08.18.09
Depression and Dissociative Identity Disorder, part 2
Welcome to the second half of “Depression and Dissociative Identity Disorder”. The first seven tips have been previously posted. At this point in time, I will continue with the list of tips for how to specifically address chronic depression for trauma survivors with DID:
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8. As the memories surface, feelings will also surface. Expressing genuine emotion is key to working through depression. Crying tears of grief, screaming out in anger, quivering in fear may not feel comfortable, but holding these very real and intense emotions deep within will create long-term depression. Allowing these emotions to come out safely and appropriately – even if years after the original point of acquiring these emotions – will help.
9. In the appropriate time, let other parts of your dissociative system know about the information that was held by the depressed parts. Overcoming the dissociative barriers by sharing that information between the system parts is critical in your long-term healing. The more that your internal system shares with each other, the more you all can work together towards healing. The full story line does not have to be shared immediately with everyone. However, keeping pockets of dissociated information will continue to create an underlying cause for chronic depression.
10. Your feelings will need lots and lots of processing time. Talk, cry, draw, write, vocalize what you are feeling as many hours and hours over time as you feel these feelings. If you have been holding your emotions in for years of time, it will take oodles of time for these feelings to be worked through. Talking about it once or twice won’t be enough. Pushing feelings back down into non-expression will create more depression. While it will be very new territory to learn how to express your feelings, it is a necessary step.
11. Learn new rules about the expression of feelings. For example, in the past, when you were at risk of being hurt by your perpetrators, you most likely learned that it was not safe to express anger towards those that violently abused you. And yes, in that time frame, when you were likely to express direct injury from your perpetrators, it was safest for you to push those angry feelings deep within. At that time, that was a good decision. However, once you are away from your perpetrators, and the risk of ongoing abuse is no longer prominent, it is both essential and ok to express anger at your perpetrators’ atrocious, criminal behavior. Your healing will require that you remember to adjust with your changing circumstances, including creating new rules for expression
12. Learn to direct your anger at an appropriate target, even if that means starting with a “generic” unnamed target. Talk with your therapist about the variety of anger-expression techniques that allow your anger to be vocalized without creating harm to anyone else. Learning to express your feelings does not give you permission to take it out on whoever is there. The more you can express your anger directly towards the perpetrators that harmed you, the more effective it will be. Likewise, misdirecting your anger towards the wrong target (ie: someone who was not responsible for your abuse or injuries), will only create more problems for you, and will harm a lot of innocent people in the process. For example, getting angry with your children or your therapist will not resolve the anger you feel towards your parents.
13. As a continuation of tip #12, be willing to learn specifically about transference, projection, displacement of emotion, etc. Survivors who have had years of repressed emotion due to duress and abuse will truly need to practice expressing their emotions properly, and will need to learn when they are misdirecting their emotions. All survivors that were not allowed to express anger directly naturally learned to displace any display of anger in sideward ways. Realize that you will continue to get this mixed up for awhile. Be very aware that you might first take your anger out on safer targets. These mistakes are to be expected, and not a “fault” of yours, but it is still your responsibility to learn more accurate skills. Making the mistake of blaming the wrong person will only add to your depression. It will leave the deeper feelings unprocessed, unaddressed, and unhealed, thereby creating the foundation for ongoing depression and pain.
14. Replace the years of trauma and abuse with your own preferred people and activities that you enjoy. Once your life is full of happier, more meaningful things, you won’t feel as depressed. This probably will not happen quickly or easily, and you might have to learn how to live again. It might feel like you are learning to live for the very first time. You might have to learn how to love, or how to experience joy, or how to play, or how to forgive, or how to explore, etc. The more you can fill your life with activities of your own choosing, the less depressed you will feel.
15. Be sure to encourage all of your insiders to have their own individual healing process. Let each of them work through their own traumas, their own feelings, and let each of them find new and more positive interests in life. As each individual part of you experiences less depression, the whole of you will experience less depression. If you let only some parts heal, the whole of you will still be affected by the parts that were not given the chance to work through their healing. Remember, as split and divided as you might feel, you are still all connected within the same one body and the same one brain. To truly overcome depression, all of your insiders need the chance to overcome their pain.
Depression can be very debilitating.
Healing your trauma issues will be fundamental to overcoming the effects of the chronic depression.
In other words, in my opinion, you will continue to struggle with depression if you have unresolved trauma issues. If your dissociative symptoms have a significant negative impact on your ability to function, the liklihood of your having a significant level of major depression (MDD) is also present.
It is true that there may be other reasons for your depression in addition to trauma. (Please note: those topics were not addressed in this blog).
However, it is safe to assume that if you have unresolved trauma issues, you will most likely have chronic depression. And, the less unresolved trauma in your life, the less depression you’ll experience.
So….. get to work on addressing your DID / trauma issues. You’ll feel better for it!!
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By:
Kathy Broady LCSW
08.17.09
Depression and Dissociative Identity Disorder, part 1
So you’re depressed, and you’re DID. That feels like a double whammy already, so what do you do now?
Depression and DID go hand in hand for many trauma survivors. They are not the same diagnosis, but can be closely knitted together.
When you are DID, you might have some parts that are depressed, while simultaneously having other parts that are not depressed. Dissociative walls and amnesiac barriers can separate the feelings / emotions / information that the depressed parts have, so that is different from what is known or felt by the non-depressed parts.
Survivors with DID can feel nearly crippled by the intensity of their depression. It follows them around like a warm blanket and a lifelong friend. Sometimes it’s hard for survivors to imagine life not depressed. The idea of being genuinely happy is a foreign concept that seems out of reach.
All too many survivors struggle with self-injury, suicidal feelings, suicidal thoughts, and suicidal behavior on a regular basis. The desire to die, or go away, or cease to exist, or quit, or sleep forever are common feelings for those that are depressed.
What to Do
Many depressive symptoms can be alleviated, or at least helped, with proper medication. If your depression feels too huge for you to manage on your own, or if your life is at risk by the severity of your depression, please make a doctor appointment at your very earliest convenience to discuss this option. At times, inpatient treatment may be warranted.
Various versions of talk therapy can be immensely helpful as well. Talking about your problems and expressing your feelings are important steps in healing, especially since depression is synonymous with emotions being pushed down and numbed into near non-existence. Addressing the traps in your life by problem-solving the double binds (where something looks like a lose-lose situation) and the things that feel impossible will help. Feeling stuck and helpless will only exacerbate your depression.
One of the key feelings to explore during depression therapy is anger. It’s commonly said that depression is anger turned inwards. Learning how to safely express your anger is essential to moving through the overwhelm of depression.
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How This Applies to Those with DID / MPD
Many DID survivors have been depressed more years of their life than not. The overwhelming pain of severe trauma and the years of crushing family abuse create fertile breeding grounds for chronic depression.
There are a variety of specific tasks in treating depression for survivors with DID:
1. Find the parts in your system that hold the most intense depression feelings. You may or may not already know these parts. Some of the parts who hold the deepest depression may be tucked away deeply within your system.
2. Check about current day plans for self-injury and/or suicidal ideation. Be sure to know if you are at risk. It is important to have a solid awareness of how volatile these parts will be in acting out their feelings of depression and self-hatred. Create safety plans as necessary.
3. Ask questions about the preferred method of self-injury being used by these parts. There are hundreds of different ways to cause self-injury. The preferred methods used by various internal parts will very likely hold pertinent information about the life stories of these parts.
4. Pay attention to the patterns of increased depression through time. Are there certain times of year or certain days that are trigger points? What significance do these periods of time have? Are these dates or times anniversaries of particular traumas or difficult events? Explore these timeframes until you thoroughly understand what happened.
5. Learn more about the time when these depressed parts were originally split off and created. Ask about the starting point of these parts. Chances are, they were created during a very difficult time. The creation point will provide a great amount of information about who these parts are and why they are like they are.
6. Addressing the underlying trauma issues will be crucial in healing the depression. These parts will need to talk about what happened to them, what they saw, what they experienced, what they felt, what they believed, etc. Holding this kind of intense information deep within most certainly adds to and creates more depression. Find the courage to talk about your trauma. While it is enormously painful to address the cruelty you experienced during those traumatic times, letting this material surface and processing it effectively will help to alleviate your depression in the long run.
7. As these parts begin talking about what has been kept frozen and tucked inside, that will create movement, life, and energy. As painful as it is to address the trauma issues, it will also allow for new experiences to begin. With that comes the opportunity for something positive and healing to replace what has been stuck for years of time as traumatic and devastating.
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*** Due to the length of this article, the second half of this list will be continued in my next blog post. Please come back soon to see the rest!
Do you have any comments or questions so far?
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By:
Kathy Broady LCSW
08.02.09
20 Types of Dissociative Splits
It always amazes me when dissociative trauma survivors tell me that after they’ve met three or four of their inside alters (or maybe even a few more than that, but not many), that they think they’ve met everyone in their system. They think they are “done” meeting their insiders.
That never makes sense to me. Oh, I understand why the survivors would want to believe they have so few others inside, but that hope rarely matches with the actual amount of dissociative symptoms that they experience in their lives.
For example, if someone is still losing time, but they believe that have a good solid relationship with the parts that they know – then why are they losing time? Yes, it is possible that someone you know in your system can still block you out of awareness at certain times. Then again, if everyone you know in your system said they did not know what happened during a period of lost time, then it only makes sense to realize there are other parts of the system out and in charge during that missing time. If all of you are losing time, then there are more insiders yet to meet.
In my definition, meeting new insiders is a sign of progress. The survivor will not be creating new parts by meeting new parts – they are simply finding the parts that have been hiding from them all along behind strong dissociative walls. Any time you can reclaim more of the information that had been previously blocked from you via dissociation, you are making progress. Learning about your system and your history are always steps of progress.
So who should you look for or when will you know if there are more parts to meet?
All dissociative trauma survivors have their own unique system, of course. No one’s system is exactly like anyone else’s. There is no right or wrong for how big or how elaborate your system is. You would have split as many times as you had to, and you will have as many parts as you needed.
However, there are some common types of alters that exist in most DID survivors. This is a non-exhaustive list:
(Please note: alters may start off in these categories, but their roles can change.)
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1. Host parts – check to see who was the host at various times in your life. This role can change and be assigned from part to part to part through time.
2. Child parts – your dissociative splitting would have started prior to age 7, so you will definitely have at least one child part, however, most DID survivors have bunches of child parts.
3. Parts that are relatively happy and trauma-free. These parts do not remember any trauma whatsoever. They can be of any age, but they believe they had a completely safe and happy childhood / adult life. Some parts might believe there was childhood abuse, but they can be blocked from the awareness of abuse happening in the adult years.
4. Parts that are created to manage the outside world. These parts may be the ones that went to school, or go to work, or handle social situations. They are typically quite separate from the trauma-holders or those that hold intense emotions. These parts may not be aware of a lot of trauma, they may hold a lot of denial, and they have the job to look as normal as possible. They will help the person get through life by doing normal things.
5. Parts that don’t remember anything “good” happening. If there are parts that only remember good things, there will absolutely be parts that only remember painful, not-so-good things. They contain the information that the normal daytime “happy” parts were not allowed to know, experience, or remember.
6. Parts that know a lot of memory information. These are the parts that either experienced or witnessed the trauma, abuse, neglect, etc. Getting to know these parts will involve listening to stories about the trauma, body memories about the trauma, flashbacks of the trauma, etc. It is common for there to be numerous parts to handle various types of abuses by various perpetrators. For example, one part may have managed a specific kind of abuse by perpetrator A. Another part may have handled a different kind of abuse by perpetrator A. Another part may have handled the abuse by perpetrator B. Yet another part handled the abuse by perpetrator C. And so forth.
7. Parts that contain a specific emotion. Many people split off various emotions into certain parts to contain those intense overwhelming emotions. If you believe, for example, that you never feel anger, you will likely have other parts in your system that do contain those emotions for you. These parts often have names such as “the sad little girl”, or “the angry one”, or “the scared one”. Getting to know these parts will mean starting to accept and experience these emotions.
8. Parts that split off at particularly traumatic years of life. These parts could also be memory-holders, but during years when there was more stress in the external life, there will likely be more parts. Years of more extreme abuse can lead to more parts being created of a similar age simply because more selves were needed to manage the overwhelming abuse.
9. Parts that are loyal to the mother. All children love their mother, even abusive, neglectful mothers. However, this emotion might need to be contained within certain parts, especially in the case of abusive mothers. Some parts are created to agree with the mother’s abuse (defining it as anything but abuse), and others are created to be obedient to the mother, even if they are terrified or in pain.
10. Parts that are loyal to the father. Just as with the mother, the father may have a variety of parts that are loyal to him, his beliefs, his ways, etc. They may learn that it is safer to align with the perpetrator and to separate themselves from the child-survivor.
11. Parts that contain loyalty to the perpetrators. These parts are often rewarded by the abuser-perpetrators and are encouraged to view themselves as separate from the rest of the system. It will take a lot of work to bring their loyalty back to the person they were created from.
12. Introjects created from external people. System introjects are internalized parts of the system that act – think- feel – believe themselves to be a mirror image of the external person that they are replicating, except they often believe they are the actual person (and not the replication). They may adamantly believe that they are a different person from the survivor-self, complete with a different body from the survivor. These parts contain a lot of memories, factual information, emotional realities for how it was like to be near the outside person.
13. Parts that contain the programming / mind controlled messages. These parts are often created by design and on purpose by organized abusers. These parts are given specific learnings that function as “rules” to control the survivor’s overall behavior. They are often separate from the host parts, and quite hidden within the depths of the system. The other system parts will experience their influence, but have trouble recognizing them as specific alters.
14. Parts that hate the mother or father. Hating the parents may be a difficult dilemma to address, especially since there will be parts of the person that naturally love their parents. However, years of repeated abuse and neglect can create the need for parts to contain the hatred felt towards parents who would allow such atrocities to happen to their child.
15. Parts that are created along the lines of family dynamics. Some survivors will internalize their family into their own DID system. You might find internal replicas of the sisters, brothers, parents, aunts, uncles, grandparents, etc. The family dynamics will be played out in a variety of ways but will most obviously be noted in the way the survivor splits off their system.
16. Floaters and other parts that separated themselves from the body during times of trauma. These parts may have risen above the body, and from the out-of-body experience position, may have specific information to share with the survivor about the kinds of things that happened.
17. Internal self-helpers. These parts would have been created by the system themselves and not necessarily during a state of trauma. They are typically leaders of the system that are considered to be holders of wisdom, or gentle peace, or spiritual guidance. They are devoted to the survivor system as a whole and work towards maintaining safety, stabilization, balance, etc. They typically do very little with the outside world, and focus most all of their energies towards helping the system to survive.
18. Parts that are specifically parental figures to the outside children. It is not uncommon for a survivor to split off “parental parts” just to be focused on raising the outside children as well as possible. These parts very often work hard at being different from their own outside parents, and strive to be the best parent they can be.
19. Parts that were involved in abusing others. This is a very difficult area for survivors to reach, but it is more common than not. Especially for those people who have been abused by organized perpetrators (ie: cults, sex slavery groups, etc) there will be parts who were forced to have the perpetrator role and required to do things that harmed other people.
20. Parts that contain a specific skill or talent. Certain parts can be created to develop positive talents and abilities, often as a way to help manage or express or avoid the pain that is felt so deeply by the others in the system. Maybe one part is better at playing a musical instrument than anyone else. Maybe someone else learned how to write poetry. Or maybe someone was created to be an athlete and to run, jump, excel at sports, etc.
As you can see, there can be a large system just by having parts to fulfill the different roles that are often needed to get through the abuse. Some parts may have a variety of these jobs, overlapping from a variety of categories.
But don’t be surprised if you have a variety of parts in each of the categories listed above.
Many survivors do.
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By:
Kathy Broady LCSW
