Imagery rescripting deep dive (with Samantha Duroska)

[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 working with imagery in therapy.

Ever felt stuck when a client says they just can't imagine anything during therapy? Or maybe you've wondered how to make imagery techniques for safe, powerful, and clinically effective?

In this episode, we're going to explore practical strategies for working with imagery and sessions, troubleshoot common challenges, and unpack how to adapt when things don't go as planned. Here to help us out today is our guest, Samantha Duroska. Hi, Sam.

[00:00:39] Samantha: Hi everyone.

[00:00:41] Bronwyn: It's so nice to have you back on the podcast. We had you on an earlier episode where we did talk about imagery scripting and reprocessing therapy, and this is more like a deep dive into troubleshooting, which I'm excited about.

[00:00:51] Samantha: Yeah. So am I, thanks for having me here.

[00:00:54] Bronwyn: No worries. Could you please remind listeners who you are if they didn't hear that episode, which by the way, I'll put the link in the show notes so that they can listen back to it too.

[00:01:02] Samantha: Yes, sure. My name is Samantha Duroska and I'm a clinical psychologist and a board approved supervisor, and I focus on imagery rescripting and reprocessing therapy in my practise.

[00:01:13] Bronwyn: And could you give us a little bit of background about what IRRT is, and that's the abbreviation of imagery rescripting reprocessing therapy, how did you get into it and what is it?

[00:01:25] Samantha: So I started training in IRRT and in trauma in general in Germany, and then my supervisor told me how to adapt this imagery approach to a broader range of difficulties that clients came to see us within private practise. So that's where I started to be a bit more creative with it, and where I learned more about inner child work using IRRT and how to adapt it. So that nowadays I use it with almost all my clients or most of my clients in some way.

[00:01:59] Bronwyn: And could you give us a brief overview of what it is?

[00:02:03] Samantha: So IRRT was first developed to help victims of early childhood sexual abuse, and now is more broadly applied to trauma of any kind. It can also be complex PTSD, as well as PTSD. So it's a really well known technique to work through traumatic, traumatic events.

[00:02:25] Bronwyn: Mm.

[00:02:26] Samantha: What it does is, as the name suggests, it uses imagery scripting, right, and it does that in a very specific way and has a very specific protocol to make it extremely effective and also very focused on emotion so that clients can reprocess their emotional experience very well.

[00:02:48] Bronwyn: So when we're talking about imagery and you're talking about trauma, how in depth do sessions get? Do they have to imagine traumatic images? It sounds pretty full on, I guess is what I'm asking.

[00:03:00] Samantha: Yes, it is, it is. I think IRRT doesn't shy away from intensity. Like there's no fear of making clients uncomfortable, the assumption is that we have to, at times, be uncomfortable and sit in discomfort to overcome things, and that's actually a big opportunity for our clients to process emotions and traumatic events and the gift that we give them as therapists.

So it's not this anxiety of, "oh my goodness, my client might become overwhelmed. We can't do this"... It's more this very calm presence of providing a safe environment and inviting them to explore this in depth and to go to those really challenging places and to, in a way, accompany them to feel those really hard things that they've been avoiding.

[00:03:57] Bronwyn: Well, maybe later we can unpack how you stay grounded as well, 'cause I'm interested in that. It's like it's evoking strong emotions. But before we get there, I just wanted to hear a bit more about why this work can be so powerful for clients. How do you think it really helps to address trauma or entrenched beliefs that people have about themselves?

[00:04:15] Samantha: Yeah, that's a great question. I think we in general see like more and more modalities that move beyond, let's say just talk therapy, right? Obviously we still talk in therapy, we will always talk in therapy, but to have some other modalities that have a deeper access point when it comes to emotions.

And I think imagery rescripting or imagery based techniques re offer this aspect to our um, clients or to us as therapists. So why it is so effective in the context of trauma is because trauma, there are people that are able to overcome it, let's say they won't develop PTSD and then there are others that will develop a PTSD, right? And people that will have PTSD symptoms, often their mind or their brain struggle to process the traumatic event because they got too intense. And with imagery rescripting, we are able to go back there and put the puzzle together of what did actually happen.

Which you're right, is intense because that's the point where we got stuck, where we got overwhelmed and where we weren't able to process it at the time of it happening. So in therapy, we can take the time to go back there and to reprocess to help our minds settle. And then the effect often is that flashbacks and nightmares, they disappear, which is a massive relief for clients obviously.

[00:05:47] Bronwyn: Yeah, absolutely. I mean, those are things that are distressing them in their nighttime, in their daytime, so I imagine it's hugely powerful.

[00:05:54] Samantha: Exactly, yeah. And sometimes they have been having them for years, right? And sometimes they've been to therapy before, but they haven't been introduced to those trauma specific techniques. And then doing imagery with scripting, or maybe just also imagery as such as an exposure, can really help them to integrate those different bits and pieces, and then the mind can settle and they can start to feel safe again as well.

[00:06:22] Bronwyn: It really aligns with... how I'm thinking of it is like a bottom up approach to trauma processing as opposed to a top down cognitive approach. So I went to a trauma, I went to a trauma conference in August, and there was a lot of speakers talking about a neurobiological approach to healing trauma, so body-based approaches and somatic approaches, and they're like, we need to work with the body to help people gain-, regain contact with their body to help heal trauma as opposed to maybe a cognitive behavioural approach, which is about, okay, you've had these thoughts as a result of trauma, that you are now hopeless, helpless, and worthless, and then having a look at, I guess, reframing and restructuring those thoughts. So IRRT seems more aligned with, instead of accessing, I guess, the thinking part of your brain, it's more like, how are we feeling?

[00:07:15] Samantha: That's exactly right, yes. And I think if we are too cognitive, especially in the context of trauma therapy, nowadays, I almost feel like it's very rude, like to expect our clients to shift their thinking or feeling by just challenging their thoughts. Like it's really hard to do that, right? Be- or to be more self-compassionate and self-validating. Like it's easy to say that in a therapy session, but how do you actually do that?

And that's where the magic of imagery based techniques happens, because in the session, for example, using IRRT, your client is actually able to feel differently or to understand why exactly they're feeling in that way and how to change it.

So it's a much more validating approach than to cognitively challenge certain behaviours or thoughts, and then maybe the client feels like, "yeah, I know I should feel or think differently. I know that I'm probably worthy, but I still feel unworthy". And then you could also feel like you're failing at therapy being a client, right? So it's not a very humanistic approach to therapy.

That's why I like IRRT so much because it really involves the client. Like there's, there's not this flavour of patronising a client and telling them what's best for them. It's more like, okay, we're here together and you seem to get- got stuck somewhere in the past because this happened to you. If it was a major traumatic event or something smaller, something happened in your psyche in that particular time, and let's just research, do some research together and go there to see what was it, what is it, let us understand it together.

And to empower the client to, to find their own solution. Like I'm there as therapist and I trust them that they're able to hold emotions, and that I can hold their emotions as well. And to uncover and have a look and experiment and to be open-minded and, and non-judgmental, instead of kind of telling them, but now you have to remind yourself using some affirmation cards and read them every day for three times that you're worthy. It's like, yeah, we can try to do that, but it's tough, right? Like it's, it's not a very validating approach to therapy, I think.

[00:09:54] Bronwyn: That makes a lot of sense. Just changing tracks, I think there's a lot of listeners who would be interested in IRRT and more broadly, imagery based work, just hearing about how powerful it is for clients. And let's say that we've got somebody who has been like, okay, I'm going to do this. I'm gonna introduce imagery to my clients, and then the client says to them, "you know what, I can't actually picture things in my mind"... how do you work with clients who struggle to visualise?

[00:10:22] Samantha: That's such an interesting question because I get this question a lot. And the interesting thing is it almost never happens.

[00:10:29] Bronwyn: Oh, interesting!

[00:10:31] Samantha: I feel like it's very, very, very rare, um, that people really can't visualise anything at all, right? So it might be an anxiety that we hold as therapists, to be like, what will I actually do if the client says this or that? But it's very rare. So to just prepare ourselves, it's very rare that this might really happen.

There are people that are, let's, let's say for some people it's more intuitive to visualise things, and for others it takes a bit more time or effort. But, you know, some people say, oh, it was actually quite blurry, or, I couldn't really see it... but imagery re scripting still works because they still have all these sensations. They still have the feelings, they still know what's going on. Somehow they still experience it, even if it's not a hundred percent visual, or even if it's not a script that we can see as such.

So if someone would say, "Hey, look, I really struggle to visualise things", I would say, "yeah, okay, let's maybe just give it a try and see how this could work for you and experiment". And we can always adjust to be open-minded and curious about it and be like, let's see.

It's similar for other people and it's again, also different for many people. So to just see how their mind responds to it, right? So instead of maybe saying, and can you see your past self in the image, you can say something different and say something like, and what's happening now? What's going on in your mind? Just slightly change your language to make it suitable for your client?

[00:12:18] Bronwyn: Yeah, that makes sense. As you were talking, I was thinking like maybe clients can put a lot of pressure on themselves to think that they need to visualise things in very rich and vivid detail or something like that, and maybe they're putting a lot of pressure on themselves, but we don't necessarily require that rich and vividness. We just require some picture, I guess, in your head of some kind.

[00:12:40] Samantha: Yeah, that's true. And we require the emotions, right? The, the goal is not necessarily to see the images as such. We use the images to experience the emotions again. How we get there doesn't really matter. If the client has a vague idea about what's going on, that's fine, and they have the emotions that come with it or came with it back then, perfect, that's all we need.

So it's all about this emotional and maybe also physical experience of moving through this memory again. And some people won't see it very clearly, but they still have this idea or sensation about it, and that's all we need. It's called imagery rescripting, but it doesn't need to be a very, very clear image as such.

[00:13:29] Bronwyn: That really helps relieve a lot of pressure, I think, for the therapist as well, because yeah, we, when, like you say, we're using the images as a vehicle for the emotion to evoke the emotions, however we get there is fine.

[00:13:42] Samantha: Exactly. And we also have to keep in mind, of course it takes a lot of courage for our clients to say yes to something that's new. And it can be a bit weird at time to do your first imagery scripting session for therapist, but also for a client, because it's new, you don't really know what is about to happen. So if a client gets a bit hesitant or doesn't really know how that will look like for them, that's also a normal reaction.

And then as a therapist, to stay curious and not to become too anxious and overwhelmed as well, because that will obviously influence the the experience, right? If they're all overwhelmed and hesitant, we are more likely to say, oh, maybe let's just avoid it because it's easier and just keep talking about it.

[00:14:30] Bronwyn: Yep, totally guilty of that myself, which leads us nicely to, what are some common mistakes you see therapists making when trying to use imagery techniques in session? Maybe we can go with that first one of the hesitancy to introduce the technique. I'm curious to hear how you introduce it, because I think it would be, there's a lot of uncertainty among therapists. How do you go about it?

[00:14:52] Samantha: Yeah, so I think when I'm in session with a client, I often have the thought first of, "hmm, I think this would be a good situation to do imagery scripting". And over the years I got better at identifying the situation and then also to act fast instead of sitting it out and thinking about it and being hesitant and maybe, avoiding it because it's uncomfortable to switch gears to be like, oh, maybe this is a good opportunity and I will suggest this now to the client in session, either to do it in this session or to take the following session to have more time to do some imagery work. So it's like, first it's this internal readiness I would call it to say, okay, this is the moment to introduce something else and to not just talk about this event, right? To make a decision as a therapist.

And then, you mentioned the hesitancy... I make a decision as a therapist and then I will share my idea with the client. And I would say something like, "Hmm, I think maybe we've talked about this before and I feel like if we would talk about it for many more sessions, it might not change anything to your emotional experience. Um, and there's something that we do more and more often therapy, it's called imagery scripting, and I think it could be very beneficial for you".

"How it works is I would, for example, invite you to close your eyes and to revisit the situation so you feel the emotions again, that you had at the time. And I will be talking to you and guiding you through it. And this gives you the opportunity to, in a way, relive it. And then at some point I will tell you when to change the script so you get the opportunity to make changes so that emotionally you will leave the situation differently. Would you be open to explore this with me and give it a go and see how you resonate with it"?

And then let's assume the student client would say "yes, okay". Then I would also ask, "do you have any questions about it"? And then most people would say, "no, I think it's, uh, let's, let's just do it. I think it's a good idea". And that's it.

So I think it has lots to do with how we introduce it, right? If we get to too, too anxious about it, or we start to over explain and almost give a workshop about imagery scripting to our client so that they, you know exactly how it all works, I think the barrier is bigger to say yes to it. It sounds tricky. It sounds difficult. There's like uncertainty If this will help me, maybe it's better to just keep talking about it instead of doing imagery scripting.

[00:17:53] Bronwyn: So I guess overexplaining it can make it a bit awkward.

[00:17:56] Samantha: I think so. And I mean I've certainly done it in the past and I still see supervisors doing it to kind of reassure ourselves, right, by explaining the technique very, very, very thoroughly. So that at the end of the session, the client could do the imagery scripting session with another client themselves.

But that's not the goal, right? It's more like an invitation to explore something new and obviously to get consent. But I think they don't need to know every detail of what I consider as a therapist doing imagery scripting, 'cause that's my job. I can do things wrong, but the client really can't do anything wrong doing imagery rescripting.

[00:18:35] Bronwyn: Yeah. I'm wondering whether you introduce imagery rescripting at session one, and then maybe you see an opportunity for imagery rescripting at session two, do you then say to the client, " remember how I told you about that thing at session one? Could we give that a try"? Is that how you approach that or something different?

[00:18:51] Samantha: So if a client comes to me for trauma treatment, then it could look like that, right? That I give them a vague idea about IRRT in our first session, maybe now a second session. And that then if they're ready to go and they'll feel like, yes, let's just do it. Because some people go, come to therapy and they're like, "yep, I'm ready, I just wanna be done with this"... Then maybe our third session is already the imagery scripting session, yes.

[00:19:20] Bronwyn: I feel like this is a very timely episode for me actually, because I've been reflecting a lot about how I do this thing, it feels like I'm at a roundabout and I'm like, I could go now, I could go now, I could go now and then, like I never go... And I feel like that way in therapy, where it's like, I'm like, oh, I could do imagery scripting now and then I just miss my opportunity. Does it just get easier with practise?

[00:19:40] Samantha: It does. And I know this feeling, it's a great picture of being in the roundabout. That's what I meant by making an internal decision, right? To be like, I have this idea now I have to take this opportunity, let's do it. And, and then to just take action. But I know this feeling, and I remember this feeling of, hmm, I think I could do it now, but oh, maybe it's a bit challenging, I'm not entirely sure. Let's just not do it.

[00:20:06] Bronwyn: Yeah. Yes...

[00:20:10] Samantha: And I think-, yeah, I know. And I think if you do more and more imagery scripting, you get more and more confident in saying, "yes, let's take this opportunity", because you see the effects of it, right? You see how fast things can resolve for clients or how the process deepens, how new things can come up through doing imagery scripting that are so helpful for the client and their emotional journey that I sometimes even find it unfair, or maybe unethical to keep holding back with effective treatment just because we are hesitant.

Obviously you gotta make sure it's good practise and it's suitable for the client and they give consent to it, but not to withhold effective treatment for too long. There's actually a lot of resilience that we can, that we can trust, right? Like most people are very resilient and are ready to do hard things in therapy, and therapy is hard and meant to be hard, so we don't need to fluff things up and be like in our comfort zone all of the time.

[00:21:20] Bronwyn: Yeah, that's related to my next question I want to ask because I think a reason that therapists can not use rescripting or imagery is a fear of overwhelming the client and wanting to avoid their discomfort. Um, so there might be a client, for example, who we're like, oh, they're not really connecting with them emotions in any way, and maybe if I go into imagery or scripting, that'll just be too much of a leap. What would you say to people who have that concern?

[00:21:46] Samantha: This is such a common concern and something I talk a lot about in my supervision sessions. So it's not a unique question to have as such. I would say, well, maybe imagery scripting is the perfect opportunity for this client to connect with their emotions, and that's where they get stuck. They can't access them, so by using other techniques other than cognitive talk therapy, it's a great opportunity for them. Like that's, that's what they need.

And if they get overwhelmed, I would ask like, what does that mean? Like if someone gets overwhelmed and why is that a bad thing, right? It sounds, oh, it sounds like it's something that should never happen, we shouldn't overwhelm our client in a session. But when you look at different disorders, most of them involve some way of maladaptive coping mechanisms, right? If we think about OCD, there's a feeling we can't tolerate this feeling. So we start checking behaviour to regulate. Similar with eating disorders, there's a feeling I can't hold this feeling, it's too much, I regulate my emotions through something else like eating. And we can see this in many other disorders. And so if someone can increase their capacity to hold uncomfortable feelings, they won't need to rely on those maladaptive coping mechanisms, which I think is a great skill to have in life.

So if we can, in a way, maybe even overwhelm our clients consciously, and with support and sessions, they can learn how to hold those really difficult emotions and it will help them cope in a more sustainable way, and it will make symptoms disappear. So I think it's, it's actually a gift that we as therapists give to our clients to make them feel safe and seen and supported, and to trust in their ability to feel emotions, because that's why they're here and that's what they need.

And because potentially the ability to hold those difficult emotions is decreased at the moment they got stuck. That's the whole issue, right? So to get unstuck, we need to actually get in there and connect with those feelings and understand them, explore them, do a bit of research together. What is this actually about? What makes it so hard? What's the physical experience doing this? And then make sure that they, they feel contained and safe.

But you'd be surprised by, what I call, the resilience. Like we are so capable of holding difficult things in our bodies and to hold difficult emotions, that nowadays I don't shy away anymore from digging deep, right? Like going, going in there and doing the work. If I would go to a GP and a GP would know, "Hmm, I think there is this deeper issue, but I don't wanna tell Sammy because she might be overwhelmed. Let's see her 10 times before I present it to her or give her effective treatment", I'd be very upset, right? I would like to know, yeah, I would like to know, okay, what is this about and what is it that I can do with the help of you as a therapist to make me feel better again, and also as soon as possible?

[00:25:25] Bronwyn: Yeah, absolutely. I love the way that you've put this. I guess the things that I'm taking away from what you've just said are we have an ethical imperative to give people treatment that works for them and is shown to be effective, and IRRT has been shown to be effective. It's a good therapy that can help a lot of people.

And then the other thing that stood out for me was that what better place to have difficult emotions than in therapy when you can be supported in that and people aren't left with those emotions by themselves, which they often cope with in maladaptive ways. So we can expand their range of tolerable emotion in this safe space. It makes a lot of sense.

[00:26:00] Samantha: Exactly, exactly. And every time your client is very uncomfortable in your session, instead of feeling like, oh, I made them feel this way, now I'm guilty of it, you can be like, yes, we got there. How great did they get to experience this? This is a great opportunity for them.

[00:26:17] Bronwyn: Totally. I love that. That really addresses, I feel this concern of overwhelming the client.

[00:26:21] Samantha: Yeah. There's also this common fear of what if my client will dissociate during imagery with scripting sessions? It's a very, very common fear of therapists. Not a very, very common occurrence, doesn't happen very often, to be honest, which is quite interesting. I think there's something unique about doing imagery based work and therapy because just our presence with our clients in the room changes something like we are in there to support them, and they feel that, right? Like while they know they go in the difficult and traumatic situation again, they still know consciously there are in a safe room and they are being supported by their empathetic therapist. So that in itself gives them a better foundation of walking through this traumatic event with our help because we also trust in their ability to do that., and then often they trust themselves that they will be able to do that.

And it doesn't happen very often that people disassociate, but if they do or if the client thinks as well, there might be a risk of dissociating during the imagery session, you can put things into place. Like, can they give you a sign when they notice, oh, now I start to feel a bit funny in my head or my body sensation starts to shift. Can you make a plan together? What your client would like you to do? Is it to say their name or to ask them, are you still there? Or would they like to maybe open their eyes and look at the spot on the ground? Would they like to walk around in the room? Would they like to play with a fidget toy? Or to just accommodate for that so that your client feels prepared and you as well.

But even if it happens, it's not dangerous for a client, right? If it happens and you weren't prepared or you didn't expect it to happen, it's okay. This is great because it might happen outside of the therapy room and you can't help. But now you're there with your client and you can understand and with your client together, why did this happen? How did this happen? And you can also help them get out of it again as well.

What I also often do is I record the imagery sessions. So we get a chance to watch the video together, and then they can also see and like watch themselves doing the imagery. And then it's almost like having another layer of consciousness on it or to go on the meta level to explore how did this work for me? What did I say? What did I, how did I feel like, what did it like for me now to watch myself doing this? So it gives them another opportunity to reprocess the emotions and to also deepen the re-scripting and self-soothing part.

And if some, someone has dissociated, they can see how that looks like for them, right? So that it can be a big learning actually, and you can be maybe really glad as a therapist that it happened because now we can learn together. That's what I mean about this approach, being researcher together and to see how their psyche works and to work it out together.

[00:29:45] Bronwyn: Yeah, yeah, beautifully said as well. I just wanted to highlight what you were saying about the grounding presence of the therapist. It's like the client can actually feel safe knowing that you are in here working together, and I really loved all those grounding strategies you suggested as well. Sometimes I find reminding the client during that grounding like, and just notice me and you working here together, um, can help as well. And I love how you video record as well, like that seems to be a really powerful way of deepening that processing and helping their observation of themselves.

[00:30:18] Samantha: It is, it is. Some people say it's like 70% of the effect that they were able to understand it again .They're obviously conscious doing imagery scripting, right? But the emotional depth is so deep that it's hard to remember every little thing. And by slowing it down or by just watching this video, it really deepens the experience again, which is a great way of, it's a great way of strengthening the effect of imagery scripting.

[00:30:46] Bronwyn: There was one other maybe mistake that I wanted to talk about, and I remember us talking about this on our last episode together because I come from a schema therapy background and I think we're talking about the difference between imagery, scripting between the two therapies, and I felt that in schema therapy it was very goal oriented. And in the supervision, I've got around imagery description from a schema therapy perspective. It's kind of like, get in there, do the thing, get back out of the image. And, but I feel like maybe with that goal, directedness could be like a mistake. Could you just speak to that as well?

[00:31:22] Samantha: Yeah, you know, I wouldn't say it's a mistake. I think it's a different philosophy of providing treatment. So there's no right or wrong here. I think IRRT is a bit less action orientated. It's not just about getting a job done, right? It's very much focused on the emotions and has a very particular language and way how to help the client to go deeper and deeper emotionally. So maybe it has a different tone as well. It's less, let's get in there and do this and empower and coach the client. It's more like, I'm here as a therapist and I'm ready to hold your emotions and you can do this. And how does this feel like, and this feels like this... like you feel anxious because, okay, and this is because... and to go slowly in there and go deeper and deeper and deeper to fully understand and feel their experience.

So I think the tone is different. And you're right, it's not about a specific goal, which I think really hard for us as therapists because we love to have a goal. We love to be able to measure it, to say, okay, after this one session, the distress stress levels are down, therapy worked, client is happy, our work is done.

And I mean, if that works, that's great. But IRRT also focuses on a process. So if things get really complex for clients, if the trauma was really complex, doesn't matter if it's a complex PTSD, or if this one situation just was really intense and complex, then it might take a couple of sessions, a couple of imagery sessions for a client to work through it because it's just so difficult and a lot to do, to digest in one imagery session.

And not being goal orientated also takes the pressure off of the therapist and the client. We are not in a rush here to achieve something magical, right? Like this traumatic event, we can honour it in a way that it was really distressing and complex and terrible and walk through it slowly. And sometimes it can be a matter of understanding what did actually happen. It can be a matter of, how did I actually feel like when I realised I'm about to die here? What were my thoughts and feelings and my sensations at that time? What did it mean to me and to work through those things?

So I think it's a bit more maybe softer, or calmer or more maybe mindful approach that also honours this complexity and gives clients the space to work through the situations on their own terms. So I wouldn't expect a client to be able to process this terrible traumatic event in one session, confront the perpetrator, and then also perfectly soothe their past self.

[00:34:37] Bronwyn: Oh, interesting.

[00:34:39] Samantha: Because that's maybe just way too much, right? If someone was suffering with this for many years or decades, we don't need to expect that all of this will happen in one session. It can happen, and when it happens, that's great, but sometimes it just takes a bit more time.

And I think that's also a difference between schema therapy or how schema therapy approaches imagery scripting and IRRT, is that I don't get in there as a therapist. I don't tell the client what to do or what to say in the imagery. I guide them through it and I'm there by their side and I support them. But it's up to their intuition to see what they need and what they wanna do or say and how they can approach their past self.

Maybe there are some blocks and they have to find their way to work through it so that they experience the sustainable change. If I would give them my solution for the situation, it might not work. Or maybe they might pretend that it was okay and they feel better, and there will be some relief after doing imagery scripting, but maybe it's not the full picture or the full resolution of this traumatic event. So that's why there's this strong emphasis of, it's a process, there's not this one goal we need to tick off. It's not just about bringing the distress down, it's part of it, but often it's more complex, and to be curious and to ask our client, what was this like for you? What stood out to you? What was meaningful to you? Was there anything that was surprising? And to explore instead of assuming, okay, I think now it's resolved, this was a good session, and to tick a box.

[00:36:29] Bronwyn: That makes a lot of sense. I wanted to ask you about how you manage your own emotions, because you sound quite confident and capable, the way you talk about and do imagery scripting in sessions. I am wondering if you have any advice for maybe early career clinicians who are starting out work with imagery re-scripting. How can they manage their own emotions when clients are perhaps describing quite confronting situations?

[00:36:54] Samantha: Yeah, that's a great question. To be honest, it can be a challenge, it can be a challenge to sit with someone in the room that experienced terrible things that we as humans prefer not to even think of or consider real that things like that happen in our society. So it can be very confronting, that's true.

I think doing imagery scripting and reprocessing therapy, often as a therapist, we are very focused on what is going on in this process for our client, what can be my next question, how I can, how can I guide them through this in the best way? So you're always thinking ahead a bit, which keeps a bit of emotional distance that can protect us.

I think there's also something very humanistic in hearing the client's story and experience, and that's part of the treatment and the relationship as well to truly support the client and to let them know, I'm ready to hear this. Like, I am not shying away, I'm okay with it, even if it's something really horrible to process, I can acknowledge how horrible it is. So I think there's a lot of value in almost this like, ethical approach or in this like, philosophy to how we relate to other people. Because often people in their friendship groups, they won't go into any details because it's horrific, right? And I think there's, that, there is some, some potential for healing and in being ready to hear their stories.

But it can be, it can be tough. And I think that's why self-care is so important as well, and to balance your caseload and to make sure you're okay as a practitioner. And to know when you have enough trauma therapy clients on your caseload, when you want to maybe focus on something else again, right? Like those normal things that we have to look out for as therapists.

[00:39:06] Bronwyn: Yeah, thank you. That really helps. It really helps, I think, to hear it from an experienced practitioner in this area like yourself, that it still can get quite hard for you, but you've developed self-care practises and ways of managing your caseload that help.

[00:39:19] Samantha: Yeah. And I, can you go, you know, maybe it comes back to being able to hold discomfort as well, to to have a bit of humour. Not to laugh about things unnecessarily, but to see the good in things. I think what I've learned through trauma therapy, there's so much resilience and that's fascinating. Like we are so resilient and with effective treatment, many people are able to have a really good quality of life again, right?

So there's a lot of light in doing trauma therapy and I wanna encourage people to do trauma therapy 'cause it's so important for our clients. And I always see the growth, which is just amazing to witness in sometimes a short amount of time. So that's something that keeps inspiring me as well. And that's something that... it also made me go into trauma therapy as a niche to see the growth and to see how effective treatment can be.

So at some, sometimes it's terrible, but we can't close our eyes and say those bad things aren't happening in our society because they are. At least we get to help people to cope with those experiences.

[00:40:36] Bronwyn: Yeah, so it sounds like you, you get a lot of meaning and purpose from the work that you do do, and it does make a difference, and that helps to keep you going too.

[00:40:44] Samantha: Yeah. Yes, exactly, yeah. Mm-hmm.

[00:40:48] Bronwyn: Samantha, I've learned so much from you today. It's been so helpful to hear you talk about these topics related to imagery. What do you hope most that listeners will take away from our conversation today?

[00:40:59] Samantha: Yeah, thanks for having me here again. You know, I'd be really happy if people would be a bit more courageous to say yes to imagery scripting and say, yes, I'm having this thought, this could be a good idea, let's do it. Let's take action and let's give our clients effective treatment methods that are available to us, and your clients will be very grateful for that, to have this confidence to try new things. It's hard, I know, but therapy is hard for clients too, right? We can do hard things, so why not offer a bit more imagery re-scripting or other techniques that you feel like you're too hesitant to offer or you're not quite sure how to get supervision, get in there, and I think it always, um, makes therapy a bit more interesting for us as well.

And in some ways I also think maybe it's a good prevention for burnout because we don't feel as stuck providing treatment, right? We feel like, yes, I know what to do here. There's this one technique I'm trained in, let's do this now and see how this will work out for the client. So it's not... um, we see a lot of success then, and I think that's really important for us as practitioners.

[00:42:13] Bronwyn: Yeah, wonderful. Samantha, if listeners want to reach out to you, where can they find you?

[00:42:19] Samantha: Yeah, so you can find me, um, on social media. You're also welcome to go to my homepage, which is samanthaduroska.com.au, and send me an email to samantha@reprocesspsychology.com.au.

[00:42:34] Bronwyn: Yeah, and you've got space for supervisees as well?

[00:42:38] Samantha: Yes, I do a lot of clinical work and also supervision in my private practise, so you're welcome to contact me.

[00:42:44] Bronwyn: And do you have training coming up?

[00:42:47] Samantha: I would recommend check this homepage by the time that this podcast will be published.

[00:42:51] Bronwyn: Yeah, yeah.

[00:42:53] Samantha: We'll see!

[00:42:54] Bronwyn: Oh, I would be totally excited and if it is out by the time this episode is published, I highly recommend people sign up to it. I imagine it would be a fantastic training, not to put too much pressure on you!

[00:43:04] Samantha: Thank you, Bron, thanks. We'll see!

[00:43:08] Bronwyn: Well, listeners, if you enjoyed this episode, please do follow the Mental Work podcast, rate and review it on your podcast app, and share it with a friend or a colleague who might benefit from the conversation.

Thanks for listening to Mental Work, I'm Bronwyn Milkins. Have a good one, and catch you next time, bye!