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Attachment & Relational Trauma with Karen Treisman: from the archives · The Trauma Therapist

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Or today we even another episode from the argives with one of my incredible guests.
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Enjoy or Welcome back to the Trauma Therapist Podcast. My name is Gaymickperson.
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My mission is to help trauma therapists be their incredible selves, to be
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human, to be real, not just a clinician. I'm a big believer
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in who we are is more important than what we know, and this requires
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cultivating authenticity, genuineness and vulnerability, and that requires intention. Can learn more
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about my courses and workshops by going to the Trauma Therapist project dot com.
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That's the Trauma Therapist Project dot com. Let's get started, right guys.
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Welcome back to the Trauma Therapist Podcast. My name's Gay Mickperson and are very
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excited to introduce my guests today, Doctor Karen Traceman. Karen, welcome and
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are you ready to go? I am? Thank you so much for having
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me. You are welcome. Doctor Traceman is a London based highly specialized clinical
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psychologist. She's worked in the NHS and Children's Services for several years. Has
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also worked cross culturally in both Africa and Asia with groups ranging from former child
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soldiers to survivors of the Rwandan genocide. Karen has extensive experience in the areas
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of trauma, parenting, attachment and works clinically using a range of therapeutic approaches
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with families, systems, and children in or on the edge of care,
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unaccompanied by unaccompanied, asylum seeking young people and adopted children. She's a director
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of Safe Hands and Thinking Minds and I'll have that linked up at the show
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notes page, as well as the author of the book Working with Relational and
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developmental trauma and Children and Adolescents. Karen, welcome, Thanks so much for
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taking the time to do this. Thank you. All right, so tell
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our listeners a little bit about where you're from, where you're calling from,
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and then let's get going. Yeah, so I am currently sitting in my
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flat in central London in England. Can probably pick up the accent, so,
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yeah, from the other side of the globe at the moment, Are
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you from there? I am, Yes, I am from London. Yeah,
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I was sort of brought up in lots of different parts of Africa.
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My parents are South African, but yes, I was predominantly sort of brought
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up in London. Nice. So let's start out here as we do,
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with a quote and excerpt sentence, whatever something Karen to kind of set the
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tone for what is about is about to come in this interview. What would
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you what you have for us? Yeah? Sure, there were so many
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different ones whirling around in my mind. But I guess one, which I
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think encompasses a lot of the work I do, is to say relational trauma
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requires relation or repair. And I guess by that what I really mean by
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it is, I think, you know, children that I work with,
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and so many of us have worked with, have experience, within the context
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of their relationships trauma, whether that's been relation or poverty, whether that's been
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you know, a neglect, domestic violence, sexual abuse. So I think
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it's all about thinking about how can we keep relationships at the heart of what
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we do, whether that's that moments moment interactions, or that more therapeutic relationship.
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But I think it's really sort of true to how do we give children
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a different way of doing and being in relationships? You know, how can
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we create for them a second chance of cure, base, a second chance
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safe haven and sort of to quote my website, how do we keep them
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in safe hands and thinking minds? Yeah, I love that quote, And
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you know, we often talk about that specific type of trauma on this podcast,
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but I've never heard it put so saccinctly, kind of the relationship between
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trauma and the treatment or care in those terms, And I love it,
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and you're just you know, I read a snippet of your bio and your
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experience is really interesting, varied, and pretty inspiring. Let's jump right in.
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How did you get into this field? Wow? Goodness. I guess
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sort of personally because I think we all we don't come to this work by
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coincidence. We've all got sort of a story. So I think personally,
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sort of intergenerationally, trauma and survivorships are real thread and script in my family.
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So my grandparents were survivors of the Holocaust, my parents were raised in
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apartheid South Africa, and my mum has had that over twenty years, multiple
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scrosser. So I think that sort of avenue of trauma and survivorship has been
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really strong. And then I guess mirroring and marrying to that a lot of
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my childhood and also pre and post qualifying as a psychologist, I've spent loads
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of time in Africa and Asia, and so I think I've seen lots of
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human rights injustices lots of different areas like HIV, survives of the Randan genocide.
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That sort of, yeah, really made me love this sort of work
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and be quite dedicated. And I guess, sort of professionally, I guess
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I've been really lucky to work with some phenomenal, inspiring clients but also have
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some amazing supervisors and colleagues. But throughout training, you know, we had
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lots of different placements, whether it was in learning, disability or anxiety or
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youth offending services. And what I was really struck by was I felt that
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trauma was a common theme and sort of thread joining all of them. So
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I guess that's where I sort of came around getting into that work. Let
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me just interject, So, I mean, your experience is certainly one thing,
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but what was it about that experience that kind of propelled you into the
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field, And why do you think you were drawn to working with these traumatized
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kids and so forth? I think so many different things. I think I
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felt like I wanted to be able to have an opportunity to intervene at an
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early stage because I'd seen different stages in the lifespan, whether that was in
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ad on mental health, services forensic services that I thought, goodness, I
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wish we could just go back to that sort of early parent child relationship and
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really try and sort of bring attachment and trauma into that. I think within
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the work it combines lots of the things I love, from sort of being
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able to work creatively, the mind body link, kind of human rights elements,
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trauma elements. So I think that really sort of drew me to the
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work as well, and just thinking what a difference it can make when you
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sort of train or educate societies and communities about trauma and attachment and how hopefully
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that can then change a child's true jectory. Was it was it kind of
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a no brainer for you to get into the field. I mean, do
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you feel that you had going into it particular affinity for or proclivity for working
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that with trauma. Absolutely. Yeah. From a really really young age I
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wanted to work, but mainly from my experiences of I suppose being in Africa
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and my grandparents from from the holocaust of my parents in South Africa. Yeah,
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I always from a very young age, I always thought I would specialize
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in working with refugee and asylum seeking people, the children and care sort of
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developed more because I had lots of placements in that area. But yeah,
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I went in to do my doctorate with the intention of working in trauma in
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some way. What was it or is it about you? Do you think
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that enables you or helps you do that type of work. That's a good
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question. I think there is. I hope that I have an ability to
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build and engage relationships and to see sort of people's in a child, I
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guess, and in many ways, I feel like to be able to do
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this work, you have to be able to build that relationship with lots of
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different people. So I feel that was something that I myself was held in
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very safe and thinking minds as a child, and was very fortunate to have
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very enriched environments and very positive relational experiences with my parents, and I think
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there was a sense of me wanting to sort of share and ground and give
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that and I think that was a huge thing. But also at heart,
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in many ways, I guess I'm sort of an artist and creative, and
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so I think there's something about being able to take some of the best and
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worst of human nature but be able to sort of bring some of my creative
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ways of working with people to try and contribute to the field. I guess
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nice, nice appreciate that. So let's talk in talk about kind of an
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early clinical error. I mean, obviously you've had a lot of experience in
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across an array of different settings. Share with our listeners, Karen, an
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early error and kind of how that impacted you, what you learned from it.
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Yeah, I guess sort of on a more general I can think of
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really specific example, but I think on a general one sort of went during
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my training and for probably a couple of years afterwards, I really didn't know
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very much at all about the impact of trauma and disruptive attachments on the body,
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on the sort of structure and function architecture of the brain, on sensory
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experience. So I think just in general, my interpretations, my observations,
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my interventions were really based on talking and sort I excluded a lot of the
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more sensory body based creative things. So I think that was sort of a
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more general big thing about sort of widening my talk and getting more of that
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knowledge. But sort of a specific one that comes to mind that I always
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talked to my trainees about is I had a young woman come into my therapy
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room during training, and she was smiling, but she reported to me that
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she was pregnant, and my instant response at that time was to say,
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oh, congratulations, And she then sort of had a startled look and said
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to me, I was raped. And I think in that moment, obviously
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I felt horrific, but absolutely in that moment, I had just let my
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own biases and lens and experience of pregnancy being a positive thing come across and
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say, you know, they took over. And I guess that was a
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really big learning experience for me, and a scary and sad one at the
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same time. But I guess it really homed in that point that we all
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learn in training but different in the room, about not making assumptions and you
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know, taking that position of curiosity and thinking before you speak. Yeah,
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And I think even though there is a somewhat extreme example in terms of a
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rape, I think they're maintaining that curiosity is huge. And I think that's
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such a great kind of nugget takeaway for our listeners. My gut. So
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what happened, I mean, were you did you work with an individual over
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a course of a period of time and we're able to smooth things out in
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a sense. Yeah, thankfully, So I guess I was able to try
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and make use of that moment. So I think, I, I mean,
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this is years ago, but I think I said something around you know,
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I'm really sorry, and I need to take ownership of my response.
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But I wonder if what just happened in the room is something that's been happening
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a lot in your life and in society and in your day to day world,
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and what does that feel like and how can we think about that and
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make sense of it. So I sort of managed to rescue it slightly in
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that moment. Well, I think that sounds like the perfect textbook. We're
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you know, recover in a sense, I hope. So I didn't feel
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like it at the time I tried. But yeah, we actually worked together
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for it was during a placement during the doctorate, so I think that was
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for a further sort of four or five months on a weekly basis. And
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yeah, actually sort of did some really positive, positive work together. So
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let's talk about your work. Your site Safe Hands, Thinking Minds, and
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that is Safe Hands, Thinking Minds all one word, dot code dot UK
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again. I'll have this linked up in the show notes page at the Trauma
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therapist podcast dot com. So talk to us about this go I guess,
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I guess what it's really about is offering training, talking at conferences, workshops,
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consultation on areas around attachment, trauma, parenting specialist groups such as unaccompanied
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asylum seeking young people or youth offending young people or children in care. We
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call it here in the UK looked After Children. And I guess it sort
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of came about from so often I was going within my different jobs and doing
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training around you know, for thinking about the impact of relations trauma for foster
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carers, or talking to journalists about vicarious trauma, and it just felt like
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being able to sort of spread that message of attachment and trauma, but doing
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sort of trainings in a way that we're really interactive, that we're using lots
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of video clips and metaphors and experiential exercises was sort of incredibly rewarding but also
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having a really big ripple effect. So I guess I decided, in addition
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to my full time job, to set up this organization that you know,
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companies from four or five people through to several thousand people can tap into that
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and sort of both have some packages but also some tailor may courses around trauma
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and attachment. So you, in addition to your full time job, you
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started this. Yes, wow, this is such a huge undertaking. Again,
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I mean, there seems to be this thread of what just you have
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this this kind of I don't know, for lack of a better expression,
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this kind of tenacity in the way you approach, and I mean that in
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the best way. I mean, to start this organization is huge. How
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did you just how did you go about doing it? Yes, it's a
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good question. I guess it was really a bit of a sort of word
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of mouth ripple effects. So I was sort of given a couple of opportunities
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by colleagues who had maybe worked with me in one job, and they would
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ask me to come and talk to just a small group of you know,
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ten fifteen foster cares, for example, about something. And then I was
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getting so much positive feedback. But also I was getting so much out of
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it. I was coming out of that day feeling so refueled, re energized
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and just buzzing that I thought, my goodness, I want to do this
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more. And actually I can sort of spread the message around attachment and trauma
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so much wider than having an individual therapy session. And then so I was
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trying to be very proactive in terms of going to conferences, go into workshops,
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using social media and lots of the things had to do voluntary or free.
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Started sort of writing lots of journals or papers or blogs, and then
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just after that really started building up and sort of snowballing from there, I
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guess, and the book Working with Relational and Developmental Trauma in Children and Adolescents?
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When did that come about? How did that come about? So that
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came about? I was actually in in the States a few years ago at
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the Attached conference, which was a brilliant conference, and I ran sort of
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three different workshops, and when I came back to the UK, I had
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some interest from from Rattledge the publishers about whether I be interested in putting some
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of my experiences and training events into a book. So I was incredibly honored
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and felt a bit overwhelmed and can I do this? It's a big undertaking
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a bit of an imposter. But actually I have to say it was one
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of the I'm actually working my second book now. That's thank you. I
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guess that says how much I loved it. It was incredibly, a lot
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of sacrifice, a lot of hard work, a lot of blood, sweat
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and tears. The laptop was going to get thrown out the window on many
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ocations, but yeah, it was. It's I'm really sort of proud of
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it, and I really hope that again it can spread the message to why
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to audiences who can't get to a conference or can't afford to get an in
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house training event. So give us a kind of nutshell, you know,
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if you will. Synopsis of the book, yeah, so, in essence,
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it starts with sort of several chapters going on the impact of relational and
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developmental trauma on children's brains, on children's bodies, on their relationships, on
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their behaviors, and on their emotions. And then I've got a chapter on
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sort of thinking on the other side of trauma, so the resilience and strengths
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and hope. I've got chapter on how to sort of assess from a trauma
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and attachment basis children. Then I've got a chapter that talks about a whole
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range of different therapeutic intervention trauma and attachment based and then it goes into chapters
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on specialist sort of sub client groups, so things like unaccompanied asylum seeking,
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young people, attachment in classroom, young offenders, young mothers, and also
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a couple of chapters on self care, stress management, and working within a
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traumatized organization like social services. And I guess it really I've tried to do
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it. Obviously, it is an academic book for practitioners, but I've tried
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to really integrate lots of theory but also lots of practical top tips, reflective
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exercises, metaphors, illustrations, case studies. So it sounds like it has
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would be a really good book for our listeners in his ends, I hope,
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so, yes, they are certainly my intended audience. I tried to
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write it so that also, you know, social workers or teachers, or
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even some parents or adoptive parents, fostcare as there's something. But yeah,
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absolutely, the main people I wrote it for was trainee therapists or people in
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the trauma industry. I guess where it came from was when I was getting
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into this work, I literally used to read hundreds of books that sort of
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had so many different elements. So I wanted a book that was the book
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that I wish I would have had after my training. Nice. Nice,
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let's I mean, there's so many questions I want to ask you, and
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I really want to. I'm excited to get to your kind of advice for
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early stage clinicians. But before we do that, talk talk to us about
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why you keep doing this work, what drives you, what's your why for
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this work, Karen, I guess just similar to what I said before,
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just in terms of I think I have this huge passion about spreading the word
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of attachment and trauma not just to individuals, but to families and societies and
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communities, to make us as a society more trauma and attachment aware. And
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I think I've got this real sense that, you know, if we do
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that and sort of create these more enriched environments, these more trauma and attachment
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sensitive and aware of environment, I think that will have a huge ripple effect
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on public health, mental health, our prison population. So I think that's
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a huge bit. And I guess also for me, there's something about,
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even though this work can be very overwhelming, very triggering, very heavy,
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there's something also about the other side of being so struck by sort of the
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human spirit and survivorship and strength, And I think partly I like to soak
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that in it gives me a real sort of faith in human spirit. But
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also I really want to find a way to sort of honor and celebrate and
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build on people who have experienced that strengths and skills and what they can bring.
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Yeah, you talked about, you know, the kind of self nourishment
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and sense that often terms of challenging aspect of this can you how do you
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deal with that? And what was I imagining that They're having periods in your
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career, in your life where things have been pretty difficult with regards to the
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work you've been doing. What was that like and how did you work through
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that? Yeah? Absolutely, I've definitely had lots of different times, chunks,
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moments where my sort of self care has certainly narrowed or been crushed or
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been challenged, and equally environments where I felt quite crushed or unsupported. So
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there's definitely been a huge amount of variety, and including sort of in Africa
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in places where I was really working as a lone clinician and didn't have that
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sort of network of support around me. So I think that can be incredibly
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difficult. I guess loads of different things that I've done in terms of self
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care and stress management I think I do practice what I preach a lot of
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the time, so you know, with young people, things like regulating sensory
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boxers or having a safe place pillow or doing relaxation exercises, and I do
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have all of those things myself. I think a huge thing for me is
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my support system. I feel like I've got a phenomenal personal support system,
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but also a really good professional system. And that's not just in my day
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to day work. That's been through Twitter, through LinkedIn, through going to
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conferences, arming myself with as much sort of knowledge as possible, but also
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just having me and my identity and not just having my career be my whole
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master identity, so you know, making sure that I go on lots of
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holidays and travels and doing things that I love like art and nurturing activities,
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and also really trying to mark, celebrate and internalize some of the really positive
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experiences in the work sort of what drives me and holding those class science that
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I've already seen a difference or seen work forward and just try to really sort
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of remind myself about why I do what I do and what keeps me going.
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Yeah, I love that, and I think that's such an inspiration for
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those of us who are listening. I mean this you. I love the
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way you talk about the the what the kind of beautiful side of this work,
24:22
watching our clients grow and improve and and and yet there's that other side
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to it that often comes along with it inevitably. But I think what I'm
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hearing you say, Karen, is that you seem to really appreciate and understand
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the the wholeness of this work. I mean when you started talking about the
24:45
different things you do for self care, and it reminded me of one of
24:49
my earliest interviews, which was with Linda Curran, who is a pretty well
24:56
known clinician here, and she just listed of all these things that she really
25:03
did to take care of herself. And I think I'll speak for myself personally,
25:07
it's I find it really difficult to keep self nourishment and self care there.
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It's so easy for it, you know, there's so many dishes in
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the saying or the kids, whatever it is. It's so hard, and
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I think it can get neglected a huge amounts offn't it. So you have
25:26
to sort of keep it at the forefront. But also, I guess have
25:30
those other people who can recognize it in you and remind you. And I
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always say to the foster cares or adoptive parents I work with, you know,
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you can't keep filling children's glasses up. Something or someone has to fill
25:45
up your glass so that you've got enough to replenish theirs and keep on replenishing
25:49
theirs. Nice. Nice? What is some some bits of advice here for
25:55
people just getting into this field? For our listeners, a lot of whom
25:59
are early stage clinicians, maybe even therapists who maybe they'll think they've worked with
26:06
a client of experienced trauma and you know, want to start getting into their
26:10
education. What would you say to them, Well, so many things,
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it's I guess, yeah, just building from what we just said how important
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self care and stress management is. I'm sure that's something everyone says, but
26:23
you know, particularly thinking about your own triggers and your own emotional hotspots,
26:29
and when working in traumatized organizations, just really thinking about how you are going
26:33
to sustain and replenish and nourish yourself and the support systems around you. That
26:41
feels really important. Also, I think sort of just trying to get as
26:45
big a toolbox as you can, so It's kind of what I was saying
26:49
before about when I started, I wasn't really aware of the body based approaches,
26:55
the sensory based approaches, the creative based approaches, And I think of
27:00
having gone on lots of different trainings and speaking to lots of people and reading
27:03
lots of books, it does help you to feel like you've got lots of
27:07
different tools in your box. Doesn't doesn't give all the answers, and doesn't
27:11
mean there's times when you don't know what you're doing, but I think it
27:14
certainly gives some sort of sense of support through someone go ahead now. Just
27:22
then there's something about holding that position of curiosity, you know, and trying
27:29
to hold on to always that the client is the expert of their experience as
27:33
well, and that you know they're bringing a huge amount that you can learn
27:37
from them and it's a reciprocal relationship, and that actually they are the expert
27:44
of their own experience. I think that's a really important thing to hold true.
27:48
That it's not being mindful of those power dynamics, it's not just us
27:52
doing something to them, And that feels even more important in the context of
27:56
tauma, where so many children have felt out of control and powerless and helpless
28:00
and hopeless, but there is a sense of providing mastery and also learning from
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them in terms of trauma education, trauma informed interventions and so forth. What
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would you say to someone who's like, all right, there's so many books,
28:18
so many workshops, so many conversastions. Where do I start I need
28:22
to read or should I read just a wide variety? What about focusing?
28:26
What about specializing? Talk to us a little bit about that. Yeah,
28:32
it's difficult, isn't it, Because I think everyone's sort of learning style and
28:37
minds work differently, and some people love to be really niche and specialist in
28:41
particular, and some people really like to have a more general area. Personally,
28:47
I found it really helpful to read lots of different avenues about trauma and
28:53
then home in onto something that particularly fit with my personal analyty or my interest,
29:00
so, for example, the more body based and sensory and art based
29:06
things. But also I always find that it becomes more alive when you're working
29:11
with a client, and so I think I did a lot of that that.
29:14
If I was working with a client who was looked after child presenting with
29:18
nightmares, that's where I would sort of home in so that it would really
29:22
become a bit more alive. Nice. Nice, Okay, So once again
29:26
your site is Safe Hands and Thinking Minds that I'll be linked up at the
29:30
show notes page as well as Karen's book Working with Relational and Developmental Trauma in
29:37
Children and adultscens Karen was the best way for people to get in contact with
29:41
you, lots of different ways. So I'm on Twitter, I'm onto there
29:45
as doctor Karen Traceman, so I'm really active on Twitter. I've also got
29:51
a Facebook page which is called Safe Hands and Thinking Minds. I'm on LinkedIn
29:56
under doctor Karen Traceman. So yeah, any of those ways, and I'm
30:00
really happy to sort of talk to people, learn from people, make connections,
30:06
and I think I'm always keen to sort of expand my personal and professional
30:10
support system as well. Okay, In terms of a go to book,
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what would you share? Go? Well, goodness, you should. You
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should see my library. I guess anything by Bruce Perry, Peter Levine,
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Vanderkulk I would hugely recommend. But I guess I'll sort of list just a
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few that maybe a less well known, that I think had been really helpful.
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So one has been it's called Neurobiologically Informed Trauma Therapy with Children. It's
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by someone called Linda Chapman, really powerful informative book. Then there's The Child
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Survivor Healing Developmental Trauma by Joyanna Silberg, which again is a brilliant book,
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particularly around disassociation, which feels really prevalent in this sort of client group.
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And then a Creative Interventions for Traumatize Children by the brilliant Kathy Malchodi. And
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I guess also anything by Pat Ogden, but particularly her Sensory Motor Psychotherapy books.
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I think they're fantastic to think about more of the body and the sensory
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world. Awesome. I think that'll that'll get people going. Look, give
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them a good start. All those books are awesome. They'll have them linked
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up. Karen, it's been awesome. I really appreciate you taking the time
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to do this, and I just love what you're doing. I just think
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it's so inspiring and I think the field is lucky to have someone like you
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in it. Oh, thank you. I really appreciate that, and I
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echo that back to you. I just think this is an amazing forum to
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have, so I really pleased to be part of it awesome, all right,
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we'll toxic and take care. Definitely you two by me