Kimberly Dudley On Vicarious Trauma

Kristi Cash White: My guest today is one of those people that just makes the world a better place. Kimberly is a dual licensed board certified therapist, specializing in trauma recovery and the Pacific Northwest. In addition to private practice, she is a domestic violence advocate, speaker and trainer with specialized training in interpersonal neurobiology, story-informed trauma therapy and brain spotting. She has worked with inner city teen parents, and she is currently working on her first book, Parenting Teens With Trauma Stories. She has a degree in human development and holds a Master's in clinical counseling. Kimberly describes herself as a "soul mama", an avid swimmer, a best friend, and a pursuer of the Feminine Wild.

I asked Kimberly to talk to me today about her experience as a trauma therapist and the challenges of vicarious trauma. I have no doubt that you and I will leave this conversation. Not only wiser, but encouraged as well.

So let's just start first, just with some introductions, so you have a private practice right?

Kimberly Dudley: I do. Yes.

Kristi: How is it going?

Kimberly: It's incredible. In a lot of ways, I feel like I'm living my dream life. And I think that's a really interesting and complicated thing to say without giving like more information, because on the one hand I am living my dream life in the sense of getting to make my own schedule and working with, them my beloveds, like my patients or my beloveds, getting to choose the people that I work with and feeling very secure and also.

I am a trauma therapist in the midst of a pandemic. So it's a lot right now, too.

Kristi: Yes, it is. I definitely want us to tease that apart cause is huge. To focus on trauma is a really difficult space to be in right now. You're trained as a trauma therapist, which, includes PTSD and a lot of anxiety, a lot of depression. I'm guessing [00:02:00] there's a lot of counselors out there who, when we get to the check boxes of what's your specialty, we'll include trauma with out actually having received specialized training in trauma.

So I'm wondering from your perspective, what does being a trauma specialist really mean?

Kimberly: I think you're right on about that. I think it's interesting trying to describe it because I think in essence, all of us are dealing with a level of trauma. And in my way of working in my training, it's always just been this natural thread that's been woven out throughout all of my career that I would work with trauma.

And I've always been pulled to the higher acuity cases, meaning the cases that are like, yeah, this is obvious trauma. In addition to the complex trauma I also treat as well. So question of like, learn? What have I studied? So have studied a lot of interpersonal neurobiology neurobiology under under

Bonnie Badenoch has been the one that I have just loved and adored. She's the most brilliant woman I probably have ever come into contact with. she was so incredibly compassionate.

So aware of the human-ness within people. So I have that both in my private and professional life. So my own therapist was trained directly under her.

I had gone through this program. And so if you don't know about Bonnie, as she wrote The Brain Wise Therapist. It's the kind of book, honestly, where it feels smart, just reading it. And also she's so brilliant with what she does.

And I'm not sure if many people know this, but she was a direct student of Dan Siegel too. So it's like this dropdown effect that I'm able to feel and sense in my own work. So that's a backbone. I've also worked really hard around Byron Kehler's, story-informed trauma therapy, and he has a name that has also been very integrated into many areas of therapy in the PAC Northwest.

So that's where the bulk of my trauma training comes from. Like I said, at the beginning, it's always been this thread throughout the work that I've been do, and it's very hard for me to separate because that's my story. And so having lived that story of intense trauma and through that own process, myself, into my program for clinical psych knowing yeah, this feels very natural to me.

I honestly can't imagine not doing trauma therapy because that's the way my entire brain has been organized around.

Kristi: It sounds like that is just who you are, what you're meant to do. You're talking about your own therapy brings up a question for me there are a lot of people that enter the counseling field because of their own personal experiences. And that can be either just this beautiful, helpful part of their story into their becoming really excellent therapist.

And then there's some who continue to use their studies as their own healing. How have you experienced that with people like what's been in your own case [00:05:00] that balance of I've been through trauma, but I'm now in a place that I'm safe enough and healed enough that I can help others.

Kimberly: Yeah. I love that term that I am safe enough. As a clinician that has to be my top priority that I have done enough of my own work and continue to do my own work in such a matter that I keep my own systems safe because that's what's going to bring other people into my office and create the safe space for them to do their own work, too.

It's interesting the way you said that. I think it's so spot on when I first started like whispering out into the rest of the world that maybe I was going to do this clinical psych program. It was very vulnerable because I think at that point I was probably seven years into my own trauma recovery.

And I thought, I don't know, can I do this? And I remember thinking part of my training feels very selfish in the sense of, I want to metabolize more of this and I want to understand and integrate more of the clinical language for my [00:06:00] own healing. So that was a very strong motivator for me.

And so that perspective of like really knowing what's the pull, what's the decision. What's the factors behind the decision that you're making and becoming a therapist and becoming a trauma therapist. I think it's vital to the work that we do. And the idea again, of going back safety and a clinician, I feel safest around not people who haven't experienced trauma, but who know that they've experienced trauma and who had definitely worked really hard at recovering and working through their traumas.

Kristi: Yeah, absolutely. I love that. which is why all the programs require us to do our own therapy, right? Because sometimes you may not be of

Kimberly: Right.

Kristi: some of those motivations and that kind of thing and therapy your own work can help bring some of that out.

Kimberly: Yeah. And I'm a firm believer in, we can only take our or our clients as far as we ourselves have been really willing to go within own [00:07:00] stories. So there's a constancy as I'm learning, I think at the beginning I felt like I'm just barely half a step ahead of the people that I'm trying to lead through this.

I think now it's morphed into, I will continue to work on this within myself because the more I do the better helper healer, I can be out there for the who come to me. .

Kristi: Absolutely. And that brings up a perfect segue into talking about the pandemic, right? Because we, all of a sudden, as therapists find ourselves experiencing the same challenges that are being brought into our offices. Uh, Along with all the traumas and everything else that people are bringing in their individual stories.

We've also got then the exhaustion, the fatigue, the fear, taking care of our own kids, all the things that our clients are bringing in therapists are wrestling with. How has that been for you

Kimberly: Yeah.

Kristi: Just in the last two years.

Kimberly: Yeah. I've noticed among kind of our people, meaning like [00:08:00] clinician and also helpers and healers in other fields too. I noticed since probably maybe the beginning of the year that all of. Who had to figure out how to get it together real quick for everyone else. It's like this new way of suddenly that fatigue is setting in a different way.

And we're starting to be like, wait now. Now I'm the one who, before I had the skills and I think this is even how I talked about it. At the beginning, I have the skills to self-regulate because I've done all this co-regulating prior to you with this anticipatory co-regulation that I've done. Not knowing the pandemic was coming. So at the beginning I had the skills to self-soothe. I could do that for myself, which kind of bled into the work that I was doing. And I think for so many of us, we held out there for our patients and our clients and our kids and our communities. And I'm kind of getting the sense now that it's like, Hey, I need to figure out how to retreat back and really take care of myself because [00:09:00] I'm now exhausted.

I've done this for two full years and now I attune to my own needs in a way in way, different ways than at the beginning. At the beginning, we're talking about work life balance, and we're talking about. We can do it. I know this is really hard. Let's talk about how we move our bodies and feed and make sure that we're sleeping well.

And this has a very different scent, different flavor to it, in my opinion, as therapists, as we're walking into this next season

Kristi: I agree. You and I both are on therapy Twitter, which is a great place for commiserating with other therapists. It would be so interesting to have somebody do a study on the themes of the last two years, because I agree in the last couple of months, even just since the holidays, I feel like the fatigue has been real and people are really feeling that struggle of this has been two years and we held it together [00:10:00] for everybody else. And now we're feeling pretty exhausted.

Kimberly: When we first got started as therapist, I remember thinking I'm never doing tele-health. I don't like it. It doesn't feel very therapeutic.

And then we moved in and I'm like there's not an option. This is my I'm going to have to learn how to do it.

Kristi: Yeah.

Kimberly: think as therapists, we're always trying to figure out simultaneously there's two tracks. There's a track of, how does it feel for us as therapists? How does it feel for clients to be out there and how do we bridge the gap and hold both our own stories and theirs as being important, different, same.

What does that look like for us as we're traveling through?

Kristi: So thinking about your clients where there's this real theme of complex trauma I wonder if, I felt like with my. A lot of things got put on hold and we were dealing with the stress. We were dealing with all the new stuff. I wonder what you saw in your clients at the themes of what you've worked on. And are you [00:11:00] continuing to see a transition of what

Kimberly: Yes.

Kristi: Are focusing on in their recovery?

Kimberly: I think those first waves, like we were starting to talk about a little bit, those first waves. I had a lot of people coming in and they're saying like all of the sudden I feel very different. All of a sudden I'm very anxious. I'm very depressed. I'm lacking motivation. And the language that I had at the time and continue to use as the idea of like pandemic activation is still a central nervous system activation.

So I work with a lot of complex PTSD as well. And so when I saw coming into my office was C-PTSD. All of these people who had these wonderful distractions before work and friends and church life and activities and sports - those were all distractions from what was happening behind the scene.

Kristi: Yeah.

Kimberly: They didn't have to feel their nervous system activation in the same way, because they had all of these activities, all of these things to break it [00:12:00] up.

And when we go into a lockdown or even just slow down of our communities. Suddenly those distractions are not within arms reaching anymore. And I saw this explosion of activation that came along and it, what it looked like was like I said, an increase in anxiety and depression are probably the most common ones and increase the interpersonal distress that was happening between them and their family members.

I started seeing a lot of people breaking up with family members, of a sudden, and I just kept attributing it to you. Yeah. Your nervous system is jacked up, out right now. And we're going to work on noticing, giving permission, curious about what's happening then working on that language to that back down.

Kristi: What an interesting look at it, almost in a backwards way, from what I have thought of, which is the pandemic was the removal of distractions that exposed [00:13:00] things that were already going on, issues that were already there.

It's like now, like you said, I no longer have this community to work in. I don't get to go to movies. I don't go to church. I don't hang out with friends. So then I'm here with myself and my thoughts

and all this stuff it's loud and now it's exposed.

Kimberly: Yeah. Yeah.

And now what do I do? Nothing's working. I can't handle this kind of stress anymore. I'm decompensating. They don't have that language, but that's, that's what we're putting in. You're doing a lot of psychoeducation of those first couple of months. So you'd ask, is it different, is what I'm seeing now different?

And I would say the intensity of describing that has started to settle down into something that feels more rhythmic, meaning I'm still getting a lot of that. And also people are not so surprised by their anxiety and their depression as they once were. Now they've lived in this state of survival and discord within their unit and frustration and [00:14:00] lack of motivation. And I think that there's probably enough language on Tik TOK and social media to talk about the fatigue that it's no longer as surprising. So I would say yes, it's often it's but it's so much quieter and now we're starting to see okay, what's wrong with me? Now I'm starting to see, I understood this to be survival, but I don't understand why it's still happening.

Kristi: Yes. Yes. I see where I'm at. I don't know how to move. know how to change I want to be out of this.

Kimberly: Yeah. Entire thing. Yeah. And part of it doesn't just mean pandemic. They're using the language often. They clients use the language. I'm tired of the pandemic, but when they really mean is, I'm tired of the way I feel. I'm tired of the way I feel excluded. My loneliness has been compounded now for the last two years.

And it's just not changing. I just don't see any kind of movement on the horizon. That feels hopeless to a lot of people.

Kristi: Yeah, [00:15:00] absolutely. So therapists, especially those of you who are in the specialty of complex trauma, run the risk of vicarious trauma. I see this a lot in my clients who are social workers, nurses, they've just been so wounded by the stories

Kimberly: Yeah.

Kristi: of the people they're helping.

And it's a really serious and legitimate issue, right? The DSM talks about with PTSD. Part of that can be vicariously experienced. How have you experienced that either in yourself or witnessed in others?

Kimberly: I think that's one of the benefits of having studied interpersonal neurobiology, or IPNB, is that it, it requires a very attuned knowledge. You can't see, but I always point to like my insides and like pointing down here, to my belly brain that's how I'm feeling, what I'm needing in that moment. so a lot of how I dealt with it myself is really just like a [00:16:00] deep breath, looking down into my system and saying, what's happening for me right now. What do I need? Because I think when we're not attuned to ourselves, when we can get very easily wrapped up in the vicarious trauma when we experienced life with our clients that are coming in with so much activation and trauma.

I tend to think about I do sit with extreme trauma. And so when I'm sitting with my clients, we use the idea of my system is going to respond and hopefully settle into your system. And so there's that, there's a part of the trauma work that we do. That's you can't skip that part. I'm using my neurons. I'm using my body to meet your body and bring it back down to a level that's workable.

And so how I dealt with that then is continuing to ask that same question Ooh, what does that feel like? What do I need in this moment and imagining what then the person that is across from me needs, [00:17:00] but all that to say yeah, in trauma, 45 minutes, every hour, I'm going into the stories.

And my body is actually like living through what they're presenting in our sessions. So it's a lot of words for me to say, I pay attention. And then I give myself permission to put it away at the end of my day. So in my brain, I've done a lot of work about I try to finish my notes before I go home. So I don't take anything with me and I in my brain, as I locked my door to my office, I start moving myself further away from the stories that I just contained.

I go wash my hands and grab some water. I let my body let go. As I'm walking down the stairs. So that by the time I get to my car, I'm not holding what I just witnessed for eight hours that day.

Kristi: I think that's really important, right? Cause that, that, especially with newer therapists, that is a really difficult part. I saw somebody on Twitter yesterday asked that, how do you leave it at work?

How do you not take it with you? And if you [00:18:00] can't balance that is where that vicarious trauma really can find root.

Kimberly: And I think that it takes so much effort as a trauma therapist to take care of myself. Like it's almost like this second part-time job that I do in taking care of myself. Whether that is paying attention to well, it's not whether these are the things that I do and my day-to-day life, sure that I'm eating throughout the day.

And then I'm not only just eating quick foods, but I'm eating like nutritional foods throughout my day. And I don't go more than a couple of hours without nourishing my body. And I'm thinking about those things all the time in the background do a lot of yoga.

How do we make sure that we're adjusting and posturing ourselves just right? I think about it when I sit in my chair. Monday through Thursday I'm not very good with friends outside of my home. I only have so much energy to give. And so I really protect those days. Cause those are my work days. And then on the weekends I do a lot of recovery, a lot of [00:19:00] hiking, a lot of meeting together with people and sharing what's been happening, but it really is.

Kristi: As you were talking about paying attention and you were doing the hand signals on your body, my clients can't see that part of me, and so how do you know, trying to connect physically? Through a screen is another part of the challenge that therapists have been going through over this last two years.

Kimberly: Yeah, you're so right. And we don't want to move very far away from our computers because then it somehow makes us feel further away from our patients too. And so I find myself leaning in and it requires more of our around saying things like, "you can't see it, but I'm pointing to my chest", a nd asking myself, or I find myself saying, "I know this is really hard to see over computer that I feel like I'm having tears for you".

Or, " did I miss that? Are you tearing up right now?" While it's in one hand, like a disruption to the work we're doing, it's also how we have to adjust so that we can do this work.

Kristi: Yeah, but it [00:20:00] also, in some ways it's such a beautiful way of bringing that to the forefront rather than just us noticing that they have tears, we are verbalizing that and saying, it looks like this is causing you to tear up. Tell me about that. And that's just another point in some ways of deeper connection,

Kimberly: Yeah,

Kristi: because we have to say it out loud.

Kimberly: You're so right. And it gives them permission to notice out loud as well. Oh, there's a shift in me, huh? Okay.

Kristi: So advice for therapists. When people talk about self care, it's always that, I think the bubble bath self-care has to be so much deeper and more meaningful than that to maintain and to be healthy in this field. So I loved what you said about paying attention.

That's what we tell clients, right?

Kimberly: right.

Kristi: What's going on in your body? And what do you need to do to care for that part of you? Is there anything else that you would add to that as far as like how therapists can be really intentional and wise about their own self care right now?

Kimberly: I think what you said, it's [00:21:00] so familiar to say self care is getting our nails done or taking a bubble bath or buying yourself something. And I think that is one form of self care. And to me, I would say that's not as not as deep of a level of self care, at least not for me..

And so asking ourselves in sitting with what do you need requires an attention to the detail within ourselves as well. To really ask oh, you need quiet right now? Okay. And giving ourselves permission then to shut things out that maybe we wouldn't have shut out before we were a therapist. In my way of thinking, being a therapist is not a nine to five job.

It's not something you log into and log off of. Being a therapist is not only what I do, but it's who I am. I have my friend actually said this the other day is looking at the bio-psycho-social- spiritual model for ourselves.

How can I check in with each one of those pieces as my part-time job of self-care. So [00:22:00] am I taking care of my nutrition? And I'm a swimmer, I have to swim a couple of days a week in order for my body to release some of that adrenaline and to refocus. So that's my thing. And then I've got to look at that social who's taking up energy in my space that I really, I can't have that energy depleted from me.

Who serves me energy back. What are the people in my life that fill me back up and I need to make more space for them. And then spiritually what our needs. And when I think of spiritual, I tend to think of like connection with something unseen. For me, it's a connection with the earth. I love being outside.

So making sure that I've got enough of that kind of rolled in And then of course the psycho part, our mental health part. Am I pursuing my own work? Do I have a good friend? I think therapists, its mandatory to have a good friend who's also a therapist. That we can check in on a level that just people who don't do the work can't.

Kristi: Absolutely. [00:23:00] Absolutely. And we do have to be more intentional about that again, because some of us are islands, and so we're not running into our coworkers in the office, like before, even if we are there's masks on or, it's just not as organic. So we have to be very intentional about all of that, that you're talking about, the self care of every aspect of ourselves, which again, is what we go over with our clients all the time.

So we have to be our first and most important client. All of that you said was so important and relevant and meaningful. And I just, I hope that anybody listening feels like they were encouraged to take the extra time to just spend with ourselves and do some listening.

Kimberly: And if I could encourage to I don't want to make it sound like I'm perfect at it or that I don't have any other distractions. A big part of my world is I'm a sole parent. I've got three kiddos. I run a private practice. It is about that intentionality and making it important. I love what you said about we have to be the first client in [00:24:00] our room.

We have to do that first for ourselves.

Kristi: Thank you so much for your time today. And for hanging out with me and talking, I loved it.

Kimberly: Thanks so much for having me. This has been so fun just to hear about you and to get to be here with you.