How I became a Trauma Therapist
My path as a clinician into the space of trauma was an indirect and messy one. When I entered graduate school, I was steadfast in what I wanted my specialization to be: exposure therapy. The reason is that I am a former OCD sufferer who was able to get my symptoms into remission with the help of two good therapists. I spent years of my life plagued by feelings of dread and anxiety, and now I was happy and comfortable. I want to do that for other people, I thought. Reflecting on my career trajectory, I remember the Yiddish proverb, “Man plans, God laughs.”
It all began with desperation regarding internship placement. My university does not help with placement, and I ran out of time. I started cold-calling hospitals in the area, knowing that they were often hurting for help and would be the most likely to give me a shot. I was right; one of the first hospitals I called brought me on as an intern in their inpatient psychiatric unit. I went into the experience with an open mind and loved many things about the work. I am helping people in crisis and have learned valuable diagnosis skills you aren’t exposed to in outpatient settings. I learned to collaborate with a treatment team and knew I was heading in the right direction.
When it comes to the mindset regarding my career, the process has always been “When you see a door, go through it.”. So, when I was offered the position to help at the outpatient center, I immediately accepted. I wanted some new experiences, and this would bring me closer to the specialization I thought I wanted. I was given an individual caseload and a mental health group to facilitate at the Intensive Outpatient level of care (one step below hospitalization). This is where it became apparent that if I were going to be any good at this work, I needed to learn how to address trauma and related disorders.
I was a strict cognitive behavioral therapist when I entered the field. It worked for me and is the most studied intervention for a wide range of symptoms, and I was having pretty good outcomes with it. I still think it’s king for many disorders and continue to use it in some capacity with everyone I see. But something was missing. With severe trauma reactions, CBT lacked a crucial element that EMDR addresses wonderfully: a focus on bodily experiences. Being skeptical of any trendy intervention, I investigated the research with the intent to see why my instincts were right, and this is bullshit, but not only is it well-supported and works quickly, but without the homework piece CBT emphasizes that turns off a lot of clients. We debate WHY EMDR works (and they do take some liberties with the mechanism of action), but there is no doubt that it DOES work.
So, I attended a training where I underwent EMDR myself, and my experience matched what the data indicated; the negative cognitions and disturbances to the traumatic memory dissipated quickly. I knew I had to continue to pursue this to use it to help my patients. After my experience with EMDR and seeing its impact on my clients, I was aggressively pursuing more training. I continued that training for another year to achieve my certification, which has helped me apply EMDR to more complicated cases. And running an intensive outpatient program, there is no shortage of complex cases. I have seen fantastic changes in self-esteem and people’s level of functioning returning to levels they stopped believing was possible. Clients that had been kicked around different therapists and branded “treatment resistant” were getting better.
Fast forward a few years, and I am still running an IOP program (and probably will for the rest of my career). Still, I also built my practice where I make EMDR accessible to people with tricky schedules, seeing clients during the evenings and weekends and doing it through telehealth. The advice I received at the beginning of graduate school was corny: “Your specialization will find you.” However, as with many corny sayings that make us roll our eyes, there is truth behind it. I am grateful to be able to say with complete honesty that I ended up exactly where I should be.