Summer 2024
By Amal Wartalska
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This article explores what we, as EMDR therapists, should consider in order to use EMDR effectively in processing socially inflicted trauma, with a particular focus on racial trauma. In the first part, I presented the main considerations stemming from the development and achievements of intercultural therapy, which I deem crucial for therapists of all modalities to be able to conduct therapy successfully across difference.
In this part, I describe the specific adaptations to the EMDR protocol that aim to adapt it to the cultural needs of clients from oppressed and marginalised groups. This is supported by case illustrations, demonstrating how I synthesise those teachings in my own practice.
Marginalised and oppressed communities are subject to denigrating and invalidating messages projected by the dominant culture, which are then internalised on an unconscious level. The EMDR therapist’s awareness of those realities of psychologically oppressive cultural dynamics is crucial in facilitating the processing of this type of trauma through appropriate target selection (client’s experiences of oppression) and helping clients understand how these led to the creation of subconscious negative self-beliefs. Nickerson writes about it using the term “socially based negative cognitions”and explores how cultural stereotypes are internalised (Nickerson, 2016, pp. 29-52).
| Culturally based negative cognition | Positive cognition | |
| Black male client | I am subhuman/I am worthless | I am worthy of respect |
| Black female client | There is something wrong with me/I’m unlovable | I am ok as I am/I deserve love |
| Transgender client | I am abnormal | I am normal |
| Gay client | I am dirty | I am worthy |
Robinson (2016) describes using EMDR to process “transgenerationally based familial, cultural or institutional abuse” in her approach, Legacy-attuned EMDR. She writes: “Legacy-attuned EMDR therapy allows clinicians to access and reprocess transgenerational associations and memories that negatively impact current lives. (…) [It] resonates for people exposed to terrorism, war and genocide, as well as for those stricken by devastating natural disasters. (…) It is germane for people persecuted by racial, religious and gender discrimination, including gay, transgendered, and minority individuals who have felt betrayed and invalidated by the culture at large or by their cultural heritage” (Robinson, 2016, p. 147).
In the legacy-attuned EMDR model, a thorough history (including the client and their close family, friends and community) needs to be taken with consideration of the generational aspect and the image of the generational history of the client’s family and community reconstructed as much as possible. It is then possible for the client to understand some of their feelings and patterns of behaviour in the context of the historical events that impacted them, their family and their community, and how they might have been passed from generation to generation, and to address them appropriately with EMDR.
It also creates a valued opportunity for the client to reflect on how their family and community survived, coped with adversity and demonstrated resilience. This sense of pride, their capacity to survive and cope, and their resilience and endurance are important, especially in healing from cultural shame, which generations of humiliation might have induced. It can lead to creating a different, more coherent and empowered narrative of the client and their family’s life and history. Robinson terms this “legacy-based core positive cognition (CPC)” (Robinson, 2016, p. 148).
Clients who suffered exposure to different social oppressions benefit from and often actively choose culturally specific and appropriate grounding resources (Robinson calls them legacy-attuned resources). For example, clients who process experiences of racism often choose as attachment resources famous figures of the civil rights movement, like Malcolm X or Nelson Mandela. Clients who are processing experiences of sexism may choose female figures or characters from historical, spiritual or popular culture, symbolising power and empowerment. One of my clients, who is South Asian, chose the Hindu goddess of power, Durga, as a protector figure.
Chang (2016) suggests that transgender and gender non-conforming clients (TGNC) can choose their ‘future empowered transitioned self’ (FETS), as a resource, which is a visualisation and activation of the client in their affirmed gender.
Clients may also benefit from choosing a safe place of cultural significance for them. One of my clients, who is British African, chose the ruins of a castle on top of a mountain in their country of origin. A Buddhist client chose the inside of a Buddhist temple, and a Muslim client chose the inside of a mosque. We can sensitively and respectfully guide clients towards legacy-attuned resources.
Levis (2016) came up with the concept of ‘community cultural wealth resources’ (CCWR) for EMDR processing. She advocates discussing and installing these often invisible and undervalued resources in the preparation stage.
The concept of CCWR builds on Yosso’s definition of cultural wealth as “an array of knowledge, skills, abilities and contacts utilized by Communities of Colour to survive and resist macro- and micro-forms of oppressions” (Yosso, 2005).
Yosso divides cultural wealth accessible to communities of colour into six groups: aspirational, linguistic, familial, social, navigational and resistant capital, to which Huber (2009) later added spiritual capital.
Types of cultural capital as defined by Yosso, Huber and Duran:
Clients from immigrant communities, dealing with the hostile environment of the country of residence, had to develop and rely on all of those capitals most of the time.
Clients from the LGBTQQ group often developed a specialised understanding of the gendered nature of speech, language and communication patterns. These can be installed as forms of linguistic, navigational, and resistant capital (Levis, 2016).
It is empowering for clients from marginalised and disempowered groups to become aware of and connected to, in an embodied way, those examples of rich cultural wealth, which are so invisible and not appreciated in a dominant culture.
Here are some examples from my own practice of processing trauma inflicted by social oppression using EMDR. The specific oppressions those clients experienced and addressed in therapy were those of racism and classism. To protect anonymity, the following case illustrations feature altered names, personal characteristics and other identifying information. The clients have provided written informed consent for their experience to be shared.
Roy is a Black, British Jamaican man in his 50s. He sought therapy because he was experiencing low mood, signs of depression, anxiety and problems sleeping. He also had high blood pressure and another medical condition, for which he took medication.
Roy was aware that these problems were linked to his work. On discussion, it became apparent that he was experiencing a lot of systemic racism at his workplace, was racially targeted and was on the receiving end of micro- and macro-aggressions. We acknowledged that his workplace was institutionally racist and oppressive and the detrimental impact it had on his mental, emotional and physical wellbeing, and we worked towards him leaving the job. He managed to quit within a few months, and after enjoying his freedom for a while, he found another, much better job where he generally felt appreciated and respected.
In our further explorations, he realised that he had suffered intense anger for most of his life, which affected his wellbeing and relationships. Roy was vaguely aware that it was linked to the experiences of racism he struggled against throughout his life.
He grew up in a working-class town in Enoch Powell’s era. His childhood and adolescence were full of overt experiences of racial violence. After he moved to a bigger city as a young man, the racism he experienced changed into more subtle systemic racist dynamics, invalidations, devaluations and microaggressions.
The resources Roy chose were of cultural significance and held a deep meaning for him:
We created a chronological list of the worst incidents. It started with his first walk to school through the white neighbourhood at age five, amid racist taunting coming from other children, while adults gave passive permission to it. He had to repeat this walk every school day thereafter. Another memory was of being chased by a mob of white kids at age eight, barely getting away with his life. There were a few more we addressed.
Roy’s culturally based negative cognitions were, “I’m weak,” “I’m in danger” and “I’m powerless.”
The culturally based positive cognitions he arrived at were, “I’m strong,” “I can protect myself/I survived and thrived” and “I’m powerful.”
We gave time to exploring his and his family’s generational history, starting hundreds of years ago in Sudan (which his DNA test pointed to), migration to West Africa, surviving a transatlantic slave journey, the trauma of enslavement in Jamaica and migration to Britain.
At the end of therapy, Roy found out that he no longer felt triggered by the reminders of racist incidents he experienced in his life, thanks to EMDR processing.
Moreover, he developed a different narrative of his and his family’s past, in which he was able to look at it with an awareness of their enormous strength, resilience and feelings of pride in their achievements. They all did well in spite of enormous adversity.
His physical health improved as a result too: his blood pressure came down, he was able to reduce the medication he was on, and generally he found himself calmer and feeling more at peace.
At some point, he needed to travel to the town he grew up in, where the most extreme of the racial traumas happened. He hadn’t been there for a long time and, each time he visited, he felt triggered, not safe and distressed.
After returning from the trip, Roy reported to me that he felt surprisingly unmoved during his stay there. He even re-visited some of the old places associated with different traumatic events, and he didn’t feel triggered at all.
Laura is a Black, mixed-race woman in her thirties. She grew up with her white mother and siblings in a working-class, diverse part of a city. During her school life, she was subjected to continuous racial aggression from both white and Black peers, mainly girls, some constituting physical violence and some verbal and emotional. As it was in Roy’s case, after she grew up, the racism didn’t stop; it just lost the physical violence aspect and became more subtle.
She sought therapy because she was experiencing high emotional distress, anxiety and problems sleeping and she felt extremely emotionally activated in triggering situations, finding herself unable to speak and have an appropriate response.
We created a list of memories of the most significant incidents of racial trauma. Most of them recounted physical and verbal attacks from both white and Black girls during their school years. Her culturally based negative cognitions were, “I’m a coward” and “I’m weak.” The culturally based positive cognitions she arrived at were, “I’m brave” and “I’m strong.”
Laura had also been affected by intersectional disadvantages related to class. Growing up in a single-mother household on a housing estate, the family struggled financially. Laura developed deep anxiety related to her financial security. Her negative cognition here was, “I will never be secure.” It was replaced by, “I am secure financially, and I can manage my income.”
Laura’s emotional wellbeing improved dramatically as a result of therapy. She started sleeping better, and no longer felt particularly distressed recalling experiences of racist attacks from the past.
She developed a different narrative of her past, where she was able to let go of misplaced guilt and toxic shame inflicted on her by the racial oppression she experienced and found deeper acceptance of herself as a Black mixed-race woman.
She also let go of a deep sense of insecurity about her finances. Laura was able to realise that she had not only survived but was able to achieve a great career and a healthy romantic relationship, in spite of the adversities she had faced and against the odds. She emerged at the end of therapy with a new awareness of her own strength, resilience, courage and creativity.
As part of her newfound confidence, she took part in a public discussion on matters of race, where she was able to speak about her mixed-race experience and perspective in a calm and coherent manner, which she thought made it possible for others to hear her and reflect on what she said.
The client stories presented in this article demonstrate the potential of EMDR as an effective approach for processing socially inflicted trauma. The successful application of it, however, depends on two key factors. Firstly, on developing an intercultural and anti-oppressive approach as a fundamental base, which was discussed in Part 1 of this article; and secondly, on using specific alterations of the EMDR standard protocol in order to adapt it for the cultural needs of clients from oppressed and marginalised groups. The main points of this article can be summarised as:
This article has explored the essential elements that EMDR therapists should consider in order to use EMDR effectively in processing racial and other socially inflicted traumas. In Part 1 I looked at what we need to learn from the achievements of intercultural therapy to be able to offer anti-oppressive, culturally safe and culturally attuned therapy; and in this final Part 2, I looked at specific adaptations to the EMDR standard protocol, supported by research.
Spence poses a very important and open question in her article, “Is EMDR an anti-racist therapy?” (Spence, 2023). I hope that I have demonstrated, through research and illustrations from my practice, that it certainly can be. It has the potential to be both anti-racist and anti-oppressive. The considerations presented here, if enacted in practice, have the potential to make EMDR therapy a powerful transformative personal healing journey for members of marginalised and oppressed communities, but even more importantly, a vehicle of much needed wider social change for everyone.
Chang, S. C. (2016). EMDR therapy as affirmative care for transgender and gender nonconforming clients. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy, (pp. 177-194). Springer Publishing Company.
Duran, E. (2006). Healing the soul wound: Counselling with American Indians and other native peoples. New York, NY: Teachers College Press.
Huber, L. (2009). Challenging racist, nativist framing: Acknowledging the community cultural wealth of undocumented Chicana college students to reframe the immigration debate. Harvard Educational Review, 79(4), 704-729. https://doi.org/10.17763/haer.79.4.r7j1xn011965w186
Levis, R.V. (2016). Placing culture at the heart of EMDR therapy. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy: Innovative strategies and protocols (pp. 97–111). Springer Publishing Company.
Levis, R.V., & Siniego, L. (2016). An integrative approach to EMDR therapy as an antioppression endeavour. In M. Nickerson (ed.), Cultural competence and healing culturally based trauma with EMDR therapy: Innovative strategies and protocols. (pp. 79-95) Springer Publishing Company.
Nickerson, M. (2016). Healing culturally based trauma and exploring social identities with EMDR therapy. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy, (pp. 29-52). Springer Publishing Company.
Robinson, Natalie S. (2016). Legacy-attuned EMDR Therapy: Toward a coherent narrative. In M. Nickerson (ed.), Cultural competence and healing culturally based trauma with EMDR therapy, (pp. 177-194). LLC, Springer Publishing Company.
Spence, O. (2023). Is EMDR an anti-racist therapy? EMDR Therapy Quarterly. https://etq.emdrassociation.org.uk/2023/10/16/is-emdr-an-anti-racist-therapy/
Yosso, T. J. (2005). Whose culture has capital? A critical race theory discussion of community cultural wealth. Race Ethnicity and Education, 8(1), pp. 69-91. https://doi.org/10.1080/1361332052000341006
Opinion
Not all trauma is the same. In the first of her two part article, Amal Wartalska guides us through important considerations when working with people who have experienced socially inflicted trauma. She argues that without due consideration to these issues as therapists, we risk reinforcing the trauma that people have already suffered.
