At least once a year, I plan a getaway for rest, relaxation, and rejuvenation. One of my favorite places to visit is Bali.
It’s not hard to love. I first visited in 2014, inspired by Elizabeth Gilbert’s book Eat, Pray, Love, detailing how she took a year off after a divorce to recuperate in Italy, India, and Indonesia. If she could do it, so could I.
It was my first “big girl” trip alone.
Not that there wasn’t anxiety. Seeing the entire nose of a 747 take up a concourse window at LAX, I distinctly remember thinking, ” Huh, last time I saw a plane like that, it was in the series LOST… that didn’t turn out so well.
Despite knowing the psychology and science of fear circuits, it’s always surprising how quickly the mind goes to catastrophe.
I was thinking about it this month, when fear was the theme of multiple sessions. The clients were overcome by fear. All had histories of emotions being chronically dismissed in childhood, or raised in homes high in judgment, high in psychological and physical abuse, and — it goes without saying — low in compassion.
I thought I’d share three observations about fear and catastrophe that I’ve learned from CPTSD survivors over the years, and their relevance to us as helpers.
Clinical examples throughout are composites — details changed, identifying features removed, patterns drawn from years of practice rather than any single client.
Observation 1: The symptoms are acute and varied
Each client’s response to fear is different.
- Freezing and being stuck in an unhealthy relationship — because leaving might confirm what the voice in their head already says: you really are unlovable.
- People-pleasing – when the drive to just belong is so strong that it means abandoning the self.
- Inability to self-soothe, leaving clients exhausted and vulnerable to old coping patterns.
- Social withdrawal and isolation.
- Noticing I don’t want to do this and doing it anyway — because standing out means risking social judgment.
With the number of clients we see daily, the symptom picture shifts from session to session. It’s like a new weather pattern every hour, and our nervous system can strain to keep up.
Each client’s sympathetic arousal and parasympathetic activation is different, and the transitions between them aren’t always easy. It can feel like an Ironman: swim 2.4 miles, bike 112 miles, run 26.2 miles.
I try and leave time to transition between sessions, but I’m known for going over time. Knowing that clients are borrowing my nervous system for an hour, I try to reset it for each new person. After all, it’s the engine that keeps treatment working.
What do you need in your day to replenish your engine?
Observation 2: The negative self-concept is strong
The fear that “I’ll always be what the voice in my head says — defective, no good, weak, a bother.” “I’m a loser.” “Who was I to think I could change intergenerational trauma?”
When clients struggle, it can be interpreted as proof of private, shameful beliefs they’ve wrestled with alone. Which is what makes this so tricky: after trauma processing, the same struggle that would mean “I’m learning something hard” for anyone else means “I’m defective” for them.
For example, the French learner who can’t roll their R’s rarely thinks I haven’t practiced this specific skill enough. They think I’m not a language person.
CPTSD clients do the same move with their own healing — every moment of difficulty becomes evidence of who they are. They were arrogant to risk believing it could be different, and now they’re paying the price.
Mark Dworkin writes in EMDR and the Relational Imperative: “Many victims of interpersonal trauma believe, no they know, they are bad people. They were to blame, after all, for what happened to them (or so they believe).”
So the acute terror clients experience when they struggle — the fear that the struggle itself is confirming what they already believe about themselves — is palpable.
It reminds me of the Dementors in the Harry Potter books. Dementors are the wispy, hungry creatures and are known to be some of the deadliest creatures a wizard could confront, draining peace, hope, and happiness from the surrounding air. Every good feeling, every happy memory, sucked out. Left behind is, as Lupin puts it in Harry Potter and the Prisoner of Azkaban, “an empty shell that lost its soul.”
It’s an image that for CPTSD clients isn’t far from what they’ve been living with for years.
Clients have been living within a frame devoid of compassion for so long that it highlights the opposite: the courage they must mobilize to show up for therapy.
When a client reads their own struggle as defectiveness, it’s tempting to reassure them out of it — to counter with, “No, no, that’s old stuff talking!”
But reassurance doesn’t change the old frame — only repeated experience of being met in the struggle does, reminding them: this is hard because it’s hard, not because you’re broken.
In the Harry Potter books, Dementors can only be dispelled by a Patronus — a guardian summoned by focusing on a positive memory. The wizard conjures it by saying “Expecto Patronum” and holding the memory steady until the guardian appears.
In therapy, being repeatedly met in the struggle can act like a Patronus Charm for the client. The form varies by modality: in AEDP and EFT, it’s being accompanied in the fear rather than left alone with it. In EMDR, it’s attachment-focused trauma processing across all three prongs.
These are the times the client may need us more — when flooded with Dementor-like thoughts. And just like Harry needed Ron, Hermione, Dumbledore, Lupin, and Sirius, they may need to borrow our nervous systems and reach out to their network for grounding and attunement.
For many of our clients, this kind of network has been missing for a long time. Issue 3 looked at what people reach for when the usual relational scaffolding isn’t available.
What Patronus Charm — what memory of their growth — could you offer your most fragile client this week?
Observation 3: Fear can be a sign of growth
Clients often come in having seen many therapists before, and for some, disappointed that previous talk therapy didn’t transform their pain. After EMDR, they can have less acute symptoms — fewer flashbacks, less anxiety, less rumination.
But when they struggle in the present, they’re terrified they’re backsliding and scared it didn’t work.
I remember explaining to a client that what they were feeling was the anxiety of growth. It was still scary, but actually a good thing.
In fearful and neglectful households, no one teaches you about emotions, so when yours are finally safe to come online in everyday life, it can be frightening and feel like going backwards.
In this case, anxiety emerged in situations where they noticed they had preferences different from their social group and didn’t feel strong enough to express them. Or they realized the people they were with weren’t safe enough to express themselves to.
Having worked years to have the experience of safety, it was now the preferred mode, but they didn’t yet have the strength to act on it.
This is the toddler-learning-to-walk phase. They can feel now. But self-advocacy isn’t yet strong enough to support boundary-setting or safe self-expression.
Standing isn’t walking yet.
If we read this phase the way the client does — as backsliding — we can unintentionally collude with the voice they’re coming from rather than the one they’re moving toward. The voice that says, “You’re a snowflake.” “Why are you trying?” “It’s going to fail like last time.”
Learning and struggle are synonymous.
These are the moments I think of watching toddlers learning to walk. They don’t quite have the strength in those chubby legs.
We watch with delight as they try — navigating by holding onto furniture, falling forward on their hands, straightening their legs with their butt up in the air, grabbing the table leg to pull themselves up. We’re there to encourage, to delight, to give a hand as needed as they start to feel and own their strength.
That’s the stance I try to emulate — delight, encouragement, a hand when needed. Clinically, it’s heavy on attunement, praise, and delight.
It can also be strengthened by installing weekly wins, people and animals modeling the emotional strength they’re striving for, and continuing to deepen the work through facilitating present and future prongs of EMDR.
For your most fragile client, can you see the toddler in the room — the new strength, still shaky, reaching for the furniture? And can you let them see you delighting in it?
Back to Bali.
The reason I keep going isn’t just the rest — it’s the reminder that fear is universal, whether it’s the fear of survival or the fear of growth.
My first trip, I needed supportive people to help me get there. I had friends. I had Elizabeth Gilbert, who I’d never met but whose voice and imagery inspired me.
It was scary. It opened up a lovely world — one big enough that I never thought about LOST again.
My clients have taught me that fear is crippling, and that at times the therapeutic relationship is one of the few resources a person has to challenge the Dementors. Which means taking care of myself isn’t optional. It’s clinical. They’re using my energy to cross their own bridge from suffering to thriving.
And when they start to make the transition, I’m watching for the difference — is this their old fear, or is this the fear of growth? Because they both need scaffolding in different ways.
Therapists have a network, too. Just like Harry had Ron, Hermione, Dumbledore, Lupin, and Sirius, we have the work of Francine Shapiro, Dave Emerson, Jenn Turner, Diana Fosha, Sue Johnson, Marylene Cloitre, Kathy Steele, Deb Dana, and Steven Gold — the researchers and clinicians whose work keeps refining how we treat the damage of early adversity.
I’m grateful for them. And I’m energized to continue offering interventions that transform pain into confidence… but first, I’m going to take in the sunrise.
