FREE CEs for listening to this episode 🎧 through Pinnacle:learnatpinnacle.com/education Content advisory: This episode discusses a widely circulated case of animal cruelty involving a mother dog named Wang Wang, her newborn puppies, and graphic footage associated with the case. The footage itself is not described, but the subject matter may be distressing. What happens when a client is deeply affected by traumatic material encountered on a screen? In this continuing education episode of Target Memory, we examine intrusive imagery, sleep disruption, hypervigilance, guilt during ordinary pleasure, altered assumptions about safety, and sustained distress following indirect exposure to disturbing media. This type of exposure does not automatically meet DSM-5-TR Criterion A for PTSD; Criterion A4 excludes exposure through electronic media unless it is work related. The formulation challenge is real: distress may be clinically significant while vicarious traumatization, secondary traumatic stress, and compassion fatigue only partially fit. Target Memory is joined by Elizabeth Warson, PhD, LPC, ATR-BC, NCC, an EMDRIA Certified Therapist, Advanced Practitioner, and Approved Consultant, and her father, James Warson, MD, a retired board-certified neurosurgeon. Together, they explore the case through EMDR therapy, trauma treatment, autonomic regulation, neuroscience, and professional scope of practice. Vicarious traumatization, secondary traumatic stress, compassion fatigue, grief, moral outrage, and functional impairment Moral injury within EMDR’s Adaptive Information Processing framework Phase 2 Preparation: autonomic psychoeducation, bottom-up regulation, containment, and readiness for direct processing EMD, EMDr, and standard EMDR: restricted versus broader associative processing for intrusive imagery Sustained advocacy: bearing witness versus repeated self-exposure under algorithmic content delivery Equine-assisted EMDR using the EquiLateral: The Equine-Assisted EMDR Protocol® Memory consolidation, repeated exposure, and afferent/efferent signaling from a neurosurgical perspective The stellate ganglion block as an off-label medical adjunct discussed in PTSD treatment—and why it remains outside psychotherapy scope Upon completion, participants will be able to: Differentiate vicarious traumatization, secondary traumatic stress, and compassion fatigue, and explain why indirect media exposure does not satisfy DSM-5-TR Criterion A4. Describe at least three Phase 2 preparation or containment interventions for intrusive imagery following indirect exposure. Identify clinical indicators for transitioning from stabilization to direct memory processing. Differentiate psychotherapy regulation interventions from medical procedures and identify presentations warranting medical consultation or referral. Elizabeth Warson, PhD, LPC, ATR-BC, NCC is a Colorado Licensed Professional Counselor, National Certified Counselor, Registered Art Therapist–Board Certified, EMDRIA Certified Therapist, Advanced Practitioner, and Approved Consultant. She is trained in EquiLateral: The Equine-Assisted EMDR Protocol® and provides consultation and intensives through Healing Pathways LLC. James Warson, MD is a retired board-certified neurosurgeon who founded the Front Range Center for Brain and Spine Surgery in Fort Collins, Colorado. He performed more than 6,000 surgical procedures and developed expertise in equestrian spinal injuries. Disclaimer: Medical procedures discussed are for education and scope awareness—not as techniques for mental health professionals to perform, prescribe, or substitute for medical evaluation. Psychotherapy regulation strategies do not authorize medical diagnosis or treatment outside professional scope. #EMDR #TraumaTherapy #ContinuingEducation #PTSD #VicariousTrauma
