An Interview with Therapist Amanda Ann Gregory
Amanda Ann Gregory, LCPC is a psychotherapist, national speaker, and author. She holds licenses in the states of Illinois, Texas, and Missouri, and has EMDR certification. She specializes in working with trauma survivors.
Anna Kiesewetter: Hi, thank you so much for joining us today on this installment of the Seattle Psychiatrist Interview Series. My name is Anna Kiesewetter, and I'm a research intern at Seattle Anxiety Specialists. I'd like to welcome today with us the trauma psychotherapist, Amanda Ann Gregory. Amanda is a trauma psychotherapist, national speaker, and author. She holds licenses in the states of Illinois, Texas, and Missouri, as well as an EMDR (Eye Movement, Desensitization, and Reprocessing) certification and a National Counselor certification. Amanda has provided individual, group, and family therapy for more than a dozen years in outpatient and residential settings, and is currently in private practice in Chicago.
Her work has appeared in Psychology Today, Psychotherapy Networker, Happiful Magazine, Addiction Professional, and other magazines. Amanda has also served as a presenter for clinical conferences, employee trainings, and community events and has spoken for the American Counseling Association, the National Alliance on Mental Illness, the Missouri Department of Mental Health, the Missouri School Counselor Association, Prevent Child Abuse Illinois, and the Missouri Association of Marriage and Family Therapy.
Before we get started, could you please tell us a little bit more about yourself and how you came to work as a trauma psychotherapist?
Amanda Ann Gregory: Yes. How I came to work in trauma was actually by accident. My very first job out of graduate school was at a very specialized residential treatment center for teenagers, which specialized in treating developmental trauma, which especially at that time really wasn't well known and it’s trauma that basically occurs in childhood over a period of pivotal development. And when I was there, I absolutely loved it. I loved working with trauma survivors, and I didn't want to leave it. And so I took those skills into the outpatient world in community mental health centers. Now, I'm in a group practice. And so this is a population that I just fell in love working with. And later, honestly, realizing that I'm also a developmental trauma survivor, and so, really feeling that I'm connected to this population. I was able to do my own work, my own trauma treatment, which is a big part of being a trauma clinician. And so really it's twofold. It's a wonderful population to work with, and also I consider them my people, my tribe, so to speak. Yeah. And I just always feel grateful to be able to do this work.
Anna Kiesewetter: That's really beautiful. Thank you for sharing that with us. What does this therapy generally look like for you?
Amanda Ann Gregory: And can you say that again?
Anna Kiesewetter: Yeah. What does therapy generally look like for you as a trauma therapist?
Amanda Ann Gregory: Right. Dealing with trauma, it's a little bit different sometimes from other types of therapies. When we think of therapy, sometimes we automatically think of talk therapy, which is typically cognitive behavioral therapy, but with trauma work, it's a bit different because you have to bring in other interventions to address those earlier developing parts of the brain. And so therapy for me really depends upon the trauma survivor, what they've already been exposed to, what work maybe they've already done, or is this their very first time participating in treatment? I tend to combine a lot of methods, so I'm attachment based. There's a big focus on the relationship with the client and creating that safety to start. And I bring in a lot of interventions to help the brain such as EMDR, somatic experiencing, maybe even at times play therapy, animal assisted therapy, internal family systems. It's really eclectic depending upon what the client needs, but it does look a little bit different at times from what people may think of as that talk on the couch type of therapy.
Anna Kiesewetter: That's really interesting. Could you tell us a little bit more about how it differs from the talk therapy practice... It sounds like it's a little bit more hands on for the things that you do. Is that right?
Amanda Ann Gregory: Yes. It could definitely be more hands on and a bit more interactive. Here's an example. Let's say I'm working with a client about, let's just say one experience that they've had that they've really kept with them. It's really blocked them in areas of their life. And we would call that trauma. Some people, if they're working with a client, they may want to talk through it. They may want them maybe to create a narrative of their experience, which can be wonderful. My type of therapy is bringing more things, for example, the body. When you recall that memory, what do you notice in your body? Connecting with that sensation, helping that sensation to process.
With EMDR, we do a lot of that bilateral stimulation to desensitize the actual impacts of those experience and reprocess adaptable core beliefs. Instead of the client telling me what happened and going through the story of it, I might move their eyes back and forth, back and forth. I may have them hold onto these vibrating tactiles that go back and forth, back and forth in their hands. And that's what's helping them process and I'm going to help them along. I'm going to be right there. It's definitely not hands off, but it does tend to be a bit more experiential in nature.
Anna Kiesewetter: I see, yeah. Thank you for explaining that. Awesome. Okay, now that we've gotten to know a little bit about you and the therapy work that you do, today, I'd like to address a topic on a lot of our minds. On June 24th, 2022, the Supreme Court overturned its Roe v. Wade decision in the US, ruling that the right to an abortion is not protected under federal law and delegating jurisdiction over abortions to the states. Following that ruling, abortion has become or will become illegal in over a dozen states whose legislatures had passed automatic trigger bans, as reported by the New York Times. In a recent article that you wrote, you write that this ruling is particularly harmful to trauma survivors. I'm wondering, what are the implications of this ruling on survivor's physical and mental health?
Amanda Ann Gregory: Yes. The issue about this ruling that tends to threaten, sorry, trauma survivors is it really does threaten that sense of safety. And if we can just use that as a foundation: just safety. And if we look at trauma, trauma is usually created by an experience or a bunch of experiences where that safety wasn't there, or perhaps that agency or autonomy wasn't there and that's created this response. If we take these folks who've had those experiences and then we have something like this happen, which does strip people of that agency and that autonomy, that does not feel safe. And so basically what we're asking now is trauma survivors to try to heal, try to recover, try to not offend others because of their trauma, which at times has happened. We want them to do this work, but we're not going to provide that safety.
It's kind of like you get healed, you do your best, but we're going to take some of that safety away. And in trauma treatment, any trauma therapist knows that doesn't work. There has to be maybe not 100% safety, but some foundation of safety for trauma survivors to be able to work on this and to be able to really move past surviving to thriving. And this ruling makes that so much more difficult, because it really does strip that safety and really specifying that, and I'll just use the word agency, taking away that agency, that bodily agency, that relational agency, which directly has a negative impact on mental health.
Anna Kiesewetter: Right. Yeah. Thank you for that. And here at Seattle Anxiety, we focus a lot on anxiety disorders. I'm wondering with the implications of this ruling on trauma survivors, how this impacts anxiety disorders or any anxiety symptoms in survivors?
Amanda Ann Gregory: Sure. If we look at anxiety, we just take trauma out of it for a second, trauma is anxiety. They're very much mixed up, but if someone, let's say, has a generalized anxiety disorder, and they're in this world, this is definitely going to create some anxiety because it's, well, now my choices are restricted. Now I may have to worry about this and that. And even if you feel like it doesn't apply to you, for example, if you are someone capable of giving birth, you don't want to do that at all. Don't want to even be involved in that. Knowing that somebody else is restricted in some capacity in their choices could make you really feel unsafe and it could lead to a lot of additional worrying. Folks who experience anxiety tend to struggle with racing thoughts, worrying, issues like that. And this could really infiltrate that and actually make that significantly worse.
Anna Kiesewetter: That makes sense. And then on the physical health aspect, I know you write also a little bit about how there is a continuation of trauma and often being more exposed to the source of the trauma if you are put in a place where you're forced to carry a pregnancy to term. Could you talk a little bit more about that and the continuation of that trauma?
Amanda Ann Gregory: Right. If we go back to safety and look at that agency being stripped, it's like you're suspecting to be back in that situation again, or you already feel like you're back in it. And so actually, I believe the United Nations actually believes that forcing a woman to carry a pregnancy is a crime against humanity. And so I think that's interesting that they have that set and then yet we have that overturned here. And if you just think about the restriction of that, and if we look at relational trauma. Okay. If somebody has a relationship, it could be with a parent, it could be with a romantic partner, it could even be with a friend or a community member, and that relationship is not safe. Let's say it's toxic. Let's say there's abuse involved. What do we tell these people as a society? We say, “Get out.” Right? “End the relationship, have some boundaries, get out.”
Okay. But what if certain decisions made by other people are forcing you to stay in that relationship in some capacity? There are states that a rapist can sue for parental rights of a child. And that means that you will need to have a relationship with this person in some capacity going forward. And so you can't just get out. You can't just have these boundaries because that's very much restricted. And so let's just take rape out of it for a second. Let's say you're in a relationship and it is abusive and you get pregnant. Would you be required to carry that child to term? And is that going to hold you to that other person for at least 18, 19, 20 years, maybe the rest of your life, honestly? Is that going to help you or is that going to traumatize you or is that actually going to feed more of those trauma responses? And it will. The thing about trauma is it compacts upon itself. It's very rare just to have this one event.
Now, some people do have one traumatic event that I need to address, but when it comes to developmental trauma or complex trauma, it compacts. It's a series of these progressive experiences. And what we sometimes see with trauma survivors is their old coping mechanisms, what they needed to do to survive, they keep doing it into adulthood. They just keep doing it. And so this can create situations for folks to continue to have that trauma compacted upon itself.
Anna Kiesewetter: Right. Yeah. That's very important. You also write about the implications of this ruling on the messaging it would send to children about consent and bodily autonomy. Would you be able to tell us a little bit more about how this ruling affects childhood development?
Amanda Ann Gregory: Sure. A couple of ways, one, I'll talk about the children being around the adults and then just the children. And so when adults don't feel safe, when adults don't feel like they have a sense of agency, children pick up on that. They do. And we try to keep that from them. We try to protect them, but we have to understand that we're actually putting that off in all this nonverbal communication all the time and children constantly pick up on that. When a child is with an adult who, let's say, is their primary attachment figure and the adult is struggling, then the child's going to pick up on that in some capacity. And so now we have parents who may not feel as safe as they did before this was overturned. And we have those children in the home who are going to also pick up on that.
And if you think of it from a child's point of view, I'm requiring, I'm really relying on this adult or this set of adults or maybe multiple adults to keep me safe. But if they're struggling, if they don't feel safe, how are they going to keep me safe? And these aren't words that are spoken. It's very nonverbal. That's one thing that may negatively impact children. Second is as some cultures, we tend to struggle at times with teaching children about bodily agency and consent. Sometimes we will do these things of “Give me a hug, give me a kiss, go hug grandma, go do it.” We send those messages, which isn't great, because it doesn't really line up with what we say and “Hey, if anybody touches you, you need to tell us. These are the places that they can't touch.” We have to provide that education, but then somebody in your family or somebody that your parents trust can just do whatever they want and you have to consent to that. We do tend to send some mixed messages to children, I think.
And there is a movement in child psychology to really encourage parents to request children to provide physical intimacy if they would like. For example, “Would you like to hug grandma? Is that something you would like to do?” Or asking a child, “Can I give you a kiss?” Things like that could actually build up more of that sense of teaching a child, “This is your body - yes, within reason, some adults may be making some medical decisions or things like that for you, but I'm going to expose you to the fact that this is your body. You get to decide what you do with your body. You get to decide who touches it, who doesn't touch your body.” And those messages can be pretty mixed. And now we're in this society with this Roe versus Wade being overturned, which well now, what are we telling children? Are we telling children that only the boys have controls over their body? Where is that line there between, we're trying to teach them to be safe, but then we're not providing this global safety or this national safety for them. For children, very, very confusing.
Anna Kiesewetter: Right. That makes a lot of sense. Still on the topic of children, you've written another piece on how to talk to children about the experience of growing up in the era of school shootings, in light of the mass shooting in Uvalde, Texas. I was wondering if we could relate this a little bit to this question and think about how you would approach conversations with children about abortion rights.
Amanda Ann Gregory: Right. When it comes to these big national events, it could be very intimidating for us to talk to children about that and to know what to do, whether it's a school shooting or a decision being overturned that really impacts us and them. I always tell parents, start with curiosity. Don't assume a thing. Sometimes we come to children and we assume they know nothing. And then we get all this information about things they've heard. And of course in our digital age, it's just one click away for them to find all of this information. Even very small children know how to do that. We don't know what information they've already been exposed to. The first thing I tell parents is, just be curious. Approach the conversation with calmness, just very gentle, and just be curious, "Hey, what have you heard about this?”
“What have you know about this? What are their friends saying?” Just be very curious and to listen first. We want to jump in. We want to give insights and advice. And sometimes, especially if a child reports not feeling safe, we want to fix it. We'd be like, "You're safe. I'm going to keep you safe. It's not going to happen to you." Well, hold on. Let's listen first. Do they have any concerns? Do they not feel safe? Do they have any questions? And then really validating what are they going through? If a child is confused about this, validate that. Absolutely it's confusing. This is a really tough thing to understand. If a child doesn't feel safe, validate that. If a child doesn't care, they're just like, "Ah, I don't really care about that." Okay. Validate that and acknowledge that. And notice that there's so many steps before we get to actually implementing or speaking. We're being curious. We're listening. We're validating.
Then I think if we need to, we can move into problem solving. We can move into providing them maybe some education or some information, but not before we go through all those steps, because that really opens up the line of communication and it keeps it open. Because things like this, whether it's a school shooting or Roe versus Wade, it's not going to go away. These things are going to keep happening. They're going to keep developing. With kids, we really want to keep that line of communication open. We want them to know it's safe to come to me. It's safe to talk about this.
Anna Kiesewetter: Yeah. Thank you for that. I think that's going to be really helpful for parent listeners. I'm also wondering: what do you think that the mental health community and psychotherapy can do to help survivors post-Roe?
Amanda Ann Gregory: Yes, there's a couple of things. First off, when it comes to mental health providers, and I'm sure they're already facing this, it's so important to allow clients, members of your family, people in the community, really a safe space to process this. And that's really exploring their thoughts and feelings related to this. Sometimes we want to shut that down. We want to move people over here, over here, but what if we just step back and we just allowed them to process. There were quite a few clients the next day and this week in my sessions with them that they needed that time. They needed that space. And as a clinician, it may be tempting to say, "Whoa, hold on. This isn't what we're working on. We're working on your trauma or we're working on this or that. Let's focus on that."
No, you can't. You have to address what's happening in their lives here and now to not only support the relationship you have with them, but free them up, get these wheels going, get that processing going. And when it comes to trauma survivors, we can't pick and choose. We can't say, "Okay, well this is something going on now, but let's focus on your past." It's interwoven. It all comes together. I think it's really important to give the people in our lives the time and the space to really explore this. And that can be really difficult. And again, when putting this to members of the community, it's the same thing. We're all going through this together. And it's regardless of if you agree with the decision or if you don't agree with the decision. I think this is really stressful for everybody. And I think when we provide those safe places for people to explore that, it's one of the best things that we can do.
Anna Kiesewetter: Yeah. Thank you. I think that's very important. With that, do you have any final thoughts or insights that you'd like to impart to our audience, on the Roe v. Wade decision or about children or school shootings? Anything that you'd like to talk about?
Amanda Ann Gregory: Yeah, I do have one more point. This might be a little controversial, but this isn't political. If you really take a step back and look at it, whether if it's Roe v. Wade, whether if it's the war in Ukraine, whether if it's a school shooting, it's not political. And I think we sometimes use that as a mask or a band-aid to hide these things. And as a clinician, I had people reach out to me and say, "Thank you so much for just talking about, for just writing about this because we don't really see this from a whole lot of clinicians." And that shocked me.
And I saw just online and in social media, there was this movement to try to get counselors therapists, social workers, to stop talking about this. People were saying, "This is political. You need to just treat people. You need to keep this out of the conversation," but that doesn't work so well. We don't live in a vacuum and if we are devoting our lives to treating these folks and helping them, then it's very difficult to stay quiet when things happen that we know is going to have a direct negative impact upon them and could very easily sabotage treatment and make it so much more difficult. And so I did hesitate before writing that article that you read or even doing this interview.
There were some people that said, "Oh, you're not going to get certain clients" or this and that. I was like, "I get that. That's a risk. But I can't pretend that it doesn't impact the same people that I'm trying to help." And so I guess I would say that if something is going on that impacts your clients, think about that. Do I want to say something? Do I want to advocate? Does that feel right for me? And if not, simply allowing your clients or the people in your life that space to process that and process that with you might be another good option, but when it comes to these events that cause trauma in folks, that really perpetuates trauma, it's not political not anymore.
Anna Kiesewetter: Right. Thank you. I think that's so important. And thank you so much for everything that you've talked with us today about. I think you have a very powerful message and it's really important at this time to have that. We wish you the best and hope to have you back for another interview in the future; thank you again for coming. And that'll conclude this installment of The Seattle Psychiatrist Interview Series. Thank you all so much for listening and we hope that you'll tune in next time.
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Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.
Editor: Jennifer (Ghahari) Smith, Ph.D.