WEBVTT 1 00:00:00.600 --> 00:00:03.680 Welcome to the Trauma Therapists podcast. My name is Gamiferson. 2 00:00:04.240 --> 00:00:07.839 I interview incredible people who've dedicated their lives to helping 3 00:00:07.879 --> 00:00:11.000 those who've been impacted by trauma. A big thank you 4 00:00:11.080 --> 00:00:14.039 to our sponsors and our guests who are supporting this 5 00:00:14.160 --> 00:00:19.320 show by for me two and one our folks, welcome 6 00:00:19.359 --> 00:00:21.640 back to the podcast. Very excited to have as my 7 00:00:21.679 --> 00:00:26.039 guest today, Doctor Rachel Siegfried, Rachel, welcome, Thank you, so 8 00:00:26.120 --> 00:00:29.640 excited to be here. Awesome. Rachel is a licensed clinical 9 00:00:29.640 --> 00:00:32.920 psychologist in New York City with extensive experience treating trauma 10 00:00:33.200 --> 00:00:36.920 across diverse populations. She holds a BS from Cornell and 11 00:00:36.960 --> 00:00:40.520 a doctorate from LIU Brooklyn, who is trained in major 12 00:00:40.600 --> 00:00:44.159 New York City hospitals and clinic settings, working with individuals 13 00:00:44.159 --> 00:00:49.920 including trauma survivors, veterans nine to eleven, first responders, undocumented individuals, 14 00:00:50.200 --> 00:00:54.520 LGBTQIA clients, and emerging adults. She recently authored a chapter 15 00:00:54.640 --> 00:00:58.159 on complex PTSD for book on Trauma and the Law, 16 00:00:58.640 --> 00:01:04.400 helping legal professionals better understand trauma psychological impact. Doctor Sigfried 17 00:01:04.519 --> 00:01:07.840 is particularly interested in exploring moral injury and how entry 18 00:01:07.879 --> 00:01:13.079 to trauma is often misdiagnosed as personality pathology rather than 19 00:01:13.120 --> 00:01:18.079 recognized as PTSD. All right, Rachel, obviously, just a little 20 00:01:18.120 --> 00:01:19.879 bit about you before we could go and share with 21 00:01:19.920 --> 00:01:23.200 the listeners where you're from originally and where you are currently. 22 00:01:24.280 --> 00:01:28.280 I'm a born, born, and brid raised New Yorker, so 23 00:01:29.799 --> 00:01:32.040 still in my hometown, New York City. 24 00:01:32.799 --> 00:01:33.879 That's it. You ain't leaving. 25 00:01:34.159 --> 00:01:37.599 I tried to get away from Cornell for a chapter 26 00:01:38.079 --> 00:01:39.920 Smester in Spain, but drew me back. 27 00:01:41.000 --> 00:01:45.920 All right, so let's go back. How does this start 28 00:01:45.920 --> 00:01:47.640 for you? How does this interest start for you? 29 00:01:49.439 --> 00:01:52.239 Well, if you ask my mom, it was in elementary 30 00:01:52.280 --> 00:01:55.840 school when she goes to the you know guy and 31 00:01:55.959 --> 00:01:58.640 meet all the teachers at a parent teacher conference, and 32 00:01:58.680 --> 00:02:01.319 she goes to meet the school count and introduce herself, 33 00:02:02.120 --> 00:02:04.840 and she's already very aware, well aware of who I am, 34 00:02:05.000 --> 00:02:08.879 because I've been bringing classmates to him who are arguing 35 00:02:09.120 --> 00:02:12.159 so that they can go work through their issues. So 36 00:02:12.479 --> 00:02:16.960 she would say, then, I would say that I've always 37 00:02:16.960 --> 00:02:22.800 just been really interested in people. I really liked observing people. 38 00:02:24.039 --> 00:02:26.159 I never really grew out of the why phase of 39 00:02:26.199 --> 00:02:33.560 wanting to know why, and my I just I started 40 00:02:33.599 --> 00:02:36.520 taking small psychology classes here and there in high school 41 00:02:36.520 --> 00:02:41.560 and things, but it really formulated in college. I actually 42 00:02:41.560 --> 00:02:44.080 wrote my college essay about people watching and my love 43 00:02:44.080 --> 00:02:49.360 of people watching, which luckily they didn't find weird. And right, 44 00:02:51.800 --> 00:02:53.400 what do I enjoy sitting on the New York City 45 00:02:53.439 --> 00:02:55.560 bus and you know, just live their lives? 46 00:02:56.479 --> 00:02:57.759 Have you heard of stalking? 47 00:03:01.599 --> 00:03:07.120 And then at in college, I was studying human development 48 00:03:07.400 --> 00:03:10.759 and there was a course on risk and Resiliency in 49 00:03:10.840 --> 00:03:16.400 childhood and Adolescents. And I really fell in love with 50 00:03:16.439 --> 00:03:22.039 that course, with understanding trauma and with childhood and adverse events. 51 00:03:23.840 --> 00:03:29.479 And so this professor would use books and memoirs, right 52 00:03:29.599 --> 00:03:35.800 like we read on Finding Fish, and we read the 53 00:03:35.840 --> 00:03:38.919 book that Pressures is based on to really understand kind 54 00:03:38.960 --> 00:03:42.439 of these childhood narratives. And so I liked the professor 55 00:03:42.520 --> 00:03:45.759 Janis Whitlock so much that I joined her Non Suicidal 56 00:03:45.879 --> 00:03:50.680 Self Interest Behavior Lab, where I spent a very uplifting 57 00:03:50.719 --> 00:03:57.879 summer just listening from nine to five to interviews from 58 00:03:58.400 --> 00:04:02.360 adolescents who were engaging non suicidal self interest behavior and 59 00:04:02.400 --> 00:04:06.400 then interviews with their parents about what they were experiencing. 60 00:04:07.439 --> 00:04:11.439 And I was just spending over a month coding these interviews, 61 00:04:11.879 --> 00:04:14.639 and in that the big theme we found was that 62 00:04:14.680 --> 00:04:19.439 these kids wanted something called respectful curiosity. They really just 63 00:04:19.680 --> 00:04:22.759 wanted to be listened to. They wanted someone to want 64 00:04:22.800 --> 00:04:27.639 to know the why. And I mean as a podcast interviewer, 65 00:04:27.720 --> 00:04:29.560 right you, this is what you do. You get to 66 00:04:29.600 --> 00:04:30.360 know people's why. 67 00:04:32.240 --> 00:04:35.160 And so if we can just pause there for a second, 68 00:04:39.959 --> 00:04:43.839 what what fill that out for us? Because you have 69 00:04:44.000 --> 00:04:49.879 these these kids here who are injuring themselves what through 70 00:04:49.920 --> 00:04:58.399 all various means, not not suicidal, but at the at 71 00:04:58.439 --> 00:05:11.600 the core there's that need. Yes, I guess, uh, I 72 00:05:11.639 --> 00:05:15.959 guess I'm a little surprised. I'm not here, We're we're 73 00:05:16.680 --> 00:05:18.439 I mean in there, there's got to be a lot 74 00:05:18.439 --> 00:05:22.360 of pain, right, I mean, you just don't hurt yourself. 75 00:05:22.600 --> 00:05:24.720 So talk more fill that out for us more. 76 00:05:26.120 --> 00:05:30.120 So these kids. You know, the interesting part of the 77 00:05:30.120 --> 00:05:32.720 studies it didn't go at that moment too much into 78 00:05:33.600 --> 00:05:38.120 maybe the individual's traumas or emotion and regulation pieces that 79 00:05:38.160 --> 00:05:39.560 were leading to the self injury. 80 00:05:40.040 --> 00:05:40.319 They did. 81 00:05:40.439 --> 00:05:42.240 That was part of it. Of course, the kids told 82 00:05:42.240 --> 00:05:46.360 their stories, but what was going on was these kids 83 00:05:46.399 --> 00:05:52.120 were struggling with recovery and why could they not either 84 00:05:52.160 --> 00:05:54.759 stop or what was stopping them from being able to 85 00:05:54.959 --> 00:05:57.800 address us with their parents, that so much of self 86 00:05:57.800 --> 00:06:03.199 injury relies on the secret, and that nobody knows what's happening. 87 00:06:04.319 --> 00:06:08.759 And you know, this was two thousand and ten, no, 88 00:06:08.879 --> 00:06:15.399 twenty eleven, the this wasn't you know. It's been an 89 00:06:15.439 --> 00:06:20.000 even more increasingly studied topic since then, And a lot 90 00:06:20.040 --> 00:06:22.560 of the parents thought their kids were acting out trying 91 00:06:22.560 --> 00:06:25.120 to get attention, right, We've all heard those words in 92 00:06:25.160 --> 00:06:29.079 the field, and that really wasn't what was happening for 93 00:06:29.120 --> 00:06:31.040 these kids. And so the more that they were just 94 00:06:31.040 --> 00:06:34.399 being told that they were acting out for attention, the 95 00:06:34.399 --> 00:06:37.639 more disconnected, the less understood they felt, and the more 96 00:06:37.680 --> 00:06:41.199 they wanted to harm themselves because it was the only 97 00:06:41.240 --> 00:06:44.680 way that they were either regulating expressing, and often the 98 00:06:44.720 --> 00:06:47.319 way that they were self injuring had so much meaning. 99 00:06:47.480 --> 00:06:50.959 What they were using to self injure, where they were 100 00:06:50.959 --> 00:06:54.720 making the marks, what were they spelling out words or 101 00:06:54.839 --> 00:06:57.600 number or did they have a number of them? And 102 00:06:58.279 --> 00:07:00.600 all of this was just being missed because of course 103 00:07:00.600 --> 00:07:03.439 the parents are panicked seeing their children who they love 104 00:07:04.600 --> 00:07:08.600 in danger, but because they're so focused on that and 105 00:07:08.959 --> 00:07:12.279 aren't really regulating themselves in that moment, they're really just 106 00:07:12.319 --> 00:07:13.920 not engaging with that curiosity. 107 00:07:15.480 --> 00:07:18.319 So how do things unfold for you after that? With 108 00:07:18.439 --> 00:07:19.439 your work, et cetera. 109 00:07:20.399 --> 00:07:23.279 After that it really drove, you know, that interest in 110 00:07:23.319 --> 00:07:26.319 the why became even bigger. And I think that really 111 00:07:26.360 --> 00:07:30.560 made me curious about specifically trauma and write that risk 112 00:07:30.560 --> 00:07:35.519 and resiliency piece. And so I joined more research labs 113 00:07:35.600 --> 00:07:38.439 and eventually go to grad school. And in graduate school, 114 00:07:38.480 --> 00:07:40.959 it was in the clinical practice that I really started 115 00:07:41.000 --> 00:07:47.759 to develop an interest in complex PTSD specifically because when 116 00:07:47.800 --> 00:07:51.319 working with patients who could identify a trauma, whether that 117 00:07:51.639 --> 00:07:55.000 was sexual assaults or write a shock trauma such as war, 118 00:07:55.759 --> 00:08:02.000 they were showing up much more like a personality disorder 119 00:08:02.399 --> 00:08:05.439 would be characterized. And that's why sometimes supervisors would point out. 120 00:08:05.439 --> 00:08:08.480 They'd say, Oh, this diagnosis is borderline personality or this 121 00:08:08.519 --> 00:08:14.399 one is narcissism. And I was just very struck that 122 00:08:14.560 --> 00:08:18.519 we wouldn't with these clients and these trauma histories, we 123 00:08:18.560 --> 00:08:22.600 couldn't do all of these amazing manualized trauma treatments that 124 00:08:22.680 --> 00:08:26.920 were out there, because so much of that work was 125 00:08:27.000 --> 00:08:35.639 just building trust and getting to understand why was this person? 126 00:08:35.720 --> 00:08:39.879 Why was the person's character and sense of self so 127 00:08:41.840 --> 00:08:45.240 impacted in a way where they couldn't have this intimate 128 00:08:45.279 --> 00:08:50.120 relationship that would help them eventually heal. And so I 129 00:08:50.200 --> 00:08:54.720 then started going to places like World Trade Center and 130 00:08:54.840 --> 00:08:57.440 the VA and seeing what it looked like when trauma 131 00:08:57.480 --> 00:09:00.720 went untreated and when people had a foundation even before 132 00:09:00.840 --> 00:09:06.519 nine to eleven or before being you know, before their deployments, 133 00:09:07.080 --> 00:09:13.000 where their childhood foundation of either neglect or physical abuse 134 00:09:13.080 --> 00:09:15.679 or sexual abuse how played a significant role in their 135 00:09:15.720 --> 00:09:21.279 inability to have safe, loving relationships in the heir. Now, so. 136 00:09:24.440 --> 00:09:30.440 This is tough stuff, I mean hard stuff. How are 137 00:09:30.480 --> 00:09:34.679 you when you start doing this? Even with going back 138 00:09:34.679 --> 00:09:38.080 to the kids in that research project, I mean that's 139 00:09:39.159 --> 00:09:42.679 for a lot of people really hard to hear. How 140 00:09:42.799 --> 00:09:47.000 are you doing that? How are you managing that? 141 00:09:54.159 --> 00:09:58.039 I there's a quote. Have you ever read Theater of 142 00:09:58.080 --> 00:10:01.799 War by Brian Dowries Mm hmm, ten out of ten 143 00:10:01.840 --> 00:10:06.960 recommend It's an amazing book. And he runs these huge 144 00:10:09.159 --> 00:10:14.320 productions where major plays like Greek works are taken and 145 00:10:14.639 --> 00:10:18.480 performed in front of audiences like veterans or people in 146 00:10:18.559 --> 00:10:26.000 Guantanamo Bay, and through acting through these narratives, he has 147 00:10:26.039 --> 00:10:29.320 the community actually come together to see their pain through theater. 148 00:10:30.159 --> 00:10:33.799 And he has this wonderful quote where he says, trauma 149 00:10:33.919 --> 00:10:44.480 narratives comfort the afflicted and afflict the comfortable. And maybe 150 00:10:44.799 --> 00:10:48.679 because I am the grandchild of Holocaust survivors, There's just 151 00:10:48.759 --> 00:10:51.200 never been a time in my life where I can 152 00:10:51.399 --> 00:10:57.080 remember there not being narratives of trauma, but not in 153 00:10:57.120 --> 00:11:01.039 an overwhelming way as a child, but that the world 154 00:11:01.159 --> 00:11:03.919 is filled with people who have been through incredibly tough 155 00:11:04.000 --> 00:11:06.720 experiences that shape who they are. And so the idea 156 00:11:06.720 --> 00:11:09.240 of not listening to that narrative or not being interested 157 00:11:09.240 --> 00:11:12.399 in that narrative, I guess hasn't really ever overwhelmed me. 158 00:11:13.240 --> 00:11:14.759 It just makes me feel closer to people. 159 00:11:16.200 --> 00:11:20.639 And when you started doing that work, and I'm guessing 160 00:11:20.720 --> 00:11:26.759 this wasn't necessarily conscious, but was there What kind of 161 00:11:26.759 --> 00:11:31.000 a poll was there towards these people, towards the stories 162 00:11:31.039 --> 00:11:37.120 they were telling. Were you feeling that somehow you wanted 163 00:11:37.159 --> 00:11:40.159 to quote unquote help or listen or what. 164 00:11:43.559 --> 00:11:46.720 I thought that listening was helping that somebody. 165 00:11:48.919 --> 00:11:49.080 One. 166 00:11:49.159 --> 00:11:53.600 People like talking about themselves, but people when we feel 167 00:11:53.639 --> 00:11:56.879 seen and heard the termine. So much of trauma work 168 00:11:56.919 --> 00:11:59.679 is bearing witness when we feel that somebody wants to 169 00:11:59.720 --> 00:12:02.759 bear witness to our pain, that we don't have to 170 00:12:02.759 --> 00:12:07.080 carry it alone. I think that's when we feel safest 171 00:12:07.279 --> 00:12:10.639 and we can really heal, and that that's what trauma 172 00:12:10.759 --> 00:12:14.759 so disrupts, especially complex trauma from childhood, that ability to 173 00:12:14.799 --> 00:12:18.120 trust and connect with others. So right, the idea that 174 00:12:18.159 --> 00:12:20.559 relationships can be what break us and hurt us, they 175 00:12:20.600 --> 00:12:23.320 can also be what heals us. And so I've always 176 00:12:23.360 --> 00:12:25.159 just really loved the opportunity, whether that was as a 177 00:12:25.159 --> 00:12:28.879 friend or as a therapist, to be in that role. 178 00:12:30.639 --> 00:12:38.320 Let's talk about this topic of moral injury and untreated trauma, 179 00:12:38.440 --> 00:12:45.159 how it's misdiagnosed, How did that resonate become resonant for you? 180 00:12:49.639 --> 00:12:53.639 It was really so while we're using the word right, 181 00:12:53.679 --> 00:12:57.159 people get diagnosed with a personality disorder with untreated trauma. 182 00:12:57.360 --> 00:13:01.399 I always really loved the more jargon a clinical term 183 00:13:01.480 --> 00:13:07.200 of characterological disruptions, because I think when we understand trauma 184 00:13:07.279 --> 00:13:13.440 as disrupting a character and that ability to build our character, 185 00:13:15.559 --> 00:13:20.600 it really helps understand us understand why, right, somebody who 186 00:13:20.639 --> 00:13:26.639 experienced trauma at age six is going to show up 187 00:13:26.759 --> 00:13:35.519 very differently than somebody who didn't and again it was 188 00:13:35.559 --> 00:13:40.120 through working and getting to see first nine to eleven 189 00:13:40.200 --> 00:13:47.000 responders rarely who were sharing that they had built their 190 00:13:47.039 --> 00:13:52.519 world on being part of a system, right, that they 191 00:13:52.559 --> 00:13:56.120 would help others, and there was some kind of justice 192 00:13:56.120 --> 00:14:01.279 in the world. For some of these responders, they had 193 00:14:01.720 --> 00:14:07.679 childhood like a childhood experience of again either physical abuse, neglect, 194 00:14:08.080 --> 00:14:13.039 or sexual abuse, where they had learned to mistrust, to 195 00:14:13.080 --> 00:14:17.759 not trust authority figures, to not trust the system, and 196 00:14:20.559 --> 00:14:23.879 they became, you know, people who could help other people. 197 00:14:24.519 --> 00:14:27.240 That was one of the ways that they survived. They 198 00:14:28.480 --> 00:14:31.519 found structure in these jobs. Right, there's so much structure 199 00:14:31.519 --> 00:14:37.320 in being an officer, being in the fire department. And 200 00:14:37.360 --> 00:14:40.639 then right, seventeen years later, after nine to eleven, after 201 00:14:40.679 --> 00:14:44.200 this major trauma in which it wasn't just the physical 202 00:14:44.240 --> 00:14:47.120 trauma of what happened on nine to eleven or working 203 00:14:47.120 --> 00:14:52.840 in the pit for months after, it was the moral injury, right, 204 00:14:52.919 --> 00:14:59.360 the betrayal of what is right that America let them down. Right, 205 00:14:59.639 --> 00:15:02.519 they not given the benefits they needed, They were not 206 00:15:02.559 --> 00:15:06.799 given the medical or psychological support that they deserved, and 207 00:15:06.840 --> 00:15:10.320 they were just not given any financial resources that they needed. 208 00:15:11.039 --> 00:15:15.519 And so seventeen years later, all of that is compounding 209 00:15:15.679 --> 00:15:19.919 into a complete mistrust of the world and a mistrust 210 00:15:19.919 --> 00:15:23.240 of me in therapy. Right in you're saying you're here 211 00:15:23.240 --> 00:15:25.840 to help me. I've heard this before. Why should I 212 00:15:25.879 --> 00:15:29.440 trust you? And that's what really did it for me, 213 00:15:29.559 --> 00:15:32.399 being asked, right, what makes you so special that I 214 00:15:32.399 --> 00:15:35.240 should trust you? When this has never worked before? 215 00:15:37.159 --> 00:15:39.080 So what do you do with that knowledge? How does 216 00:15:39.120 --> 00:15:43.120 that impact your work? What's important to you? 217 00:15:44.840 --> 00:15:47.159 I think so much of that work has been informed 218 00:15:47.519 --> 00:15:52.320 really by Judith Hermann's work about establishing safety and that 219 00:15:52.440 --> 00:16:00.120 being the first thing we do. And you know, in 220 00:16:00.159 --> 00:16:04.399 our field, that's something that I think is not so unusual. 221 00:16:04.960 --> 00:16:06.919 It's not definitely not unique to me, the idea of 222 00:16:07.039 --> 00:16:11.120 really establishing trust in safety and psychological report, but in 223 00:16:11.159 --> 00:16:15.799 other fields it's quite foreign, right with You might just 224 00:16:16.000 --> 00:16:19.399 develop a professional relationship as a lawyer or a doctor, 225 00:16:20.320 --> 00:16:23.000 but the idea that you have to win over someone's 226 00:16:23.039 --> 00:16:28.360 trust is not necessarily as common. And so I think 227 00:16:28.360 --> 00:16:31.919 I also have really developed a passionate interest in how 228 00:16:31.960 --> 00:16:34.320 to help people with complex trauma or how to help 229 00:16:34.360 --> 00:16:37.279 other professionals bridge that gap. 230 00:16:40.399 --> 00:16:44.960 That's interesting, So talk more about that. How do you 231 00:16:46.200 --> 00:16:51.120 translate that how do you communicate that to a professional 232 00:16:51.679 --> 00:16:54.919 who for who maybe that that is a foreign concept 233 00:16:56.840 --> 00:16:59.200 not in their wheelhouse, if you will. 234 00:17:00.639 --> 00:17:04.880 So, I actually come from a family of many lawyers. 235 00:17:05.000 --> 00:17:12.079 I'm the black sheep as the psychologist, and my so 236 00:17:12.160 --> 00:17:16.440 my experience when I'm you know, interacting with family or 237 00:17:16.480 --> 00:17:22.119 other lawyers that I know is so often you can 238 00:17:22.119 --> 00:17:24.079 make a case out of anything, but you have to 239 00:17:24.119 --> 00:17:28.759 have your evidence. Does your argument make sense? And there's 240 00:17:28.799 --> 00:17:32.039 a you know, there's a lot of love of the rational, 241 00:17:33.680 --> 00:17:41.079 and complex trauma does not love rational right, and they're 242 00:17:41.359 --> 00:17:44.599 what I love. What I love about psychology in the 243 00:17:44.599 --> 00:17:47.480 mind is right with the why is there's always if 244 00:17:47.480 --> 00:17:49.680 you go far enough, you will get to the why 245 00:17:49.720 --> 00:17:51.880 and it will make sense. But you have to take 246 00:17:51.880 --> 00:17:54.599 the journey to get there. And that is what I 247 00:17:54.640 --> 00:17:57.400 really enjoy helping other professionals understand, is to have that 248 00:17:57.480 --> 00:17:58.759 patience to get there. 249 00:18:00.960 --> 00:18:05.319 That you do you find yourself having to explain and 250 00:18:05.519 --> 00:18:08.200 or justify why that why is important. 251 00:18:08.720 --> 00:18:15.759 Absolutely. I think helping other professionals understand when the basis 252 00:18:16.279 --> 00:18:20.359 of complex trauma, where it's coming from, right, how disrupted 253 00:18:20.519 --> 00:18:25.759 this person's trust system and sense of self. Is that 254 00:18:25.839 --> 00:18:30.440 when you're coming in and telling them you do this right. 255 00:18:30.480 --> 00:18:34.799 If you, you know, don't get into any arguments or 256 00:18:34.839 --> 00:18:38.079 fights while you were, you know, incarcerated, it's going to 257 00:18:38.119 --> 00:18:42.240 look better to the judge. Makes total sense when you 258 00:18:42.240 --> 00:18:46.920 say it that way. However, when your client, something happens, right, 259 00:18:46.960 --> 00:18:49.200 your client gets into a fight, gets into an argument, 260 00:18:50.000 --> 00:18:56.920 something happens with another inmate. Lawyers can get frustrated. You're 261 00:18:57.000 --> 00:19:00.000 hurting the case. Right, there's your clients now hurting the case. 262 00:19:00.039 --> 00:19:04.599 They're not working with you, and there might be an 263 00:19:04.640 --> 00:19:08.559 inclination to reprimand right, you can't do that, you shouldn't 264 00:19:08.559 --> 00:19:15.039 do that, and helping lawyers and other pressions understand that 265 00:19:15.039 --> 00:19:17.000 that isn't what the person needs in that moment. The 266 00:19:17.039 --> 00:19:22.160 person has been chastised and berated and humiliated really by 267 00:19:22.279 --> 00:19:25.680 authority figures and systems their whole life. And so in 268 00:19:25.720 --> 00:19:30.680 this opportunity, starting with why did you get in the fight? 269 00:19:30.799 --> 00:19:33.359 Why did that happen? I know you know that that's 270 00:19:33.359 --> 00:19:35.759 not a good idea, so why there had to be 271 00:19:35.799 --> 00:19:38.440 a reason. And then once you get to the reason, 272 00:19:38.480 --> 00:19:39.960 then you can kind of work with the person and 273 00:19:40.000 --> 00:19:44.039 say I completely understand where that came from and let's 274 00:19:44.039 --> 00:19:46.799 talk about how that isn't That behavior isn't going to 275 00:19:46.839 --> 00:19:49.039 help our joint goal. 276 00:19:50.880 --> 00:19:58.119 Is is that their job? Though? Would at night? Would 277 00:19:58.160 --> 00:20:02.119 it not be more? And I guess every example is different, 278 00:20:02.200 --> 00:20:05.759 or every circumstance is different, but maybe it would even 279 00:20:05.839 --> 00:20:08.200 open the door for them to say, you know what, 280 00:20:08.400 --> 00:20:13.319 let's bring in doctor Rachel Siegfried speak with her. This 281 00:20:13.519 --> 00:20:18.599 really sounds like you're dealing with a kid right who 282 00:20:18.680 --> 00:20:22.799 is having explosive behavior, and we're berating that kid for 283 00:20:22.839 --> 00:20:25.039 all the explosive behavior when we're not really looking at 284 00:20:25.039 --> 00:20:27.119 what the hell's going on behind the scenes here with 285 00:20:27.200 --> 00:20:27.920 this kid. 286 00:20:28.599 --> 00:20:33.720 Absolutely, I think bringing in a psychologist is great. There 287 00:20:33.759 --> 00:20:35.000 are a few things when you have to have the 288 00:20:35.039 --> 00:20:39.240 money and resources for that, right and you have to 289 00:20:39.240 --> 00:20:40.960 get your client to agree and to trust to that. 290 00:20:42.279 --> 00:20:44.359 If your client doesn't already trust you, they're not exactly 291 00:20:44.400 --> 00:20:46.480 going to be in client, especially if they come from 292 00:20:46.480 --> 00:20:49.920 a background where psychologists stigmatized that they're going to say, 293 00:20:50.039 --> 00:20:53.039 you're now you think I'm crazy? Right now, you're just 294 00:20:53.119 --> 00:20:55.079 going to send me to a shrink. There was a 295 00:20:55.119 --> 00:21:00.160 totally real reason I did that, you know So I 296 00:21:00.240 --> 00:21:02.519 think that there's I love when people would bring in 297 00:21:02.680 --> 00:21:06.759 a consultation that I think the lawyer also has to 298 00:21:06.799 --> 00:21:08.880 be able to work with the person, and the person 299 00:21:08.920 --> 00:21:10.640 has to be able to trust their lawyer. And so 300 00:21:10.720 --> 00:21:15.680 I think that's where sometimes asking the why and knowing 301 00:21:15.720 --> 00:21:17.559 your limits, right, if you feel that you're not able 302 00:21:17.599 --> 00:21:21.039 to navigate that conversation, maybe it's bringing in a professional 303 00:21:21.079 --> 00:21:22.799 who can and having them there with you. 304 00:21:23.960 --> 00:21:32.359 But so in the bio, I mentioned that you authored 305 00:21:32.359 --> 00:21:36.759 a chapter. What was that about? Specifically? Are you able 306 00:21:36.799 --> 00:21:37.920 to talk about that a little bit? 307 00:21:38.000 --> 00:21:41.880 It's specifically actually about this. It is going through and 308 00:21:41.920 --> 00:21:45.359 breaking down a lot of the jargon that is in 309 00:21:48.480 --> 00:21:53.039 complex trauma research and explaining kind of that foundation of 310 00:21:53.079 --> 00:21:59.319 the loss of autonomy, the loss of trust, feelings of inferiority, 311 00:22:00.079 --> 00:22:02.279 and how those will play out can play out within 312 00:22:02.319 --> 00:22:05.559 the system and with your clients, and how to even 313 00:22:05.599 --> 00:22:08.799 maybe start seeing flags to even think about the question 314 00:22:08.839 --> 00:22:14.880 of trauma. Is your client being labeled as difficult? Do 315 00:22:14.920 --> 00:22:19.599 they carry multiple diagnoses of different mood or psychotic disorders? 316 00:22:21.079 --> 00:22:26.079 And that I think a lot of the times those 317 00:22:26.119 --> 00:22:30.960 can be really great indicators that is the person really 318 00:22:31.000 --> 00:22:35.880 that difficult or is the person pushing back because they're 319 00:22:35.880 --> 00:22:38.960 feeling disregulated or trapped or victimized. 320 00:22:39.000 --> 00:22:47.720 Again, feels like you're educating a whole population. I mean, 321 00:22:48.440 --> 00:22:54.319 does this come Is this something that's like a brief 322 00:22:54.319 --> 00:23:00.079 workshop in law school? If at all, are they I 323 00:23:00.119 --> 00:23:03.119 would that would you know? Are they taught this any 324 00:23:03.160 --> 00:23:05.279 portion of this? No? 325 00:23:05.400 --> 00:23:09.799 Not that it in my experience, No that I've heard. 326 00:23:09.799 --> 00:23:12.319 I've never heard of people saying that in law school 327 00:23:12.359 --> 00:23:16.359 they got a class on maybe like you know, how 328 00:23:16.359 --> 00:23:21.200 to use psychology in vordear or something else, but not 329 00:23:21.759 --> 00:23:24.720 how to deal with clients who are struggling with mental 330 00:23:24.720 --> 00:23:28.559 illness and how to really question trauma as a basis. 331 00:23:29.839 --> 00:23:35.400 What we talk more specifically about why this became important 332 00:23:35.440 --> 00:23:35.640 to you. 333 00:23:40.279 --> 00:23:43.880 So all of my training was within hospital systems, and 334 00:23:44.960 --> 00:23:48.319 my last year was at Elmhurst, and it was during 335 00:23:48.359 --> 00:23:57.359 the pandemic UH and it was really hard to see 336 00:23:58.119 --> 00:24:01.119 when our clients were already struggling in world where everything's 337 00:24:01.119 --> 00:24:05.240 shut down. But so often when I was working on 338 00:24:05.319 --> 00:24:09.200 inpatient units, I was getting called to the unit to 339 00:24:09.680 --> 00:24:13.759 handle my patient because the patient wasn't cooperating with the psychiatrist, 340 00:24:14.000 --> 00:24:16.400 the patient had gotten into a fight with the nurses, 341 00:24:16.839 --> 00:24:19.400 or and so it felt like I was constantly being 342 00:24:19.400 --> 00:24:22.799 a parent called to school right because your kid did 343 00:24:22.839 --> 00:24:27.079 something and it didn't feel right for the client. Right. 344 00:24:27.160 --> 00:24:32.240 These patients are here because they're really struggling right there there, 345 00:24:32.240 --> 00:24:34.200 because they've had a psychotic break or wanted to done 346 00:24:34.200 --> 00:24:39.079 their life, and nobody it didn't feel like people weren't 347 00:24:39.079 --> 00:24:42.920 necessarily trying to understand them because it's an overwhelmed public 348 00:24:42.960 --> 00:24:46.559 hospital system. There were absolutely people who did, but in 349 00:24:46.599 --> 00:24:49.279 that overwhelmed system, you can't spend as much time as 350 00:24:49.319 --> 00:24:52.400 you want to with each client, right, and so right 351 00:24:52.440 --> 00:24:55.160 when clients aren't taking their medication, it's we're going to 352 00:24:55.240 --> 00:24:56.880 go to court or you're gonna have to take it, 353 00:24:57.960 --> 00:25:00.759 And well, why don't you want to take it? Right? 354 00:25:00.799 --> 00:25:03.319 I've heard clients say, because I'm drowsy. This is a 355 00:25:03.319 --> 00:25:07.119 co ed unit. I don't feel safe. That's a great 356 00:25:07.160 --> 00:25:11.799 reason if you've experienced sexual trauma and people are saying, well, 357 00:25:11.799 --> 00:25:13.279 they didn't tell me that. They didn't tell me that 358 00:25:13.359 --> 00:25:17.160 during intake. Of course they didn't. They hadn't built any 359 00:25:17.160 --> 00:25:17.799 trust yet. 360 00:25:18.599 --> 00:25:21.880 Mm hmm. What do you think allows you to do 361 00:25:21.920 --> 00:25:25.599 this work? Because you seem I asked that question because 362 00:25:25.880 --> 00:25:31.599 there's a particular obviously curiosity that you have or almost 363 00:25:31.640 --> 00:25:34.920 like a need you have to get in there. And 364 00:25:37.359 --> 00:25:40.599 what listen ask these questions? What is it? 365 00:25:45.720 --> 00:25:48.720 I feel like I've just always felt this. It's just 366 00:25:48.880 --> 00:25:51.160 everybody does make sense at the end of the day, 367 00:25:51.359 --> 00:25:53.799 like there's a grain of truth at the end of 368 00:25:53.839 --> 00:25:57.640 the day. And I just I love a puzzle. I do. 369 00:25:57.839 --> 00:26:02.119 I loved to puzzle so much. You know, I'll spend 370 00:26:02.119 --> 00:26:03.480 way too much time on sadogu. 371 00:26:04.119 --> 00:26:07.759 So and is it is it like we need to 372 00:26:07.880 --> 00:26:14.039 find out what's behind or beneath We're at the core 373 00:26:14.119 --> 00:26:17.079 of this, And that's important because why. 374 00:26:20.480 --> 00:26:25.960 I think once we understand where our behaviors and our 375 00:26:26.000 --> 00:26:28.279 feelings are coming from, we can have so much more 376 00:26:28.319 --> 00:26:33.640 empathy for ourselves. And right if we feel that we're 377 00:26:33.640 --> 00:26:36.519 doing something and it doesn't make sense to us or 378 00:26:36.559 --> 00:26:41.279 to anyone else, that's incredibly painful. Right when we feel 379 00:26:41.279 --> 00:26:45.279 that we are doing something right, maybe it's that I 380 00:26:45.359 --> 00:26:51.599 push away everyone I feel close to. Maybe I understand that, 381 00:26:51.680 --> 00:26:54.400 but if nobody else understands why, I'm going to feel 382 00:26:54.440 --> 00:26:57.200 incredibly lonely, I'm gonna feel even lonelier than I already did, 383 00:26:57.279 --> 00:27:00.799 because I'm not being seen, and that if I don't 384 00:27:00.880 --> 00:27:04.640 understand why I'm doing it now, I just I feel crazy. 385 00:27:04.680 --> 00:27:09.400 I feel disconnected, And I think I've such a gift 386 00:27:09.400 --> 00:27:11.000 to be able to feel that we make sense to 387 00:27:11.039 --> 00:27:13.640 ourselves and that others can then also understand us. 388 00:27:14.759 --> 00:27:19.559 I think it's interesting to be doing this as a psychologist, 389 00:27:19.880 --> 00:27:24.880 but it takes on a different aura or you when 390 00:27:24.920 --> 00:27:30.240 you were educating other popular or other other professionals about this. 391 00:27:30.480 --> 00:27:33.039 Right again, it's it's it's it's a language that they 392 00:27:33.079 --> 00:27:39.079 don't normally use, and it's asking. I feel it's asking 393 00:27:39.680 --> 00:27:43.880 them to do something that. Okay, it doesn't matter to 394 00:27:43.920 --> 00:27:46.839 me why they're doing it. They they created this problem 395 00:27:46.960 --> 00:27:49.720 or this X, and why happened. We now we got 396 00:27:49.759 --> 00:27:51.640 to deal with all that. Why are you asking me 397 00:27:51.680 --> 00:27:55.039 to deal with why? Why is that important? Why is 398 00:27:55.039 --> 00:27:55.839 why important? 399 00:27:59.000 --> 00:28:01.440 You know? I definitely I've gotten this from my parents 400 00:28:01.440 --> 00:28:03.720 when they last at different points, like I've got this case. 401 00:28:04.480 --> 00:28:06.799