Helping survivors of family and domestic violence (with Patricia Gallagher)

[00:00:05] Bronwyn: Hey, mental workers, you're listening to the Mental Work podcast, the podcast about working in mental health for early career mental health workers. As always, I'm your host, Bronwyn Milkins, and today we are talking about helping survivors of family and domestic violence.

Working with clients impacted by DV can feel daunting, especially when you're still building confidence as a clinician. In this episode, we're going to unpack how to approach this work with safety, sensitivity, and skill, and explore what survivors really need from us in the therapy room. Our guest today is Patricia Gallagher. Hi, Patricia.

[00:00:35] Patricia: Hi, Bron. Thanks for having me.

[00:00:37] Bronwyn: It's so nice to have you on the podcast, thank you for coming on. Could you please start us off by telling listeners who you are.

[00:00:43] Patricia: Yeah, so I'm Patricia Gallagher. I'm a registered psychologist from Melbourne. Um, I've been practising for 17 years now. I've got my private practise, which is Gallagher Psychology, two locations in Melbourne. My niche is domestic violence, family violence and trauma recovery, um, and I've worked in a number of different settings and it's been really good.

But also do, um, teachings, um, I train sometimes in this space. I train, um, different clinicians around guidelines and how to work effectively with domestic violence. And, um, I'm also a board approved supervisor, so I'll do a lot of supervision, and I'm an EMDR consultant, so I'll do consultation for, um, people going through the accreditation.

[00:01:21] Bronwyn: Amazing. Gosh, that was a lot, isn't it? You've got a lot of hats that you wear.

[00:01:24] Patricia: Yeah, I do.

[00:01:25] Bronwyn: Yeah. Um, so, you know, DV can be a bit of a heavy topic. How did you come to be interested in helping survivors of family domestic violence?

[00:01:34] Patricia: Yeah, so it started when I worked at an agency called Doncare, and this is when I was a provisional psychologist doing my old four plus two pathway. Uh, that would've been the start of 2011, so quite some time ago. But from there I learned, um, a lot about the nuances around domestic violence. Uh, I probably worked in that more the heavy duty, you know, um, obvious physical violence space where, clients, you know, just couldn't afford private psychologists, so they'd sort out these, the counselling services that donkey could offer.

So from there, you know, my learnings and my practise and supervision, that really got me kind of well versed and, um, passionate about this area. Um, and just because of, there's not a lot of training in this space, uh, for psychologists. So I'm really passionate in stepping up and having had the mentorship and the supervision, I now feel well placed to, um, offer, you know, early career psychologists or any psychologists across the board, um, just the confidence and the guidance, um, in working in this space. Because it's, I think so many people think they don't have a client that works, that doesn't experience domestic violence, but it can be in the subtle nuances as well. So I guess that's what got me, you know, into this, uh, passion and this niche area.

[00:02:53] Bronwyn: Yeah, I guess one thing that stands out for me is like, um, I guess you pointed to that there's a continuum of domestic violence, so it can be from air quote minor behaviours or unhealthy, uh, behaviours in relationships right through to, the person is at risk of dying by domestic violence. Um, but one thing I wanted to ask you was like, how was that for you as a provisional psych, I guess, going into this agency? Um, because sometimes with provisional psychs, we're like, don't have the complex cases... how was, what was that experience like for you?

[00:03:24] Patricia: Yeah, it was, look, initially it was daunting, I won't lie. I guess like anyone, you know, in early career, there's this sort of imposter syndrome, this sense of, oh no, I can't do it, or who am I to be helping in serving these clients that are going through such complex traumas and the complexity of DV and family violence too.

But through just a lot of encouragement, a lot of education, supervision, I was able to break down those barriers I had all those, um, doubts as a young psychologist back then. And looking back, I guess doing the four plus two then. I was doing a lot of client facing work, so that gave me extra confidence and competence to, to work in these spaces. Um, yeah, and it certainly, I, I would have waves of doubt and imposter, but I was able to break through that myself through supervision and just, um, debriefing with colleagues and fellow counsellors at the time that really helped.

[00:04:17] Bronwyn: No, that's really good to hear. So it's like while you are working with clients who, yeah, had complex trauma and difficulties in their lives, it sounds like you weren't drowning, you had people around you to support.

[00:04:27] Patricia: Absolutely. And that's what I recommend and encourage strongly, um, particularly for early psychologists that do get faced with, um, a DV client or a family violence client, seek out a lot of buffer of support if you can with supervision, with colleagues and, um, people that are really well experienced in this area.

[00:04:47] Bronwyn: Yeah, absolutely. So for early career clinicians who might be unsure, how would you define family and domestic violence? Like what should they know about what it is and the different forms it can take?

[00:04:57] Patricia: Mm-hmm. Mm-hmm. So domestic violence is, um, I guess any violent or aggressive behaviour from an intimate partner, violent or intimate partner perpetrator. Where there's a, you know, a power differential, there's an intent to harm, whether that be physically, psychologically, verbally, financially, socially, existentially, um, but there's just this level of coercion and dominance with an intent to harm. And that comes from either a, um, an intimate partner person, or it can be from a family member as well, and that takes it into the family violence realm. And family violence is more or less defined as the same, um, the same dynamics at play, but just from a family member rather than an intimate partner.

[00:05:42] Bronwyn: I really like how you mentioned the different forms, like the psychological, emotional, spiritual, existential, um, because I still think that perhaps a common myth is that when it says violence, it only means physical. Is that something that you come up against still?

[00:05:54] Patricia: Yeah, absolutely. Or people that just don't know the nuances of covert, um, or, um, emotional abuse or the coercive control. Look, coercive control is certainly a term that's getting thrown around a lot because I know certain states have introduced, um, more formal legislation, um, and more and more, I guess clients, but also more clinicians are getting well versed in knowing what this is.

But I'm still finding that a lot of people don't know the covert examples of it, or when there's an absence of something or when someone pulls away, and that's actually a form of um, DV, but not a lot of people can really identify those nuances.

[00:06:32] Bronwyn: How do we know the difference as clinicians between what might be acceptable behaviours within a relationship and what is coercive? I'm thinking of the example of like, let's say one partner says to the other partner, just let me know when you get to the place where you're going, and the partner requires them to do that like all the time. So whenever they go to a new place, they need to tell their partner that they've arrived and that they're there and who they're with. How do we know that that just isn't the partner looking out for the other one's safety, or if that's something more?

[00:07:01] Patricia: Mm, yeah, it's a really good question. I guess when there's a pattern of that that's clearly coercive because, you know, someone might be feeling threatened by that or, um, surveil-, you know, having that sense of surveillance, um, or check in. Um, 'cause I think there's a difference between, you know, being, you know, making sure safety's intact and, and that's okay, but there's an autonomy there. There's, there's not a control there or there's not an intent to harm or hurt.

Um, but when that's constantly done, um, and the person or the perpetrator knows that it's harming or creating distress psychologically for the other person, well that's when you know, evidence there, there's evidence of abuse. When there's green flags in that relationship, there's, there's a level of safety being checked in on, but it doesn't come with surveillance, it doesn't come with, um, power, it doesn't come with control.

[00:07:55] Bronwyn: That makes a lot of sense. And I guess like maybe early career clinicians listening to this, if they're unsure as well, it's like there's benefits to going to people like you who can help discern like, okay, is this an isolated behaviour or is this like an atmosphere or pattern of behaviours as well, and what's the context?

[00:08:11] Patricia: Exactly, yeah, absolutely. Atmosphere is a really good word. When there's a constant atmosphere or a sense, or yeah, just a real passion. Um, that's, that's when you can tell, that's DV.

[00:08:22] Bronwyn: Yeah, I got that word actually from Jess Hill. You'll, you'll know the book like See What You Made Me Do, yeah, oh my God, it's such a formative book. I totally recommend it to everybody, but just, I mean, it's a bit of a harrowing book as well, like difficult to read at times, but like it really changed my understanding of DV and yeah, she uses that, it's, it's not a single behaviour, it's an atmosphere and what that means for you.

[00:08:43] Patricia: A hundred percent.

[00:08:44] Bronwyn: Yeah.

[00:08:45] Patricia: Yep. Yeah. She's very, very well versed.

[00:08:47] Bronwyn: Yeah, totally. So what are some of the common emotional and psychological impacts you see in, um, I know they like the term victim survivors as well, I've written survivors here. Um, but what are some of the common emotional and psychological impacts you see?

[00:09:01] Patricia: Yeah, lots of second guessing, lots of self-doubt, self gaslighting, um, belittling of self. Um, a lack of agency, like an erosion of self-esteem. It's, it's, I think a number of different experts will describe it as soul destroying, it's really soul destroying stuff. Especially in that insidious realm of domestic violence, that sense of, um, putting up with the abuse and it, you know, there's a sense of just going along with it and, and, you know, it's, it goes against someone's, um, will to do, you know, to put up with it, but they'll do that purely out of survival .Um, so there, I guess some of those really kind of deep, um, examples of what that looks like.

[00:09:44] Bronwyn: Yeah, because I think like, um, maybe a myth that you can help us bust is like, we can hear a client describe their relationship history and then we might think to ourselves, oh, that just sounds like a bad relationship. Can you just emphasise to us that, what seems like a air-quote bad relationship could really have significant impacts on the person?

[00:10:05] Patricia: Yeah, because there's toxic bad relationships, but usually that's when it's sort of two-sided. That both partners will contribute in and indulge in toxic behaviours toward one another. Um, but in a DV context, it's quite, it's, it's discerning and distinct, but it's there it's that sense of one person dominates over the other or will undermine the other. So it's one over other.

And there's this term called reactive abuse. But that basically means the person that the victim survivor, in this case, they're reacting maybe in a somewhat aggressive or abusive way, but that's because they're responding to what was done to them in the first place, so it's outta that flight fight, freeze but there's a nuance, but certainly it, on the outside it can look like a toxic relationship. But if you really kind of dig deep, and if one person is sort of dominating that landscape, then it's, it's DV, it's coercive control.

[00:11:03] Bronwyn: Yeah, with that, like are there any questions that you might ask clients to work out was this say a bad relationship, maybe unhealthy but not abusive. Are there questions that you can ask that definitively? Uh, I suppose I'm asking for uncertainty and an uncertain thing, but is there any tips or tricks?

[00:11:24] Patricia: Yeah, I, I guess like, um, really looking for those, uh, red flags or the, how did the relationship start? Did it start with like grandiosity? Did it start with being, you know, someone being over the top? Did it start with what's called love bombing? You know, I'm not sure if anyone here in the audience would be aware of, um, a cycle of abuse, back in the day, it used to be called the honeymoon period, where you know, things would look really rosy and it's so easy for someone to get lured into that. These days, there's actually, that model has changed and it's now called the false remorse cycle of abuse.

[00:11:58] Bronwyn: Oh, wow. I haven't heard of this. That's so cool.

[00:12:01] Patricia: Yeah, And it's basically saying that clearly it's false because it's so cyclical. If it were genuine remorse, someone would take action and, and really own that they were being abusive and make changes to ensure that they're not harming their partner. But when it keeps happening, obviously that leads into that sort of slow erosion of buildup phase, and then it goes into that more overt form of abuse.

But yeah, I guess sort of asking questions about early days of the relationship, um, you know, did the person talk badly about, um, women or men, depending on the, the, that, the gender of the perpetrator, if you like, the opposite sex, you know, normally there's that kind of putting down someone, what's their relationship like with their mother, with their brother, with their sister, that can give you clues as well.

[00:12:47] Bronwyn: That's really helpful. Um, I really like that cycle of abuse. I have, um, I've got it, I've got it printed out actually, because I find that when assessing clients who may have, um, a presentation of DV, sometimes the picture can just really help and be a clear, like this pattern is so, known that we have a- a word for, a name for this cycle, um, and like, does this resonate with you?

[00:13:15] Patricia: Yeah, definitely. And I think when clients are really visual, to see it can be so empowering that psychoeducation, um, is, is so powerful to name it, and to allow that client to just digest that for a moment. But even for ourselves, like you say, Bronwyn, you know, having a name, it is just like, okay, this is a thing, this is actually really harmful.

[00:13:39] Bronwyn: Absolutely, yeah, absolutely. So many new clinicians, I think they do worry about getting it wrong or retraumatizing a client who is a survivor of family domestic violence. What is some simple principles to follow when working with victim survivors?

[00:13:55] Patricia: Yeah, really ensuring safety, that's the number one theme. And yeah, I guess you've gotta really assess where, where the client is at with regards to have they exited? Are they on the precipice of exiting? Are they about to, or have they or is that a post, um, separation abuse scenario? So you really wanna be able to discern and assess where, which stage the client's at, um, with regards to intimate partner violence or domestic violence.

But also in that, once you've assessed the stage, really assess the safety. Do some risk assessments, keep checking in that level of safety. Uh, do they have other services, um, like Orange Door, Safe Steps, or depending on, you know, where the client is based 'cause of course, Australia has different services nationally and per state for DV, uh, crisis support.

So making sure that they're really well versed and well connected with those other supports, um, which I think I wanna speak about where a lot of psychologists feel pressured to be the case manager or to be those other roles, um, which we can't be 'cause it's not our scope, it's not part of our profession. But we can liaise with and break those silos, uh, which a lot of clients face, um, in DV scenarios where different services aren't really mingling or connecting. So it's really good to have obviously the client's consent to speak with other services and make sure they're really well versed, um, and yeah, so that we don't take it all on 'cause that's where the overwhelm sits with a lot of early career psychologists, but even psychologists in later stages of their career sometimes, where that anxiety can come into this work.

[00:15:32] Bronwyn: Okay. I, I have two questions for you. I have lots more, but these are the main two that come to mind. I think they're hard questions, so I'm sorry in advance. My first one is, what, what advice would you give to psychs who, the client is saying, Nope, I don't feel afraid. I feel pretty safe. But you as the psychologist is like, there are like multiple red flags here. How do you manage that emotionally? What do you do?

[00:15:56] Patricia: In terms of if they feel safe with their partner?

[00:15:59] Bronwyn: Yeah, but you as a psychologist is like, this is not safe.

[00:16:02] Patricia: Yeah, yeah, yeah. It's really hard, isn't it, because you can't collude with a client or argue with a client if that's how they feel, that's how they feel. I think it's just a matter of us being patient, um, and holding safe space and compassion, um, because of course we wanna take them outta that situation, of course, we wanna scream from the rooftops, "no, you're in an abusive scenario or situation". But if they're adamant, they feel okay, they feel safe... there's not really a lot we can do other than kind of just be a good psychologist and listening, holding space. We might gently affirm, um, or maybe gently challenge things, but we don't wanna challenge and put offside the client too much to impede on that therapeutic relationship if they're not ready to hear certain things. It is what it is, we've gotta work with that, which is hard 'cause it goes against our instincts. It goes against, you know, like we wanna help treat and fix, so to speak, um, the trauma or the, the anxiety they feel, but if they're not owning that they're not in an abusive or relationship, or they're not calling it abuse, that's something we just need to really sit with, which is hard.

[00:17:12] Bronwyn: Yeah. I feel like it activates this part of many therapists, which is like their rescuer part or this like fixer part. It's like I've gotta swoop in and rescue them. Is that something that maybe resonated with you, and if so, how did you manage it?

[00:17:27] Patricia: Yeah, it did, early, early days, absolutely, I did wanna go in and fix like, so many of us. Um, but I, yeah, I, I really got told, not told, but I was gently encouraged by my supervisor at the time, just having to be patient, check in gently with where the client's at. Could we do some other, I think just to go back to your early question in terms of stability for the client and where they're at stage wise, give them some emotional regulation tools. Teach the client maybe some breath work or some breathing techniques. If they're feeling anxious and they don't want to talk about the abuse or don't own that they're in an abusive situation, but they're anxious... Okay, well how can we move into other areas of therapy or, or treatment, regardless. So it might be just teaching them some, um, cognitive, um, changes, you know, some cognitive reaffirming statements, like a little bit of light CBT here, perhaps. Um, just some different, um, frames of thinking, you know, like in terms of confidence. Um, yeah, some anxiety regulation or, you know, emotional regulation techniques for anxiety. Helping them kind of work on behavioural activation if they're going through depression. Things like that, I think it's just about sort of changing their dial. If the client's not ready as sort of say or own that they wanna work on that, we just have to kind of accept that and we can move into another part of the therapy.

[00:18:49] Bronwyn: Yeah. No, that's, um, really good to hear. So it's like, yeah, work on our own reactions, because I could definitely say, as you say, it would be a mistake if we were to keep on insisting, like it's, you're in an abusive relationship that would like, as you say, put the client offside. It would potentially cause a rupture in that sense of safety with us.

[00:19:09] Patricia: Absolutely, absolutely. Because it can, there can be such counter transference in, in terms of strong emotional responses we have in the therapy room. And a lot of supervisees will say that to me as well with when doing this work, and I just affirm the same advice and the same, um, guidance here that, yeah, we just need to own and acknowledge our staff or our response and, uh, yeah, definitely not go in a fix it mode because that... yeah, and that's what I was told as well as early career, um, and that helped me a lot, um, and I just had to be patient and write things out. And eventually a penny would drop for the client and they might say, oh, actually that thing you said to me 10 sessions ago, I've actually just realised it for myself. I've come to that realisation and then we can go, okay, yes, but we have to wait for the client to... uh, something, I always say to supervisees, it's about how we walk with the client. We, we walk with the client to ensure we don't create a rupture and we really monitor our own responses as to keeping check that countertransference from our clients.

[00:20:15] Bronwyn: That's a really beautiful way of putting it. So this is the other scenario I had. So we've got a client who is in abusive relationship and they accept that they are in an abusive relationship... how do we help them when it's not? Feasible to leave that relationship, at least for now. Um, how do we help them when they're still in an unsafe environment?

[00:20:38] Patricia: Yeah, there can be a number of ways we can help them in that regard. It might be that we empower them to somehow process past traumas if they're not ready to exit now, but they're willing to look at what traumatic experiences and memories they've had from the DV that they do wanna work on. We could help, you know, utilise, say, EMDR or um, other therapy modalities to help process those traumas in the meantime.

Do risk assessments to ensure their safety because the exit is the most dangerous. So whilst they're not exiting, um, if the perpetrator or the person perpe-, you know, creating the abuse somehow senses that the other party is thinking about exiting, then we keep in check their safety, 'cause sometimes they can just smell it or sense it from a mile off. So we wanna check in with our clients about safety around that.

Um, I guess working on other tools and techniques in the meantime. You know, I guess sort of evaluating some therapy goals whilst they accept they can't leave. Okay, how-, what would you like to work on in the meantime? So, asking those questions and really checking in with our clients and, um, I guess just updating our, our formulations and our conceptualization accordingly.

[00:21:50] Bronwyn: Yeah. I imagine the client would say that as really caring as well. So it's like we're being direct with them, we're communicating, we know that this is the situation, we're gonna try and work out what you still want from therapy and how we can help you.

[00:22:02] Patricia: Absolutely.

[00:22:03] Bronwyn: Yeah, it sounds really good. So you mentioned EMDR beforehand, I know that this is a really passionate area of therapy for you. You're an EMDR consultant. So could you just tell us, there might be listeners who dunno what EMDR therapy is, could you tell us what it is in a nutshell and what role it has in recovery for people who are victim survivors of family and domestic violence?

[00:22:24] Patricia: Yeah, absolutely. So EMDR stands for Eye Movement Desensitisation Reprocessing. Long word formed by the latent great Francine Shapiro in the late 1980s. Um, it is a therapy, is gold standard treatment model for processing and treating PTSD, post-traumatic stress disorder, and now it's got like a lot of, um, great effects for depression, anxiety.

It's a three-pronged therapy model designed to process and desensitise, uh, traumatic memories, help build up adaptive networks in the nervous system for a client, really in, uh, embody a positive belief. So it's un it's very different to CBT, which is top down therapy. EMDR is bottom up therapy designed to really match the physiology with a cognition. Um, undergo a bit of a body scan, close off the memory, and then you keep going until different memories and, um, are treated and processed.

But it can also process and treat, um, depression, anxiety, different areas that someone might be experiencing, um, when going through domestic violence or family violence as well, including complex trauma or childhood trauma.

[00:23:30] Bronwyn: Yeah. Amazing. And yeah, what, what do you think, um, is its role for FDV victim survivors?

[00:23:38] Patricia: Mm, yep. So, um, a while ago I spoke to, I don't know if, uh, anyone's familiar with, uh, Tracy Lynch, who's actually an EMDR consultant and she's got a podcast if anyone's a fan of EMDR here called Understanding EMDR. I actually talked about it on her podcast, uh, two years ago, which is really interesting as well.

Um, but yeah, I think just utilising different phases of EMDR based on where the client is at with the stage of, um, DV recovery. So if they're early on, they're certainly not well placed, I don't think, usually to do the harder, deeper work or phases, um, four to eight, um, to do the desensitisation, it might be about stabilisation. And it's about different, um, phases, you know, you can use them differently and, and you can go back and forth and it's so, okay, it's not, um, you know, linear or one size fits all. You can accommodate and use this treatment like you would with any other therapy modality.

[00:24:35] Bronwyn: Yeah. Um, and I guess like something that comes to mind for victim survivors of FDV is that they may have a history of like interpersonal abuse. So maybe there's been trusted figures in their lives who have broken that trust and abused it. Um, is. EMDR therapy. Good for when you have long, long standing and lots of memories in relation to that?

[00:24:57] Patricia: It is, and with lots of memories. I guess it's not about every single memory because there's so many, but I guess you're really looking at themes. Or if anyone's trained with schema therapy, it can be an excellent modality to inter- integrate, uh, with EMDR with regards to what some of those schemas are, uh, developmentally and interpersonally as well, like mistrust or abandonment or defectiveness, shame, et cetera. So that can be incorporated into the treatment model, the treatment plan here as well.

[00:25:27] Bronwyn: How do you know if somebody, um, like a victim survivor of FDV is ready for the desensitisation part? Do they need to be out of the relationship completely to be able to go into desensitisation or, or something else?

[00:25:41] Patricia: Not necessarily. If someone-, it really depends. So if they've got good family support and secure attachment, um, I'll often use, um, phases four to eight in EMDR a bit more efficiently because they've got the scaffold of support and adaptive networks from others to help them support and contain their trauma. Um, and they can get that support elsewhere from, you know, outside the kind of, um, the, you know, the DV... that they can seek, you know, safe figures it or safe people in their life. That can really help, um, catapult that sense of recovery from other people.

So I'll just go into that really quickly, but it just depends if someone doesn't have those level of supports or really hone in on stabilisation or, or, um, emotional regulation and building those resources, um, pretty steadily... you know, it just depends on the level of support they have and where they're at. Um, so it's kind of a, not a one size fits all, it's just more about conceptualising and working out those other levels of support before discerning and working out, um... but generally, yeah, it really just depends on their backend, background support.

[00:26:50] Bronwyn: Yeah, absolutely. So, um, I guess the next thing with that is, so during EMDR or maybe even during the assessment or sessions with their client, they may hear things that are really scary, upsetting, um, of violence, of abuse. How can early career clinicians manage their own emotional reactions and avoid vicarious trauma when hearing these things?

[00:27:13] Patricia: Yeah. So attending, um, CPD on DV, uh, on coercive control, getting lots of support, education information on that. Um, lots and lots of supervision. Lots of self-care in that. Lots of checking in on one's own emotional state. Um, attending CPD on vicarious trauma. Um, building your own repertoire of self-care tools, um, networking with other friends, peers, colleagues, um, that do similar work in this space, really getting that support from one another, I can't recommend enough. I was lucky in a career because I had, I guess, a counselling team where we could, um, banter off one another and get the, you know, just bounce off one another and that really helped. So I can't recommend that enough as well.

And just doing fun things. Having a, you know, some self care, self care with relaxation, with fun. Just things that take away or distract even for, you know, a couple of hours or, um, yeah, just some journaling as well. Um, meditation, mindfulness, all the things we would encourage our clients, um, but how we might build that repertoire of emotional regulation for ourselves.

[00:28:27] Bronwyn: Yeah, absolutely. And I wanted to ask you as well, like with EMDR, with desensitisation, like do you use the blind protocol sometimes? Like where clients, like you ask them to hold the memory in their mind, but not necessarily tell you about it?

[00:28:43] Patricia: I don't use the blind, um, technique or the, the, no. But if a client is too dysregulated to use the full standard protocol, I might use the flash technique, which is somewhat similar, but it's less intrusive. It's just about really building something that's positive, and then you'll get a client to blink a couple times and you'll still process that memory, but it's done in a different way. Or you might titrate or use EMD or EMDr, just restricted sets. Um, just depends on that. They're the what I'll, the modifications I'll use if someone's dysregulated.

[00:29:17] Bronwyn: Could that be a way to also avoid strong emotional reactions for the practitioner?

[00:29:23] Patricia: It could be. And, uh, if the practitioner's avoiding then, um, yeah, really that, that supervision needs to be sought because we can't have that impede on, because, uh, the, the client's treatment or the wellbeing of the client. Because they could really benefit from a full repertoire of, um, going through activation, but a lot of therapists, um, and even supervisees I see, and consultees will be afraid of really entering that big realm of, um, oh, what if the client has an abreaction, you know, like a panic attack. Okay, then we can use our, our toolkit as therapists to regulate with the client, we can pause, we can do lots of things. But that anxiety is very common, but we can't let that collude with, um, the client's healing.

[00:30:06] Bronwyn: Yeah, so it really comes back to like the importance, particularly when you're working with FDV victim survivors of that self-care and noticing your own anxiety and your avoidance in this, um, because, yeah, that those feelings can impede, like you say, on the treatment of the client.

[00:30:20] Patricia: Yeah, yeah. Absolutely.

[00:30:22] Bronwyn: Hmm. So you've worked across a number of systems like schools, agencies, private practise... it's a big question, but what do you think needs to change to better support victim survivors?

[00:30:33] Patricia: Oh gosh, so much, so much. Um, believability in the victim survivors, um, stronger, justice and jail time for perpetrators. Stronger mechanisms for the perpetrators to exit. I guess like enforcement systems, enfor-, you know, so much. It's really so multi-pronged.

Um, I think Rosie Batty talked a lot about this even, um, in her, in her talks, um, and I think the National Press Club, uh, speech she did possibly last year at the 10th year anniversary of, um, her son Luke's death, um, anniversary. She talked a lot about these systemic changes really needing to be made and, and just the exhaustion of, um, the, you know, these things haven't changed much in that time. She became Australian of the Year and really talked about these things.

So a lot of systemic changes clearly need to be made. Um, a lot of things I think outside our scope, which is the frustration because clearly there's so much more we could do, but we can't because systemically there's just so many barriers, um, and we've gotta just sort of sit with that and accept that.

I guess workplaces are starting to roll out DV grants, which is really good, um, DV leave. Um, but yeah, that'd be a really good thing if, um, workplaces could really make that much more simple. I've had a client recently that said that that process was quite complicated, even though they had the policy intact, um, but it took two, three weeks when the client was actually, um, financially struggling. So it'd be good if, yeah, these things could be streamlined and believed and, you know, just in the first instance, granted and affirmed. So a more affirmative stance in a more trauma informed lens, um, I would like to see systemically, you know, change as well.

[00:32:20] Bronwyn: Totally. Um, how do you not get down about all of this? Because it's like even hearing you talk, it's like, from Rosie Batty that nothing's changed in 10 years... it just makes my heart go out to her, to every victim survivor, it makes me feel down , so I'm just wondering how do you not get down given that this is, like, your core thing?

[00:32:35] Patricia: Oh, trust me, Bronwyn, I, I definitely do. Um, and I think I acknowledge that and, and allow that, for me to feel that. And then I just make sure I don't ruminate on that because it's easy to, it's easy to go, oh, this is really shit, like, I'm so powerless. And it's natural and it's okay to have those emotions and those thoughts, and we just gotta be compassionate with ourselves in that. Um, and that's what we can really do.

Um, but yeah, I guess in practising all the self-care measures and good supervision to go, yeah, this is really terrible, and just to name that and accept that and, you know, um, go with that really, but not letting it get you down. It's, you know, it's a bit of a art form, but, you know, I think over the years, in the 14, 15 years I've been doing DV work, um, I've really just had to make sure I've, I've kept my own kind of fun and self-care and my supervision as well, and all these sorts of measures.

[00:33:28] Bronwyn: And I guess like for yourself as well, you do a lot of meaningful work in the area, so it's like, you must say, good outcomes or good progress, or hear good things, and you're like, yes, this is working or doing something good.

[00:33:39] Patricia: Yeah, I do. And um, it's really interesting. I had a, this is well before I did EMDR, but this is years ago. Um, I dunno if anyone's familiar with the framework, the Shark Cage, um, it's actually devised by Melbourne psychologist Ursula Benstead, um, with regards to, um, helping build those boundaries, helping clients discern between, uh, sharks, so abusive, I guess men, just statistically speaking, but I know that that can be women too, and dolphins who are people that are really beautiful and non abusive and respectful.

So a client messaged me, um, I think on some sort of social media platform, and I didn't really respond to it. She didn't want me to respond, but she just wanted to let me know that she got married, she exited DV into a beautiful, healthy relationship, two kids... the shark cage model that I'd done with her back in the day had really, really helped her and, uh, she was ever so grateful, and that was incredibly moving to receive that message.

[00:34:40] Bronwyn: Yeah, I-, I've gotten chills. It's really, that's such a beautiful outcome and just a real testament to your work and just the safety you've built in that relationship.

[00:34:48] Patricia: And that's, that's a rewarding thing with it, seeing the transformation that just makes my heart sing. And what I love about this, and there's so much heaviness and deep sadness and deep traumas that really exist in this space, but, um, I think you know, someone as a public figure, Jelena Dokic, gone through family violence and lived experience of mental health and, and borderline personality disorder and all these things, but she talks a lot about post-traumatic growth, and so I guess even in my kind of work as well, I instil that with, um, clients about, you know, there is a possibility of getting to the other side. There, there is an opportunity to even thrive. It's hard to see in the thick of things right now, but that, that could be a possibility.

And it's just so beautiful when people can get into this sort of post-traumatic growth area, they've got meaning, they've got purpose, they've got, um, you know, a new life, they've got, they're so free from, you know, they're so safe. Um, that's just such a beautiful thing to witness and see in this area of .Work.

[00:35:52] Bronwyn: Totally Um, well, Patricia, this has been an awesome conversation. I know we've just touched the surface of this topic, um, but I feel like it was, it would be so valuable to listeners and to really help them understand this area a little bit better. What do you hope that listeners will take most from our conversation today?

[00:36:10] Patricia: Just the self-compassion for therapists. Um, don't feel compelled to fix all the issues because we've gotta remember, we've got, um, our code of ethics, we've got our ethical guidelines, and legal guidelines we need to abide by. So let's just sort of hone in on our scope. Let's just be one part of that client's journey. Don't feel compelled to do it all or pressured to do it all. Just do what you do best, hold the safe space, patience with the client, um, recognising our own internal responses and emotions, working with that, seeking really good supervision and upkeeping your own sort of self-care, uh, repertoire just to make sure you don't burn out.

[00:36:51] Bronwyn: Amazing. And if listeners want to get in touch with you or learn more, where can they find you?

[00:36:56] Patricia: They can find me on Instagram or Facebook, Gallagher Psychology. I'm also under Patricia Gallagher on LinkedIn. So if any, um, you know, early career psychologist wants to reach out to me for supervision, absolutely welcome that. Um, yeah, I think they're the main and gallagherpsychology.com.au, which is my website, which I'm also in the process of updating.

[00:37:15] Bronwyn: Awesome. Could you just tell us, um, you've been on like another podcast or two, could you just tell us where you've been so I can pop the links in the show notes as well and they can hear more about you and from you.

[00:37:25] Patricia: Absolutely. So as mentioned, I was in the Understanding EMDR podcast with Tracy Lynch, um, mid 2023. So I talked about family violence and EMDR, um, so I really kind of did a deeper dive. So if you really wanna listen to, I guess, how EMDR works with different phases and, and, and treatment in that regard, alongside intimate partner or family violence, you can listen to that episode. Um, but also featured on the Neurodivergent Women Podcast with Monique Mitchellson and, and Michelle Limick, so I was also talking about DV and neurodiversity.

[00:37:59] Bronwyn: Perfect.

[00:38:00] Patricia: Yeah, so they're probably the main two, um, that I can think of. I think I featured on a few other ones. But in terms of, um, what would be relevant, um, for psychologists, that'd be probably the main ones to look

[00:38:09] Bronwyn: Yeah. And you have a podcast as well, right?

[00:38:12] Patricia: I do, but I haven't recorded on there for a while, but you can check it out, it's called Phoenix Rising with Gallagher Psychology. In 2026, I really hope to relaunch that and have some wonderful, um, guests, someone like yourself, I guess, or, and, and other people, um, just to rejig that. But, um, yeah, so I recorded a couple of episodes quite some time, but it's still available on Spotify and Apple Podcasts as well, and all the other platforms.

[00:38:35] Bronwyn: Wonderful. I make sure all those links are there. Thank you so much, Patricia. You are a wealth of knowledge and just really excellent at communicating it as well, so thank you very much.

[00:38:42] Patricia: Thanks so much Bronwyn, it was a pleasure to be here today.

[00:38:46] Bronwyn: Listeners, if you found this episode helpful, please do share it with somebody else. It's the best way to get the podcast out there. That's a wrap. Thanks for listening to Mental Work, I'm Bronwyn Milkins, have a good one, and catch you next time. Bye!