February 28, 2009
What if you don’t like being Multiple?
This week, the readers here have posted a wide variety of reactions to the idea that being multiple could have benefits. If you haven’t yet read all the comments on that blog, please do so. They are very interesting.
When people have DID/MPD, they have experienced life as a multiple since their childhood. It is their norm – basically the only way of life they know. Multiples typically have not experienced life any other way other than being multiple, even if they didn’t realize they were as split as they are. Sure, one or two of the host personalities may not have a strong personal connection to what it’s like to be multiple, and many of them can deny the existence of the internal others to some degree, but the internal system as a whole would have been there for nearly your whole life.
And frankly, many DID’ers that are newly diagnosed just haven’t realized how much they have been switching their whole lives long. But just because they haven’t recognized their dissociative abilities doesn’t mean that they haven’t been living their life as a very active multiple, switching, possibly losing time, and putting amnesiac walls around anything that is too uncomfortable for them.
So what if you are dissociative and you really really detest being a multiple personality? What if you can’t stand being DID/MPD, and you hate it, and you despise it, and you make sure that everyone in your system knows it, and that everyone in your treatment support team knows it too?
Then what?
- How does that affect how your internal system views you?
- Will they feel loved and accepted?
- Will you feel good about yourself?
For sake of argument here, let’s be sure to separate the fact of being dissociative as being very different from being traumatized and abused. I will clearly and adamantly acknowledge that no young child likes the trauma and abuse that happens as the first step in the process of creating various alter personalities. I am not proposing that the road to becoming DID is a pleasant one. It clearly is not. The very idea of being forced to become a multiple is horrifically tragic in itself. Any trauma, abuse, neglect, violence, horror, pain, that you’ve gone through is too high a price for anyone to pay.
Often the fact of being multiple becomes inextricably entangled with the fact of having been abused. The multiplicity comes to represent all the pain and fear and wrongness of the abuse, and rejection of the multiplicity is part and parcel of rejecting the reality of the painful past that caused it.
But how do those feelings of adamant rejection affect your healing?
One of the ways to treat and understand multiplicity is to join in, to some degree, with the idea that the alter personalities are their own individual people. Of course they are all connected to the same one person, but you can balance that out with also seeing each of the insiders as their own unique person. How would an outside person feel if they were treated the same way your insiders are being treated?
If your internal parts know that you hate the fact that you are multiple, might they begin to internalize that feeling as if you hate them? I would think so.
How would you feel if you were repeatedly told that you were disliked and unwanted and despised? Remember, your insiders don’t have to be told these things in actual words. They are connected to you, and they will know how you genuinely feel about them, whether or not you make a point of telling them. They will be able to feel how much you don’t like them. You will not be able to hide this fact from them.
How would you feel, if day after day after day, the people that you lived with refused to speak to you? Or to acknowledge you? Or to care about you? Would you feel cooperative? Would you want to be friendly and helpful? At what point would you lose your patience and tolerance? How might you act when that happened?
In this context, if you have Dissociative Identity Disorder, and you also firmly believe that multiplicity in itself is a horrible way of life, that strong pervasive belief will negatively affect your treatment progress and your healing. How could it not? Your insiders are aching for acceptance and kindness and comfort no less than you are – and constant rejection can and will make them continue to act out in resentment and anger and desperation. Nobody else’s acceptance will ever mean as much to them as the acceptance of their own group – their own self – and if that is perpetually withheld from them, then both they and you will be at a self-created stalemate in your healing.
Because the flip side of treating your insiders like individual people is remembering that they are the same person as you.
If you are repeatedly telling yourself that you hate the way you are, what does that do for your self-image and self worth?
If you believe that the way you are is not ok, not good enough, not right, not acceptable, not normal, then you are reinforcing a lot of negative beliefs of yourself – and it is a short road from having a low self-esteem to have a ton of self-hatred.
- What if hating your multiplicity is a version of hating yourself?
- What if accepting your multiplicity is a version of accepting yourself?
Multiplicity is simply what it is – the fact of having more than one personality / “person” in your head. In my opinion, it does not have to be a bad thing. The trauma and the abuse were devastatingly bad – absolutely. The dissociative walls can really cause problems in the current day, even if they were initially helpful. The PTSD, anxiety, depression, and other emotional fallout can be debilitating at times.
But the multiplicity – just the multiplicity… does it have to be bad to share your life with others?
Again I ask….
Is accepting your multiplicity “as is” a version of accepting yourself?
__________
By:
Kathy Broady LCSW
February 15, 2009
DID Trauma Survivors and Getting Support from Other People – or not
As the show, “United States of Tara” is gradually starting to demonstrate, survivors with Dissociative Identity Disorder have friends and family members that offer varying levels of support:
- Those that find dissociative trauma survivors to be really good, kind, decent, and wonderful people, and will stand by them faithfully.
- Those that genuinely love and support and accept them even though the DID survivors can be all kinds of weird and “nutty” and difficult.
- Those that get angry and upset with them because DID survivors can be all kinds of weird and “nutty” and difficult.
- Those that believe and support the trauma and abuse history of the DID survivor.
- Those that do not believe that the DID survivor was abused at all.
- Those that believe the multiplicity, are comfortable with a variety of alter parts presenting, acknowledge the switching as a very real thing and a natural part of DIDer’s life.
- Those that don’t believe the multiplicity is real, accuse the DIDers of just play-acting, and don’t recognize the other parts even when they are there.
- Those that initially say they will be a friend, only to totally reject, leave, or abandon the dissociative person when things get complicated or difficult.
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So far, the Showtime Series has not adequately addressed the issues involving trauma and abuse. It also has not shown any young child parts (teenage parts are very different than child parts). Have you met a multiple that didn’t have child parts? I most certainly have not. I don’t know if the series will get into those serious elements of dissociation or not, but it is a critical element in normal life with DID. How the friends and family members treat the DIDer’s child parts is often an extremely accurate barometer of how supportive and accepting that person will be for the DIDer over all.
It is, of course, the most helpful if the friends and family members of the dissociative survivors are gentle, accepting, kind, and understanding. And sometimes, that is the case. There are some wonderfully supportive spouses, parents, and children out there. They make the healing process so much easier by contributing with their comfort, faithful assistance, gentle patience, and reassurance.
Unfortunately, all too often dissociative survivors continue to be alone and isolated, even abused and neglected within their own families.
Spouses often feel angry, ripped off, frustrated with all the added relationship complications. They might feel like they are left picking up the pieces, and overloaded with more than their fair share of the household work and parenting. It’s often hard for spouses to have patience for all the complications caused by the dissociative disorder and the survivor’s trauma history because of the heavy load it creates for them.
Extended family members are all too often filled with the perpetrators and original abusers. Most perpetrators that engaged in violence so extreme as to split a child are not ever going to become a positive support for the DIDer.
Children of dissociative people can certainly be loving and accepting of the different sides of the DIDer, but the external children cannot be the main source of emotional support or the emotional care-taker for the trauma survivor. If dissociative parents put too much emphasis on their own needs, hurts, and wants, and keep their own struggles as the bigger focus in front of the external children, those external children will be left emotionally neglected and will most likely become angry, resentful, spiteful, and hateful towards their dissociative parent.
And as much as dissociative survivors may not want to admit that they can be more difficult than average to live with, it is generally true.
What can a DID person do to facilitate their getting more support from others?
- Be genuinely appreciative – recognize even the smallest of kindness from someone and thank them. Thank them each time they give something of value to you. Nobody likes to be taken for granted, and if you have the attitude that these favors are “owed” to you, you will soon find yourself alone.
- Communicate what is going on for you. Often, others will be more willing to give if they understand why it is necessary or important. Don’t assume that they will automatically understand why you need certain things. Tell them, and explain it in a way that they can understand.
- Be determined to do as much as possible for yourself on your own. Yes, your trauma history has left big gaping wounds, but the more you meet your own needs and find ways to resolve those issues without “taking from” or “pulling on” others, the more genuine your friendships can be.
- Reciprocate kindness. When someone takes the time and effort to be supportive of you, be sure to return the favor by doing supportive things for them as well. If you are taking, taking, taking more than you are giving, the relationship will either die or explode in your face.
- Get professional support when your emotional needs become too heavy for your friends and family members. For example, friends and family members may very well pull away from you if you lean on them too heavily during intense times – ie: during extended or repeated times of suicidal feelings, episodes involving self-injury, or flashbacks. These heavy, intense issues belong in the therapeutic context and not between you and your support people.
- Build your support options so you are not putting too much pressure on one or two people to support you through the hard times. The more support options you have, the less likely any one individual support person will feel burnt out or overloaded by how much you lean on them.
- Remember that is it more important for you to learn how to emotionally support yourself and your internal system than it is to teach (force) someone else to support you.
- Take time to enjoy everyday “normal” experiences with your support people. Put your trauma issues aside, and do something that is pleasant and enjoyable to everyone.
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Remember the old adage: To have a friend, be a friend.
__________
By:
Kathy Broady LCSW
February 1, 2009
Multiplicity in the Media
So are you watching the “United States of Tara” series? (It’s on again tonight.) Have you been watching “One Life to Live”? Have you seen the various other shows on television that have a character with Dissociative Identity Disorder (DID/MPD)?
I certainly have not watched all the shows and movies that incorporate DID’ers into their character line-up, but I have seen enough of them to hope that in the “United States of Tara” Showtime series, the dissociative character does not end up being the local serial killer.
Doesn’t that plot line get old for you?
It sure does for me.
The “United States of Tara” has potential to go either way. So far, one of Tara’s insiders, Buck, angrily refuses to conform to society’s rules, beats up neighborhood teenagers, aggressively humiliates his own children, and frequently takes target practice at the local gun range. Great – so the propensity for violence is there, but the show is supposed to be a comedy, so we’ll see how far they take this theme.
In the soap opera, “One Life to Live”, the dissociative character Jess-Tess-Bess (aren’t the rhyming names cute?) was just seconds away from being an official killer of her kidnapped sister, but something dramatic and wonderful happened just in the nick of time, and the sister got out, no thanks to Jess-Tess-Bess the great big mess.
I do like how “One Life to Live” has attempted to show the inside (internal world landscapes) and the ongoing discussions between internal alters as part of their storyline. That’s been interesting, and at least shows to the viewing audience that the insiders, even when inside, don’t just go back into nothingness. The scenes from the internal world are limited to one internal place where at least one character at a time is in a big cage (what’s up with that?). It shows how the external world becomes the world viewed on a movie screen, far away and separate from the insiders that have conversations with each other.
Jess, Tess, and Tara have shown amnesia for areas of their lives, especially the areas that are emotionally harder to digest. Ok, that’s true enough. And in that sense, the shows demonstrate how strong amnesia is for the dissociative person, but how much outside people can see the various alters, and their actions, and how outside people who aren’t filing information away via amnesia, can and do remember all the different actions that the dissociative person does.
Tara’s husband and children all remember vividly when Tara switches to T the obnoxious sexualized teenager. Tara’s son doesn’t forget how rude and crude Buck’s nasty comments are to him. Tara’s children are affected severely by the behaviors of her alters, and while Tara conveniently blocks out her obnoxious, damaging behaviors from her direct awareness, the children still carry the scars of her behavior.
Tara is a good mother, but she just isn’t there all the time. Tara’s relatively helpful alter, Alice, has potential to have positive motherly traits — she bakes a really mean cake! And she can put the troubled schoolteacher in his place, but she’s still not the mom, and the kids miss their mom. A lot. And understandably so.
While Jess is barely recalling the incidents involved with locking her sister up in a hidden room in the basement with dynamite, the sister and her fiance remember every detail and are understandably angry and upset about it.
Ok – ouch. That’s a painful point, but it can be true for dissociative disorders. Dissociative people can block themselves off from truly grasping how their negative behaviors have affected other people.
Obviously, the media has built up the extremities of the DIDer’s bad behavior for the drama ratings on their show, but the point is there. In regular life, most multiples do not go around locking their sisters up with dynamite or beating up ratty teenagers on the local schoolyard. They may feel like it, but most don’t actually do that.
Working on accepting responsibility for what the other alters do (or have done in the past) is a hard part of dissociative treatment. As demonstrated in the media, these negative behaviors which are much more comfortably hidden behind dissociative amnesiac walls, are often painfully remembered by others.
Now, if you are dissociative and reading this blog, please don’t start screaming at me about how much you are hurting, and get all in a huff about how dare I say that you could hurt others. I KNOW that you are hurting too – I really and truly do understand that. This blog is about a slightly different topic, so… please take a step back from that raw edge, and let me talk about what it’s like for other people.
For Tara, her husband is extremely supportive and understanding. That is actually very nice to see. It’s not easy for spouses to be as understanding of everything, but the fact that he accepts all of her insiders, has a connection with each of them, and responds to each of them as who they are, is good. (And no, I’m not going to touch the “who he should or should not have sex with” controversy in this particular blog, but who knows, I might tackle that another time, because it is, in all reality, a big issue.)
Tara’s daughter both loves the DID and hates it. It’s very cool, and yet it’s very embarrassing for her.
Tara’s sister seems to not understand or accept the dissociation, so that factors in another element in family dynamics. That’s going to be a big topic for further discussion too!
While I’m not totally thrilled with the way DID is being presented on these shows, for now, I’m certainly going to keep watching. I want to see more about how Dissociative Identity Disorder is being portrayed in the media, and I can use the shows as a baseline starting point to teach about the actual reality of DID to others. These latest shows have at least progressed somewhat from the old murder mystery approach to DID, and I’m pleased to see that.
I’ll certainly have many more comments to make before either of these television series are done.
In the meantime, what are your thoughts and comments about these dissociative characters in the media?
- Who is your favorite DID character in the media? What makes them your favorite?
- What is your most hated DID characterization from the media? Please explain.
- Have you seen yourself in any of the DID characters portrayed on the media? How so? How not?
- If you could affect how the media presents DID/MPD on the television, what would you suggest?
- What are your thoughts about “United States of Tara”?
- What are your thoughts about the dissociative characters on “One Life to Live”?
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I’ll be posting more about this topic in weeks to come….
Happy SuperBowl Day everyone….
__________
By:
Kathy Broady LCSW
January 24, 2009
Understanding Child Parts in the Dissociative System
Child parts come in all shapes and sizes – small, tall, skinny, short, chunky, pristine, messy, filthy, princess-like, raggedy, male, female, quiet, noisy, screaming, crying, silent, confused, dazed, sleepy, busy, playful, happy, sad, angry, fearful, bouncing, babyish, stiff, awkward, hurting, numb.
As different as they are, they all have similar qualities. They are typically some of the oldest, most knowledgeable members of your system.
But as the youngest parts, how can they be the oldest?
Let me explain.
For example, if you split off a 5-year-old child part when you (and the body) were a literal age 5, and you are now age 35, that child part has been around for 30 years. Even though that little one might not have aged during that time, they may very well have seen or participated in many of your life’s events over the past 30 years. Being around for 30 years means they are one of your oldest parts. They could contain 30 years worth of memories, information, emotions, relationships, etc.
Child-aged parts do not have to be split off when the body was young, but many of them were. They will be very much aware of many of your life’s events. They will remember who many of the people are, and they will know who else from your system was involved in activities of the time. They lived through all the various years, so their ability to know and remember can be impressive.
Child parts will also, of course, retain much of the trauma information from your early years of life. People are at their most natural dissociative ability when under age 7 – the same years when they are also the most physically vulnerable, small, and defenseless. For young children, almost every single person in the whole wide world is bigger, stronger, and smarter than they are. Children are at the mercy of the adults around them, and when those adults are sadistic – cruel – vicious, children have to find a way to cope. Being physically unable to defend themselves, and typically not given the option to literally leave abusive environments, children can “leave” in their minds, even if they can’t leave with their feet.
During the crisis moments of the actual trauma, dissociative splitting is incredibly helpful. Going far away inside when you cannot go far away outside at least gives most of the person a fighting chance to be in a place to be as far away from the trauma as possible.
But it is sad, massively sad. These child parts were split off because there was no other help for them. There was no other way out for them. There was no other safety for them. There was no other protection, no other escape for their pain, and all too often, there was no other comfort for their heartbreak and emotional conflict.
The very first time you see your child parts, they may very well be locked into the same state where they were split off. They may still be trapped in that “time zone” of the original trauma, and they may or may not know that years of time have gone by. They may present with the same injuries, messiness, blood, and gore that they experienced at the time of their trauma. Or they may manifest in metaphorical pictures of what they felt like during their trauma, or in the aftermath. Most of a dissociative survivor’s internal kid parts were split off to deal with trauma-based situations, so unless you had a happy childhood, don’t expect to find bunches of happy child parts.
Because these little young ones are the foundation of your multiplicity, it is very important for the older leaders and hosts of the system to understand that so much of your healing revolves around meeting the needs of these children frozen in time.
Each time a little part of you had to split off and stay stuck in that their trauma, a piece of you – the overall person – was unable to grow up in a healthy, safe, productive manner. And honestly, until their young needs are met in a safe manner, the inner kids will stay there, exactly as their abusers left them.
The good news is that as you meet the needs of these child parts, they will naturally progress on their own.
Many mental health professionals use age progression techniques to “make the kids grow up quickly.” I have a different perspective on that. First of all, I do not think that snapping the fingers and magically saying (or hypnotically suggesting) that kids parts grow older means that the kids can actually get older. I am sure they will try their darndest to do that. But I doubt that they will be able to maintain that kind of suggested aging.
In my opinion, the child parts are frozen in these young ages for a reason. They were not safe enough to move forward in life, and their entire development was arrested on the spot. Pay attention to that. Listen to them. Look at their appearance. Have empathy for their emotional state. All this information means something. They are telling you exactly where they were, what was happening, and why they are stuck there.
If a real child, in the outside world, was standing in front of you, and looked like that, what would you do for that child?
How would you help an outside child to overcome a current-day trauma?
Use those same exact skills to help your inner children.
As you tend to all their unmet needs, and give your child parts the healthy, positive, comforting response they needed at the time of their splitting, they will be allowed to move forward from the place they were stuck. If they need safety, protect them from whatever they are afraid of. If they need food, feed them. If they need a drink, give them something safe to drink. If they need a chance to play, let them have fun. If they need to learn and develop their intellect, let them try new things and develop more skills. Figure out what they have been lacking for genuine growth and development, and give it to them.
Create positive, healing experiences for your child parts. As you give them what they were missing in the first place, they will automatically, naturally grow older. They won’t stay “stuck” as they are once their needs are being met. They will progress. They will learn. They will expand their vocabulary. They will find new skills and develop greater mastery.
This creates natural age progression. Your internal child parts can mature the same as any outside child would. It is a much more realistic way of helping your inner kids to grow up. It is real. Genuine. It’s not going to fall apart at the first hint of stress.
Magical answers are unrealistic. If you want your child parts to progress into healthier parts of you, then let them experience life in such a way that they can naturally grow up on their own.
However, growing up and maturing doesn’t automatically mean your child parts will get older!!
More about that and ideas about how, where, when to do all this will be presented in future writings.
__________
By:
Kathy Broady LCSW
January 17, 2009
25 More Ways to Avoid Self-Injury and Prevent Self-Harm
This blog is a continuation of the initial article posted on December 31, 2008, “25 Ways to Avoid Self-Injury and Prevent Self-Harm.”
If you are feeling pressured to get past the “heat of the moment” and you need some ideas of how to do this safely, try using a handful of the following ideas. These ideas will not help solve your self-injury issue on a long-term basis, but they could help you to get through the actual moments when you are feeling at the highest risk. Safe distractions that also provide some element of emotional expression are a good balance.
- Find a brick wall (or any kind of strong wall with no windows), and kick a soccer ball against the wall. Consciously put the anger you are feeling into the ball as you kick it. The cracking sound of the ball smacking the wall can be satisfying as well. The louder the better!
- Use handfuls of ice, ice packs, or cool cloths to soothe and calm yourself. Some people may find warm cloths or heated warm towels more comforting. Changing a physical sensation in your body and concentrating on that may help to calm your frayed nerves.
- Put your anger into something useful — be more assertive with utility companies that aren’t doing their job, or tackle other external household issue that need a more aggressive approach. I’m not necessarily promoting being rude to someone who doesn’t deserve it, but you might be able to constructively resolve an existing problem with your added energy and intensity.
- Color or draw. Small, repetitive movements are soothing and calming, and you might learn something from your picture. The others inside might tell what they are upset about through the drawing that is made.
- Dance out your feelings. Use strong energetic body movements to release the adrenaline and to wear yourself out. Pick music that fits your mood. Sing along if you can – the voice release is good too.
- Write a long letter to your abuser(s). At this point, write these letters with plans to NOT send them. The point is not to set up a confrontation. Let your focus be on expressing your feelings about what they did to you. Write the things that you might never have the courage to actually say to them in real life. When you are finished, you can read the letters out loud repeatedly. Use intensity in your voice. Let yourself say the words with emotional honesty and genuine expression.
- Get obsessed with some safe activity — for example, do in-depth research on a particular subject on the internet, pull every weed from your yard, wash every dish in your cupboards, pace 10,000 steps, etc.
- Count those annoying little doodads on the ceiling, and when you lose count - which you will – start over.
- Do puzzles (the harder the better). There are lots of free online jigsaw puzzle sites if you do not have any actual puzzles in your home.
- Practice relaxation, yoga, and deep breathing exercises. Take long, slow, deep breaths. Inhale deeply and slowly, hold for a few counts, then release your breath slowly. Do this until you can feel yourself calm down.
- Play video games, and take your aggression out on beating the game, or smashing and bashing the other “enemy” characters in the games. Time away “in another world” can help release the pressure you are feeling right now in your world.
- Clean out your fridge or freezer, scrub it, making it clean and organized. This same idea can be applied to closets, or drawers, or bookshelves, etc. Getting involved with a complicated household task will give you another focus, a place to put your energy, and a positive sense of accomplishment when you are finished.
- Alphabetize your books, CD’s, Videos, DVDs, etc.
- Hammer nails into a piece of lumber or old tree stumps until you are exhausted. Watch your fingers – the idea is to NOT do any self-injury! The physical movement will be helpful, the noise will be satisfying, and if you speak about your anger and upset while you are banging away, you will be expressing your feelings at the same time.
- Wash your vehicle, your outside windows, your driveway, your floors, etc. The physical movement helps, and the accomplished feeling of being clean afterwards can help lift your mood.
- Go sit in the waiting room of a hospital, and read a book or magazines, and sip on coffee. You do not have to talk to doctors or any of the hospital staff – people will assume you are there waiting for someone who has an appointment. Just being in a calm, safe place can help.
- Take the time to groom your pets and give them treats. Try teaching your dog a new trick.
- Do something for yourself that makes you feel pretty, such as brushing your hair, doing your nails, getting your hair cut, coloring your hair, wearing perfume, etc. When you feel lousy, try doing the OPPOSITE of that by doing something that helps you feel pretty.
- Make something creative. You might have to pre-plan this, or have some options available just around the house. Finish a paint-by-number picture, work on needlepoint or sewing projects, try beading, learn how to make your own jewelry, etc. Getting creative will help distract you and put you in a better frame of mind.
- Do a collage. It is amazing what comes out in pictures, and you might not have realized what was going on in the background. The collage might explain it to you.
- Do acronym writing exercises. These might help you uncover why you are feeling so terrible while expressing some of the pain. Expression often eases the pain.
- Hold a frozen orange. Feel the coldness. Look closely at the frost on it. Hold the frozen orange where you wish to SI. Scratch the orange, smell the aroma. Look at bright orange color. Count the little dots in the orange peel. As you feel better, allow yourself to eat the orange and throw the peelings away.
- Throw water balloons at a fence, a wall, or a tree and watch them explode. As you throw each water balloon, make a comment about something you are upset about. Use your body and your voice to express your feelings.
- Build a model car or airplane or create something that takes a lot of detailed mental focus.
- Go to the library or book stores where it’s fairly quiet, but people are around. Make a list of 100 books you would like to read at some point in time. Or pick five books from each aisle that you would be willing to read. You can browse for hours, and no one would think anything of it. The same kind of book browsing could happen at online book sites as well.
Stay busy – do things over and over from these lists until you feel safe enough to manage your self-injury impulses. Sometimes just getting past the peak time will be enough to keep you safe.
The more you work on emotional expression in an ongoing way without allowing it to build up to a critical numbing point, the better. One of the biggest keys to resolving self-injury issues is to increase your emotional endurance. The more you can sit with your feelings, the less you will have to hurt yourself to numb them away.
Safety first!
__________
By:
Kathy Broady LCSW
January 3, 2009
Overcoming Instability Issues and Unsuccessful Memory Work
Kerro commented:
I have a question about stability. I accept that I need to be reliable, motivated, responsible and willing to delve into things I generally don’t want to delve into. As for stability – I can see how a stable client is easier to work with for a therapist. However, what if the beginning stages of therapy have resurfaced old issues or retraumatised the client to the extent that they are now “unstable”? How would this fit with your schema? And what should the therapist’s (and client’s) roles be in re-stabilising?
Typically trauma survivors, particularly those with Dissociative Identity Disorder and PTSD enter therapy because their life is already full of emotional complications, symptoms of depression, anxiety, self-injury, internal chaos, flashbacks, confusion, memory loss, time distortion, time loss, body numbing, nightmares, voices, etc. As a whole, people do not enter therapy because their life is already stable. They go to therapy because they have some awareness that they are starting to fall apart. There is something wrong, something very uncomfortable, and something very unmanageable about their life. They may not be able to define it, but they can feel it and see it in the way their life is unraveling.
And yes, Kerro, you are right. There are various stages of therapy that can be quite de-stabilizing, yet maintaining stabilization is a fundamental building block of therapy. Sometimes the path seems like two steps forward, one step back. And, yes, there are times when it feels more like one step forward, two steps back. It is a very fine balance. To do the healing work required for trauma survivors to gain overall life stability, these survivors have to address painful difficult issues that are potentially de-stabilizing.
So, not doing the work leaves people de-stabilized.
But doing the work also can cause people to be de-stabilized.
Some days, it feels like the line between the two is nonexistent.
Now what?!
Take it slowly, one step at a time. Look ahead, increase your self-awareness, try to maintain the stability that you have, and try to predict the areas of your stability are the shakiest and and prepare for them ahead of time. This is important.
What is stability?
Stability consists of a lot of different elements all at once. Some examples of stability are when survivors:
- Can manage intense emotions without using serious self-injury to cope.
- Can be challenged with something emotionally difficult without making it ”the end of the world” or some other dramatic crisis.
- Are willing to move forward by learning about new areas of life and using new coping skills, instead of self-destructing from the same old place and/or blaming others for their lack of progress.
- Do not consider suicide as a realistic problem-solving solution to difficult situations.
- Can manage feeling depressed, and even suicidal, but knowing they wouldn’t actually do anything lethal or harmful.
- Take their medication as prescribed, regularly and consistently.
- Eat regularly, without starving themselves or without bingeing repeatedly.
- Get a regular, sufficient amount of sleep, rest, and personal down time.
- Have a steady source of monthly income that meets their basic needs.
- Can incorporate painful trauma memory work into their lives without self-destructing or attacking others.
- Work cooperatively with their internal system without attacking each other from within.
- Maintain a safe and consistent distance from and/or can establish boundaries with people that repeatedly abuse them.
- Can keep their regular job/employment, even while working on therapy issues.
- Can use their dissociative skills to their advantage, instead of to their detriment.
Sometimes therapy is like walking through a minefield. If you know you have to get through the minefield to survive, but there is the potential that you will set off one of the mines on your way through, you would tread very carefully. You would check everything you do, in smaller and more detailed increments. You would listen and watch for clues every single step of the way.
In the therapy process, once you start feeling a little too de-stabilized in a particular direction, back off and stop pushing that issue at the moment. Give it a break for an hour, a day, a week, a month — depending on the circumstance. Get to know yourself and what you can handle. Learn your own red flags for when you are starting to fall apart and getting too overwhelmed. Give yourself the space and the time to do your work. There’s no need to rush headlong into things that particularly de-stabilize you.
Remember, when healing from trauma, there are usually many, many different areas of healing. Remember the list of 50 different treatment issues for DID/MPD? If you are finding one area too difficult to deal with right now, simply put that issue on hold, and work on a different area. They ALL have to be done. They ALL have to be addressed. You can decide when something is genuinely too difficult, or too tangled, or too emotional, or too destabilizing for right now.
As a general rule of thumb, put internal communication work and system work as the first steps to focus on. If you cannot even speak to your insiders, you certainly will not be able to tolerate their intense emotional trauma memories.
In years gone by, the mental health profession used to promote abreactive memory work as valid and necessary. I absolutely, unequivocally disagree with that. Abreactions are often hypnotically induced, and they are basically inducing a flashback — putting the person back in time and directly into the intensity of the trauma. Most survivors find they do not even recall abreactive work, so as far as I am concerned, it is an absolute waste of time, and just leaves the person feeling more traumatized than healed.
If you cannot speak, in your normal voice, discussing your trauma memories from the safety of the here-and-now while still connected in the present, then don’t even try to address your memories. It is too soon.
In my opinion, memory work is NOT the core of the healing from dissociative disorders. I believe that developing the internal communication, internal cooperation between parts, and system teamwork is a much more important element, as well as being crucial to a person’s stability. Decreasing the dissociation and separation between the inside people has many facets to it. The trauma is only one area of separation between insiders. Build strong connections with each other first and then, much further down the road, address the memory / trauma issues, and you will likely find that the memory work is much less de-stabilizing than it once was.
Memory work has its role, and yes, survivors do have to process their trauma. Please know that you are not getting a “free pass” on not addressing that. BUT, it is not the first goal of treatment, and it is certainly not the main focus of the therapy.
In your outside life, when you first walk up to someone new, as you are first meeting them, do you say, “Hi. You don’t know who I am. I don’t know who you are. But I want to know your most painful memories. Tell me all your deepest, darkest secrets RIGHT NOW.”
Hello??? Of course you don’t approach people like that. SO, don’t approach your insiders that way either. Get to know them as people first. Find out who they are, what they are like. Build a relationship, a connection, and a rapport with them first.
In fact, building connections in your internal system, building that teamwork approach, improving communication, and etc. is the main and most effective stabilizing factor that I know. Once you truly can connect with your insiders, and you care for them and have relationships with them, you can hear their trauma through an entirely different perspective. You will have compassion for your inner people, and that will help you to heal. Jerking their memories out of them before you even have a relationship with them isn’t good for anyone.
Focus first on relationship building with your parts. Get to know them. Talk to them. Learn their names. Overcome your fears of who they are. Appreciate their strengths. Develop friendships with them. I guarantee that your overall stability will greatly improve as you are more connected with your internal system on a genuinely friendly, caring basis.
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by:
Kathy Broady LCSW
