EMDR trauma treatment with Rachel Harrison

Dan King: [0:00] Hello, everyone. This is going to be a unique conversation. They're all unique, Dan King: [0:04] but I think this one may be especially unique with Rachel Harrison. She is the founder of Trauma Specialists in Maryland and the Trauma Specialist Training Institute. She's also the host of the Excellent Mental Health Evolution podcast. Welcome, Rachel. Rachel Harrison: [0:20] Thank you. I'm so glad to be here, Dan. Thanks for having me. Dan King: [0:23] It is always a pleasure to speak to you. So what is exciting in your world? And we think about all the many things that you and I are both interested in. What's jumping out at you is most exciting right now? Rachel Harrison: [0:33] Most exciting. I think I am always excited about the idea and sort of the motivation for what I do about literally treating trauma and the way that that changes Rachel Harrison: [0:47] the trajectory of people's lives. That is sort of the foundation of why I built what I did, and that continues to excite me to be able to increase availability to the type of care that can cure people, can help them completely move down a new road in life where trauma is no longer blocking their path. Dan King: [1:09] I like that you're hitting that head-on because even in the behavioral health world, we don't often hit it head-on. Why is that? Rachel Harrison: [1:16] I think there's a little bit of hesitancy, maybe not to over-promise or to be like, Well, we're not sure. I think there's a culture among mental health professionals where we're hesitant to say things in a very solid way. We're always couching things as like, well, perhaps, or well, maybe, or if it works for you. There's a lot of that kind of language, which is understandable to allow people. Clients to have a say, and we want that. That's primary in what we do. But I think when you look at the research, and I'm a huge fan of evidence-based practices, let's look at what works, let's see what works, and let's make more of that. And I think we do have these very powerful interventions, and we should be highlighting Rachel Harrison: [2:09] those and letting the world know that those are out there and available and really do work. Dan King: [2:16] What interventions are you most talking about? Rachel Harrison: [2:19] Well, I have been a fan of EMDR. That has been the thing that has worked for me. There are other based evidence interventions, so no shade on those either, but this has been the one for me. I was a practitioner for about 10 years in private practice doing what I would consider the best work I knew how to do at that point. When I learned how to do EMDR, experienced it firsthand as well, and then started integrating that into my work and saw such phenomenal changes that I couldn't go back. So I sort of slow-boated the, like, I was passionate about it. I kept learning about it. I eventually kind of became certified and then a consultant and then a trainer. And then when I started this current practice that I have, I was like, this is what I want to do. This was in 2016. Rachel Harrison: [3:12] Everybody was so in such therapy, like somebody's name therapy, or like a family therapy or Frederick therapy. I was like, I want to call this trauma specialist, like I want to create trauma specialists. But at the time, trauma really wasn't even a buzzword or anything. And I was like, this feels risky. And I remember filling out that LLC paperwork wasn't my first business. But I was like, this is what I really want to call this. Rachel Harrison: [3:43] But I don't know if people will even come. Like, will this scare people away, right? But this embodies what I want to do, so I did it, and that has sort of launched the practice in Maryland, Delaware, and Pennsylvania, and then the Training Institute, and it all just kind of ballooned from there. Dan King: [4:00] We say in our marketing, you know, it's a classic 101 concept, that we want to use language that resonates with our clients, patients, customers, not ourselves, right? I mean, in this case, though, Some of your clients, customers, patients are themselves clinicians, right? And I wonder also if the mental health profession's reluctance to hit the issue head on is a reflection of some of our own trauma, is a reflection of some of the kind of hemming and hawing, right? I think at times there's a desire not to offend, right? There's a desire to be very careful and cautious. And it's, as you say, so understandable. And yet we need to be able to talk openly about hard things. We just need to. That's a part of the healing journey. Rachel Harrison: [4:46] Yeah, I so resonate with what you just said there, because I think and that is a piece of where EMDR comes into play as well, because it's not we do open up somebody's trauma, but it's a one and done kind of thing in a safe way. We've prepared for it, all the things. But when our brains are storing these things, it's a little bit like surgery. We have to get in there to actually address it. Getting to the root of the issue, talking about what's really there with trauma, I think. I always think about treating trauma kind of like this. If we are helping people with things like coping strategy, cognitive reframing, all of that is useful, helpful work. But when it comes to trauma, it's kind of like bandaging it up, right? And EMDR is a little more of a surgical process, if you will, kind of using that metaphor, like we are going into it, we are going to help your brain process through it and then literally store it differently. Rachel Harrison: [5:56] So it's not impacting you in the same way. So it is not, I don't want to paint it as this miracle cure or even an easy process. Like we still have to address what's there, but it is the thing that helps us not have to keep dealing with it and rebandaging and rebandaging and rebandaging. That's some of what I love about that work. Dan King: [6:19] And I want to credit you with, in talking about it so openly here and in your branding and marketing, it's a reflection of the need to acknowledge it in the first place, which is a prerequisite for the healing, right? And I think you can see this pattern in so many different spaces where it's very natural, you know, in order to call out what we have experienced, which is stored in the body, we have to experience discomfort. And our whole society has been organized around escaping discomfort. Rachel Harrison: [6:49] Yeah, I was reading a little thing on social media, you know that was talking about the neurobiological process of crying for example and how that is our body's way of releasing stress tension grief whatever it is and when we fight that and we shut down our body's natural flow we're really only harming ourselves. Dan King: [7:11] And the body has all kinds of different, you could call them coping mechanisms, or all kinds of different ways to sort of unbalance itself, right? If it doesn't, if it isn't able to directly address what's stored there, it will be some kind of compensation. Rachel Harrison: [7:27] It always goes somewhere, right? One of my favorite, I mean, I think every human on the planet probably says this at some point, but that idea of like, oh, I just, I just put that out of my mind. Or that's stored somewhere away. And as the trauma therapist and in neuroscience shows this too, it doesn't go nowhere. It's somewhere your body remembers it. Your brain remembers it. It is there and some kind of energetic force, whether you're aware of it or not. Dan King: [8:00] Absolutely. So concretely, you know, you talked about EMDR as an important treatment tool. What does your work look like both at the group practice and at the training Dan King: [8:12] institute? How do you operationalize this? Rachel Harrison: [8:15] So you're talking more the business structure side of it or the actual therapy? What does that look like? Dan King: [8:21] Yeah, great, great question. Let's start with the business side. What does that look like? Rachel Harrison: [8:27] Yeah, so we have kind of taken on a model where we... Rachel Harrison: [8:33] We originally had kind of a group of EMDR clinicians, and EMDR is foundational for our practice. Anyone that we hire, if they are not already trained in EMDR, that is one of the early things that we do with them. So we train them in EMDR. We also, and around COVID time, we created an internal training process that's about a year long because what we started to recognize is that we weren't able to hire clinicians with some of the trauma treatment knowledge we needed in addition to EMDR. So our clinicians go through a year-long training program to kind of become a trauma specialist. So we are very training heavy and really value that excellent treatment. So making sure that our clinicians all have the tools that they need to provide that higher level, that specialization type of care to our clients. Yeah. So that's one of the pieces. We also offer like ongoing peer consultation. That's a requirement for our practice. And we have multiple locations. So kind of creating an environment that feels more homey is part of our brand, too. So you're not walking into an extra large clinic. You can kind of tell my office, I'm in my office, looks a little more like a living room, maybe. And all of our offices are like that. Dan King: [10:00] Does the market want, before we get to what the sort of therapist market that might work with you on the training institute side wants, do patients want this? Rachel Harrison: [10:10] I think so. We typically have a waiting list for our work. So I think that was the risk, right, of saying this is a name that people will resonate with. But I think what we're finding is we get a lot of people who have tried other treatment modalities and have not felt like they've really gotten what they needed. And that tends to be a lot of our clientele that find a home here. Right. Dan King: [10:38] Yeah, sometimes talk therapy, which is evidence-based in so many instances, is the hammer, right, that we try to use for every single thing that comes up. Dan King: [10:48] And the reality is, I know we are huge believers in our company in a broad-based set of tools. We need to have the right tool for the right situation. And so I'm not surprised that so many patients come to you knowing, wait a second, the other stuff just hasn't worked quite as well for me. Rachel Harrison: [11:05] Yeah. And you brought up the training institute side too. And every EMDR basic training or training that we start, we often get a sense of where people are coming from. Why did they choose this training? Why do they want to be here? And over and over and over again, the resounding information is I've realized that I'm helping people, but I want to be able to do more. I actually want to treat the trauma and clinicians hitting this point where they recognize that like, Everything, I'm going to be bold, I'm going to say just about everything comes back to trauma. And as a therapist sitting with people for years and years, for me it's been 27 years, that is what it comes down to, is there's usually traumatic experiences that are creating different symptomologies, all the things, right? There are some cases where that's not true. There are physiological things like a TBI or something like that. But by and large, it comes down to trauma and it's therapists. I mean, therapists want to help. And they're like, what else can I do? Can I actually go in and learn how to shift the brain instead of just bandaging? And that's really the thing that draws people to EMDR, I think, on both sides, client and clinician. Dan King: [12:29] I don't think it doesn't get from the clinician side. I don't think you could get more meaningful work than that. Right. Dan King: [12:35] I struggle to see what that would look like. Do you do so beyond the EMDR, are there other trauma treatments that you offer? Rachel Harrison: [12:43] Absolutely. We do internal family systems. A lot of our clinicians are trained and we train everybody actually in polyvagal theory, you know, just the regulation of the body pieces. And then we have clinicians that do all kinds of things. We have art therapists. We have marriage and family therapists. We have santra therapists. We have child play therapists. So there are definitely all kinds of things that kind of hang off of that foundation, but the EMDR is what we all have in common. Dan King: [13:17] Of all the modalities that you mentioned, the one I don't know about, sand tray, what is that? Rachel Harrison: [13:22] Yes, so it's a little more of a projective type of work, maybe a little bit like art therapy in the sense that, so there are sand trays, like literally trays of sand is what this is. You can do this virtually, by the way, too, but also in person. And you choose figurines. So your sand tray therapist in a very basic way might say, if we just talk about how you are coming into session today, what are you bringing in with you? You have this open canvas of the sand tray and you choose figurines or items that you want to put into the sand tray and how you want to place them to express yourself. And what often happens is people put something into the tray and then as they're reflecting on it, they're actually learning more about what their maybe more Rachel Harrison: [14:16] subconscious mind is telling them in the tray, right? It's a way to make the internal external. Dan King: [14:22] So it's like the, okay, so the tray is a representation of either the subconscious or a container where they can explore deeper parts of themselves. Yeah, you've got to think that, I mean, ultimately in trauma treatment, one way to articulate what we're doing is helping bring up what's been buried, Rachel Harrison: [14:40] Right? That is absolutely a way. And I would add to that, helping people tolerate doing that. Honestly, that's the toughest part of the work. In EMDR, we have a phase called preparation phase because we never are going to just jump right into opening up a trauma. The preparation phase is often the longest and most difficult part because once we actually open up the trauma, we follow the brain. That's kind of how this process works and the brain will take us exactly where we need to go is pretty easy. The preparation of having the tools and the courage to go there is the bulk of the work. Dan King: [15:28] Is it then the case that the process of helping people develop the skills the Dan King: [15:34] courage to go there how do you train clinicians to help people with that piece? Rachel Harrison: [15:39] So many things I mean sometimes it's helping clinicians pace themselves to the client's pace. We have a phrase we use, like, if you want to get there faster, slow down, right? You're never going to go as any faster than a client's own body and mind can go. So we've got to attune to that and make sure that we're pacing to that. There are lots of skills. Rachel Harrison: [16:07] EMDR is a body-based treatment, so we have to make sure people are okay tuning into their bodies. We have to make sure people are okay tuning into their emotions. Both positive and negative emotions and feeling feelings is something that is not always easy to do. So those are some of the pieces. We might also do coping skills. We might work on, We create what are called resources. So there's a lot of science behind the idea that what we create imaginally in our minds gives our brains the same experience as if it's really happening. For example, if you are. And I were working and I created a nurturing resource and experienced the feeling of being nurtured. Imaginally, my brain is doing the exact same things, releasing the oxytocin as if I were actually being nurtured in that moment. So we use tools like that to powerfully build people up to be able to do what we would call the trauma reprocessing part of the work. Dan King: [17:16] I mean, that makes a tremendous amount of sense. And as we've been saying, so many people struggle to be with their body, to be with their emotions. Does that struggle, I'm curious how that translates to how you expand the business. Do you see, we can get to the training of the trainers, the training of clinicians, but do you see the possibility of bringing the work you're doing with patients? Dan King: [17:40] Do you see doing that nationwide? Is the potential there? Is the ambition and mission there for you? Rachel Harrison: [17:45] Hmm. I think that might be beyond me, right? I love having this localized group. We're in three states now. I can definitely see us expanding to states, but I don't want to do anything too fast and too rash. And so when I look at that realistic timeframe, listen, I have gone from being that jump in, do everything now entrepreneur to learning and That that's my tendency and the reality of what time things actually take to do effectively and do well. I've had a lot of that push-pull kind of experience. So for me, I look at that and I say, yes, absolutely. I would love that. Our vision, we actually use the word that it's a unified movement to provide excellent trauma treatment and training. And so that movement, yes. But I think when I look at my time in this, that's probably beyond my next 10, 15 years that I intend to be the one leading this work. I would love to pass the baton. And I think there's some letting go of the vision when you pass the baton, right? I would love it to grow and evolve, but that's going to be who's next. Dan King: [19:07] Part of the trauma journey in general is understanding your own role, right? So we talk about alignment so much in our world. And part of some of the deepest pain comes from misalignment of various kinds. It comes from understanding your role and appreciating that there are all kinds of forces that push you away from what is aligned with you, right? And so it's a beautiful thing to know. Yeah, this is why I'm here and I'm content with my dharmic destiny. Rachel Harrison: [19:35] I think I said this when we talked on my podcast. I'm a starter. I'm a visionary. I'm not an operationalizing and growing and scaling. I mean, I love that, but I can inspire and I can set the vision. And so I have learned to be able to do that and then allow that to continue to be a part of what I do and how I lead my leaders, but letting go of the rest. Dan King: [20:03] I think for anyone that sort of places themselves in the visionary category, I think that makes total sense. And maybe there's a question also of, is it letting go completely or is it participating in a partnership? Where one is still playing, you could call it an accountability role, or you could, you can see yourself, I can see myself right now creating new visions as the initial vision takes shape, right, for what we're doing. But then as it takes shape, the visioning still needs to happen. Rachel Harrison: [20:35] Yes. And I should be clear, I am in our, we do EOS models. So I'm in our level 10 meeting every week. I am part of the strategic planning. I meet with my leaders once a month. Like I am not completely hands off. Right. But I also have learned to allow and empower. I think empowerment is one of our values as a company, and that is the style of leadership, is empowering my staff to really be able to own complete decisions of their area. Rachel Harrison: [21:13] I think it's hard for group practice owners to sometimes let go of. Dan King: [21:17] That's a good segue to one last topic we can talk about, which is clinical leadership. You and I have spoken a little bit about how that is often such a challenge for group practice owners. What are your current thoughts on what most practice owners miss with clinical leadership and what you've seen work so well for trauma specialists? Rachel Harrison: [21:36] I love this question because, my, have I learned so much about clinical leadership? Being a clinician, while I do think that innately that is a leader role, when you are meeting with a client, you are leading in a way. But I think so many clinically trained people struggle with the business aspect of running a practice. And I think in order to clinically lead a practice well, you have to sort of understand both pieces and it requires learning a new set of skills outside of your clinical skills. So over and over and over again, I have, and I have done this, you promote somebody who does great at their job and then they don't necessarily do great at that new role that you've put them in because I wasn't looking at the right skills for the right role. So being an excellent clinician does not mean you can be an excellent clinical leader is, I think, the first thing that I would want any group practice owner to understand. Don't make the mistake that I made. They're a great clinician. Rachel Harrison: [22:46] Let them continue to be a great clinician. The ability to coach clinicians and to understand the business side of the practice requires a different brain skill, requires a different mindset, and I think it requires being okay directing a conversation. And a lot of clinicians are not okay with that, right? Rachel Harrison: [23:09] In a therapy session, you walk in and you say, maybe how was your week and what's on your mind? And kind of like what you said to me at the start of this podcast, what are the things you're thinking about? It's a very open-ended thing. When you're coaching someone in a job role, it's not as open-ended. There are requirements of the job. There are things that need to happen. Rachel Harrison: [23:30] There's more authority, perhaps, required. So we talk a lot in our practice about the idea of, we call it ruinous empathy and radical candor. I don't know if you've read that book by Kim Scott, Radical Candor, right? But we use that language to help us as we are developing because even those that have the skills can fall into that ruinous empathy very quickly. Or am I just supposed to do all the things for all the clinicians? We need empowerment. It's part of where that value comes in. Pretty hardcore for us. But it's, boy, it's been a learning curve. It's been a learning curve for me, too. I came up as a clinician. I tell people I almost feel like I'm in a second career. I don't work clinically anymore. I am now running a business and you better believe I have had to do a lot of learning that has not stopped about the business Rachel Harrison: [24:26] side of things because that's not the same brain as the clinical brain. Dan King: [24:31] It is not. So I love all of those reflections and could not agree more from what I have seen. I kind of it's interesting. I don't come from a clinical background, but I come to the mental health world partly from a coaching background. So, one of the big trends in coaching these days is to coach middle managers, which in the coaching world typically means equipping them with the skills to move from frontline contributor to leader of a small group of people. Yes. And that requires, as you said, the mindset shift that you described. I'll tell you what most surprised me. So, this trend I see in a variety of worlds, which are a bit more, we might think of as a bit more conventionally left-brained than therapy world or the mental world. So for example, in biotech, in Silicon Valley, you'll see this trend where companies are bringing in coaches to train their middle managers, especially the young middle managers who have just progressed from frontline contributor to management. I came into the mental health world thinking, oh yeah, I'm going to see that thing. No. Dan King: [25:34] No, not at all. So in three years of sort of going across the country as an investor looking at all kinds of different mental health practices, for the most part, we don't see infrastructure at all. Even with some of the larger sort of independent mental health practices in the country with 60, 70, 80, 100 clinicians, we often see virtually no middle management whatsoever. And when it is there, there is often such a struggle to transition in part, I think, because of exactly what you said. Why is it that industries that seem a little less sensitive have cotton on to the need to train middle managers Here, so much of the training runs so counter to the identity of middle manager. And I'm pretty damn confident that's a hard nut to crack. Rachel Harrison: [26:22] Boy, I think you're right. And I have currently been developing some additional leadership training for our leaders. And that's part of why this has been on my brain, because... I think clinicians, I've had coaching for our different leaders and things like that to try to do some of that training and mentoring, like what you're mentioning. I think one of the barriers is that clinical leaders tend to have a difficult time embracing ideology from outside of the clinical world. So it really takes helping merge those two things in a way that their clinical brain can relax with, and then they can learn the new skill. I think that's at least where I'm at with my thinking. Dan King: [27:10] Clinicians do such important work there with people in such vulnerable contexts. And I can understand how their training makes them protective of the tools that they have learned and how they see their own role, right? And so it has been interesting to see, no doubt you've seen it as well. You know, when I was on your podcast, we had a conversation about how there is at times I feel I see it as something of an outsider. I see how the training and the worldview in which so many clinicians have been indoctrinated is too strong a word, but the worldview they've been taught makes them very suspicious of outsiders. And in some instances, that's warranted. It is always good to understand what people's agendas are and where they come from. And you're right, one of the costs of that is an insularity that diminishes flexibility. And part of, I mean, if we want to tie it back to trauma, we need the flexibility to go within and learn a whole new identity, a whole new way of being, a whole new approach to agency, right? Rachel Harrison: [28:13] Yes, yes, I would completely agree with that. And I think I would go a little further and say that in some of the training. Rachel Harrison: [28:24] The clinical training, sometimes there's a label of bad, sort of, maybe not overtly, but covertly put on things like money, put on things like business. And I'm often finding myself telling different clinicians here or there, I have a lot of connections to local business leaders. And every single small business leader I have interacted with is very. Rachel Harrison: [28:54] Very concerned with the welfare of their staff to the point of asking me things like, what can I do to help this person? Do I do this? Do I do that? Like offering the moon to help an employee that is struggling with something. And I think that's something I add to that perspective of like, if you think a business owner is innately bad, let me introduce you to some of the ones that I know in my community and how they are bending over backwards to honestly provide a social work kind of approach to helping an employee that's struggling in some way or has a family struggle or something of that nature. So I think it's important. I lean on this very heavily right now. Rachel Harrison: [29:40] I believe that people, most people, innately want to do good. Not all people, but understanding and coming from that lens is very clinical, but I think we need to apply it to everyone, not just our clients that are sitting in front of us. Dan King: [29:59] And not just a world that feels safe and familiar. Rachel Harrison: [30:03] Yeah, it can be scary, for sure. Dan King: [30:06] Yeah, like we've talked about in this conversation, we are here as humans, not just as people in the mental health world, to be with what is scary and feel all of the sensation that comes from confronting the terrifying. Rachel Harrison: [30:19] Yeah, yeah. But that is where the growth is. And I think sometimes I might have bitten myself in the rear on this one, but our mission is very simply cultivating growth. And sometimes that flies in my face, Dan, and I'm like, well, here we are. We signed up for this. We said cultivating growth. It's challenging always to cultivate growth in ourselves. And then to cultivate growth in another leader means watching that whole ray of the process and not jumping in to save, but allowing the process to happen. Dan King: [30:55] Yes, what a beautiful note to end on. And maybe I might throw one last question in, which is when you're not doing this super important work, when you're not advancing your mission, what do you do for fun? Because sometimes we got to get out of the soup, right? Rachel Harrison: [31:11] I love that. I'm a big nature fan. Favorite probably nature thing right now is paddleboarding. I also love music, so I sing in a band, and that is something that takes my brain completely out of this space, and I love it. Dan King: [31:28] What kind of music? Rachel Harrison: [31:29] The band is mostly a rock band. Yeah, that's a different one. Yeah, it is. It's great. Dan King: [31:36] Rachel such a pleasure what a what a rich conversation I think practice owners and clinicians will get just so much from this so I love all the different places we were able to go and grateful for the beautiful energy that you brought to the conversation so thank you thank Rachel Harrison: [31:55] You Dan always enjoy talking to you.