Emotional First Aid Expert Dr. Guy Winch on Trauma

While it’s well-known that recovering from addiction is a non-linear process, it’s more difficult to tell what throws people off course. After getting clean and sober, the difficulty of staying clean and sober is often a surprise—particularly when drugs and alcohol were previously used to medicate many different discomforts and psychological issues. It’s the latter that Guy Winch, a licensed psychologist, author and pioneer of the concept of Emotional First Aid, has taken aim at.

Winch got his doctorate in clinical psychology from New York University, completing a post-doc at NYU Medical School. Though he has a private practice in Manhattan where he sees individuals and couples for psychotherapy, he has also written books such as The Squeaky Wheel and Emotional First Aid. Perhaps what he’s most popularly known for, though, are his wildly popular TED Talks about practicing emotional first aid and fixing a broken heart. While his work has all kinds of helpful applications, it applies particularly well to addiction recovery.

In a recent interview with Joe Polish, Winch expanded on his concept of emotional first aid: “We really know how to address physical injuries when we have them,” he says. “We have no such practice whatsoever when it comes to emotional or psychological injuries.” As it turns out, the “injuries” that we try to ignore the most are the things that create the most problems for us. “Injuries like failure, rejection, loneliness, guilt,” Winch says. “Unless we’re aware of these things, we’re just going to get deeper in and sustain more damage than we need.”

Becoming aware of our emotional state is a practice Winch calls emotional hygiene—and  according to Winch, we should all strive to make it part of our everyday life. “One of the things I’m really for is…gratitude exercises,” Winch says. “A gratitude exercise is getting up in the morning and saying, ‘You know what? The people I really care about right now are healthy, my parents are in good health, I’m really grateful for that because there may be a time in the future where that may not be the case.’”

Research shows that substance abuse disorders are often strongly correlated to a variety of mental health issues—issues which can further worsen our emotional states. Although this isn’t specific only to people with diagnosed disorders, overly negative self-talk is one of the negative symptoms of mental illness that Winch says is a major culprit. “The self-critical internal voice that so many of us have in so many frustrating moments is absolutely useless,” he says. “It’s purely damaging, there is no utility to it.”

While negative self-talk can have any number of causes, it can sometimes be exacerbated or caused by underlying trauma. Some addiction experts like Gabor Maté have theorized that trauma or a lack of connection may be to blame for all (or at least nearly all) of addiction. While Winch agrees that trauma can be a cause, he hesitates to give a blanket explanation—and says that the reality of trauma is much more complex.

“It only takes a few seconds to have trauma,” Winch says. “It’s not a quantitative thing, it’s a qualitative thing. Trauma is something that shocks the system, something that’s impactful enough that it causes you to reassess and rethink your general views on yourself, on life, on the people around you. It causes a fundamental shift, a seismic shift in your psychological system.”

Much like his concept of emotional hygiene, Winch similarly agrees that untreated trauma could lead addicts back to drugs and alcohol, or to negative emotional states that then lead to drugs and alcohol. “When I read that ‘the generalized approach to trauma should be this or that,’ it’s hard for me to endorse,” he says. “You have to have some kind of understanding of it in a way that gives it meaning. In the narrative of your life, it has to be a plot point that leads to something of significance.” While for some people this may mean excavating the experiences, others, according to Winch, may not need to.

Perhaps the underlying problem for recovering addicts, as Winch sees it, is one of positive and negative identity—particularly as they relate to trauma and negative self-talk. “Having a strong sense of self is actually really important,” Winch says. “At a certain level of addiction, it is so prominent in [an addict’s] life that it is the organizing principle. Many people get sober but they can’t maintain it. The problem there is that the addiction has become so central in their lives that there is nothing else central enough to attract them into another way of being.”

For his part, Winch has hope from his practice and his understanding of psychology that people can make changes in their habits to increase their chances of recovery. “I’m not a psychiatrist,” he says,” but my general thought is that it’s a two-way street. Our brain chemistry, our wiring, those kinds of things, impact our behavior significantly. But there are things we can do, behaviors we can assume, that will impact our brain chemistry.” Still, he notes that it’s a bit more complicated than that. “The impact of neurochemistry on our behavior is like a six-lane highway,” he says. “Our ability to impact brain chemistry and hormones by thinking or behavior is like a single-lane country road.”

Because of these hard facts, Winch also advocates getting on medication whenever necessary to treat depression, anxiety or whatever else may be ailing a person. With that chemical boost, people can then begin positive habits to reinforce their change. What all these disparate threads have in common, according to Winch, is simple. “Self-awareness,” he says. “When you hear yourself go through the same argument and it’s not going to get anywhere, stop doing that. That’s my advice in general. When things aren’t working for you, change the script. Don’t just try the same thing but try harder. Change the system.”

Recovery Month Contest Winner #1: Recovering in Waves by Lynn Fraser

In honor of Recovery Month, we asked you to send us your stories about the impact community, nutrition or environment has had on your life since you put down substances and picked up life. Winners are not only receiving copies of our book, The Miracle Morning for Addiction Recovery, but are also being published here on the site.

First up we have Lynn Fraser. Find out more about Lynn here.

As a teen, I was desperate to escape the pain of bullying and used sugar, alcohol and other drugs. I dissociated. I considered suicide.

We medicate ourselves when we can’t stand feeling powerless and shamed. I’ve used the “bad ones”—sugar, alcohol and other drugs, and socially approved addictions like codependent relationships and over working. I stopped drinking and drugs in my mid-20s.

In the past five years, I finally healed the trauma and disconnection that was driving the need to escape.

Twenty-five years ago, I learned meditation and developed a connection within myself and within a community. I began to see how the mind worked and gradually healed the what-if catastrophic and compulsive thinking that was torturing me. I got to know myself on many levels and became kinder to myself.

Six years ago, I left an unhealthy relationship. I learned about Developmental Trauma. I began to release trauma stored in my body and I now specialize in supporting people to feel safe enough to heal. With the right support, we reach a tipping point where we no longer need to hide out or escape.

I connected with myself. I felt hopeful I could end my suffering. I stopped shaming and judging myself. I begin to have experiences of being okay. I became patient and compassionate with myself.

I connected with my sense of value through inquiring into and seeing through core deficiency beliefs of unworthiness and shame. Many of us had experiences as children of feeling unloved and unworthy, of feeling like we are being hurt because we are fundamentally bad. We developed beliefs based our experiences and these beliefs persist. They are the innocent beliefs formed when we were children and they are not true.

As I let go of the self-loathing and shame, my mind became healthier. When a negative thought comes up now, I notice it. I gently inquire into why I feel triggered into shame. My whole life and experience is workable.

Every single day I am grateful for my stability and presence and that I can help other people find their own safety and healing.

How Do You Heal Core Trauma? An Exclusive Interview with Dr. Jamie Marich on EMDR

Dr. Jamie Marich is an EMDR bad-ass. Sure, that’s a kind of crazy way to identify someone but it’s true.

Here are her stats: she travels internationally teaching on EMDR therapy, trauma, addiction, expressive arts, yoga and mindfulness while maintaining a private practice in her home base of Warren, Ohio. She is the founder and director of The Institute for Creative Mindfulness, developer of the Dancing Mindfulness practice and co-developer of the Yoga Unchained approach to trauma-informed yoga. She is also the author of five books on trauma recovery, most recently EMDR Therapy and Mindfulness for Trauma Focused Care (with Dr. Stephen Dansiger). Oh and she’s over 16 years sober.

While I’d dabbled in EMDR before (I went to a therapist in the 90s and asked her if we could figure out if I had any repressed memories and she waved a pencil back and forth in my face and nothing happened), I knew a time would come when I’d have to dig in and really do it. But who wakes up in the morning and says, “Today I’d love to go pay someone to make me cry about all the things I’d rather forget”? I waited until I was, as they say, going through it and decided, since I was already sad, I might as well capitalize on that and try breaking down the thought patterns that were causing me to suffer more than I needed to.

I’m about 25 appointments in and I can say without hyperbole that it has been one of the most significant experiences of my life. While I love my regular therapist, EMDR has a way of making you go, “Why in God’s name have we been talking about all these issues all these years without ever SOLVING them?!!” Through EMDR, I have dismantled destructive thoughts in ways I never thought possible and been able to shed those labels my family gave me so that I can step into my greatness.

We all deserve to step into our greatness, as Dr. Jamie Marich knows better than anyone. Below are snippets from the conversation I had with her when I interviewed her over Facebook Live,

ANNA DAVID: Let’s start with the basics. What is EMDR?

JAMIE MARICH: EMDR stands for Eye Movement Desensitization and Reprocessing and, as you and I were sharing in our chat before the interview, it is a terrible name. It really is reflective of the historical context of which the therapy was founded.

There’s this story which is almost the stuff of legend now that Dr. Francine Shapiro, who came up with EMDR, was taking a walk the park and was contemplating some terrible things that had happened to her. She is a cancer survivor and had recently gone through some issues around that. Because was a very devoted student of mind body medicine, she was used to experimenting with her body to see “If I do this with my body, how will it affect my mental processes and vice versa…”

So she was taking this walk and discovered that her eyes started doing this bizarre back and forth thing as she was processing her thoughts and feelings, and so from there she started trialing and erroring with her friends saying, “Follow my fingers. As you reflect on these thoughts, feelings, emotions, notice what happens.”

It’s not as simple as “Just think of the trauma—follow my fingers and it’s going to go away.”

ANNA DAVID: How is it more complicated?

JAMIE MARICH: There is a method and a protocol that therapists need to be trained in so they can do EMDR safely and properly. But the reason it’s a horrible name and a clinical misnomer is that it was eventually discovered that you didn’t need the eye movement component to have a lot of the effect. You could do it by having earphones and hearing alternating beeps or by being tapped or by holding pulsers.

The mechanism at play really is this back and forth stimulation. We sometimes call it bilateral stimulation or dual attention stimulus…that oscillating motion back and forth.

ANNA DAVID: What does the bilateral stimulation do?

JAMIE MARICH: The easiest way I can explain EMDR is that it really helps us go deeper into the brain than talk therapy alone. A lot of people who’ve had experiences with EMDR will say things like, “I’ve mulled over this issue in talk therapy for years and years and years, and it just never quite shifted. I have good cognitive understanding, but at the heart and the body level, I still feel stuck.”

EMDR is one of the approaches that can help us go deeper than talk alone. It’s probably the most effective method I have seen for allowing me to access the holistic person and allow these shifts to happen more effectively and more quickly.

ANNA DAVID: What exactly is happening to the brain?

JAMIE MARICH: The limbic brain, which is the middle part of our brain that we cannot easily get to by words—our fight or flight brain—can say stuck in trauma repetitions. So we can’t easily get to it through words. This sort of stimulation opens up neurotransmitters that connect the limbic brain—the neocortex, which is the more rational brain.

It’s like this: We can have that talk over and over again where we say, “I should know better” but it’s not linking up in the heart and the body. So what the dual attention stimulus is doing is it’s literally widening the bridge between those two brains in ourselves…we can call them parts of the brain, but they’re technically different brains.

But when you’re getting into reprocessing trauma, the speed is usually set up a little higher because we want to move information more efficiently over that neuro fiber bridge between the feeling brain and the neocortex. The way that I’ve heard one of my mentors explained it is that when we help a person process trauma in this way, we move memories to the neocortex. It’s not that we’re eliminating memories. It shifts how memories are stored in the brain.

ANNA DAVID: What percentage of your clients are you doing EMDR with and what percentage are you doing just talk therapy?

JAMIE MARICH: I do EMDR with all my clients. Because once you get known in an area as doing it, a lot of people end up finding you. Of course I do other things—I do 12 step facilitation and expressive arts therapy, there are other things I bring into the mix. But EMDR is my primary method.

ANNA DAVID: While I know how it works, how can you explain it to someone who’s never done it?

JAMIE MARICH: The client and therapist talk about something and the therapist asks the client the level of distress around the issue, from 0 to 10. After doing some of the stimulation, the therapist asks, “What are you noticing now?” as opposed to “What are you thinking about now?” We want to be open to the full range of your experience. Some people will give us the thought that’s on their mind. But if what you’re noticing is that your chest is on fire, tell us that because that means your body is giving you that information. The magic EMDR phrase is “Go with that” because we want you to be able to be with that but then keep allowing more to be revealed. At the end of the session, we ask the level of stress again, with the idea that the number goes down.

ANNA DAVID: I know it’s for reprocessing memories but is it also so people can access repressed memories?

JAMIE MARICH: EMDR may take you by surprise; you may think, “I forgot that happened, or I never connected those two things together.” But one thing Dr. Shapiro always said is that EMDR does not bring up memories just for the sake of bringing them up. The point is not to torture you with your past, but if something is going to come up in the reprocessing, it’s because it’s connected to the issue that you’re working on. EMDR reveals what needs to be revealed.

ANNA DAVID: Why do people think EMDR is sort of woo woo when in fact it’s medically supported?

JAMIE MARICH: It used to be considered very fringe, very alternative. Like, “Oh, move your eyes back and forth while you sense into memory experiences in your body.” But one of the things I do credit Dr .Shapiro for is she really did soldier very strongly in those early days, in the 90s and 2000s, saying. “We have to research this.” And so she developed a very technical protocol.

One of the reasons you’re asked those questions about your level of distress is so that we can measure how it’s working. EMDR is one of the three most researched therapies for PTSD. There are other things out there that can treat PTSD but none of them has the research support quite like EMDR.

On, which is our big international organization, there’s an up to date listing of all of the research reviews, literature reviews, and clinical randomized controls on EMDR. It’s really quite exquisite and it’s something I’m just proud to be a part of.

ANNA DAVID: So the research is just based on what the client reports?

JAMIE MARICH: There are some really highly randomized controlled studies where those ratings around distress are taken into effect but we also have seen symptoms eradicated. A measure of success is if you go in as a client and have this clinical threshold that meets PTSD symptoms and then by the end of a certain course of EMDR treatment, those symptoms are eliminated.

ANNA DAVID: What sort of symptoms?

JAMIE MARICH: The major symptoms of PTSD are things like flashbacks, nightmares, intrusive thoughts and body level distress memories. You can have what we call the heightened arousal symptoms like the increased startle response, hypervigilance, outbursts of anger and problems concentrating. Also feeling intense, negative effect or having negative experiences of emotion all the time—anger or terror, shame, sadness—or just an intense negative self-image where you’re thinking thoughts like “I’m bad. No one can be trusted. I am defective.” A lot of these symptoms may sound like other diagnoses you heard of, like ADD and depression, so it really does become important to work with a clinician who can weigh out what things are affecting you. But the more we learn about trauma, the more we see that a lot of the behaviors and issues that cause human beings distress are explained by unhealed trauma.

ANNA DAVID: Is there a typical number of sessions of EMDR that people do?

JAMIE MARICH: Some of us have long-term clients for one issue or another because the nature of an individual’s disability may require that they have some type of check in on a more permanent basis. But we’re not trying to get people into therapy long-term with this. I do find that EMDR can work a lot more effectively and quicker than other forms of therapy. But I don’t ever want to sell it as a quick fix; that’s one of my pet peeves around some of the marketing around EMDR. You’ll read things online where someone says three sessions wiped out what years of therapy could never do. Now, I think in three sessions you can go very far and if you have a person with a pretty good life who has been through one single incident trauma, you may be able to eradicate most of the symptoms. But even our international guidelines say EMDR is not done in any certain number of sessions and it really is up to the clinician and the client together to devise the best treatment plan possible.

ANNA DAVID: What actually “counts” as trauma?

JAMIE MARICH: PTSD is typically understood to be single incident…like one bad thing happens to you and so you have all of these symptoms. But then there’s complex trauma and honestly, most of us who would meet PTSD criteria, it is of the more complex variety typically—meaning it’s one thing after another that has made the trauma symptomology a little more volatile or the trauma happened at a very developmentally vulnerable point in your life…typically before the age of eight and often by a primary caregiver.

ANNA DAVID: What do you say to people who think EMDR is not going to “work” on them or they’re scared to do it?

JAMIE MARICH: It’s a very good question. I mean two things. Let’s start with the fear first. I usually approach that by validating the fear because any change process is scary. The first thing I try to understand is what the fear is about. For a lot of people, it really is a fear of getting better. What would my life look like if I made these changes and shifts?

A lot of people are also scared that they couldn’t handle what may come up. EMDR can be pretty emotionally intense and so one thing I tell folks who work with me is “I’m willing to help you get ready for that process.”

And when people say, “I don’t think this will work for me,” often it’s because they’ve been jaded by other forms of therapy. So I will often explore what some of those experiences have been. Sometimes the core idea is “Nothing will work for me because nothing has worked for me so far.” And sometimes I explore that by asking the question, “Well, what does it mean to you for something to work? Well, let’s start there.” And um, then usually from there we can develop a plan.

I think it has the potential to work for everybody but I also know that not every therapy is the best fit for everybody so I usually try to invite people to give it three to six sessions. And if it’s not a good fit for you, then I’ll help you try to find a therapy that is a good fit. But I have honestly seen this work for about every type of client out there, if they’re willing to do some of the work required.

ANNA DAVID: Amen. Well, this has been fantastic. Where can people go to find out more information about you and EMDR?

JAMIE MARICH: Everything I’ve written for free online is on my website. I also have a big YouTube presence with mindfulness videos and EMDR demos that you can watch. Just go to YouTube, type my name, EMDR or ”trauma made simple” and you’ll see.

How Does Addiction Affect Families?

You don’t necessarily have to be an addict in order for your drug and alcohol use to annoy members of your family or have a negative impact on your family’s dynamics. However, an addiction often forms around dysfunctional family behavior that can be aggravated by the addictive behavior.

Families in which parents are addicts have their own particular dysfunction. Instances are they will not able to their own children. Because of what they’ve witnessed as models for adult behavior, these children are at an increased chance of becoming addicts. Sometimes, as they mature, children of addicts may attempt to distance themselves from their parents’ compulsion. Only to find later on that they have abuse a different substance. This might happen, for instance, when a parent is an alcoholic. Even though the adult children of this parent don’t drink, they might develop an addiction to sex. Or might run up high debt because they are shopaholics.

How Does Addiction Affect FamiliesFamilies in which children are addicts often have problems distinguishing the difference between helping versus enabling the addict. Addicted family members should be handled with tough love. Don’t give in to the temptation to try to make the situation better for the addict. Only he or she can make the decision to get clean. Families in this situation must first make the addict aware that their behavior is unacceptable and then they must seek to heal from the trauma that addiction has caused in their daily lives. Sometimes the financial devastation of addiction (if family members are stealing money from other family members or opening fraudulent credit in their name) can takes years to set straight. In cases of theft or violence, family members often have to make the tough decision whether to involve law enforcement.

Dealing with Addiction

Usually, these extreme steps might be the final push that an addict needs in order to seek help. Addiction causes damaged on the normal family bonding. An addicted family members cannot be trusted. They usually cannot hold onto a job and may often go missing over night or for multiple days. They inevitably betray people who love them and more prone to violence. Above all, they are not able to attend to small children.

In addition to the emotional impact, the cost of an addict’s attempts at recovery might ruin the family financially. While the cost of buying drugs or alcohol can be a drain on a family’s budget, which may dwindle due to job loss, recovery programs can often be very costly, too. Many families dealing with addiction have to consider whether they might be better off filing bankruptcy, which can lead to the loss of future opportunities, such as the purchase of a home or the ability of your children to attend college. An addiction doesn’t just affect the person suffering from it; it affects everyone around him or her.

It is normal for the dysfunction of addiction to trigger feelings of anger, bitterness, resentment, jealousy, and many others from those who love a person abusing drugs or alcohol. The bottom line is that families should be very careful when dealing with addiction. It can damage relationships for years.