May 1, 2012

Integration – A New Category and Nine Quick Opinions

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Integration - yes or no, Internal Communication, mental health tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , at 2:39 am by Kathy Broady


Hello Everyone,

I hope you are doing well today.

This will be a short post, but I made an important update to the Discussing Dissociation blog and wanted to be sure that you all knew about it.

I have been asked repeatedly about my views on integration.  I’ve written posts and comments about this topic, but unfortunately, I didn’t create a “category” for these posts. So now, with the 170+ articles on this blog, these posts and comments are difficult to find.  Of course!  This means it’s time to simplify this topic search for everyone, and to make it simpler for the Discussing Dissociation readers to find these blog articles.

If you look on the right side of this page, scroll down until you see the Categories drop-down box.  I’ve added the category “Integration – yes or no” to this feature.

This drop-box will link you to here.

I’m assuming, in all my many blatherings on this blog that I’ve made more comments about integration than just what is written in these two blog articles.  However, this link is a good start. If anyone finds comments about integration in other articles, please let me know, so I can be sure to add that article to the category list as well.

In case you don’t have time to read the other articles at the moment, I’ll give you a quick summary of what I think about integration right here in this post.

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Quick Thoughts about Integration – Kathy Broady’s Opinions:

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Is integration necessary?  
Absolutely not.

Is integration beneficial?  
I doubt it.

Is integration the ultimate peak / proof of healing for dissociative trauma survivors?  
Not at all.

Does integration need to be your treatment goal?  
Not unless you say so.  I wouldn’t ever ever make it a treatment goal for any of my clients.

If integration is not the treatment goal, what is?
Team work.  Lowering the dissociative walls between internal people.  Internal communication.  Talking together.  Not hiding information from each other.  Building trust and genuine relationships within your system. Learning to genuinely love and care for each other.

Do you, Kathy, think that integration is possible?  
Honestly?  Not really.  Not complete and “total” integration.  I have not yet met anyone who integrated in such a way that they stayed integrated permanently for the rest of their life.  I have not even met anyone that I would say has been integrated successfully for years of time.  I have heard the stories of many such claims, and met some of these people, but in my opinion, none of the “integrated” people that I have ever talked with were able to literally demonstrate true integration.  They were still very multiple in oh so many ways.

I’m not convinced that a person who has lived most of their entire life as a multiple can literally change their brain in such ways to become a singleton.  Besides, what would be the point anyway?

Do you think that blending is possible?
Yes, absolutely.  To me, blending and coming closely connected together in a co-conscious ways are very different from integration.  Blending does not imply a complete union of absolutely everyone.  It is perfectly natural, normal, and healthy for some of the splits to become more blended together, especially those parts that are already very close to each other.  If their blending happens naturally, that is great.  You cannot force blending to happen, and it doesn’t happen instantly.  It is a very gradual process that happens over years of excellent therapy, healing work, and genuine external safety.  If there is any kind of “forcing” or demanded blending under duress or coercion or deception, you can bet that those insiders will step back and separate again in the not so distant future.

Do you think that integration keeps you safe?
Ummmm…. No.   In fact, I think that claims of integration can lead to the very opposite of safety.   Why?  Because I think that real and genuine integration so very rarely happens (if ever), that when someone begins to believe that they are integrated, this is the beginning of some really dangerous times.  This typically means, in my experience, that some of the top layers of the system may have blended together, and/or learned how to work well together, but the darker under-layers of the system have hidden behind very thick dissociative walls.  This is extremely dangerous because the dark parts are able to function without being noticed, and the top layers of the system are too busy being proud or protective of their integration and/or completely absorbed in their outside lives that they don’t notice the dark rumblings behind the wall.

Do you think that integrated multiples are safe leaders for other dissociative survivors?
No.  Not that I have seen.  In my opinion, it is much more likely that the alleged “integrated multiple” has very neatly hidden or shoved away their dark sides, even if they do not realize  this.  All the claims in the world of being integrated do not actually make someone integrated.

In fact, following the leadership of someone who alleges to be an “integrated multiple” can be extremely dangerous for others, especially for those who are newer in their healing process.  You would be safer to run 100 miles in the other direction than to assume that an integrated multiple is “automatically” a safe person.

I know many of you will not like these statements, and it is ok if you disagree.  I am not meaning to offend you.  We each have our own opinion and our own experiences in life.  Let me repeat this, because it is so very important.   In my years of experience, “integrated multiples” have more often than not been used as lures, and in reality, they are people who have not completed  HUGE areas of work, and they are not automatically “safe” people.  Going further into this topic  is an entirely different blog post, but in my opinion, there is a whole whopping lot of danger in this area.  PLEASE be careful when you meet an “integrated multiple”.

I am very aware that there are many multiples who have had spiritually-based integrations.  That is yet another complicated topic, to be discussed at another time.

Ok – this was going to be short (and of course, it’s not short!!), so I’ll stop at this point.  I can feel the waters already getting stirred out there.  Ah well.  What is life without controversy, yes?

IF I thought integration was a great thing, I would certainly say so.  I just haven’t seen it as such.

What about you?

Do you have any comments about integration?

Warmly,

Kathy

Copyright © 2008-2012 Kathy Broady and Discussing Dissociation

July 31, 2010

Do Dissociative Trauma Survivors Actually Lose Time?

Posted in Child Alters, DID Education, DID/MPD, Dissociative Identity Disorder, Internal Communication, therapy, Therapy Homework Ideas, United States of Tara tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 9:35 pm by Kathy Broady


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One of the diagnostic criteria for dissociative identity disorder is experiencing amnesia or lost time.  While losing time may seem like an obvious hole in your every day life, it really might not be as obvious as it seems it could be.

For dissociative trauma survivors, the sliding of time is a normal everyday way of life.  It just is how it is, and time feels very different for DID survivors than it does for other people.  Dissociative survivors may or may not pay attention to the minutes that are gone, or the hours that have slid quietly by.  They are very used to the ebb and flow, and unless there is reason to pay specific attention to the idea of lost time, they may not really be genuinely aware of how much time they lose.

Every dissociative survivor I have met has recognized specific periods of lost time in his or her life.  Sometimes, multiples think they do not lose much time, but with a few detailed questions, it can soon enough be shown that there are very clear gaps in memory and awareness of regular life events.  There will be everyday type things that they know they should know, but they don’t.

Some multiples will notice big chunks of time that seem to be gone.  It will be 2 pm, and then suddenly, it’s 9 pm, and the survivor has no awareness of what happened during those seven hours.  Those hours are considered lost time because they feel completely lost and unaccounted for.  The host parts don’t remember what happened.  If they look around, they might get some clues about what may have happened, but for the most part, it feels like time completely jumped seven hours ahead.  Time feels lost to them because there is basically no information and no awareness about what happened.

Other times, DID survivors will feel like they are mostly aware of everything that happens through their day, but their ability to remember what happened yesterday, or even to remember what happened this morning, or an hour ago is extremely limited.  This is a different kind of lost time in that the recall is so nonexistent that it becomes the same as lost time since the survivor has next to no idea what happened.

In both of these situations, time is being quantified from the perspective of the front host personality.  Time loss can include other parts of the system as well, but the questions about lost time are typically addressed towards the host.  This is an important distinction to remember.

Because you see, even though time feels lost to the front host personality, in all reality, time is not lost at all.

Yes, you read that right.  Time is actually not lost. Time has not actually gone away.  The DID survivor’s day is not shorter than everyone else’s day.  Time has not disappeared in the way that it feels.

While we use the term “lost time” all the time, that is actually not what happens.  In fact, no one with DID actually loses any time at all.

So where does the time go?

Actually, what happens is that the dissociative trauma survivors have switched to another part.

Yep, they’ve just switched.

Switching.  Shifting from one part or another.  “Transitioning” as US of Tara called it.

That’s all that happened.  You’ve switched!

The hours of time can be completely accounted for if you know who was out and what they were doing.  Time itself isn’t missing.  What is missing is having the awareness or knowledge about who in your system was out doing what.

So when the host or front personalities are completely unaware of life events, and there is no knowledge of what has happened, they have simply switched to someone else in their system who is out and doing all kinds of things. The body is likely up and active, and any number of things could be happening.  Someone inside the system will know exactly what happened between 2 pm and 9 pm!

For there to be “lost time”, this switch occurs with parts that are so dissociated and separated from the host personalities that the host personalities are not aware of what happened.

Actually, this kind of time loss / lack of awareness can happen between any part of the system with any other part of the system.  Many of the insiders may not be at all aware of what the host personalities are doing either.  Part of the reason for time distortion, triggers, and flashbacks is connected to the insiders not being aware of the outside life in the current day, place, or time.

Sometimes the lost time between these parts are just from not paying attention.  For example, one set of parts can simply be daydreaming or drifting off, and simply not concentrating enough to be aware.  Maybe they were choosing to have an internal nap or be otherwise internally occupied. However, if they actually tried to be aware of what was happening in the outside world, they may fully well have known exactly what happened during that lost time.  Or with a little effort, they may have been able to get close enough to the front of the body to be aware enough to see, or hear, or know.

Other times, the dissociative walls / amnesiac walls are much thicker and less penetrable.  In these situations, one set of parts does not want the others inside to know what is happening, and the blocks put between them are strong and absolute.  Parts from within the internal system are specifically dividing themselves away from everyone else so everyone inside is not aware.  If you have parts that are specifically hiding their activities from the rest of everyone else, this is an important issue to address in your therapy.

In my opinion, integration is not necessary for successful stable functioning.  But, eliminating time loss and/or periods of unknown switching is important for exactly those reasons.  It is ok that everyone within has their chance to do what they need to do, but it is also important to build the communication around what is happening.  You all share the same life.  Being more aware of what happens in that life is important.

So the next time you want to know what happened during that chunk of time that you don’t remember, ask inside.  Ask who knows about it.  Ask who was out, or who saw what happened. There will be someone inside that knows exactly what was happening during that chunk of “missing time”.  You might need to work on increasing your internal communication with those parts, but once you know the others in your system, that time loss will decrease.

Even if the time loss is happens, but if you know who is out, that can help with knowing what happened.  The more you know your whole system of insiders, the less unaccounted for time you will have.

Once again I’ll say, internal communication is the central core of treatment for dissociative identity disorder.

If you want to know what is going on, talk to each other!!!

__________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

March 23, 2010

United States of Tara is Integrated Now? Really?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Family Members of Trauma Survivors, Friends of Multiples, Integration - yes or no, Internal Communication, Supportive Spouses, therapy, Therapy and Counseling, trauma therapist, United States of Tara tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:00 pm by Kathy Broady


Toni Collette wins Best Comedy Actress Emmy, 2009

Toni Collette wins Best Comedy Actress Emmy, 2009

So here we go again.

The second season of the Showtime series “United States of Tara” starring the Emmy Award winner Toni Collette has begun.

The first season was full of controversial episodes, and most of the survivor population with dissociative identity disorder was disappointed and angered by the series.  Even though some of the best-known trauma psychiatrists were allegedly acting as advisors for the show, there were still far too many inaccuracies and misrepresentations for the comfort level of real DID survivors.  (Maybe next time, Showtime, executive producer Steven Speilberg, or writer Diablo Cody should speak more with clinical therapists that treat dissociative clients on a long-term basis.  If you ask me, therapists know more about the clinical realities of DID than psychiatrists anyway, but that’s a whole different rant.)

The first episode starts with Tara tossing out the clothing and personal items that belonged to her formerly recognized four or five insiders.  Tara had ended the first season in the hospital, and had apparently done so well in her brief hospital stay, that it had been three whole months since her insiders had surfaced.  She was sure they were all gone.  She was already saying goodbye to them – more like good riddance to them – and her family gathered around the charitable donations dumpster to make crass comments toward the inside parts.

Oh dear. What a way to start the season.  Fifty-one seconds into the show and my eyes are popping out with enough material for a blog post. (Dare I even watch the rest of the episode?!)  Yeeesh!

So this very first minute of the show brought up some of my very biggest complaints about the way some mental health professionals and hospital programs treat DID / MPD.

One of the most devastating techniques that treatment providers can use with dissociative survivors is to push the whole integration idea.  To push the idea that insiders need to not be allowed out, or need to be silenced, or need to be pushed to the back, is damaging to the person as a whole.  Integration is not anywhere near the cure-all or ideal goal it is professed to be, and frankly, expecting dissociative clients to having these “alleged integrations” too fast is absolutely harmful.

I have seen too this happen far too many times.  This is not good treatment for dissociative identity disorder!!

You cannot go into a hospital program and walk back out, a few weeks later, as an integrated multiple.  This is NOT possible.  I don’t care how much this is advertised as possible, it is not.  It is complete farce, and it will not work.

Sure, you can temporarily push your insiders back into hiding.  Or, your insiders can push you out to the front and rebuild the dissociative wall behind you so that you are completely separated from your system.  You might think you are alone. You might think you are “integrated”.  But you are just separated from your insiders.   In fact, you are more dissociated than ever because now you have a complete dissociative block between you and the rest of your selves.

This is not helpful.

Unfortunately, there are hospital programs or therapists that encourage this kind of treatment.

It doesn’t work.  It won’t stick.  Those inside parts are not gone.  They might be hidden, but they absolutely are not gone.  And this new or encouraged separation will just cause problems down the road.  I’d bet money on that.

I realize that many of you may want to push your insiders back in, or make them shut up, or make them go away, because you believe that your life would be easier and more manageable if they were gone.  I can understand the concept that having one personality is easier than having a dozen or two (or three) personalities.  I get that.

But it’s still not a good idea.

The various parts of you were created for a reason, and they hold valuable pieces of your life, your history, your emotions, your skills, your abilities, your memories, your talents, your energy, etc.  They represent years of your life, and it takes all of you together to make the whole picture – and as appealing as it might be to think that three weeks in the hospital can solve everything with a quick integration, this is an illusion and a lie. Genuine integration, if it is actually desired and if it is actually going to be successful, requires years of work.  The various selves to work through all the things that caused them to be separated in the first place – and that just takes time.

It is a cruel trick for hospitals to sell this approach as something they can achieve for the client – because the hospital won’t be there six months or a year down the road, when the apparent “integration” falls apart and the devastated client is left feeling at fault.  And it is compounding the wrong for Showtime to present this approach as something that actually happens.

The other problem in this first minute of United States of Tara is the negative way that Tara and her family are speaking about her insiders.  Where is their kindness and compassion?  Why such blatant disrespect?  Where is the appreciation for what those insiders did for her?

EVEN IF I believed in sudden or quick integration as a general theory (which I most definitely do not), I would still say to Tara and her family members that their “good riddance, you big pains in the butt” attitude was an obvious indication of why this particular attempt at integration was not going to work.

Clearly, there were still plenty of issues left unresolved.  Clearly, Tara and her family harbored resentment, irritation, and bitterness toward her insiders.  The insiders did not integrate because there was acceptance, understanding, and blending of their roles.  These insiders were clearly not wanted, not liked, not understood, not appreciated.  They were hated.  And if Tara is still hating on her insiders, then she is still hating herself.  This is not the kind of foundation from which any kind of healthy progress is made.

You cannot integrate your insiders if you hate them.
You cannot make them go away, just because you hate them.

I suppose you can pretend they do not exist because you don’t like what they did. But that will not help you to get better.
I suppose you can act like they are not real because you don’t want them.  But that will not help you to get better.

Hating on your insiders, in any way, shape, or form, is not conducive to good treatment.
Hating your yourself, in any way, shape, or form, is not conducive to good treatment.
Your insiders are still parts of you, now and for always.

As far as I am concerned, neglecting your insiders is a form of self-abuse.  Neglect is neglect, and if you are not working hard to appropriately meet the needs of your insiders, you are carrying out of form of neglect.

It is so very important to develop positive acceptance and understanding with your insiders.  It is imperative to the success of your healing, and one of foundations of your treatment, to be kind, gentle, and compassionate to your inside parts.  Build positive teamwork.  Build good cooperation.  Build good internal communication skills.  Become friends with each other.  You and your insiders really have to be able to get along and work things out together in order for your healing to progress.

Somehow Tara forgot to do this, and somehow her hospital program forgot it as well.

She can pretend that shoving her insiders away, or pretending they don’t exist, is a wonderful option for her.

But it really will not work.

Later in the previews, it becomes clear that Tara starts realizing she is switching again.  (She calls in transitioning.  What a bulky word, but ok – it’s a transition from one self to another.)  So yes, she clearly switches from one part to another.  That’s no surprise.

Someone on her treatment team should have told her months ago that that her “they are gone” approach wasn’t going to work.

Because it didn’t.

Obviously.

—–

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

May 23, 2009

One Life to Live and Jessica’s Integration

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, One Life to Live, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , at 1:49 am by Kathy Broady


Multiplicity has made it into the Soap Opera world.

On the soap opera, “One Life to Live”, the character named Jessica Buchanan has Dissociative Identity Disorder.  In earlier episodes, Jessica spent a fair bit of time in an inpatient hospital unit addressing her trauma, her grief, etc.  According to Jessica, she resolved her difficult emotional issues and dealt with her internal system conflicts so sufficiently that she was able to integrate.  Her small internal system agreed that it was time for them to tuck back inside, and even though the viewing audience knew that Jessica had at least one more huge unresolved traumatic secret, Jess went about enjoying her life as if she was completely healed.

For what appeared to be months of time, Jessica looked and acted as if she was integrated.  Bess and Tess were nowhere to be found – she was only Jess.  She felt like she was completely integrated.  She believed it.  Her family believed it.  Her best friends believed it.

Did you believe it?

Anyone that knows anything about real multiplicity and dissociation should not have believed it.

Why was it inevitable that Jessica’s alleged integration would fail?

Because she had unresolved trauma, and she was still holding a secret from herself.  This wasn’t a small secret – it was a huge secret involving the death of a child and criminal behavior.

Jess was still unaware of what Bess did.  Tess knew a portion of the story, but not the whole thing.  Both Tess and Bess knew they hadn’t told Jess.  Jess didn’t know that she didn’t know.

Frankly, Jess-Tess-Bess are still a big mess. :)   But it’s a soap opera, so I wouldn’t expect anything less. :)

The point is this.  When the parts of the system hold important, traumatic, and/or emotionally distressful information from each other, and from the host personality, there is no way that a genuine integration can occur.  Holding this kind of secret from yourself means that you are keeping dissociative barriers and amnesiac walls.

Maintaining dissociative walls is not possible in real integration.  The very definition of integration means there are no more dissociative walls holding back secret information.

So of course, for Jessica, Bess and Tess would return.  They couldn’t not return.  If they could have kept anything and everything totally controlled and not let any kind of trigger or reminder occur, they might have been able to stay hidden inside, but that is unrealistic.  Unresolved, unprocessed trauma is much more likely to get triggered repeatedly until those memories are resolved.

In your healing journey, there will be trauma issues to sort out and address, but remember, until the whole of your system is aware of what happened to everyone else, you will still have dissociative walls.  As long as you have dissociative walls, you cannot be considered integrated.

Questions to think about:

  • If you could talk to Jessica, what would you say to her?   What would you recommend to her?
  • Do you relate to Jessica’s desire to be integrated, and yet still not want to know what has happened in your past?
  • Have you heard the stories and life experiences of every one of your internal parts?
  • Have your insiders listened to the stories and life experiences of each other?
  • Are you refusing to listen to certain parts?  Why or why not?
  • While there are obviously important reasons to pace your healing work, are you intending to listen to every memory that your insiders remember and need to talk about?
  • Would you prefer to continue to “not know”?  If so, how do you define what is necessary for your healing?

___________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

December 18, 2008

Integration: A Requirement for DID Therapy – Or Not?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, Integration - yes or no, mental health, therapy, Therapy and Counseling tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:07 pm by Kathy Broady


I am well aware that many trauma therapists are highly supportive of the treatment goal to integrate dissociative selves.

I have a different approach to this topic.  Please understand I am not at all opposed to the idea of integration if that is what the person wants.  However, that is a very complicated topic, and I’ll discuss the integration issue from that perspective at another time.

In my experience, by far, most dissociative trauma survivors and their systems have been opposed to the idea of integration.  They like themselves as they are, and they don’t want to lose the various individual parts / people from inside.  The concept of integration feels more like killing each other off, or losing unique characters, real people, and best friends. While integration may be the favored ultimate treatment goal of mainstream mental health professionals, it is not necessarily the favored option of the dissociative trauma survivors.

For that matter, I’m not even convinced that true integration is literally or physiologically or psychologically possible.  When one person’s mind-self-body gets pushed to the point of separating and breaking apart into entirely different selves, with entirely different lives, preferences, interests, knowings, time awareness, relationships, friends, hobbies, memories, realities, likes, dislikes, etc. and that distinct plurality solidifies as extremely different people for 20-30-40-50+ years, can it ever really be as if it didn’t happen?   Once that distinct separateness occurs, is it really possible to make that group of folks back into “one” person?

I’m not convinced there is a need, or even a benefit to trying to do this.

I do believe that creating teamwork, cooperation and communication between the different selves, and lowering and removing the dissociative amnesiac walls is critically important.  I can’t stress how important that is.  But developing these internal communication, self-bonding skills is entirely different than integrating these unique selves into one single solitary person.

Developing a highly successful internal group approach is hard, intense work.  It takes a very long time to achieve that goal.   The good news is that a dissociative person can actually function incredibly well as separate selves.

So why is there any need to remove or eliminate this amazing talent and ability?  Why would someone want to try to become somebody else when they can successfully cooperate with their selves as they know them and stay who they are?

If a person does not want to integrate, I do not believe that genuine integration can be forced or “made to happen”.  Instead, I think that forcing the integration issue actually causes the creation of new dissociative walls, which means greater separation, not integration.  Internal parts can be forced to hide from the others inside, giving the appearance of integration without an actual integration being achieved.  This is not good!!  This is the very opposite to helpful healing.  It creates an emotional time-bomb just waiting to explode.

Forcing an appearance of premature integration sets up a horrible dynamic within the dissociative person.  All too often the person is rushed into this conclusion when there hasn’t been sufficient time for the parts involved to heal properly.  They are not finished telling their life experiences, or expressing their feelings, or developing connections with the other inner selves, or challenging their own abuse-related approaches to life.  It happens too fast — and the therapy healing work is just not done.  So that is not ok.  The “integrated” but still dissociative person is left with a huge overwhelming sense of failure if — and when — the parts need to reemerge and finish their healing work.

Healing takes as long as it takes, and the point of therapy is to provide that healing, not to cut it off at the pass. Attempting to rush or force the idea of integration causes, in my opinion, great and significant harm to the dissociative client.  It is a huge set-back.

I believe that any kind of system blending and system cooperation takes a very long time.  It is a slow process.  The reasons for the dissociative splits in the first place are huge and fundamental.  Pretending these splits haven’t happened is like denying the reality of a person’s life and all the conflicting things that have happened along the way.  Bridging the gap between the splits requires huge pieces of therapy work.

My recommendation is to throw that nasty i-word away. Don’t even go there.  Instead, use your time and energy to focus on getting to know your people and becoming really good friends with them – with ALL of them, including the insiders that you are afraid of or angry with.  Focus on building the connecting bridges instead of smushing and smashing people into each other.  As you develop your internal relationships, you will find a great sense of inner peace and satisfaction.

You’ve got good people in there.  Keep them!!!

December 9, 2008

50 Treatment Issues for Dissociative Identity Disorder

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, sexual abuse, therapy, Therapy and Counseling, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 7:06 pm by Kathy Broady


“How long will it take for me to feel better?”

As a clinical therapist, I hear that question frequently.  It’s a reasonable question.  I certainly understand that when someone is deeply hurting and struggling in their life, they want to feel better as quickly as possible.

However, the clinical treatment for someone with DID / MPD is long term.  Some research has said that the treatment can be completed within two or three years, but in my clinical experience, that is far from the truth.

Dissociative Identity Disorder is a result of long-term, chronic, severe, sadistic child abuse.  As children, these survivors witnessed and experienced a myriad of heinous crimes.  They typically describe repeated consuming abuse by multiple perpetrators, and then were otherwise emotionally neglected, starving for comfort, consolation, or attention. They were left alone, even while very young, to process and contain their pain by themselves.  For these children, the splitting process became their way of coping with emotional intensity, conflicts, huge distress, and intense pain that were otherwise far too difficult to manage on their own.  They blocked off their pain, locked it away from themselves, and left it there.  Sitting, waiting, piling up for years.

When you understand how much pain and abuse has occurred in order to create the dissociative splits in the first place, it is no wonder that the healing process is also so very long.  All areas of dissociative survivors’ lives are touched and profoundly changed or affected by the abuse.  It simply takes a very long time to address everything properly.

Some of the treatment issues are:

  • Stabilization of the person – both internally and externally
  • Managing and eliminating self-injury and self-harm issues
  • Examining and obtaining current-day external safety from abuse
  • Internal system safety
  • Developing effective internal communication
  • Calming internal noise and chaos
  • Working specifically with child parts
  • Working specifically with adult parts
  • Working specifically with teenage parts
  • Learning about the other system parts
  • Working with internal perpetrator introjects
  • Creating emotional separation from external perpetrators
  • Working with triggers
  • Correcting cognitive distortions
  • Addressing gender confusion, male vs. female issues
  • Processing emotions
  • Body image issues
  • Reducing time loss, memory loss, amnesia
  • Time confusion, time distortion
  • Trauma processing – memory work
  • Body memories and kinesthetic issues
  • Understanding re-enactments and trauma bonds
  • Healing sexual abuse issues
  • Healing physical abuse issues
  • Healing emotional abuse issues
  • Healing ritualized abuse issues
  • Healing exploitation, pornography, prostitution, sex slavery issues
  • Managing family, marital, parenting issues
  • Addressing addictions
  • Managing eating disorders
  • Household management issues – improving daily functioning
  • Relationship issues and teaching social skills
  • Understanding the effects of trauma on the brain
  • Improving self-independence and self-reliance
  • Improving self esteem issues
  • Leaving disability and regaining employment
  • Depression and medication management
  • Bipolar disorder and medication management
  • Anxiety / Panic and medication management
  • Post-traumatic stress issues (PTSD)
  • Reducing phobias
  • Social anxiety and social isolation
  • Safely eliminating suicidal ideation and suicidal behaviors
  • Homicidal ideation and anger management
  • Exploring spiritual confusion
  • Philosophical issues
  • Detachment and separation issues
  • Treating sleep disorders
  • Treating medical complications and physical harm resulting from the abuse
  • Reaching integration, blended states, or effective system team work

That’s a tremendous amount of work.  And most of these issues surface again and again and again, requiring in-depth attention on a regular basis for years of time.

Emotional healing on such a wide scale just does not happen fast.  Forcing the issues or pretending to be “done” sooner than realistically possible is not helpful.

Simply put, years of severe injuries will require years of intense healing.

It takes as long as it takes.

__________

by:

Kathy Broady, LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

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