Kim Howard  00:04

Welcome to 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 and Beckley forest about EMDR therapy and dissociation and children. Let’s get started. Today we are speaking with EMDR, certified therapist, trainer and consultant and Beckley forest to discuss indoor therapy for dissociation in children and adolescents. Thank you, Anna, for being here today. We are so happy that you said yes.

 

Ann Beckley-Forest  00:34

Thank you for asking me.

 

Kim Howard  00:35

Ann, can you tell us a little bit about your path to becoming an EMDR therapist?

 

Ann Beckley-Forest  00:41

Oh, well, actually, I do have a little bit of an interesting story because I was a play therapist for many years. And I used to make fun of EMDR, which is very ironic projectory of my career, so because you know, I went to grad school in the ’90s EMDR was new, it was mysterious. It was trademarked, you know. And so therefore an object of suspicion. And then I got trained my agency that I was working for at the time around 2010 asked me to get trained. And, you know, I did but I was kind of like a bad student that was asking a lot of questions challenging a lot on how am I going, because I really my specialty has always been kids. And I in those years, I was also seeing adults, and I do still see some adults. Now that I know EMDR I found a model that also worked with my adults but and then Annie Monaco, who is now my kind of training partner, business partner, co-editor, collaborator, she was the trainer for EMDR basic for me, and instead of telling me that my questions were dumb, she welcomed them. And now we’re still collaborating, and still trying to figure out how to, you know, get child clinicians from basic training into a kind of robust integration of EMDR. With kids, because I really think that’s still a growing edge for EMDR as a whole.

 

Kim Howard  02:00

And what’s your favorite part of working with EMDR therapy?

 

Ann Beckley-Forest  02:03

I think the thing that has been the most transformative is the whole idea of dual attention. Obviously, I learned as part of EMDR. I think that we did not understand how important and key that was to psychotherapy, until Francine kind of happened across it. And now look what’s possible, right? Yeah. And even in terms of like how I am doing some things that I’ve always done with children in terms of inviting play, especially with little kids often have a lot of spontaneous play kind of bubbling up anyway, which has the ability to tap into some of those trauma memory networks. But then, you know, it’s kind of systematically looking for targets, adding the bilateral for dual attention, I think is just much more powerful and works quicker, with fewer risks. And we wouldn’t have that without Francine work and when without EMDR. So, you know, if you think about where else in therapy, were they talking about? The need to have dual attention when you process trauma, when when I was doing in the 90s prolonged exposure, and worked in a psych unit.

 

Kim Howard  03:11

That sounds fun….prolonged exposure: this is traumatic for me, but you’re gonna make me you’re gonna expose it to me.

 

Ann Beckley-Forest  03:18

Our dropout rate was incredibly high, right? Because we weren’t managing the dose, right, of the exposure to the trauma. And so people would add react all over the place. So now in terms of safety and all that I’ve pretty strongly about EMDR now, so we’re happy about that.

 

Kim Howard  03:35

So for the people out there who are not in the therapy world professionally, can you explain a little bit about what you mean by dissociation?

 

Ann Beckley-Forest  03:43

Sure, yeah. How long do you have? Oh, you want me to do that in five minutes? Okay. [Laughing] Well, you know, actually, dissociation is a resourceful adaptation that children are especially good at. And it tends to come up a lot for children who are growing up in very adverse situations. So abusive parent or caregiver, or a lot of medical trauma pain, are kind of two of the ways in which we often see that. I mean, we all dissociate to some degree if we have something painful that we have to push aside so we can go on with life for period of time, it starts as as that very adaptive skill. But you know, I think about how resourceful these little minds were to develop this way of distancing from pain in order to survive, and you know, especially when it’s an attachment figure, and then the problem, of course, is that the as life goes on those parts of ourselves that we’ve pushed aside or frozen in time, don’t grow up with the rest of us, and then kind of laying in wait for triggers. And you know, that word trigger has really entered our common conversation now, but it’s very real. It describes a very real phenomena in our neurobiology, which is, the brain kind of wants to deal with all those painful experiences and integrate them. But if they’re frozen in time in fragments, then, you know, some situation in here. And now that kind of reminds my brain of that can take me there in a minute. Yeah, I want to talk about dissociation. It’s, it’s where those patterns are those pathways have kind of hardened over time and in, you can end up feeling really kind of divided up inside. And I think that’s a reality for a lot of our clients. And we’re all kind of on that continuum somewhere. But out at the more severe end, I think it’d be quite disruptive.

 

Kim Howard  05:42

So, my first sort of real life exposure to somebody being triggered about something was came out of completely unexpected place. We were on vacation, my husband was driving, our daughter was in the backseat, she was an adult – 19 or 20. And he’s turning left into the place where we are staying. And the oncoming traffic’s come pretty fast. And Mike is a safe driver. He hasn’t had an accident in 30 years. And the last accident we had was, we spun around ice and we couldn’t control the car. It wasn’t our fault wasn’t like we were speeding. And he took the turn a little too late, right? So the car oncoming car a little too late. And she had been in a car accident her senior year and totaled her car. And she completely freaked out. We didn’t even think about that the pole car accident connection and the the response of her and so I was like, wow, well, dude, we can’t. I mean, after that car accident she had she would drive it away for like two weeks, you know, it took her a while. And then if she drove with somebody, you could be driving the neighborhood 15 miles an hour, and she’d be like, you’re driving too fast. Yeah, so you just never know where they’re coming from? Or who’s going to have them? And so thank you, for making us aware.

 

Ann Beckley-Forest  06:54

Survival instinct, that’s really where that comes from. When it’s like, oh, I have this bad experience. How can recreating it? And can I avoid it? Yeah, instead of buffer, you know, kids who are growing up in adversity, you know, layer upon layer of that, those kinds of experiences of threat. And you have to avoid more and more and more and more. And then in order to function, you have to really get all the way. You should. Yep. Yes. It’s that phenomena. And I think it is something when you hear a description of that you’re like, Oh, that makes sense. Right? Yeah. And then you know, our work. For those of us who work with complex traumas, then, you know, how can we help our clients to first of all feel enough here and now safety, to in that work, and then, you know, we’ve those last experiences kind of back into our awareness, little by little, and that’s where, you know, obviously EMDR has kind of sometimes feels like we discovered Association, even though that’s not true. But it’s been in the literature for a long time. But as we started doing trauma work with more and more people, pockets of dissociation kind of bubbled up. And we, you now I think, are getting much more creative and resourceful in terms of how we can adapt the EMDRIA protocol to accommodate that and to make sure that we can extend those benefits not just for those kind of isolated incidents, but also for the complex cases. Thank you.

 

Kim Howard  08:20

Are there any specific complexities or challenges with treatment for children with this association?

 

Ann Beckley-Forest  08:26

Well, you know, there’s the there’s the question of caregivers, right, and their role, their role in you know, creating some of the trauma in the first place. And, you know, we always do better work with children, if they we have their caregivers involved. And of course, that takes some structure, sometimes it takes relationship for the therapist, I think that’s probably one of the big challenges and that is kids get into adolescence, there’s a natural kind of developmental need to push away that kind of support. And if repair hasn’t happened prior to that, then I think that can be very complicated. And and I also work with a lot of adoptive families, and I work with foster families. So these are the caregivers who maybe didn’t make the original wounds, but they’re struggling to understand why the reactions that they get are so big, in some cases, so out of character, you know, almost like have more more than one kid here. And one is one is like growing fond of me and attached to me. And the other one is very defended and very hostile, and in fact, even can be threatening or aggressive in ways that I don’t you know, that it just doesn’t make intuitive sense. And so bringing the caregivers along in the work is always the challenge for child therapists.

 

Kim Howard  09:43

Well, this question was not our question was how do you do that work with a child if the person who’s the caregiver is the one who’s causing the trauma?

 

Ann Beckley-Forest  09:55

Well, that’s yeah….

 

Kim Howard  09:57

I mean, that must be really, really difficult….

 

Ann Beckley-Forest  10:01

That’s why you didn’t put on the list because you know, it’s complicated, it’s hard to heal from something that isn’t over. So, you know, a lot of times our first job, you know, it’s a phase one, job safety and stabilization. And that can sometimes take the time that it takes to advocate for more safety day to day. But you know, I’ve sometimes worked a lot with parents before ever even working with the child to navigate some of that and negotiate for some of that, I think being as I am now, kind of mid career, I’m older, I’m not so easily pushed around. I’m stronger advocate for that. I think that I make some rules now for your family. So like, you know, you want me to help your kid, you’re gonna have to make some changes to this right? For them. And, you know, talking about emotional safety, what does that look like? What does that feel like? And, you know, advocating for that, but it can be very challenging. Yeah, I would imagine, make those changes. If there’s active harm going on. Obviously, that’s still for whether you’re EMDR therapist or any other kind of therapists, it’s still our first job. Yeah, to do what we want that but I mean,

 

Kim Howard  11:14

I’ve had a lot of jobs in my lifetime. But I will tell you that raising our two children was the most important job I’ve ever had. And all like all you think, well, at least, Mike and I, all we could think about when children were younger was, Oh, my God, please don’t let us screw them up. Like, please make us because there’s no manual, they don’t come with instructions. There’s no manual.

 

Ann Beckley-Forest  11:35

We all come with a list of things we think our own caregivers did wrong. So mine was like yours, but a little different. I was like, please don’t let me screw up my kids the same way that I was screwed up. Oh, I mean, realistic, like, let me at least do some different things.

 

Kim Howard  11:54

What successes, have you seen using EMDR therapy for this population?

 

Ann Beckley-Forest  11:57

I would say, when we first of all have a present condition of safety, which again, as you were just saying is a big, you know, it’s a big if, then I think there’s a lot that’s possible. And, you know, one of the things is that we know the child’s nervous system is organized around avoidance of the work. And so we do have to kind of lead kids towards that work, you know, I use a lot of expressive materials, play therapy setting, you know, art, and do, you know, trying to use those modalities to make it kind of detoxify the intensity of that and just make the entire process more playful, with just these kind of, you know, you touch the hot iron for just a little bit. So a lot of titration a lot of managing of the dose of the EMDR. But and also not avoiding it for forever, either, you know, we have to do a good preparation phase. And of course, for kids, a lot of times, that’s about the attachment work with the current caregivers. And I think explaining to caregivers about dissociation about that kind of fragmentation that you they’re experiencing, and kind of giving them a framework for that. And really what we know from, you know, all the different brands of dissociation theory that there are out there ifs and structural dissociation, all that is really this notion that we can’t be at war with our own selves, and be whole. So getting out of this, like bad behavior, good behavior, right? And said this, like, Oh, this is behavior that maybe it was originally designed for self protection, but isn’t working for you anymore. And this is behavior that’s moving you towards connection, and how can we get those parts to kind of dialogue and come to some agreements inside the child, you know, for, for attachment. And then we can do, if you have that going, you can do a lot and I have some a couple of cases right now, where there’s really a lot of pain, there’s a lot of horrible situations that parts are holding early in life experiences, but with a attuned caregiver who’s in it with us, and it took a while to get there, but we’re there now. And, you know, this is the work of a very creative child mind to sort of build these, you know, kind of parts or personas to hold some of this. And so for, you know, kids who have more structural dissociation where, you know, the, sometimes they’re not even aware of all the things are saying and doing all the time, they’ll even this tiny doses of trauma work of EMDR and I’m talking tiny, like five minutes at a time with, you know, kind of in the context of a lot of regulation and play and attachment work. It’s making huge differences in day to day life. And then also you’re thinking about the prevention of, you know, lifetime adult, more severe mental illness and severe symptomology. So it’s actually interesting because I think a lot of people felt that it was easier somehow or better to wait till kids were older to do trauma work, so they could do it like adults. But I think the My experience has been the earlier the better. You know.

 

Kim Howard  15:18

They’ve been carrying around for so much longer and dealing with it or not dealing with it for so much longer and well,

 

Ann Beckley-Forest  15:23

And it’s interfering with growth, normal growth and development. Yeah, and emotional development. So if we can kind of get kids reattached, and, you know, at an age where they still, you know, have the ability to kind of invest some trust in adults to be bigger and stronger, and wiser. And it’s very powerful. So that’s why I’m after a lot of people who stopped seeing kids, for one reason or another EMDR therapists to say, come on back, we’re having kind of an epidemic of kids who need good trauma work and not enough trauma therapists who work with kids. And so you know, that’s the work that I’m interested in is how to give people more confidence to go there with kids in the room, because you’re using the context of play and, you know, physical movement, and dancing and drumming and all of those kinds of things to manage.

 

Kim Howard  16:15

That’s, that’s sad to hear that, that people are leaving the profession, or at least that part of their practice, you know, walking away from the next generation, right?

 

Ann Beckley-Forest  16:29

Well, what I’m hearing from people, first of all, a lot of people don’t want to disrespect telehealth. But a lot of people found telehealth more comfortable way to work, but also find that younger kids don’t respond as well, which is my been my experience as well. Now, some people really special, exciting people can make telehealth fun enough to engage kids. But I found that exhausting. So I went back to the in person. And then it’s just really hard to work with the younger kids that way. And so if, you know, Willie, we have a lot of I’m curious to see the statistics, but anecdotally, I’m hearing from a lot of people are like, Yeah, my whole practice is telehealth now, so I had to give up the kids, or the kids. You know, I still work with teens, but I don’t want kids you know, and that to me that, you know, feels that’s heartbreaking. Yeah, pendulum may swing back the other way. Yeah. It may.

 

Kim Howard  17:20

Hopefully, it will. Are there any myths that you would like to bust about working with EMDR therapy and dissociation for children and teens?

 

Ann Beckley-Forest  17:29

Myths that I would like to bust us? You know, I’ve been surrounded by really good messaging around dissociation kind of from the beginning. So I don’t know, if I ever, if I was to impacted by myths. I mean, certainly this idea that dissociation is rare, is a myth that it’s that we need to let go of, once you have that lens in which to see what’s going on with kids, especially kids, you know, in foster care, kids who were adopted from, you know, difficult circumstances, whatever they may be, you know, kids who have parents who have significant challenges of their own, whether it’s, you know, mental, physical or otherwise, and kind of big number of kids with early medical trauma. And in order to manage chronic pain, or painful procedures, or things like that, and these are kids who have, you know, good attachment figures, but there’s just some challenge came along that no one could protect them from Right, right. For all of them. It’s really not that rare in any of those groups for there to be, you know, somewhere on that dissociative continuum, and it’s a good move for the nervous system, to manage the unmanageable, it’s just that, you know, we have to, in order to get to those, those targets those painful experiences to process them and heal them. It just takes a little bit more work. Because, you know, if you ask the kids, they’re like, I’m fine. Now. You know, that’s all behind the wall.

 

Kim Howard  19:02

Right? Right. Yeah. Everything’s fine.

 

Ann Beckley-Forest  19:05

Yeah. And then, you know, and a lot of kids, you know, if parents want to believe that and they jump on, on that bandwagon. They can last for a while, and then adolescents or other kinds of challenges or triggers that come up, and then you’re not certainly we haven’t even touched on sexual abuse. And, you know, the whole prevalence of sexual abuse and precocious exposure to sexuality and exploitation that happens for a lot of kids is another kind of fertile ground for dissociative coping. And kind of putting those pieces back together. I think it’s not impossible to do. It’s actually work that we know how to do we have tools we have EMDR we have some great teachers in the dissociation world who, including like Fran Waters, who’s someone that I’ve been able to collaborate with and learn a lot from and you know, various other people who are I have been studying this for a long time, and that we have the tools, we know what to do. It’s a resource rich work, like it takes sometimes a lot of investment of time to get to the point where we can do that. But we actually have the tools we can heal.

 

Kim Howard  20:15

That’s good to know. And that’s a great message. Thank you. What would you like people outside the EMDR community to know about EMDR therapy with this population.

 

Ann Beckley-Forest  20:28

We’d like insurance companies to know that things take time. I would like insurance companies to cover intensive trauma therapy where we don’t have to fraction this often 60 minute segments, that’s one, I, you know, I would say people should not wait to get help. So if you have a child, you know, someone has a child in their life, or if you’re therapists working with a child that has this kind of sense of of being, you know, having to kind of split themselves into tiny little pieces to survive, or to push a lot of their emotions, you know, aside in order to survive, and then you happen to have a chance to intervene with that child Don’t deny the evidence or front of you. And that’s what we see when therapists get trained, even in a very at a very basic level and dissociative theory, along with, you know, obviously trauma theory AIP thinking, then, it’s like the blinders come off. And they’re like, Well, of course, and unfortunately, what children have tended to get is a lot of behaviorist kind of intervention, which works find with securely attached kids with low exposure to adversity, because it’s all kind of like reward, you know, reward consequence, stuff running through the frontal cortex great, does not work and in fact, can grow. The sense of threat that trauma expose kids have, and can actually make dissociation worse. You know, if you’re undisciplined in a family that has a very kind of rigid behavioral approach, or you have professionals that are advising those kinds of approaches, it actually can make these kind of protective parts that become very aggressive, and any, even when you just tell me to, like, empty the dishwasher, and that’s what a lot of our foster kids and adoptive kids are in scenarios like that, where that’s the kind of advice their parents are getting. So so when we give even a little bit of information to parents, or to caregivers, foster care workers, schools, teachers, about the strategies that kids trauma exposed kids use to survive. It’s a total game changer. Because to be, you know, accepting of all the parts of the kid and not have like, over those are the bad parts of you. I don’t want that. Because that’s where the pain is.

 

Kim Howard  22:47

Yeah. Well, that’s when the blinders sort of come off, I think. Right? Well, yeah. How do you practice cultural humility as named your therapist?

 

22:57

Hmm. Well, I think you have to practice humility, humility, as every kind of therapist. So that’s the starting point, and not having, you know, just really flipping this whole idea that we’re somehow the experts, and we’re gonna come down from off the mountain. No, you’re not. You don’t know all. But I do think that that kind of like, mentality, yeah, top down, thinking or pedagogy exacerbates the problems that come up, when you also add in, you know, the intersection of like power and control and dominant racial groups and, you know, oppressed groups and all of the intersection of that neurodiversity. You know, having a mentality that I have the answers for you, is going to open you wide to a lot of mistakes, you know, whether you’re working across culture, across gender across generation. So so that’s just to regular all humility, I think is in short supply in this world. So. So I try to ascribe to an overall attitude of humility and just you know, it’s kind of like, chill curiosity network. I’m actually very interested in how this plays out in a lot of the Fosse daughter and adoptive families that I work with actually, one of my colleagues, Rene Hewitt, who’s a BIPOC clinician, and I took a deep dive into this together last year for EMDRIA. In Arlington, we presented on cultural and race based trauma in families, so multiracial families, adoptive families, foster families, and you know, how caregivers how can we work with caregivers to make space for processing those kinds of, you know, to broach that stuff, and then, you know, show up ourselves authentically to do that. And of course, that’s different. If you’re a white therapist or BIPOC clinician if you share ethnicity with one party and not the other by just being curious about all that and open to it and learning how to get better at holding all of that. So….

 

Kim Howard  25:10

That’s a great answer. Thank you. And do you have a favorite free EMDR related resource you would suggest either for the public or other EMDR therapists?

 

Ann Beckley-Forest  25:20

Oh, free an imprint, I didn’t prepare ahead of time for this, although there is a lot, there’s a lot of things people are putting out there in the world just in terms of like mindfulness and regulation and all of the things that we can use to kind of to buffer the EMDR work, you know, kind of going beyond just safe place not to knock safely. Often our clients need lots more.

 

Kim Howard  25:42

If you have something that people have to buy, like a book or something, or a website that you recommend that people go to, we can always include that. And if they want to buy stuff….

 

Ann Beckley-Forest  25:54

On my website, and I don’t know if that was appropriate to say we I am Annie and I have a website, Playful EMDR. We have a couple of free things for EMDR clinicians, one is like a one hour, quick take of EMDR with kids, and how you can embellish decorate and you know ‘propify’ your EMDR therapy to make it more engaging. And then we also I have a very short instructional segment on how to do the EMDR storytelling method, which is Jon Lovitz’s work. And it’s just some work that I put out there, and it’s free to EMDR clinician so only, and how to how you can involve caregivers in their child’s EMDR. So those are our resources that we have on our website. And I’m assuming other people have free stuff, too.

 

Kim Howard  26:44

I’d be happy to include that link in the description.

 

Ann Beckley-Forest  26:46

Okay, that’d be great. Yeah, and well, no, there is a there is an EMDR. For kids, I was very happy couple years ago, EMDRIA put out a kind of a toolkit for a primer on doing EMDR. With kids, it’s good to see more workshops about children and adolescents at the EMDRIA Conference. And at the [EMDRIA] Summit. I always like it when I’m not the only one.

 

Kim Howard  27:12

Like beating the same drum, I’m still here talking about the same stuff.

 

Ann Beckley-Forest  27:17

The one presentation, you know, so it was really interesting, because I think there was a big kind of openness to like integration with, you know, kind of thinking about creativity across the age band, by the way, not just little kids. But you know, there was there was quite a few sessions that I think tapped into that. So.

 

Kim Howard  27:39

If you can heal the children and the adolescents, they can go on to be healthier adults, right? And then that if they ever have children better, they can be better than the previous caregiver or parent. And so that’s, that’s not a bad thing. So if you weren’t named your therapist, what would you be?

 

Ann Beckley-Forest  28:00

Possibly a travel agent? No, I don’t know.

 

Kim Howard  28:03

I like that. Where are we going?

 

Ann Beckley-Forest  28:07

I think I was an event planner, and another life or, you know, I like I like that sort of thing. We have a summit coming up, which I think is going to happen before you err, actually probably. But and I’m having just like such a good time planning all the little details of it. So this is just we started periodically, like every other year trying to get together, all of the child therapists, like therapists are also doing EMDR in our own little conference. So we’re having that in Utah, May 13, to the 16th. And online, so, so I’m having a really good time, like planning all that. And I think I was an event planner. So that’s still out there for me. You know, if EMDR doesn’t work out.

 

Kim Howard  28:49

There you go! If it doesn’t work out? Yeah, I have worked with some really good meeting planners over the years who event planning and they really know exactly what they’re doing and exactly what they want. And they make things. They’re usually behind the scenes. I guess most people that go to those events don’t really understand what’s involved in putting one on until you’ve put one on. And they do it so seamlessly that as an attendee, you don’t really notice what’s happened. Yeah, that’s how it’s supposed to be.

 

Ann Beckley-Forest  29:18

That’s like a good attachment figure who’s anticipating your needs, and you know, making sure you have what you need. So.

 

Kim Howard  29:24

Yeah, absolutely. Is there anything else you’d like to add?

 

Ann Beckley-Forest  29:27

Well, I would like to add that I had a wonderful time at the EMDRIA Summit, which is where you and I talked about during this podcast and that I felt really good about I think a lot of the messaging and the tone. There was a real tone of inclusion. There was a fantastic keynote presentation and you know if people have been away from EMDRIA live events for a while as many people have it felt they start coming back to them because was really special. What happened up in Bellevue. So…. Yeah.

 

Kim Howard  29:54

So everything we seem to be hitting on all cylinders, like the facility was wrapping was good, which Yeah, we got a lot of good feedback on on the summit. And one of the things were…with the background stuff, but we just talked about with main planning, if it’s wrong or bad, it sets the tone for the whole meeting, right? So if you’ve got a broken air conditioner in the, in the conference room, or it’s, you know, the hotel was dirty or whatever. So weird things happen to the food is bad. And then oh, that conference suck when the content could have been really good. And the speakers could have been fantastic. But that supersedes what people remember.

 

Ann Beckley-Forest  30:33

[weather] hadn’t to Seattle in April, that was not a guarantee.

 

Kim Howard  30:37

I know.

 

Ann Beckley-Forest  30:38

I know. I just thought I thought it was a great event. And a lot of younger generation therapists who are, you know, also holding the organization accountable as far as diversity inclusion is concerned. So a lot of talk about neurodiversity. And obviously, you know, EMDR, as we’re sort of mucking around in the nervous system, we should be leading that charge, you know, in terms of understanding how different brains are. And you know, we have to get out of the lane narrow lanes. I thought it was wonderful. Yeah.

 

Kim Howard  31:09

Good. I’m glad you felt that way. So thank you for your time. I appreciate it.

 

Ann Beckley-Forest  31:13

Well, it’s nice to hang out with you.

 

Kim Howard  31:14

This has been the Let’s Talk EMDR podcast with our guest Ann Beckley-Forest. 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.