At the start of every day, I check the news - not because I’m a responsible citizen, but because doing so helps me prepare for my work as a psychotherapist who specializes in working with complex trauma. George Floyd’s murder, the COVID outbreak, the war in Ukraine: in the wake of these each of these events, I had to take deep breaths before seeing my clients. On the morning of 6/24/22, I read that Roe v. Wade had been overturned, and deep breathing was no longer enough. Instead, I held back tears as several of my clients bravely unpacked the ramifications of this historic decision for their safety, autonomy, and sense of self-worth.
“When Will I Matter?”
Ruth is 72-year-old black heterosexual cis woman and complex trauma survivor who suffered from years of childhood sexual abuse as she was continually raped by her father. She participated in talk therapy for years with little progress and began seeing me in order to try EMDR, Internal Family Systems Therapy, and Somatic Experiencing. This combination of theoretical perspectives and interventions appeared to be successful, as Ruth reported feeling safer, an improved sense of self-worth, and the courage to begin exploring her sexuality (which had been developmentally delayed for most of her life). The day following the Supreme Court’s ruling on Roe v. Wade, Ruth arrived at our session appearing irritable and stated, “Don’t ask me how I’m doing, you don’t want to know.”
Even though she often presented herself to others as “the nice old lady” (which is a response to complex trauma that many mental health professionals refer to as “fawning” or “people- pleasing''), fortunately Ruth and I had developed a relationship in which she was comfortable feeling and expressing her emotions.
“What if I had gotten pregnant by my father?” she asked. “Some of these states would have forced me to give birth like it was my fault. It’s taken me most of my life to realize that it wasn’t my fault and that it was my father’s illness, but now it feels like there are people who believe that I would have been to blame and that I should have suffered the consequences.” Ruth’s voice began to quiver as her anger morphed into grief. “It’s like my father mattered more than me, my mother mattered more than me, and if I had gotten pregnant now, that fetus would have mattered more than me. When will I matter?”
Complex trauma creates and fuels low self-worth. Ruth was treated like a second-class citizen for most of her life: as a child, as a woman, and particularly as a black woman. The overturning of Roe v. Wade re-awakened and exacerbated past experiences that had nearly destroyed her self-worth. It’s difficult to sustain a healthy sense of self-worth when you are constantly barraged with messages - perpetuated by systemic racism and misogyny - that you are not, in fact, inherently worthy of life, liberty, happiness, or respect; that your life is disposable or only, at best, peripherally or instrumentally considerable. Under such circumstances, how can I help Ruth sustain the self-worth that she has fought so hard to obtain ?
“I’m Next, They’re Coming For Me!”
Leigh is a 32-year-old white married gay man and complex trauma survivor who experienced childhood neglect, abandonment, and emotional abuse. At 14, he was outed by a sibling and subsequently kicked out of his home. He lived on the streets and eventually found his chosen family. After Roe was overturned, he arrived at session making no eye contact, which wasn’t like him. He began the session stating, “I have to start by reading you one of my favorite poems.” I encouraged him to read the poem, which was written by Martin Niemöller.
“First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me”
We sat in silence as his eyes darted around the room, desperately trying to find the words to express what he was thinking and feeling. “I’m next, they’re coming for me,” he whispered. Some therapists might categorize this thought as paranoia, but I didn’t. There are now rumblings to suggest that overturning Roe v. Wade will become a precedent for overturning same-sex marriage and legal consensual gay sex. Clarence Thomas has even explicitly suggested this.
Leigh arrived to therapy 2 years ago experiencing severe anxiety in social situations, sexual situations, and intimate relationships. He worked hard to address his trauma with attachment-based therapy, EMDR, and Animal Assisted Therapy in order to feel safe and secure in his relationships, sexuality, and social interactions. Now, once again, his safety is threatened. Every therapist knows that if your client doesn’t feel safe, they can only make so much progress. The client’s mind and body are focused on reestablishing safety, leaving little energy to focus on recovering from trauma or coping with the demands of their daily lives. Trauma survivors need to feel safe in order to heal, and now Leigh no longer feels safe.
“I’m Just a Vessel For Others To Use”
April is a 24-year-old nonbinary heterosexual Latina who survived multiple sexual assaults. At age 9, they were raped by an uncle, at age they were molested by a baby sitter, and at 15, gang raped at a college party. As a child, April was taught that they had no agency over their body. They were forced to hug and kiss their relatives on command, and thus they learned that adults get to decide what happens to their body – an experience that is all too common in many cultures. Unfortunately, these experiences caused April to internalize a lack of autonomy that made them unable to report their sexual assaults.
“Déjà vu,” April said, smiling wryly.
“Déjà vu?” I asked.
“My body isn’t mine, remember?”
“Yes, I do. Does this feel like before?
“Exactly like before.”
Due to a greater awareness of child sexual abuse and the importance of bodily autonomy, there is a movement in the psychology community that urges adults to ask children for their consent to acts of physical intimacy (e.g., hugs, kisses, snuggles, etc.) rather than command or coerce them to engage. There is a hope that these children will experience and internalize the value of bodily autonomy, practice establishing physical boundaries with adults, and be able to report violations of their boundaries. April never experienced bodily autonomy, and each sexual assault reinforced this lack of autonomy.
Over the past year, April addressed their trauma with Somatic Experiencing, EMDR, and Art Therapy. Slowly, they began to feel safer with others and in their body and were better able to establish boundaries in their relationships. I remember the first time they were able to say “no” on a date. They arrived at the session stating, “I didn’t want to go to his place and I didn’t care if he got angry.” Yet, after the overturning of Roe v. Wade, April experienced intense triggers that made them feel as if they were back at the beginning.
“I’m just a vessel for others to use,” April said as if it were a fact.
Once a trauma survivor is denied bodily autonomy, they are deprived of safey. The overturning of Roe v. Wade undercut April’s sense of autonomy, thus interfering in her trauma recovery. Will Ruth reclaim her self-worth? Will Leigh feel safe again? Will April reclaim her sense of bodily autonomy? I believe they will, but now they’ll have to struggle to do so more than anyone ever ought to have to. They have all made gains in their treatment that are still present at a deep level, and none of them are giving up.
As April proudly proclaimed at the end of their session, “ You know what? Fuck that, I’m not going back.”
File under: The Art of Psychotherapy, A Day in the Life of a Therapist
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“When Will I Matter?”
Ruth is 72-year-old black heterosexual cis woman and complex trauma survivor who suffered from years of childhood sexual abuse as she was continually raped by her father. She participated in talk therapy for years with little progress and began seeing me in order to try EMDR, Internal Family Systems Therapy, and Somatic Experiencing. This combination of theoretical perspectives and interventions appeared to be successful, as Ruth reported feeling safer, an improved sense of self-worth, and the courage to begin exploring her sexuality (which had been developmentally delayed for most of her life). The day following the Supreme Court’s ruling on Roe v. Wade, Ruth arrived at our session appearing irritable and stated, “Don’t ask me how I’m doing, you don’t want to know.”
Even though she often presented herself to others as “the nice old lady” (which is a response to complex trauma that many mental health professionals refer to as “fawning” or “people- pleasing''), fortunately Ruth and I had developed a relationship in which she was comfortable feeling and expressing her emotions.
“What if I had gotten pregnant by my father?” she asked. “Some of these states would have forced me to give birth like it was my fault. It’s taken me most of my life to realize that it wasn’t my fault and that it was my father’s illness, but now it feels like there are people who believe that I would have been to blame and that I should have suffered the consequences.” Ruth’s voice began to quiver as her anger morphed into grief. “It’s like my father mattered more than me, my mother mattered more than me, and if I had gotten pregnant now, that fetus would have mattered more than me. When will I matter?”
Complex trauma creates and fuels low self-worth. Ruth was treated like a second-class citizen for most of her life: as a child, as a woman, and particularly as a black woman. The overturning of Roe v. Wade re-awakened and exacerbated past experiences that had nearly destroyed her self-worth. It’s difficult to sustain a healthy sense of self-worth when you are constantly barraged with messages - perpetuated by systemic racism and misogyny - that you are not, in fact, inherently worthy of life, liberty, happiness, or respect; that your life is disposable or only, at best, peripherally or instrumentally considerable. Under such circumstances, how can I help Ruth sustain the self-worth that she has fought so hard to obtain ?
“I’m Next, They’re Coming For Me!”
Leigh is a 32-year-old white married gay man and complex trauma survivor who experienced childhood neglect, abandonment, and emotional abuse. At 14, he was outed by a sibling and subsequently kicked out of his home. He lived on the streets and eventually found his chosen family. After Roe was overturned, he arrived at session making no eye contact, which wasn’t like him. He began the session stating, “I have to start by reading you one of my favorite poems.” I encouraged him to read the poem, which was written by Martin Niemöller.
“First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me”
We sat in silence as his eyes darted around the room, desperately trying to find the words to express what he was thinking and feeling. “I’m next, they’re coming for me,” he whispered. Some therapists might categorize this thought as paranoia, but I didn’t. There are now rumblings to suggest that overturning Roe v. Wade will become a precedent for overturning same-sex marriage and legal consensual gay sex. Clarence Thomas has even explicitly suggested this.
Leigh arrived to therapy 2 years ago experiencing severe anxiety in social situations, sexual situations, and intimate relationships. He worked hard to address his trauma with attachment-based therapy, EMDR, and Animal Assisted Therapy in order to feel safe and secure in his relationships, sexuality, and social interactions. Now, once again, his safety is threatened. Every therapist knows that if your client doesn’t feel safe, they can only make so much progress. The client’s mind and body are focused on reestablishing safety, leaving little energy to focus on recovering from trauma or coping with the demands of their daily lives. Trauma survivors need to feel safe in order to heal, and now Leigh no longer feels safe.
“I’m Just a Vessel For Others To Use”
April is a 24-year-old nonbinary heterosexual Latina who survived multiple sexual assaults. At age 9, they were raped by an uncle, at age they were molested by a baby sitter, and at 15, gang raped at a college party. As a child, April was taught that they had no agency over their body. They were forced to hug and kiss their relatives on command, and thus they learned that adults get to decide what happens to their body – an experience that is all too common in many cultures. Unfortunately, these experiences caused April to internalize a lack of autonomy that made them unable to report their sexual assaults.
“Déjà vu,” April said, smiling wryly.
“Déjà vu?” I asked.
“My body isn’t mine, remember?”
“Yes, I do. Does this feel like before?
“Exactly like before.”
Due to a greater awareness of child sexual abuse and the importance of bodily autonomy, there is a movement in the psychology community that urges adults to ask children for their consent to acts of physical intimacy (e.g., hugs, kisses, snuggles, etc.) rather than command or coerce them to engage. There is a hope that these children will experience and internalize the value of bodily autonomy, practice establishing physical boundaries with adults, and be able to report violations of their boundaries. April never experienced bodily autonomy, and each sexual assault reinforced this lack of autonomy.
Over the past year, April addressed their trauma with Somatic Experiencing, EMDR, and Art Therapy. Slowly, they began to feel safer with others and in their body and were better able to establish boundaries in their relationships. I remember the first time they were able to say “no” on a date. They arrived at the session stating, “I didn’t want to go to his place and I didn’t care if he got angry.” Yet, after the overturning of Roe v. Wade, April experienced intense triggers that made them feel as if they were back at the beginning.
“I’m just a vessel for others to use,” April said as if it were a fact.
Once a trauma survivor is denied bodily autonomy, they are deprived of safey. The overturning of Roe v. Wade undercut April’s sense of autonomy, thus interfering in her trauma recovery. Will Ruth reclaim her self-worth? Will Leigh feel safe again? Will April reclaim her sense of bodily autonomy? I believe they will, but now they’ll have to struggle to do so more than anyone ever ought to have to. They have all made gains in their treatment that are still present at a deep level, and none of them are giving up.
As April proudly proclaimed at the end of their session, “ You know what? Fuck that, I’m not going back.”
File under: The Art of Psychotherapy, A Day in the Life of a Therapist