Dr. Jamie Marich on Trauma and How To Process It

The definition of trauma has changed over the last few years, and so has the understanding of the best way to treat it. We talk to an expert who explains how and why.

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Fifteen years ago, the daughter of a friend left her office building for lunch and, when she returned, found the body of a man who had leaped to his death.

Sad and disturbing, yes, but did she experience trauma? Her employers, a health insurance company with a solid reputation for taking care of its employees in a progressive, holistic way, thought it was. They insisted she visit the mental health therapist they provided to help her deal with any trauma she felt about the incident.

What struck me at the time was both that the employers defined the sight of a dead body as trauma, and that they sought to help her deal with any reactions to it by insisting she visit a therapist. I asked myself, “What exactly is trauma, and what can heal it?”

During my years publishing Point of Light, the topic of trauma came up repeatedly. Many mental, emotional, and energy healers I met believed that trauma remained stuck in our system until processed. I often wondered where exactly trauma stayed stuck, and what exactly processed meant.  

The Truth for this chapter is that Unprocessed Trauma is stored in the mental, physical, and emotional bodies, and the DNA, then is passed on to the next generation. When it came time to get more details on the subject, I knew who to call. 

I met Dr. Jamie Marich six years ago when we produced a short video promoting a Mindful Dancing event she hosted locally. She describes herself as a facilitator of transformative experiences. She calls herself a clinical trauma specialist, an expressive artist, a writer, a yogini, a performer, a short filmmaker, a reiki master, a TEDx speaker, and a recovery advocate. She unites all of these elements to inspire healing in others. She began her career as a humanitarian aid worker in Bosnia Herzegovina from 2000 to 2003, primarily teaching English and music while freelancing with other projects. 

Jamie travels internationally and teaches trauma-related topics, such as EMDR therapy, expressive arts, mindfulness, and yoga while maintaining a private practice and online education operations in her home base in Northeast Ohio. She’s written numerous books on trauma, recovery, and healing, and founded the Institute for Creative Mindfulness. 

To explore this topic, I knew she could answer my questions about trauma and explain which healing practices she finds especially effective.

Please enjoy these highlights of a podcast we recorded recently.

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Sven: Where did you get your training and education in dealing with trauma?

Jamie: Most of it came from that time in Bosnia because my undergraduate degree is unrelated to what I do now. I have a history and American Studies degree, which is a facet of the English department. However, I believe I use those degrees in my work because so much of being a therapist is getting to know a person’s history and the context of the culture surrounding them. In American Studies, I got so much pop culture training, and that’s how I work with people in my practice, getting to know what stories they’re passionate about and what themes in their lives they're passionate about. 

I ended up working in Bosnia because I didn't know what I wanted to be when I grew up. I finished my undergraduate degree, I was very lost, mainly because of my own emotional trauma. My family is of Croatian ancestry and a few other Slavic groups. I started going there and studying in 1998 and fell in love with the country of my ancestors. It was a good idea to live there for a while, which is what I did in the four or five years following the Civil War, the Homeland War, that followed the demise of Yugoslavia. 

I was teaching English and music, and I was mentored by an amazing American social worker also working over there at the time who had many years in her recovery from addiction. And she helped me piece together much of what was going on in my own life. At a certain point, she asked, “Why don't you go back to graduate school for counseling?” I laughed at her, saying, I didn't even like psychology when I took an undergrad course. And she said, working over here, you've gotten the field training. She said, now that you've got this artistic training, go back and learn the technical stuff. And that's what I did — a master's and doctorate here in the US, but even more than the technical university education. I did a lot of continuing education. And specialty therapies for trauma, most notably EMDR therapy. I still maintain the greatest training anybody can do is to continue to work on their own trauma processing. I've stayed committed to that even as I've grown professionally.

Sven: Let’s have a conversation about trauma from the big picture. Can you say that some kind of trauma lies at the root of most of the problems in our lives?

Jamie: That's very well put. I get into battles a lot, even with other psychologists, about "not everything's about trauma." And if you understand what trauma really means and what it is, yeah, in one way or another, if trauma is not causing it, it's at the very least exacerbating it. 

Before we go any further, I have to get into my working definition of trauma, which is “wound.” The English word that we use, "trauma,” comes from the Greek word “traumatikos,” meaning “wound.” As a clinician, even though there are tons of technical definitions out there, my simple humanitarian aid worker definition of trauma is any unhealed human wound. And that wound can be physical, emotional, spiritual, or sexual. And yes, just like with physical wounds, some wounds may automatically need more attention, more care, and more professional treatment, or fatality or severe injury can result. But many other wounds may require some time and space to heal, yet we still need to validate that they're there. Not all trauma is necessarily going to meet clinical thresholds for certain diagnoses. Yet, if we can appreciate this broader definition of trauma as a wound, that is the core of what ails the human condition.

Sven: Can you describe the many different degrees of seriousness of trauma? If an adult yells at a child, the child may feel a real threat with a strong adverse reaction, which is much different than somebody who survived combat.

Jamie: I'll answer from my lived experience, especially since we've already talked so much about my time in Bosnia. When I was there, my mentor, Janet, first used the word trauma to describe a lot of how I grew up. And my initial resistance was, “But I never went to war. I was never in combat. I was never like these kids, who I'm working with now, that lost a parent from the war or were displaced in some way." And she said, "Jamie, would you consider though that the war zone was your house?" And it hit me that this is very subjective. I think we can get into some precariousness when we compare too much because some people already have the mental resources they may need to survive a combat experience relatively unscathed.

Sven: That's the next degree of variability. More resilient people can see a traumatic event and seem okay a short time later. Some people can't absorb it, can't process it. Can you lay out the varying degrees of people's reactions and resilience?

Jamie: There are so many variables at play. I think that's the word I want to hit on because even people -- and this is where we can get semantic and philosophical -- even people after a trauma, maybe who do drink a lot or do dissociate a lot... They're doing what they have to do to survive. That's some degree of resilience, even if it's not the proud resilience we may celebrate in the public forum, “Oh, you can bounce back up and go to work like nothing happened." A lot of those people who seem resilient, who are bouncing back and going to work like nothing happened, are still carrying a lot of crap inside. 

Sven: Can you describe some of the most common causes of trauma? A friend of mine never thought he had PTSD. Then he talked about losing a daughter at two years of age. I told him, "You buried a daughter. You have PTSD.”  It didn't even register for him. What kinds of things happen in our lives that cause trauma that stays with us? 

Jamie: The original conceptualization in the Diagnostic and Statistical Manual -- the DSM -- when these discussions around trauma really started happening in earnest after Vietnam, the initial indicator was any life-threatening or injury-threatening experience could be classified as traumatic. But even now, in the last ten years, newer editions of the DSM, which have expanded to include witnessing a traumatic death witnessing a traumatic event, could qualify you for a traditional PTSD diagnosis. Sexual assault or sexual injury of any kind is now considered a PTSD-qualifying event. Yet, it's also important to consider that PTSD is not the only trauma diagnosis in the DSM. There are dissociative disorders that can stem from long-term childhood neglect, abuse from primary caregivers, adjustment disorders, which are one of the traumas, and stress-related disorders that could be a result of a divorce or losing a job. We can think of anything you think of as wounding, which causes some fallout, as traumatic. 

Dr. Francine Shapiro developed EMDR therapy, and in the early days of that therapy, she came up with a system of classifying trauma as large T and small t. Large T are the things that would qualify you for the PTSD diagnosis: the Life and injury-threatening events. Small t traumas were everything else. But even in the last five years of her life, she moved away from that classification, leaning more into trauma is trauma. It just sometimes shows up in certain diagnoses. Sometimes it doesn't. I've seen it consistently where some people can go through one big T, so to speak trauma, but because they have the skills and the support and the treatment, the access that they need in life to process, they go on relatively unscathed. And then you have some people who may experience what we used to call the small t kind over and over and over again. But if nothing gets addressed, it can cause more long term damage than somebody in a car accident. 

Whenever I lecture on this, people inevitably come up to me and say, “As you were talking, I was thinking of this thing. Is that trauma?" “Yes” is my answer. If anything I'm saying resonates with an experience you've had that you've had a hard time getting over, we're talking about trauma.

Sven: We've talked about PTSD, and you've mentioned disassociation. What other kinds of symptoms of post-trauma exist? What kind of things do people get into mentally and emotionally?

Jamie: In the post-traumatic stress disorder diagnosis, the main symptom areas are re-experiencing, which would be flashbacks, nightmares, body sensations, body memory, and intrusive thoughts.

You could have avoidance symptoms, literally not wanting to go near the scene of something that happened. Let's say you were traumatized in a car, and you need to drive to get to work or to take care of your kids. Then, there could be a more significant barrier. A lot of people will leverage drugs and alcohol or other problematic maladaptive behaviors such as avoidance.

The third symptom area would be increased negative cognition states and mood. So, symptoms that may look like depression may be better explained by the trauma, these negative cognitions, or negative beliefs that drive you, like "I am bad. No one can be trusted." Sometimes, cognitive impairment can include blanking out of memory, which we also see in dissociative disorders. 

And then, under PTSD, the fourth major area is hyperarousal and hyperactivity, so being jumpy, being on guard for something to happen. But other symptoms in that area could include problems concentrating, problems falling or staying asleep, and reckless or self-destructive behaviors. A lot of symptoms often get identified as other things like ADHD or bipolar, or even addictive disorders and eating disorders. There may be some overlap here with PTSD symptoms. 

With dissociative disorders, there's either a higher degree of fracturing in the personality or just disconnection from what the rest of us may see as reality. Dissociation under the PTSD diagnosis can be considered a re-experiencing because of flashbacks. When you think you're back there, when every cell in your being believes you're back there, that's a dissociative phenomenon. Those are some of the main highlights.

Sven: Sometimes, these effects take a while to set in. I know a guy who survived a gunfight, made it back alive, and was fine through the rest of his tour in Afghanistan. When he was in the States for about a month, all of a sudden, wham, he experienced one of these flashbacks where he could not get out of the panic attack. Is that fairly common? 

Jamie: The short answer is it depends. Yeah, again, to go to the DSM, for a technical PTSD diagnosis to be issued, 30 days have to have passed since the time of the qualifying injury. So that's not uncommon at all. Anything within 30 days that is experienced, at least according to the DSM, would be labeled an acute stress disorder diagnosis. But using the metaphor of the wound and what we know about wounds medically, if you can treat something at more of an acute level, you can hopefully prevent these more long term after 30-day complications from happening. 

Yet another component of PTSD is something called delayed expression. And that may be even longer than a month, where we see six months or more. That is a very common phenomenon with Vietnam-era veterans who would come home from Vietnam and seemingly be fine. What we saw with a lot of these individuals is when a spouse passed away when they retired, it brought back up all the old stuff because their essential coping or displacement was no longer there. Delayed expression is very common. We see it happen in sexual abuse survivors as well when either the primary abuser dies, or somebody in the family close to the abuser dies. I've treated cases where a grandmother or an aunt died, and they were the person who kept the secret, and now that they were no longer there, it all came flooding back. Delayed expression can happen for a variety of reasons.

Sven: Well, we're just a mess as a species, aren't we? 

Jamie: You may have heard this axiom, or this idea, that "hurt people hurt people.” Using the trauma-as-wound metaphor with that, it's because we bleed all over each other. We cross-contaminate. After COVID, we've learned about what contamination meant at a physical level. Something that I wrote even at the beginning of COVID is why we can’t take these universal precautions with mental health that we have learned to do better with physical health because wounds, emotional wounds, and spiritual ones don't get treated. We're going to bleed all over and infect everybody we come into contact with.

Sven: Where does that trauma go in the body? You've got training in some of the standard mental health arts and some of the more esoteric, like EMDR. And you've got a mystical side to you. So where does it go? Why does it say stored for 30 days or more and then start to express? Where is it coming from?

Jamie: This is very much your English teacher’s guide to the human brain. I think it’s important here, as I try to explain this, that when we go through, for lack of a better term here, a traumatic experience, even a stressful experience that we may not go on to label as traumatic, our limbic system activates, and our limbic system originates from the midbrain, which is where functions like the amygdala, the hippocampus are stored. I've often looked at the amygdala as the brain’s panic button to alert us that something is wrong. And when something is wrong, our limbic system can go on high alert to tell us we're in danger. You've likely heard of the fight-flight-freeze responses. Sometimes, they happen in combination. The limbic system leverages those behaviors to keep us safe at the time. 

A way to look at the definition of processing is to let that memory storage shift to the area of the brain we call the neocortex, which is more efficient in its long term storage. Something in the neocortex doesn't mean you have forgotten it. It just means that the charge is more removed. 

The issue is the limbic system, the amygdala, to some degree. People who have long term symptoms of trauma may never reset. Our body, our limbic brain, that middle part of the brain, which is like a central processing unit, may never learn that the danger is past.

 A student expressed it well once in a paper, which stuck with me. She said our brain, this limbic system, is designed to keep us safe from saber-toothed tigers. But it's not meant to keep you safe from saber-toothed tigers every day. Having the brain on high alert over and over as if this trauma keeps happening is what can cause the flooding of cortisol, which can make our body more stress-taxed than it's naturally designed to be. That's one way to look at it: the limbic system, which is also the highly emotional brain; the highly reactive brain means we need it. It's not the enemy here. When it's not properly cared for after it gets activated that way, we hold things in the body.

Sven: That's how people think of it. And even specific areas of the body. When I think about this trauma, I feel pain in a particular place,

Jamie: There's usually a reason for it when you get in there and feel or experience it. There's a reason for it. Survivors hold a lot of tension in their jaws. Sometimes, it is because of forced oral sexual trauma, but more often, it's because we went to speak up and couldn't.

Sven: These days, everybody lives with so much stress. I see many people with their shoulders up around their earlobes. 

Jamie: When the shoulders are up around the earlobes, that's the universal symbol of hypervigilance—being on guard for something bad to happen. I do an exercise with many clients where we exaggerate the shoulder tension. You can feel what your body's been doing on a subtle level. When you exaggerate this tension in the shoulders, what's happening to your breath, people usually can make the connection there. I'm not breathing fully. An early yoga teacher I studied with was constantly calling me out. “Jamie, your shoulders are up so high.” Part of my healing and processing was to become more aware of it. When I noticed my shoulders spiking up like that, I would make sure I gave them some TLC by doing shoulder rolls. I do get a lot of massage and bodywork and ask myself, “What is causing me to still feel like I have to live my life on such high alert?“

Sven: Let's talk about what the term processing means. Processing trauma. I think this is your forte: all these things we can do that will help us process trauma. 

Jamie: But there are a couple of different ways to look at processing trauma. A psychologist colleague of mine is a Vietnam veteran. And he said it's when you have processed something; it's when you can move it from being this hot charge memory that controls your life to just be a bad memory.

Sven: So, the emotional charge makes the difference. 

Jamie: It's like we're defusing the bomb behind a memory when we've processed it. This is an excellent question because even when I teach EMDR training, I ask my students, “How would you define processing?” You break something down so that you can more easily digest it. You try to make sense of it, you try to move it, and when we're biologically talking about moving it, it's from more of that limbic area of charge to the neocortex as the primary area of storage, which is more efficient for holding things long term. What helps us do that? Anything that involves not talking alone. 

I'm a talker. I love language. Sometimes, just speaking my story and having somebody I trust here will help. I do a lot of writing, which helps. Yet, generally, one method alone is insufficient. Many people I've worked with can tell me everything about what happened to them. Yet, they haven’t emotionally held and felt and moved it. So crying, spiritual practice, getting bodywork, yoga, and doing forms of therapy promote a sense of communication between the limbic brain and the other parts of our brain. Anything that has an action speak-louder-than-words type of approach can help people process. I have worked with trauma survivors over the years and have done a lot of my own trauma work; it's rarely one thing. Yet, to quote the African proverb, “It takes a village." That's been the case for me. I needed to work with several different healers from somewhat different angles to have a lot of this traumatic material move in a way that no longer has a charge on my life.

Sven: Let's talk about EMDR next. Can you describe it, and what makes it so effective?

Jamie: Well, it's a horrible name. It's a great treatment, and it's a horrible name. EMDR stands for Eye Movement Desensitization and Reprocessing. Since we've already talked about processing, the re in reprocessing was coined by Dr. Shapiro, the founder, with the understanding that if a survivor never had a chance to process it fully and thoroughly and correctly the first time, now we have to go back in and help them process it again. You can think of it as digesting, re-digesting, processing, and reprocessing. 

Dr. Shapiro stumbled upon something, and she researched it to get it codified as something mainstream. Yet, the primary principles of EMDR therapy are indigenous in nature. Shapiro was walking in the park when she happened upon this discovery. So many of the healing salves of traditional medicine involve being outside, taking a walk in the park, drumming, dancing, and moving the body in a bilateral or back-and-forth way. Much of what EMDR therapy leverages is bilateral stimulation, where we take a walk and move the body back and forth. As she was walking, some disturbing images came to her mind from her own life experience. She noticed that her eyes started doing this back-and-forth oscillation. 

She also drew from Buddhist mindfulness in the development of EMDR. When she sat down along the river and started moving her eyes back and forth, keeping this natural flow going, she noticed that the more and the faster she moved her eyes back and forth, the less and less the charge of memory came down. She has said in her recounting that it wasn't a eureka experience. But isn't it interesting that I'm doing this thing with my eyes, and it removed the charge? She gathered a group of her friends and started moving her fingers back and forth so they could follow and create eye movements as they thought of disturbing material. In her initial trial and error, she thought it had some kind of desensitization effect. 

The more the therapy developed, a couple of different things happened. We saw that it wasn't just desensitization that was happening. It was genuinely reprocessing, where people made connections, moved material, and learned new things about themselves. Some early folks who came through the therapy also were unable to move their eyes because of seizure disorders or because of vision impairment. At that point, she rigged up a stereo box where people could have audio tones go back and forth in their ears. Even before she passed, Shapiro saw that EMDR is a misnomer because you don't need eye movements to do it. 

Right now, EMDR is considered one of the two most evidence-based approved treatments for post-traumatic stress disorder, and that surprises a lot of people to hear because some people still think EMDR is this fringe, experimental, esoteric, weird thing, and it's not. It's been highly codified and researched, especially for PTSD right now.  It's just a fabulous treatment. 

If I was listening to this podcast and hearing about it, I might be a little “That sounds weird." I had it delivered to me in 2004 when I was two years into my recovery and still needed to do a lot of trauma work. I had a lot of talk therapy, a lot of traditional recovery principles, and a lot of spiritual practice in my head at that time. Yet, there was just something about this method that helped me bring it all together and process some of my worst memories in a way that they no longer affected me as much.

Sven: You touched on this a little bit. With talk therapy, you relive that trauma, and it may re-traumatize you. However, with EMDR and some of the other, more esoteric practices, you feel the emotion of it. But during that process, that emotion decreases. 

Jamie: Yeah, anytime you bring something other than words into the picture, it will facilitate that movement happening.

Sven: Because there is so much information, there is so much wisdom in our bodies. We just need to learn how to tap into it.

Jamie: Right. And I think what's fascinating even about the history of EMDR is that it debuted as a therapy formally in 1989, which was within only ten years of PTSD officially being introduced as a diagnosis. At the time PTSD was named as the diagnosis, the psychological community didn't have any new treatments for it other than just doing what they'd usually done in psychology. 

When she had this paper published -- and a lot of people criticized it immediately as sounding too weird, too esoteric, too this, too that -- there weren't enough people whose interests were picked at the beginning, saying that, well, what we're doing with just talking isn't working. This thing that she stumbled into with the eyes or bilateral movement gives us a way to go beyond words. And if you know the brain chemistry, the brain science is helping us go below words into this limbic system by using bodily processes.

Sven: That leads us into a conversation about creative practices, such as art, dance, and music, and how they are used as therapies for trauma.

Jamie: Similar to what we've been talking about. Words don't need to be involved. Especially when people have been traumatized very young, maybe even before the brain is fully formed, experiences can be stored more as images rather than words or memories that you can necessarily put clear, coherent form to. I'll often ask clients, "What color does this feel like for you? You see this or feel this as a shape in your body. Is there a song or sound that feels reminiscent of what you've been through?" I'm an expressive arts therapist, which, by definition, means we work with all of the art forms that a person may find organic to work with. It can be appreciating art or creating art; it can be dancing; it can be making music -- putting together a playlist is a fascinating exercise. You can really get into a person's inner world -- theater, acting, filmmaking. I'm an avid TikToker at this point. I was a YouTuber before that. Putting together short films is very healing for me because it's a form of expression, especially in making commentary about many things that upset me about the field and the culture. 

Expression is our birthright. We all have something to express. Sometimes, the most significant benefit of using any of these expressive forms is letting people know you have a right to share what you need to share. That thing that got stuck in your jaw or your throat may need to come out in a way like painting first before people can speak it.

Sven: You and I are both creative people. I need to be doing something creative all the time. When dealing with your clients, are there many people who don't have any way to express creativity in their lives?

Jamie: Yes, however, a lot of that is because the culture has told them they're not good at it.

Sven: If you're not good at it, you shouldn't do it.

Jamie: Right. This is why, even in English, I lean into the word expressive arts more than creative arts because the word creative can be so loaded. "Well, the creative people get record deals, have their paintings in a museum, and are performers." Hell, expression could be going to the top of the hill and screaming at the top of your lungs. That's an expression. It never has to be about quote-unquote quality. It's giving what you have to say or feel a chance to come out.

Sven: It's not for an audience of people; it’s for an audience of you and the creator, however you perceive that.

Jamie: In expressive arts therapy, we use the phrase "process over product." It's what you learn in the expression and the doing, not necessarily what comes out at the end.

Sven: For many people, the goal might be not to be so triggered by things.

Jamie: Yes. A more mindful way to look at it is to learn to respond to life instead of reacting to it. 

Sven: People find the whole idea of mindfulness, just paying attention to what’s going on in your body or what’s going on in your life or what’s going on in your relationships, so difficult. We have such short attention spans. We have so many things trying to get our attention all the time. Just practicing mindfulness -- talk about how that works with healing trauma.

Jamie: Practicing mindfulness can be very difficult at first for trauma survivors, especially if they have a high degree of dissociation because one of the reasons trauma survivors dissociate can be because the present moment, which is what so much of mindfulness practice is about, feels unsafe and unpleasant.

My working definition of mindfulness that I lean into comes from the Sanskrit translation of the word “smiriti” which suggests it's the practice of coming back to awareness. I always tell folks it's not about, “Can I sit still for 25 minutes?” “Can I notice when my mind is wandering from present-moment awareness and learn how to gently invite it back?” And that is why we call this a practice. 

One of the things you mentioned is my dancing mindfulness work. I've long believed that sitting still and silent when you're new to healing can be more promoting of dissociation. It could be too activating, so engaging in mindful walking, mindful dancing, mindful art, and using daily activities of life around your house to be attuned to that may be where we need to start.

Sven: One of my spiritual teachers visited India and studied with a big guru there. And he said that many Indian people walk in their bare feet on the ground all day long. They hardly ever touch metal. They touch a lot of natural fibers and wood. Their bodies are so grounded that when the guru says, okay, sit and meditate, they can go right into meditation because their electrical system, their mental and emotional systems, have all been conditioned to be able to do that. Take the average Westerner who hasn't put his bare feet on the ground in 10 years. They look at a screen all day, touch metal, and wear polyester under fluorescent lights. No, they can't just sit down and meditate. Their electrical system, their nervous system, and their emotional system are not wired for it.

Jamie: As you're saying that, it reminds me of a concept we share a lot, especially in treating dissociation as part of trauma, which is getting out in nature is so beneficial as a treatment. Dr. Kelly Kirksey, one of my dear friends and collaborators, is an African American therapist, well-schooled in West African folklore, and she says all the time if we were doing this workshop or therapy in West Africa, we would not be in an office. We'd be outside doing this.

Sven: I want to ensure we’ve covered everything you thought we should. Before we finish, would you like to make any particular point or cover any topic?

Jamie: You've asked some amazing questions. And I'm leaving this conversation feeling very connected, alive, and full of joy that we could have this conversation.

Sven: Thank you so much. I feel the same way.