7 minute read
Sheets of rain are pounding the pool.
I arrived in Thailand after a 22-hour flight. On my second night here, I’m wide awake at 1 am, flipping channels. I’m watching For All Mankind, the fictionalized series about the global space race, and the episode, “Nixon’s Women,” explores what it could have looked like if women’s contributions to the space program had been recognized.
In this episode, President Nixon charged NASA with training and certifying women as astronauts. Sadly, he didn’t do it because it was the right thing to do. Nixon was motivated by public polls and competitiveness — he needed to boost his poll numbers with women, and since Russia just landed a woman on the moon, he hoped the program would earn him accolades, too.
The training environment wasn’t easy, as the women’s presence in a male-dominated field was routinely questioned. One scene depicted John Glenn expressing doubt about whether the women were biologically fit to be astronauts. Deke Slayton, head of the Astronaut Office, bristled under the political pressure to deliver the “All American” blonde, blue-eyed girl that America could “love, take into their hearts, and feel good about doing it.”
Nixon wanted Tracy Stevens, a former pilot married to an astronaut, to symbolize his fantasy of “love in the sky,” and she had to prove herself as others resented her favored status. Throughout the training, some candidates relished inspiring young girls. Others were there for personal reasons and couldn’t be bothered to be a social icon.
But politics and symbolism wouldn’t bring a crew home. Overseeing training, Deke considered the training criteria needed and how to organize it for safe space travel. Candidates were graded in celestial navigation, simulator training, basic science, and desert survival. The stakes were real — reentry into the Earth’s atmosphere too steep, and they’d burn up; too shallow and they’d bounce back into space. Exercises like desert training simulated a botched landing and needing to survive a harsh environment alone; he trained for all possible scenarios. As Deke put it: if they can’t survive the desert, they can’t survive the moon.
I don’t know EMDR therapists who are also astronauts, but our work shares similar stakes. Each client has a different health “mission” and environment. Our goal is to get clients home safely, and there are so many nuances, especially with complex PTSD clients. In the EMDR culture, there’s a particular posture to contend with impacting that goal, and the episode provided a lens for thinking about it.
A Different Posture
EMDR therapists have a range of feelings about the therapy. Some feel constrained by it. Many are relieved to have a tool to address the impacts of their clients’ trauma.
Within the community of EMDR therapists, I often hear a sentiment that goes something like this: “EMDR can be used with everything!” I know the intent is to convey relief, but it’s discussed as if EMDR were a home remedy akin to apple cider vinegar.
That framing erases the science our work depends on, and home remedies can become automatic — what we reach for before we’ve assessed the needed approach. Maybe you had a grandma who swore by her home remedy to treat chest colds with whiskey, lemon, and garlic. It probably did some good. But family wisdom has limits. When a child’s fever surpasses 103 or 104 degrees Fahrenheit, a medical evaluation is necessary.
A home remedy posture makes clinical thresholds invisible. Grandma only has one play — add more whiskey.
Sometimes EMDR is the only play we know right now; applying it may not be a bad move. We learn by doing. What I’m encouraging is being guided by the territory.
Prior issues addressed pieces of the picture. The whole picture is that complex PTSD is complex.
It’s a history of conditions — the domestic violence, maternal depression, and parental addiction that resulted in neglect and impaired attunement. The tremendous toll of gender oppression sits underneath much of this. Sometimes there wasn’t abuse — just a lack of parental knowledge of neurodivergence or of emotions in general.
Either way, our clients adapted. With inconsistent social support, they may have learned to be invisible, not make waves, dismiss their emotions. Others coped through chronic dissociation, trancing out, or maladaptive daydreaming.
Decades of research point to the environmental conditions contributing to these symptoms — research that helps us make sense of what we see and normalize the impacts for clients.
Knowing that territory requires a different posture. Science formed the foundation of Deke’s training. As a seasoned astronaut, he trained candidates against the actual conditions of space travel: how to read stars, the physics of reentry, what to do if you missed your landing, and had to survive alone. He had to train against what was known about the territory. He couldn’t just “apply” astronaut training.
Using EMDR with clients who have a history of complex trauma, we have to know the complex trauma territory — what it is, how it presents, and where the trap points sit. Incorporating the complex trauma research validates the actual conditions our clients lived through. Deke designed astronaut training the same way — based on what was known about space. That knowledge allows a different posture: to adjust the preparation, intervention, pacing, and modify the work given what’s emerging.
Holding the Line
Deke knew what space actually asked of the people going there, and he wanted them to come home. The clinical parallel is the same idea. Validating the territory is what gives us permission to hold the line — to say not yet, or not this, or this client needs more preparation before we begin. It’s care, with unique information about the client behind it. In future issues, we can explore what’s included in more specialized knowledge.
What the Work Makes Possible
Just as astronauts get to see a particular beauty, clinicians who train against the actual conditions of complex trauma get something similar. We get to witness moments most people never see: the client who learned to be invisible beginning to accept their emotions and take up space. Complex PTSD clients have a lot to teach us — like how lonely, strong, and forgiving they can be. I recall with admiration clients who rescued younger siblings from dangerous conditions or set boundaries with abusive parents.
We came all this way to learn EMDR, and the most important thing is to discover our clients’ needs and to defend the appropriate intervention. A science-informed posture has long-term ripple effects that a home-remedy perspective may not provide.
I’ll tell you a quick story that brought this home for me.
This issue is late because I just returned from Thonburi Hospital in Bangkok, where I was treated for an ear infection after snorkeling. (I should have known better; this happened before.)
While in Phuket, I’d bought the recommended antibiotics and painkillers, but the pain was still excruciating and impacted my hearing. At Thonburi, I was pleasantly surprised to be met by a medical concierge who helped me with registration. Within forty minutes, I was evaluated by the ENT (ear, nose, and throat) doctor. While waiting, I learned Thonburi was rated by Newsweek as one of the best hospitals in the world. Dr. Pitiya Piyanud cleared an obstruction, allowing the medication to work. I’ve never hugged a doctor before — she was the first. Her knowledge of “the environment” directly impacted my health.
There are so many factors in the complex PTSD environment. Which would you most want to know more about to help your work?