December 9, 2008
50 Treatment Issues for Dissociative Identity Disorder
Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, sexual abuse, therapy, Therapy and Counseling, Trauma tagged Add new tag, Addiction, Amnesia, Anxiety, Bipolar, Body Image, Body Memories, Childhood Sexual Abuse, Depression, DID / MPD, dissociate, Dissociation, dissociative, dissociative disorders, Dissociative Identity Disorder, Emotional Abuse, Emotional Crisis, Emotional Healing, Exploitation, Grief, Healing, Hurting, Integration, Isolation, multiple personality disorder, pain, Physical Abuse, Pornography, Prostitution, Relationship, Ritual Abuse, sadistic, Safety, Self Esteem, Self Injury, sexual abuse, Sexually Abused, Social Anxiety, Social Skill, split personality, splitting, Stabilization, Suicidal, Suicidal Behavior, System Work, Therapeutic Process, Trauma Bond, Trauma Survivor, trauma therapist, traumatic history, treatment, treatment for DID, Violence at 7:06 pm by Kathy Broady
“How long will it take for me to feel better?”
As a clinical therapist, I hear that question frequently. It’s a reasonable question. I certainly understand that when someone is deeply hurting and struggling in their life, they want to feel better as quickly as possible.
However, the clinical treatment for someone with DID / MPD is long term. Some research has said that the treatment can be completed within two or three years, but in my clinical experience, that is far from the truth.
Dissociative Identity Disorder is a result of long-term, chronic, severe, sadistic child abuse. As children, these survivors witnessed and experienced a myriad of heinous crimes. They typically describe repeated consuming abuse by multiple perpetrators, and then were otherwise emotionally neglected, starving for comfort, consolation, or attention. They were left alone, even while very young, to process and contain their pain by themselves. For these children, the splitting process became their way of coping with emotional intensity, conflicts, huge distress, and intense pain that were otherwise far too difficult to manage on their own. They blocked off their pain, locked it away from themselves, and left it there. Sitting, waiting, piling up for years.
When you understand how much pain and abuse has occurred in order to create the dissociative splits in the first place, it is no wonder that the healing process is also so very long. All areas of dissociative survivors’ lives are touched and profoundly changed or affected by the abuse. It simply takes a very long time to address everything properly.
Some of the treatment issues are:
- Stabilization of the person – both internally and externally
- Managing and eliminating self-injury and self-harm issues
- Examining and obtaining current-day external safety from abuse
- Internal system safety
- Developing effective internal communication
- Calming internal noise and chaos
- Working specifically with child parts
- Working specifically with adult parts
- Working specifically with teenage parts
- Learning about the other system parts
- Working with internal perpetrator introjects
- Creating emotional separation from external perpetrators
- Working with triggers
- Correcting cognitive distortions
- Addressing gender confusion, male vs. female issues
- Processing emotions
- Body image issues
- Reducing time loss, memory loss, amnesia
- Time confusion, time distortion
- Trauma processing – memory work
- Body memories and kinesthetic issues
- Understanding re-enactments and trauma bonds
- Healing sexual abuse issues
- Healing physical abuse issues
- Healing emotional abuse issues
- Healing ritualized abuse issues
- Healing exploitation, pornography, prostitution, sex slavery issues
- Managing family, marital, parenting issues
- Addressing addictions
- Managing eating disorders
- Household management issues – improving daily functioning
- Relationship issues and teaching social skills
- Understanding the effects of trauma on the brain
- Improving self-independence and self-reliance
- Improving self esteem issues
- Leaving disability and regaining employment
- Depression and medication management
- Bipolar disorder and medication management
- Anxiety / Panic and medication management
- Post-traumatic stress issues (PTSD)
- Reducing phobias
- Social anxiety and social isolation
- Safely eliminating suicidal ideation and suicidal behaviors
- Homicidal ideation and anger management
- Exploring spiritual confusion
- Philosophical issues
- Detachment and separation issues
- Treating sleep disorders
- Treating medical complications and physical harm resulting from the abuse
- Reaching integration, blended states, or effective system team work
That’s a tremendous amount of work. And most of these issues surface again and again and again, requiring in-depth attention on a regular basis for years of time.
Emotional healing on such a wide scale just does not happen fast. Forcing the issues or pretending to be “done” sooner than realistically possible is not helpful.
Simply put, years of severe injuries will require years of intense healing.
It takes as long as it takes.
__________
by:
Kathy Broady, LCSW
