April 22, 2012

Don’t Touch My Stuff !!

Posted in Compulsive Hoarding, Depression, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Hoarding, mental health tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 6:16 pm by Kathy Broady


Through the years, some of the most popular articles of the Discussing Dissociation blog has been about compulsive hoarding:  Compulsive Hoarding and Dissociative Disorders and Land of the Free?

I can’t explain their popularity on this blog, other than the way a rash of television programs have increased the awareness of the complications about hoarding. However, hoarding issues are typically accompanied by extreme anxiety, depression, isolation, family conflict, self-hatred, chaotic thinking, eating disorders and other problems also common with DID / MPD / trauma survivors.  Many emotional struggles are certainly not limited to the Dissociative population.  Hoarding is probably one of those disorders that the Dissociative community can potentially share with thousands of people more suited to other mental health communities.

It appears that hoarding is a much bigger issue than once officially recognized.  As a social worker who has done many home visits over a span of 25 years, I can say that I have seen hoarding issues repeatedly and yes, in my experience, hoarding is a consistent theme within various mental health populations, including dissociative trauma survivors.

How do we address these issues?
Does the professional “helping” community understand the depths of what is involved?
Do the mental health professionals really know what is needed?

On the various Hoarders shows that I’ve watched on television (such as “Hoarders” on A&E, and “Hoarding: Buried Alive” on TLC), most of these processes are expected to be completed within a matter of a few short days.  The interventions are quick, intense, and highly dramatic.  The hoarders have obvious struggles, and the gains made in their homes and living situations are typically significant and impressive, even if only one or two rooms demonstrate the successful changes.

Over the past few months, I’ve been thinking a lot about the groups of people that experience the anxiety, stress, distress, personal gains, relief, and emotional freedom from having professional organizers empty their houses.  There are many groups of people, in addition to the hoarder community, that may require assistance in emptying or reducing the amount of items located within a specific property or home.  These issues could surface in extremity, for example, after someone dies (especially when there is no one to inherit the stuff), or during a divorce settlement, or after a bankruptcy, or prior to moving to new home, or downsizing from a large home to a small home, or for any other reason people may decide to liquidate their possessions.

To me, just cleaning out a messy closet is a big job!  Emptying, or organizing an entire property is an enormous job! It’s an overwhelmingly huge job.

Recently, I hired some professional sales assistants to help me to downsize / sell many of the items from my home / office in order to prepare for a new phase of my life.  My children are grown up, and each has moved into their own homes as adults, giving me all kinds of options for what to do with the physical space that lives around me.  I don’t particularly like the “empty nest” phrase, and yet for the first time in dozens of years, I have more freedom to do whatever I want to do, wherever I decide to do it.  It’s exciting, and yet very weird feeling all at the same time. That’s all a long story, of course, and it has taken several months (years?!!) of hard work to sort through those kinds of things, including what to do with all the leftover “stuff” that everyone has grown out of.

I took weeks of time to pull out the cherished treasures I wanted to keep, and then left the rest for the organizers to pick through, and to present in the way they created a sale for the masses of people they invited to come dig through my things.  As much as I thought I had already selected my most important items, it was never that easy, or that clear.

“Wait!  Wait! Maybe I want to keep THAT afterall!”

Or, “Wait!  Where did you find that?  I didn’t SEE that before.  Give me that back!”

Or another rough part was seeing my things just tossed in the trash.  Can you believe that my favorite coffee cup ended up in the trash?!!  My FAVORITE one!  I thought I was going to have a melt down right then and there!

Breathe, Kathy, breathe!
Count to 10.
Ok, count to 100, lol.

The whole process was not anywhere near as fun as I had thought it might be.

In fact, it wasn’t fun at all.

It was really painful and horrible, to say the least.

And I chose to do it.  It wasn’t forced upon me.  It was MY IDEA.  ( yeesh, lol).

This changing, transitional experience has been much more complicated and emotional than I ever expected it to be, giving me all kinds of fodder for blog articles, and a much deeper understanding of the intensity felt by hoarders as they go through their housing changes.  Even though I had lots of time to prepare prior to my professional organizers arriving, and I was not forced into making these decisions in any way at all, I found myself having far more struggles, and feeling intense emotional turmoil, and frequently overwhelmed with memories (both good and bad) while sorting through the rooms of stuff.  Wow.  Yeeesh.  Gee Whillakers!  Jiminy Crickets!!  It was a much more difficult experience than I would have ever imagined it would be.

One thing is for sure.  For any television production company to expect to go through and toss away / give away 80 – 90 % of a hoarders belongings over a period of just a few days is just ridiculously cruel.  Most people — especially those that tend to be collectors in the first place — are not ready to let go with that much finality that quickly, or that easily.  There is no wonder the hoarders on the television shows have so many emotional outbursts – the whole process is set up exactly to create that kind of emotional conflict within them.  I suppose that makes for interesting television, but it is not very kind to the hoarder.

My experience of working with professional organizers also reminded me of some of the stories I have heard over and over from many of my clients with Dissociative Identity Disorder (DID / MPD).  Let me ask you a few questions.  Can you relate to any of these experiences?

As children or teenagers, or even as adults, have you felt violated when your parents or caregivers or family members rifled through your belongings without your permission to do so?

How invasive did it feel to have people touching your things when they were not invited to do so?
How powerless did you feel to see this, and to know you couldn’t stop it from happening?

How did this affect your personal boundaries?
How did it affect your ability to feel like something – anything – belonged to you, and to only you?
How did it affect your privacy, or lack of having any privacy?

When your boundaries were disrespected and exploited, what did you to do cope with the feelings you had?

With whatever trauma and / or neglect you experienced in your life, did you develop a greater attachment and emotional connection to physical items and personal items as a way to bond with something / anything?  Or did the repeated violations leave you distanced and unattached to your personal items, able to easily walk off, staying coldly disconnected and apathetic to having anything of your own?

How would you feel if someone took your things from you?  Or if someone threw your favorite items in the trash?  Or if someone broke an item that you cherished?  Would you have an anxiety attack?  Would you be angry?  Would you withdraw inside, crashing into depression?  Would you find yourself switching from insider person to insider person?

Does it feel good and more under your own control to keep the amount of your personal belongings to a minimum?  Does that feel safer for you, or does that feel like deprivation?  Do you prefer to have bunches of things, feeling safer being surrounded by stuff?  Does having layers of stuff feel like layers of protection?

How do victims of floods, fires, tornadoes, and earthquakes, or other natural disasters feel after suddenly losing all of their stuff?  Even if they evacuated with a few things, how would it feel to lose so much, so quickly?

It is interesting to explore these questions with yourself.  If you aren’t sure what some of the answers would be, try creating the situation, and let yourself experience it first hand.  Experience having someone else / something else take your cherished items from you.  Chances are, many of you reading this blog have already experienced these situations in your life.  But if you haven’t experienced this, don’t judge other people’s reactions and their big feelings about having “house invaders” mess with their things.  These experiences are a lot more difficult than you might have ever realized.

It certainly was for me.

Kathy

Copyright © 2008-2012 Kathy Broady and Discussing Dissociation

November 21, 2010

Freedom of Choice and Client Empowerment or Therapeutic Exploitation?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, Online Therapy, therapy, Therapy and Counseling, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:31 am by Kathy Broady


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I would like to make a follow-up comment from a comment made on the “What Would Your Perfect Treatment Plan Look Like?” blog.

Specifically, a portion of heartofindigo’s comment includes the following paragraph:
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a final comment: I wish that T’s would do exactly what you are doing, and ask. I have heard of so many… can’t think of a way to put this delicately… asinine demands on the patient. like the therapist doesn’t trust the patient’s process or intent or something. like the therapist has “superior knowledge.” unless one has DID, I don’t see how one can assume that they can make the judgment about what is working or not. that has to come from the patient, and so there HAS to be a partnership.
plus that will empower us to reclaim our power, which is the root of the problem in the first place.

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This is an extremely important point.

The dissociative survivor IS the expert for what helps them.

And from what I can see in reading through the comments in the previous blog, the normal 50-minute hour is far from helpful.  For most dissociative trauma survivors, it’s not sufficient, it’s not enough, and in many ways, it’s not helpful.  DID survivors simply need more time to make sufficient progress in therapy.

Should insurance panels be the final “experts” on how long sessions can be and on how many sessions a trauma survivor can have?

If DID clients are cash-paying for their therapy, can they make their own decisions about how much time they would like to have with their therapist?

Should therapists or counselors have the final say on how much time a dissociative client needs to work on their issues?

Should psychiatrists or doctors have the ultimate decision-making power to determine all treatment plans for dissociative trauma survivors?

Who gets to decide these things?  Are clients allowed to have freedom of choice and the freedom to want or request something more or different than the norm?   Do mental health professionals have the only vote about what is helpful?

In too many instances, treatment plans for dissociative survivors are designed by – and limited by — mental health professionals and insurance companies.  And all too many DID survivors truly do not get their therapeutic needs met because the mental health professionals are setting “appropriate limits” to what they are willing to offer their clients.  These limits are decided on based on the therapist opinion, and not on the clients’ needs.

In my personal opinion, a 50-minute session once per week is barely scraping the surface of what is needed to work with the dissociative population.  Most DID survivors have a minimum of 5-10 insiders that could productively use the therapy session time at any given day, and the issues that these 5-10 insiders would be discussing would not be simple issues.  Typically everyone in the DID system has complicated situations, painful issues, complex conflicts to discuss.  Is this going to happen in 50 minutes?  Not likely.  Is everyone going to get a turn in 50 minutes?  Absolutely not.  In reality, it would be more likely that each and every insider could fill up a 50-minute session!  To have to share such limited therapy time between so many inner people means that the pertinent and important issues just are not discussed in any great depth or detail.  It takes a lot longer to make progress because so much just can’t be addressed.

Because of dissociative walls, the need to switch between inside parts, amnesia between many parts, time distortion, other dissociative complications, etc., it very often takes a DID survivor longer to dig into the issues of the day, and longer to get grounded and stabilized afterwards.  Having the time to talk to a few of the insiders, to get their opinions about the topic, or to give them a chance to talk about their own issues does not happen quickly.

Part of what created and solidified dissociative identity disorder in the first place was having no where to discuss complicated, painful emotions, turmoil, and distress.  For the therapy hour to remain a drop in the bucket in terms of meeting the needs, it leaves the dissociative survivor feeling like they will never get through the healing process.   And in some ways, that is too close to being true.

But is it therapeutic exploitation to “allow” clients to have longer sessions and / or more than one 50-minute session per week?

When is too much?  If a DID client needs more than normal, even for the dissociative population, should they be allowed to have more sessions than normal?

Should therapists be “required” to set an “appropriate limits and boundaries” by insisting on short sessions, even if DID survivors say and believe they need more time in therapy?

If clients say they need 2-hour or even 3-hour sessions, should they be allowed to have extended sessions?  OR should therapists have the right and responsibility to limit these sessions to “normal limits” instead?

Whose opinion is correct?

In these situations, do therapists know best or do dissociative trauma survivors know best?

In case of a disagreement between the client and therapist, who should have the final say in length of sessions and frequency of sessions?

As heartofindigo stated, a big part of the healing process is about reclaiming personal power that was not allowed during the years of trauma.

Is freedom to decide length and frequency of sessions part of client empowerment?  Or part of therapeutic responsibility?

What are your thoughts about this dilemma?

———-

By:

Kathy Broady LCSW

http://www.AbuseConsultants.com

http://www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

November 21, 2009

Why Do You Need a Therapist Anyway?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, therapy, Therapy and Counseling, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , at 9:44 pm by Kathy Broady


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There have been some interesting discussions and comments from various trauma survivors about how much their therapists have meant to them.  These readers have shared some very tender moments with their therapists and have talked openly about the depths of their heart-warming connections and healing moments.

Clearly, these survivors have found their therapists to be important and significant people in their lives.  The work and the effort of developing these therapeutic relationships have clearly been worth it to them.

But why?

Why is their therapist important?

On the flip-side, other commenters in this blog have written about horror stories they have had with former trauma therapists.  It seems there is an endless supply of the “bad t” stories that get passed around and shared over and over.  I can’t tell you how many of those stories I’ve heard.  I’m sure each of you have already been told about at least a dozen bad therapists.  In these stories, the clients are angry with their therapist, they accuse the therapist of causing all kinds of harm, and they speak of these therapeutic relationships as traumatic or disturbing or exploitive.

Who are these bad therapists?!

Is there any trauma therapist that has not been considered to be a “bad t” by someone or another?  Honestly, most therapists get targeted sooner or later by someone. It happens frequently.  (Please remember the blogs about love/hate relationships and protecting your therapeutic relationship.)

So if there are allegedly so many bad therapists, or perceived bad therapists, why do trauma survivors repeatedly risk having a therapist in the first place?

Why does a therapist matter to you?

Why bother with the hassle of developing and maintaining a therapeutic relationship?

Why does a therapist warrant your business, your time, your respect, or any caring connection from you?

What does a therapist do anyway?

There are a variety of reasons why dissociative trauma survivors might find therapists to be important.  I’ve listed 50 benefits of having a therapist. This is not an exhaustive list. If you have an idea to add, please comment.
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50 Benefits of Having a Therapist

1.   To have someone encourage you to love and accept yourself to the point that you can truly live, without focusing on death and needing to die
2.   To have someone in your life that will make it ok to not have to dissociate away from your real life
3.   To have someone to bounce ideas on, to problem solve, to explore new behaviors
4.   To have someone to talk to about deeply private and personal things
5.   To have someone who can genuinely hear your pain, and sit with you when you are hurting
6.   To have someone who can give you their undivided attention, their best listening ear, even if for a specified period of time
7.   To have someone who gives you courage and hope to keep going, even in the darkest moments
8.   To have someone who provides a gentle, safe environment for the healing of your deepest wounds and painful memories
9.   To have someone who repeatedly offers positive emotional support and encouragement
10.  To have someone who sincerely believes in you and your abilities, talents, and accomplishments
11.  To have someone who truly sees you as a good person, a worthwhile person, a valuable person
12.  To have someone who will address the variety of issues that underlies the mental health difficulties in your life.
13.  To have someone who will build a relationship with you, willingly connecting with you, no matter how badly you feel about yourself
14.  To have someone who will challenge your thinking and cognitive distortions
15.  To have someone who will connect the dots of your dissociated life experiences
16.  To have someone who will encourage you to be comfortable becoming your very own self
17.  To have someone who will encourage you to build a life based on your strengths instead of the life your abusers may have designed for you
18.  To have someone who will encourage you to try new things and to stretch your horizons
19.  To have someone who will expect you to honestly work on your issues instead of blaming others
20.  To have someone who will foster your leadership skills, job skill development, educational opportunities, etc.
21.  To have someone who will genuinely accept you, warts and all
22.  To have someone who will have the courage and ability to tell you “no”
23.  To have someone who will hear your heart and the depths of your soul
24.  To have someone who will help to remove the jagged edges from your life
25.  To have someone who will help you build a tolerance and acceptance of others
26.  To have someone who will help you create personal safety, both inside and out
27.  To have someone who will help you find and connect with your very best self
28.  To have someone who will help you to build the ability to tolerate and sit with intense emotions in yourself and in others
29.  To have someone who will help you to contain the extremes of your behavior and feelings
30.  To have someone who will help you to emotionally grow, develop, mature
31.  To have someone who will help you to move past the blocks, walls, and black holes
32.  To have someone who will help you transform self destruction into self acceptance
33.  To have someone who will hold you accountable and responsible for troublesome areas
34.  To have someone who will hold your secrets with you
35.  To have someone who will listen to you, and understand your point of view
36.  To have someone who will look for the positive in each and every one of your insiders
37.  To have someone who will make it safe enough for you to express your true feelings
38.  To have someone who will offer encouragement and support, even when its tough
39.  To have someone who will offer guidance as needed
40.  To have someone who will offer opportunities to explore trust, acceptance, compassion, kindness, gentleness, patience
41.  To have someone who will push you to move forward, instead of sitting complacently
42.  To have someone who will recognize family dynamics and their impact on you
43.  To have someone who will remember what your insiders say, especially when it is too difficult for you to retain it
44.  To have someone who will set appropriate limits and boundaries
45.  To have someone who will sit with you while you face your deepest fear, shame, guilt, horror
46.  To have someone who will sort out conflict and disagreement
47.  To have someone who will stay with you, even when you expose your worst self
48.  To have someone who will talk to your inner parts, even the ones you are afraid to speak to or unable to speak to
49.  To have someone who will teach and model new behaviors, and healthy emotions
50.  To have someone who will team up with you in your healing journey

True therapy is so much more than a sequence of techniques to address trauma, or emotional containment, or cognitive distortions, or dissociative separation, or destructive behaviors.

Therapy happens with real people, between real people.  Therapy is a healing process.  It touches many levels of life. The emotional depth of true healing is founded in the solidity of the therapeutic relationship.

Unfortunately, your trauma and abuse happened at the hands of violent, hateful, destructive people.

Fortunately, your healing will happen within a caring, accepting, compassionate relationship.

———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

August 30, 2009

Protecting Your Therapeutic Relationship and the Therapeutic Community

Posted in Dissociative Identity Disorder, Therapy and Counseling, DID Education, trauma therapist, DID/MPD, therapy, Therapy Homework Ideas, Self Injury, Borderline Personality Disorder, Transference Issues tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 2:44 pm by Kathy Broady


There are thousands of clinical therapists in the world.

However, of all the therapists in the world, only a few work with trauma and PTSD.

Of all the trauma therapists, only a few work with the areas of sexual abuse and severe trauma.

Of those therapists, only a few work with dissociative disorders, DID/MPD and DDNOS.

Of the DID therapists, only a very few work with issues relating to organized perpetrator groups.

And in that small subset of therapists, only a few work with more than two or three dissociative survivors at any one time.

And it is the rare therapist among that already vanishingly small number who stay in the field for more than a few years… or long enough to gain the experience they would need in order to be most helpful to the population of clients they serve,

So of all the thousands and thousands of therapists in the world, there are relatively very few who will have the kind of knowledge and experience that you are looking for when you need a specialist in the areas of trauma and dissociation.

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Why do so many therapists refuse to work in this area when there is so much need?

And why do so many therapists leave the field after committing years of dedication to dissociative survivors?

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It’s time to be honest.

First – please remember, I am one of the rare few who has stayed loyal and passionately dedicated to the fields of trauma and dissociation for more than 20 years.  It is hard to find trauma therapists with that much commitment to the dissociative population.  I am on your side – I will prove that over and over – but I am going to be honest.

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DID’ers are a very difficult population of people for a therapist to work with !!!!

Now don’t get me wrong.  Some of you are absolutely wonderful – without question, the most incredible heroes and the very most courageous people I have ever met.  Those of you in this category are absolute diamonds, and I really cannot say enough positive things about you.  You all are truly inspirational, and I am honored to work beside you.

Unfortunately, those who are genuinely dedicated to their therapy and who work hard to achieve their deepest healing are all too often undermined by the few survivors who are willing to do anything but work on their healing.

Oh, these survivors will SAY they are working in therapy…. They will CLAIM they are dedicated to their healing…. They go through the motions, and they spout all the right words.  To a point.  And then they don’t anymore.

Because in reality, this small number of survivors is more interested in hurting other people than they are in healing their own pain.  They are more interested in destroying others than they are in helping themselves.  They are willing to lie about anything or anyone just to get attention drawn to themselves.  They are very destructive and they are very sick.

And these destructive survivors could be costing you a lot more than you realize.

Ouch.

I am sure as a population, this is not pleasant to hear.  Please know that I am not saying this to all of you.

Those of you that are genuinely dedicated to your healing know exactly what I am talking about – I’m sure – because you have most likely already witnessed your healing resources being used up, beat up, and exhausted by fellow survivors whose intentions were far from honorable.  The survivors that do this are sabotaging those of you that are truly trying to heal, because the therapeutic field gets completely burnt out by “them” and ends up not having the time or energy or interest to work with you.  Many good therapists simply will not be willing to risk working with other survivors after they have had some bad experiences with these destructive survivors.

So… the survivors that are undermining your therapists are doing harm to themselves, to the therapists, and to you.  They are attacking, abusing, and destroying your therapeutic resources, leaving  you with less.  These “bad apples” are giving the whole dissociative population a bad name, and frankly, this kind of behavior should not be tolerated by any of us.

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Now what?

If you all want mental health professionals to stay working in the fields of trauma and dissociation, it is important to make that work worth it to them, and not a “nightmare” for them.

I am not saying that you have to feed the egos of the therapists, or provide support for them, or do any freaky weird boundary violations.  Therapists became therapists for intrinsic reasons of their own.  We don’t need y’all to “make it worth it” to us by what you give to us.

Therapists want you to make their work worth it by allowing them to genuinely do their job.  We want you to address your issues, work on your healing, stay focused on your system, be honest with your feelings, etc.  If you will do your job of focusing completely on your own healing, we as therapists will be thrilled with that.  Your genuine progress will be our reward.

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That being said, what can you do to protect the relationship you have with your therapist in particular? And how can you do your part to protect the resources available in the therapeutic community, so that therapists are more motivated to enter and remain in the field, and more survivors have the opportunity to work with truly skilled professionals?

How can you separate yourself from those survivors that are destructive?

How can you make sure you are helping the problem, and not creating the problem?

Here are some ideas of what NOT to do:

  • Don’t lie to yourself and expect others to believe you.
  • Don’t lie to your therapist.  How can you heal if you are not honest in your sessions?
  • Don’t lie about a therapist.  Don’t believe lies about a therapist.
  • Don’t gossip about a therapist. Don’t believe gossip about a therapist.  Don’t spread unfounded false allegations.  Don’t chase off or destroy therapeutic resources with false accusations.
  • Don’t forget to examine your transference feelings, and recognize them as transference issues.  Don’t forget how projection, transference, displacement, and amnesia can affect your thinking. Work openly and genuinely on these issues instead of blaming the therapist.
  • Don’t attack a therapist because you are too afraid to address the real source of your anger.
  • Don’t let therapists become the “bad guys” in your definition.  Therapists are your helpers. They are there to help with your healing.  Learn quickly how to define the helpers from the hurters, and address that confusion as often as necessary.
  • Don’t assume that all “survivors” are automatically being honest with you (or themselves) when they are trashing a therapist.  Remember, they may be in the “hate” cycle of the love-hate dynamic.
  • Don’t assume that all “survivors” are working for the betterment of the survivor community.  Some so-called survivors are truly moles from the dark sides of the world, and are here to cause trouble in any way they can.
  • Don’t let your jealousies and insecurities consume you and destroy your focus.  If you want your therapist all to yourself, hire them to work 40 hrs per week at their full hourly rates.  If that is not an option, be mature enough to know your therapist is going to have other clients.

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Here are some ideas about what TO do:

  • Be genuinely honest with your yourself. The more honest you are, the more healing you will accomplish.
  • Be genuinely honest with your therapist. Your therapist can help best when they genuinely understand the issues.
  • Remember that your healing is to be focused on you, your behavior, your feelings, your mistakes, your strengths, your weaknesses, etc.  Your therapy is about you, so keep the topics focused on you, even when it is hard to look at yourself.
  • Do your own internal system homework in between sessions.  Your healing will progress as you put your own time and effort into it.
  • Be kind, appreciative, thankful, and polite.  This doesn’t mean to grovel or do penance.  Just use normal social manners and social politeness.
  • Remember that your therapist does not have to be your emotional (or physical) punching bag. If you are hitting too hard, redirect your anger towards your abusers, where it belongs.
  • Give yourself adequate time to work through the complexities of your healing process. An experienced therapist will not rush you, and it is truly ok for you to take as much time to heal as you need.
  • Separate yourself from other survivors that are troublemakers and instigators of negative drama.  Just like school days, if you hang out with people causing harm, you’ll end up doing the same, or being tangled in their web. Their poor behavior will cost you.  You can decide if that is worth it to you or not.
  • Ignore the drama queens determined to cause trouble in front of you.  If you refuse to buy into their antics, they will move on to other pastures.  If you give drama precedence over your own healing, you will not be progressing in your own healing.  Protect the entire dissociative community by supporting your therapeutic resources.
  • Remember to think for yourself.  All too often, survivors listen to any strong, authoritative voice that tells them what to do.  If someone is telling you negative things about your therapist, set a boundary, stop, and re-evaluate all sides of your situation.
  • Talk openly with your therapist about any concerns you have.  Give yourself the chance to problem-solve any difficulties or conflicts that arise.  Working through conflicts is an important part of your healing process, and it does not necessarily require a therapeutic rupture.

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If you can truly apply these guidelines, you will be honoring your own healing. You will also be showing respect to your individual therapist, protecting other ongoing therapeutic relationships, supporting the greater survivor community, and enhancing the larger therapeutic community.

Maybe most of you think that you are not actively involved in the destruction of the therapeutic resources, but if you support it, believe it, allow it to go on by your “friends”, etc, then you could be more involved than you realize. You can either help to maintain effective therapeutic resources, or you can allow their destruction.

It’s a conscious decision that each one of you has to make.

Everyone has to do their part in protecting the few therapeutic resources available for dissociative survivors.  You can choose to support the destructive people, or you can choose to kick them to the curb, and get along with your own healing.

Remember, if you genuinely focus on yourself and your own healing, then you are doing all you need to do.

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By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

July 16, 2009

Being Hated, Feeling Hated, Overcoming Self-Hatred

Posted in Depression, DID/MPD, Dissociative Identity Disorder, Family Members of Trauma Survivors, Self Injury, sexual abuse, Therapy and Counseling, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:45 pm by Kathy Broady


Practically every dissociative trauma survivor that I have ever spoke to has said to me at some point in time or another, that they have felt hated, truly hated. What’s worse, they didn’t feel hated by strangers — they felt hated by their loved ones. They felt hated by their mothers, their fathers, their siblings, their spouses, their children, their friends. They felt hatred from the very people they cared the most about.

What effect does feeling hated have on someone?

How does this experience change someone’s life?

It’s a natural human response to want to feel liked, loved, cherished, treasured. Children very much want to be the in the spotlight for their parents, the apples of their eyes. They each want to feel special, and to be treated like they are the most important person on earth. This is normal for children. It is part of a natural, normal, healthy development.

What happens if a child does not experience a positive sense of self in early childhood?

What happens if that child feels hated instead of loved?

What if the only time the child feels loved, accepted, appreciated, wanted is during times of sexual abuse?

What happens when abusive parents treat their children in such consistently abusive and neglectful ways that the children are left with feelings of self-hatred instead of self-love and self-acceptance?

What are some of the effects of being hated?

  • Inherent sense of badness and worthlessness
  • Long-term self-hatred and self-loathing
  • Loneliness and Isolation
  • Sadness, emotional pain, emotional scars
  • Self-injury, self-destruction, and suicidal behaviors

Children that are treated with hatred internalize that hatred. Children find it difficult, if not impossible, to blame their parents for their hateful behavior. Instead, children will blame themselves. Children decide it must be their own badness, their own poor behaviors, and their own inadequacies that forced their parents to not love them.

With each violent assault, abusive parents spoke hatred to their children. Even if the words “I hate you” were never said, it was understood clearly enough by the children. In order for their loved ones to purposefully cause so much hurt and harm to them, their parents must have hated them. It is not hard for children to figure out that people causing physical injuries and emotional wounds are acting in hateful ways. Children will feel that hatred to the very core of their being.

Children tend to internalize that hatred as if they deserved it. They decide that they must be bad, they must be worthless, they must “need to be punished”, they must “need to be abused” because of their badness. Children cannot blame their parents — so they blame themselves.

The more the children are treated with hatred, the more the children hate themselves.

They may learn to hate the parents / abusers eventually, but their first response was learning to hate and despise themselves. And the self-hatred isn’t something they just grow out of or leave behind the way they might leave the actual abuse. Self-hatred can continue to affect them for all the years of their life. It is a fundamental part of self-injury behaviors. Without intense self-hatred, survivors would not be nearly so prone to cutting, burning, overdosing, or any other number of self-destructive and suicidal behaviors. It’s not uncommon for trauma survivors to carve or burn “I hate myself” messages into their body, sometimes scarring it for life. I dare say, most survivors that commit suicide were able to do so because of their incredibly deep sense of self-hatred and self-loathing.

People that truly hate themselves don’t want to live with themselves.

It’s equally difficult for people that hate themselves to be in long-term positive relationships. Trauma survivors often find it easier to love someone else more than themselves, but part of being in a positive loving relationship is comfortably accepting the reciprocal love-caring-compassion-support from others. People that inherently hate themselves find it very difficult to believe that they could be loved / lovable. This belief will ultimately (and repeatedly) be noticeable. It will cause problems in those relationships, and it will absolutely undermine the strength of those relationships.

The emotional pain connected to feeling hated digs very deep within the core of the person. It is hard to battle on an intellectual level, and it penetrates into the deepest layers of the person’s being. The emotional wounding caused from feeling hatred is one of the most difficult traumas to heal. Layer upon layer of years of blame, guilt, shame make the self-hatred feel locked into place. It’s just soooo hard to feel differently.

But part of healing from trauma involves healing from that self-hatred. Survivors may not be able to change the behaviors and actions of their perpetrator parents or any other abusers that have acted criminally towards them, but survivors can learn to separate themselves from such hateful people. It will take working with all the parts of the internal system, but then again, remember that healing for all the inside parts is important.

Learn to separate who did what, and what belongs to whom. The person that committed the hateful acts is the creator of the hate. That negativity belongs to them. Hateful people can project their own feelings of hate onto anyone around them. As survivors become old enough to think through the emotional process of their abuse, they can begin to build emotional protection around those kinds of hateful attacks.

Let the hate belong to the ones that sent it. Don’t take it in, don’t claim it as yours, and don’t let it apply to yourself. Picture a strong emotional, spiritual shield around you, and let that protect you from the barbs of the haters. Hold tight to your own feelings of kindness, compassion, caring, gentleness, and know that your own ability to love and to connect are coming from a different place than hatred. Recognize that your ability to genuinely care for your loved ones is proof in itself that you are not to be hated or considered worthless. Your ability to feel genuine kindness, gentleness, patience, and compassion prove that you are a good person, completely different and separate from the haters.

The haters will always be haters. Unless they work on their own deep-seated self-hatred, they will always project hatred onto others.

But you don’t have to accept yourself as a rightful target of their hatred. You don’t have to be one of them. You don’t have to shove hatred in the face of everyone else, and you don’t have to internalize it within yourself. You can be different from that. Let the hatred belong to the ones that it came from. Give it back to the abusers and let them own it for themselves. Don’t contain that for them. You don’t have to accept their hatred as yours when it came from them.

Spend your time in life doing things that you enjoy and let you genuinely feel better about yourself. Connect with the people and animals that you care about, and build bigger boundaries and stronger separations from the people that treat you with hatred. Give positive time and pleasant experiences to the people around you, and let your own behaviors define who you are.

Be a good person, and let the very fact that you are choosing good, positive behaviors define to you that you are not that hated person you once felt you were.

If you want to be a good person, you can be. You are not who your haters say that you are. Let their nasty ways belong to them. You can be someone very different from them.

You can be as good of a person as you want to be. No one else gets to define you — the final word on who you are belong to you, and only you.

__________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

February 16, 2009

Do’s and Don’ts for Singleton Friends of Multiples

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Friends of Multiples, Supportive Spouses tagged , , , , , , , , , , , , , , , , , , , , , , , , , , at 10:02 am by Kathy Broady


I am not sure who wrote the following list of “Do’s and Don’ts for Singleton Friends of Multiples”.  This list was e-mailed to me years ago by a person with Dissociative Identity Disorder, saying this list was comprised by an anonymous group of multiples.  I have had it posted on AbuseConsultants, in the survivor poetry section of that website.

I am sure that there could be many other suggestions added to the list, but for today, I will post it in exactly the same format as I received it.

For anyone wanting to offer friendship and support to a person with Dissociative Identity Disorder, a group of multiples have suggested the following helpful guidelines:

.

Do’s and Don’ts for Singleton Friends of Multiples

  • Do NOT ever touch us from behind.
  • Do NOT ever touch our throat.
  • Do NOT ever touch the back of our head.
  • DO speak to our inner children like children.
  • Do NOT ask “Who’s here now?” If we wanted you to know we would tell you.
  • Do NOT tell an alter that you don’t know to “go get” the host…there could be several of the same name…different age groups.
  • Do NOT expect consistency of feeling, thought, or action on any subject.
  • Do NOT tell anyone to go inside because you do not like their views.
  • DO set healthy boundaries.
  • If you are uncomfortable with something said or done, say so, and do NOT avoid us in the future without an explanation.
  • Be HONEST.
  • Be understanding that we have many crisis situations in our lives of healing from our abuse, i.e.: flashbacks, panic attacks, body memories.
  • Laugh, make jokes with us, really, it’s OK!
  • Do NOT assume anything if you honestly want to know about our “disorder” please ask, we’ll tell you the truth.
  • Do NOT treat us like “the freak you happen to know” around your singleton friends.
  • Do NOT use our difficulties as a subject of conversation with your singleton friends.
  • Sometimes we are paralyzed with depression, and cannot call you, clean our house, or get out of bed. Don’t take it personally.
  • We will fight being hospitalized….. even though we actually show that we need it at the time. Hospitals are extremely frightening for us.
  • DO be supportive of our healthy behaviors no matter how small the accomplishment may seem to you.
  • DO be encouraging.
  • When we ask to talk to you, we aren’t asking you to come up with answers to our problems. We don’t expect you to FIX it. Sometimes we just need someone to LISTEN… that is the greatest gift of all!!
  • DON’T tell us that the abuse happened a long time ago and for us to “just get over it!” That is a HUGE insult!!

.

For those of you that are multiple, what other suggestions would you add to this list?

Do you agree or disagree with the suggestions as listed?

What have you needed your husband or wife to do – or not do — specific to your needs as a trauma survivor?
.

Your thoughts, comments, and suggestions are welcome.

__________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

January 1, 2009

Is Your Life How You Want It to Be?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 7:33 pm by Kathy Broady


Happy New Year !!

I’ve been thinking for hours now about what kind of profound post I would make at the beginning of this new year.  My words are still trickling in slowly….

So, while I’m thinking, I’ve decided to ask you all what you are thinking….

What are your goals for 2009?

And, seriously, if you could rule the world this year, what would you do?  What changes would you make, and how would you bring those about?  How would you address the world economy?  How would you approach world peace? What would you do about famine, wars and diseases?

Wouldn’t it be nice to be able to fix such big problems with just the snap of your fingers.?!

Ok, ok, so all that is just a little too unrealistic.

It doesn’t hurt to dream, but let’s talk about the worlds you can control – you own life, your own system, your own internal worlds.

At this stage in your life, you do have a lot of input into what happens in your life.  You aren’t a helpless, child without resources or power.  You are grown.  You are much older, and while you might be stuck and struggling at certain points, you truly do have considerably more freedom, more power, more options, more control than you had in your early years of life.  You can’t change the past, but you can make it so the past does not cripple your present so much.  You can make this year, these days, even right now, better for yourself.

I’m just sure you can.

It’s not necessarily easy and it might take a whole lot of hard work, but you do have the ability to make things better for yourself.

So let me ask again.

  • What are your personal goals for 2009?
  • What are your hopes? your dreams?
  • What could realistically happen for you this year if you really worked for it?
  • What areas of your life do you want to heal?
  • What do you want to happen within your own system?
  • How are you going to help your internal parts this year?
  • Who do you want to meet from within?
  • Who do you want to establish a friendly, working relationship with from within your system?
  • Who do you want to connect with in the external world?  Even if that means mending some fences, and working through conflict issues?
  • With whom do you want to create stronger boundaries, so you aren’t as vulnerable or as abused by them?
  • What topics are going to be the focus of your therapy?
  • What areas of your life are you willing to leave on hold for now?

We are each in charge of our own lives.  Some say that to a very large degree we actually create our own lives.  I understand that some things happen outside of our immediate control.  However, we can decide to work around and grow past those obstacles, no matter how big they are. As much as we have to work with the cards that we have been dealt, we also can make decisions in the current day to make our lives more how we want them to be.

What do you want for yourself this year?   How hard are you willing to work – learn – research – stretch – push yourself to get that?

If getting something new and better in your life means letting go of something familiar but “crappy”, are you willing to do that?  Are you willing to prevent or refuse to allow victimized thinking that keeps you stuck in places you don’t like?  Are you able to find your own way, your own strengths, your own power, your own ability to think?

Do you believe in yourself and your self worth enough to get something better?

It’s a New Year.

What’s going to be new about your year this year?

__________

by:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

December 23, 2008

10 Qualities Therapists Recognize in Good Clients, part 2

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, therapy tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 7:15 pm by Kathy Broady


Hello to all my Readers,

I hope this day finds you doing well.

The first part of this article certainly caused a little stir, and maybe raised a few eyebrows along the way.  Please know, my intention in posting these blogs is not to offend anyone.  If you have any questions or concerns about anything I’ve posted, please comment and let me know what you’re thinking!  And here’s a big Thank You! to the folks who did comment to the “Part 1″ post.  I appreciate that.

Let me try framing the context of this article.  In previous blog posts, we’ve been discussing questions to ask a new therapist.  This article is, in some ways, a follow-up to that idea, because these are the kinds of things a therapist is going to be thinking about / assessing in new clients as they arrive at their door.  These are also the strengths that you want to emphasize when you are meeting a new therapist.

If you approach your therapy keeping these qualities in mind, you will honestly find that more therapists will stay interested in working with you for the long haul.  That is not to say you have to be perfect.  Who is???!  It means, work on these things.  Be mindful of them.  Developing these strengths will make you a better person overall, and that is very much the goal of therapy.

These qualities, in my opinion, have nothing to do with mental illness.  I have worked with some very disturbed people with huge issues, and yet, they possessed these qualities, and they made huge progess in their healing.  I’ve also seen some folks who appeared to be rather high-functioning, and yet, they did not, or could not grasp some of these basic ideas.

I agree with the brave soul who commented that these qualities are an important part of everyday life.  The more that survivors strive to incorporate these strengths into their approach to everything, the better.  Your self esteem will improve, your self-dignity will be solid, and people around you will appreciate you more.

I don’t expect every trauma survivor to have a solid grasp on these qualities, but I do hope every trauma survivor strives to.

Intermingle these strengths into your life everywhere that you can.  You’ll be glad you did!

And here is part 2 of the article, “10 Qualities Therapists Recognize in Good Clients”:

6. Honesty and Trustworthiness

  • Are you willing to be honest with yourself?
  • Are you willing to lie to your therapist, or hide information, or lie by omission?
  • Do you gossip and tell lies behind people’s backs?
  • Do you gossip about your therapist?
  • Do you lie to your inside parts?  Does anyone in your system try to trick or deceive the others in your system?

Therapeutic relationships are built on honesty and trust.  Your therapist will need to know you possess these qualities as well.

7. Loyalty

  • Will you treat your friends and family members with kindness and respect even if they have done things you do not like?
  • Will you loyally protect your internal system from predators and perpetrators, putting the safety of your inside parts as a priority?
  • Are you loyal to your therapeutic process and will you keep clear boundaries around the therapeutic process?
  • Will you respect your therapist’s trust in you to the same degree that you expect your therapist to respect your trust in them?
  • If you and your therapist experience a conflict, where do you look to resolve that? Do you expect to resolve the conflict within the context of therapy, or will you spread the conflict outside the therapeutic relationship and draw others into it?

Your therapist and support team can be your greatest allies in your healing journey.  However, a deep level of mutual respect is expected and needed in order to progress in therapy.  It is crucial that you thoroughly differentiate the “good guys” from the “bad guys”.  Therapists understand the concepts of transference and projection, and they will work with you in those tender moments, but there will be limits to that. I can promise you, your helpers do not want to be thrown under the bus any more than anyone else.

8. Creativity

  • Are you determined to do the same things over and over again?
  • Are you open to trying new options?
  • Can you think outside of the box instead of being boxed in?
  • Do you help to problem-solve the various dilemmas that surface?
  • Will you work on ways to reach even the most difficult of insiders?  Even if this involves several failed attempts before you successfully connect with these parts?

We’ve all heard the saying, “the definition of insanity is doing the same things over and over again, expecting to get different results.”    A huge part of the healing process is learning new things and doing different things.

9. Gratitude and Appreciation

  • Do you appreciate what people do for you?
  • Do you recognize when someone is doing something for you?
  • Do you thank them for helping you?
  • In relationships, do you overlook smaller imperfections in appreciation of bigger strengths?
  • Do you thank others in your dissociative internal system for the ways they have helped you to survive through the years?  Do you recognize their strengths and talents in the current day?

Gratitude and appreciation are key elements of any healthy relationship.  Don’t take the goodness of others for granted.  Be thankful for what you receive from others.

10.  Safety

  • Are you a safe person?
  • Do you use threats of violence, or threats of harm to others, or threats of emotional blackmail, or threats of any kind to destroy or control other people or to get your own way?
  • Do you threaten self-harm or suicide as a way to manipulate others or to get your own way?
  • Are you willing to hurt yourself or someone else in order to get your way, including others in your internal system?
  • How far is “too far” to go to get what you want or prove you are “right”?  Do you think there is such a thing as “too far”?

Therapists will model safe behavior.  If you are acting in ways that are unsafe for yourself or manipulative of those around you, your therapist will set boundaries with you — just as you should set boundaries with someone who is unsafe in your direction.

If you follow these guidelines, you will have a much better relationship with your therapist and others around you.   If you are looking for a new therapist, remember that the more you can genuinely offer in the areas listed above, the more those therapists will view you as a client with potential — and the more positive potential you demonstrate in these areas of your life, the greater interest more therapists will have in working with you.  It goes to your advantage, your healing, your self-respect, and the amount of respect others will feel toward you to learn these things.

All people, including trauma survivors with Dissociative Identity Disorder (DID/MPD), can claim these strengths as their own.  Work hard to be a “good person” in your therapy, and you’ll be amazed at how much difference this can make in your relationship with your therapist and with your system.  Remember:

Maintain your stability the best you can.
Be dependable in what you do, and do what you say you will do.
Maintain your motivation and your willingness to work hard.
Be courageous, even when it is scary.
Stay clear and upfront about your personal responsibilities.
Be honest and trustworthy at all times.
Stay loyal to your helpers.
Be creative in the hard times.
Have gratitude and appreciation for the good things and good people.
And be a safe person.  Be safe for yourself, and be safe for others.

You can do it.  I’m just sure of it.

__________

by:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

December 14, 2008

Blocking Therapy vs. Therapeutic Mismatch

Posted in mental health, therapy, Therapy and Counseling, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:36 pm by Kathy Broady


Castorgirl’s comment to the article “Therapy for Trauma Survivors, Part 1″:

Hi Kathy,

An interesting post. It raises many issues that have been a struggle over the last three years of therapy…

The question whenever things don’t seem to be going well in therapy always seems to come back to – “Is this our fault?” Are we sabotaging our own recovery, misinterpreting what has been said or meant.

It always brings forward the issues from the past about the health professionals being infallible and beyond questioning. We’ve just tried to question our therapist, and it hasn’t gone well. Our first foray into challenging a health professional has pretty much come crashing down around our ears…

In a rather rambling way, we’re trying to ask what indicators can you use to see whether it’s a block from us, or a therapeutic mis-match?

Great thought provoking blog…
Take care…

Thank you, Castorgirl, for asking such a great question.  I wish there was an easy answer.  This is actually a very big question with lots of layers to it.  I could probably make several different posts from this question, each with a different approach.

I have a response for you, but please remember, there are just my thoughts, are cannot be taken as medical advice nor are they to replace or usurp the recommendations of your therapist. (Please see my disclaimer.)  For the purposes of this post, I am going to write it from the perspective that the therapist is not making any grave errors.  Addressing therapeutic blunders is a big topic, and will reserved for another day.

I want to commend you for talking with your therapist about the issue at hand.  You have taken an important step in talking to your therapist about it, and that’s excellent.  Even if it didn’t go as well as you wanted it to, you initiated a conversation about it, and I strongly encourage you to keep working on it.  But do your homework – meaning… explore your feelings on your own as well, and see if you can move yourself forward through it.

Actually, I don’t think for a second that health professionals are infallible.  We all make mistakes and that very fact makes therapists’ human too.  However, when we have our “Therapist Hat” on, we make a conscious shift in our heads and our thinking to put our energy and attention on the client.  We’ve also been given rules, guidelines, boundaries, and restrictions to follow from our employment agencies, training institutions, educational facilities, and theoretical perspectives that highly influence our thoughts and our behavior.  We may very well approach conflict in therapy different “in the office” than we do in our personal lives.  Remember that the point of therapy is to be about you, the client, and even in rough patches of the therapeutic process, therapists will tend to keep that mindset in the forefront.

I’m guessing that most therapists examine the interaction between themselves and their clients with the greater focus on their client, what the client is doing (or not doing), saying (or not saying), expressing (or not expressing), etc.  Part of keeping the therapeutic process about the client is by keeping our thoughts and interpretations on the client, while keeping our thoughts about ourselves more neutral or in the background.  Otherwise, the therapy process becomes about us, and that becomes a boundary issue.  Particularly complicated problem points are when the client does something that is actually harmful or damaging to the therapist, or vice versa.

Keep in mind that all relationships have simple misunderstandings and small pockets of confusion.  Little mistakes are not the end of the world.  If you find yourself blowing normal miscommunication issues up into huge conflicts, then chances are, you are adding other personal issues into the situation.

You would probably be surprised to see how many conflicts with therapists are actually directly connected to projections / transference issues related to the client’s painfully unresolved mother- father-family-trauma issues.  As cliché as it sounds, the biggest portion of therapeutic conflict can be seen in the “this is actually about your mother” context.  The therapeutic relationship, while it is a current-day professional relationship, becomes the battleground for all the emotional hurts and deep heart wounds of the years past.  Because an element of caring and emotional attachment builds between the therapist and client, all too often conflicts arise when the client expects the therapist to fulfill too many of their unmet emotional needs.

Of course, a huge part of therapy is experiencing a correction of formerly wronged emotional experiences.  But there is a limit to how far a therapist can go in terms of meeting those unmet needs.  There will be a boundary line. It’s understandable that when this line is approached, and the client wants more from the therapist than the therapist can give within their professional or personal limitations, there will be a conflict.

That means many clients get their feelings hurts.  The therapist often becomes one of the very most important people in the client’s life, especially for trauma survivors who have poured out their heart and soul in their healing process.  Even being as critically important as therapists are, therapists can’t necessarily participate in the important social events for the client, or be emotionally or physically or therapeutically available as their clients want them to be.  Many times, therapists can’t even approach the client, or make the first phone call, or offer extra time.  While the professional opinions on proper therapeutic behavior vary greatly, the point being, to maintain proper boundaries, therapists have limitations to what they can do.  Many client requests will be denied because they go too far outside of the therapeutic box.

One of the very biggest blocks that clients can do that will harm or destroy their therapeutic relationship is to not talk about these conflicts with the focus on their own thoughts, feelings, behaviors.  Remember, the goal in your therapy is for you to learn more about yourself and to learn more about how to be personally responsible for your own health and well-being.  If you insist on defining the issues as “the therapist’s problems”, then you have missed the boat of what your therapy is about.  That doesn’t mean the therapist doesn’t have problems.  It means, you are trying to distract from your issues, and your therapist is not to be the focus of your therapy.  Keep the focus on yourself.  If you want to make gains in your therapy, talk about you.  Examine your wants and needs.  Examine your behavior.  Poke at your beliefs.  Keep it all about you, you, you.  And protect this time.  Treat it as precious for you.  Having the time to work on your healing is incredibly important, so don’t share the focus with anyone else.

Because it is your therapy, claim the issue as your own.  Attacking or blaming your therapist isn’t going to help you address your own issues, nor will it help your therapeutic alliance.  If you are really in therapy to address your own issues, then even in situations where there are potential conflicts with your therapist, first look at how the conflict relates to you.

Talk openly about how the painful conflict at hand affects you.  Be courageous enough to look at the painful historical roots for this issue.  Be willing to see how this current conflict has shown itself in your life, time and time and time again.  Look to old family dynamics and find the parallels.  Look at how this new wound is similar to previous wounds.  When you find those connections, you will be making progress.

Ask yourself: Why does this bother me? And what’s under that?  And then what?  And then what?  Peel the emotional onion, in terms of getting further down into the root of the issue.  Your therapist will be able to help you do this, but you have to be willing to look at it from that perspective.

If you are unsure if there is a therapeutic mismatch, use the same approach in tackling that issue.  For example, write out a list of the things that seem mismatched.  For each individual issue, ask yourself why that bothers you.  Take this first answer, and ask yourself why that bothers you.  Take your second answer and ask yourself why that bothers you.  Take your third answer, and ask why that bothers you.

Remember, there are many good therapists out there.  If your needs truly clash with the style of a particular therapist, then thank them for what they have offered you, and simply move on to someone else.  Don’t assume the therapist will or can change to be what you want them to be. It doesn’t mean the therapist is “wrong” or “bad” for not doing what you want them to do.  They are who they are, and they have their style of working in place.  I use this metaphor:

If you don’t like the food at a particular restaurant, then go to a different restaurant.  It would be unreasonable to throw a hissy fit in a Chinese restaurant, demanding Mexican food.  If you want Mexican food, just go on down the road till you find the Mexican restaurant, and leave the Chinese restaurant to do what it does best – serving Chinese food.

Too many clients expect the therapist to become what they want or need, typically based out of their own trauma-related issues.  Your healing isn’t based on making your therapist change to be what you need.  Your healing is based on your addressing your needs, and making positive changes with the assistance of your therapist.

If you want to do more thinking, here are some sample homework questions:

  • What is a therapeutic mismatch?  How do you define that for yourself?
  • Is your therapist challenging you to think / act in ways that are new or uncomfortable?  Are these harmful challenges?  Or, is your therapist encouraging you to develop new skills?
  • List 5 areas you are mismatched, and for each area, list five reasons that feels upsetting to you.  What are the common themes, and what have you learned from this?
  • What are you doing to encourage or enhance the mismatch issue?
  • What do you want your therapist to do that he (she) is not doing?  Why is this so important to you?  What does it mean if your therapist will never do these things?
  • Are these reasonable requests?  Do any of your requests take the therapist out of the therapy box?

I hope these ideas give you a starting place.

Thanks for the question.

__________

by:

Kathy Broady, LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

December 13, 2008

Are Specialized Trauma Therapists Necessary?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, therapy, Therapy and Counseling, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 9:04 pm by Kathy Broady


I am writing this post in response to a question asked by BehindtheCouch.

BTC wrote, “do you think that a “trauma client” (ie one with PTSD or a dissociative disorder) should necessarily be treated by a specialised “trauma therapist” or, in your opinion, could any therapist who has the skills that you mention in your post do just as good a job with the client?”

This is a good question.

My first thought is yes, a client that has experienced a significant amount of abuse should (hopefully!) receive better therapeutic care from a trauma specialist.  If you have the option to work with an experienced therapist who specializes in trauma disorders, snap up that opportunity as quickly as you can.

Trauma therapy is very much its own area of study, the same as with any other medical issue.  In trauma work, the therapist must understand dynamics of traumatic relationships, trauma bonds, wide-ranging effects of trauma, layered complications of dissociative disorders, issues of external safety, self harm, system work, memory work, etc.  There are dozens of issues specific to trauma disorders, with dissociative disorders being the most highly complex and requiring the greatest clinical skill.  (Please see my article listing 50 Treatment Issues for Dissociative Identity Disorder.)  The terms “trauma specialists” or “trauma therapists” imply these clinicians have invested significant chunks of time learning about trauma disorders.  They should be more comfortable than the average therapist in terms of recognizing, understanding, and addressing the details of trauma work.

Please remember there are many areas of clinical expertise for mental health professionals.  For example, I am licensed to provide clinical therapy for any area of my choosing, but in my 20+ years as a therapist, I have not worked with autistic children.  However, I have worked with families with traumatized children who also have some very definite and particular needs. Sure, I could apply my basic, fundamental clinical skills with autistic children and their families, but once it became necessary to understand specifics related to autism, I would fail miserably.  I would be scrambling for information, and fast!  Even though I am a good trauma therapist, would these autistic children receive the same quality of clinical treatment with me as they would with a clinician that specialized with autism?  I am quite sure they would not.

Who is a trauma therapist?  For most clinicians, there are no regulatory boards that specify exact qualifications.  Trauma therapists are self-proclaimed experts in the field, and clients are left hoping the professionals they are trusting are actually qualified to be specialists.   Unfortunately, I have seen far too many problems caused by well-meaning professionals who simply did not know as much about trauma issues as they claimed.  Their lack of understanding of trauma-related complexities, timing, processes, etc. caused significant harm, damage, and confusion.

On the other hand, finding a trauma specialist is difficult, and you simply might not have many therapists in your area that work with severe abuse issues.  It is imperative that people suffering from Post Traumatic Stress Disorder (PTSD) or any of the Dissociative Disorders receive treatment in order to heal from their traumatic experiences.  If your only option is to work with a “general practitioner” instead of a specialist, then that is what you do.  Good basic therapy is certainly better than no therapy at all.

Select therapists who are open-minded to the effects of trauma, honest about their limitations, and willing to learn more.  As long as their clinical skills include active listening, deep understanding, gentle compassion, effective communication, recognition of family dynamics, emotional tolerance, clear boundaries, etc., you will be able to progress in your healing.

However, it will be highly important to augment your treatment with additional information.  Read books, search online, get regular and ongoing consultations with trauma specialists, join trauma / DID support groups, attend conferences, consider online or distance therapy with a trauma therapist as an adjunct (secondary) therapist, etc.

Don’t assume that general therapists will learn enough on their own to get you through the most difficult and complex places in your healing.  You will have to take charge of your own work.  Make sure to do extra homework!

Your greatest therapeutic gains will be with a therapist you trust.  Therapy is about you.  It is your looking at your life, your history, your feelings, your reactions, your truths, your beliefs.  When you feel safe enough to be totally and completely honest with yourself, you will be able to look at your painful wounds and all the resulting affects of the trauma.  You will be able to bring down those dissociative walls that you built for safety and separation from “all the hard stuff”.

Pick a therapist you can connect with, build a solid foundation, and keep going from there. You’ll feel better for it.

__________

by:

Kathy Broady, LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

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