Kim Howard  00:05

Welcome to the let’s talk EMDR podcast by the EMDR International Association, or EMDR, I’m your host. Kim Howard, in this episode, we are talking with EMDR, certified therapist, consultant and trainer, Mark Nickerson, about EMDR therapy for culturally based trauma and adversity. Let’s get started. Today, we are speaking with EMDR certified therapist, consultant and trainer, Mark Nickerson, to discuss EMDR therapy and culturally based trauma and adversity. Thank you, Mark, for being here today. We are so happy that you said yes,

 

Mark Nickerson  00:35

thank you for having me. Kim.

 

Kim Howard  00:37

Mark, can you tell us about your path to becoming an EMDR therapist?

 

Mark Nickerson  00:43

I think, to be fair, let me go back to the beginning, and I’m if you don’t mind, I’ll say not only my path to being an EMDR therapist, but a little bit to this topic as well. My father was a Methodist minister, and I was influenced by a sense of morality, a sense of thinking about the higher minded principles that can link humanity and a sense of fairness. So I was influenced by that. My mother was a sports coach, women’s sports coach, team sports. And apart from loving athletics, I also learned about the importance of everybody for a team to work well, so people doing their own part, but also having to work together as a team. So those things influenced me. I went on to choose social work as the particular discipline for mental health that I was interested in, and that was because I, at that time, long time ago, was really thinking about the social context as it affects people. Having undergraduate degree in psychology, I felt like it focused too much on individual things and not really broader societal forces. So I chose social work, and was glad I did that influenced me. And then, after completing that, I was part of a group of men in the 70s who formed a men’s center and very intentionally went about thinking about issues of sexism, homophobia, racism, and designed a place where people could come and talk about it, where we provided domestic violence services and basically men’s consciousness raising groups. So with the idea that men could look at our totality as human beings and get out of the box of the socialization that many experience. So so that really opened me up to the topic. Then when I found EMDR therapy. It was a perfect fit for a variety of reasons.

 

Kim Howard  02:45

That’s a great story, Mark. Thank you for sharing that. What kind of sports did your mother coach?

 

Mark Nickerson  02:50

She coached field hockey, basketball and softball.

 

Kim Howard  02:55

All right.

 

Mark Nickerson  02:56

I remember her coming home, coming to dinner, talking about plays and new players she had on her team and everything else.

 

Kim Howard  03:03

That’s that’s pretty neat. Mark, what’s your favorite part of working with EMDR therapy?

 

Mark Nickerson  03:08

I think where I feel privileged, really, is to have a way to get to the heart of matters that affect clients in a way that allows them to do the work they need to do, and so as a therapist now, knowing the method that we can help clients face their experiences and unpack their disturbing memories, we’ve got a method that can allow them to find their own way through it, so it allows me to feel like an important influence, without being the one that directs where a client might go for healing. I think that and the ability to stay mindful and in the moment with clients, just in general, frees me up to see people discovering things about themselves that that suddenly go against some of the things they’ve been told by others for so long.

 

Kim Howard  04:05

So let’s talk about why you’re here. Today, we’re going to talk about culturally-based trauma and adversity. So can you please explain to us what you mean by culturally based trauma and adversity?

 

Mark Nickerson  04:17

Okay, so I know that can be a mouthful, and that, but is that is the term that I used in putting together the first and second edition of “Cultural Competence and Healing Culturally-based Trauma.” And just to put it in the right context, human beings are social animals. We thrive on connection to others, we do better in connection with others, as I learned in sports, it isn’t just the sum of the parts, it’s the synergy of people. And so we all naturally gravitate toward that kind of connection, and many of us are rewarded for that. But almost everybody runs into social adversity on different levels. When I was in grad school, I also was a Family Systems major, which meant that I was interested not just in individuals, but how they fit into family culture and then the larger family into the bigger world. So when I think about culture, I’m thinking about various formations of people, not just race and ethnicity, which is or nationality, which is often what we think of when we think of culture, but family culture, and also groupings of people along different identities, older people culture, younger people culture. So really the ways in which people are bound together, which can include shared values, shared experiences, but not always, we have to be really careful not to predict who one person might be or what their experience is, just upon based upon their cultural identity.

 

Kim Howard  06:06

Mark, are there any specific complexities or challenges with treatment for people with culturally based trauma?

 

Mark Nickerson  06:13

Certainly Yes. As EMDR therapists, we’re prepared to look into the darker areas where people have had adversity, had traumatic experiences. And so this is something that we can bring to looking at people’s experiences in a broader societal context, as we know society isn’t equitable, and people have individual experiences in which they feel mistreated by individuals based upon societal inequities, or other types of social experiences like bullying, being excluded and so forth. So we in thinking about the larger societal lens, it’s important that we ask our clients about their experiences socially. And I think as a profession, psychotherapists have been criticized for being focused on sort of a narrow type of inquiry around for instance, the ACES evaluation tool is a wonderful tool. It’s been very effective in helping us assess early trauma, in setting priorities for policy and therapy, around addressing those 10 different categories. But the ACES focuses on in within the family trauma, and just in recent years, people have been adding to the ACE evaluation with extra questions related to culturally based circumstances. So someone may have had a wonderful family that did not have to face adversity in the aces, but through their location and a broader society, may have experienced many difficulties, including poverty or exclusion or having to fit into a new community, having a different language. So there’s lots of adversity that might exist that aren’t those classic within the family type of things. So I think to be sensitive and mindful of the larger context, we need to ask about that in our assessments and and listen when our clients give us hints of some of the social adversity that they may have experienced. Additionally, I think, because perhaps of not only the history of psychotherapy, but also just the patterns and habits. Sometimes people have had this idea that we shouldn’t be broaching the subject of culture or the many different types of social identities that people might have, because somehow we should wait for the client to be able to bring that subject up. But that isn’t easy when you’ve had an experience or a history of no one listening to it, being tiptoed around. So I think one of the challenges for therapists is to bring the topic up at the same time. Doing that is not that hard. I think if people make a commitment to being curious about the full range of experiences our clients might have had, being prepared to ask questions in tricky areas where generally therapists, EMDR, therapists, are really good at asking about different types of adversity related to addictions, let’s say, or self harm. So we should be comfortable asking about adversity that people may have experienced in other realms of their life due to the circumstances of their neighborhood or their family, and then that’s with a sort of a tilt. Toward the family’s place within a larger culture. But many people have identities that clash with their families values. So in the case of LGBTQ T related issues, or gender non conformity, oftentimes is tension within a family within some immigrant families, there’s tension between generations where the older generation wants to hold to traditional values, the younger wants to fit in to the world around them. So there’s so many different ways in which we can help our clients see themselves in that context, just by asking. And we don’t have to be experts in other cultures. We have to know that we’re not experts. We have to have that humility to be able to talk with our clients with a real, visible way in which we show that we’re learning from them as we go. On the other hand, we don’t have to apologize per se for the limits of our understanding. We have expertise as EMDR therapists, and we work. We all EMDR therapists work with trauma that we never experienced, and we don’t have to have lived that in order to help our clients heal from it. So in that way, an approach to include inclusively welcoming in cultural identity and is simple if we just lean into it. So it’s that blend of of multi faceted, but also pretty straightforward in terms of how we can approach it by leaning into it.

 

Kim Howard  11:52

Great points Mark, thank you real quick. Can you please tell the listeners what ACES stands for?

 

Mark Nickerson  11:59

Oh, so ACES would be the Adverse Childhood Experience Scale. The study of done in California, I think, of 17,000 plus individuals filled out a survey for Kaiser Permanente, and there was correlate that they were 10 questions, like, was there violence in the family? Was there a death in the family? Divorce? So the kind of things that are typically traumatic or adverse, and the more of those 10 boxes the participants checked, the higher the correlation between mental health and physical health difficulties leading right up to premature death. So that study let us know that if we that trauma affects people, and if we have a treatment for trauma, then we’re doing service that will likely lead to better outcomes in health.

 

Kim Howard  12:54

Yes, thank you, Mark. I will put, oh, sorry, go ahead.

 

Mark Nickerson  12:57

Well, no, I’ll just add that there, even before or alongside of the research done with the aces, there have been many, many studies that looked at socially based trauma, especially associated with discrimination, exclusion and poor mental health and physical health outcomes and premature death. So it wasn’t that this hasn’t been correlated, but they were much smaller studies. So meshing together the in the family and then the larger context really gives us a better way to look at what contributes to problems.

 

Kim Howard  13:34

Yes, and I will put a link in the podcast description to the ACEs study so people can go investigate on their own.

 

Mark Nickerson  13:41

Yes, and also to Google for a community based aces. So there are different tools that people have identified that ask about community based experiences that can supplement the aces. Eval,

 

Kim Howard  13:56

Thank you, Mark. What successes have you seen using EMDR therapy for culturally-based trauma and adversity?

 

Mark Nickerson  14:04

Well, I’ve been fortunate because I’ve had this interest for a while, and I remember, as most people do, in meaningful encounters with Francine Shapiro, I remember approaching her in the mid 2000s and asking, what was being done in the realm of cultural awareness within EMDR. And she shared some things, but mostly she said not as much as there should or could be. And so that was an added incentive. And so I formed some local study groups, initially, where a bunch of us got together and looked in particular, at cases where social forces seem to be at play. We did our own work using EMDR methods, and since then, I’ve had a chance to do trainings of different sorts, and so I’ve been able to learn not just from my own cases, but from the work I’ve. Seen people do, and also as a consultant, what I see my consultees talk about so and it is very hard to come up with one or two examples. There are many that I mentioned in my writings, but I think the pattern is that suddenly a sector of one’s life has a safe place in order to unpack it and and look at it. And so by having validation for some of the trauma associated with social or cultural context, first of all, lays the groundwork and then being able to see how the personal struggles one has maybe internalized by the way they were treated. And of course, we know this in EMDR, but we don’t necessarily apply that as as we should. We really don’t consistently apply it in general to the broader social forces so on, when a person says, Well, I’ve never been able to accomplish as much as my neighbor, and it’s because they did not have the money to get education or training, to be able to have a career that might pay more then suddenly, If they can see that in a social context, they don’t take it as personally. They don’t look at as a personal flaw. They can see that I’m the product of the opportunities I had, as well as as the direction that I went in terms of the things that were possible performing. So in many ways, the work is standard EMDR, but it just has that flavor of identity. And I think with regard to various components within EMDR, we we work right from the beginning of the first training with the idea of blocking beliefs, the limiting thoughts we have about what’s possible for us, and there are often these messages, not only come by family messages, but by cultural messages as well. So people who feel they can’t show their feelings because they’ll be preyed upon or they can’t show weakness, that can be a barrier in therapy, because a person’s just toughen themselves up to be able to handle their circumstances. So if we can identify where that came from in their lived experience and target it, then that can begin to soften that stance that they’ve learned. Yes, thank you, Mark.

 

Kim Howard  17:44

Are there any myths that you would like to bust about working with EMDR therapy in culturally based trauma and adversity?

 

Mark Nickerson  17:52

Yeah, I would say there are a few. One is that we have to have had the same lived experience to be able to help somebody. Now, of course, any one client should select the best therapist for them, but adding to what I said, before, we want to focus ourselves as EMDR therapists on what we can bring and what we can add to our typical approach in order to embrace or include people’s ability to talk openly about cultural experiences. So the idea that we have to be an expert, I think, can be supplanted with the idea that we just have to apply certain principles of cultural humility. One is to know the limits of what we know, to not view people through our lived experience, but to be curious about theirs. So curiosity is important. So I think that’s one another myth. This is kind of tricky to talk about, I think, but the politics of identity and the divisive forces that exist out there in our world pit people against each other, and this can play out in a therapeutic environment, where people somehow have the idea that You should leave certain topics alone. You shouldn’t ask people about these sensitive issues. And so we might tiptoe around those. Also the idea that if you are somehow bringing up the topic of culture, we are inherently somehow politicizing the therapeutic environment, and so certainly not in all or in most cases, but in some areas, these topics have these overtones. So it’s really important for us to hold our ground as trauma therapists who look at the strengths our clients have the adverse. They’ve been through, and just talk about that and to give them room to unpack and as I say, and sort through those things. And maybe that’s the third. I don’t know if it’s a myth, but I think sometimes when we see our clients struggling with adversity, we feel like we have to have answers that we can offer, and that isn’t our job as an EMDR therapist, being aware of possibilities that we can offer, certainly, but what we see as EMDR therapist is clients find their own way through their material. So I think the idea that we have to know how a client will learn to cope with adverse circumstances is we don’t have to know more than we know. And many times in basic training, I’ll give examples, let’s say, of a person who is experiencing discrimination. And sometimes people will say, Well, how can you work with somebody on a past experience of discrimination when this is still happening? And the answer is not that hard, but the answer is, we do our best to help clients come to terms with what’s happened in the past, and we hope that that builds resilience to handle things in the present. And so because I think sometimes people get quickly discouraged, that if a person’s dealing with adversity in an imperfect world, that we somehow it’s a hopeless venture to try to help them learn to cope. And of course, the reality is, people handling cultural adversity have been resilient and finding ways to cope for eternity. And generally, EMDR will just improve that process.

 

Kim Howard  21:53

Yeah, when I was growing up, and I I wish I could remember the poem, or whatever it was. But there was a line in the poem, and it was, I think it was a poem, sort of an inspirational thing about you don’t really know someone until you walk, specifically used the word moccasins. So I feel like it might have come from the Native American community, I’m not sure. But something about, if you don’t really know somebody, unless you’ve walked in their moccasins for two weeks, or something like that. And that is very true. I mean, you really, truly don’t understand what it’s like to be a black man or a black woman, or an Asian woman, or fill in the blank, or somebody who’s in who’s in the LGBTQ plus community, unless you are in that community and so And even then, that doesn’t mean that your lived experience is exactly the same, because everybody’s lived experience is different as humans. If we would just try a little more empathy toward our fellow human beings, the world would be a much safer and better place to to be in.

 

Mark Nickerson  22:53

Well, and and I think that’s where, again, I feel, and probably most therapists feel privileged to be able to just be present with a client and creating the safest space we can as they reveal themselves. And so I’d say one of the best gifts of committing to doing this sort of work is I feel like I’ve expanded. I feel like I’ve seen more of people’s experiences in many ways, and somehow integrate them into me so that I feel a little bigger, a little little wiser, but still always realizing that I’m learning, yeah, absolutely it’s a good way to put it. I’ve had some chances in recent years to travel to different countries, different continents, to bring up some of these issues, and been reassured that the essential points resonate for people, but often are really not talked about, is as much as we struggle still as a nation, we’ve brought issues like sexism up For a very long time, as most European countries have, but there are parts of the world where sexism really is an unspoken about phenomenon that still leaves people locked into gender roles and inequities.

 

Kim Howard  24:14

Yeah, absolutely. What would you like people outside of the EMDR community to know about EMDR therapy with this population,

 

Mark Nickerson  24:23

I would want, first of all, people to just understand EMDR, and in the sense that we don’t fix people’s problems, we create an atmosphere in which people can address their issues and find their own solution. So I think EMDR is known and trusted as a as a therapy that, in empowers people basically whatever they’re working on to find themselves. Then by would certainly want them to know that this is something we can offer regarding this, I’ve actually. I for a while, I back in 2010 I began experimenting with creating a place for people to work on their own personal prejudices, and mostly in workshops the EMDR therapist being brave enough to admit to a prejudice and work on it in a with another person and keep some notes confidential. And what I found is that biases are built on misinformation and negative experiences, and at least for people who are aware of their biases and wish to have them melted, then those are good candidates often for EMDR work and without having to hit somebody over the face shame them for their biases, I found that EMDR can help a person look at different biases. And these biases go in all sorts of different directions political ideology toward people of different sorts, and that generally, they bring what we all know happens in EMDR, people become can suddenly see things in perspective. They can see where they might have formed. And we tend to move to a more adaptive place, which I see as being often tolerant, understanding and empathic toward others. Now this isn’t meant to say that EMDR is going to work with people who stand by their biases and double down on them have basically ego syntonic prejudice. There need to be different approaches in the world, but EMDR is a place where we can go into these areas without necessarily even talking about the experiences that might have led to our bias and unpack it and come out a little bit wiser.

 

Kim Howard  26:57

Thank you. Mark this next question might be moot, given the topic today, but I’m going to ask it anyway, just in case you have any more insight. How do you practice cultural humility as an EMDR, therapist, Mark?

 

Mark Nickerson  27:09

Well, I know the literature and that how central it is, and it cultural humility, even though the understanding of cultural competence has greatly increased in terms of more voices talking about it in the last five or 10 years. It’s not like it was just born yesterday and the term itself, and including key things like cultural humility and curiosity explicitly in terms of cultural competence about 30 years ago, but it’s been a very slow building to increased interest. So it’s it’s fundamental, and, you know, I again, I think it fits well with EMDR, where we understand that we’re not directing our clients way through their material, and we are limited by our own knowledge and as I say, but we shouldn’t hold back having confidence that our method can can be helpful to people.

 

Kim Howard  28:11

Thank you. Do you have a favorite free EMDR related resource you would suggest, either for the public or other EMDR therapists?

 

Mark Nickerson  28:20

Well, there’s a lot out there. I don’t know if this is appropriate, but I can’t resist saying that the book Cultural Competence and Healing Culturally-based Trauma, is in its second edition, and it includes a number of chapters written by me. But I’ll also say that there are over 20 other authors who have contributed chapters related to using EMDR, and these authors talk about their lived experience, their clinical practice. So it’s a unique resource. Is just not anything like that in the EMDR world of this volume. And then I also enjoy hosting advanced trainings, and so I, in addition to this topic, look at other topics where I like to host world leaders talking about important topics and make those available to people as well. I

 

Kim Howard  29:17

I’ll put a link in the podcast description to your book and to your website. Great. Thank you, Mark, if you weren’t an EMDR therapist, what would you be?

 

Mark Nickerson  29:31

I think I would either be a sports coach, athletic coach, or a tour guide. And I know in my mind, the glamor on his tour guide life, I think it’s a gritty life with people that complain and that sort of thing. But the idea of taking the people to places they like to explore, and guiding them in that process would would just be a delight.

 

Kim Howard  29:59

Yeah, it would be fun. Would you be an international tour guide or national wherever?

 

Mark Nickerson  30:04

Whereever. I would be a tour guide to the the interesting babbling brook that’s just down the street, or to another country like it really just the idea of taking a group of people that are interested in something and helping them be learn about it.

 

Kim Howard  30:19

Yeah, that’s a that’s great. And we have not had anybody on the podcast who’s ever mentioned either one of those career paths. So that’s that’s awesome and new. And I will say that shout out to the tour guides out there. I think the best money we ever spent when we went to Italy several years ago for a major wedding anniversary was personal tour guide of the Vatican, rather than being with a group of 50 people or get in, getting stuck in the back, and everything is very cavernous there, obviously, and it echoes, and I don’t know how people can actually hear anything that’s going on that we just hired somebody who you know, and did a little tour with just the four of us, and it was fantastic, and she was local, and she was wonderful and very knowledgeable. And so shout out to other guys out there. Thanks for doing what you do to educate the rest of the world. We appreciate that.

 

Mark Nickerson  31:07

Now, I’m even more excited see this through.

 

Kim Howard  31:09

We’re planning your post EMDR therapy retirement, and we’re gonna, we’re gonna move you along to some other career path. Is there anything else you want to add?

 

Mark Nickerson  31:17

I wanna I just wanna say one more thing here before we finish, which is that, as I’ve said, I’ve had an interest in this for a while, but I just want to acknowledge a lot of like minded people, starting way back in about 2010 on the EMDRIA Board and also participating in panels at conferences, speaking about cultural issues. And just been a nice evolution, and especially in the last five years that EMDR has made space for a lot of speakers, very knowledgeable people, presenting at conferences and elsewhere. And it’s just delightful to see the growth of this and to see the whole notion of connection and belonging, that human need being an increasingly recognized as a fundamental belief that can be shattered by adverse experiences. So I just wanted to shout out for the larger evolution on this topic.

 

Kim Howard  32:18

You know, we’ve had several minority EMDR therapists on the podcast and writing for the [Go With That] magazine. I remember when I had David Archer on, and we talked about, I think his topic was anti anti-racist EMDR therapy. I think that’s what the name of the podcast epsidoe.

 

Mark Nickerson  32:34

Right, sounds like him.

 

Kim Howard  32:35

And, yeah, and, you know, we talked about how it’s hard, it’s difficult to I am white. It’s hard for me as a white woman to understand what it’s like to be a Black woman or an Asian man or a Black man. It’s hard for me to understand that. But the conversations are hard too, and yeah, because they make us uncomfortable. But that doesn’t mean that we shouldn’t have the conversations, and that doesn’t mean that we shouldn’t do our best to try to understand other people who are different than we are, whether it’s different in terms of where they come from, from a nation or different parts of the world or whatever. And so it’s it’s hard, so we can do hard things, people.

 

Mark Nickerson  33:11

And and also, as important as it is to listen to the voices of people who have been left in a minority status or disadvantaged status. It is essential that those in the majority speak up as well. Otherwise, the burden lies to those that have already been burdened to be a voice for their experience. So I think there isn’t really an obligation for people as white as me to be able to embrace these issues and and stand up for the evolution of our world in these ways. So whether I think of myself often as an ally, you know that term can be looked at in different ways. So in a sense, the humility lets me know I’m an imperfect ally, but it goes against the idea of just being silent around these issues that has been too long, the option, let’s say, taken by people that have higher levels of privilege.

 

Kim Howard  34:14

Yeah, ignored too long. Yes. Is there anything else you want to add, Mark?

 

Mark Nickerson  34:19

No, just that this work. I’m hitting a moral note here in my last comments. But on a personal level, it’s just plain fun and gratifying to get to know people and to to just engage in these even gritty issues. It’s fun. May not all be the right term, but certainly rewarding.

 

Kim Howard  34:40

That’s a great way to end the podcast. Thank you, Mark.

 

Mark Nickerson  34:42

Hey, thank you for having me, Kim

 

Kim Howard  34:43

This has been the let’s talk EMDR podcast with our guest Mark Nickerson. Visit www. emdria.org for more information about EMDR therapy, or to use our find an EMDR therapist directory with more than 16,000 therapists available. Like what you hear? Make sure you subscribe to this free podcast wherever you listen, thanks for being here today.