Kim Howard  00:00

Kim, welcome to the Let’s Talk EMDR podcast brought to you by the EMDR International Association, or EMDRIA. I’m your host, Kim Howard. Let’s get started. Today, we are speaking with EMDRIA Certified Therapist and Approved Consultant, Bethany Warren, to discuss the myths surrounding EMDR therapy for the perinatal and postpartum periods. Thank you, Beth, for being here today. We are so happy that you said yes.

 

Bethany Warren  00:28

Ah, Kim, thanks so much for having me. I really appreciate it. It’s such an important topic, obviously, near and dear to my heart, since it’s my specialty, but I love, love, love being able to chat with you about it. So thanks for having me on.

 

Kim Howard  00:40

That’s awesome. Beth, can you tell us about your path to becoming an EMDR therapist?

 

Bethany Warren  00:43

Yeah, absolutely. So I’ve been in this field for 25 years or more now, working with perinatal populations, people who are pregnant, postpartum people who are trying to conceive or who have lost babies. And I’ve really it was only about halfway through my career that I eventually was trained and then became certified in EMDR. And it was honestly because I was finding, I like to call it like a ceiling of healing for my clients. I don’t mean it to rhyme, but it was that classic thing of you know, I was a CBT [cognitive behavioral therapy] girl, I was finding that, you know, using trauma informed cognitive behavioral therapy, a lot of mind-body techniques worked for a number of my clients, or it worked, quote, well enough, and especially where there was more complexity to their trauma, maybe they were experiencing reproductive trauma and loss, as well as having had childhood trauma, sexual trauma, where the wound the trauma was so embodied that man my clients were working so hard in session. It certainly wasn’t a lack of their effort, nor mine, but they just weren’t really breaking through, and sometimes we’re even expressing a frustration, or it was that classic disconnect of logically they knew, let’s say, they hadn’t done anything wrong, or they had done the best they could, or logically, they knew they weren’t at fault for their pregnancy loss or the the negative outcome with their cesarean Section or whatever it was, but they still felt inherently the sense of doom, like the other shoe was going to drop, or there were significant triggers they kept experiencing, or they kept talking in themselves in these negative ways. And it was often so confusing, both my client and myself, where I was like, but we’re doing all the things like we’re we’re trying all the things we’re doing, all the the therapies, right? And so I just have always been a lifelong nerd, a big time research nerd, and I love attending trainings. I just was always eager for figuring out, what else could I offer my clients for peace and healing. And I kept hearing about EMDR from colleagues, and the more I researched it on my own, I just kept thinking, you know, I think this is potentially the missing piece, especially this bottom up approach idea. And I attended my first training, and it was like, Yes, yep, this is it. And Sure thing, you know, as soon as we get basic training weekend one and start practicing our clients, I mean, I just saw this absolute transformative experience happening with my clients in terms of, this was the missing piece, and so I just really started applying it with the majority of my clients, and saw really the missing part there. So that’s kind of it in a nutshell.

 

Kim Howard  03:42

That’s a great story, and thank you for sharing that. And I will mention this again. And for those of you who listen to the podcast regularly, I’m sorry that you have to hear me say this over and over again, but it’s for anybody new out there. When somebody walks into a therapy room, the therapist really has to approach it sort of in a customized way. Yeah, they’re looking at the client and they’re trying to figure out, Okay, which one of the modalities do I work with is going to help this client the best? And so if you’ve tried therapy before, other forms of therapy, and it hasn’t worked for you, and you’re still having a problem, EMDR, therapy might be the solution for you. It’s just that somebody that you’ve been with hasn’t known about it, or had to, or had or doesn’t use it in their practice. And so please keep trying, because, you know, it’s like medication. You know, you don’t know if you’re allergic to something until you take it and you have a reaction, and you don’t know if any kind of form of therapy is going to work until somebody uses it on you for a while, and you either see good results, and it’s you’re pressing forward in a good way, or it’s not working. So please, please don’t give up.

 

Bethany Warren  04:41

Yes, oh, that’s such a beautiful way to say it. And that idea of feeling maybe some internalized shame or frustration or stuckness, I think we’ve all experienced, both as clinicians and as clients, and that’s where I really had this internal drive to figure out more what is. This missing piece.

 

Kim Howard  05:01

You’ve already alluded to it, but in case you want to elaborate, what’s your favorite part of working with EMDR therapy?

 

Bethany Warren  05:08

Oh, gosh, so many things. Sometimes I laugh that we sound like zealots who are so just passionate about this work. But to your point, what you were talking about the flexibility of it, but also the adaptability just how comprehensive This is, by far the most comprehensive treatment I have ever discovered, that it does interweave so nicely. I remember on day one of my basic training all those years ago, almost having a panic, like feeling like I was a fairly seasoned clinician at that point, I’m like, wait what? I’ve got to drop all the things that I already know so well, like DBT and CBT and all these things, like, you know, exposure, response, prevention. I have to drop all these things and feeling incredibly relieved and empowered when I saw it and also was supported by the trainers. Actually, this is comprehensive. In this, it really is such a robust therapy that can interweave all of these various modalities, because it is so client centered. This is such a collaborative, you know, there’s not that power differential, but we’re going to collaborate together on what’s going to be the best approach for the client, and also, again, that bodied, embodied aspect with so many of our clients, but especially in the perinatal spaces, that bottom up approach is just so crucial. Even when a client is really needing to tell their story, maybe this is the first time that they’ve been able to share their story in a complete way, or with someone who isn’t judging them or interrupting them to give them the toxic positivity messages, or, you know, insert themselves, that we’re doing so in a pacing way, that we’re pausing and checking in on on their body, that we’re using the stabilization skills that you know that EMDR really is the full eight phases. It’s not always using the bilateral stimulation. In other words, that we’re we’re really pacing the work all throughout.

 

Kim Howard  07:11

Yeah, absolutely. What are the specific complexities or challenges when offering EMDR therapy during the perinatal and postpartum periods?

 

Bethany Warren  07:19

I love how you enunciated. That there is a lot of Ps with this work.

 

Kim Howard  07:24

Yes, I am just glad they’re not S’s because I used to have a lisp when I was a kid, and sometimes it shows up if I’m not paying attention.

 

Bethany Warren  07:29

Oh, well. And with a microphone too. You know, I’d mentioned pacing, but to talk about that a little bit more with the reproductive period, pacing is so important with this work that is not often present with many of my other non perinatal cases. And of course, pacing is always important with trauma work period. But by that, I mean why it’s a bit unique with reproductive clients is that, you know, they’re also needing to incorporate all other aspects of their lives and tend to other aspects of their lives, and we’re we’re building and resourcing. And I don’t always mean that in terms of the like stabilization, classic phase two aspect of of building resources, although there’s that aspect too. But for so many of our perinatal clients, we’re pacing our EMDR work because they’re also tending to so many practical tasks of a pregnancy and parenthood. Maybe we’re addressing sleep because sleep deprivation is no joke and sleep is is so much another present character in the room. You know, we’re addressing the relationship with their partner that has been greatly impacted, maybe communication with their support people, or even building support, because maybe they don’t have any, especially here in San Diego, where I am, we’re a big military community, and so a lot of people I work with have zero support locally. And so becoming a new parent that is so crucial that we’re, you know, kind of pacing our work, because we’re also helping them build just a foundation of support. You know, maybe there’s distress around like breastfeeding and chest feeding, and we’re helping them connect to resources there, as well as starting to slowly develop a trauma treatment plan, identifying some targets there. Maybe we’re helping facilitate time off work and parental leave, connecting them with a psychiatrist managing medication referrals, child care challenges, you know. So there’s all of those aspects that are really unique to working with this population. The other thing that’s unique is that baby is oftentimes in the room, and I’m kind of embarrassed to admit this, but I always feel like, let’s talk about it, because if I know I dealt with it. Other people probably dealt with it when I was a brand new little baby EMDR therapist, because not many people were doing this work at the time or specialized in this work. I didn’t have a lot of peers or mentors to be able to draw from, so I was just out there kind of bumbling through it. I didn’t know that. It would be okay to do EMDR while the baby was in the room. And so I erroneously was thinking, Well, gosh, we probably have to wait until this parent either has one child care or the baby is sleeping. And as a result, early, early days, I probably was suggesting to my client that they were needed to wait, when, in fact, they didn’t need to wait. And eventually I kind of was realizing, like, why are we doing that? Like, if they’re game, I’m game, let’s just try to see. And thankfully, I had some clients that, first of all, were just suffering, and they were like, I don’t want to wait. But second of all, we’re game to just try. And so that’s another unique I wouldn’t necessarily call it complexity, but I would say aspect of doing this work is Be bold. Try incorporating the baby, and it’s actually really super successful. And there’s some really cool attachment benefits from it. And it’s neat to see how there can be like a like, the dual attention aspect can be helpful. There’s nothing like feeding a baby that can help keep you rooted in the present while also not catapulting back to this memory that you’re working on anyway. So that can be something that comes up and then, I guess last, but probably not least, I’m sure I’ll think of other things. Is attachment, attachment threads. Because I, you know, speaking of the baby in the room thing, attachment threads come up with almost every single perinatal client and attachment, meaning their own attachment styles and patterns from childhood tend to be tugged at. And, you know, it kind of come up in various ways that are probably surprising and tender for them, but also, of course, they’re developing bond throughout pregnancy to this baby as well, as you know, postpartum as well. So attachment is a through thread. We do a lot of attachment work.

 

Kim Howard  11:58

That’s great. And I remember when our children were newborns, I feel like the sleep pattern thing didn’t happen for weeks after the baby was born. Like, I couldn’t predict, especially with my firstborn, I couldn’t predict when he was gonna nap. Yeah, I mean, I didn’t even realize I was so young and dumb as a mom. I didn’t even realize you’re supposed to put them down for a nap, even when they don’t, you don’t think they need one. Like, I just was like, well, when he’s tired, he’ll just go to sleep. Well, that was a mistake, because then he got over stimulated, and then he couldn’t go down to sleep, and so he Yeah, I could imagine, wait for your therapy appointment until the baby’s asleep. You’re like, well, I don’t know when the babies go to sleep, so I’m glad that you figured that out early in the in the EMDR therapy career path, that that was not going to work for the new, new parents.

 

Bethany Warren  12:40

So that’s why I say that. I’m embarrassed about it, but I also feel like, let’s just share so that maybe other people can learn with a lot of my consultations too, that they’ll share with me that they too thought that you can’t do EMDR while a person’s holding their baby, or while baby’s even in the room. And so we

 

Kim Howard  12:59

Yeah, and there are some myths out there, and we’ll get to those later. But the first one, let’s address it now, yes, you can do EMDR when you’re pregnant,

 

Bethany Warren  13:07

Yes

 

Kim Howard  13:08

And postpartum.

 

Bethany Warren  13:09

Yes

 

Bethany Warren  13:09

And, myth number two, yes, you can do EMDR therapy with the new baby in the room. So.

 

Bethany Warren  13:14

Yes, we’ve dispelled two myths already. Yes, we have, yeah.

 

Kim Howard  13:18

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

 

Bethany Warren  13:22

Oh, my gosh, so many. I mean, we could do like three hours on this. I just am so so grateful again for this mind body connection, the bottom up approach. What I love so much is watching clients be surprised by their own transformative experience, reparative experience, that they go to places that they didn’t even think were possible. And I say that with such gentleness. You know, even folks who have lost a baby and come in saying like, I will never be able to experience joy again, or I will never be able to have another baby and love a baby like I love this baby, or I will never feel whole again after this birth trauma. I will never feel, you know, whatever it is that they’re saying and then find such transformative experiences. And Kim, you and I know that it’s not me then saying anything I’m not, you know, planting a seed. Now it’s like, well, but maybe, and that’s where I’m so grateful for that the power of our clients, own brain, doing the healing, and that I’m so much staying out of the way and just watching, but just that transformative healing of watching people, you know, heal from past experiences. And so, you know, we just spoke a little bit about attachment. So people who are healing from tremendously challenging childhood wounds while simultaneously becoming their best selves as a parent, is truly like goose bumpy to watch. That’s where I really feel so. Led to this work. It’s really breaking some multi generational patterns, drawing on their multi generational strengths and individual strengths, but also breaking some of those really painful patterns to then become a different parent than the one that they had or the parent that they needed, parenting their little inner self while simultaneously parenting their little baby like, oh, chef’s kiss.

 

Kim Howard  15:27

Right? Yeah, like my mom used to say that anybody can have a baby, but it takes somebody special to be a mother. And I remember that because, you know, you look at sometimes the well, you guys see it more than I do, but I when I read about it in the magazine or blog post, and the things that parents, quote, unquote, parents, I use that term loosely, say to their children, and they either they realize they’re inflicting the pain, or they don’t realize it. But I just read something the other day in an article, and the dad had told the son that he was his biggest disappointment in his life, and I thought I just wanted to reply back, I think that guy should be hard and feathered for saying that to his child. I mean, you know, so you’ve got people who are dealing with parents who parented them like that, and then they’re trying to become a parent, and then they’re, they’re thinking about all of those things, you know, they had grown up that were negative, and trying not to pass that along in their relationship with their newborn, and so our future newborn, and so, yeah, it’s, it really matters. And so, you know, unfortunately, there’s lots of parenting books out there, and you can read all you want to, but not everybody, not everybody gets it. Doesn’t matter how many resources we have out there. Some people just shouldn’t be parents. So unfortunately, you know, the people who are the children of those people have to deal with it, and so EMDR, can help you with that.

 

Bethany Warren  16:46

And what I would add to that, Kim is like, my heart just goes out, not to just the example you gave the son who is hearing this harmful message, but frankly, to that dad who is giving and it makes me wonder how then he was parented. That’s where, like, these generational patterns oftentimes get passed along, unless there’s an intervention or support. And truly, everybody is deserving of support and intervention. And that is where, oftentimes it is so such an honor to watch this, this transformation happen. People are often sitting in our offices, healing from such such wounds of abuse, neglect, such such awful harm caused by their caregivers, and then to watch them transform from that and become a better parent for their own child, I’m telling you, oh my gosh, Chef’s kiss. Also watching people have new relationships with their bodies after former experiences with sexual trauma, with, you know, abuse, etc, and then it becoming apparent themselves. Because, as you know, as I was talking about, just being pregnant is such an embodied experience, even going through, let’s say, infertility treatments, you know, going through birth, postpartum, healing, it’s all so embodied. And so if a person has had a really tenuous relationship with their body, maybe with disordered eating, or maybe that, you know, dissociation and disconnect with their body at various times, this can be a really vulnerable time. So that’s another transformative and powerful experience that I’ve seen with EMDR, with this population as well, especially when then they feel so much more empowered and mindful and present in their body as they’re, let’s say, in a pelvic exam, or even being able, as we, you know, Coach and prep for it to be able to talk to their provider in a certain way. Maybe we’re even doing like a future rehearsal to prepare them for one of their upcoming treatments, etc. So, yeah.

 

Kim Howard  18:52

That’s amazing. Yeah. Beth, are there any myths that you would like to bust about working with EMDR therapy for the perinatal and postpartum periods?

 

Bethany Warren  19:00

Little bit. Kim, I’m so I’m so, so grateful. You’re asking me that. Because honestly, even though I was so grateful for my trainer initially in basic training, even that trainer specifically said, Don’t do EMDR with people who are pregnant. And my hand shot up in the air. I was like, wait, what I like? This is the the majority of the people I work with. Can you explain why? And what was so interesting is that trainer couldn’t explain to me why. I just like, it’s probably not safe. Please don’t do it. I’m paraphrasing, of course, right? What’s sad is, even though that was a long time ago, I continue to hear that that is actually one of the most common reasons why people come to me for one off consultation. Actually, you know, people, of course, come to me for certification, for consultation, for basic training, for specific perinatal mental health consultation. But I…people will often come to me for consultation because they heard somewhere along the way, whether it was at their basic training or from their consultant, or someone has told them you can’t do EMDR with pregnant clients. And maybe they have either a pregnant client or this is their specialty, or maybe they work with Trauma Recovery Network, and they happen to be working with, you know, an emergency experience, like the recent wildfires in LA and someone is pregnant, and they’re like, well, shoot. What am I to do? Like, is this actually a thing? So this is the biggest myth that I would love to dispel. I really am trying. I always try to lead with compassion and curiosity, and I think that the myth exists out of an abundance of passion. I really do think people are trying to be well intended, and it’s probably because of thinking about the viability of the pregnancy, that being said, I think it’s rooted in fear, and it’s not having on the the information. And I really wish if you didn’t have the information, that you would go get the information, or even say, you know, I don’t know. Let’s go find it together. Because here’s the thing I really want people to know there is no evidence that EMDR with pregnant people is unsafe. In fact, it’s the opposite. We have a number of randomized control trials, as well as case studies that show that EMDR with pregnant people is not only safe and effective, but there are numerous benefits to doing EMDR with a pregnant person. We see, you know, decrease in PTSD symptoms. We see a decrease in overall distress, decrease in depression and anxiety symptoms, decrease in fear of childbirth. And by the way, that one’s a really important one, because fear, having a fear of childbirth is one of the number one predictors of then having a traumatic birth experience. If someone goes into their birth with having an an overwhelming fear of childbirth, that is one of the biggest risk factors for them having a traumatic birth experience. So helping them decrease their fear of childbirth is a huge, huge benefit EMDR therapy, there’s also decreased intrusive thoughts and just overall increased confidence about their delivery, not to mention, of course, a successful reprocessing of what traumatic and distressing information brought them into therapy for the in the first place, you know?

 

Kim Howard  22:43

Right? And it makes sense what you say, because, as we know from Dr. Bessel van der Kolk’s book, The Body Keeps the Score, where he talks about how your body takes on all of the trauma that you’ve experienced. And so if you have that trauma in you, you’re passing that along to your baby. There’s been studies out there about, you know, how that is intergenerational. They studied women who have been in very traumatic situations, and whether that trauma is then passed on to the child. And so it would behoove you, as somebody who was pregnant, to get that out of your system. No pun intended, in terms of getting the trauma to go away from your body and be released. And so really, the only way that you can do that is through EMDR therapy, in terms of getting rid of that trauma. So that’s a good point that you make.

 

Bethany Warren  23:28

Yeah, and I’m so glad you talked about that. In terms of that embodied trauma and stress. There has been research that shows that traumatized women, the study were done on women with PTSD during pregnancy will sometimes have 10 times the amount of cortisol. And we know that EMDR provides symptom reduction and cortisol reduction, which is helpful both to our pregnant clients, but also the developing baby over time, because, you know, there are such negative impacts on developing baby when there is pervasive and chronic stress that haven’t been addressed. And I say this very gently, I say this anytime I’m providing a training or on a podcast, recognizing that there are probably parents listening that were stressed during their pregnancy who is not stressed at some point. That is a natural part of being a human especially right now, these are very prickly, tough times, but what we’re talking about is pervasive and chronic distress that isn’t supported. And so if we are withholding or potentially even gate keeping trauma therapy out of our own fear as a clinician or our own misinformation as a clinician, it’s not helpful to not only our pregnant client, but then this developing baby, because we know so many studies are out there in terms of the negative impact on a developing baby where there has been parental and maternal stress, like smaller birth weight, preterm delivery. Have negative emotional regulation problems throughout a lifetime, mental illness, health, illness. You know, I firmly believe that aces, that adverse childhood events, one of them should be your parent while pregnant, having distress should be one of them too, because we see such negative impacts. So if we have, in other words, therapy that can provide all these symptoms being reduced, and why? Why would we hesitate? Why would we just sit in resourcing and why would we just sit in stabilization zone? Even though those are important skills for a client to develop, they’re not going to fully help a client reprocess, rewire their nervous system in their brain, you know.

 

Kim Howard  25:43

Yeah, thank you. So you’ve already mentioned a little bit of this, but in case you have anything else to add, what advice do you have for EMDR, therapists listening on how they can help these clients?

 

Bethany Warren  25:53

Yeah, you know, I just want to again, maybe gently or not gently, so gently, say if you’re afraid, it’s okay. It truly is okay. There are populations that I don’t specialize in. We we all don’t have to be experts in all populations. We sometimes will get clients reaching out to us that we’re like, well, shoot, I I don’t know how to help this person. It is okay to refer out. It’s also okay to seek consultation. I shouldn’t say it’s okay. I recommend that you seek consultation and and, you know, advanced specialty trainings if you are going to keep working with a pregnant or and or postpartum client, especially if you’re noticing some hesitation on your part, or if you are wanting to work with this person, but if you’re getting maybe some mixed information, maybe from a consultant of yours. Or, like I said, if you had heard in your basic training to not do EMDR with a pregnant client, or, you know what else I hear sometimes, that’s another myth. Is like, well, you can do EMDR with pregnant people, but just wait till after the first trimester. There’s so many iterations of this. Or they’ll say, you know, you can do EMDR while they’re pregnant, but only work on perinatal content, like, don’t work on like childhood trauma. Only work on their fear of, you know, the birth or what have you. So in other words, if you’re feeling nervous about this, please get consultation. There’s a number of us who specialize in perinatal mental health and are proved consultants. If you are at all hesitant based on like, your lack of experience in working with pregnant and postpartum folks. Or maybe you are eager to keep working with this particular client, but maybe you are now confused by some of the information you were given, and maybe now hearing my voice in your head and wondering, like, what to do, it is totally okay. I would rather you name it for yourself and then seek consultation and support, or know when to refer out, because it’s all right, we don’t all have to have expertise in all different populations. It that is impossible to do. So you can either see consultation. There are a number of us who specialize in perinatal mental health and are approved consultants. There’s also specialty trainings out there. I did one, for example, that’s available on demand with Trauma Recovery Network, EMDR, humanitarian assistance program, or hap for short. I know there’s several available touch tone Institute as well. Or, you know, the other thing to just name is, I would really strongly caution you from just staying in phase two. I hear this a lot, is that people think, because they have a pregnant client, that they just really need to sit in stabilization and building resources and skills, and not because of what the client needs clinically, not because of what the client needs, because of their window of tolerance or lack of readiness, but simply because they’re pregnant. And I say this maybe a little bit tongue in cheek, but sometimes clinically, the least interesting thing about our client is that they’re pregnant. It’s actually you know, that they are ready for EMDR, otherwise, that they have the adaptive information needed, the readiness in terms of, you know, window of tolerance, etc. But if it’s your own hesitation that’s holding you back, then please do seek consultation. And you know, the other thing I was thinking about is there are a couple other iterations of these myths that show up. And one is that idea of, okay, yeah, yeah, you can do EMDR while someone’s pregnant, but wait until after they get out of the first trimester. And really, this is just kind of a an iteration of that idea of of gate keeping. I think it’s probably out of an abundance of caution, because the majority of losses do happen. In the first trimester. Again, there is no evidence to support that there have, there have never been any unsafe or adverse experiences with EMDR. Randomized control trial. Studies have been neat, showing EMDR versus CBT, for example, that there’s been no adverse experiences. And by the way, as an aside, I have never, ever heard in any other training. DBT, trauma focus. CBT, you know, prolonged exposure. ERP, I’ve never heard anyone else ever say, don’t use this therapy with with pregnant individuals. It’s so interesting that this gets thrown around with. EMDR, so I just want to say that as an aside, you know.

 

Kim Howard  30:42

Yeah, absolutely, and we’ll get to this question later, but we do have resources on our website that are open to non members. Our focal point blog is one of them. And members have written several articles about EMDR therapy and Perinatal population, and we’ve done a couple of podcasts about that as well, so people can look in the EMDR library and search and find those so they can go to the those landing pages and search within those, each of those publications. And by the time this podcast issue comes out, our perinatal issue should be coming out a summer issue, q3 so I think it’s going to be published sometime in late July, early August. So we have a whole issue on that. Granted, that’s for members only. But given, given the subject matter, we had so many people reach out to we had more authors, potential authors reach out to us than we had space for that is how hot this topic is in terms of people out there who are providing this service, and the fact that they want to spread the word about how it can be done and done well. And so that’s another resource, but yeah, so please do your research.

 

Bethany Warren  31:45

Yeah, and I love hearing that because, you know, there’s so many ways that this can show up people’s fears clinicians. Fear is primarily although sometimes I’ll hear it from other providers, OBGYN, etc, usually, though, it’s from mental health clinicians, and specifically EMDR clinicians. You know, sometimes you’ll hear things like, Well, okay, it’s okay to do to use EMDR therapy with pregnant clients, but only focus on, like, perinatal content, like, only work on, let’s say, her pregnancy, when the birth or when, that might not be why the client is coming to us. You know, maybe there’s significant family conflict coming up, or again, like these attachment wounds as they’re becoming apparent, they’re starting to really mourn and grieve the the parenting that they didn’t receive. Or there is significant work distress. Or, you know, that sense of, you know, identity layers and becoming a parent anyway, and starting to step back from work is really pulling on those threads, etc. So whatever it is that they’re working on, we don’t want to have to again gatekeeper dictate, no, no, we’re not working on that thing.

 

Kim Howard  32:55

Right, right. Absolutely. Beth. What would you like people outside of EMDR community to know about EMDR therapy with this population, you’ve already alluded to some things, but in case there’s something else you

 

Bethany Warren  33:05

want to add. I mean, again, it’s a very safe and effective option. The resources are out there to your point. The research is out there to be able to educate and empower yourself, especially if you do happen to have a provider who is questioning or wondering, if you yourself are wondering. And then I think the other thing that I’ve spoken to a little bit but is just that sense of trauma is cumulative, and it is very understandable that you might be heading into your reproductive journey and noticing things that you might have formally felt were, quote, resolved, or maybe that you had legitimately worked through, even in therapy, are now coming to the forefront again. And that might be sexual trauma, that might be a former loss, that might even be relationship patterns. And I know that can be very confusing and and maybe even really frustrating, and it’s not that you didn’t do the work before, and it’s certainly not that you are weak or that something’s wrong with you, but because this can be such an embodied time and and the trauma can be cumulative, your body can remember certain things that maybe logically don’t make sense to you Right now, and so that’s where trauma therapy can be really useful.

 

Kim Howard  34:24

That’s a good way to put it. Thank you, Beth, and you mentioned this earlier, that you are in the San Diego area, and so you have a lot of people who don’t have maybe local resources, because they’re in the military. And I was a military brat, and I totally understand that concept. So this question is probably good as well for you. So how do you practice cultural humility as an EMDR therapist? Because you are getting in the door people from all over the country more likely and every every walk of life, you could probably get.

 

Bethany Warren  34:52

Yeah, that is such a great question. You know, first and foremost, my client is the expert on them, and I really. Like practicing from an anti oppressive lens, this collaborative lens, EMDR, is inherently very collaborative, client centered. It is not prescriptive. It is we’re going to go at the pace of where the client is. And what I also really love about the work is bringing choice and agency and autonomy into the work together. And sometimes that’s very small and subtle, in terms of, like describing with informed consent, the this is when I’m talking about, this is what I’m recommending. What do you think? What do you want to work on today? Sometimes it’s, it’s, you know, in terms of as we’re actually in the middle of reprocessing a memory, just paying attention to cues and asking, Are you needing to stop? Are you needing to pause this work, you know, especially for a client who has had, let’s say, sexual trauma, or reproductive trauma where choice was stripped from them, or maybe they were coerced, overpowered. How reparative that can be, to then have choice brought into the room, and especially when there’s layers to it, if we’re working with a client, let’s say of color, who has experienced systemic racism and oppression, to then have some semblance of choice and autonomy brought into this space, and especially if we are from different lived experiences. And the other thing to name is that, unfortunately, perinatal mental health disorders, as well as PTSD, disproportionately, does impact not just women of color, parents of color, but also the LGBTQ parents community, due to so many different factors, systemic racism and implicit bias and inequities and safe and quality care, excuse me, and there’s been so much harm caused in the space of healthcare, especially with women of color and black women in particular, and so that can really show up in our work, in terms of, you know, feeling mistrustful and guarded. And there can be so many layers, like we’ve talked about, there’s trauma layers when it comes to trauma and compounding, but also in terms of how their reproductive journey was experienced. So I could go on and on about that. But again, my client is the expert on them and and sometimes exploring some of these impacts have to be done in a very gently paced way, and not in a prescriptive way, not in a, you know, one question in my paperwork kind of way, but very gently,

 

Kim Howard  37:39

yeah, absolutely. And it’s useful to know, I mean, you guys have to know a lot of things, but it’s also useful to know how women of color, especially have been treated in the medical profession, and how there were myths out there. And God, I hope they’re not out there anymore. They probably still are that that black women and black people in general have a higher tolerance of pain. So if you’re going through a process, you’re going through labor and delivery, and you’ve had a traumatic experience from the labor and delivery because you didn’t get the pain medications that you needed because some doctor thought that you didn’t need them. And so those kinds of things come into play in terms of the labor and delivery experience, at least. And so when you know things like that, you can sort of be a little more on the lookout. We did a podcast interview the first year the podcast came out with Ava Hart, I can’t remember the exact title, but I would be happy to put a link in this podcast description. And we talked a lot about women of color and birth trauma and birthing and those kinds of things, and how that happens. And so it’s important that the community knows that, because it’s it’s legitimately happening, unfortunately, still in 2025 I can’t even believe I have to say that.

 

Bethany Warren  38:50

But, yeah yeah, but we do have to say it, and we do have to talk about it, and those do exist. A couple years ago, a really important study was done on new medical residents and their perceptions of of pain and that they still 50 percent of them believed that black people experience pain differently than white people do, and that was only a few years ago. Yeah, we see disproportionate impacts on maternal and infant mortality with black women and black babies, even when they are decreasing overall that they’re still increasing in the black community, and that’s oftentimes due to implicit bias, racism. I always think of Serena Williams was such a great example.

 

Kim Howard  39:40

Oh, yeah, with the blood clot issue with it was her first baby, right? The first girl she was…..

 

Bethany Warren  39:45

Having to had a great um interview afterwards where she said, I saved my own life that even Yeah, women of quote privilege, meaning, you know, notoriety and being famous was still not listened to. She was. Literally screaming like, pay attention to me. I need a scan. I think I’m having a blood clot, and was still dismissed and ignored. And so these these stories are happening to our clients with great frequency. And so of course, it’s showing up in our spaces and very layered ways, because that probably was not the first time that they’ve experienced, being dismissed, ignored, overpowered, coerced, etc. And so when we’re talking about the layers of trauma, that’s often what’s happening is that might have been that reproductive traumatic experience, but then that there were layers in the past that, you know, get appealed, get appealed. Yep, there

 

Kim Howard  40:37

was an article, I think it was the Washington Post, within the last couple of years about is my doctor gaslighting me? And they actually use the word gaslighting in the headline, yeah. And it talked a lot about how women are often gaslit by their doctors, even if they have a female doctor, you know, and how, unfortunately, it falls to us individually. We still have to be our own, you know, advocate, and we have to make sure that we’re getting the best care that we can possibly get, and that our medical doctor is really listening to us, especially just not just for general care, but especially if you’re in a perinatal or postpartum situation. And so that’s one more thing that you know we have to deal with. And it becomes even more intense for women of color, especially black women you know, who are often ignored by the medical community and in general, black people don’t trust the medical community, and they have good reason not to, when they do experiments on you in the 1920s and they don’t tell you that they’re doing experiments on you, then there’s really no reason for them to trust you in general. And so you have to, you come into the therapy room and you’re dealing with a lot of that history coming forward that some people may not recognize is in their history. So it’s good to know that.

 

Bethany Warren  41:51

Thank you for brining that up. Yeah, yeah. And I’m so glad you added to that conversation. Kim, thank you. And you know that’s just another reason why it’s important that we don’t withhold trauma treatment if our client is asking for it and wanting it. Because think about this client, this, you know, pretend client, that we’re talking about, this woman of color, who is now pregnant and thinking about a birth that her birth in the future, that she’s terrified about, there’s all this historical trauma that she’s carrying, there is probably personal trauma that she has experienced, maybe in healthcare spaces, maybe in other, you know, systems spaces. And we know that if someone is in a trauma response, they often lack the capacity to speak up for themselves. They lack the capacity to articulate well, what they’re needing, what they’re thinking. You know, when you’re in a fight, flight, freeze or find response, you’re not really able to say, like, this is what I’m feeling, this is what I’m thinking, this is what I’m needing, right? And so this is the importance of the work that we are doing is helping reduce the distress, the trauma and processing through that which has previously been really fragmented, really embodied. And this is the unique aspect of working with reproductive clients, is that then we’re also helping prepare them for these various upcoming whatever it is, whether it’s you know, exam, pelvic exams, whether it’s their ultrasounds, which can be really tough for a lot of clients, whether it’s you know, collaborating with the sign release, with their providers, letting you know, helping kind of take a load off so that we’re doing the teamwork together, helping do a future template, future rehearsal for prepping for some of these events, for delivery, etc. So yeah, there’s so many ways of helping prepare and support this client.

 

Kim Howard  43:48

Absolutely. Beth, do you have any favorite free EMDR related resources you would suggest, either for the public or other EMDR therapists?

 

Bethany Warren  43:56

Yeah, one of my favorites is the it’s called the client history, identity, race and culture interview. It’s housed on the Diversity, Community and Culture SIG, the special interest group on EMDRIA [website]. It’s available any EMDR clinician can access it on there. I believe you have to be a member, to be able to do that. SIG, it is so useful. I really recommend and appreciate that. I recommend utilizing these questions, incorporating them into your intake sessions. You can do so in writing and or verbally, as you’re getting to know your clients, and broaching topics of identity and culture and race. But I also really, really appreciate it was an act of love and communicate, communication, excuse me, community, collaboratively, all the people involved. When you see the citation on it, I mean, there are so many people that collaborated together to create. This. So it’s it’s lovely. There’s even a video on there of people of color talking about what it was like clinicians of color. Excuse me, I’m talking about what it was like for them to start utilizing it with their clients. It’s great.

 

Kim Howard  45:13

That’s great. I’ll put a link to that, that SIG in the podcast description. Members Only have have access to that, but I will put the link in case there’s a member out there listening, who, who’s not familiar. Great. So they can find it very easily. So thank you for that. That’s That’s great. Yeah, Beth, if you weren’t an EMDR therapist, what would you be?

 

Bethany Warren  45:30

That’s such a cool question. I’m divided. I have written a couple books. I’m in the middle of writing my third. So I love writing. I think maybe I would just keep writing. Um, but a little curveball, I also love, love, love elephants. And so my husband, I have visited elephant sanctuary in Thailand and in Kenya, and we just enjoyed our experience so profoundly. So we always talk about retirement goals. Maybe we would go back and forth between Thailand and Kenya and volunteer with elephants.

 

Kim Howard  46:02

So yeah, that would be awesome. And that is the first time that somebody has mentioned elephant reserves on the podcast. So that’s awesome. I love I would imagine that’s not a company. Yeah, it’s not that’s pretty cool. Though. I like it. Is there anything else you want to add?

 

Kim Howard  46:16

I don’t think so. I think we have covered a lot. Thank you, Kim for having me.

 

Kim Howard  46:20

Thank you for being on the podcast. We appreciate it. Appreciate it. Beth Thank you. This has been the Let’s Talk EMDR podcast with our guest, Bethany Warren, 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. You.