Healing the Fragmented Self_ E…omplex Trauma and Dissociation

Mon, Aug 18, 2025 9:39AM • 54:31

SUMMARY KEYWORDS

EMDR therapy, complex trauma, dissociation, sand tray therapy, childhood trauma, attachment issues, therapeutic process, memory integration, systemic approach, client safety, relational templates, cultural humility, advanced training, therapeutic relationship, trauma processing.

SPEAKERS

Kim Howard, Speaker 1, Ana Gomez

 

Kim Howard  00:00

Kim, welcome to the Let’s Talk EMDR podcast brought to you by the EMDR International Association, or EMDRIA. I am your host, Kim Howard. Let’s get started today. We are speaking with EMDRIA Certified Therapist, Approved Consultant and Trainer, Ana Gomez, to discuss EMDR, sand tray based therapy for complex trauma and dissociation. Thank you, Ana, for being here today. We are so happy that you said yes.

 

Ana Gomez  00:29

Thank you so much. I’m incredibly excited to do this. I know we’re planning this for a while.

 

Kim Howard  00:35

We have been I’m glad we were able to finally connect our schedules. This is fantastic. Ana, can you tell us about your path to becoming an EMDR therapist?

 

Ana Gomez  00:44

Yeah, well, towards the end of my master’s program, I heard a teacher talked about EMDR therapy, and I heard a click inside me for some reason, so I went back home, and the first thing I did was to search for EMDR. So I found a training provider, and right away I went for the training. So that was 20  – over 25 years ago, and I am fell in love with it to the training. And was skeptical, of course, yeah, therapy where you have to move your eyes back and forth, suspicious. So during the practicum, of course, this happened to many of us. I started to work on something I thought was very tight, and ended up in places that I felt I had I was well, I was equipped to manage them, but I was surprised by how quickly I went to those places, and at that point, I knew EMDR was part of my path.

 

Kim Howard  02:01

That’s a great story, and we’re very glad whoever that instructor or professor was that they mentioned that to you, because we are very glad that you are within the EMDR professional community and associated with EMDR. So we are very grateful for that. So whoever’s out there, if you’re listening, we thank you. So what’s your favorite part of working with EMDR therapy?

 

Ana Gomez  02:23

Oh, so many things, so many parts, I love the fact that EMDR therapy holds space for the whole human experience. So it really embraces cognitive, emotional, somatic, behavioral issues. It supports the pattern of the nervous system, there is meaning making, and it holds such potential for transformation, and it it helps us go to where we need to go. And I’m speaking from a therapist perspective, but I’m also speaking from a client’s perspective, because I have also received a lot of EMDR I don’t think I could do EMDR therapy without having experienced it first hand myself, and it really moves you and takes you to deeper places where you can find integration and realize wholeness. And what I love about EMDR therapy is that it’s not just about memory integration. That’s how we see it. Certainly that’s how I learned it, even from Shapiro, but after seeing hundreds of clients and working by their side and working on my own memory networks, when I realized that this goes beyond memory systems, it really goes into Self and fostering a much greater connection with self, and in that regards, is so transformative, because it becomes about is the process of becoming and also unbecoming as we leave behind what blocks our, you know, most authentic self and capacity to really honor who we are, because trauma really put us onto a path of self betrayal and self abandonment. And EMDR is restorative. It gives us the soil for repair, right, not beyond memory, certainly. So this is the part that I really, really appreciate about EMDR therapy. It embraces top down, bottom up processes, so it really embraces the whole self.

 

Kim Howard  04:53

That’s a great analogy when you talked about the soil and making it fertile for healing. And that’s a it’s a good, it’s a good visual for us. And I, I feel we’ve talked about this before on the podcast. And I’ll reiterate for anybody’s new First of all, you’re pretty brave if you’re going to therapy. And second of all, there’s not anybody walking on the face of the earth, earth that has not had some sort of trauma in their life, whether it was major trauma as a child or minor trauma as a child, or whether it’s something happened as an adult. I mean, there is, there are things that you know you as a human, you just think, Oh well, that just happened in my life. But then when something triggers you later on, you’re like, Well, why am I so upset about this? And then you, if you do some therapy, you find out, Oh, well, this happened in my life, and this is why I’m really upset and it’s bothering me. So let me figure out how to manage that. So let me reiterate, don’t be afraid. Go to therapy. It’s okay.

 

Ana Gomez  05:45

Yeah, and it’s not about them clients who experience trauma and us that we have everything resolved, because that’s not true. I think we’re all in the same boat and trying to to find a much greater connection to ourselves and to heal and to find integration and how lucky we are, and I feel incredibly blessed to be able, in the process, to support the healing of others, especially for me, Children and adolescents. I have worked with clients across development throughout my life as a clinician, and it that gave me such experience of our human existence right working with children, adolescents and adults, looking at the whole spectrum of development and to see how we if we work with children early on, if we really provide the treatment that they need, imagine all the suffering that we are saving this child from. And in addition to that, the changes that we’re promoting, not just for this child, but to generations to come. This child will become a caregiver, a parent that now doesn’t have to pass on to the next generation the same relational wounds, the same issues, the same fear, the same shame, and in that regard, when we look at this generational perspective, EMDR can be incredibly transformative.

 

Kim Howard  07:31

Yeah, that’s a that’s a very good reminder, and a great way to put that. Thank you. So before we talk about your new book, “EMDR Sand Tray Based Therapy: Healing Complex Trauma and Dissociation across the Lifespan” can you please define for us what complex trauma and dissociation are?

 

Ana Gomez  07:48

okay, so I guess to say it’s quite complex to define it, because there are so many definitions, dissociation and complex trauma are complex, multifaceted phenomena that really you know that that has a great deal of complexity, and complex trauma has received so many different definitions and terms, poly traumatization, developmental trauma, cumulative trauma, but generally speaking, complex trauma occurs chronically, so it’s not a discrete event. Instead, is the chronic exposure to traumatic events. Also this, traumatic events take place during sensitive periods of development, so critical periods of development, and this type of trauma, because of its chronicity, because it’s happening interpersonally and within a very important relationship, the caregiver, child relationship, it really impacts the neurodevelopment of the child. Impacts, of course, memory integration, and it also impacts identity, right and the sense of self. So it has long and lasting, multidimensional consequences, complex and developmental trauma, and certainly complex trauma quite often, is accompanied by dissociative processes, right? So dissociation is also quite complex and multifaceted very long.

 

Kim Howard  09:35

We don’t want to make it easy on you today.

 

Ana Gomez  09:39

And there are multiple definitions, and it can go from everyday experiences of absorption and detachment, and it can go to profound disruptions of memory, identity, perception, and certainly. By the sense of self. So we have, you know, dissociative processes that span from mild to moderate to severe dissociation, right? So there is in many of our clients that there is a disruption, and this is from the DSM five, a disruption or discontinuity in the normal integration of consciousness, memory, identity, emotions, perception, body representations. This is all from the DSM five. And in addition to that, the way I see it, I have to say dissociation is adaptive in the face of overwhelming stress, and is adaptive in the face of severe trauma. Imagine your primary caregiver and a parent is the source of fear, is the source of terror, and so you have a child that doesn’t have a way out, because the only two exit roads that they have that the only portals that they have, first one is the defense system, the fight, flight, response. But when you’re a child and the abuser or the person inflicting the wounds is bigger, older, more powerful. That portal is not available, and the other portal, in the face of distress and fear and terror, is the parent as an external regulator, is the one that will provide protection and safety, but in many cases, is the caregiver who’s inflicting the wounds. Whether it’s inflicting the caregiver is inflicting abuse, or the parent is utterly unavailable, and the parent fails to provide the safety, the protection in the parent becomes, again, the source of terror. And so in this cases, there’s the child doesn’t have a way out, and that has profound, a profound impact in the neurobiology and the neuro development of of the child. And so to adapt to such complex and overwhelming environment, the child must adapt to it by dissociating right. We have to honor this adaptation and the brilliance of the mind to be able to adapt to an abdicated caregiving system and adapt to coexisting with the insufficiencies of this caregiver and also the terror, the abuse, the fear that is occurring in this important relationship.

 

Ana Gomez  12:50

Absolutely and this is why there are many of us in the field that we advocate for a systemic approach to EMDR therapy, a systemic delivery where we’re not only holding the child accountable for generational wounds, because quite often when when we see a parent that is abusing a child or is disengaged emotionally and available. And when the child has to grow up in such really impoverished relational environments, this is often generational, as from many, many generations. And if we only work with the child, we’re missing the larger picture, which is the transmission of inner generational trauma, and in that regards, even the adaptive information processing model, one that’s one of my proposals in my two books, is to look at the AIP model, not as an individual system, but as a systemic and shared system, because then you have the parent and the child that they continue to activate each other’s memory networks that hold trauma and adversity right. And in this mutual activation, they continue to enhance this synaptic architecture that holds. Holds the generational trauma, and quite often, if we just work with the child and the child goes back to the same relational environment, they continue to enhance the same meta perceptions of you’re not good enough or you’re defective. They continue to enhance the shame, the fear, the sadness and the somatic reactions that accompany such emotions, influencing again, behavior, right, right? So we need to have a much larger picture of what is happening for a lot of our kids, especially in teenagers, and look into how delivering EMDR treatment to truly heal the root of the issue and the problems here.

 

Kim Howard  12:50

That’s a good explanation. Thank you. And I know that there are several definitions out there according to whose group you’re with, but I thank you for sort of breaking that down for us. Children do not come with manuals for any of us. Maybe I was naive when we had our children, but I don’t think I realized the impact you make as a parent or a caregiver until you have a child in your home and you’re like, Whoa. This is, this is, I’m responsible for a lot, and so it can be overwhelming and but they’re the most vulnerable of our population, right, the children and the elderly. And so it’s sad that we need it, but it’s good that we have some kind of healing solution out there for the trauma that people endure.

 

Kim Howard  15:49

Thank you, Anna. What are the specific complexities or challenges when offering EMDR therapy for complex trauma and dissociation?

 

Ana Gomez  16:00

So there are multiple complexities.

 

Kim Howard  16:04

Give me your top three or top five, whatever you think you have time for.

 

Ana Gomez  16:07

Yeah, it certainly is complex, but it’s very much doable, and EMDR can be an incredible form of treatment for this population. Is challenging one because the systemic nature of this complex trauma and the need to involve the system, and the challenges in involving the system. You talk to any child therapist, and the first thing they say is, how do I engage the parents? They don’t want to be here, because there is we have systems of self protection. So with along with complex trauma, you have systems of self protection. You have to defend. You have to protect yourself from the legacies that you carry within. So usually, a lot of the parents and children, they they come along with a lot of the fenders, with the squat team, with soldiers and with systems of self protection, such as, and there is a large number, but such as avoidance, for example. So then you have a parent that says, No, I’m not available. I have to work. I’m sorry I cannot meet with you. So you began to see the strategies right of avoidance or submissiveness or pleasing or control, for example, is a strategy that we see very often in children with disorganized attachment, for example. So we have to deal with the defenses that they developed in the service of survival that is challenging, and quite often the EMDR clinician does not address this from the start, from phase one, from phase two. So that way, when we go into processing, we have already developed or support the client in developing a relationship with their their own systems of self protection. That brings a great deal of complexity, right? Another area of complexity, of course, is the how dissociative the child or the adolescent may be. If the child, for example, present with structural dissociation, or more severe dissociation, where their emerging personality is already showing compartmentalization. It is complex to work with different parts of self. Certainly is not something we should be afraid of, because that’s one of the things that many people in the field brought up to the surface. We should not be afraid of working with dissociation. However, I’m going to add to it, we should respect dissociation as well, because when we enter a dissociative system without that honor and respect and honoring their own capacities and their own windows of tolerance, in their own defenses and systems of self-protection, then it could be messy, right? So we do have to honor that. We have to work with our clients that present with complex trauma and dissociation while honoring their natural rhythms, honoring their natural pace. I’m not the one who’s establishing the pace and the rhythm. So it requires humility on our part, in a recognition of our own defenses that we believe all clients need to go fast, fast, fast. That’s not the rhythm for everyone. So it does require that we honor the client that we have in front of us, that we honor the rhythms and this rhythm. Rhythms may change from session to session, moment to moment. We honor the need to create safety, and safety not just as a protocol, but safety as a much larger phenomenon where we co create safety moment to moment, and honor the natural rhythms towards integration, right? So this is a very important part when we work with complex trauma, and there are many other nuances. But I know you said, give me some…..

 

Kim Howard  20:34

Oh, you could talk. You could…we’ve… you can do a whole podcast on those two topics, just putting them together. And you know, you could talk for a couple of hours, I’m sure, at least, and have different points of view, depending on who you’re interviewing. So I appreciate you breaking that down sort of in a nutshell for us. So let’s talk about your book. So in your new book, “EMDR Sand Tray Based Therapy: Healing Complex Trauma and Dissociation across the Lifespan,” you talk about how this approach can heal anyone, from children to adults. You may have already alluded to this before, but in case you want to continue, can you tell us why this approach works so well?

 

Ana Gomez  21:09

Okay, so why I appreciate so much the union of both is because it honors that by him is fairy structure of the brain, not just a linear verbal brain, but also the brain that communicates through metaphors, through analogies and through symbols. What I have experienced throughout 25 years of using both is that the symbol becomes a bridge from implicit memory into explicit memory, and that’s for clients across development, but especially for children that is much easier to access a traumatic event that is absolutely overwhelming from the distance that the symbols offer. So the sand tray provides a space, a sacred space, for the mind to be able to access what otherwise is utterly overwhelming, and the figures become avatars of the mind through which the mind can express itself, can complete truncated actions. So let me give you a quick example. You have a child creating a story about a zebra being attacked by a lion, and in the sand tray, the child is portraying victim perpetrator dynamics because they were also perpetrated upon. But now it doesn’t have to be me. Is the zebra. See the distance, that level of distance allows the mind to enter such challenging emotional states, meta perceptions, somatic reactions through the distance offered by the symbol. And now the zebra may fight. The zebra may have friends that come to help the zebra and fight against the lion giving the child the act of triumph through these avatars, and I have also seen clients of all ages that present with dissociation, whether it’s mild, moderate and severe, and how parts of self, whether an ego state or a dissociative part enters the sand tray under the costume of the figure, the character, the avatar, and it offers such refuge to the mind, it becomes A mirror to the mind, where the heavy, difficult, painful, work can be attained, can be done without having to activate the embodied mind of our clients so much. And so I have seen I didn’t start to work with this two approaches, just because I had extra time, because they usually don’t, but because I had clients with such clinic complex clinical presentations, and I couldn’t find a portal into their minds, because they will become utterly dysregulated, or after a session, they the urges to self harm will increase. But what I noticed was that with the sand tray, they were able to tell their stories without having to own it. It’s not me, is not mine, is not self. Is the tiger, is the llama? Is the fear of the llama? No? Not my fear, and that’s a gift the sand tray can give us, so we can use the A faces and procedures, types of EMDR therapy, while these characters and symbols offer that space to the mind.

 

Kim Howard  25:17

That’s a great explanation. Thank you. And I would also presume, because sometimes children are not, especially younger children are not really good at expressing what they’re feeling. So this gives them an opportunity, in an art form, way to do that kind of thing. And if you think about also, when you look at art in the art world, people go to museums, or they bid millions of dollars on original pieces from famous people. You look at the art that people have portrayed in their life, and sometimes, a lot of times, those artists are tortured, and that those experiences come out on the canvas or the drawings or throughout their music, whatever art form they take. And so that makes logically, for me, that makes a lot of sense to me about how you’re taking that, and you’re you’re basically kind of illustrating how you’re feeling and what has happened, and so that’s a great segue to working with such a vulnerable population.

 

Ana Gomez  26:13

Yeah, and I would like to add another piece. I mean, think about at our deepest, most intimate level, our communication happens through symbols. When we dream, we don’t have this well formed verbal narratives, but it’s everything is it comes to us in the form of stories and metaphors. And if you look at the traditions that are passed from generation to generation, they’re passed in the form of stories and symbols, and you are absolutely right in terms of how children communicate their trauma. They don’t come in with well, develop and form verbal narratives. They tend to re enact. They reenact relationally, but they also reenact through play and in the sand tray, they are telling us their story in the way that is developmentally appropriate, yet it works very well, also with adolescents and adults as well.

 

Kim Howard  27:16

All right, people, any therapist out there, don’t be afraid to go into the sand tray. We like that. So you’ve already alluded to this, but in case you want to share some more stories, what successes have you seen using EMDR therapy for this population?

 

Ana Gomez  27:30

Well, so most of my life as a clinician, I have worked with very complex clinical presentations, especially children that were adopted in the US, and they grew up in orphanages or children in the foster care system, where they have experienced a lot of attachment traumas, attachment disruptions, and this is a population when I started to use EMDR therapy with them 25 years ago, that had very unstable home environments. I mean, they were moved to different foster homes, and they were not living with their family. I mean, I cannot imagine if I as an adult, I’m removed from my home into another home. I mean, I just want our listeners to think for a moment how traumatic that is in itself, and for many of these children, because they were often in crisis, they were moving from severance to reunification with their biological parents going into multiple foster homes. These are children that historically don’t show a lot of I mean, the therapeutic gains are very small and the process is quite small. When I started to work with them, it was really in using EMDR therapy, it was about necessity, because I didn’t want, I didn’t know what else to grab at that point, because what we were doing was not giving us the results that we wanted for this kids to heal, for these children to be able to find greater integration with them. And when I notice with this population is that when I started to use EMDR therapy, of course, with play and you know, other approaches that speak the language of children, what I started to notice was something different. And that’s another point, another moment of realizing, okay, this is my path. This is part of my path, the EMDR therapy, because we I started to notice shifts and changes in behavior, and not just symptom reduction, but. Started to notice that they were open to formant relationships. They started to form friendships. They started to learn because, of course, trauma blocks their capacity to take in new information. But they were able to learn because I keep very much in contact with parents, foster parents, teacher; what’s going on, what’s happening, and after every processing session, I will check with them. And I was quite impressed by what I was hearing. So is not a treatment that is going to last a month or two or three. These are children, many of them with complex and developmental trauma, exposed to chronic instances of trauma. However, these are children that, if they go through treatment, whatever they need, a year, a year and a half, we see changes. We see transformation, not just symptom reduction, but we see a child that begins to, you know, develop a relationship even with self. That was a turn, another turning point for me.

 

Kim Howard  31:22

Yeah, that’s, that’s a great That’s a great story. Thank you. And I, I don’t think if anybody’s out there, and I think people in the therapy world, of you know, probably experienced working with vulnerable populations, maybe in or out of the system, I’m not really sure, depends on your kind of a practice that you’re doing and kind of work you’re doing, but for the average person out there who’s not in the therapy world, I don’t…unless you’re a foster parent, or unless you’ve been in the foster care system, I don’t think you understand how traumatic that is and how awful that is. And I remember, I think it sort of became a realization for me many years ago, when we lived in Virginia, I worked, I did some freelance work for a local magazine, and one of the groups that we had there did some kind of donation thing where people would donate luggage for children in the foster care system. And I was like, what? Why do they need luggage? And that’s because when the children are taken in the middle of the night, their their belongings are put into bags, they don’t even have a suitcase for themselves or a backpack for themselves of their stuff. And I’m like, my god, that’s horrible. I mean, another situation they’re in is what much more horrible than that fact, but just that, that kind of constant thing that happens to them as they’re processing through the quote, unquote system that, in and of itself, is traumatic, much less what happened to get them before they even got into the system. And so, yeah, there’s a lot to unpack there for you guys who work with children and people that are in the foster care system. So I’m just grateful that somebody’s out there doing that work, because they need it. So…

 

Ana Gomez  33:08

Yeah, and also think about this. I mean, this is a major traumatic event, just having to move out of your home, out of what’s familiar for you, even if unsafe, is still what’s familiar, that in itself, is traumatic. But many of these children have experienced in the first 5-6-7, years of life, more trauma than many of us in a lifetime. And then there is separation and deep attachment ruptures. They grew up maybe with parents that were physically, emotionally, sexually abusive, or parents that were utterly unavailable, very impoverished relational environment, and children that often they don’t know what’s safe? You know, I can’t tell you how many times I asked a child for a safe place and they didn’t. They…they didn’t know what’s safe, what that is. They couldn’t find a safe place because that was foreign to them. They didn’t have any memory systems holding experiences of protection, safety, reciprocity from others. And so their relational templates are, you know, they hold the lack of trust, the fear. I don’t trust adults. I don’t think they can hold me. They cannot protect me. So they come in. That makes it also quite challenging the therapeutic process is that they come in with relational templates that were formed through survival and trauma, yeah, and that’s

 

Kim Howard  34:52

I mean, and I don’t know what the statistics are, and I know that there are a lot of good foster parents out there, but you know, you’ll see the news story pops up about some foster parent who was abusive to a child who was already pulled out of a situation, and you’re just thinking, Oh, my God, now this poor child has been doubly traumatized. You know, they went out of the frying pan into the fire, so to speak, with that analogy. And so you can’t always assume that you know that they’re in a safe place, and they even know what that means at that point.

 

Ana Gomez  35:22

Yeah, and the thing is, we have to acknowledge that our system needs to do better. It’s a dysregulated system across the board, from the mental health system to the judicial system, judges, attorneys, they need a much greater understanding of the impact of trauma, and especially developmental and complex trauma, so I have done some work at that level, in teaching attorneys and judges about the core and center of complex trauma and understand the child’s behaviors not as something that we have to get rid of or we have to give points to the child so we reduce the behavior, because children communicate through their behaviors that there is something that is not functioning well, And so we need to really explore the symptoms, the behaviors, to understand what is it the child is communicating. And it does require a shift in in our field, and it requires that we all including EMDR institutions across the world, where we need to give more to the child clinicians, right that we need to support our child clinicians more. And for example, the EMDR basic training is highly focused on just adults. Some of us have added hours to it, but there is a strong focus on adults. I mean, this is something that I have advocated for in terms of giving our child clinicians a little bit more than what they are receiving currently.

 

Kim Howard  37:16

Yeah. Thank you. Are there any myths that you would like to bust about working with EMDR therapy for complex trauma and dissociation?

 

Ana Gomez  37:26

Well, there are a lot of myths when we don’t understand complex trauma and dissociation. So I do invite people to dive deep, a little bit more and study and learn about the topic. And another book, book that I co edited with Jill Hosey was released in March, is the “Handbook of Complex Trauma and Dissociation in Children.” We have 47 chapters in over 60 contributors from around the world, and we all went deep into exploring, not only the theories therapeutic relationship, assessment, symptomatology, different therapeutic modalities. And I authored the chapter on dissociation and in complex trauma and EMDR. So this is a comprehensive chapter in terms of how to work with this population, not to fear it, but to respect and honor what our children have done in the service of survival. So there are myths in terms of if you have a client with complex trauma or dissociation, EMDR is not appropriate, is the one that I hear the most. And EMDR, newly trained EMDR clinicians tend to think of EMDR as just the processing phases, and I always remind them EMDR therapy has eight phases. It has a preparation phase, so it has time for supporting the client in developing capacities, expanding their affect tolerance, increasing integrated capacity, stabilizing before we move into processing. Some people believe EMDR could be EMDR therapy is too activating for people with complex trauma. Certainly can. Can activate rapidly memory systems that hold traumatic material. However, part of delivering EMDR therapy is to do it in a way that honors the capacities of the client that we have in front of us, and this is why advanced applications where we tie trays, where we enter the memory systems through portals that may access just a small portion of the trauma. So EMDR therapy can be incredible. An amazing with this population, and it’s a myth that we cannot work with them, and that EMDR therapy will be too much. And also with dissociation, of course, we’re going to be working with dissociation, and we’re going to enter processing sessions, where, while processing, the client may present with some level of dissociation, we just want to make sure the client has enough presence, just enough present to maintain that dual attention the Shapiro so much spoke about and keeping the client present enough to do the work we’re working on the edges of the windows. Of course, there’s going to be effective and somatic activation, and there is going to be dissociation, but it’s up to all of us to get advanced trainings consultation to be able to work with this population. But certainly we can help our most traumatized, and the clients that have been exposed to complex traumatization, and especially children and adolescents. And one more in terms of we’re all afraid of dissociation. And again, I wouldn’t say that it’s fear, and some people do, they may feel afraid that’s not helpful, because we need to embrace our clients that also present with some level of dissociation, where it’s mild, moderate or severe. But we honor the client’s capacities, integrated capacities. We honor where they are, and we enter those memory systems with meta perceptions emotions and somatic and behavioral schemas with respect. We honor the rhythm of the client. We honor where they are. We co create states of safety as they can tolerate them, and we arrive to a place of integration that makes sense to them. We don’t define the integration the client will, right? So it’s not about let’s jump in and just forget about the dissociation. We have to honor and respect it as well. So it’s not one or the other somewhere in the middle.

 

Kim Howard  42:21

You may have already answered this, but I’m going to ask it anyway, in case you have anything else you want to share. What advice do you have for EMDR therapists listening on how they can help these clients?

 

Ana Gomez  42:31

Yeah, well, I think it is important. Number one, there are many pieces that we have to do. One is get consultation, and you have to get advanced trainings quite often. We don’t, I don’t remember seeking the clients that were dissociative. In fact, I didn’t know they dissociate. They were dissociating. I had n idea. And when clients that were presenting with dissociative symptomatology, they dermatology, I remember my supervisor saying, well, refer them out, and then who has knowledge and expertise back in the days and even now, so I had to learn to read, to attend trainings, to get consultation. And the other piece here is we have to do our own work, because when we work with complex clinical presentations, our relational capacities, our mentalizing capacities, are fundamental in the process. As we these clients go into deeper layers of self, they look for the other, the relational to change this relational template, we need the the capacity of the clinician, to be present, to be curious, to be compassionate, and to be able to hold The client’s mind in mind while holding their own. That’s what we call mentalization. So doing our own work is transformative, and receiving EMDR therapy is transformative for the helper. I think those, those three components are fundamental, and no EMDR therapy. Sometimes we deviate from procedural steps. I emphasize case conceptualization, moment to moment decision making in the therapeutic process. I really encourage my students, my consultees, and the people I come across with doing EMDR therapy that they have questions the case conceptualization. How do you make decisions? But this moment to moment, decision making needs to be conscious so we understand how we’re responding and why we’re responding in the way we. Do and when we deviate. So we deviate from mastery, not from not knowing our procedural steps. So I use the analogy of the dancer I used to be many years ago. I love dancing, and when you’re dancing and you learn complex choreographies. First you train, you do it over and over and over again, you study them, your practice. And the moment comes when it becomes a piece of art. The moment comes when you start dancing, and from your heart and the movements are not just isolated movements, but there is cohesiveness and coherence in that piece of work. The choreography comes together as a piece of art. It’s not different for EMDR, we have our choreography, we have our steps, just like the dancer of musician that’s the same way as they do. As we know it. Well, we embrace it, we study it. You begin to dance with EMDR therapy. You began to make decisions, very conscious, intentional decisions, moment to moment. And certainly even when you deviate, the deviation becomes an intentional decision.

 

Kim Howard  46:26

Great advice. Thank you. Anna, what would you like people outside of the EMDR community to know about EMDR therapy with this population?

 

Ana Gomez  46:37

Well, I hope they become interested, because they’re missing out without EMDR therapy. I think EMDR therapy has a lot to offer. It in many offerings that we starting just to understand, even the rhythmic movement I was just reading the latest book of Dr Linus in terms of sensory systems and in how we embrace that in trauma processing. And what I see in EMDR therapy is that we embrace top down and bottom up processes, that we embrace sensory systems that are altered and impacted by trauma, especially complex and developmental trauma. So what I have to say is be curious about EMDR therapy, just like many of us have, and experience it and then that will help you make the decision to get trained, hopefully.

 

Kim Howard  47:47

How do you practice cultural humility?

 

Ana Gomez  47:49

As an EMDR therapist, cultural humility is a topic that I very much appreciate, and it’s not something the way I see is not something we achieve, something that we practice on a daily basis. It really means that we approach others with openness, that we approach others with curiosity, and we are aware that we don’t know everything, and that we are humble, and then we have humility, in openness to get to know the other when we enter that the we space. This is a term from the an Segal, the relational terrain with the other. We enter in humility because they are the experts of their lives. They are the experts of who they are, not us, right? So we have to, as we enter that, that relational terrain and that we space, we reflect constantly on our own history. So we hold our minds and mind, we hold a cultural lens. We also hold the knowing of privilege and how that can impact the therapeutic relationship, right? And again, we go into intentional decision making. What kind of therapeutic decisions I make based on the assumptions that I’m making and how my own history, ideology, belief system, religious beliefs, cultural beliefs, influence this relational terrain, the therapeutic relationship. So I truly believe that an EMDR therapy in trauma work in general, cultural humility also means understanding that trauma is not occurring in isolation, right? That many of our clients also have been shaped by systems of oppression, for example. So understanding how all the procedural steps of EMDR therapy, the eight phases of EMDR therapy, are held relationally, and in that relationship, where is the person of the therapist, right, and how my own lenses influence what I see, how I interpret and how I guide the therapeutic process. And that requires that we’re willing to travel into ourselves and understand self in the person of the therapist.

 

Kim Howard  50:45

Good answer. Thank you. Ana an if you weren’t an EMDR therapist, what would you be?

 

Ana Gomez  50:50

well? So when I was young, believe it or not, I wanted to be a philosopher, and before psychology, I wanted to study philosophy. I was quite young. I was 16 years old, so my parents and my family were like, What are you going to do? And I kept saying, what was the problem with being a thinker if I was not and let me say this, because there are so many moments throughout my journey as a clinician where I am accompanying another client, another mind to find healing and realize wholeness, I have this deep sense of knowing that this is what I came here to do, that I would not do anything else beyond this, there are moments of writing, which is the calling of my heart now, there are moments where I reflect. I think this is why I’m loving writing and teaching, because that 16 year old is saying, Yep, you want it to be a thinker.

 

Kim Howard  52:08

And now look what happened.

 

Ana Gomez  52:12

I turned around, picture me in my office, just sitting down, really reflecting upon something I just read, something I just wrote, and really thinking about about life. So if I wasn’t a therapist and a writer and a teacher, which I love teaching, I will be a philosopher, probably, or someone that studies the stars in this vast universe. That may be another one, and certainly I will continue to dance. I love dancing and movement.

 

Kim Howard  52:53

Yeah. Well, those are all talents that you have. My mom used to tell me when I was growing up that God gives you 10 talents, and you’re it’s up to you to find out what they are. And if all those things that you just named, you know, author, writer, teacher, dancer, you know, thinker, all those are your talents, along with the therapy, along with your profession. And so, um, that’s that’s great that you’ve, you’ve found all those things that fill your soul and feed you up. Feed you your soul and fill you up. So that’s great. Is there anything else you want to add?

 

Ana Gomez  53:25

No, I just want to express a deep gratitude for inviting me. I’m grateful that you’re giving me the space to share it with you, little bit of my work and share with your audience about my own mind and you know, all the stuff I think about often,

 

Kim Howard  53:50

We are happy to have you on and that’s a great way to end the podcast. Thank you. Thank you so much. This has been the Let’s Talk EMDR Podcast with our guest, Ana Gomez. Visit www.emdria.org for more information about EMDR therapy, or to use our Find an EMDR Therapist Directory with more than 17,000 therapists available. If you like what you hear, please subscribe to this free podcast wherever you listen. Thanks for being here today.