May 24, 2010

Sorting through Transference Issues

Posted in Child Alters, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Family Members of Trauma Survivors, therapy, Therapy and Counseling, Therapy Homework Ideas, Transference Issues, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 1:03 pm by Kathy Broady


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In response to some questions asked about my previous blog article about Mother’s Day, I’ve decided to follow up with an additional post on the topic of transference.  Transference isn’t necessarily an exciting topic, but it is fundamentally important to understanding the dissociative therapy treatment process.  Hopefully, this article will help to clarify more about the importance of these issues.

What is transference?

How do you recognize it?

How do “mother issues” become a common transference issue for female therapists?  (And likewise, how do father issues become common transference issues for male therapists?)

Is transference healthy?

Is it important?

Yes, transference issues are a common part of the healing work done with every trauma therapist / dissociative client.  The frequency of transference issues makes them very important topics to talk about and to understand.  Transference issues surface all the time in the DID therapy process — in a variety of ways — often in simple and unexpected ways.  It would probably be fair to say that some kind of mother transference can potentially show up every week in therapy.

Addressing transference issues appropriately are fundamental to healing, so if it seems I write about them a lot in this blog, it’s because they are important.  Transference issues are when feelings about an important person in the past become “transferred” onto another person in the present.  It can be as simple as a little reminder, or in the case of some dissociate trauma survivors, it can go as far as the client literally seeing someone else’s face put on to the other person in a flashback type fashion.

Transference happens when something connected to Person A significantly reminds clients of Person B, or to their relationship with Person B, to the point that Person A can be viewed as the same as Person B.  Person A is not Person B, but clients deeply tangled in their transference issues may not be able to tell the difference.  In essence, it becomes a type of relationship psychodrama where clients address their complicated, complex feelings about Person B by acting them out with Person A.  At some point, clients need to recognize Person A is Person A, and that Person A is not Person B.  Only Person B is Person B.

In the therapy process with survivors with dissociative identity disorder, the therapeutic goal of working with transference is to allow clients address emotionally painful material with Person A while having that safe distance from Person B (the alleged “bad guy” or traumatic figure).  However, therapeutic progress will occur only as clients see that Person A is simply the “reminder” of their feelings and memories regarding Person B.  By exploring the issues about Person B with Person A, clients can achieve deep healing on their genuine trauma and simultaneously successfully separate Person A from staying in that “bad guy” place.

If clients do not transfer the feelings back to Person B, but keep them stuck on Person A, they have prevented healing from occurring.  Person A is only a temporary “substitute”.  The real issues belong with Person B.  Staying focused on Person A prevents and distracts the real healing from happening.

Understanding complex details of the actual relationship between clients and their mothers is important to recognizing specific instances of transference, but some common examples of how mother transference issues can be seen in regular DID therapy session situations are:

  • The therapist cancels a session (or two or three) and the client fears the therapist will never come back, or that the therapist hates her, or that the therapist is abandoning her.  (re: mother abandonment)
  • The therapist doesn’t call or email a response quickly enough and the client feels like the therapist is ignoring her, or refusing to speak to her, or hates her, or is mad at her. (re: mother neglect)
  • The therapist wears a green shirt that reminds the client of a traumatic situation when the mother was wearing a green shirt, and the client becomes fearful that the therapist will abuse her the same as the mother did.  (re: mother trauma)
  • The therapist hands a male co-worker a file containing conference information and reference materials but the client becomes convinced that the female therapist (mommy) is telling the male therapist (daddy) all kinds of bad information about her so that the client will end up getting in trouble and abused. (re: mother betrayal)
  • The therapist shows genuine kindness, acceptance, and compassion with the client and the child parts.  The child parts attach to the therapist and wish with their whole heart that the therapist could be the mommy they never had.  The client clings excessively to the therapist and pretends the therapist is her mother. (re: mother fantasies)

Survivors struggle with transference issues all the time, and there are many survivors that find it “safer” to blame a therapist instead of really looking at their family dynamics / actual trauma issues.  While it may feel safer or easier to displace the issue onto a therapist, those same survivors can spend a lot of time not actually addressing their real issues because they are obsessing about the wrong person.  It can create a lot of wasted therapy, wasted time, wasted resources, ill feelings, etc.

However, it is important realize that some people really will not (or cannot? Or chose not to?) face their real issues, so they transfer and project their issues onto someone else instead for an extended period of time.  There can be a number of motivating factors, and addressing why someone wants to (needs to) focus on the wrong target is a critically important part of the healing process too.  Why are they stuck at this point? What else is going on for them?  What are they avoiding?  What secondary needs are they meeting by obsessing on the wrong person?  What’s the rest of the story?  There has to be more going on somewhere.

Obviously, one of the role of therapists is to help someone build the skills / ability to look at their real issues, and to weed out or steer away from the incorrect focus on distractions / displacements.  For a therapist to encourage a client to stay focused on a surrogate target would be a disservice to the client.  That would be like medically treating someone for a broken pinky finger when in reality, they had bone cancer.  The diagnosis of the problem has to be correct, or it is not proper treatment.  This is true in understanding the complexity of transference issues.  Accurately recognizing what is being transferred from where to where is critical in resolving the issues.

If someone wants to address their healing, it typically is much more effective for the clients to genuinely address their mother (or father) issues directly instead taking it out on a therapist (or a co-worker, or a neighbor, or a friend, or a spouse, etc etc.).  No one will find healing on Situation A if they are obsessed about Situation Q.

It is fair to say that female therapists are frequently put into that “mother role”, far more than the average person would be, especially with traumatized clients.  This is even more true for DID survivors with child parts.  (Most child parts have bunches of unresolved mother issues, and understandably so.)  Yes, working on mother transference issues is a natural part of the therapeutic process, but it is only the starting place, not the ending place.

There is a very fine balance of working with the transference, and not getting caught in them, or stuck in them.

If your therapist is not your mother, but she reminds you of your mother, what can you do to sort out your deep painful feelings?

If your therapist is not your mother, but you wish she were your mother, what can you do to meet those unmet needs?

Do your feelings for your mother effect how you view your therapist?

Have you discussed these feelings openly with your therapist?

The very best remedy to keep from getting caught in a negative transference dilemma involves a lot of detailed, honest communication between you and your therapist.  Talk about this.  Talk LOTS about this.  Sort out who is who and what is what.  Don’t be afraid to approach this topic with your therapist, as it is fundamentally one of the most important areas of your healing work.

Good luck – and keep working at this.  It’s important!

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By:

Kathy Broady, LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

May 31, 2009

Now I have lost my father…

Posted in Depression, DID Education, DID/MPD, Dissociative Identity Disorder, Family Members of Trauma Survivors, HBO's Series "In Treatment", mental health, sexual abuse, therapy, Therapy and Counseling, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 5:23 pm by Kathy Broady


“So thanks to all of this therapy, I have lost my father.”

“You haven’t lost your father….You did lose the father that you thought you had…”

“OK, I get it.  I didn’t have the perfect dad…. And my therapy has successfully shattered my romanticized image of my narcissistic father.  Is that how you would say it?”

“I would say, the patient, born to a depressed mother, idealized her father so as to not feel completely alone….. and now she can see her dad for who he really is.  It is shattering.  But if you can now move beyond that connection to your father, it may open the possibility of finding love elsewhere.”

“Now I’m left with nothing!”

“Maybe it’s worth it to finally take off the blinders, even if you don’t like what you see. Or you are left to wonder in the darkness for even longer.”

“Why did you take my blinders off?”

“I didn’t remove your blinders.  You did.”

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This is a paraphrased, condensed conversation from “In Treatment” – Dr. Paul Weston’s final session with Mia.  In this session, Mia discusses a difficult conversation she had with her father, and she realizes that her father – the man she idealized for years – actually did things to hurt her.

This “In Treatment” episode highlights a dynamic that many trauma survivors face in their therapy process.

Many dissociative trauma survivors enter therapy with the belief that their parents would not and could not hurt them.  While it is certainly true that some survivors with Dissociative Identity Disorder have one “safe” parent (a non-offending parent that was not directly involved in the abuse), most DID survivors have at least one parent with a dark, offender side to them.

Through the years of growing up, many survivors that split within themselves also keep a split view of their parents.  This is easy to understand especially when you keep the dissociative framework in mind.  For example, the day parts (front parts, host parts) that are not allowed to know about the abuse, will very often view the father as a relatively normal father that does normal fatherly things.  They will see their father as a good guy, a man that provided for the family, and while they may not always like the rules of the household, they typically won’t think of their father as an abuser of any sort.  In fact, these day / host parts will adamantly say that they have never been abused by their father, and will be highly insulted if anyone thinks otherwise.  The day parts will know nothing else about the father other than his day world presentation, and they will especially not know anything in regards to any kind of abuse or trauma or perpetration.  They often feel a strong connection to the father, and are convinced that he loves them (and specifically not in a harmful, sexual way).

These day parts may be in denial about the father’s abuse, or in the context of dissociation, they probably did not experience very much if any abuse from their father.  When this is the case, these parts can come to the absolute adamant defense of their father, and not be lying.  As far as they are concerned, their father was NOT a perpetrator, and they have absolutely no recall and no memory of anything else happening.  Sexual abuse and trauma may feel like totally absurd oddities, and these parts will argue incessantly about their father’s innocence.

So, what happens when the other parts of the dissociative system start to talk about their experiences with the father?  What if the inside parts actually did experience sexual abuse or physical abuse from the father?  What if these parts have memory after memory of abuse by the father, and remember nothing nice about him?

Now what?

Who is telling the truth?   Are the day parts that say the father did not abuse them telling the truth?  Or are the inside parts that clearly have body memories and flashbacks of painful sexual abuse telling the truth?

Who is lying?
Who is telling the truth?

Actually, each of these parts, in most circumstances, is genuinely telling the truth from their own perspective.

The day parts genuinely did not experience abuse by the father.
The inside parts genuinely did not experience anything but trauma from the father.

How is that possible?

Because of the dissociative walls in between the different parts of the system.   Strong, intense dissociation can create absolute amnesia.  What happens in one world will not leak through to the other worlds.  One side of a dissociative person can have totally and completely different memories than the other people in the dissociative system.

One side of the dissociative person can be totally blocked off from another side of the dissociative system.  What can be true for one set of system alters can be entirely false for another set of system alters.  It is this very conflict that supports and creates the dissociative splits in the first place.  When something is too conflictual to be contained, splitting off the opposing information into different parts of the dissociative system helps the child to manage each of the conflicting worlds.

Thick dissociative, amnesia-creating walls allow the day world to not be overwhelmed or upset about abuse – they can’t tell or show difficulties when they don’t even know about the abuse.  They can interact with the public world and not see or know or tell anyone about abuse.  They can function normally in school or at work, and not give off too many troubling signs.  Their dissociative walls serve to exclude them completely from information about the abuse.

For the parts that withstand the abuse, their thick dissociative walls keep them isolated and contained away from the world.  These parts experience nothing but their abusers.  They cannot grasp how wrong and vicious abuse is, especially since they have no other awareness of right and wrong, or that it shouldn’t be happening to them.  This leaves the abused parts completely trapped in their abusive worlds because they cannot conceptualize anything other than tolerating abuse.  Abused parts don’t attempt to leave their abusers as they simply cannot fathom any element of life outside of their abusive prison walls.  They do not know that a life different from abuse can exist.

When a trauma survivor with DID presents in therapy, both sides of their system will begin to speak.  The front parts will share their happy day-life experiences, and the inside alters will tell their stories about trauma.  The therapist sitting outside of the dissociative walls will hear both sides of the story.

Part of the healing work is then to get these two sides to listen to each other. Of course, there is a balance and a timing for when to say what, but the basic goal is to lower the dissociative walls and let each side of the system learn about the reality of the other side.

The day parts will hear that their father was not always so kind and gentle with them.  The inside parts will catch up to the current day timeframe and learn that they do not have to stay stuck in abusive relationships.  Each side of the system will help each other see the whole picture.

It’s not easy – but taking the blinders off and looking at the whole picture of your life and your relationships are extremely important pieces of your healing journey.

You can do it.  The safety and healing will be very much worth the hard work involved.
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  • Have you realized that the various parts in your dissociative system have experienced very different lives from each other?
  • Are you willing to take your blinders off and look at the whole truth of your life?
  • Do you understand what it means to keep internal parts stuck within dissociative walls where they know only the world of abuse?
  • What are the worst things that could happen to you if you actually lowered your dissociative walls and connected with the realities of your other parts?
  • What are the benefits of genuinely connecting with the others in your system?

__________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

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