s there, I don’t even know all have what’s in my own mind. And so learning to tolerate the not knowing this, I think makes us better clinicians. It also helps us I think, if we can tolerate doing it, it helps us be more pragmatic, and more strategic in how we do what we do.

Kim Howard 11:30
That’s a great point. It’s a good segue to my next question, which is what successes have you seen using EMDR therapy for complex trauma and dissociation or dissociative disorders?

coy 11:41
So I do want to highlight so in a previous Let’s Talk EMDR podcast, I think it was episode 11. Jamie Marich makes the important distinction between dissociation and dissociative disorders. I won’t go back through the distinction. But I think the distinction that she draws is important. So dissociative disorders sit in their own realm in a way. However, if we’re talking about complex trauma, we are talking about dissociation. This has been found in the research, I would say there are political debates about the extent of dissociation that exists within the realm of, quote, complex trauma or complex PTSD. Nevertheless, you still have to be careful and thoughtful. I will maybe say more about this as this discussion unfolds. But with all that said, I feel really fortunate to have seen a number of positive outcomes during the course of treatment. In employing EMDR therapy with clients. There’s one client in particular, who is someone with what’s called polyfragmented DID. Polyfragmented DID is a concept that was posited in the 1980s, by someone in the dissociative disorders field named Bennett Braun. And it’s a self a person with more than 100 self states. We’re talking about a lot of internal complexity, born out of a lot of prolonged suffering. So this person brings to mind in this moment, I have been given permission to talk about teach about this person by them. So I feel comfortable, I’m not going to go into any gory detail or reveal any personal information, but what would identify them, but what I would say is, it’s been a very involved treatment with a lot of different layers a number of years ago, and working with this person for about six or seven years, it came to light that this person had a profound phobia of both medical and dental care decades long. And the medical and dental issues were unrelated to one another. Well, ostensibly, except they both manifested the same way. Stay away from providers, right. And as life brings you things, this person was imminently faced with necessary medical and dental care. So I collaborated with the different self states that held the trauma material associated with each of these issues. I would highlight that the, the self state that fronted in sessions, they didn’t know a lot of their own history. It was held by other self states. So different aspects of the story, not just the facts, but the emotions, the sensations, etc. We’re fragmented. That’s what makes EMDR so complicated. It doesn’t work the same way when there’s this level of or doesn’t I should say it doesn’t necessarily work. The way the label says it should, the way we would expect with AIP Exactly. AIP being adaptive information processing the theory that underlies EMDR. But I had to do a lot of collaborating and trying to figure out who held this material. So that as much as it was possible to avoid surprises during processing, to yield a positive outcome, we can achieve that. So, ultimately, we were able to use EMDR to address the root causes. And it was a number of sessions. Though not nearly as many as I would have expected, probably three sessions for each of the the medical and the dental issues. It didn’t look like standard protocol. But it looked close enough that it was recognizable as EMDR. And what happened was, this person was freed from the bonds of these traumas. Subsequently, as we were reflecting upon their experience. They observed that this processing changed their life, after decades of avoiding medical and dental care. And they have been, they’ve subsequently had other rather complex dental stuff that they needed to do because of neglecting dental care for so many years. They went through it like a pro.

Kim Howard 16:11
That’s fantastic.

Michael Coy 16:12
It was totally amazing. And I feel so gratified that I got to participate in this person helping clear those blockages. So this person could actually learn to take care of themselves in a way that nobody else ever did.

Kim Howard 16:28
Yeah, for them. Yeah. And that’s always a shame when anyone has to go through something so horrific that it impacts their life in a negative way. But thank goodness, this person found you and was able to process some of that so that they could go and get the medical and dental help that they needed. So they can be physically healthier in their life and not in pain, hopefully, and that’s wonderful as well.

Michael Coy 16:58
And, you know, I’ve had really good teachers, I have likened using EMDR, therapy methods, etc. With someone with complex forms of dissociation. I’ve likened it to riding a unicycle, blindfolded uphill while juggling.

Kim Howard 17:18
Oh, it’s a great image. But yeah, it sounds, it sounds complicated.

Michael Coy 17:25
It can be challenging, which is why knowing the terrain, before you start off, as much as it’s possible to is helpful. There’s something else that pops to mind. That’s not specifically about the processing piece that I kind of want to mention, because I don’t know if it gets a lot of airtime. I mentioned earlier kind of the process of discovering is gratifying like that. There’s this learning how I can use EMDR with people. I will own upfront here, I’m not a fan of umpteen protocols. I think if you understand how EMDR tends to work, and you understand the phenomena that you’re working with, you can be a really good cook. And mix together your ingredients without necessarily always having to rely on established modifications. They’re good to know they’re important to know. And ultimately, you may not go by the book, because every client is different. So with this said, and not being a fan of umpteen protocols, I ironically found myself developing an integrative protocol to address a very specific problem with people with complex trauma and dissociative self states, in particular that are imbued with perpetrator energy like someone that harmed them in the past. I won’t go into any the details here because I don’t think it’s the place where but what I would say is, I had to come up with something when established approaches were not satisfactorily getting the results that I needed with this client. So I ended up initially on the fly, combining elements that I knew it’s like being in the kitchen and combining ingredients. I’ve got these leftovers, what can I do with them, right? And you’ve got to know your ingredients. So I ended up combining elements of Jack and Helen Watkins is ego state therapy with a capital E S T, clinical hypnosis and EMDR therapy, which ended up yielding a really positive impact. Since then, I’ve further developed it, I’ve taught others about it in webinars that I’ve done. And I’ve promised myself that I will actually write this down in an article and submitted for publication, fingers crossed if I can get myself to just sit down and finish it. This is sometimes you actually come up with something that’s unique enough and there are plenty of examples of this in the EMDR literature. There’s Jim Knipe there. I mean, we could spend hours just talking about all the different modifications, right to accommodate complex trauma, dissociation. But sometimes, it’s kind of amazing what happens when you just start when you know enough that you can improvise and riff. Yes, you know,

Kim Howard 20:22
That’s where the art form comes into…

Michael Coy 20:24
Yeah.

Kim Howard 20:25
…your therapy practice where you have to kind of know what’s working and what’s not. And where you can, those tools where you can pull from to integrate something, that’s the best result for your client.

Michael Coy 20:35
Yeah, and it’s sometimes it’s not, the evidence is n is a sample of one. Right? And that’s the reality of things. Sometimes it’s it’s just enough evidence, the research world doesn’t tend to pay much attention to N of one these days. But I think it’s overlooked. And it’s still important, because a sample of one can turn into a sample of five can turn into a sample of 50. Yes, over time, assuming that people actually document their work.

Kim Howard 21:03
Well, I’m sure that that sample of N1 was extremely grateful to you for you being able to sous chef, all of that together in the kitchen, it wouldn’t make a new dish.

Michael Coy 21:14
You know, and I’ve repeated it since then. And so other clinicians, and the results are pretty consistent, which should tell us something. So what you end up almost sometimes becoming a clinician researcher without really intending to be, I’m allergic to statistics. But the process is still engaging and invites curiosity. And wow, it’s amazing what you can do, if you know what you’re working with and whom you’re working with.

Kim Howard 21:43
It’s an excellent point. Michael, are there any myths that you would like to bust about EMDR therapy and complex trauma and dissociation?

Michael Coy 21:51
How much time do you have?

Kim Howard 21:54
Well, you’re not the first person to ask that. So if you can’t come up with a good number just give us like your top two or three myths.

Michael Coy 22:01
Well, so the history of EMDR therapy to treat complex trauma isn’t necessarily very pretty. EMDR continues to have a negative reputation among a select number of people in the dissociative disorders field, which is the waters I swim in the EMDR pool, and I swim in the dissociative disorders field pull, probably equal time. It’s not the EMDR in my opinion, that’s the problem. It’s the lack of education about dissociation and the dissociative disorders. That’s the problem. There is a thinker in the dissociative disorders field named Phil Kinzler, who in a webinar back in 2018, said, any intervention is risky if you don’t know your client. And in the same way that we talk about not understanding someone’s culture of origin, or what they’ve been through, etc. Well, learning about the dissociation that comes the complexity of their trauma also leaves you ignorant, unaware and potentially going to you’re going to step in mud puddles, more often than not, right. Now, with that, you know, people will say you should never use EMDR. And I think Jamie [Marich] actually talks about this in her interview, podcast [episode] number 11. Now, the opposing myth, which I would better characterize as a political belief at this point, and I may be treading on thin ice talking about this is that treating complex trauma dissociation is simply a matter of using either faster or overlapping forms of dual attention stimulus, or doubling down on reprocessing to break through the dissociation so that it’s just no longer there. I disagree. And the research is limited. And I guess what I would say is, I’m much more apt to listen to 140 plus years of evidence in the dissociative disorders field, than I am to listen to a couple of papers, or even a meta study that didn’t take actual dissociative disorders into account. And that’s just the science. So with that said, most of us didn’t get much training and trauma. In grad school, I didn’t get any. And I had to learn the hard way. And I could easily based on my early experience with EMDR have gone in the direction of never use EMDR I became scared because I did harm to someone and the route that I ended up taking was going to go get consultation from somebody who was a is was an is a big name in the field. And I am eternally grateful that this person was really patient with me as I was trying to figure things out. What I learned was the depersonalization/derealization or the beginning of disassociation, not the end. They’re the most obvious manifestations. There’s an idea that if if it’s visible, I don’t know that it’s been said. But if it’s visible, you can treat it. The problem is that most association is invisible to the naked eye. And that’s where people tend to get into into trouble using EMDR is the stuff you don’t know. So there’s that. So I always encourage people to get more training. And there are ways to get trained to understand dissociation consultations helpful too. I’d also like to highlight I know that there is a discussion about what is EMDR there was even a paper it was [Deany] Laliotis, and others in 2020, or 2021. And EMDR is a psychotherapy, etc, etc. And EMDR alone is probably not going to be enough to resolve the issues. That surface when someone has complex trauma, or dissociation in dissociative disorders, both because of the deep relational harm. And how it manifests as what in psychodynamic psychotherapy is described as transference and countertransference dynamics in the therapy relationship. And EMDR doesn’t necessarily speak to that. There’s only like one paper that’s more recent that talks about transference and countertransference dynamics in EMDR. And, you know, there’s like the relational imperative and EMDR. It’s Mark Dworkin from 2013 that talks about the relationship. At the time, nobody was talking about the relationship, and now everybody is in the EMDR world. But the reality that I have found is that sometimes for some clients, and a lot of my clients, the issues that they experience are too deeply set within the psyche, to just start poking around with a scalpel, such as EMDR, metaphorically speaking. So I don’t know that that necessarily speaks to myths so much as ingrained beliefs. But sometimes they overlap, because what starts out as an ingrained belief actually becomes widespread fact.

Kim Howard 27:09
Right.

Michael Coy 27:10
Without scrutiny.

Kim Howard 27:11
Correct. It does happen. So you may have already answered this question. But if you need to elaborate or want to add more points, you’re welcome to. Are there any specific complexities or difficulties with using EMDR therapy for this population?

Michael Coy 27:24
I would say that the level of fragmentation that someone experiences internally is usually the biggest challenge. And that possibility, demands a more advanced capacity for the clinician, to know how to screen diagnose symptoms, we’re not talking necessarily diagnosing disorders, I don’t necessarily love the DSM. But you do need to know how to diagnose symptoms, because certain symptoms are going to make things more challenging. And Francine Shapiro was very clear that you need to make sure that you’ve accounted for anything that can inhibit processing, and address it as best you can. You need to understand how to conceptualize a more complex treatment, you know, that metaphor of the hand, as the node and the fingers as channels? Well, when you’re talking about complex trauma, you’re generally an even more, you know, some fragmented PTSD, you’re talking about multiple hands interlinked. You know, it’s like different fingers from different hands or touching. You don’t always know, by eyeballing what’s going on for someone or even eyeballing the dissociative experiences scale screening, whether that’s the case, because sometimes people don’t know what’s going on for themselves, and how are they going to report it on a screener? If they don’t know it? That’s true. Sometimes people explicitly deny what’s going on for them because they feel ashamed, or they don’t want to be labeled as crazy, or weak. You know, if they learned that you gotta be perfect in order to get by in this family. And perfect means you don’t have anything happening for you. So there are a lot of different reasons that it might not be obvious at the surface, which means the therapist kind of has to become a detective in a way. It’s not saying it’s not a us versus them. It’s a we’re walking alongside one another or we’re passengers on that train together, reading from the same book in a way. I would also say, and I touched on this earlier, training only in EMDR informed approaches to treat complex trauma and dissociation in the dissociative disorders is not adequate. You can learn all kinds of approaches and protocols. But that is not a replacement for knowing how to be a therapist. There are different I realized that some people may disagree with this and that you can do a lot or most within the realm of EMDR But it’s not all about protocols and target sequencing. In my estimation, there have been studies done, where you’ll see therapists from different traditions put alongside one another, so to speak. And evaluators, experts in those different approaches, trying to figure out well, is this person actually practicing fidelity to that model? And what has been found is that there’s a lot of overlap, because there’s not a lot that’s new under the sun. And so even if you think you’re doing pure EMDR, you’re probably not because you as a clinician are an amalgam of everything you’ve learned. EMDR is considered an integrative therapy, it is very amenable to integration. But they say we’re ignorance is bliss is folly to be wise, I’m inclined to think that the more you realize intentionally what you’re doing, the better the outcome is.

Kim Howard 31:00
No, I think you’re right, I think, and again, I’m not a professional therapist, so but we talked about this earlier, we’ve talked about this before, and I, I see it in the magazine articles, and that kind of thing. I mean, it, you guys have to decide what works for your client. And sometimes it’s a blend of what you know, to get the job done, right. And that’s where that whole art and science thing blending happens in your chair. You know, you take all of those pieces that you have in your kitchen, you know, you said analogy earlier, and you’re blending up something new. And you’re serving this dish to your client, and you’re serving it customized based on what their needs are at the time. I don’t see anything wrong with that. I think that’s how it’s supposed to be. Same thing when you go to a medical doctor and you have a physical issue. You know, they have to figure out what’s going to work for you. And they have to bring in all that knowledge that they have, and they have to find the solution that’s good for you.

Michael Coy 31:56
It’s funny that you mentioned so the way that you framed that. So I in the fall 2021 issue of EMDRIA is Go With That magazine, it was a it was an issue on dissociative disorders. And I was invited to do sort of top 10 things that you should know about dissociation. I quoted Catherine Fine [Ph.D.]. And for anyone who doesn’t happen to know who Catherine Fine is, she’s a thinker in the dissociative disorders field. She was a student of Richard Kluft was one of the considered one of the pillars in the modern dissociative disorders field or one of the members of the dissociative disorders task rorce. And you can find that task force’s report in was it Appendix E client safety in the 2018 edition of Shapiro’s EMDR text. But in 1999, in an article Catherine Fine stated, and I’ll quote here, “It is important to recognize that when working with DID, and she’s talking about DID specifically, but I would broaden this even to talking about complex trauma and more generally, two things stand out with respect to the organizing treatment models. One, even though the therapists preferred model of treatment is relevant, particularly to the therapist. The disorder itself will impose the therapeutic interventions you must adjust to what you’re working with. Essentially, that’s my parenthetical. Yeah. And to the therapists need to be fluent in the traditional psychodynamic and cognitive perspectives, aided by a clear understanding of hypnosis, because where there’s where there’s trauma, there’s trance, somebody who’s having a flashback is in a trance. That’s my parenthetical there. And the rules governing trance states to best help this patient population negotiate their own stability. So again, some people might argue with that, based on my experience, I’m very inclined to agree with Katherine Fine.

Kim Howard 33:52
Got it. Michael, how do you practice cultural humility as an EMDR therapist?

Michael Coy 33:57
Funfact: the term humility comes from the Latin word humilis. It’s related to the adjective humulus, which has been translated as humble, but also as grounded, or from the earth. With that in mind, I try to remain grounded and lead with curiosity. I try to avoid assuming anything, which is not easy. Because we’re loaded with assumptions. Yes, we are also to continue to cultivate both an understanding of where my clients are coming from. And they’re evolving understanding of where they came from, and also where I came from. So different aspects of our respective identities and how they influence the frame and create blind spots. Mine and theirs. I mean, you know, it’s not so simple to say, we all walk in with, you know, what they call our assumptive world. It’s based on what we’ve learned. You know, it’s based on our insecurities. I certainly have plenty of mines My own insecurities and so on. And it’s not just the culture at large or specific subcultures, by my, by my estimation that I want to attend to family culture plays a really significant role in how we’re shaped on a really primal level, even when we’re not explicitly aware of it. And I speak of myself in that way, I feel fortunate to have trained as a social worker, and find myself drawn to thinking in terms of how different systems and layers within those systems interact with one another. I am by no stretch of the imagination, always very successful in this. And hopefully, for me, and all of us as clinicians, that’s where curiosity and self reflection comes in, you know that we don’t get mired in shame or double down because of shame that we don’t even know we’re holding on to. Because that might prevent us from openly and open heartedly owning our mistakes. It certainly, I have found that in myself, it makes me feel embarrassed at times to discover that, but I’m also like, well, this is just what being a human is. So the older I get, and the more healing work of my own that I’ve done. It’s gotten a bit easier. But sometimes I’m still like that 13-year-old kid who doesn’t know that he’s queer yet, and kind of knows, but knows that it’s not okay to be a certain way, and grew up in a kind of rough family. And in a place that was really white, and racist. And there are all these embedded assumptions about what gender means, and that gender is binary, and all this other stuff, and it comes back and bites me sometimes. So I just have to keep growing and learning.

Kim Howard 36:57
We’ve talked about this on this podcast before. And I’ve said it now I’ll say it again, that we have, as a society tend to put people who are in leadership roles, solution oriented roles, doctors, lawyers, dentists, therapists, medical community, people, we tend to put them on a pedestal right? You know, they’re, they’re an