Episode 69 Transcription: Beyond Trauma: Reclaiming Your Life with ACT

Distribution Date:  August 18, 2025 

 

Dr. Robert Boland: 0:02 

Welcome to the Mind Dive podcast brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, Dr Bob Bowen and Dr Kerry Horrell. 

 

Dr. Kerry Horrell: 0:11 

Monthly we explore intriguing topics from across the mental health field and dive into hidden realities of patient treatment. 

 

Dr. Robert Boland: 0:18 

We also discuss the latest research and perspectives from the minds of distinguished colleagues near and far. 

 

Dr. Kerry Horrell: 0:23 

So, thanks for joining us. 

 

Dr. Robert Boland: 0:26 

Let's dive in. 

 

Dr. Kerry Horrell 0:32 

Welcome back to the Mind Dive podcast. Today we are very excited to have two guests, Dr. Robin Walser and Dr. Darrah Westrup. Welcome to you both. I'm going to read your bios before we get going, so I will start with Dr. Westrup. Dr. Darrah Westrup is an internationally recognized clinical psychologist, author and expert in acceptance and commitment therapy, which, moving forward, we're just going to call ACT. With over two decades of experience, Darrah is a peer-reviewed ACT trainer, a fellow of the Association for Contextual Behavioral Science and a trusted leader in trauma-informed care. 

 

Dr. Kerry Horrell: 1:06 

Dr. Westrup spent a decade directing a women's residential PTSD treatment program at VA Palo Alto Healthcare System. She emerged as a national expert in both trauma and ACT. From there, she began training clinicians across the US and around the world, sharing her deep knowledge through workshops, consultation and written work, including five books on ACT as author or co-author. Her latest book is one we're going to be talking about today “You Are Not your Trauma: An ACT Guide for Healing from Within.” Her academic credentials include a PhD in clinical psychology from West Virginia University, a clinical internship at the VA Palo Alto and a two-year postdoctoral fellowship at Stanford University's Department of Psychiatry and Behavioral Sciences. She also holds degrees from San Jose State University and the University of the Pacific, now based in Durango, Colorado. Dr. Westrup balances a thriving private practice with her global teaching and writing. Welcome, Dr. Westrup, thank you. 

 

Dr. Kerry Horrell: 1:59 

We also have co-author of this book, Dr. Robin Walser, here. Dr. Robin Walser is an internationally recognized clinical psychologist, author, educator and a leading expert in ACT. She's the Director of Trauma and Life Consultation and Psychology Services, director of Research at Bay Area Trauma Recovery Clinical Services and an assistant professor at the University of California, berkeley. She also works with the National Center for PTSD, engaged in national efforts to improve care for trauma, depression and related conditions. Dr Walser authored or co-authored nine books, including the latest co-authored act Guide to Healing called you Are Not your Trauma Again, the book we're going to be talking about today. A gifted trainer and consultant, Robin's work spans the globe, helping clinicians grow their skills and helping clients build meaningful lives rooted in values, acceptance and compassion. Her academic path includes a PhD in clinical psychology from the University of Nevada, reno, a master's in clinical psychology from the University of Nevada, Las Vegas, where she also received the Outstanding Thesis in Psychology Award, and her Bachelor's in Psychology from University of Utah. Welcome to you, both. Welcome both. 

 

Dr. Robyn Walser: 3:09 

Thank you, happy to be here. 

 

Dr. Kerry Horrell: 3:10 

We are very excited. I was just telling both of these authors, right before we hopped on, that I've already told my teams about this book because I'm deeply excited about it. We're going to be talking to you both today about your new book and also, in general, acceptance and commitment therapy and how we can use that for coping with trauma. 

 

Dr. Robert Boland: 3:28 

Right, but why don't we start out how we usually do? Can you just tell us a little bit about yourselves and how you got interested in working with folks who have trauma? 

 

Dr. Robyn Walser: 3:37 

Sure sure. So, I think both Darrah and I have had a, I guess, a passion for human resilience after trauma and also human complexity, and with those two things combined, Acceptance and Commitment Therapy is an ideal fit for promoting both of those things. And so, we've long, I mean 30 years now, Darrah. Does that sound? 

 

Dr. Darrah Westrup: 4:05 

Right, oh my gosh, I was thinking more like 25. 

 

Dr. Robyn Walser: 4:09 

I think between the two of us we have like 60 years. 

 

Dr. Kerry Horrell: 4:14 

In your book you cite that between the two of you it's 60 years. I remember because I thought, wow, that is a lot of expertise. 

 

Dr. Darrah Westrup: 4:21 

I was thinking of when we met, which was 2020, I think somewhere around there. 

 

Dr. Robyn Walser: 4:26 

It's actually closer to 2000. 2020 was just five years ago. 

 

Dr. Darrah Westrup: 4:35 

Is this how this is going to go? 

 

Dr. Robert Boland: 4:39 

Yeah, I met 2000. 

 

Dr. Darrah Westrup: 4:40 

Yeah, it's almost 25 years ago that we met. 

 

Dr. Kerry Horrell: 4:45 

Dr. Westrup, do you want to share how your path led you to working with folks who had trauma? 

 

Dr. Darrah Westrup: 4:40 

Sure, my first trauma case was when I was a graduate student at WVU and I had an excellent supervisor, an expert in the area and we together worked on woman who had had a horrific car accident where people had been killed and it was really just an awful thing that she went through and could no longer drive and her life it become very narrow and just in the course of our work I was completely able to reclaim not only driving but the rest of her life. 

 

Dr. Darrah Westrup: 5:23 

I was sold and I made sure that my follow you know, my subsequent training involved training in this area and then I had the fortune to have my first career be at VA, Palo Alto, and I was director of the Women's Trauma Recovery Program there and I was very interested in ACT. I had done an ACT-related dissertation, and I kept hearing about this fabulous person named Dr. Robin Walser that was also interested in ACT. So, we met, and we brought ACT into our residential treatment for trauma in 2000. It was the first time it had been brought into a residential treatment and what we saw there was so extraordinary and so meaningful, and we saw firsthand how greatly people can be helped with trauma, even severe trauma symptoms and multiple traumas and not only that, but build lives that are full of meaning and purpose. To have this opportunity to bring this to the general public is something we've been wanting to do forever. 

 

Dr. Robert Boland: 6:36 

Wow, I mean. So. Kerry already defined ACT, Acceptance and Commitment Therapy, but could you tell us a little bit about it, to just kind of ground this so we understand where your book is coming from? 

 

Dr. Kerry Horrell: 6:47 

Yeah, our podcast is geared towards clinicians, so if there are clinicians who haven't dabbled in this too much, if you give us a bit of an overview. 

 

Dr. Darrah Westrup: 6:56 

I'll let you grab that one, Robyn. 

 

Dr. Robyn Walser: 6:58 

So, it's part of why I think Darrah and I were drawn to. It is. What it's about is, when you think about treatments, they often don't point to the other part of what is required for living. So, you can recover, but recover for what? 

 

And so what we're working on here is a kind of “hold and move process” where we're helping people to open up to their internal experience, be connected to it and what's called diffused from their thoughts or their ongoing flow of thinking, what's happening in their mind, or to be able to see that they think. So, they're open, and then we want to build an awareness, which is about being in the present moment and noticing yourself as something more than your thoughts or your past. Thus, you are not your trauma. And then moving into where I started, values and committed action, like helping people build meaningful lives. So, we're holding internal experiences and moving forward in ways that matter, and we don't find that in other treatments very much like this values-based living, and so both Darrah and I were quite drawn to that aspect of it. It's all in the service of psychological flexibility, so you can vary and adapt your behavior in ways that help you stay connected to what's meaningful. 

Dr. Westrup, anything to add to that overview? 

 

Dr. Darrah Westrup: 8:26 

I think the title is really important to both of us. It really encapsulates the great gift of the therapy. And since we're kind of talking about that early experience working with individuals who'd been usually traumatized since childhood and then had repeat trauma that sense of self is really a sense of being broken, or something is wrong with me, and prior to ACT I'd never come across a way to really help someone shift that and come to hold themselves differently, and so this offered a way in to that and it's really, it's meaningful that that's how you know that's the name of our book is “You Are Not your Trauma.” 

 

Dr. Kerry Horrell: 9:14 

When I was thinking about. You know I have some but pretty limited experience with ACT as an intervention, as a modality, but one of the things that has stood out to me is the aspect of and tell me-- if I'm getting this right-- reducing suffering through not struggling so much with your internal world, like some of our suffering is increased through the I shouldn't feel this way, or I shouldn't think this way, or some of the ways in which we kind of wrestle with our mind and I feel like, for folks who are traumatized again, if I did get that right, like that would be so important, because obviously a pretty significant part of trauma is this distorted or impacted worldview, sense of self, painful, intrusive, you know emotions and experiences. It makes sense to me that this is a route for trauma, and I wonder if there's more you guys want to say on that of why particularly ACT for recovering from trauma can be so important. 

 

Dr. Robyn Walser: 10:10 

Well, so one thing that we know about what can happen post-trauma and how it can impact people's life is that people do get in a struggle with themselves, as you're noting, Kerry. They stand against themselves and are trying to find ways to eliminate, get rid of, stop having, move away from, essentially avoid the traumatic experience, the bodily sensations that come along with it, the memories, the thoughts, bodily sensations that come along with it, the memories, the thoughts, the emotions that come along with it. And so, they get in full-on struggles with their internal experience as a way to escape. And it makes sense. I mean, these are really unpleasant experiences for people, and I don't know who might not want to get away from those things. 

 

The problem is that you truly begin to suffer inside the struggle, and your life becomes very narrow in that fight. You can't think of things, you can't go places, you can't see things, you can't be triggered, right Like it gets really tight and constricted. And so, what we're doing with ACT is we're opening that space back up again. We're helping people move back into a place where they're vital, moving, engaging and able to be with those experiences, without getting in a full-on,  as we often say in ACT , tug of war with your own emotional experience, which is exactly where the suffering lies, and you can't have your past and there's no other thing to do with your past except for let it be. We can't go back in time. History only goes one direction. We know it's painful and hard and we want to honor that, but we also want you to get freedom so that you can expand your life back out again and encounter joy and encounter freedom and be living in ways that you care about.  

 

Dr. Darrah Westrup:  

When you, and I think most providers can relate to this, start working with someone who is  dealing with a traumatic experience or experiences, and you ask the right questions, a certain path of questions, I should say, you land on that they want it to be gone.  And of course, that makes so much sense and tucked in, that is the sense of I'm not okay until this is gone and my life won't be okay until this is gone.  And you can hear the bind in that and there's already like a sense of hopelessness, almost like we all know that we're in a bind here, and so to offer hey, there is actually a way through this. 

 

Dr. Darrah Westrup: 12:51 

It's not about getting rid of what can't be gotten rid of, and I just think it's, sometimes it just mystifies me, how suffering is common. Trauma is not uncommon, and I never got a class on this. I don't think you did. We don't learn how to do, how to have these hard experiences and these tough emotions and not be swallowed up or defined by them. So, it's just, again, having opportunities to get this out and help people help themselves is what this is all about. 

 

Dr. Robert Boland: 13:24 

Sure, you know your model, you use the phase model for trauma treatment which is, you know, well-documented and it shows lasting recovery. But can you talk a little bit about the stages involved in that? 

 

Dr. Darrah Westrup: 13:38 

It's a little kind of in reference to what I was just pointing to, is that we don't have classes, and this isn't like a knowledge transfer.  It's not an information dump. We're talking about ways of being. These are abilities that need to be established and addressed. These are abilities that need to be established and addressed, and so we're really careful in our book to help people develop a sense of safety and learn how to really get grounded and then move through the skills that, together, will take us to the place that we're hoping to get with psychological flexibility. It's a very thoughtful, careful kind of scaffolding in a way. Would you agree with that, Robyn? 

 

Dr. Robyn Walser: 14:19 

Yeah. 

 

Dr. Kerry Horrell: 14:20 

Yeah, yeah, you know, one thing I was thinking about with this is, you know, working here in an inpatient setting with primarily folks who've gone through trauma, I have people come in and they're often saying something like I really want to get to trauma treatment. And I think, really referring to kind of what you were talking about, Dr Westrup, with this idea of I want to get rid of this. I came here, you know, I might, you know, a patient might be here for four weeks, six weeks, eight weeks, you know, somewhere in that ballpark. So, in this grand scheme of things, not too terribly much time. I know they can feel like they're here forever, but you know, a couple months at most, and they come here and they say I'm coming here, I'm dedicating this time so I can deal with my trauma, and when we're working through, especially that skills and safety part of it, the kind of grounding part of it, I think a comment I give my patients a lot is when do we get to the trauma work? And I often have to remind them I say, in the world of recovering from trauma, this phase that we're doing IS trauma work. 

 

Dr. Kerry Horrell: 15:15 

In fact, it's incredibly essential and I think so many people think of like particularly trauma work and I'm thinking of patients, not necessarily clinicians, as the middle stage of doing some of the work, of kind of exposure to trauma narratives and the story of someone's trauma. That that's the trauma work. And I think it's so important, yeah, and I was so glad to see this in your book is like right there right in the intro, that this progress through trauma looks like working on those grounding skills. And there are, I mean, ways to be working on that. And then the part of doing the kind of exposure work. And then comes a whole other part too of working on how do you reintegrate. And so again I to me that just makes so much sense. And again, I'm wondering if and this might feel like a silly question, but is that pretty integral in like act in general, is usually taken as kind of like a phase approach, or is it specifically for trauma? 

 

Dr. Robyn Walser: 16:04 

I mean not typically. I mean there's lots of ways to work with acceptance and commitment, therapy in sessions, and you can start in all kinds of different places when you're just doing straightforward ACT work, and we put this in the book too. One of the things that we understand is that treatment isn't always linear, but that you know you can move from safety and stabilization into exposure to the trauma and something happens like, maybe it's an event in the person's life, perhaps another trauma, or something happens that they weren't anticipating, like a death of a family member, like we've had some of those kinds of things happen and they have to go back to stage one. We've had people move into stage three and go back to stage two and they told us, oh well, I didn't tell you about this other trauma that I've been struggling with because I didn't want to tell you about that one. 

 

Dr. Robyn Walser: 17:06 

Right, and so we really get that it's not a linear process. This is just a way of helping the clients organize and think about how they're going to move through it, and we let them know that. And even in stage one, feel free to look at stage three. We understand that it's not a linear process, but we do absolutely want the person to be in a place where they feel they can do the exposure work which, when you're working with complex cases, often requires gaining stabilization first. 

 

Dr. Kerry Horrell: 17:40 

Can you say a little bit more about that phase three as well and what that kind of piece looks like? 

 

Dr. Robyn Walser: 17:45 

Well, so in this phase and, Darrah, feel free to weigh in on this as well. We're really, you know, values are woven throughout the entire process, like what you care about and how you want your life to be is really an important part of the work that we're doing. What you want to stand for and we want to kind of bring that home with a real sense of empowerment and groundedness in this one life that you have to live and what is it going to look like? And so, after we've done the exposure work, we want to reconnect people to that space. And then what are going to be the bumps along the way? How are you going to overcome obstacles that show up after you've done this work, using what we've given you? So, we want to ground them in that, keeping your values as a compass direction to where you're headed. 

 

Dr. Robyn Walser: 18:40 

And also, how might you grow? So, not only what's important to you here in terms of what you'd like to see happen, but what's important to you in terms of what you'd like to see develop as you move through. How do you want to expand what you encounter as you, you know, take this one life that you have and make it as big as possible, and so that's our stage three work. Would you add to that Am I missing anything?  

 

Dr. Darrah Westrup: 19:08 

Oh, I thought that was beautifully said. I was thinking of how often you can imagine someone who's been struggling with trauma maybe much of their life and have been defined by it, have been engaged in that, and now they've done the work, and the trauma is in the past. It's something that they carry right, it will always be something they carry, but it's not…it's almost like what comes to mind is the individual kind of working with the past, honoring the pain of these experiences, but from a stance of power, like by choice, I'm choosing to head into this work for myself. And then there's this turning towards the future and kind of like seeing what's next. I'll get that with folks who have been working with this for years and years and years and all of a sudden, they realize, oh, I'm actually whole and acceptable, even with this history. Now what? 

 

Dr. Robert Boland: 20:16 

Yeah, you talk a lot about values, and you mention that here of how it's woven throughout the treatment. Can you say more about that and why it's an important anchor for folks to use in trauma work? 

 

Dr. Robyn Walser: 20:27 

When you think about what's been sort of stolen from trauma survivors if I can use that language, it sort of feels like a piece of themselves has been yanked away by whatever the trauma was, including complex trauma. Like years of feeling, like little pieces of you have been sliced off, let's say in the example of child sexual trauma, that's repeated and ongoing, and so, inside of the pain that you're hearing from them, they're wanting something. Right? There's a yearning. Am I okay, am I acceptable? Am I a worthwhile human being here and whole enough to be loved and part of belonging and a connected space? And so, we want to come at that right up front. 

 

Dr. Robyn Walser: 21:16 

Like most, Darrah and I operate on this supposition all the time, like we have a therapeutic stance, that it doesn't matter what trauma you've had. You walk through our door. You are whole, acceptable and capable. You don't have to be something different first and so and values sort of help instantiate that.  There's a human being here who wants something and yearns for something. So, let's get you to belonging and connection and love, compassion, acceptance, all those things that matter to you, authenticity. Let's start weaving them in right away. We don't have to wait. You've been waiting too long already. Let's not another minute go by where we're not thinking about how we're going to get you connected to that right away. 

 

Dr. Kerry Horrell:  

Dr. Westrup. Anything to add? 

 

Dr. Darrah Westrup: 22:02 

Oh, I'm thinking of some of the veterans that Robyn and I have both worked quite a bit with and who can feel as though they don't deserve value, perhaps because of things that were said or done or witnessed. There's a sense of who am I to value love? Who am I? Sometimes they, they give up faith, feeling is and to understand that values is treated here are inviolable. They are always there; they can't be destroyed. You can have never been honest in your entire life and decide to value honesty and that's available to you in the next moment. So, they stand and they're to reclaim that caring and then decide that that's going to be kind of your guiding light moving forward is a pretty big deal. 

 

Dr. Kerry Horrell: 23:00 

You know, one of the groups that I lead here and I've led for a good number of years is looking at shame and resilience to shame, and one of the things that we talk about a lot also is values, and obviously there's a significant overlap between people who've had shame and who've had trauma, and I think one of the things that's standing out of what you're talking about is so often when my patients we do some sort of values identifying activity, they'll say but can I really say this is my value if what I've been doing, you know this doesn't line up with it? do have to prove something about my value to be able to say this is my value? And I just love what you just said, of like no, if what you value is kindness and you feel like in your life you've not been kind to yourself and kind to others throughout the pain you've been in, then you can choose right now that that is what you value and to keep moving forward. And yeah, I just really love that because I think that is so often something patients need to hear. They don't have to prove, they don't have to like to have some roster of their values before they say, yeah, clearly, this is my value. The other thing I was thinking, as you were sharing about values, is just this idea that recovering from trauma is so hard. I mean these questions you're talking about even like: Am I worthwhile? Am I even capable of recovering? Am I too far gone? Am I too broken? Like this is profoundly challenging work, and I think anybody who works to recover from trauma is remarkably brave and remarkably strong. 

 

Dr. Kerry Horrell: 24:21 

And I think that helping people know what their values are also gives them something in the moments when they're like I don't want to do this anymore, like they're in it, they're in the process and they're like I'm in so much pain. Maybe it was better to just avoid, and it was just better to stay with my world so small, as you were talking about, Dr Walser, and I feel like values are those things to hold on to, those anchors. But in those moments when patients are like I can't even see the light, to be like you're in the thick of it. Remember this is so important to you and, yeah, I mean I'm just really appreciating that as part of your work. 

 

Dr. Robert Boland: 24:51 

As Kerry mentioned, like a lot of our listeners are clinicians. Do you have any advice for them or any suggestions for clinicians who would want to use the book with their clients? 

 

Dr. Robyn Walser: 25:01 

I think so. I mean, you know it's a self-help-oriented book, but it can be a true companion to therapists. So, therapists who are working with trauma can ask their clients to use it as a companion to the work they're doing. They can work through it together. The therapist can use some of the exercises and help the client to work through them. The therapist can just read it by itself and, I think, get informed from the kind of work that we're doing here. So, we're quite happy for therapists to use it in a bunch of different ways but really see it as a companion to the work that they're doing and hope that they will find it useful. 

 

Dr. Darrah Westrup: 25:42 

I don't know if I've had a chance to tell you Robin, but I've already had that feedback from a provider. She said this is the book I've been looking for. I'm so excited, she said, because I haven't been sure of myself or really know. This is what I was looking for and I cannot…I was so excited to tell you that.   

 

Dr. Robyn Walser: 26:06 

I got an email this morning from a clinician who had all the emails that said look what I've got, and it was a picture of clinicians right. 

 

Dr. Kerry Horrell: 26:21 

I have to say, as a clinician, I feel that when I read through your book, I thought I'm going to repeat what this other clinician said. I feel that when I read through your book, I thought I'm going to repeat what you're what this other clinician said, like this is something I've been looking for Again, especially working with a lot of folks who've been traumatized. Is something that they can read through themselves. I think so often people are hungry between sessions, especially when they're in the thick of it, and they're really wanting to work on recovery, like they want something to be able to utilize that’s not clinician-focused, you know, like it's for them. To have something specifically about trauma, and coming from this very values-based, meaning-based work, I think is so, so important and again I'm really grateful for it. 

 

Dr. Robert Boland: 26:57 

Yes, thanks so much Once again. The name of the book “You Are Not your Trauma: An ACT Guide for Healing from Within” and it's by the people we're talking to Drs Robin Walzer and Dr Darrah Westrup. So, thanks so much for joining us today. 

 

Dr. Kerry Horrell: 27:16 

Do you all have any final words for the day for our folks who are listening? 

 

Dr. Robyn Walser: 27:20 

Well, since it's largely clinicians, we sure do hope that you find this book helpful to you and the work that you're doing. We're humbly proud of it and we think that we're offering something that can really help clients move forward in their lives in really meaningful ways. So, we hope that clinicians find that to be the case as well. 

 

Dr. Kerry Horrell: 27:43 

Thank you both for your time and truly for this work that you're putting out there for clinicians and patients and we really appreciate it. And again, you've been listening to Drs. Walser and Westrup and we are the Mind Dive Podcast. I am Dr. Kerry Horrell. 

 

Dr. Robert Boland: 27:59 

And I'm Dr. Bob Boland and thank you for diving in. 

 

Dr. Kerry Horrell: 28:02 

The Mind Dive Podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen. 

 

Dr. Robert Boland: 28:11 

For more episodes like this, visit www.menningerclinic.org. 

 

Dr. Kerry Horrell: 28:16 

To submit a topic for discussion, send us an email at podcast at menninger.edu.