Transforming Trauma: Episode 185

When we receive a genetic testing result that changes our understanding of our body, our risk, and our future, something shifts at the level of identity. There is a before and an after. And in that threshold moment, the medical system is ready with options, timelines, and next steps. But who is holding the grief, the terror, the confusion, and the deeply personal question of what this means for how we want to live? This episode explores that gap and why closing it matters so much.

On this episode of Transforming Trauma, host Emily Ruth welcomes Sara Champie, a licensed clinical social worker and trauma therapist based in Northern California, for a deeply personal and clinically rich conversation about the emotional and relational dimensions of hereditary cancer, genetic testing, and the high-stakes medical decisions that follow. Together, they explore how the NeuroAffective Relational Model® (NARM®) offers a framework for understanding why people with similar diagnoses can respond so differently, and how therapy can help restore agency without bypassing grief.

Sara Champie is a licensed trauma therapist who specializes in supporting individuals and families navigating hereditary cancer risk, genetic testing, and preventative or reconstructive surgeries. Her work integrates trauma-informed, somatic, and relational approaches to help clients reconnect with their bodies and make meaning through uncertainty. Sara is the creator and host of the podcast Walking the Genetic Line, which explores the human experience of living with hereditary cancer risk. She is also a BRCA1 carrier whose mother was diagnosed with ovarian cancer when Sara was seven years old and passed away when she was ten. That early loss, and the long arc of healing that followed, shaped not only her career but also her deep understanding of the community she now serves.

“When we’ve been through a trauma, the projective memory is literally a voice like, I’m gonna die. I’m gonna die. I have to do something,” Sara shares, naming what so many feel but struggle to articulate when genetic results arrive. She describes how the concept of projective memory, a term for the way unresolved trauma from the past colors our experience of the present, helps explain the visceral, sometimes overwhelming quality of learning you carry a mutation associated with cancer. For Sara, finding out she was a BRCA1 carrier was terrifying not because of abstract statistics, but because all she had to associate with that result was the death of her mother at age forty-six. That kind of context, she explains, shapes everything about how a person holds genetic risk.

Sara uses the NARM® survival styles as a clinical map for understanding the range of responses she sees in her practice. Some clients arrive numb and intellectualizing, buried in research at three in the morning but unable to name a single feeling. Others cannot hear their own needs because the weight of being a burden to their family is too great. Some hide their vulnerability behind strength, terrified that showing fear will unravel the roles they hold at work or at home. Others go along with treatment plans while privately wrestling with choices they feel unable to voice. And for many, the experience of losing or reconstructing parts of their body opens profound questions about identity, sexuality, and selfhood that reach far beyond the surgical suite. “This amazing opportunity to finally get free, to finally explore these pressures and themes and the ways we relate to ourselves,” Sara reflects, “so that maybe this is a process of liberation that was never available to us earlier in our life.”

The episode also takes a clear-eyed look at the gap in emotional care within the medical system. Sara describes common examples of interactions with medical professionals that reveal how much work still remains. She advocates strongly for specialized providers, not general practitioners, to guide the care of people with genetic mutations, and for mental health referrals to be treated as a standard, not optional, part of the care model.

Transforming Trauma is grateful to Sara for the courage and compassion she brings to this work, and for her willingness to share her own story in service of a community that deserves far more support than it has been given. Her insistence that we can hold agency and helplessness at the same time, that we can grieve what medical decisions cost us even as we honor what they gave us, is a message that reaches well beyond hereditary cancer. It is a reminder that healing happens not when we rush to safety, but when we find someone willing to stand with us in the full complexity of being human.