Target Memory

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Content advisory: This episode discusses a widely circulated case of animal cruelty involving a mother dog named Wang Wang, her newborn puppies, and graphic footage associated with the case. The footage itself is not described, but the subject matter may be distressing.

What happens when a client is deeply affected by traumatic material encountered on a screen?

In this continuing education episode of Target Memory, we examine intrusive imagery, sleep disruption, hypervigilance, guilt during ordinary pleasure, altered assumptions about safety, and sustained distress following indirect exposure to disturbing media.

This type of exposure does not automatically meet DSM-5-TR Criterion A for PTSD; Criterion A4 excludes exposure through electronic media unless it is work related. The formulation challenge is real: distress may be clinically significant while vicarious traumatization, secondary traumatic stress, and compassion fatigue only partially fit.

Target Memory is joined by Elizabeth Warson, PhD, LPC, ATR-BC, NCC, an EMDRIA Certified Therapist, Advanced Practitioner, and Approved Consultant, and her father, James Warson, MD, a retired board-certified neurosurgeon.

Together, they explore the case through EMDR therapy, trauma treatment, autonomic regulation, neuroscience, and professional scope of practice.

• Vicarious traumatization, secondary traumatic stress, compassion fatigue, grief, moral outrage, and functional impairment

• Moral injury within EMDR’s Adaptive Information Processing framework

• Phase 2 Preparation: autonomic psychoeducation, bottom-up regulation, containment, and readiness for direct processing

• EMD, EMDr, and standard EMDR: restricted versus broader associative processing for intrusive imagery

• Sustained advocacy: bearing witness versus repeated self-exposure under algorithmic content delivery

• Equine-assisted EMDR using the EquiLateral: The Equine-Assisted EMDR Protocol®

• Memory consolidation, repeated exposure, and afferent/efferent signaling from a neurosurgical perspective

• The stellate ganglion block as an off-label medical adjunct discussed in PTSD treatment—and why it remains outside psychotherapy scope

Upon completion, participants will be able to:

1. Differentiate vicarious traumatization, secondary traumatic stress, and compassion fatigue, and explain why indirect media exposure does not satisfy DSM-5-TR Criterion A4.

2. Describe at least three Phase 2 preparation or containment interventions for intrusive imagery following indirect exposure.

3. Identify clinical indicators for transitioning from stabilization to direct memory processing.

4. Differentiate psychotherapy regulation interventions from medical procedures and identify presentations warranting medical consultation or referral.

Elizabeth Warson, PhD, LPC, ATR-BC, NCC is a Colorado Licensed Professional Counselor, National Certified Counselor, Registered Art Therapist–Board Certified, EMDRIA Certified Therapist, Advanced Practitioner, and Approved Consultant. She is trained in EquiLateral: The Equine-Assisted EMDR Protocol® and provides consultation and intensives through Healing Pathways LLC.

James Warson, MD is a retired board-certified neurosurgeon who founded the Front Range Center for Brain and Spine Surgery in Fort Collins, Colorado. He performed more than 6,000 surgical procedures and developed expertise in equestrian spinal injuries.

Disclaimer: Medical procedures discussed are for education and scope awareness—not as techniques for mental health professionals to perform, prescribe, or substitute for medical evaluation. Psychotherapy regulation strategies do not authorize medical diagnosis or treatment outside professional scope.

#EMDR #TraumaTherapy #ContinuingEducation #PTSD #VicariousTrauma

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Racial trauma is not just another target - and treating it like one means missing the clinical picture. In this continuing education episode, we break down how to use EMDR therapy at full power with clients carrying race-based traumatic stress: what to assess, how to prepare, and what the current research actually supports (and what it doesn't).

🎧 Episode Summary

Three sessions in, a client is doing everything right — and still bracing like the danger is in the building. In this episode, we make the case that the bracing is the clinical data, and we walk through how to use EMDR therapy at full power with clients carrying race-based traumatic stress. It's about practicing it with the precision racial trauma demands: assessing direct, vicarious, historical, and ongoing stressors; building culturally congruent resources; selecting targets that honor the whole network; and reading the difference between a danger that's over and one that's still active. We also cover what the current research does and does not support: honestly, with its limits in view.

Racial trauma is not just another target - and honoring the whole context is exactly what lets the protocol do its most powerful work.

FREE CEs for listening to this episode

She has no single “worst day” - just a hundred small ones, stacked. This is what race-based traumatic stress looks like in the therapy room, and how to attune EMDR to treat it. A full worked case, phase by phase. Free CE if eligible.

Some clients don’t have one big trauma to target. They have a thousand small ones: the meeting where her idea was ignored then praised on someone else’s lips, the hair touched without asking, the badge checked at a door no one else got stopped at - stacked over years, in a context that isn’t over when they leave the room. That’s race-based traumatic stress, and the standard “find the worst event” frame can miss it entirely.

In this episode of Target Memory, Host and Certified EMDR Therapist M.R. Estante, follows one composite client, “Dana,” through the 8 phases of the EMDR Adaptive Information Processing (AIP) to illustrate culturally attuned trauma treatment in action - not in the abstract. Strategies such as attuned history-taking and target sequencing, what to do when “safe place” doesn’t exist for a client, how to build relational and ancestral resources, and how to choose a positive cognition that’s both adaptive and accurate for the client. Respectful of the protocol, fidelity to the treatment model, grounded in the peer-reviewed literature (Carter; Shapiro’s AIP model; Nickerson; the Journal of EMDR Practice and Research), and aligned with APA multicultural standards.

What may have been charted as “treatment-resistant” when the real issue was a protocol that hadn’t been attuned to the person in front of you - this episode explores.

For EMDR-trained clinicians, trauma therapists, and anyone working with complex, cumulative, and racialized trauma.

🎧 Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode! (learnatpinnacle.com/education)

This episode is for Education only - not therapy, supervision, or consultation. “Dana” is a fictional composite for teaching.

FULL SHOW NOTES

Racial Trauma in the Therapy Room: How to Attune EMDR (A Worked Case)

Some clients don’t have one big trauma to target: they have a hundred small ones, stacked over years, in a context that isn’t over when they leave the room. In this episode, M.R. Estante (Rheba) follows one composite client, “Dana,” through the EMDR phases to show culturally attuned trauma treatment in action: recognizing race-based traumatic stress, attuned history-taking through the AIP lens, resourcing when “safe place” isn’t simple, and choosing positive cognitions that are both adaptive and true. Grounded in the peer-reviewed literature; respectful of the protocol; aligned with APA multicultural standards.

🎧 Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

References / further reading:

— Carter, R. T. (2007). Racism and psychological and emotional injury: Recognizing and assessing race-based traumatic stress. The Counseling Psychologist, 35(1), 13–105.

— Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy (3rd ed.). Guilford Press.

— Nickerson, M. (Ed.). (2017). Cultural Competence and Healing Culturally Based Trauma with EMDR Therapy. Springer Publishing.

— Cultural Adaptations of the Standard EMDR Protocol in Five African Countries. Journal of EMDR Practice and Research.

— Lewis, B., et al. (2025). Cultural adaptations to the assessment and treatment of trauma experiences among racial and ethnic minority groups: A mixed-methods systematic review and meta-analysis. Trauma, Violence, & Abuse.

— American Psychological Association. (2017). Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality.

— Menakem, R. (2017). My Grandmother’s Hands. Central Recovery Press.

This podcast is for education only and is not therapy, clinical supervision, or consultation. If you’re struggling, please reach out to a licensed mental health professional or 988.

Inner Critic or Perpetrator Introject? An EMDR Therapist on the Voice You Can’t Affirmation Away.

Your inner critic might not be yours. For trauma survivors, that harsh inner voice is often a “perpetrator introject” and you can’t affirmation it away. An EMDR therapist on what the self-talk trend gets wrong, and what actually heals it.

Check out the Show Notes on the FREE CEs for Listening to this Episode!

Everyone talks about the inner critic: quiet it, befriend it, download an app for it. For a lot of people, that helps a little. With survivors of childhood trauma and abuse, the cruel inner voice often isn’t a bad habit you can journal or affirmation away. It’s something with a name: a perpetrator introject , a part of the self that took on the voice of someone who hurt you,. Why? The belief that keeping it was once safer than the alternative … and still is.

Host and Certified EMDR therapist Maria Rheba Estante, LMFT, LPCC unpacks the difference between an ordinary inner critic and a trauma-based introject. This episode explores why positive affirmations can backfire, why and what recent EMDR research findings - including the 2025 Introject Decathexis Protocol - indicate about the counterintuitive strategies to actually resolve it.

Navigating the nuances in complex cases is means that treatment may not move in a straight line.

This podcast is for education only and is not therapy, clinical supervision, or consultation. If you’re struggling, please reach out to a licensed mental health professional in your state. If you are in crisis, contact 988 to reach the National Crisis Hotline, or call 911 and go to your nearest hospital emergency.

SHOW NOTES

Your Inner Critic Might Not Be Yours

Everyone’s talking about the inner critic. Almost nobody’s talking about this: for survivors of abuse, that harsh inner voice often isn’t a habit you can affirmation away - it’s a perpetrator introject, a part of the self that took on the voice of the person who hurt you. Let’s unpack what that means, why affirmations can make it worse, and what the newest EMDR research says about the counterintuitive way to heal it.

🎧 Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

In this episode:

• ​Where the inner-critic trend gets it right and where it stops
• ​Perpetrator introject vs. ordinary negative self-talk
• ​Why “I am safe, I am worthy” can make a trauma survivor feel worse
• ​The three-task framework from current EMDR research: orient, reconsider, lower the fear
• ​The reframe that changes everything: a protector wearing the perpetrator’s face
• ​Free peer-reviewed research now that the Journal of EMDR Practice and Research is Open Access

Resources Mentioned

• ​Coy, D. M. (2025). The Introject Decathexis Protocol: An EMDR-based approach to unbind perpetrator parts. EMDR International Association.
• ​Journal of EMDR Practice and Research — Gold Open Access via AAAS Science Partner Journals (2025).
• ​Van der Hart, Groenendijk, Gonzalez, Mosquera, & Solomon (2013, 2014). Dissociation of the personality and EMDR therapy in complex trauma-related disorders. Journal of EMDR Practice and Research.

EMDR Consultations for Certification focused on Perpetrator Introjects I Sundays at 5pm PT: www.SacramentoEMDRtherapost.com

**EMDRIA Consultants in Training (CIT) can provide up to 15 of the 20 consultation hours required for Certification.*** Consultations are overseen for treatment fidelity and quality by Approved Consultant Briana Smith, LMFT

Target Memory is produced by Pacific Clinician Collective, a California educational nonprofit supporting trauma-informed clinicians through affordable consultation, reflective practice, and continuing education. Advanced trauma trainings in EMDR, Brainspotting, Deep Brain Reorienting are expensive. High costs keeps skilled care out of reach for the clinicians and clients who need it most. Learn more at pacificcliniciancollective.com.

Why do some trauma clients understand exactly what happened to them and still not feel relief from symptoms? In this first episode of Target Memory, we explore why insight and resolution aren’t the same thing - and why trauma so often won’t process through talk therapy alone. We cover three practical, in-the-moment signals that a client has connected the trauma the talking brain can’t reach. This episode introduces the bottom up modalities : EMDR, Brainspotting, Deep Brain ReOrienting, and Accelerated Resolution Therapy - that work where words run out.

A podcast from Pacific Clinician Collective, an education project supporting clinicians training in EMDR, Brainspotting, Deep Brain Reorienting, Accelerated Resolution Therapy.

#EMDR #PTSD #Trauma #CompexTrauma #Brainspotting #DeepBrainReorienting #AcceleratedResolutionTherapy

Why do some memories still feel emotionally real years later?

Target Memory explores EMDR, Brainspotting, emotional memory, nervous system reactions, and the psychology behind why certain experiences continue to shape us long after they’re over.