Trauma-Informed Care put into Practice

A trauma-informed approach is defined as a strength-based program or system that realizes the widespread impact of trauma and understands potential paths for recovery, the signs and symptoms of trauma in clients, and others involved in the system; it then responds by integrating this knowledge into its practices and seeks to actively resist re-traumatization

I’m so glad that there has been a movement to implementing trauma-informed principles in all sorts of workplaces. Yoga classes, massage and physiotherapy, dental clinics, schools, and family lawyers have all made commitments to be more trauma-informed. While therapists may work with people who have experienced trauma, that does not always come with being trauma-informed. One would assume it’s part and parcel. That is not always the case, unfortunately. Further, sometimes the therapist is but their office or clinic does not work from a trauma-informed practice. Over the years of my work, I have both learned and implemented key principles and practices to ensure that my work is trauma-informed. For me, that includes doing what I can to help people I support feel safe and respected by me, that they are valued as the expert in their lives (versus me as a professional), their voice is empowered and have choices, as well as working from an intersectional anti-oppression framework: I work with compassion, collaboration and non-judgment. Being trauma-informed for me also includes knowing that everyone has a right to resilience and recovery/healing and trust is earned. I also know about the impact of trauma on people and have tools to assess for the symptoms.

As a Feminist Therapist for over 20 years, I strongly believe that being trauma-informed is deeply connected to my work: I’ve been a trauma-focused therapist for over 15 years. For instance, I know that people who identify as women (whether it is cis-gendered, trans or genderqueer, non-binary) experience gender-based violence at a far greater and disproportionate amount compared to their male peers. When I work with a new client, this informs my work – while she may be coming to me for support about adjusting to parenthood, she may have witnessed or experienced violence first-hand in her past. This may implicitly impact how she sees her role, workload, and role as a parent. Unresolved trauma lives and manifests in our bodies and lives in a way that keeps the trauma storied part of us activated.

Further, as a therapist who works with sexual violence, I also know that people who are giving birth who have a history of sexual assault may be very likely to experience triggers during pregnancy and birth – the birth process can be quite re-traumatizing in fact. This includes both the birth itself as well as the early postpartum period.

There are so many good models of trauma-informed care (TIC). I have put together this one with the 6 key principles that inform my work. For instance, I take the intake and assessment process slow. I don’t expect clients to share with me their history of trauma in the first 1-3 sessions (typically it’s seen as required information in order to get service). That disclosure should come with time, established trust and rapport, and the development of a relationship. I am a relational therapist – I value alchemy between us, I self-disclose my own lived experience at times (i.e my own miscarriage loss), and I am committed to work from a place of non-judgment and compassion. We build our work together on compassion and collaboration and they navigate how the sessions go – be it how and where they sit in the room, and what they want to talk about in session. As I’m trained in several therapy modalities, I also believe it’s important to use what is best for my clients, and would refer to someone else if it’s not the right fit.

Being a trauma therapist does not mean I expect to hear the trauma story itself. In fact, that may not happen at all. To me, being a trauma-informed trauma therapist means I work to help people access their resources (strategies that are physical, relational, spiritual, emotional and mental) so that they can find ways to integrate their trauma part (i.e traumatic birth experience) into their everyday life now, so that it doesn’t remain a fragmented part that still triggers them when it’s the anniversary/birthday. As trust is earned, it’s important to me that we build this connection slowly, and pace the trauma work so that people feel safe when they leave their session with me. While I don’t think anyone can guarantee a 100% safe place, I make it a practice to do my best to collaborate my clients.

Trauma-informed care for me also means that the person seeking my support is the expert in their own life – Clients are their own expert. I am just a guide that is there to support them. I don’t carry any expectations of my own. I also bear witness to the various social locations and how that can impact their healing i.e from birth trauma and the intersection if they are a racialized or otherwise marginalized person. I also overtly acknowledge my privilege as a white cis-gendered woman, who also has power as a psychotherapist. I make this intersection explicit in my work by naming the oppression for what it is, instead of minimizing. Making links to the systemic forms of discrimination is an important practice of TIC as it holds space for multiple truths instead of internalizing shame and guilt.

Working from a trauma-informed place also means that I am an advocate if the people i support need or request it. I share resources with you if part of your chosen healing journey includes taking legal action. There are great organizations and advocates that can support someone in their healing process. As big component of post-traumatic growth is when survivors advocate not only for themselves but others as well. That’s why movements like #metoo and Birth Monopoly are so powerful. It is inherently healing to feel interconnectedness with others who have similar stories. It’s part of my role and responsibility to share these resources with the people i support. I also bring it into my practice even when people don’t ask for it overtly – we don’t know what we don’t know is available as a resource.

Trauma-informed practice also includes how I take care of myself as I can be impacted by vicarious trauma. I have tools, activities, and regular practice of self-care. I also think it’s necessary to keep learning about my work, and push myself to be even better as a therapist. I seek out peer and clinical consultation and believe that all therapists need to do this, regardless of them being in practice for 5 or 25 years.

When you are seeking support from a therapist or practitioner, ask them what their definition of trauma-informed care is. If they don’t have one, that may be a sign that they are not thinking of the inherent impact and context of trauma. Not everyone works in a trauma-focused profession but if they are not at least trauma-informed in the practice, that means they are not keeping your safety and needs at their forefront of their work. Trauma does not have to be complex and Big T, but anyone who has lost a job, grieved the death of a loved one (including a pet), moved to a new city with no support, had a significant injury or illness have all experienced trauma that still lives in their body.

We deserve better. We deserve to get support that honours what our body knows. As Pat Ogden has so wisely shared, “the body always leads us home.”

An Eternal Flame – How to Say Hello to Mom Burn-Out

I’m a mom. I’m a feminist. I’m a therapist for women. I am a feminist mom wholeheartedly. And yet i am faced with that beautiful vulnerability of being flawed like anyone else: I am burning out.
My little flame is wavering a bit.

It is not lost on me that i am a therapist who supports new parents, especially mothers, with the transition into parenthood. And i can’t help but feel the grasp of imposter syndrome that I too am immersed in the impact of Impossible Parenting. I do all the things i suggest to others. That’s not the point – in fact, it’s much bigger than me and what i can do for myself. As i grapple with parenting my children in real life, and in public, i feel a self-imposed burn of pressure to be Mary Poppins perfect – what kind of model am i to others if i too am struggling to keep my kids’ (and my) shit together at the Grocery store? Ugh – the pressure can be too much, and then i seek out my self-compassionate voice and breathe a bit better. I love the lists of ways to heal from mom burn-out, but those are band-aid solutions and not touching on the root of the problem.

I chose to be a parent, i wanted kids and i love the idea of the matrescence rite of passage. And yet, part of me wonders if this is all it is?

I love my life. I really do. This isn’t a passive aggressive way to try to get a message to my partner. (though this open letter to dads is great!). I also recognize my vast privilege as a white cis gendered woman who is able-bodied and partnered to a cis man who i love and have a healthy relationship with, where both of us have permanent work.

And yet…

I’m so tired. And irritable. And cranky. For a while, I thought it was work overload then I wondering if I’m not practicing what i preach with work/life balance. So i read some books, slowed down some evenings, met up with friends here and there, did less work after-work hours. And still…i was crabby.

I love the work of Esther Perel that reminds us how we put on our good work pants for work, only to take them off when we get home. Then proceed to show our own family our more authentic and messy side. Like I should still be wearing my nice pants all day, or at least notice how i present my good side only at work.

At first, i thought ‘oh oh’ I’m not being so kind to my family and felt self-critical of my own internalized want to have it all at the same time. I was sad with myself for putting work first, and being tired by the end of the day, when my kids needed me. And then i realized, “huh, what is playing a role in me feeling this way.’ Surely it’s not just my own doing.

I think I’m more right about that side of the coin.

A few weeks ago, i had to point out to my beloved dependents that people come to see me on purpose to help them when they are sad or stuck with a hard feeling and decision. And yet, my kids will yell over me to keep arguing with each other. For a while, i would be ashamed that I could not be able to help them de-escalate or regulate their feelings – that’s what i do ALL DAY long at work after all. I realized then and there that maybe i am better at helping others who want to be supported, and that my kids need me in a different way.

Sure, i know they need me to model self-soothing behaviour and emotion regulation. Sure I have the tools – i even make a real toolbox for them.

I’ve begun to resent weekends. Sure, i practice what i preach – i take time for myself in the evening and don’t always do the dishes, unpack lunch bags, put stuff away. Sometimes i watch a show by myself or write articles like this one… And feel guilty about it. The idea of a mini mom vacation sounds decadent and yet i know it’s just a band-aid solution.

I do live from a family-centred place and attachment theory is my jam. I get hugs and love from my family, even a thank-you and I’m sorry sometimes. I don’t want to be worshipped per say, but to be more appreciated and noticed would be great. What i need is less work and chores and tasks and requests and and and..

I love all the articles on social media that remind us of the mental load of mother’s work (and yes it’s quite gendered still, and also still seen under the umbrella of women’s work). I’m glad we are acknowledging this burden and current iteration of sexist division of labour. Motherhood is still tasked by the same glass ceiling that we feminists fought for some many years ago. I wish i could turn off the brain thinking part of the mental load of mothering. Yes, it’s a verb now too.

For instance, here’s a run-down of some things that i carry in a given week:

* I once woke up in middle of night to pack a swimsuit for my kid’s class – i went to bed knowing i forgot something!
* I keep the health cards even though I now hate the sight of blood (and I learned that after my son fell off a tree into a river on a vacation and needed stitches – that i wanted to get him but my partner’s didn’t think were necessary)
* On that note, i wake up through the night whenever my kids move, or cough, or cry out
* i am a sous-chef that knows my son only likes raw veggies and tomato soup and my daughter hates the idea of sandwiches
* I have to get the rascals out of bed while he makes lunches – yes I’m grateful he makes lunches because it’s a yucky job, but what’s easier?
* I know exactly how to pour their juice in the morning so that one is not jealous that the other got more to juice (not to drink it mind you, but you know “fairness”)
* I coordinate playdates for the weekends that I work or it’s not my turn to take a day off for a PA Day
* I know what their favourite socks are and where to find them
* I know when they have homework, or class trips, or birthday parties and send in the forms and RSVPs
* I book childcare for the 4-times-a-year date nights
* I know when the birthdays are of their friends!
* I feel guilty when i am at work on a Saturday or can’t make it to them if the school calls mid-day
* I know when the tooth fairy is going to visit and save the coin for that night
* I have forgotten twice and felt so shitty

There is no such thing about a maternal instinct. You read that right – there is NOT one but rather we are taught and learn how to be moms. Who reading this has babysat at a young age, or was taught how to mend socks and buttons, or what is best for a sore tummy since you were a child yourself? Yes i do know that men of my generation may have learned this too, but are they doing all the other things too? Do they stay up thinking about all this too? When we list what we do and thing about, especially during that 3rd shift of labour in a day, do our partners say “i took out the trash, or changed the litter box.” Yes thank you sweet lover, but do you also wake up worrying about your kid’s strained friendships or start planning their birthday party 2 months ahead of time?

Just look at all the books dedicated to this – they all are geared to mommy blog readers, or mommy mojo sex fullfillment, or mama rage. And guess who reads these books and articles? Yup, moms and women. So, while I’m a glass half-full gal at the best of times, I’m not so sure this will change.

Don’t get me wrong, i read all those books and enjoy most of them. This photo is just some of the books i am reading right now, in fact. My partner has yet to finish one parenting book – but he chose a good one so I’m glad he has that under his belt. And i do love my self-identified label of mom. I even loved it was the first word of both my babies. And yes, i identify as a mother, not a parent. Go figure. I even loved it was the first word of both my babies.

And again, i will remind you that i love my partner dearly, our relationship is absolutely solid, and he is a very hands-on, active, and available dad to my our children. This is about him nor needing to change our roles, gendered or not. It is bigger than just us. I am so grateful for all my partner does. The homemade bookcases and winter tires and …

And yet…

(( written by a tired and grumpy Middle Aged perimenopausal woman ))

How to Have a Dialogue with Your Inner Critic

Have your ever noticed what you say to yourself after doing something wrong? Is it mean or extra critical? Is it offering advice without you asking for it? I don’t know anyone who doesn’t have an inner critic at times. There are definitely ways to put the voice to rest, or at least have a more balanced conversation with it. Hare some some tips that work for me. And yes, i am my own client!

As much as i know that my inner critic is trying to help me, i also have learned that i can choose not to listen to you, and even tell it to go away. Just like learning any new language, being able to talk BACK to your inner critic takes practice. Here are some tips that can help you be fluent in this process.

1) Somatic Sense of Inner Critic
First, it’s important to recognize what your inner critic voice is. What do they say? What is their voice like? Do they blame your or push you down? How do they undermine you.

When your inner critic shows up, see where they live in your body – is it a loud dull pain in your chest, or a sharp scratch on your shoulders. A tool that can help is PATH – notice the pressure, air, tension, heat that may rise in your body. Where is it located? Spend some time noticing this. This mindfulness is a great tool to help you notice your inner critic more quickly. If you can locate the felt sense in your body, you can tend to it more quickly.

You can also do the great tool by Tara Brach called RAIN – recognize what is going on in the given moment allow the experience to be there, investigate with kindness and be open to Nurturing the new awareness with self-compassion. Click here for a lovely guided meditation that Tara has created using this tool.

Be really clear about when the inner critic shows up. They are not your only voice so notice if there is a pattern or consistency when they come up. Notice what your physical reaction is – is there a knot in your stomach, does our throat feel tight, is there a heaviness in your legs? This is the inner critic speaking.

2) Name them
I call mine Pam. She was someone that bullied me when i was in grade 6. I also love these meme: “My inner critic is An Asshole” and find it inspiring.

Acknowledge it is here, but like a vampire, you can tell it to leave. It’s an emotional vampire after all! Say hello to them, and then tell them they are not wanted. Externalizing the voice helps keep it separate from you. As a tool of Narrative Therapy, it is so helpful to externalize this voice as it helps you not take all the blame or responsibility on your shoulders.

The inner critic is an external voice that has been internalized. Spend some time hearing the voice – what does it sound like? Is it your voice or someone else’s? Can you remember when the inner critic was born? Our inner critic is usually related to not allowing ourselves to be proud of our accomplishments. Can you recall what it was like for you as a child? I know that at times, my inner critic has a Serbian accent that is similar to my mom’s. I definitely hear her (now helpful) voice at times, if only when i’m cooking or doing laundry at this point. It now carries a tone of guidance.

Also, it’s totally okay to be rude and interrupt this voice! By doing so, you are establishing a new habit and helping your poor brain make the changes it needs too.

3) Reflect
Spend some time at the end of a day and see how you often your inner critic showed up – we don’t always notice it in the moment. Stay with the feeling to help move through it. You might want to start a journal that helps you record when your inner critic shows up. Is it daily or after a certain thing – like going to the gym, or scrolling through Instagram. Make a point to recall how it felt in your body when your Inner Critic was crashing your party. Then spend some time writing a list of positive things about yourself – work on self-compassion and witnessing your own gains to balance out the judgement. Take a look at Kristin Neff’s work and the helpful journal prompts and exercises that help you reflect. One of my favourite questions form her workbook with Christopher Germer is “Is your Inner Critic tiring to protect you in some way, to keep you safe form danger, to help you, even if the result has been unproductive?”

While it doesn’t always seem like it, but your Inner Critic is a part of us that is trying to help. It is always loudest right before the breakthrough. The inner critic can be a protector for you, as a part of you that helps soothe your worries. It lives in our sympathetic nervous system, that part of the brain that is ready for flight or fight response to a threat or scary challenge. It truly is trying it help, if only in the all the wrong ways.

When you are reflecting, make sure to make a point to also allow space for self-love and acceptance. Talk to yourself like someone you love. Self-affirmation work can be a direct OFFset to the inner critic. Developing a compassionate inner voice can counter the critic. Ask yourself what you can say with love back to the critic. Acceptance is about being good enough or good-ish, very perfect. It is about being okay with what is.


4) From Inner Critic to Inner Guide
Your inner citric needs love. It is trying to help you. It is usually there to protect you from potential shame or failure. Explore what it is trying to tell you. And put it to work. If it’s telling you that what you did is not good enough, as it to do better.

We need a bridge to get to positive so work on being neutral first. It is about being both/and – both a critical lens to help you make sure you got it right AND a compassionate lovely voice that encourages you to try. Bring in a dialogue – add your cheerleader, warrior, nurturer, or wise future self – like Toni or Frida and bring in some self-compassion – remind yourself that your thoughts are not always right so add more to the conversation. When you feel sad about being hard on yourself, give yourself time to feel this and then move on.

For instance, instead of saying…
I am a terrible cook BUT RATHER i am learning to cook
I am a bad mom BUT INSTEAD i am good at taking care of boo boos
I can’t do this TRY I’m going to try my best for today

Sometimes that inner critic is trying to be a guide or reminding you of something hard, but instead of being supportive, it is keeping you stuck. You can thank the critic for supporting you and then say it’s job is no longer needed – the writer Donna Tart has said that she uses criticism as a guide to getting stronger because she treats it like a vaccine. It makes you stronger. Put your Inner Critic to work with something useful! Laura Markham of Aha Parenting speaks further to this idea here.

This might be a tricky question so bear with me, but try and see what part of your houses your Inner Critic? I am not referring the body now, but rather the part of that is wounded. Is it your Inner Child, work-in-progress Goddess, protector, Adult Self, or your Worker Bee? I’m not suggesting we have multiple personalities persay but we are made up of parts that are shaped by the experiences in our life – both the good and the challenging ones. So, this is a chance to re-parent yourself. This Inner Guide may have a calm and warm voice. It cherishes you and accepts you as you are. In time, this voice will become your own and will be more present. Channel this voice as much as you can – it is a practice after all. You truly are learning a new language and what better way to do so than to practice it in a dialogue with someone else!

5) The Four Agreements
This book is to help us be more intentional and loving citizens of the world. So, why not use the 4 principles and apply them to your own self? The book itself is a small book, but it’s quite powerful. The photo here captures the essence of the 4 agreements and I especially like the one “don’t take it personally.”

Speaking of good books to read, here are some great ones that help you become even more fluent! Radical Acceptance by Tara Brach, Your Resonant Self by Sarah Peyton and
Healing your Emotional Self: A Powerful Program to Help you Raise your Self-Esteem, Quiet your Inner Critic and Overcome Your Shame Beverly Engel

As you start to practice this new intentional relationship with your inner dialogue, be kind and gentle with yourself. Notice the criticism or impatience and send it the kindness you would anyone else that is learning a new language for the first time.

Resilience after the Punch

My youngest was hurt by another student recently. She was holding the door open and he sucker punched her. Because she said No to him. He had overheard her talking with friends about snails. She said she liked them but never wanted to be one. Then, at the door, he called her a snail and she said she didn’t like that and he needed to stop. Then, boom, she got punched in the gut.

The mama bear in me is fierce right now. The trauma therapist knows how this may sit in her body – she was intentionally punched in the stomach for saying no to someone. What does that say to her now? The parent in me knows that 6 year olds are still learning how to regulate their emotions so I am working on empathy for the other student. The therapist worries about the boy and where he learned to do this. And the feminist in me knows that boys that hit girls make me mad as hell.

I was at work when i got the call. I left pretty soon after to tend to her, and see how she was coping. And you know what, she is the definition of resilience. She was able to share how it made her feel, she was able to find ways to play regardless of the event, and she was able to rest that night and cuddle with me. Gordon Neufeld talks about what children need in order to be resilient. It is a sound foundation of attachment and then access to Rest, Play and Feelings. This helps them bounce back after adversity.

((This photo captures her making friends with another child at the beach where we camped this summer – she makes friends as easy as she breathes))

My daughter is also fierceless – be it an incident like this or when she fell on the train tracks this summer. She was going over a tricky train track on her bike. We were able to discuss it that night and help her prepare to go over it again. We were able to access her upstairs brain (thanks Dan Siegel) and know that she could get over the tracks again.

It’s no surprise that her dad and i helped her access her feelings – we made it clear that she did nothing wrong, and that we were proud of her for going to the teacher. She followed her instinct to bring in the support of the staff at school, and felt seen by them. My daughter was able to recognize that maybe the boy’s bucket was empty whereas her’s is full – she has a community of friends and he is new to the class. My daughter was also about to reflect that a sucker punch is different than a fight with her brother. The fact that it came from nowhere hurt her more than the punch itself.

Each year, there is an event called Take Back the Night. It’s for women-identified people and children to reclaim the street and fight for the right to feel safe at night. I have been going for years and love the energy that the group commands. I have also taken my kids since they were babies and toddlers. It feels like the timing is perfect this year, as it is this coming Friday in Toronto. I think my daughter needs to march and know what her right is to her body and saying NO. Check out this link to read more about it – there are events like this all over the world.

Don’t get me wrong – we are still working on co-regulation of her emotions too and she has her own struggle still with impulse control and the infamous 6-year change. Just this morning, she was so mad that her brother (who’s older) got a smidge more of juice in his cup. She refused to bike to school with him.

I told her this was emptying my cup, literally. I tried to remind her of bucket filling and she told me that it was a juice cup, not a bucket so it didn’t count. Go figure.

Let That Good Feeling Linger

Sunflowers are my absolute favourite flower – they are strong yet fragile, bend to the sun, and keep facing upwards. I also love their cheery colour and reminder of hot summer days. I went with my family recently to a sunflower farm, where we were about to walk among hundreds and hundreds of rows of them. I took in the felt sense of this experience and it lingers in my body in a happy way (kind of like that smiling flower in the photo here). I’ve been practicing this a lot lately.

Since summer break is coming to a close this week (for many of us it feels like the end of summer as a whole), I want to share this experience with you as it may come in handy when you need to hold on to the good feelings in your body.

It was my anniversary this summer and my partner and I were able to have an extra long date. While it happened over the course of a seven-day long therapy training for me, we were still able to stay present in the date. It might be because I am immersing myself in somatic-based therapy work but we were able to put our good feelings from the date in an imaginary jar.

We love bike riding in the city, both with our kids but definitely without them as well. After a delicious meal at one of our favourite places, we took a long bike ride along the harborfront. It’s such a gift that the city I live in has a great lake connected to it. As an ocean lover, i know that it may not be an ocean persay, but a Great Lake is a close second. As a water loving person, I know I never spend enough time in its presence. So, we decided to bike along a new path that is right beside the lake. It just opened recently – that itself was such a nice gift as we may not have done it with our children.

I was able to use the bike ride as a way to share with my partner more about Sensorimotor Psychotherapy (SP) and how it works. There are 5 core organizers that are the main base of how SP therapy helps connect the body to the mind both in healing trauma but also in everyday mindfulness. It’s a great way to help good feelings linger in an intentional way, like an imaginary jar of a good date you want to hold on to.

The 5 core organizers are body sensation, five senses, movement, emotion, and cognition, and in that order. So on our date, we decided to blend all of them and this is what we came up with:

1) Body Sensation: My body felt like a warm glow in my heart and my core, and a freedom in my shoulders that experienced the wind
2) The Five Senses: The feel of air touching my arms, the smell of the lake, the beautiful skyline of the city, the sounds of life around us, the taste lingering from my delicious dinner
3) Movement: We brought awareness to our legs pedalling both up hills and around us. It was an incredibly hot day so we also noticed how the pedalling felt with our warm bodies
4) Emotion: I carry with me now such a deep sense of love and happiness both for that experience, to share with my partner, and to be with my partner in that moment
5) Cognition: I acknowledged how grateful I was that we had that time together, and shared this talk with him so that we could hold onto it together

Now when life gets in the way, and we are getting stuck in the grind of everyday life, all i need to do is to recall this date and my body will respond. I will embody the memory and not just think about it. When I’m forgetting a detail, all i need to do is to recall the smell of the lake, or the body sensation in my core. As i bike daily, i get a quick hint of the memory whenever i feel the breeze on me or grip my handlebars. I don’t need to recall a big part of the story, but rather a single moment and my body and mind are united in recalling the happy moment. It’s a lovely way to practice more intentional felt sense of positive moments – we are so prone to minimize them and rush through them. It’s like I’m peering into that jar of happy memories or giving myself a warm hug by recalling this night.

As summer is coming to a close, you can try this tool. What memory from these last 2 months do you want to cherish and hold on to?