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From the archives: Ghislaine Boulanger, PhD · The Trauma Therapist

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Speaker 1: Trauma Therapist Podcast, Episode forty five.
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Speaker 2: Passion, Dedication and Inspiration. If you're ready to hear inspiring
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Speaker 2: interviews with amazing trauma therapists, this is it right here,
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Speaker 2: right now, with your host, Guy McPherson.
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Speaker 1: Welcome back to the Trauma Therapist Podcast. My name is
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Speaker 1: Guy McPherson, and this is the podcast where we're interviewing
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Speaker 1: master trauma therapists really from all over the world really
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Speaker 1: to learn about, you know, what they're doing, what's driving them,
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Speaker 1: and the steps they've taken to become masters in their field.
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Speaker 1: If you're trauma therapist, if you're interested in trauma therapy,
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Speaker 1: or if you're just passionate about helping other people, this
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Speaker 1: is it today. I'm so excited to introduce my guest,
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Speaker 1: doctor just Lean Boulange. Just Lane, are you ready to go?
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Speaker 3: I am Guy yet all right?
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Speaker 1: Boulange is a psychologist and psychoanalyst in private practice in
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Speaker 1: New York City and a member of the Relational Faculty
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Speaker 1: at New York University's Post Doctoral Program and Psychotherapy and Psychoanalysis.
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Speaker 1: Since the publication of her book Wounded by Reality, Understanding
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Speaker 1: and Treating Adult onset Trauma, she has taught and published
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Speaker 1: extensively on the psychodynamic dilemmas facing adults who have survived
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Speaker 1: violent and life threatening events. All right, just lend just
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Speaker 1: just a little bit about you in your background. I've
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Speaker 1: given take a moment share with us something personal. Where
1:34
Speaker 1: you're calling from, and if you're calling from New York,
1:38
Speaker 1: how the snowstorm's getting to you or not? But go ahead.
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Speaker 3: Well, we're not that far north. I'm in New York City,
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Speaker 3: and while it is unpleasantly cold and very unwelcomely cold,
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Speaker 3: it's I'm in my office on the upper West side
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Speaker 3: of Manhattan, and I have my Skype open on my desk,
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Speaker 3: so I'm looking at your face here, although I know
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Speaker 3: we're not doing a visual.
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Speaker 1: And so how long have you been in New York?
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Speaker 3: I hate to say this, fifty years?
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Speaker 1: Wow? Okay? And you're originally.
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Speaker 3: From I was raised in England, but my father was French.
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Speaker 3: That was a little unusual for the years when I
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Speaker 3: was growing up in England. Now England is very heterogeneous.
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Speaker 1: So Giselen, you know, as you know, this podcast really
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Speaker 1: is about getting to know you, finding out your influences
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Speaker 1: and experiences along the way. The way we start here
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Speaker 1: is with a quote, something that's inspired, you share with us,
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Speaker 1: something that's kind of guided you along along your journey.
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Speaker 3: I'm going to read something, guy, because actually you gave
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Speaker 3: me an opportunity to go back to the passage that
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Speaker 3: I was literally walking through the airport in Atlanta, in fact,
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Speaker 3: going to International Trauma. I don't think it was the
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Speaker 3: International at that point, the Trauma Society Studies whatever it
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Speaker 3: is group. And I came across this passage in a
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Speaker 3: book called The Interpersonal World of the Infant. I'm sure
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Speaker 3: many of you your listeners know it by Daniel Stern.
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Speaker 3: And when I read this, I said, oh my god,
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Speaker 3: this is exactly what happens to At that point, I
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Speaker 3: was mainly working with Vietnam beabs, and I thought, I
3:32
Speaker 3: really have to find a way of understanding how this
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Speaker 3: happens to them. So let me read you what Dan
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Speaker 3: Stern says. He says, and I'm paraphrasing a bit that
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Speaker 3: he's talking about the sense of the self and the
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Speaker 3: necessity for each of the senses of the self to
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Speaker 3: be online, to be up and functioning, and he says,
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Speaker 3: without the sense of agency, there is paralysis, the sense
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Speaker 3: of non ownership of self action, the experience of loss
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Speaker 3: of control to external agents. Without the sense of physical cohesion,
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Speaker 3: there can be fragmentation of bodily experience, depersonalization, out of
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Speaker 3: body experiences, and derealization. Without the sense of continuity, there
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Speaker 3: is temporal dissociation, fugue states, amnesia, and to quote Winnicott,
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Speaker 3: not going on being. Without the sense of affectivity, there
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Speaker 3: is anne hardonia, dissociated states, and I would add numbness
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Speaker 3: to that. And then without these there it is very
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Speaker 3: difficult to achieve a subjective sense self, the sense of
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Speaker 3: a subjective self, and without that there is a sense
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Speaker 3: of tremendous isolation and not being able to communicate with
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Speaker 3: other people, which leads to a loss of meaning. So
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Speaker 3: I've given you a very long paraphrase of this.
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Speaker 1: Yeah, but go ahead, But.
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Speaker 3: I mean, as I say, it just stunned me. I
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Speaker 3: was really excited when I read it, and I remember
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Speaker 3: and I you know, this must have been about nineteen
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Speaker 3: eighty three or eighty four, these meetings, and I remember
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Speaker 3: buttonholing one of my friends, Tom Williams, who was an
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Speaker 3: ex marine and a psychologist, and saying you have to
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Speaker 3: listen to this because this explains what goes on. This
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Speaker 3: explains why what I now call it delta on set
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Speaker 3: trauma lasts so long, why it feels like a collapse
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Speaker 3: of the self. I have no idea what he said
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Speaker 3: to me. I think he thought I was over excited.
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Speaker 3: But that sort of fueled my work actually for the
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Speaker 3: next twenty years.
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Speaker 1: Wow. Well, I think that's a pretty amazing quote, and
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Speaker 1: I think it really wonderfully just you know, as you said,
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Speaker 1: describes what happens from the you know, the the neurobiology
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Speaker 1: and how that sets everything offline and then the subsequent
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Speaker 1: kind of cascade of the association, depersonalization, de realization. Why
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Speaker 1: did that at that time have such resonance for you?
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Speaker 1: It almost begs the question, what was going on prior
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Speaker 1: to this? You know that kind of prepared you or
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Speaker 1: set you, set you up in a sense for being
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Speaker 1: so moved by this by this quote, that this passage.
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Speaker 3: Yeah, exactly. When I was looking for a dissertation topic
6:33
Speaker 3: in the late seventies, I was in the clinical psychology
6:37
Speaker 3: program at Columbia University, and a professor who was actually
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Speaker 3: not in clinical psych but in the social psych program
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Speaker 3: said to me, do you want to join a group
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Speaker 3: of researchers or social scientists, no other psychologists with whom
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Speaker 3: I'm working looking at Vietnam vets and trying to understand
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Speaker 3: what the hell happened to them. I think at this
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Speaker 3: point I should tell you, you know, in the seventies it
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Speaker 3: was as if we were reinventing the wheel after the
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Speaker 3: First World War. After the Second World War, in some
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Speaker 3: ways Korean veterans totally disappeared. But it was like we
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Speaker 3: couldn't hold on to the idea of how long the
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Speaker 3: reactions lasted. And here there were a group of Vietnam
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Speaker 3: vetts meeting, in fact with a guy called Haigh Shatten
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Speaker 3: and with Bob Oh. I doesn't that as we'll come
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Speaker 3: back to his name any moment. They formed the first
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Speaker 3: kind of group for vets to talk to one another
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Speaker 3: outside of the mental health professional professionals, because mental health
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Speaker 3: professionals and particularly the VA simply were not listening to
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Speaker 3: what they were saying. I mean, I remember a paper
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Speaker 3: from that time saying sorry my ear for that, saying,
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Speaker 3: you know, we have to think about whether this is schizophrenia,
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Speaker 3: and this is how we were differentiated from schizophrenia. So
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Speaker 3: these guys found in this rap group some people who
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Speaker 3: would really listen to them, and the folks who would
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Speaker 3: listened to them. Came to this professor at Columbia University
8:22
Speaker 3: trails condition and said, would you like to start an
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Speaker 3: epidemiological study of this group? And we started, I think
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Speaker 3: with gee, I don't remember how many we started with,
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Speaker 3: but we ended up with thirteen hundred people, which was
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Speaker 3: actually very very big group at that point. It was
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Speaker 3: it was nationwide, it was in rural areas, it was
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Speaker 3: in suburban areas, it was in urban areas, and we
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Speaker 3: were looking at the adjustment of Vietnam verbs on a
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Speaker 3: number of different levels, mainly psychosocial. But I was interest
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Speaker 3: did in what we called at that time long term
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Speaker 3: stress reactions, because I'm sure everybody in your audience knows
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Speaker 3: that in nineteen seventy not seven seventy eight, there was
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Speaker 3: no such thing as PTSD. We had a number of
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Speaker 3: diagnoses open to us, but there really was no such
9:18
Speaker 3: thing as PTSD. So we called them long term stress reactions.
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Speaker 3: And I found with my work that if I controlled
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Speaker 3: for combat and for the amount of combat that that's
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Speaker 3: had seen, even if I also controlled for predisposition, in
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Speaker 3: other words, levels of mental health, prior to entering the military.
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Speaker 3: Those men who had been in very high combat developed
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Speaker 3: these long term stress reactions. I should say, you know,
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Speaker 3: thirty to forty percent of them. At lower levels, there
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Speaker 3: was an interaction between the predisposition and the level of combat.
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Speaker 3: Levels of combat, there was an interaction with predisposition. This
10:04
Speaker 3: absolutely rocked my world because I was being trained in
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Speaker 3: what was then a very psychoanalytic program that told us
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Speaker 3: that if something happened to you in adult life, as
10:16
Speaker 3: long as you, if I can put it this way,
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Speaker 3: had your shit together in the first place, you were
10:20
Speaker 3: going to be able to withstand it. But we knew
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Speaker 3: from these verts, and we also knew from World War
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Speaker 3: two vets, that these reactions, which were very similar across
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Speaker 3: personality types, could last for thirty forty years. They became chronic,
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Speaker 3: and I said, well, my goodness, psychoanalysis clearly is not
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Speaker 3: reaching these guys. I should just say parenthetically that the Germans,
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Speaker 3: when they were asked for reparations for the Holocaust survivors,
10:54
Speaker 3: used this argument too from DSM two. From the ways
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Speaker 3: of talking about long term stress reactions. In DSM two,
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Speaker 3: there was no such thing. They said, if people haven't
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Speaker 3: recovered within a few months of the stress, or then
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Speaker 3: you have to look for another diagnosis, a pre existing diagnosis.
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Speaker 3: So I guess I've always been somewhat iconoclastic, and I
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Speaker 3: was just stunned because I said, we have to find
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Speaker 3: a way of explaining this to psychodynamic therapists, two psychoanalysts,
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Speaker 3: to the people in my graduate program, so that they
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Speaker 3: don't keep dismissing these feats who are continuing to experience
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Speaker 3: these symptoms and say, oh, it was a personality disorder.
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Speaker 1: So yeah, I mean, that's just really fascinating, and you
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Speaker 1: can hear your passion you know, about this and how
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Speaker 1: this has kind of generated the work you do, and
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Speaker 1: what a finding, What a discovery really because as you
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Speaker 1: can see, as we know, much of the quote unquote
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Speaker 1: in a sense blame was put on you know, the
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Speaker 1: person for not having their shit together such that they
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Speaker 1: maybe experienced this or allow in a sense allow this,
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Speaker 1: you know, stress to prolong for thirty or forty years.
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Speaker 1: But now here we have this finding that you're talking about,
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Speaker 1: and it really does a lot of the explaining about
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Speaker 1: what's going on here. So let's kind of move on
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Speaker 1: just Lane, and I think you know, you've kind of
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Speaker 1: set the frame really well about really what got you
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Speaker 1: into the specialization. But again this is about, you know,
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Speaker 1: highlighting your journey. People get into this field for a
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Speaker 1: number of reasons. You know, for me, in part, you know,
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Speaker 1: my brother was in the Special Forces and he came
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Speaker 1: back from Iraq with PTSD And when he came back,
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Speaker 1: I was so psyched to find out what he had
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Speaker 1: done and learned about his experiences, and I nagged him
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Speaker 1: and pressured him, and of course, you know it was
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Speaker 1: everything everything that I shouldn't have done, and I did.
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Speaker 1: That was several years ago, and in part, you know,
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Speaker 1: I want to come back and really make a difference.
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Speaker 1: But share with us, you know what got you going
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Speaker 1: into this field? Why? Why this specialization?
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Speaker 3: Why? Why agree? When this professor offered me chess conducing,
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Speaker 3: offered me a number of projects that he was working
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Speaker 3: on at the time, why did I jump on the
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Speaker 3: Vietnam One? Is what you're asking.
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Speaker 1: I think, Yeah, yeah, what about what about trauma?
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Speaker 3: Oh okay, all right? Firstly, just to just to say
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Speaker 3: something about the Vietnam One because I think superficially rather
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Speaker 3: than unconsciously, I was, you know, through the sixties here
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Speaker 3: I had protested the war. I had had, in fact
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Speaker 3: a number of vets for a number of reasons come
13:54
Speaker 3: through my home and started to say, Oh my god,
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Speaker 3: we're not paying enough attention to these guys in and
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Speaker 3: of themselves, the protesters too much. So what was it
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Speaker 3: that perhaps more unconsciously drew me to trauma as you gather,
14:12
Speaker 3: since I'd been here for so long. And I always
14:14
Speaker 3: hate to admit it, but I was born during World
14:16
Speaker 3: War II in England and my family lived in London,
14:21
Speaker 3: and we actually didn't live in London. We lived just outside,
14:26
Speaker 3: but occasionally the A raids would come over us. And
14:32
Speaker 3: one of my first memories, possibly my first memory, was
14:36
Speaker 3: off my parents taking me into the air aid shelter
14:41
Speaker 3: that we actually had under a dining room table. It
14:43
Speaker 3: was this sort of metal box with a wire front.
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Speaker 3: So I guess if the house was going to collapse,
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Speaker 3: the table would prevent it from collapsing on us, but
14:50
Speaker 3: also this metal box would. And at that point my
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Speaker 3: brother hadn't been born, and the three of us got
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Speaker 3: into this metal box and my mother brought in some cherries,
15:00
Speaker 3: and my father then decided to distract me by encouraging
15:03
Speaker 3: me to spit cherry pits, or as they call them
15:07
Speaker 3: in England, cherry stones out of the out of the
15:11
Speaker 3: air age shelter. I find this hard to believe. I'm
15:14
Speaker 3: wondering what my memory is doing with this, because my
15:16
Speaker 3: mother was quite fussy. But anyway, this is what I remember,
15:20
Speaker 3: and it was a sense of such security just it
15:26
Speaker 3: was really something I later, when I was in boarding
15:29
Speaker 3: school was actually near an American air base, and when
15:32
Speaker 3: the airplanes used to go over our heads terribly terribly loud,
15:37
Speaker 3: I again experienced this sense of security, which was obviously
15:41
Speaker 3: taking me straight back to those auditory memories as a
15:44
Speaker 3: child when the planes were going over. It's a little
15:46
Speaker 3: perverse paradoxical, to say the least, but my parents clearly
15:50
Speaker 3: did a good job of giving me a sense of
15:53
Speaker 3: security there. So I think that I have not run
15:57
Speaker 3: away from those kinds of topics that draw people. And
16:01
Speaker 3: at the same time, obviously there is that sort of
16:04
Speaker 3: prurient curiosity about trauma at the same time, and on
16:10
Speaker 3: the other hand, I have an uncle who was in
16:12
Speaker 3: World War Two who came back with PTSD and was
16:16
Speaker 3: never the same again, and at one point ten years
16:20
Speaker 3: after he got out of the military. He was marching
16:24
Speaker 3: down Wimbledon High Street with his umbrella over his shoulder,
16:29
Speaker 3: imagining somehow that he was getting ready to be sent
16:34
Speaker 3: over to France. So, you know, this was very powerful influence.
16:40
Speaker 3: So I think that both the feeling of not being
16:46
Speaker 3: frightened off by trauma on the one hand, and yet
16:50
Speaker 3: being so so disturbed by this lovely uncle and what
16:55
Speaker 3: had happened to him, I think brought me into this field.
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Speaker 1: Yeah, I just like the almost juxtaposition of those two
17:03
Speaker 1: different things. On the one hand, you know that that
17:05
Speaker 1: that image of you sitting crouching, I don't know what
17:09
Speaker 1: it was down in this you know, this air raid
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Speaker 1: shelter spitting cherry stones and the sounds, you know, the
17:16
Speaker 1: image of the sounds of the planes coming over. And
17:20
Speaker 1: how that developed this sense of security, How are you
17:22
Speaker 1: maybe your parents even shared in that developing of that
17:26
Speaker 1: sense of security for you, and how that has since
17:30
Speaker 1: you know, compelled you moved you forward into this field
17:34
Speaker 1: is fascinating. I think for our listeners, people get into
17:36
Speaker 1: this field again, as I said before, for you know,
17:38
Speaker 1: innumerable reasons, and obviously it's on a continue in a sense.
17:43
Speaker 1: You know, some people have obviously experienced trauma. Others have not,
17:46
Speaker 1: but whatever it is, it's just really fascinating to to hear.
17:52
Speaker 1: So thank you for sharing that. So, you know, we
17:55
Speaker 1: talked a little bit about you know, what's what's driven
17:59
Speaker 1: you here. You shared with us that that beautiful piece
18:02
Speaker 1: by Daniel Stern, And what I want to kind of
18:06
Speaker 1: focus on now, just lane, is an early clinical kind
18:10
Speaker 1: of error, something that you know occurred when maybe when
18:14
Speaker 1: you were just starting out or a little bit thereafter.
18:17
Speaker 1: What happened and really how it's influenced the work you
18:21
Speaker 1: do since.
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Speaker 3: Well, in some ways, guy, this wasn't so early. And
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Speaker 3: it's interesting that I'm talking a lot about vets because
18:29
Speaker 3: of course that's started my work, And of course you
18:32
Speaker 3: have that story of your brother, And if I could
18:35
Speaker 3: just say parenthetically about the how badly you feel about
18:40
Speaker 3: having tested your brother for information in fact, the fact
18:43
Speaker 3: that you showed interest. Maybe you pushed him a bit
18:46
Speaker 3: too much, but at least he didn't feel that kind
18:49
Speaker 3: of Nobody wants to touch me. I'm radioactive, but so
18:54
Speaker 3: many vets feel when they come back.
18:56
Speaker 1: Yeah, thank you for that.
19:00
Speaker 3: So I'm going to actually talk about it. Who was
19:03
Speaker 3: radioactive and I didn't he came. He came when I
19:12
Speaker 3: was in private practice. It wasn't so early, but he
19:18
Speaker 3: worked for the government and went about that job in
19:25
Speaker 3: a kind of plotting way. He was quite paranoid. He
19:30
Speaker 3: didn't have many friends. He had terrible fights with his
19:34
Speaker 3: ex wife, who was not letting him see his child,
19:38
Speaker 3: and at one point accused him of molesting the child,
19:42
Speaker 3: which I do not believe he had done, and I
19:45
Speaker 3: helped him with that in the lawsuit. But there were
19:48
Speaker 3: points at which he would talk about what happened in
19:51
Speaker 3: Vietnam when he would start giggling, the kind of deference
19:57
Speaker 3: that he showed me, and I don't particularly like defference
20:00
Speaker 3: and my patients, but it kind of fitted in with
20:02
Speaker 3: this guy's general personality, the kind of difference that he
20:06
Speaker 3: showed me, just he shared it. He was arrogant and
20:10
Speaker 3: basically he was using neologisms, sort of made up words,
20:15
Speaker 3: and I would think, what in God's name is happening here?
20:18
Speaker 3: I can't follow what he's said. He's psychotic at this moment,
20:24
Speaker 3: and I would start too. At first, I didn't even
20:32
Speaker 3: think about it. From session to session, I just blanked
20:35
Speaker 3: it out, and then I realized that on the days
20:38
Speaker 3: that he was coming, I would be very jumpy, and
20:41
Speaker 3: I thought, oh God, I have to deal with this
20:43
Speaker 3: guy again. What is going on with this He keeps
20:47
Speaker 3: returning to this place, what is going on with it?
20:50
Speaker 3: And I started to dream about bodies, about fire, about
20:57
Speaker 3: babies being killed, and I said, far, I mean sort of,
21:02
Speaker 3: you know, villages being set on fire. I think it
21:05
Speaker 3: wasn't that explicit in my dreams. And I realized that
21:09
Speaker 3: what I was being told through my unconscious was that
21:15
Speaker 3: this man had in fact committed with a number of
21:18
Speaker 3: other people and my light type atrocity. And I think
21:23
Speaker 3: for maybe as much as six months, I had simply
21:28
Speaker 3: not been able to hear him. I had cut him off.
21:32
Speaker 3: I had sort of I'm sure I got kind of
21:36
Speaker 3: proper or something. I just wasn't open to what he
21:41
Speaker 3: was going to say to me. And then when I
21:42
Speaker 3: was open to it, I thought, oh my god, I
21:47
Speaker 3: have to listen to this. I have to take this
21:49
Speaker 3: poisonous material inside of me. I mean, I believe that
21:54
Speaker 3: it is very important that there is something that happens
21:57
Speaker 3: between the mind of the clinician, and I should say
21:59
Speaker 3: that of the clinician and the mind of the patient.
22:02
Speaker 3: And that we can strengthen by taking him not just
22:06
Speaker 3: the words, but the whole affect everything that surrounds what
22:10
Speaker 3: the patient is telling us. We can take it in
22:12
Speaker 3: and start to make sense of it. This is really
22:15
Speaker 3: I'm paraphrasing what wilfould be On would say, and I
22:19
Speaker 3: thought to myself, I think I thought misconsciously, but I
22:22
Speaker 3: was acting as if my God, I am not going
22:25
Speaker 3: to take that material inside of me. It will it
22:27
Speaker 3: will pollute me. It is terrible. How do I get
22:30
Speaker 3: rid of this guy? And it took me, so, I said,
22:35
Speaker 3: it took me about six months to really pull myself
22:40
Speaker 3: together and start to say. You know, I've called him
22:44
Speaker 3: David and some writing that I've done about this. You know, David,
22:47
Speaker 3: I think you're trying to tell me something that I've
22:49
Speaker 3: not been listening to. And I'm sorry that I haven't
22:54
Speaker 3: been listening. I'm going to try and hear you now,
22:57
Speaker 3: so let's go go here together. But it was a horrible,
23:02
Speaker 3: horrible failure. I'm sure I've done it to other people too,
23:08
Speaker 3: without being aware of it. This kind of vicarious traumatization
23:12
Speaker 3: is horrifying, even if you come into it with a
23:16
Speaker 3: little of the imagined resilience that I have.
23:19
Speaker 1: So that would be my wow, just le to thank
23:23
Speaker 1: you so much for sharing that. I mean, that is
23:24
Speaker 1: just so. I think this is something so intimate about that,
23:29
Speaker 1: you know, sharing that experience and how vulnerable in a
23:35
Speaker 1: sense we as clinicians sometimes have to be, need to be,
23:41
Speaker 1: don't want to be. But the kind of description you
23:48
Speaker 1: created of you know, the heart, what needs to happen
23:51
Speaker 1: between the heart of the clinician and the mind of
23:57
Speaker 1: the client in a sense, and how that needs to
23:59
Speaker 1: be open, uh, and for you know, for six months
24:03
Speaker 1: or maybe long or what this struggle seemed to be
24:05
Speaker 1: going on, this fight not to let you know in
24:09
Speaker 1: what needed to be let in and what what was
24:14
Speaker 1: it about this situation that was it that you didn't
24:18
Speaker 1: have the experience or was it in a particular time
24:22
Speaker 1: for you that you just could not stand or could
24:26
Speaker 1: not allow and sit with with what this person was
24:30
Speaker 1: talking about.
24:32
Speaker 3: I think I think it's the letter guy. I mean,
24:35
Speaker 3: I'm I actually in my spare time do a fair
24:40
Speaker 3: amount of human rights activism and so I and I've
24:44
Speaker 3: been very involved. If I can just put in this
24:46
Speaker 3: plug against the American Psychological Association and the collaboration with
24:53
Speaker 3: what's going on in Guantanamobay and what has gone on
24:56
Speaker 3: for so many years. So I'm very I know a
25:01
Speaker 3: great deal more than I really want to know, but
25:04
Speaker 3: inevitably have to know about torture, about suffering, as any
25:08
Speaker 3: of us do who do this kind of work, and
25:12
Speaker 3: so but to know about it from the point of
25:14
Speaker 3: view of the perpetrator rather than the person who's perpetrated against.
25:20
Speaker 3: That was the first time I let myself know that
25:24
Speaker 3: I was hearing that material. Had I heard it before,
25:27
Speaker 3: quite possibly, But it's to imagine the horror in that village,
25:35
Speaker 3: to imagine the excitement, and to credit that excitement that
25:41
Speaker 3: these young kids. I think this guy was in the
25:45
Speaker 3: middle as it was in the Army that these young
25:49
Speaker 3: army kids felt as they went through this village. The
25:53
Speaker 3: omnipotence that they felt at that moment to be able
25:57
Speaker 3: to go there was hard.
26:01
Speaker 1: Hmm. Yeah, I mean, I just really appreciate what you
26:04
Speaker 1: just said about, you know, the humans right, human rights
26:07
Speaker 1: activism that you're doing, and that you know, it was
26:10
Speaker 1: at that point when you were sitting with that gentleman
26:13
Speaker 1: that you recognized or allowed yourself to to realize that
26:17
Speaker 1: you know, this is what was happening, and you for
26:20
Speaker 1: the first time in a sense, heard that. And I'm
26:24
Speaker 1: curious about and maybe we'll get to this later, but
26:28
Speaker 1: how how you take care of yourself? You know, what
26:32
Speaker 1: what what things do you do to buffer against that,
26:38
Speaker 1: you know, vicarious traumatization and so forth.
26:40
Speaker 3: A very it's a very very good question. I have
26:43
Speaker 3: two answers to them. One is that I'm tremendously fortunate
26:49
Speaker 3: to have a lot of colleagues who share my interests
26:53
Speaker 3: and there's always someone to talk to. I After nine eleven,
27:02
Speaker 3: I went and debriefed a lot of the well so
27:06
Speaker 3: many of us did who were in New York, went
27:08
Speaker 3: and debriefed various organizations whatever they call companies that are
27:13
Speaker 3: down by the World Trade Center. And I remember one
27:18
Speaker 3: guy saying to me, I feel so he'd actually been
27:23
Speaker 3: close enough to see people jumping out of the windows
27:26
Speaker 3: and keep known some of those people. He wasn't obviously
27:29
Speaker 3: in the World Trade Center, he was across from it,
27:31
Speaker 3: and he said, I feel so guilty to go to
27:36
Speaker 3: the gym now. Just whenever I go, I imagine those
27:40
Speaker 3: guys will never go to the gym again. And I
27:44
Speaker 3: talked to him very firmly about the importance of taking
27:50
Speaker 3: care of himself. I was talking to this whole group,
27:53
Speaker 3: this whole board, about the necessity of going to the gym,
27:56
Speaker 3: of eating not drinking too much. I was I also
28:01
Speaker 3: worked in New Orleans three years after Hurricane Katrina. I
28:06
Speaker 3: was invited to go down there by the Psychoanalytic Institute there,
28:10
Speaker 3: and it was a wonderful experience because I worked only
28:14
Speaker 3: with the mental health professionals there, and I heard how
28:18
Speaker 3: they had taken care of themselves. And I will tell you,
28:21
Speaker 3: I mean so so one of them talked about cooking
28:24
Speaker 3: a lot, and another one talked about gardening. I think
28:29
Speaker 3: many of them had had a hard time allowing themselves
28:31
Speaker 3: to do these things that felt so nurturing at first.
28:34
Speaker 3: But I'm telling you about the things that I also do.
28:37
Speaker 3: I mean, I do cook, I do garden. Not in
28:41
Speaker 3: New York, although I do a bit in New York.
28:45
Speaker 3: But it's having colleagues is so important and being able
28:51
Speaker 3: to talk to them. And of course I also write,
28:54
Speaker 3: so that if I can write about these experiences even
28:57
Speaker 3: while it's rough, either solitary, and I think when would
29:00
Speaker 3: broaden the into subjective field post trauma. I think writing
29:06
Speaker 3: very much helps me sort out my ideas. So that's
29:10
Speaker 3: one way of how do I take care of myself.
29:12
Speaker 3: The other way is that I actually believe that vicarious
29:16
Speaker 3: traumatization is a way of telling us that we are
29:20
Speaker 3: on track with a patient. And so if we keep
29:25
Speaker 3: working with the patient and we resolve our own vicarious traumatization,
29:31
Speaker 3: we are also helping the patient come to terms with
29:35
Speaker 3: I would never say resolve, I would never say cure,
29:39
Speaker 3: but come to terms with the experiences that they have had.
29:43
Speaker 3: So vicarious traumatization is like a signal that says, oh,
29:47
Speaker 3: hang in there, You've got to work on this in
29:50
Speaker 3: more depth with your patient because you are both scared
29:54
Speaker 3: at this point.
29:57
Speaker 1: Awesome, Okay, I love that. I love the that kind
30:00
Speaker 1: of duality in a sense of self care. Just Lane,
30:06
Speaker 1: we get to one of my favorite questions right now,
30:09
Speaker 1: and you know, we've talked about some of the challenges, uh,
30:13
Speaker 1: some of the mistakes.
30:14
Speaker 3: If you will, I'm sorry, I'm gonna cough. Can't. I
30:19
Speaker 3: don't know if it's a way of stopping you from hearing,
30:21
Speaker 3: that's okay.
30:22
Speaker 1: We we allow coughing on this podcast.
30:24
Speaker 3: Went down the wrong way I am.
30:27
Speaker 1: But so I really feel it's important to know you
30:31
Speaker 1: know what drives us day to day in this field.
30:35
Speaker 1: I mean, you shared a lot of your passion, your inspiration,
30:39
Speaker 1: and also some of the challenges too, but share with us,
30:43
Speaker 1: just lane, you know what's your why in the sense,
30:45
Speaker 1: why do you keep doing this day in and day out.
30:51
Speaker 3: Let me be clear, clinically, I don't do it day
30:54
Speaker 3: in and day out. I you know, have a pretty
30:59
Speaker 3: regular jet this practice psychotherapy, psychoanalytic practice, and I think
31:06
Speaker 3: it's terribly important for people not just to see trauma cases.
31:10
Speaker 3: I remember saying this when I was in New Orleans
31:13
Speaker 3: during the first talk that I gave down there, And
31:16
Speaker 3: of course I felt like a total fool because everybody
31:19
Speaker 3: in New Orleans had had this dreadful experience with Katrina,
31:23
Speaker 3: and of course they had no choice. But so I
31:30
Speaker 3: I think if I did it every day, I would
31:32
Speaker 3: be burned out. I don't even with the guidening, the cooking,
31:36
Speaker 3: the friends, et cetera. I would if I did it
31:38
Speaker 3: every day, it would be too much. I would be
31:41
Speaker 3: very raw. But it is. There's a couple of things.
31:46
Speaker 3: I've been stunned by the way in which my book
31:51
Speaker 3: has generated interest, and so that's very very proud flying
32:00
Speaker 3: to me, of course, but it also makes me want
32:02
Speaker 3: to think more about this topic. It's when I first
32:10
Speaker 3: just to go back to the whole question of psychoanalysis,
32:13
Speaker 3: and it's recalcitrance in this area. As you read, I'm
32:18
Speaker 3: a relational analyst, and relational analysts are not particularly in fact,
32:23
Speaker 3: many of them not at all Freudian, not at all classical. Nonetheless,
32:27
Speaker 3: I was told not to write this book. I was
32:31
Speaker 3: told everybody knows everything they need to know about trauma.
32:35
Speaker 3: So there is a kind of sweet revenge in finding
32:39
Speaker 3: that actually a lot of people are very curious about
32:41
Speaker 3: adult onset trauma and feel helped by being understood. So
32:49
Speaker 3: that keeps me going and other professionals This sounds very
32:54
Speaker 3: self involved, but other professionals interest in what I have
32:59
Speaker 3: to teach, which is very important to me, and then
33:03
Speaker 3: the opportunity to sort of build on my knowledge by
33:06
Speaker 3: talking with other people who share these interests. So it's intellectual,
33:11
Speaker 3: but I, you know, I don't think at the level
33:14
Speaker 3: at which I and I suspect you too, live and work.
33:19
Speaker 3: You can really separate out intellectual and effect and the
33:23
Speaker 3: passion sort of puts them together.
33:25
Speaker 1: So just kind of continuing on with this thread here,
33:30
Speaker 1: you know, to that end, what advice or suggestions would
33:33
Speaker 1: you have for people who want to begin, you know,
33:37
Speaker 1: getting into this field of trauma or learning about trauma
33:41
Speaker 1: informed treatment. Yeah, okay.
33:45
Speaker 3: The first thing I would do is that if you
33:50
Speaker 3: are going, if you are interested in becoming a psychotherapist,
33:57
Speaker 3: whether it's as a psychologist, a social work, or a
33:59
Speaker 3: council any of these things, please get a good all
34:05
Speaker 3: round general training. The idea of going in to qualify
34:11
Speaker 3: or to become a trialate therapist, which is an expression
34:14
Speaker 3: I really dislike before you have an all around basis foundation,
34:21
Speaker 3: is a very bad idea because you really don't know
34:25
Speaker 3: about working under better conditions, and you need to know that.
34:33
Speaker 3: I would say, get a lot of supervision when you
34:35
Speaker 3: start to work, when you find yourself with a patient
34:39
Speaker 3: who's been traumatized, get a lot of supervision. Certainly at
34:48
Speaker 3: that point. Perhaps classes that present you with the whole
34:55
Speaker 3: range of what people consider traumatic today is a good idea.
35:01
Speaker 3: I as I said to you, guy, I think before
35:03
Speaker 3: we started, really feel that the term trauma is terribly overused.
35:09
Speaker 3: And when I talk about trauma for an adult. I'm
35:13
Speaker 3: talking about adult onset trauma, so that it's something that
35:16
Speaker 3: happens in adulthood. I am talking about an experience that
35:21
Speaker 3: where you think that you are about to die, or
35:26
Speaker 3: you see other people who've been badly wounded, or someone
35:30
Speaker 3: very close to you has died or had a terrible experience,
35:34
Speaker 3: so that you are exposed to these extremes of human experience.
35:39
Speaker 3: That's what I consider trauma in adulthood, and that is
35:47
Speaker 3: important to learn about that independently of learning about what
35:52
Speaker 3: people talk about trauma in childhood, and that can very
35:55
Speaker 3: often be betrayal, trauma and seduction in sir, of course, separations,
36:04
Speaker 3: that's those are terrible things. I'm not making value judgments here,
36:09
Speaker 3: but I'm saying that they're very different, and I think
36:11
Speaker 3: it's important to have a sense of what is included
36:18
Speaker 3: and what is traumatic for children, what is shocking for children,
36:22
Speaker 3: and what is shocking for adults, and it's important to
36:25
Speaker 3: get exposed to both two ideas that deal with both
36:29
Speaker 3: those things.
36:31
Speaker 1: Okay, great, so you're talking about you know, the first
36:35
Speaker 1: thing you said was really make sure you get a good,
36:37
Speaker 1: really strong general education, get that foundation, and you know,
36:45
Speaker 1: supervision obviously comes up, get a lot of supervision, and
36:50
Speaker 1: you know, I think it's really important what to hear
36:52
Speaker 1: what you're saying for our listeners too, which is you're
36:54
Speaker 1: really drawing out the distinction and making that clear between
36:59
Speaker 1: you know, adult onset trauma and you know traumas that
37:03
Speaker 1: happened to kids, or betrayal, trauma's attachment traumas, et cetera.
37:08
Speaker 1: Understanding that difference, understanding what's involved with you know, working
37:12
Speaker 1: with individuals who've been exposed to either or both in
37:15
Speaker 1: that sense, and what as.
37:18
Speaker 3: You say so often and just to say so often,
37:21
Speaker 3: unfortunately it is both. Yeah, but it's a good idea
37:24
Speaker 3: to understand the consequences of so.
37:26
Speaker 1: So your book, can you just talk a little bit
37:30
Speaker 1: about your book? And because it sounds like that was
37:35
Speaker 1: really something you almost needed to write in a sense,
37:39
Speaker 1: I'm getting that feeling from you.
37:42
Speaker 3: Oh, I think I think kind of questionably I needed
37:44
Speaker 3: to write it. I had a box sort of, you know,
37:48
Speaker 3: that had held bottles of wine or something under my
37:51
Speaker 3: desk for several years when I was in analytic training,
37:54
Speaker 3: and I would just throw into this box any thoughts
37:58
Speaker 3: I had, any quotes I have, I remember had a
38:01
Speaker 3: patient who was, among other things, an alcoholic, and she
38:04
Speaker 3: used to keep looking at this box with this empty
38:08
Speaker 3: liquor box. It was quite funny. But that gave me
38:12
Speaker 3: an opportunity then to sort of sort out all these
38:17
Speaker 3: random thoughts, and using that quote of Daniel Stearn's that
38:22
Speaker 3: I gave you, to try to start to make sense
38:26
Speaker 3: of what I considered to be adult onset trauma, both
38:31
Speaker 3: to define it as I have defined it to you,
38:34
Speaker 3: but in a bit more long winded than that. It's
38:36
Speaker 3: taken me a chapter to do that. Maybe I'll say
38:39
Speaker 3: something about separating it from or how I distinguish it
38:43
Speaker 3: in my mind from PTSD, but we can do that
38:46
Speaker 3: in a moment. I then wanted to write about the
38:49
Speaker 3: phenomenology of these symptoms. You were so right in summarizing
38:54
Speaker 3: what I said about Daniel Stern by talking about the
38:57
Speaker 3: neurobiology of stress. But in fact, of course, phenomenologically we
39:03
Speaker 3: experience that neurobiology in a particular way, and I wanted
39:08
Speaker 3: to talk about it in the moment of trauma, and
39:10
Speaker 3: then how that lasts and lasts and lasts, how it
39:15
Speaker 3: kind of it gets into a kind of feedback loop. So,
39:19
Speaker 3: for instance, if you feel just to give you one
39:22
Speaker 3: one thing where you feel you have no agency, right
39:25
Speaker 3: you're in. Actually, sometimes soldiers will say I was on
39:28
Speaker 3: an automatic pilot, but it's still not them that are doing it.
39:32
Speaker 3: Or a woman who was raped saying I couldn't do it.
39:34
Speaker 3: I had to do what he said, I had no agency.
39:37
Speaker 3: Those are not the words she would use, but that
39:38
Speaker 3: would be the feeling. And then afterwards you know the
39:45
Speaker 3: of course, you know the intrusive thoughts memories that we
39:51
Speaker 3: have of a traumatic experience. Again, we feel as if
39:56
Speaker 3: we have no agency, we have no control over those,
40:00
Speaker 3: as if it's happening from the outside. So how the
40:03
Speaker 3: trauma continues to be experienced through post traumatic life is important.
40:11
Speaker 3: Then I took about how because of the loss so
40:16
Speaker 3: often of the NTO subjective, the ability to feel that
40:23
Speaker 3: there's going to quote someone here whom I very much admire,
40:28
Speaker 3: which is Dorry Loub. Dorry Loub is a psychoanalyst at
40:33
Speaker 3: Yale who co ran the Holocaust Archives at Yale. He
40:37
Speaker 3: was a child survivor and he writes most beautifully about
40:44
Speaker 3: adult onset trauma, and Dorry talks about the loss of
40:48
Speaker 3: the internal imperfect other during massive psychic trauma. If you
40:53
Speaker 3: lose that, if you start to unravel and you lose
40:58
Speaker 3: the sense of internal or voices in your head, good
41:02
Speaker 3: voices in your head, you lose the belief that you
41:07
Speaker 3: can talk to someone who will listen to you. You
41:10
Speaker 3: lose the belief that you will have a witness. And
41:14
Speaker 3: so that has a lot of meaning for how you
41:18
Speaker 3: do how you go into therapy, whether you go into therapy,
41:22
Speaker 3: how the therapist works with you under those circumstances. And
41:28
Speaker 3: then once you may have established yourself as an empathect
41:34
Speaker 3: other to the patient, there's a whole question of what
41:37
Speaker 3: kind of work can you actually do? How do you
41:43
Speaker 3: how do you hear the patient's narrative Sometimes it's very
41:48
Speaker 3: very concrete. How do you tolerate that concrete narrative? How
41:52
Speaker 3: do you resist the temptation that people sometimes have to
41:58
Speaker 3: make links with earlier experiences. Maybe the link is there,
42:02
Speaker 3: but right now you have to pay attention to what
42:06
Speaker 3: the patient is telling you about their real life experience
42:10
Speaker 3: during the trauma. So I think that, and then and
42:14
Speaker 3: then the other part of the book that I talk
42:16
Speaker 3: about all the ways in which this is such difficult work,
42:20
Speaker 3: just the kinds of things I was saying about vicarious traumatization,
42:24
Speaker 3: but all the ways in which we avoid doing this
42:26
Speaker 3: because it is such difficult work.
42:29
Speaker 1: And that the name of the book again is Wounded
42:31
Speaker 1: by Reality, Understanding and Treating adult onset trauma, And that
42:34
Speaker 1: will be available as a link on the show notes
42:37
Speaker 1: page at West Coast Traumaproject dot com. Just Lane, that
42:42
Speaker 1: was just I just love the way you're speaking about
42:46
Speaker 1: the importance of understanding the phenomenological experience and how we
42:51
Speaker 1: as clinicians you know, need to be that empathic other,
42:56
Speaker 1: and how that's going to inform the world we do.
43:01
Speaker 1: So just just phenomenal stuff for our listeners. What two
43:08
Speaker 1: books trauma or later or not would you share with
43:13
Speaker 1: us that have really kind of influenced influence you either
43:16
Speaker 1: personally or professionally or both.
43:20
Speaker 3: You know, it's difficult to say books because I tend
43:24
Speaker 3: to read articles more than books. So if I could
43:28
Speaker 3: just say authors for a moment, I would really recommend
43:33
Speaker 3: And if you if you need me guy to give
43:35
Speaker 3: you some actual articles, I would be happy to give
43:38
Speaker 3: them to you.
43:40
Speaker 1: That'd be great.
43:42
Speaker 3: But I really recommend anything by Dorry Loud. Loud tends
43:49
Speaker 3: to write. I guess because English was not his first language,
43:52
Speaker 3: tends to write with other authors, but his grasp of
43:58
Speaker 3: the adult on set and also of childhood trauma. It's
44:04
Speaker 3: a lot. He speaks in very much the kind of
44:07
Speaker 3: language that I'm speaking in.
44:09
Speaker 1: That's d O R I L A U B.
44:12
Speaker 3: Right, two words, and I can send you a representative
44:17
Speaker 3: selection of Dorris articles that have been helpful to me. Gosh,
44:22
Speaker 3: there are so many articles that are important. I'm sorry
44:29
Speaker 3: I didn't think about well, I mean.
44:34
Speaker 1: We don't need the name of articles right now, but
44:35
Speaker 1: I think the name is sufficient at this point.
44:38
Speaker 3: I'm going to send you one other. Actually, I'm going
44:40
Speaker 3: to send you a reference for another which was written
44:43
Speaker 3: recently or in the last five years by some some
44:47
Speaker 3: folks in Texas talking about the feeling of being an
44:52
Speaker 3: exile as a as a as a survivor, not just that,
44:57
Speaker 3: but as a survivor generally, the feeling of being an
44:59
Speaker 3: ex It's something that I write about a lot, and
45:03
Speaker 3: it's a wonderful article, and I will definitely send you
45:06
Speaker 3: that reference too.
45:07
Speaker 1: Okay, okay, so those those are two there again, Well,
45:11
Speaker 1: they'll be linked up in the show notes page. Gislane,
45:14
Speaker 1: I want to thank you so much for taking the
45:16
Speaker 1: time to do this. You know, just you are a force.
45:23
Speaker 1: I mean, your passion in this field and for the
45:25
Speaker 1: work you do is palpable and I'm not the only
45:28
Speaker 1: one I know who can sense it and experience it.
45:31
Speaker 1: So I just want to thank you so much for
45:32
Speaker 1: taking the time to do this.
45:34
Speaker 3: Thank you guy. It was a really it was a
45:36
Speaker 3: great interview. It's lovely to be able to talk about this.
45:38
Speaker 1: Okay, we'll take care and then we will speak soon. Sure,
45:43
Speaker 1: all right, folks, I want to say thank you so
45:45
Speaker 1: much for listening to the podcast. What I want to
45:47
Speaker 1: do right now is an invite you to contact me
45:49
Speaker 1: at guy at West Coast Trauma Project dot com. I'd
45:53
Speaker 1: love to hear from you. I want to invite you
45:55
Speaker 1: to share two things with me. One, why are you
45:58
Speaker 1: doing this? Why are you in this field? And that's
46:01
Speaker 1: my favorite question I ask every master trauma therapist on
46:04
Speaker 1: the podcast. Number Two, what are you struggling with? What
46:08
Speaker 1: are your sticky points? I have so many myself, but
46:11
Speaker 1: I'd love to hear from you Guy at West Coast
46:14
Speaker 1: Trauma Project dot com. Thanks so much.
46:28
Speaker 3: The Street