February 10, 2010
Lots of trauma survivors with dissociative identity disorder are just starting their healing process. Other dissociative survivors are not new to their healing process, but they might realize that they haven’t yet covered all the basics.
DID therapy can feel huge, daunting, difficult, and overwhelming. There is so much to do and so many areas of work. For a broader overview of the many areas of DID healing, please refer to the article, “50 Treatment Issues for Dissociative Identity Disorder”.
For individuals building the foundation for their work with your dissociative system, here are some of the first things to do.
DID 101 involves:
1. Get to know your system. Build the courage to find and meet your insiders. Remember, they were formed and created to help you – even if it doesn’t feel like it, you are (or can be) on the same team. Who are your inside parts? What jobs do they have? What kinds of things are they able to do? It’s really ok for you to build positive relationships and actual friendships with your insiders. If this feels scary for you, explore those feelings. What makes it hard for you to get to know your insiders? What fears or resentments do you have? Understanding your resistance to these ideas is important.
2. Become more comfortable with your diagnosis. If you don’t understand what dissociative identity disorder (DID /MPD) is, be sure to speak more with your therapist or psychiatrist about what it means to be dissociative. There are lots of books, websites, blogs, articles, conferences, etc that can help to educate you about the basics about DID. Understanding DID will help take out some of the mystery and confusion for you.
3. Build a support system and capable treatment team. It is very helpful if you can surround yourself with a few other people that understand trauma dynamics, preferably at least one or two other people, besides your therapist and doctor that understand that you are working on healing from trauma. These support people don’t have to be experts in DID – if they are just willing to spend some time with you when you need a safe distraction from your healing work, that will be helpful. Please don’t lean on lay-support people for the heavy issues. Leave the complicated treatment issues for your therapist to work with – your support friends are not therapists, so be very careful about not pushing them too far or demanding too much of them.
4. Once you have recognized at least one or two other parts, work on building communication with these parts. Internal communication is one of the very most important factors in DID therapy, and the sooner you can interact cooperatively with your other parts, the better your healing progress will happen. Approximately twenty of the articles in the Discussing Dissociation blog reference tips for building internal communication. This link groups these articles together. Learning how to talk to your other parts is the most important factor in your healing.
5. Connecting with your internal landscape. What can you see inside? Can you see the other insiders? Do you have an internal safe place? Internal visualization work is an important skill as it builds a way to connect with your insiders. Even if you can’t see the others inside, there will likely be someone else who can. Maybe ask if that insider will draw a map of your system for you? The sooner you can see inside, the better. And of course, if you see insiders that are not in positive, healthy, clean living conditions, you and other helpers in your system will need to do something to help them.
6. Working on limiting or preventing self-destructive impulses and self-injurious behaviors. Learning how to address self-harm urges is particularly important for your stabilization and progression in therapy. You have already been hurt enough – adding more hurt may feel like it helps you to cope in the short-term, but using behaviors such as cutting or burning is not any more helpful than using a shot of whiskey or a hit of cocaine. Explore better ways to cope with your intense feelings, develop more grounding skills, build positive containment strategies, and methods to reconnect with the here-and-now. A grouping of articles about preventing self-injury can be found here.
7. Live in a safe place both inside and out. If you live in a violent environment, address this issue as quickly as you are able. If you are continuing to be abused or sexually assaulted in any way, your dissociative walls will stay strong, and your system will have greater trouble trusting you and your treatment team. Of course, when anyone is fearful of abusive repercussions, it is much harder to disclose the real issues. Dangerous environments can include everything from domestic violence, abusive parents, organized perpetrators, to internal system perpetrators and angry introjects. Building more and more current-day safety is vitally important for your overall healing process. If you aren’t safe, make this a priority in your therapy process. Building an internal safe place is also critically important. However, please remember that in order to build an internal safe place, you have to have a genuine belief that safety can happen, at least part of the time. Making an internal safe place for your insiders is much more difficult when you are still concerned about external safety.
8. Start building options for positive self-comfort, self-soothing activities. The therapy process can be so very painful and emotionally difficult. Having a variety of options to do that are comfortable, safe, gentle, soothing, and stabilizing is important. What can you do when you want to have a break from the hard work of therapy? What can you do when you need some quiet space to think – or to not think? When you are hurting, what can you do that will help you to feel better? Soothing your pain in ways that help your healing (vs. using self-destructive options) is an important skill to develop.
9. Create healthy options for expression of feeling and emotion – use art, music, journaling, collage, blogging, forum posting, sculpting, painting, poetry, play therapy, sand tray therapy, scrapbooking, etc. DID therapy involves processing a lot of flashbacks, violent images, intense feelings, overwhelming thoughts, body memories, body pain, etc. Building a repertoire of artistic avenues to describe your feelings and experiences will be very helpful. You might not always have words that you can use so it is important to find non-verbal ways to safely express what you feel.
10. Create your own personal space. In this space, let it be ok for your insiders to come out, to be themselves, to be out in the body, and to exist. Out in the world, and when you are around other people, most of your daily life will be about keeping your insiders tucked in and acting socially inappropriate. But somewhere in your private time, your insiders will need time to surface, to know that it is ok for them to come out. Having the freedom to switch without reprimand is important as each of your insiders will need to do some personalized healing work of their own.
Not 11. Please note: I am specifically not including memory work or skills to do memory work in my top then list of DID 101 skills. The reason for this is that if you are just beginning DID therapy, it can be very destabilizing to focus on heavy-duty memory work. Yes, of course, doing trauma work is an important part of your overall healing process, but in the beginning of this journey, you need to build these basic skills before you begin to put a lot of energy into memory work. It is much safer and more stabilizing to have these foundational therapy skills in place before focusing on the trauma content of DID therapy.
DID therapy is intense, long-term, exhausting, and difficult. But your healing is worth it. As you truly address the painful conflicts, unmet needs, and internal confusion caused by your years of trauma, abuse, and neglect, you will feel better within your own self.
I wish you the very best in your healing journey –
Kathy Broady LCSW
November 28, 2009
It’s Thanksgiving weekend here in the US, and besides the wonderful traditional family meal and pleasant times with my kids, this time frame reminds me of something else.
Discussing Dissociation has been up and visible for nearly one year now. Yep, in a few days, it will be a year already!
Wow. Where has the time gone??!!!
There is truth to the saying that time flies, or is it because time flies when you’re having fun … or maybe I’m just getting older, lol.
Anyway, I’m being silly, but I do want to say today how much I appreciate all of you that have been readers here at this blog. The number of faithful, returning readers has been utterly amazing to me. If you look back through all the pages, you’ll see well over a thousand excellent comments from a wide variety of the readers. Wow! The input you all have made in this blog has brought it to life and given it a life-filled energy that I certainly couldn’t create on my own.
For the way each and every one of you have contributed to the positive, educational nature of this blog, I sincerely thank you. I truly appreciate your involvement, your thoughts, your comments, your questions. You’ve helped to make this little site a safe, comfortable community for dissociative trauma survivors. I think it’s a job well done, and once again, I do sincerely thank you for your part in this process. Writing a blog wouldn’t be nearly so fun without hearing comments from the readers! You all rock!
Many of you have questioned why I started this blog in the first place. The original reason is not as mysterious or worrisome as some of you may have thought. It’s a widely stated and highly recommended common practice for therapists to use blogs for marketing purposes. Marketing experts recommend to write what you know about, and to respond to the comments you receive. Blogs get quickly listed in search engines, and they are an easy, economical way for your target audience to get to know you, and to see what you do, and to become more familiar with the work that you do. It’s a simple as that. Check the blogosphere for blogs by therapists. You’ll see that most therapists write about their fields of work the same as I do.
I just happen to know about a very specialized topic – dissociative identity disorder. And my readers are a very distinct but wonderful population – dissociative trauma survivors or trauma therapists. (There aren’t very many of us out here — it’s no wonder that we are congregating together!) And yes, practically all of my blog articles have been very specific to DID, not that the topics couldn’t also apply to other populations, but the point of this blog is to “discuss dissociation” so I do tailor my articles to being about dissociative disorders, and the DID population. There’s no mystery there, lol. I think I’ve said that pretty upfront.
But something much bigger has been happening besides my having found a very effective marketing tool.
With all the positive sharing and support that has been created here, this blog has provided a deep sense of hope and healing for so many people. Having that absolute knowing that others are progressing along their healing journey as well, many survivors don’t have to feel so very alone. You might learn things from my articles, but you can also learn from each other, the same as I learn from you as well. It’s a wonderful circle of positive, helpful information, and that in itself is priceless.
Building a sense of safety, knowing you are not alone in your struggles, and learning from others who have been there too provide emotional foundations that so very crucial to healing and can augment your therapeutic process. Please remember, this blog is in no means a substitute for actual therapy, but it does provide a lot of educational support for survivors working on their own healing, or for therapists learning about working DID / MPD.
Again, you all have immensely helped to create that healing, informative atmosphere, and I am grateful for that.
We have to create and protect places of healing.
Even survivor-led blogs such as the truly incredible BTC blog have become targets for destruction by the “hazing / flaming / insaniacs” of the world. Do we really want the haters and gossipers to take over and ruin all the places of healing and support? How sad is this?!!
I know that you know there are predators and perpetrators out there in the world. For some of you, your abuse stopped years ago. For some of you, you are still smack dab in the middle of fighting your abusers. Some of you are being hassled and manipulated by internet predators (whether you know it or not), and some of you are safely away from any direct attack from anyone. No matter where you are in your life, there are abusers and predators out there in the world, (including those wolves in sheep’s clothing hiding within the dissociative population itself), so the importance of having safe retreats amongst all the danger and destruction is more important than you might realize.
Those of you that feel the loss of BTC’s blog can understand what I’m talking about. It’s a real shame that abusive people continue to ruin the good places and run off the good people. I think that is a tragedy. But it happens.
- Are you one that sits back quietly, doing nothing even though you see others destroying places of support?
- Do you believe the lies and negative gossip spread about helpers and healers?
- Are you so angry from your own abuse that you are willing to take that out on people who have helped you?
Surely the survivor population can see through the manipulations of abusers. You are adults now – you can start seeing through the tricks that are being played out there. Please remember to think for yourself the next time you hear some negative hogwash about someone who has dared to be a helper / healer. You can take a stand against that.
Complacency only allows abuse to continue.
Trauma survivors, I encourage you to ban together in protection of your valued and positive healing resources.
So many of you grew up without any safety or comfort or support. You learned to pull deep within yourself or to block out the world entirely. You survived it alone.
But it doesn’t have to be that way anymore.
Most of you are still learning about how important and helpful it is to have places of safe connection, genuine relationship, and gentle bonding. It may be scary to be around people, but building a positive, healing, trustworthy community is a way of overcoming the need to be isolated in order to avoid abuse.
Again, I challenge you to protect your places of healing. Protect those that are your helpers. Stand firm around your leaders that fight against abuse.
Don’t fall into the trap of complacency or destructive participation.
Your healing resources are depending on that.
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
October 23, 2009
There is a young woman who will always be precious to me. I haven’t spoken to her in years, but she forever changed my life.
This date – October 23rd — had specific meaning for her.
And every year on this date, I specifically think of her.
Back in the 80’s…
Annemaria was a 13 yr old wildly aggressive but enormously quiet girl that kept setting fires in the residential treatment center and starting fist fights with grown men. She was a complicated child, and was court-ordered to have an assessment by a psychologist. Fortunately for Annemaria, the psychologist had just attended a presentation about multiple personality disorder (MPD), learning about the symptoms of dissociation and trauma. Annemaria was quickly diagnosed with MPD and due to the variety of extreme acting out behaviors she demonstrated within the custody setting, she was given an unusual opportunity.
It was clear that Annemaria was acting out her child abuse history. She openly admitted to purposefully committing violent crimes so she would be taken out of her abusive home. It was a brilliant plan for finding safety from her offender-parents. Unconcerned about the long list of legal charges against her, she knew she would be safer living in residential treatment centers, and she was glad to be there. No one doubted her abusive past, and a long string of child protection workers advocated for her safety.
As requested, the Court agreed to give Annemaria the longest sentence possible so she could remain in the residential treatment center instead of being forced to go home. They did this for the preventive safety of the people she would be willing to assault in the future, but also for her own current-day safety and protection. The Court also ordered that she be given specialized treatment and intensive therapy.
Since she was so violent towards men, she was to be assigned a female staff member, and this staff member was to devote the vast majority of her time to working individually with Annemaria.
This is when Annemaria changed my life.
I was assigned to be Annemaria’s personal staff member.
I knew about sexual abuse, but I didn’t know a thing about MPD. I had been trained to work with family systems, but I didn’t know anything about internal systems. But I was thoroughly pleased to have been given the assignment of working with Annemaria. I knew it would be fascinating work, and frankly, Annemaria and I already had a little bit of a connection. Afterall, I was the only person in the entire treatment center that she would speak to.
I had two years to work with Annemaria. We did hours and hours of therapy every week, and even more hours of everyday life-skills work. She blossomed in that safe, healing environment but for such a young child, her stories of abuse were more than any of the treatment staff could fathom. Eventually, a non-threatening but strong young man was assigned to assist me during Annemaria’s acting out or heavy-duty memory flashbacks. She bounced a lot of male anger in his direction, but he handled that like a pro. The work was tough, and we leaned on each other a lot. Even so, I developed secondary PTSD, and experienced numerous nightmares after listening to Annemaria’s stories of trauma. I really hadn’t known such horrors existed. Talk about a learning curve… They hadn’t explained ANY of that in grad school!
I had so much to learn. I had no idea anyone could be abused in the ways that Annemarie described in such vivid detail. She was only 13. It had just happened. She had been abused her whole life, but still… it had just happened! Even though she was dissociative, she knew a lot about it.
She and I taught each other about two very different worlds. She taught me about her world, and I taught her about mine. We both ended those two years in a very different place.
I was truly never the same.
I hope that I impacted her life in the same way.
I also wish I could re-do those two years with Annemaria. Now that I have had 20 years experience working with MPD – currently called Dissociative Identity Disorder (DID) — I would do those first two years very differently. I’ve learned more about self-injury and how to manage those behaviors effectively. I’ve learned about depression, anxiety, PTSD and vicarious traumatization. I’ve learned about flashbacks, amnesia, body memories, and internal system communication. I’ve learned about organized abuse, the sex slave industry, pornography, and ritual abuse. NOW I am properly prepared to address the issues that Annemaria was speaking about.
I just didn’t have a clue.
And how sad was that.
Today is Annemaria’s day.
And today, while I was recording my BlogTalkRadio show on Internal Communication, I thought of Annemaria.
While I felt confident in explaining how so many things work for DID / MPD, I thought of Annemaria.
I just wish I knew then what I know now.
I could accomplish so much more with Annemaria in two years at this point in time than I could have back in the 80’s when I was new to the field. It saddens, me in that respect, because I didn’t give to her then what I could give to her now.
But she changed my life.
In fact, she changed the entire course of my life.
I would not be where I am if it were not for Annemaria.
And for that, I owe her a few years of decent therapy.
Annemaria, if you ever find me again, you’ve got yourself a therapist for as long as you need one!
And thank you, Annemaria.
Kathy Broady LCSW