Outline silhouette of a man and woman separated by a brain colored in orange red and blue against a black background

CONNECTED YET SEPARATE: How to Navigate the Waters of Interpersonal Neurobiology in Trauma Therapy

Erika Tsoukanelis, LCSW, Center Faculty and Lead Trainer

Have you ever felt your internal state merging with a client?

Have you noticed being unnervingly frozen as they shut down?

 Agitated in the face of their anger? 

Despondent alongside their insurmountable sadness?


How to Navigate the Waters of Interpersonal Neurobiology in Trauma Therapy

My consultee Pat, a seasoned and savvy clinician, was stuck. Her client, John, had willingly sought her out to help him with relationship issues. The 34-year-old single white man told her that for as long as he could remember he had felt like he lived inside an ice cube: suspended, isolated, and emotionally cold. An accountant by trade, he had recently met a colleague whom he found alluring and attractive, but he could not find the courage or the language to connect.


John and Pat were clear about the past experiences that were the source of his pain. As a child, he had been sexually molested by an older brother and an uncle, and both men had told John that if he said a word to anyone about the abuse, they would slit his throat. Already a quiet child living in a quiet home, John was frozen and alone. He sought out comfort by creating routine and order in his life, and as an adult kept his world small and predictable.


Now he wanted to expand. He wanted love in his life.


Pat worked to prepare John for EMDR reprocessing. She helped him develop resources and desensitized certain uncomfortable recent experiences. He started going for walks and was thinking about getting a pet. He was sleeping better and attended an event at a local community center. Pat was delighted for him.


It was when they approached the reprocessing of the memories of the abuse that John shut down. He found himself mute. Pat sat with him, feeling for him. He was not being obstinate; he was suffering. His face was flushed, his lips pressed tight. There were tears in his eyes. She said, “Just a few words are all we need. You can even write them down.” She asked what she could do to help, but John could not break free of his silence. He was trapped in the ice.

Disturbingly, Pat found herself trapped along with him. After a few sessions, she felt exhausted and helpless. She was desperate to help John, and uncharacteristically out of ideas.


In The Developing Mind: How Relationships and the Brain Interact to Shape Who We AreDan Siegel writes, “For ‘full’ emotional communication, one person needs to allow their state of mind to be influenced by that of the other.” For me, that is about the therapeutic alliance and to the extent that our clients let us in.


As Relational EMDR therapists, we track how our system interacts with our clients on a nonverbal and verbal level. We are not just asking questions and following protocols. In attunement with our clients, we are tracking and feeling their physical, mental, and emotional states. Open-minded and open-hearted, we gain a better understanding of where our clients have been, where they are now, and where they can go. Simultaneously, we attend to our own internal states, as they will influence that of our clients. We keep ourselves planted, steady, open, and compassionate.


In these “full” but non-verbal exchanges between systems, a synergy fuels transformation. This emotional communication is necessary for the reprocessing of trauma to be truly successful. Our clients need to feel that we are with them all along the way, here and now, and that it is safe at last to expand beyond the pain of their pasts.


It is inevitable that we, like Pat, can sometimes merge with our clients' experience. We feel empty and flattened when our clients continually shut down, agitated when our clients get mired in anger, and hopeless when our clients struggle to break from the role of the victim despite the trauma having long ago ended. What then can we do to free ourselves from these places?


Validate and normalize our experience.

Every clinician attuned to their clients will sometimes experience this merging. I told Pat that what was happening to her had happened to me and that it would happen to both of us again. We can consider the merging to be information that we need to adjust our stance.


Practice mindfulness.

Notice when we are beginning to merge with our clients. Ground ourselves. Press ourselves to the backs of our chairs. Breathe. Return to our truth and separate what is ours and what belongs to our clients. Pat and I explored whether she had memory networks activated by John’s silence. We talked about whether her desire to help had veered into the territory of the need to rescue, an adaptation common to most therapists, when we inadvertently take on ourselves what is the client’s responsibility to address.


Secure ongoing consultation.

These cases are often the ones we learn the most from, about our work and ourselves. After our consultation session, Pat could return to John with fresh ideas, inviting him with compassion to join her in exploring how they could move forward together.


We are not the agents of change.

We are clinicians co-creating a space with our clients that makes it possible for their neurobiology to process now what it couldn’t before, moving toward a place of resolution and health.


We are together with our clients, offering compassion and holding space. Yet we are also separate from our clients, knowing their journeys are their own. As part of the privilege of bearing witness to our clients’ journeys, we are responsible for bringing our best selves to this work. As a Trainer, Consultant, and Relational EMDR therapist, the ongoing support of consultation creates the necessary space for me to continue to grow and learn.


Have you felt connected but separate from your clients at one point? What has worked for you?


Want to learn more about The Center for Excellence in EMDR Therapy? Interested in seeing what a masterclass in Relational EMDR therapy could do for your practice? Contact The Center today!