In this episode of Happy Hour with Bundle Birth Nurses, Justine and Sarah Lavonne get deep into trauma work and trauma-informed care. Sarah shares a personal experience of a traumatic event that happened to her in Ecuador and how she has been working through it with therapy, specifically eye movement desensitization and reprocessing (EMDR). She explains how EMDR helped her reprocess the traumatic memory and find a sense of empowerment and healing. They talk about the prevalence of trauma among nurses and the impact it can have on their lives and work. They also discuss the concept of adverse childhood events (ACEs) and how they can contribute to chronic illnesses and trauma in adulthood. The episode emphasizes the importance of addressing and healing from trauma to live a more fulfilling and resilient life. Thanks for listening and subscribing!
Note: this episode describes physical violence.
Helpful Links!
- Healing Trauma in the Birth Professional On-Demand Class (2 CEs)
- Preventing Birth Trauma Level 1 On-Demand Class (2.75 CEs)
- Preventing Birth Trauma Level 2 On-Demand Class (2.5 CEs)
- Grounding Techniques On-Demand Class (1.5 CEs)
- No Bad Parts book by Richard C. Schwartz, PHD
- What is ACEs (Adverse Childhood Experiences)
In this episode of Happy Hour with Bundle Birth Nurses, Justine and Sarah Lavonne get deep into trauma work and trauma-informed care. Sarah shares a personal experience of a traumatic event that happened to her in Ecuador and how she has been working through it with therapy, specifically eye movement desensitization and reprocessing (EMDR). She explains how EMDR helped her reprocess the traumatic memory and find a sense of empowerment and healing. They talk about the prevalence of trauma among nurses and the impact it can have on their lives and work. They also discuss the concept of adverse childhood events (ACEs) and how they can contribute to chronic illnesses and trauma in adulthood. The episode emphasizes the importance of addressing and healing from trauma to live a more fulfilling and resilient life. Thanks for listening and subscribing!
Note: this episode describes physical violence.
Helpful Links!
- Healing Trauma in the Birth Professional On-Demand Class (2 CEs)
- Preventing Birth Trauma Level 1 On-Demand Class (2.75 CEs)
- Preventing Birth Trauma Level 2 On-Demand Class (2.5 CEs)
- Grounding Techniques On-Demand Class (1.5 CEs)
- No Bad Parts book by Richard C. Schwartz, PHD
- What is ACEs (Adverse Childhood Experiences)
Justine:
Hi, I am Justine.
Sarah Lavonne:
And I'm Sarah Lavonne, and we are so glad you're here.
Justine:
We believe that your life has the potential to make a deep, meaningful impact on the world around you. You as a nurse have the ability to add value to every single person and patient you touch.
Sarah Lavonne:
We want to inspire you with resources, education, and stories to support you to live your absolute best life, both in and outside of work.
Justine:
But don't expect perfection over here. We're just here to have some conversations about anything, birth, work, and life. Trying to add some happy to your hour as we all grow together.
Sarah Lavonne:
By nurses for nurses, this is Happy Hour with Bundle Birth Nurses.
Justine:
One of the things that we are passionate about, if you've been around here, you'll know is trauma and trauma-informed care and being aware of trauma and how to navigate that while also living your best life. And so this episode, we are going to talk about some trauma and some trauma exercises and trauma therapies that Sarah has experienced and will share today on this episode. We're talking about and planning this episode. I had told Sarah, "I don't know what to say because I haven't done the therapy that you're going to talk about. What do I do?"
And so I was pushed to do a little research on trauma because I know that nurses are traumatized. I know that anecdotally, I know that with people I work with. And so I just Googled it. I Googled nurses and trauma. And one of the first things I saw was that there's an article that says, "It's no secret that nursing is a tough field and more nurses are reporting violence and trauma more than any other job." And we went to a conference, Sarah and I, actually a few months ago to an A1 California conference, and we learned about ACEs, so adverse childhood events.
And apparently that was groundbreaking 20 years ago. I wasn't aware at 14, but there are people that if you experience enough ACEs, and we can link what that is on the show notes. That you are more likely to have more chronic illnesses, be those "frequent flyers," be our patients that come into triage every single night for the same reason, et cetera. And it actually said that a lot of nurses also have a lot of ACEs. And honestly, that makes sense to me because we are traumatized as children and we have some of these things and then we want to help people.
We want to prove our existence and prove our worth to the world and so we become care providers. And then we have all this trauma and then we haven't worked through it. And then now we work in a job that could potentially cause us trauma. And if you work in labor and delivery, you either have had a traumatic birth, been a part of traumatic experience or have heard about it, vicarious trauma through someone. That was one thing that I've been trying to work on. No one needs to hear my traumatic births unless they really, really want to know.
I'm not just throwing that out because I don't want to just traumatize you for no reason. It's not worth it. So we are going to talk through some trauma things.
Sarah Lavonne:
And I think there's trauma that happens in our work, which by the way, we have a class for that. Our healing trauma and the birth professional class for that. There's a grounding techniques class, and then there's trauma level one and two, all related to this stuff for how we apply this to our practice with our patients to not traumatize them and be more trauma informed. And then also, we want you... And part of our mission, one of our taglines is we want you living your best life both in and outside of work. And so a lot of what we do, we speak to what happens on the job.
And like I said, we have whole classes on that. We have lots of other episodes on that. But I'm actually going to focus in on something personal that happened to me because we also know that we can be traumatized outside of work and that we are a whole person and that we don't disconnect from our whole person and what's happened to us outside of work when we show up to our patients. We also know that co-regulation is... I've been really pushing into that recently and I've been more cognizant of the idea of co-regulation. What that means is that we can jump onto the nervous systems of those around us.
And so what that means is more practically is that if my energy is calm, you are more likely to be calm. We see this a lot in children with their parents, that if their parent is freaking out because something scared me or whatever, the kid's going to respond, "Ah, I'm also freaking out. I'm not totally sure why, but I know that and I'm learning that because I'm seeing that modeled before me in my parent." Where the opposite is also true, that if we stay calm, that those around us also stay calm.
And so we're sort of all this one moving unit of our nervous systems. And so very often, again, this is a huge area of passion for me and honestly partially why I started Bundle Birth. Because I envision a world in which we are so much more healed. We are so much less traumatized. And even though we can't control what happens in our lives, for the big T and the little T traumas, big T meaning those really big things, natural disasters, violence, sexual assault, the big ones. There's also the little t traumas of the repeat offenses, the moral injuries of our jobs.
Big T trauma might be a death. A little t trauma might be bullying over when you were a child over and over and over again. And it leads to a nervous system that is out of whack, that is responsive to certain things that may not be similar to other people. And you'll hear us talk a lot clinically, but also the challenge becomes personal because we do carry so much of who we are into the bed side. And we can offer who we are to our patients and help them to have better experiences and help them to potentially ride off of our nervous systems and really make a difference in the most pivotal time in their life.
In my experience, we're going to be more effective when we are doing that internal work, when we are regulating, when we are healing, when we are caring for ourselves. My passion for this episode is that you would feel challenged to take one step forward in your mental health journey. Doesn't mean you have a mental health disorder. And if you do, then no problem. There's no stigma to any of that. Either we all need to say where we're at and then be taking steps forward towards post-traumatic growth.
Because when traumas happen, it can leave us broken forever where we can't tolerate certain things. It's affecting our daily living, or it's actually a catalyst for growth and opportunity to be better and make a bigger impact or shift where we go with our lives and all of that. And so that's sort of what I'd envisioned for this episode and why I'm also willing to share something very traumatic that happened to me. But also I want to be clear that in sharing this, I think I was very strategic in what I am choosing to share.
One, it's not a clinical scenario related to birth. It's completely outside. It happened outside of the US and it was one isolated experience. I want to be mindful that we also don't want to cause vicarious trauma either. But I will say that the end result, I'll give you a spoiler, that I feel very healed from this trauma and I feel very released, and I want you to experience the same thing. And so again, I hope that you find some sort of little nugget and challenge to take one step forward in all of our journeys to growth and leveling up and being better.
And just being able to offer more of ourselves to our worlds and our environments around us.
Justine:
Sarah, so tell us what happened.
Sarah Lavonne:
So I grew up in Ecuador. I do also want to disclaim that I love Ecuador. Ecuador has been the most special place to me in my entire life. I call it home. I graduated high school there. I had the best childhood. I have the coolest memories growing up. I totally attribute who I am today, so much to how that environment really raised me. And the people are amazing. The food is delicious. It's like a small country in South America. If you don't know where it is, look it up. And they have mountains and beach and the Galapagos Islands are a part of it and jungle.
All in this whole country, the size of the state of Nevada. So it was amazing. So I do want to make sure that I'm very clear that this is just a current state of where Ecuador has been in more recent years and it's really unfortunate, but there was something traumatic that happened to me there. So my family was back for Christmas. This was a year and a half ago at this point. So we went back and my sister and her two kids at that point, Riley was six months. Her son, the old one, Dakota was two years. My parents came in and it was me.
And we went to the beach in Ecuador and we go to this little beach on the coast that I've gone to my entire life. It is the most precious place. If people were to say, I'm not going to say the name, like your hidden password. Where it's like, "Where's your favorite place on earth?" That's my answer. So we had planned on going to the beach. I've gone there for every vacation growing up. We'd do Thanksgiving there, anytime we could go. It's these little cabanas that are right on the beach.
You walk down the beach to Bernabe. Which he goes out fishing in the morning to fresh seafood on the sand. It's six bucks for a ton of shrimp or fish or whatever. It's just paradise. There's no one there. And amazing. But we had been hearing that there was some violent crime happening on the coastal region, and people were kind of like, "I don't know if you should go." We had some pause. I intentionally actually left my computer. I normally don't really wear jewelry when I travel back to Ecuador, but sometimes I'll wear little things here and there.
I intentionally left a ton of stuff home for work and stuff, just because we had heard that things were getting a little more dicey. So the night before, interestingly enough too, I also... You function much more in cash than card there. And so I was like, "Should I bring cash?" I asked my dad and he was like, "No, I think I'm going to pay for anything else." I was like, "Let me just throw 60 bucks in my bag." You can sort of anticipate where this is going. And so we had traveled all day, it's eight hours or, well, it's probably not eight anymore.
It's six and a half hours probably down the mountain. You're going down 10,000 feet from 10,000 feet in Quito to the beach and arrived. And I will say that when we got there, things were really eerie. There was no one else staying at the place that we normally stay. They had put barbed wire on the fence that blocked off the cabins from the ocean. It was just a weird vibe. I was also sick at the time, and so I kind of just felt like crap and was like, "I'm going to go take a nap." So I pretty much slept all day, woke up for lunch and was sleeping and missed dinner and all that.
And so what had happened was that I was asleep in this cabin that I grew up in. I've probably stayed here 50 times in my life. Our names were inscribed on the inside. We'd carved them out on the inside of the wall. You don't understand, this place is the most precious place to me in the entire world. And the cabin that I was in, I had my own room. My parents were next door, and there was a door between us. And then each of our rooms had a door towards the outside that went to a covered patio right on the beach.
And so I awoke to banging and my dad [inaudible 00:10:59], some sort of something. And honestly, I thought he was having a stroke or if he was falling or there was some sort of medical emergency. And so I kind of pop out of bed, and as I'm getting out of bed and coming around the corner, my mom comes in through her bedroom, had shut the door and ran into my room and looked completely panicked. And had gone to my door, which was going towards the outside and was holding the door trying to latch the door. The door was not locked.
It all happened so quickly, but I saw the fear on her face. I knew my dad was outside. I knew there was something. And then my mom's trying to latch the lock. So I run over and I latched the lock, and then I'm like, "Oh my God, there was banging on the door." At that point, I knew we were being attacked. And this was, to me, the most traumatic point. There was a window and I looked out the window and like a freaking horror movie. You know when you look out a dark window, it's dark outside, maybe eight P.M.
And I'm looking out and in appears from the side, a man's face with a white mask over his mouth and nose with some sort of weapon. And he just slides into the window, looks me dead in the eyes with this super scary face and yells, and then bangs at the window, goes to hit the window. And mind you, in that split second, one, that's the most terrifying vision of the world. But also I saw my dad being held up at gun outside. So I'm like, "Oh my God, we're being attacked." So at that point, I know what's happening.
And so where I go to hold the door, and next thing you know they're banging in this door and banging. At this point, I used what I had at the time, and that was my extreme vocal cords. Let me tell you, your girl can scream. So I just start screaming as loud with all of my might as hard as I can. And I'm like, [foreign language 00:12:52]. And then I'm just like, "Ah" screaming, knowing that there's a guard on campus, and I can see out the window from the angle that I'm trying to hold the door and I can see it lit. And no one's coming. No one's coming.
I didn't even know there was 911, by the way, in Ecuador until after this incident because you just don't call the cops. The police presence is just not trustworthy. Most of them are corrupt and they're not reliable. And so I'm screaming, screaming and looking out the door and saying, "No one's coming. There's no help. We're totally alone here and we're a target." And so they're banging, banging, banging on the door, and I can see, like a movie, the wood cracking. And I'm like, "They're going to break in. Oh my God, my mom's in here."
And finally the door is giving way. And so I pull my mom to the other side of me. So I'm between the door and my mother. My mom's sitting, I'm still screaming as loud as I possibly can, and the guy gets in and starts yelling at me. [foreign language 00:13:54] blah, blah, blah. I'm like, "Give me your money." My mom's like, "We don't have money." And interestingly enough, now since we've reflected back now, I can actually laugh about it, but my mom was super feisty and I was also super feisty.
So talk about... When you think about being in these scenarios where I always pictured myself just hiding in a corner somewhere. I don't know that anybody who knows me would picture that because I became, I want to swear so badly, the really aggressive, mean, angry, loud. It was a fight. I was a fighter. And I was like, "No, we don't have money, blah, blah, blah, blah, blah." And he goes to grab my backpack and I was like, "Wait, I have money. I have money." So I'm like, "We got to satisfy him for something."
And mind you, he's waving a machete around and coming down at my mom and I'm yelling at him like, "No." And he'd look at my mom at one point, and this is pivotal. He's yelling and swinging machete at my mom. And I was for sure that we were going to get something sliced off, if not killed. He's looking at her. I wish you could see my face. I kind of looked at him with big open eyes and I just took a big deep breath and was like, "Ah" as loud. You don't understand. I am loud. And he jumped back and his eyes got big and he kind of looked at me and was thrown by it.
So remember that moment. So I am like, "I have money. I have money. Stop it. I have money. Give me a second." And I'm yelling straight back at him. I'm sure they were unprepared for that. My mom's being aggressive. So I dig in my purse, he's shaking me around and I'm like, "Oh my God, I can't even do anything." Mind you, this is my perspective now. So in the moment, of course, I am petrified, I am shaking. There's no liquid in my mouth. I'm trying to get the thing open. I know where the cash is.
I grab the cash, he grabs it aggressively out of my hand and then turns to my mom and he goes to grab my backpack, which my backpack had my iPad in it and a bunch of work stuff, but I also had a liter of water. It was super heavy. So my mom jumps on the backpack and leans back and was like, "No, [foreign language 00:15:54] that's for her work." And the guy, he totally had a confused, "Why do I care?" Why are you telling me that look on his face is very funny. But he gave up. But then I saw the moment where my phone was on the bed and it was in this bright pink case.
And I saw him see it, and I looked at it and I'm like, "No, my phone, there it goes. It's going to be gone." We love our phones. And it was connected to a charger, whatever. And so he grabs my phone and then he saw that I had a necklace on. And so he grabs my necklace. At this point, I turn, and my dad's now in the cabin with us, with blood down his face covering the side of his face with a gun to him. And another man had come in, there're screaming at us. He grabs my necklace, pulls the necklace off my neck, jumbling my dad around.
And then he's like, [foreign language 00:16:43]. Which is your ring to my dad, I'm pointing to my dad's wedding ring. I was going to say my stupid dad, my sweet dad, who's just so adorable, was like, "No, no, mi matrimonio, mi matrimonio." And just kept saying, "My wedding, my wedding." And I'm like, "Dad, give him your F-ing ring." And I'm screaming at him. And then I like, [inaudible 00:17:02] and I'm like a psychopath. I mean, I look like a crazy person. Mind you, it's spooked him. So he takes my dad's wedding ring, they shuffle us up a little bit, and then they run off into the outside.
They jump the fence, they shoot their gun. So their gun was loaded. And we hear this gunshot that plays in. So we shut the door. The door doesn't even latch at this point. And all of us, you can imagine. My mom is completely hysterical, full-blown, acute, traumatic stress. If you look up in the DSM, not able to speak, talking in circles. My dad's totally silent, bleeding down his head. I'm like putting pressure. Of course the nurse turns into me honestly. It was like, I mean, this resembled an emergency in the hospital where I'm like, "Okay, put pressure on his head."
And I looked at it and I was like, "Okay, it's not a bad gash in his head, but it's your head bleeds." So I get something on him. He can't hardly speak. And then we realized they didn't even go in my parents' room. My dad told him, all the money's in our room, let me go get it for you. All the money's in our room. So they know that they have money in there. And then my dad goes, "Why is Hannah's computer on the deck?" And I'm like, "What?" And my first thought is... My sister, who was two cabins down. My first thought is, "What an idiot.
What a stupid head that she left the computer outside. Did we not grow up in this country? That's a no-no anywhere. You don't leave it out at Starbucks hardly. And you left it out." And sure enough, then my dad goes, "No, that means they've been there." And then we all die inside a little bit because we're like, "Oh my God. They also..." And I hadn't even thought of my sister and the babies and all of that, but we knew that they'd also attack them. Hopefully they're okay. We don't know. And so we all regroup.
I hide the computer. My dad goes over to check on them. My mom's trying to call anybody, called Gladys, who's the owner person. And she can't type anything in her phone. She couldn't even unlock her phone. My dad couldn't unlock her phone. I'm like, "Here, swipe." So I swipe them both. She's trying there. She's like, "All their money. I have all my credit cards." So we're hiding all this stuff because we're thinking they know they didn't get the computer, they didn't get my parents' phone. They didn't get the money that my dad said.
And they know that we're completely sitting ducks. So they are coming back for round two. There's no way. We also know they've attacked my sister. So now we need to check on them and make sure that they're okay. My dad's bleeding down his face. It was horrible, horrible. And so I at some point leave my mom, which ended up being more traumatic for her later but I couldn't think of anything other than flee. And I was like, "We got to pack everything up. We got to get out of here. I don't care. We'll drive up the hill."
And in general, in Ecuador for all of growing up, you just don't drive at night. We would drive during the daytime. You don't do overnight drives. It's just not the safest. And we know this stuff, but I was like, "I don't care. We got to get out of here. They're coming back. They're coming back." So I go over to my sister, everything was okay. They did attack them. I'll tell that story in a second. What ended up happening was we ended up grabbing all our stuff and moving to a separate apartment in the same building, but up three floors that only had one entrance where we could sort of watch the environment and have some warning.
But we moved all in the dark. So we're covertly moving through the night, not making any noise and not turning on a single light. And at one point, Josh, my brother-in-Law, was like to my dad, "Don't you dare let Dakota see your face. He can't know." All of that. So we get up into this apartment and we stay up all night watching. And on hypervigilance, I'm using tools from our trauma classes. I'm not kidding. I'm like, "Okay, we need to walk and metabolize the hormones. Everyone start moving, do some squats, do some lunges. Keep moving, keep moving because we got..."
All that adrenaline literally has to be worked out of our system. And so we sent the boys to bed, which they barely went to bed. Every bang in the night, you can imagine we're crying intermittently, every trauma symptom you could possibly imagine, hypervigilance, dissociation, all of it. We did the Find My iPhone thing with my iPad. Luckily we were able to jump on and we set everything up to be wiped and all of that, but they got all of our phones, so we're up all night. The boys sleep, us girls stayed up. And then when we... In the morning, we drove back to Quito.
Mind you, at the same time, there was a cop that showed up and he was like, "Oh, I think I know these guys. Are these their Facebook profiles?" And showed us their faces. We're like, "Yeah, that's them." It's like, "Oh yeah, they've been doing that." I'm like, "Okay." Tried to pay them to stay to watch for the night. And he was like, "Yeah, we'll be back." They didn't show back up. But one of the scary things was that we were ready to pack up and go. And the cop was like, "Oh no, you can't do that. You can't drive right now. You really can't."
We were like, "What? Why?" And he's like, "Well, the cartel have taken over this area, and if you leave, they're throwing spikes across the road and stopping you, gutting your car. At about half the time you survive, half the time they kill you." I'm like, "Oh my God." So talk about feeling isolated and we're expecting them to come back. So we're about to be attacked again, and we can't leave because we're going to be killed by the cartel. And we can't protect ourselves because everybody's eight hours away and there's no police reinforcement whatsoever.
So you can imagine the trauma continued. But I will say that we did use a lot of the tools. I used visual convergence from our trauma classes. I used breathing techniques. I mean, I was coaching my whole family through everything I could possibly remember from all of those to help down regulate our nervous systems, mind you how effective, whatever. But we spent the next three days together as a family before we ended up having to go back to the states and leave my poor sister there who still lives there and is moving back, thank God. But there's lasting effects of this stuff.
And we went to a hotel and all of us are crying in the lobby because we were asking about security. My mom had a panic attack. I mean, it was brutal. And my sister's been in therapy for it. My parents are in therapy for it. I went to therapy for that and other reasons. But in general, thinking like, "Oh, I could tackle that one too." This trauma for me is probably one of the minor ones. But it was a really good tester for pursuing finally some EMDR therapy. Because for me, my lasting symptoms were, I had a really hard time looking out a dark window.
You can imagine why. And my back entry, for instance, is usually dark and I have to walk past it to close the door at night, really being obsessive about the locks. I asked my landlord to put bars on certain windows and then just really jumpy. The sounds that would send me back would be running something, like a [inaudible 00:23:24] that and then banging noises, any kind of banging noise. And then particularly when I'd sleep, I'd hear things outside and it would wake me up like, "[inaudible 00:23:34]. Somebody's in my house." Sort of all of those things were my lasting symptoms.
Now, what happened with my sister, just to add to the full picture, there were six of them. They came in through the front and the back, and two of them went straight to the guard and held the guard at gunpoint. They knew exactly what they were doing. They had already scoped us out. They knew exactly where to go, of all the cabins, et cetera. And one of them went to my sister's cabin. My brother-in-law was sitting outside. He saw them jump the fence and went running in, and the guy was chasing in after him.
So you imagine that nightmare, where you're trying to get the door open, you close the door and they're banging on the door. He got in, hitting him as he's laying on the floor, and he's like, "I am not..." They were very calm. Their approach was very calm. Ours was very aggressive. "I'm not pushing back. Please be quiet. I have two young babies. Please don't be loud. Please don't be loud. We'll give you anything you want." And my sister, poor thing, was wearing a face mask and asleep and woke up to taking her face mask on and a guy being standing over her with a gun, being between her and her six-month-old baby.
So he is like, [foreign language 00:24:36]. Mind you, he actually was quiet. So looking back we're like, "It was definitely an act of desperation, not one of violence necessarily." They didn't hurt any of them other than Josh and my dad also, it sort of shows a little bit of respect for the women and children. That's sort of helped me have a little more compassion. Mind you, in the moment, I was like, "I'm going to kill him." Absolutely. And if I learned anything, in fact, my therapist was like, "What did you learn about yourself?" And I was like, "That I could kill someone. That sounds crazy."
But in that moment, I'm like, because they also turned to Riley and said, "You know how much she would go for?" Riley, my little baby girl niece. And I'm like, "Oh, they're coming back for her. We will all die. We will all die before that happens." There's no way. My sister works in sex trafficking. No, no. So there were just layers of the story that kept adding. And so they took everything from them. And then I think because the guy with the computer that took it from my sister wasn't intending to come into our cabin, but because I was so loud, they heard the struggle.
He came up to help set the computer down and then forgot it. So then what happened was when everything was said and done, they shot the gun. And my sister at that point was in the bathroom hearing me scream. That's part of her trauma. So me screaming around her is not great. And then heard a gunshot and the screaming stopped. So her story in her mind as we were separated was that something terrible, terrible had happened to us when really, I think it was just an alert like, "Hey, we're out. Y'all can leave the guard behind and vacate the premises."
Justine:
You mentioned that you started EMDR therapy, but for people that don't know what that is before we talk about it. So in our trauma classes, we learned that EMDR is eye movement desensitization. No, we learned that EMDR is eye movement desensitization. I can't ever say that word.
Sarah Lavonne:
Desensitization.
Justine:
Thank you. And reprocessing, just add that. The technique involves the patient imagining a scene from the trauma focusing on the accompanying cognition and arousal, while the therapist moves two fingers across the patient's visual field and instructs the patient to track the fingers.
This sequence is repeated until anxiety decreases, at which point the patient is instructed to generate a more adaptive thought. An example of a thought initially associated within a traumatic image might include, "I'm going to die." When the more adaptive thought may end up being, "I made it through. It's the past." Now, is it true, I can't remember, Sarah, that this was developed with veterans?
Sarah Lavonne:
Well, most of the PTSD research on trauma has been done with veterans. If you know of or have read, The Body Keeps the Score. That's probably one of the most foundational books on trauma. It's sort of got everything going. I don't know that it got everything going. Don't quote me on that. It's one of those core trauma books, and a lot of the research that we have is related to veterans and PTSD.
Justine:
So you worked with a therapist and it was an interesting route. I feel like you were like, "Let's do EMDR." And she made you work for it in a way.
Sarah Lavonne:
She totally made me work for it [inaudible 00:27:39]
Justine:
You had a lot of pre-visit, but normal talk therapy is what I think, right?
Sarah Lavonne:
So I pursued therapy just in general. I've been in therapy in and out. I think everybody should be in therapy. We are all a work in progress. And the way that this therapist worked is she works on an internal family systems model. And her way that she frames it is that she wanted me to discover my wisest self. And I was like, "Okay." So she does a lot of psycho education as well, which of course, if you know anything about me, I eat that ish up. And so basically the idea is that you have to separate your wisest self from parts of you.
And this has been really impactful just for my overall life because I think, for instance, I may say something that I am such a mean person. You have a mean thought, or I'm like, "Oh, I'm catty about something, or I'm rude." I have to be able to separate that from my wisest self and say, "There's a part of me that's really irritated and kind of hates them. But my wisest self has so much compassion on the scenario and actually is asking the question, what happened to them versus what's wrong with them?"
I think that work that we did before... Her philosophy is that you have to be really self-resourced and really in touch with your wisest self when you go in to do EMDR for it to be even more effective. And I think that is why it was so effective for me. I think I have put in a lot of work. I will say right now, in this season of my life. I have a lot of work to do that's been slacking for me. But for years and years and years, I've done a lot of therapies. I've gone to workshops, I read books, I podcast, I journal.
I have practices of meditation and prayer and all of that. I think going into it, I was very well-resourced and very in touch with my wisest self and saying, "I know who I am at my core and what I do, or moments that I have that maybe aren't my finest. Don't reflect who I am at my core." You have to be able to separate that internally, if that makes sense, because otherwise you end up, "Well, I'm a failure." No, I just failed in that way. That didn't go. Or "I'm such a mean person." No, I'm not a mean person. I had a mean moment. And there's a part of me that is mean.
There's a part of me that is catty, or there's a part of me that is jealous or prideful or all these things. But if I'm really in touch with my wisest self, my wisest self is loving and compassionate and generous and smart and gracious, empathetic, all these things. So I went into therapy to finally do EMDR with her. Also, knowing from all our trauma classes that EMDR is one of these up and coming therapies that they're seeing insane results with trauma. It's become the gold standard if you have a particularly good for an acute traumatic event. It's less good for the ongoing stuff.
It still can work. But what I've learned is that these big moments where you're like, "It was this moment in time." Like this incident. It can be very, very effective for healing. And I know Krista had said, "In one to three sessions, I'll see people totally regulate." And how you know you're traumatized is when I'm telling the story, my heart races, I'm sweating, I'm shaking, I would cry. I mean, Justine heard the story very fresh out. I was not okay. It was very different than me telling that story right now.
And even as I'm telling it, I'm like, "Yeah, I'm aroused for the sake of, it's an intense story, but my whole nervous system isn't out of whack. But before it was. So the goal of EMDR being you can actually help heal those traumas. And so we went in very well resourced. And what she had me do was retell the story like I did. And what she asked me was focus in and try to identify the most arousing, and by arousing, I don't mean it the way that you're thinking it. I mean the most nervous system stimulating moment. And this also I will say is that many of us are very disconnected from our bodies.
We're not able to identify when we're dysregulated, when we're heightened, when we're not coping, when we feel certain things instinctually and all of that. And so I do think that all of the work that I've done to help be really in touch. And honestly a lot of the physiologic coping prep I did for that class, which by the way is for sale on our website for a little bit longer. And sort of my own journey and process of trying to heal from various traumas in my life. So I could sense when I'm dysregulated. And I even use those words of, "I'm feeling very dysregulated right now." And that means tension in my back.
It means a pit in my stomach for me, it can feel very different for other people. It can feel like your voice is choking up. People will get very tearful. They'll maybe get angry or you'll have a response that's outside the norm. You're like, "Anybody else would have... Why are you acting like this?" That's a form of dysregulation, sort of where your fight and flight is activated. And I would very much get activated when I'd tell the story. And I cried when I told the story. And she's like, "Okay, what's the highest moment for you?"
This is what was so fascinating. I always thought it was the window because that's where my lasting effect was. So I'm like, "I can picture him bumping in the window." I'm like, "Ah." My whole body would freak out when I had that thought. But when I was going through the memory, the moment that hit me was when I saw my mom run in towards me through the door to go towards my door to hold it from them coming in. And I saw the terror on my mom's face and her panic. That was my moment actually when I was going with her.
Backtrack a second, because when you read that definition, it's talking about eye movement. For me, it's actually, and I think the more modern techniques that are moving in... The therapies are moving that direction is using bilateral to help reprocess the memory. So bilateral is anything left and right. So it could be tapping, it could be walking is a form of bilateral stimulation. Or there's bilateral music where music goes in one ear and then it goes on the other ear and it goes back and forth where there's this left right activation.
And if you do this yourself, one of the best ways, and we teach in our grounding techniques class, meaning Krista teaches in our grounding techniques class, is if you cross your arms across your chest and then tap your left shoulder with your right hand, right shoulder with your right hand. So just tapping left and right is a form of bilateral. It actually hacks your nervous system to help create calm in the body. But what she had me do was just tap my feet left and right as I was telling the story, that's all I did. And I closed my eyes and I'm tapping my feet the whole way through as I'm talking to her, whatever.
And so she asked me, what's the highest form of activation? My feet are still tapping. I'm like, "hen my mom comes in." And she's like, "Okay, what do you need in that moment?" I think there's a lesson here for us in this. I love a metaphor from our life stories. "What do you need in that moment?" She's like, "Go to that place and go to that moment and stay there for a second." So in my mind, I'm imagining standing there and seeing my mom come through the door. And she's like, "What does your instinct tell you? What do you need?
Is there an object? Is there a person that would make you feel safe in that moment?" And I said, "I think my instinct is I want to grab..." and this is so random, but I was just in the moment and tapping my feet. And I'm like, "I want to grab my mom and my dad and pull them behind me. I want to physically pull them. So they're behind me and now I'm between the attackers and my parents." And she's like, "Okay, so do that in your mind," as I'm tapping. And I'm like, "Okay, actually, no. I want to put them in the shower." The bathroom was in the back and it was off on its own. "And I want to put them in the shower.
I want to draw the curtain." And I could envision my parents cowering in a corner together, all quiet, hiding in the shower. And I'm like, "They're never going to go in there. And I'm protecting my parents from the attackers." And she's like, "Okay, put them in the shower." And so I'm like, "Okay." And Justine, I hadn't told you the story for this reason because we wanted to keep it live for this episode. I instantly felt better in my nervous system. My eyes are shut. And I'm like, "What the f is this voodoo?" Because I felt like this wave of calm come over my body.
And I was like, "Okay, they're safe." And she's like, "They are safe. They're safe." And I'm like, "Yeah. Oh my God, what the hell?" So now I'm sitting there in this room in my mind, and the attackers are breaking in, and she's like, "Okay, now what?" And she didn't have to do anything. And I was like, "Okay. I knew they were going to come." I knew I had an instinct even before we left. I specifically removed my money. I specifically left my computer. I had this eerie feeling when I got there. I didn't know this was going to happen, but looking back, I'm like, "I knew this was going to happen."
And you never want to... I wasn't going to be like, "Family, we're not leaving. We're not going to the beach." But honestly, a bunch of us had weird feelings about it that we talked about later. Our instinct was right. Our vagus nerve sensed our environment with our gut brain. We learned about that in physiologic coping, that we knew. I was like, "I knew they were coming." And so in my mind, I sat on the end of the bed, they're breaking it in, and they're just like [inaudible 00:36:54] barbaric, just looking dumb. And I'm sitting there with this sort of kingpin look on my face, a prideful little, don't mess...
I want to swear so bad in this episode because that's the aggression, right? "Don't F with me." And I'm just sitting there waiting with this smirk on my face. You know in the movies where they're like, "Oh, we're going to attack them." And they're like, "Oh, we knew you were coming." I knew they were coming. So they break in and they're totally thrown by me being like, "Here you go." And I hand them the cash. I'm like, "You done? Here's my phone and let me unclasp my necklace. You really want it?" By the way, they dropped it on the way out, because they're idiots. And I am just like, "No, I win."
And I went back to the moment where I saw that man's eyes and I could see it. I'm like, "He is afraid of me." And that played into the story where I'm sitting there and I'm like, "Y'all are afraid of me. You need to be afraid of me. I am one badass person." Again, I'm trying to keep it PG on here. "But I am one badass person. You should be afraid of me. I have vocal cords. You cannot shake me. My family is safe. Get the F out of here and bye. How lame are you?" Almost this just like this empowered woman who's just like, "I'm not afraid. Don't mess with me." So I hand them the things in I think they're totally stumbling around like stupids, "[inaudible 00:38:14] oh, whatever."
And they run off, shoot the gun, and we're all fine. And I'm telling you, at the end of this session, Justine, I feel totally fine. What is happening? And I just kept saying, "What is happening? What is happening?" She's like laughing. She's like, "Well, you were ready to reprocess it." And I'm like, "Okay." And now, like I said, when I tell the story, it is gone for me. I can look out dark windows. Of course, I'm mindful of my safety. That's more little t trauma from growing up in an environment where I was the target for everything and stood out like a sore thumb.
But I feel totally fine. So when I think about it, and as I walked away, I'm like, I hope first of all, that story wasn't too traumatizing for you. If anything, it's like true crime on both the happy hour and Bundle Birth Nurses. But I think the message that I want people to hear is that there is hope. And if you're feeling dysregulated, please don't stay there. And there is such a thing, if you want to look this up, you want to learn about it in our classes, it's called Post-Traumatic Growth. And so now I'm like, "Why don't we all do EMDR? Why isn't there EMDR?"
I know that's what Krista wants. EMDR on every unit. That when you have a traumatic experience, that you have some tools to go home and down-regulate and process out your trauma. You can do bilateral on your own. Go put some headphones on. At the end of a hard shift, put on bilateral music. We can link a playlist here for you on Spotify that you can listen and use those hacks for your nervous system. And imagine a world in which now I thought I would never be able to look out a dark window again.
The sun would start to go down, and I would run around my house closing the windows and the blinds before the sun went down, because I was so frantic about it being dark and me having to go to a window to shut it without panicking. And now my windows are open all the time. I'm like, "Oh, doop-de-doo." Sometimes I'll think about it like, "Ooh, intrusive thought." But it's not fully dysregulating my nervous system.
Justine:
Well, I want to thank you for sharing that story because you're right. I laughed when he said true crime for I know [inaudible 00:40:14] Lot of people.
Sarah Lavonne:
We got to keep you on your toes.
Justine:
Who knows?
Sarah Lavonne:
Keep it creative.
Justine:
I am thankful that I've been in this work with you and have heard of EMDR because we had a maternal loss a couple of weeks ago in my unit and my first messages to those nurses, and what was the bilateral tricks? And search acute EMDR. You need an EMDR therapist. You have to go to EMDR. Because the reality is too, and I'm just thinking straight clinical, which I'm glad that you're bringing it to our whole self too. But when something happens to us on our job, they'll give you a pamphlet or a QR code to talk your therapist, and it's like, "No, what?"
It's nothing against therapists. They're not expert trauma therapists. I'm like, "They're not Krista." She's not... I know my unit. So I just think that you need more. And just knowing more tools and what's out there is going to be really helpful. And so even just to write EMDR on your notes, on your app, take our healing trauma class, have some skills in the acute... Even when Krista teaches us in that class, you should immediately walk after something like that happens because you need to walk off the adrenaline, just like lions do. They run it off and they don't just go to sleep after.
There was an example that I'm totally butchering. [inaudible 00:41:33] was something, it really connected with me because something happens to me on my shift. I'm going to clock out at 7:30 and I'm going to try to go to bed as fast as possible to not think about it. And that isn't what I should be doing. I should walk off my adrenaline, walk off that steam. And so I think there's probably a lot of people listening that have residual stuff going on that need to work on. I can't be in a vacuum delivery without feeling nauseous no matter what.
And I'm in a role where I am constantly feeling that. And so we all have probably some things we need to really work on. Because two, even going back to being traumatized and being a traumatized provider, we might be traumatizing our patients by not allowing them to do things or being afraid to do things because of... We think about those doctors that are like, "They can't get out of bed." I had a doctor tell me once if I could do restraints, I would. I don't want them out of bed. And mind you, I was so frustrated. But she has trauma. She has trauma from a loss, and that's why she practices that way.
So I actually went, the doctor that was involved in the loss, it was EMDR. And she's like, "Okay." And she wrote it down because you have to do this. So thanks so much for bringing that up. And I hate that you went through that, but I love that you were able to experience it, to talk to it. What better person in my mind, because you're so good at inputting and experiencing something and then sharing the story.
Sarah Lavonne:
I am thinking something specifically non-clinical because again, of that vicarious trauma piece that sometimes it's therapeutic for us to talk about our stuff. And yes, we need to go to breakfast after night shift and be like, "Holy moly, that was awful." And just tell the story. Tell the story, tell the story. Get it out of our systems. It is a part of our reprocessing. And for some that might be helpful, but for others that may not actually be helpful and sometimes reliving the trauma over and over and over again actually is potentially even more traumatizing.
And so I think we all need to just take a reset in our own bodies and think about what we need and limit our inputs to certain things or identify what's going on in your body. That if you're having the nausea for the vacuum deliveries, there's something there and you can choose to push into it, or you can choose to not. We're not going to judge you either way, but I will say that there's so much potential healing possible for you. And we are here and exist because we want you to feel free and light and fully capable and equipped. As nurses to take on your shifts and take on the trauma that you will inevitably experience.
And also recover from the trauma that you will inevitably experience so that you can have a lasting career. And it doesn't totally burn you out, because we know that burnout rates are linked to the trauma and the moral injury that we're experiencing day in and day out.
Justine:
Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram.
Sarah Lavonne:
Now it's your turn to go and start paying attention to your nervous system and those little tingles, those sensations in your gut, in your mind, in your body that may indicate that something is a little dysregulated. And then take one step forward towards treating and doing something proactive in response to helping you live a more parasympathetic existence. We'll see you next time.