Show Notes

Kayla: Welcome back to the Designer Practice Podcast and I’m your host Kayla Das.

Today I’m sitting down with Charity Lui, Registered Clinical Social Worker and private practitioner who will explain how to recognize stuckness in clients who have experienced trauma.

Hi Charity, welcome to the show. I’m so glad to have you here today.

Charity: Hi Kayla, thanks for having me.

Kayla: Charity, before we dive into today’s episode, please introduce yourself, where you’re from, and tell us a little bit about your own practice journey.

Charity: Sure. So, I’m in Edmonton, Alberta. I’m a Registered Clinical Social Worker and I am a mental health therapist and own my own practice. Calm River Therapy, Thérapie Calme Rivière, where I focus a lot on trauma, anxiety, and OCD.

So, my journey to private practice, it was during COVID time, there was lots happening in the world, we were kind of all locked up inside in our homes, and I took that opportunity to dive into private practice a little bit in the evenings and on the weekend. And found that it was really my passion. It was my intention to go into private practice earlier on in my career, but then I had really amazing opportunity to take a job with the Alberta College of Social Workers and did that for 10 years. And during COVID was a time really to get back into what kind of my passion was. And that’s what’s brought me here today.

Kayla: I know we have a lot of social workers, a lot of therapists, coaches listening to this episode. So, they might, know what trauma is, but can you explain what it is from a clinical aspect?

Charity: Okay. And maybe what I’ll do is I’ll talk about how I understand trauma, because I think there’s a lot of information and people might think about trauma in different ways. I was recently listening to a podcast where Gabor Mate was interviewed. And I really liked what he said. He said, trauma’s not just what happened to us, but it’s how it’s changed us.

And so, sort of building on that, I see trauma as really individual and depending on the person. It’s not just an event, it’s how the body has adapted. And some of your listeners may have already heard of big T, small T trauma. But if they haven’t, I thought I would just very quickly give an overview of what that is.

So. Big T trauma is something that is often life threatening. So, you can think of that as in maybe a violent crime, a natural disaster, a sexual assault. I had a client who witnessed a parent having a heart attack. So, it’s a big sort of event that happens. And sometimes people think of that as trauma. And that’s all that trauma is a big event people coming back from Vietnam War, for example. This is how maybe even traditionally we thought of trauma.

What we know now and the way that I see it coming up in my practice is there is something called little t trauma. And I don’t know if I like that title quite so much because it seems to kind of diminish and I don’t think it’s like that at all. But this is the term that being used currently. So, this kind of trauma is really an accumulation of life experiences. And it can be an accumulation that I often see of not getting our needs met, particularly as we’re growing up, particularly in childhood. So that can be anything from feeling valued and supported, getting comfort, experiencing comfort, feeling safety. If we don’t have that earlier on in our life, our brain hasn’t made those connections and doesn’t know what it’s like to feel those things.

And what can happen then is life can be more difficult overall, or if we do experience one of those big T traumas, often what I’m seeing is it takes a lot more time for people to be able to move on or recover from a more big T trauma because they don’t have those experiences of some of these things that I’ve just mentioned.

The other thing I wanted to mention is generational trauma. And, here in Canada, we have had a really terrible history, but also continue to have a lot of systemic racism, oppression for over 150 years with our indigenous people, including residential school, missing murdered women. Even now, representation in the jail system. So, when we have a client show up who has been part of this, who has parents, grandparents, even more so than grandparents at times, who’ve been part of this generation of trauma. They’re not just coming as a single person with a single, here, I’m here with anxiety can you give me coping techniques to help me get better? We’re working with somebody who has much more complex than somebody who’s grown up in a supportive environment and somebody who has that experience, who their parents, their grandparents have not had the oppression and systemic racism. And this is just one example of one population.

Kayla: Thank you for that explanation. And I know the topic for today’s episode is being stuck or the stuckness of trauma. So what is the stuckness when it comes to clients who experience trauma? And how can we as therapists, as social workers, as coaches recognize when a client is stuck due to trauma?

Charity: That’s a good question. So, what I find in people that I work with, what stuckness might look like is somebody who’s already done lots of therapy before and hasn’t seen improvements. Who continue to come to therapy and just aren’t making the kind of improvements that they want to make, or even who have difficulty knowing what their goal is in terms of why they’re even coming to therapy.

I also see people who come with very low window of tolerance. And for anybody who doesn’t know what the window of tolerance is, it’s our nervous systems ability to. So this might look like people who come and even online. I work virtually as well. Somebody who can’t get out of the house. They’re just so panicked. They’re so scared. They’re so worried. Or it might look like a client who’s just angry all the time and can get angry at just about anything. So really low level of ability to stabilize yourself.

Also, people who aren’t able to do things like mindfulness kind of interventions that that’s not helpful for them. Also, people who have already done lots of cognitive kind of strategies. So, there’s people who come who have tons of insight, very articulate, know why they’re feeling things, are able to journal, understand their emotions and why things are coming up. But they still have their symptoms of, let’s say, feeling so inferior or always needing to be perfect. And they’re just not able to move past that. So to me, that’s some of what stuckness looks like in therapy.

And I have learned that, the more and more I’ve become trained and comfortable and experienced in working with people with trauma, it’s become more easy for me to identify this pretty quickly and more quickly than before and to be able to start making the connection between trauma that they have encountered or have experienced and how this is keeping them stuck and unable to move ahead with feeling better.

Kayla: Are there specific treatments, modalities or techniques to help clients get unstuck?

Charity: There are certainly modalities that are specific for trauma treatment. So, the one that I use is EMDR, which is eye movement desensitization reprocessing, which started with veterans from Vietnam. So, people who had experienced that big T trauma. It’s now expanded, so it’s not just for trauma anymore and that’s a whole other episode about EMDR.

Other trauma therapies include internal family system or ego state. So, these are a few kinds of therapies that if you’re feeling your clients maybe up against some trauma stuff and that they’re not making the kinds of improvements that they want to have in therapy that you could seek people who are therapists who have some of these trainings.

Kayla: So, let’s talk about EMDR specifically. How does EMDR help a client?

Charity: Yeah, sure. That’s a great question. So EMDR works at getting at the root causes, the beginning of the symptoms that we are experiencing right now. So, we look at what is a client showing up with in therapy? Maybe they’re showing up with that feeling of panic all of the time. What we invite them to do is to sit there with that, letting that come up a bit. And thinking back to when are other times in my life where I felt a similar kind of sensation. And as we move back into time and identify some of these periods, we can start what we call processing this trauma without going into all of the science behind it. The idea is bilateral stimulation. So, it started with eye movements back and forth, now uses tones. It uses other ways without only the eyes.

But EMDR is not just the processing piece. It starts with assessment. It starts with resourcing people. And sometimes if people have done a lot of therapy before, they have some of these skills, the psychoeducation, the ability to stabilize themselves, to calm themselves. And then we go into the processing, integrating that. Going out in life with these new beliefs about yourself, these new feelings that have come up in your body and follow up.

Not always a linear path through those steps exactly, sometimes it’s a bit of back and forth, but I hope that that’s helpful, very nutshell of explaining EMDR in a short period of time.

Kayla: I think it is really helpful because when we think of helping clients, I know many therapists are probably listening to this episode and thinking how can I help a client that comes into my practice today? What are some of those strategies? And you’ve identified that, some of those modalities, some of those things that, that I can do.

Do you have any additional advice, insights, or tips to help listeners? One to recognize stuckness in their clients, but as well as any ways that they can take away from today’s episode that can help their clients overcome the symptom of stuckness specifically.

Charity: You know what it’s interesting because we often think of and I do myself and clients come to me saying I’m stuck, but I think another way to think about it. Especially if you’ve been working with a client for a while, is that the therapist can get stuck. And so, that’s a bit of a way of reframing it. And I think it’s really important to realize when what you’re doing isn’t working anymore, or isn’t being effective. And having conversations about that. And knowing that it is a special skill set, there’s special training, there’s advanced training to do trauma treatment. We don’t just listen to a couple of podcasts and start doing EMDR. No, that is very dangerous. It’s not just something you can do on your own.

So, I think it’s been realizing when your client is stuck and when you’re stuck and referring them out. Also, if you’re interested in doing this work that you go and get training that you do supervision. And I just want to say sometimes when you’re starting out in private practice, you might not want to refer clients out, especially if you have a small caseload and you’re building your caseload. But I don’t feel that that’s good practice. Something that’s really important to know is that retelling a story, a traumatic story over and over again is not helpful. It can create more harm. We’re reinforcing messages. We’re reinforcing feelings. If we keep repeating that story over and over again, and I think that sometimes if we’re doing more supportive type of counseling, as opposed to a trauma therapy, that there’s a possibility here of causing more harm.

So even right up at the referral stage. If you’re getting a sense, if people are starting to tell you all of these really big things that they’ve been through, of being able to say, I’d love to support you, but I think you might be best served by somebody who is specialized in trauma. And here are a few names.

Kayla: I think that’s really great advice, because sometimes as private practitioners, where our clients are our income, that sometimes referring out can be challenging. But from an ethical supportive standpoint, it’s important to acknowledge the limits of your training so that you can refer out.

And I love that you also identified have a couple of people that you can refer to specifically when it comes to trauma, because that’s also going to help you build your referral network that can also, in turn, help you build your practice. So if you know someone that specializes in trauma or a couple different people, then you can continue to give referrals to those therapists, and guess what? Those therapists are likely going to reward you. I don’t want to put like a reward standpoint to it, but they’re likely going to refer back to you because you are building that network with each other.

Charity: It is so important to have a list of different people that you can refer to in different areas. Somebody’s coming to see me for couples counseling. No, sorry, I don’t do that. Here’s my list of three to four people. I totally agree that is part of building your network.

And I do think it’s really important to give people more than one name, and not just say here, I’m referring you to Kayla. I think it’s great to say here’s a couple of names, check out their website. See if they might offer free consultation and you know what I can continue to support you until you find somebody who can do that trauma work with you.

Kayla: I love that. And something that just came to mind, maybe you find someone who specializes in trauma, but you’re unsure of, you know, should I refer to this person? Is this the best person for my client? Why don’t you reach out to that person as a therapist yourself and say, “Hey, I’m looking to build up my referral network. I’m looking to have some people who specialize in trauma or couples counseling” or whatever it is that that specialty is and say, would you mind getting on a call for a little meet and greet so that we can chat so I can learn more about your approach so that when I am referring out to somebody, I can feel confident in that I can refer to you.

And I’m going to tell you, I don’t think anyone is going to say no to that. It was like, yeah, like you want to reach out to me to give me referrals? Of course, right? And then you really are building up that referral network and you can be confident in those referrals to that person.

Charity: Yeah, for sure from a business perspective, from an ethical perspective, I think that’s such a great thing to do is getting a sense of who these people on that list are.

Kayla: Definitely. So, Charity, if any listener would like to connect with you, how can they do that?

Charity: Welcome to visit my website calmriver.ca and send me a message. I’d love to connect.

Kayla: Are you currently accepting clients who are dealing with trauma?

Charity: Yes, I am both English speaking and French speaking clients. I have a virtual practice for clients in Alberta or Ontario. And then I also have my office here in Edmonton.

Kayla: Amazing. So, check out Charity’s website, calmriver.ca

That’s calmriver.ca

Or simply scroll down to the show notes and click on the link.

Charity, thank you so much for joining us today on the podcast and teaching us how to recognize stuckness and clients who have experienced trauma.

Charity: My pleasure. Thank you for the opportunity, Kayla.

Kayla: Thank you everyone for tuning into today’s episode, and I hope you join me again soon on the Designer Practice Podcast.

Until next time, bye for now.

Credits & Disclaimers

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