July 19, 2009
Posted in Depression, emotional pain, sexual abuse, Trauma, trauma therapist tagged Abandonment, Abuse, AbuseConsultants, AbuseConsultants.com, Alone, Aloneness, Betrayal, Broken Heart, Depression, DID/MPD, Dissociative Identity Disorder, Emotion, Emotional, Emotional Healing, emotional pain, Grief, heartbreak, Hurt, Kathy Broady, Listening, Loss, Neglect, pain, Sadness, sexual abuse, Sexual Trauma, Trauma, Trauma Survivors at 9:17 pm by Kathy Broady
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Something about heartbreak totally changes a person.
Repeated heartbreak.
Changes your life.
I’m not sure I can put words to it yet, but I know it happens.
Depression.
Sadness.
Loss. Grief.
Pain.
It consumes your thoughts, your mind, your time.
What hurts the most? Abandonment? Abuse? Neglect? Betrayal? Dishonesty? Physical pain? Sexual trauma? Aloneness?
I suppose there is no way to say what hurts the most. It’s probably different for different people anyway.
When there is heartbreak, the heart breaks.
The sadness lingers.
You breathe it in with every breath. It’s all around you at all times.
It sits with you. Next to you. Beside you. On you. Behind you. In you.
The heart hurts.
You can feel it. It’s a physical pain. It’s an emotional pain.
Sad, slow music can express it oh so very well.
It’s just hard to find the words.
Sometimes heartbreak cannot be soothed. There are no words to comfort or reach or soften the depth of the break.
Sometimes sitting with is helpful.
Sometimes aloneness is all that can be tolerated.
Sometimes someone else’s heart can hear the heartbreak, even without the words.
It’s in the emotion. Or in the feeling of the person.
Or in the feeling around the person.
Real heartbreak is palpable.
Anyone listening or paying attention can see it, and feel it, and sense it – if they will.
Most don’t.
Maybe that’s why heartbreak changes life.
It creates profound crossroads in a person’s life.
The road chosen changes after heartbreak.
Life changes after heartbreak.
It’s never the same.
The heart breaks.
Profoundly.
__________
By:
Kathy Broady LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
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January 7, 2009
Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Internal Communication, mental health tagged Acceptance, Belonging, Breaking, Communicate, Communication, Confidence, Denial, DID/MPD, Dissociated, dissociative, Dissociative Identity Disorder, Dissociative Wall, Effective, Emotion, Family, Healing, Hear, Hidden, Hurt, Information, Inside Part, Insider, Internal Communication, Internal World, Intimidating, Journal, Kathy Broady, Landscape, Learn, Learning, Letter, Listen, mental health, Overwhelm, Painful, Panic, Potential, Private, Relationship, Safe, Skill, Social, System, Talk, Talked, Talking, therapy, Trauma, Trigger, Triggering, Understanding, Upset, Visual, Visualize, Wall, Worry at 3:48 pm by Kathy Broady
There are a variety of ways to develop basic, effective skills in internal communication with your dissociative system. Most of these skills are very similar, even the same, as the communication skills used with real people in the everyday world. There is no fancy trick to learning to talk to your inside people. Everyone can do this.
Have you spoken to people in your everyday world? I’m sure that every one of you has spoken to outside people before. If you can speak to real people and develop ongoing relationships with them, you can certainly develop the ability to communicate and build relationships with your insiders.
Don’t panic — I completely understand that many people with Dissociative Identity Disorder have difficulties with social situations and social relationships. I am fully aware that speaking with “real people” can be intimidating, challenging, difficult, disastrous, etc.
Here’s the good news. In some ways, it is actually easier to develop communication with your internal system because they are there with you more of the time. The opportunities available to you to speak with your internal system exist all day long, and frequently all night long as well. And because they are a part of you, they will already have some innate understanding of how you think and why you think it. The ability to connect with each other can happen more easily because you already have the foundation of literally belonging together.
One of the easiest ways to facilitate internal communication is using the internal worlds – the internal landscapes of your dissociative system. Simply said — step back and go inside, look around, see who is there, and then speak to them. If you see someone — anyone — say hello, and start a conversation with him or her. If you hear others inside, even if you can’t see them, speak in their general direction. Chances are, if you can hear them, they can hear you. You don’t have to know their names. You can easily begin a conversation with “Hi, what’s your name?” or “Hello, how are you?”
Looking inside is a natural skill for most DID/MPD folks, especially once the idea of having an internal dissociative system is accepted and denial is not clouding your willingness to interact with your other parts. Communicating with your other parts will be much easier if you are truly willing to see them and hear from them. Your genuine positive acceptance of their existence is a critical foundation to effective communication.
You don’t have to be comfortable with absolutely everyone in your system to begin working on internal communication skills. Start with who you know, who you can see, who you can hear, and then build that over time to include more insiders. If you can already see someone inside, that means there is significant potential to build that relationship. The folks that are the most dissociated from you will still be hidden, or further away. That is ok. Start with folks that are already closer and less intimidating to you.
Learning to communicate well with even one or two or three other inside parts will make a significant difference. Especially in the beginning while you are learning these skills, keep yourself from becoming overwhelmed by speaking with only a few others. Even in real life, we don’t have to talk to everyone we see. Start with the people that are the closest and feel the safest and the most comfortable to you. Build your confidence with them, and plan to meet others at a later point.
If visualizing your insiders is difficult or too scary for you, try putting your communication out on paper. The main point is to start somewhere — and the sooner, the better.
Create a handwritten journal or a document in your computer that can be specifically designated as a place for you and your insiders to communicate. This needs to be private, and not open for the world or your family members to see. In that space, write letters to each other. These letters don’t have to be long. Brief introductory comments and simple questions will work just as well, if not better, than long paragraphs.
You will be breaking through old, long-term dissociative walls by doing these communication exercises, and it is critically important to not flood yourself with too much emotion or too much information when first talking to the others inside. Do not start with trauma material. Do not ask about painful secrets. At these beginning stages, purposefully stay away from any triggering topics.
The following questions and comments are typically safe conversation starters:
- Hi, my name is …. What’s your name?
- Hi little one, how old are you?
- Hi little one, you look very scared. Is there something I can do to help you feel safer?
- Hi there. My name is …. Some of my favorite things to do are … What do you like to do?
- Hi. It’s nice to meet you. Have you seen me around here before? It’s great to get a chance to speak with you. I’m hoping that several of us can get together a little more often. Would you be willing to meet some of the other people in here?
- What kinds of things are worrying you today?
- Is there anything I can do to help you feel better? Would you like a drink of water? Or a nice soft blanket?
- Hi there. You look upset. I’m not here to hurt you. Can you tell me what’s bothering you today?
- Hi there, little one. Have you ever met the little girl over there? She is about your same age. Maybe the two of you can be friends. Would you like to meet her?
- Hi there. It’s nice to meet you. Have you talked with anyone before? Would you be willing to write in our journal and introduce yourself to the others that are in here?
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These are some basic ideas. Communication gets much more complex than this, of course. This topic will be continued in future posts.
__________
By:
Kathy Broady LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
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January 3, 2009
Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health tagged Abreact, Abreaction, Abreactive, Anxiety, Approach, Caring, Chaos, Communication, Confusion, Connection, Cooperation, Core, Crisis, De-stabilizing, Depressed, Depression, DID Treatment, DID/MPD, Difficult, dissociative, Dissociative Disorder, Dissociative Identity Disorder, Emotion, Emotional, Fall Apart, Fear, Flashback, Friendship, Healed, Healing, Insider, Instability, Intense, Internal, Internal System, Issue, Kathy Broady, Medication, Memories, Memory, Memory Loss, Memory Work, mental health, Nightmare, Numb, Overwhelm, Painful, Process, Progress, PTSD, Relationship, Secret, Self Destruct, Self Destruction, Self Injury, Self-destructing, Sleep, Stability, Stable, Suicidal, Suicide, Survivor, System, Teamwork, therapy, Time Loss, Trauma, Traumatized, treatment, Voices at 3:44 pm by Kathy Broady
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.
__________
by:
Kathy Broady LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
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December 31, 2008
Posted in DID/MPD, Dissociative Identity Disorder, mental health, Self Injury, sexual abuse tagged Blanket, Breathe, Comfort, Comforting, Compulsion, Cry, Crying, Danger, DID/MPD, dissociative, Dissociative Identity Disorder, Dissociative Wall, Distance, Draw, Emotion, Emotional, Emotional Distance, Exercise, Feel, Feeling, Friend, Garden, Guitar, harming, Herbal Tea, Hurting, Imagine, Journal, Kathy Broady, Music, Numb, Numbness, pain, Paint, Pet, Piano, Picture, Safety, Self Destruction, Self Harm, Self Injury, Self-soothe, sexual abuse, Shut Down, SI, Sleep, Song, Soothe, Soothing, split, Split off, Stress, Support, Survivor, Trauma, Trauma Survivor, Urgency, Vacation, Visualize, Write at 6:17 am by Kathy Broady
Survivors of sexual abuse often struggle with self-injury (SI).
Survivors often use dissociative walls to contain and separate intense emotions from themselves. This allows them to stay numb, and to not feel. They can split off their unmanageable, uncomfortable, or conflicting feelings into other parts of themselves, as frequently seen in dissociative identity disorder (DID/MPD).
As those dissociative walls begin to crumble, allowing more emotions and feelings to emerge, survivors often want to maintain or regain that sense of numbness and emotional distance. They will use various forms of self-harm to re-create more distance from feelings.
However, purposeful self-injury and self-destruction creates a myriad of other complications. There are a number of reasons why trauma survivors hurt themselves, and hundreds of different ways to do it. I will discuss some of these topics in blogs to come.
For now, the following is a list of 25 ideas of activities to do when the urgency of self-harm is there. These ideas do not necessarily address the issues fueling the SI, but they can be a helpful distraction during an acute crisis point. If you complete a handful of these ideas when you start feeling compulsions to SI, you might find that you can work past the danger point and get yourself into a more stable place.
Remember — Safety First! (that includes safety from yourself as well)
When you are in the immediate danger of harming yourself, try at least five or six of the following ideas. However, do as many as you need to get past the urgency to self-harm.
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- Call a friend or two and talk to them about anything – the weather, politics, the news, old times, new recipes, etc. Distract yourself, and enjoy the company.
- Watch a movie or two, or three, or however many it takes till you get past the urge to SI. Promise yourself that you will watch movies until you feel safe again.
- Write about your feelings in your journal. Write a poem out about your feelings.
- Scrub the house from top to bottom. Distracting yourself with tedious tasks, paying close attention to details can give you a different focus for the energy you are feeling.
- Get out the hottest jar of salsa and add jalapeno pepper or red chili peppers, and dig in. It might burn your mouth or make your eyes water and your nose run to eat this, but it won’t scar or cause actual harm.
- Draw or paint on paper what you want to do to yourself. Draw or paint a second picture showing why you want to do this. Draw or paint a third picture showing how you wish you were feeling.
- Play with, pet, hold, or hug your pet. Find comfort and soothe yourself with the company of your dog and cat instead turning to pain or injury.
- Take a walk or exercise. The physical release of energy is helpful.
- Plant a small garden. Creating something nice, making something pretty to look at, and tending to something alive can put you into a different frame of mind.
- Take a bath or shower. Let the water soothe you and help release your stress. Talking out loud or crying in the shower helps get the pain out that is locked inside you. Let the stress rinse off and send it “down the drain” away from you.
- Draw on yourself with a red marker instead of cutting.
- Put a rubber band on your wrist and snap it when you think of hurting yourself.
- Hit a pillow over and over and over till you tire yourself out or the thoughts go away. Speak or cry while you are doing this, if you can.
- Listen to soothing music (or scream to angry music).
- Read your favorite book, or read a new book from your favorite author.
- Watch something really funny on TV – use comedy and laughter as a release.
- Play games online. Computer games can be monotonous, trancey-hypnotic, time-consuming, and calming.
- Work on web pages or any other big task that requires your attention.
- Sleep, just have to complete shut down. Let the time pass, and hopefully when you wake up, the intensity of the emotion will have subsided.
- For those with DID / MPD, go to the safe place you have created inside. Visualize nice things, comforting things, favorite things. Allow yourself to be surrounded by good things in life, even if it exists only in your internal world at that moment.
- Snuggle under your favorite blanket in a safe, private, secure place, and allow the feelings to surface. Cry, shake, feel, breathe. Let yourself experience and feel your feelings.
- Think of all the people who have ever had good, kind thoughts of you. Imagine each of them standing with you, holding hands and being with you. Allow them to offer comfort and support to you, even via your own thoughts. Write letters of appreciation to them.
- Play the guitar or piano and play out your feelings through the music. Write a song about your feelings. Sing out loud with your favorite CD’s. If you find a song that fits just right, play it over and over and over.
- Close your eyes and visualize yourself on vacation, far away from your stress. If you love the beach, for example, picture yourself walking at your favorite time of the day, barefoot along the shore, feeling the cool breeze across your face, listening to the waves coming and going, watching the sea gulls fly, picking up sea shells. Imagine yourself walking in the warm clear water, swimming with the dolphins, being totally safe.
- Eat a healthy snack (not too sugary), have a cup of herbal tea, or a glass of milk. Avoid caffeine. Nibble on saltine crackers. Challenge yourself to take 50 nibbles or more on each cracker
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Stay Safe!
__________
by:
Kathy Broady LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
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