July 10, 2010
I Had a Great Time – Thanks for Asking
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*** trigger warning for dissociative trauma survivors ***
The collage and the material discussed in this blog is emotionally intense and could be triggering. Please be sure that you are in a safe place before reading further.
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Trauma survivors with dissociative identity disorder often have to live a double life. There is the public face, full of pretty smiles and general surface chatter that says “I’m fine”, “I’m doing great!”, “I had a good time”, “Nothing is wrong”, etc.
Recognize any of those kinds of cover-up phrases?
Unfortunately, all too often, looking the other side of these statements proves a very opposite reality. The person is feeling anything but “great”.
Every DID survivor I have ever met has a whole repertoire of phrases and quick answers that indicate they are doing well, that everything is ok, even when they actually are not ok. DID survivors know how to cover and hide their pain. Besides dissociating away the evidence, feelings, and awareness of the abuse from themselves, they have also developed a variety of social skills to cover and hide the depth of their confusion, upset, emotions from others.
On the other side of “I’m fine”, there are very different feelings – depression, fear, anxiety, sadness, overwhelm, emotional pain, grief, shame, anger, just to name a few. Sometimes there are flashbacks, body memories, nightmares, self-injuries, addiction issues, etc. There are often feelings related to self-injury, self-destruction, and self-hatred. Sometimes there are incidents of trauma in the current day, or domestic violence, or sexual assault, or date rape. Life can feel pretty dark.
But still, all too often, the survivor will say, “I’m fine.”
The following collage says it well.
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I'm fine. Thanks for asking.
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In case they are a little hard to read, the words on the collage are as follows:
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This can’t be happening
It’s not real
It’s not real
It’s real.
It’s really happening.
To me.
What will I say? What do I say?
I can’t breath I can’t breath
I need air.
Gravel in my hair hurts.
What will I say tomorrow?
What if I get grass stains on my dress?
I can’t breathe.
Please God help me. Please.
Please save me.
Help me
Someone help me
Someone
Anyone
Please.
Please.
PLEASE.
There’s no on
And he’s on top
And I can’t breathe
And this is hopeless
And I think
I can’t escape
God please —
I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine
I can never tell anyone about this
What would everyone say? They’ll all be bragging
About what a good time they had tonight
I can’t say
This is the night
God abandoned me
That my soul was killed
That the world left me behind.
I had a great time, thanks. Thanks for asking.
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In this collage, notice the initial dissociative statements. “This can’t be real” indicates the need to dissociate and separate from what is happening. Even when the artist recognizes that it is really happening to her, she separates herself with the tiny “to me”.
The middle section describes a sexual assault. Some of the pain and discomfort of the abuse is included – for the most part, the details of the rape are not mentioned. However, the fears and pleas for help are included, showing the desperation felt by the woman being assaulted.
Finally, at least for a short while, the abuse has stopped.
It appears, that after the assault happens, this survivor is expected to make a social appearance at a party or a dance. The social event is supposed to be great fun, but how can a social event be fun right after having experienced a sexual trauma?
But still, the survivor says she’s fine.
- What keeps her from talking about what she just experienced?
- Do you understand why she covers and hides the abuse instead of telling others about it?
- Does this survivor remember that she was just assaulted?
- Did she build an amnesiac wall around the abuse?
- Did one insider deal with the trauma, and another insider go to the party?
- Is this survivor denying the abuse?
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Part of the healing process is connecting the reality of the situation with the truth of emotion. Chances are, this survivor does not actually feel fine at all.
What could she do now?
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By:
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
August 18, 2009
Depression and Dissociative Identity Disorder, part 2
Welcome to the second half of “Depression and Dissociative Identity Disorder”. The first seven tips have been previously posted. At this point in time, I will continue with the list of tips for how to specifically address chronic depression for trauma survivors with DID:
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8. As the memories surface, feelings will also surface. Expressing genuine emotion is key to working through depression. Crying tears of grief, screaming out in anger, quivering in fear may not feel comfortable, but holding these very real and intense emotions deep within will create long-term depression. Allowing these emotions to come out safely and appropriately – even if years after the original point of acquiring these emotions – will help.
9. In the appropriate time, let other parts of your dissociative system know about the information that was held by the depressed parts. Overcoming the dissociative barriers by sharing that information between the system parts is critical in your long-term healing. The more that your internal system shares with each other, the more you all can work together towards healing. The full story line does not have to be shared immediately with everyone. However, keeping pockets of dissociated information will continue to create an underlying cause for chronic depression.
10. Your feelings will need lots and lots of processing time. Talk, cry, draw, write, vocalize what you are feeling as many hours and hours over time as you feel these feelings. If you have been holding your emotions in for years of time, it will take oodles of time for these feelings to be worked through. Talking about it once or twice won’t be enough. Pushing feelings back down into non-expression will create more depression. While it will be very new territory to learn how to express your feelings, it is a necessary step.
11. Learn new rules about the expression of feelings. For example, in the past, when you were at risk of being hurt by your perpetrators, you most likely learned that it was not safe to express anger towards those that violently abused you. And yes, in that time frame, when you were likely to express direct injury from your perpetrators, it was safest for you to push those angry feelings deep within. At that time, that was a good decision. However, once you are away from your perpetrators, and the risk of ongoing abuse is no longer prominent, it is both essential and ok to express anger at your perpetrators’ atrocious, criminal behavior. Your healing will require that you remember to adjust with your changing circumstances, including creating new rules for expression
12. Learn to direct your anger at an appropriate target, even if that means starting with a “generic” unnamed target. Talk with your therapist about the variety of anger-expression techniques that allow your anger to be vocalized without creating harm to anyone else. Learning to express your feelings does not give you permission to take it out on whoever is there. The more you can express your anger directly towards the perpetrators that harmed you, the more effective it will be. Likewise, misdirecting your anger towards the wrong target (ie: someone who was not responsible for your abuse or injuries), will only create more problems for you, and will harm a lot of innocent people in the process. For example, getting angry with your children or your therapist will not resolve the anger you feel towards your parents.
13. As a continuation of tip #12, be willing to learn specifically about transference, projection, displacement of emotion, etc. Survivors who have had years of repressed emotion due to duress and abuse will truly need to practice expressing their emotions properly, and will need to learn when they are misdirecting their emotions. All survivors that were not allowed to express anger directly naturally learned to displace any display of anger in sideward ways. Realize that you will continue to get this mixed up for awhile. Be very aware that you might first take your anger out on safer targets. These mistakes are to be expected, and not a “fault” of yours, but it is still your responsibility to learn more accurate skills. Making the mistake of blaming the wrong person will only add to your depression. It will leave the deeper feelings unprocessed, unaddressed, and unhealed, thereby creating the foundation for ongoing depression and pain.
14. Replace the years of trauma and abuse with your own preferred people and activities that you enjoy. Once your life is full of happier, more meaningful things, you won’t feel as depressed. This probably will not happen quickly or easily, and you might have to learn how to live again. It might feel like you are learning to live for the very first time. You might have to learn how to love, or how to experience joy, or how to play, or how to forgive, or how to explore, etc. The more you can fill your life with activities of your own choosing, the less depressed you will feel.
15. Be sure to encourage all of your insiders to have their own individual healing process. Let each of them work through their own traumas, their own feelings, and let each of them find new and more positive interests in life. As each individual part of you experiences less depression, the whole of you will experience less depression. If you let only some parts heal, the whole of you will still be affected by the parts that were not given the chance to work through their healing. Remember, as split and divided as you might feel, you are still all connected within the same one body and the same one brain. To truly overcome depression, all of your insiders need the chance to overcome their pain.
Depression can be very debilitating.
Healing your trauma issues will be fundamental to overcoming the effects of the chronic depression.
In other words, in my opinion, you will continue to struggle with depression if you have unresolved trauma issues. If your dissociative symptoms have a significant negative impact on your ability to function, the liklihood of your having a significant level of major depression (MDD) is also present.
It is true that there may be other reasons for your depression in addition to trauma. (Please note: those topics were not addressed in this blog).
However, it is safe to assume that if you have unresolved trauma issues, you will most likely have chronic depression. And, the less unresolved trauma in your life, the less depression you’ll experience.
So….. get to work on addressing your DID / trauma issues. You’ll feel better for it!!
__________
By:
Kathy Broady LCSW
August 2, 2009
20 Types of Dissociative Splits
It always amazes me when dissociative trauma survivors tell me that after they’ve met three or four of their inside alters (or maybe even a few more than that, but not many), that they think they’ve met everyone in their system. They think they are “done” meeting their insiders.
That never makes sense to me. Oh, I understand why the survivors would want to believe they have so few others inside, but that hope rarely matches with the actual amount of dissociative symptoms that they experience in their lives.
For example, if someone is still losing time, but they believe that have a good solid relationship with the parts that they know – then why are they losing time? Yes, it is possible that someone you know in your system can still block you out of awareness at certain times. Then again, if everyone you know in your system said they did not know what happened during a period of lost time, then it only makes sense to realize there are other parts of the system out and in charge during that missing time. If all of you are losing time, then there are more insiders yet to meet.
In my definition, meeting new insiders is a sign of progress. The survivor will not be creating new parts by meeting new parts – they are simply finding the parts that have been hiding from them all along behind strong dissociative walls. Any time you can reclaim more of the information that had been previously blocked from you via dissociation, you are making progress. Learning about your system and your history are always steps of progress.
So who should you look for or when will you know if there are more parts to meet?
All dissociative trauma survivors have their own unique system, of course. No one’s system is exactly like anyone else’s. There is no right or wrong for how big or how elaborate your system is. You would have split as many times as you had to, and you will have as many parts as you needed.
However, there are some common types of alters that exist in most DID survivors. This is a non-exhaustive list:
(Please note: alters may start off in these categories, but their roles can change.)
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1. Host parts – check to see who was the host at various times in your life. This role can change and be assigned from part to part to part through time.
2. Child parts – your dissociative splitting would have started prior to age 7, so you will definitely have at least one child part, however, most DID survivors have bunches of child parts.
3. Parts that are relatively happy and trauma-free. These parts do not remember any trauma whatsoever. They can be of any age, but they believe they had a completely safe and happy childhood / adult life. Some parts might believe there was childhood abuse, but they can be blocked from the awareness of abuse happening in the adult years.
4. Parts that are created to manage the outside world. These parts may be the ones that went to school, or go to work, or handle social situations. They are typically quite separate from the trauma-holders or those that hold intense emotions. These parts may not be aware of a lot of trauma, they may hold a lot of denial, and they have the job to look as normal as possible. They will help the person get through life by doing normal things.
5. Parts that don’t remember anything “good” happening. If there are parts that only remember good things, there will absolutely be parts that only remember painful, not-so-good things. They contain the information that the normal daytime “happy” parts were not allowed to know, experience, or remember.
6. Parts that know a lot of memory information. These are the parts that either experienced or witnessed the trauma, abuse, neglect, etc. Getting to know these parts will involve listening to stories about the trauma, body memories about the trauma, flashbacks of the trauma, etc. It is common for there to be numerous parts to handle various types of abuses by various perpetrators. For example, one part may have managed a specific kind of abuse by perpetrator A. Another part may have handled a different kind of abuse by perpetrator A. Another part may have handled the abuse by perpetrator B. Yet another part handled the abuse by perpetrator C. And so forth.
7. Parts that contain a specific emotion. Many people split off various emotions into certain parts to contain those intense overwhelming emotions. If you believe, for example, that you never feel anger, you will likely have other parts in your system that do contain those emotions for you. These parts often have names such as “the sad little girl”, or “the angry one”, or “the scared one”. Getting to know these parts will mean starting to accept and experience these emotions.
8. Parts that split off at particularly traumatic years of life. These parts could also be memory-holders, but during years when there was more stress in the external life, there will likely be more parts. Years of more extreme abuse can lead to more parts being created of a similar age simply because more selves were needed to manage the overwhelming abuse.
9. Parts that are loyal to the mother. All children love their mother, even abusive, neglectful mothers. However, this emotion might need to be contained within certain parts, especially in the case of abusive mothers. Some parts are created to agree with the mother’s abuse (defining it as anything but abuse), and others are created to be obedient to the mother, even if they are terrified or in pain.
10. Parts that are loyal to the father. Just as with the mother, the father may have a variety of parts that are loyal to him, his beliefs, his ways, etc. They may learn that it is safer to align with the perpetrator and to separate themselves from the child-survivor.
11. Parts that contain loyalty to the perpetrators. These parts are often rewarded by the abuser-perpetrators and are encouraged to view themselves as separate from the rest of the system. It will take a lot of work to bring their loyalty back to the person they were created from.
12. Introjects created from external people. System introjects are internalized parts of the system that act – think- feel – believe themselves to be a mirror image of the external person that they are replicating, except they often believe they are the actual person (and not the replication). They may adamantly believe that they are a different person from the survivor-self, complete with a different body from the survivor. These parts contain a lot of memories, factual information, emotional realities for how it was like to be near the outside person.
13. Parts that contain the programming / mind controlled messages. These parts are often created by design and on purpose by organized abusers. These parts are given specific learnings that function as “rules” to control the survivor’s overall behavior. They are often separate from the host parts, and quite hidden within the depths of the system. The other system parts will experience their influence, but have trouble recognizing them as specific alters.
14. Parts that hate the mother or father. Hating the parents may be a difficult dilemma to address, especially since there will be parts of the person that naturally love their parents. However, years of repeated abuse and neglect can create the need for parts to contain the hatred felt towards parents who would allow such atrocities to happen to their child.
15. Parts that are created along the lines of family dynamics. Some survivors will internalize their family into their own DID system. You might find internal replicas of the sisters, brothers, parents, aunts, uncles, grandparents, etc. The family dynamics will be played out in a variety of ways but will most obviously be noted in the way the survivor splits off their system.
16. Floaters and other parts that separated themselves from the body during times of trauma. These parts may have risen above the body, and from the out-of-body experience position, may have specific information to share with the survivor about the kinds of things that happened.
17. Internal self-helpers. These parts would have been created by the system themselves and not necessarily during a state of trauma. They are typically leaders of the system that are considered to be holders of wisdom, or gentle peace, or spiritual guidance. They are devoted to the survivor system as a whole and work towards maintaining safety, stabilization, balance, etc. They typically do very little with the outside world, and focus most all of their energies towards helping the system to survive.
18. Parts that are specifically parental figures to the outside children. It is not uncommon for a survivor to split off “parental parts” just to be focused on raising the outside children as well as possible. These parts very often work hard at being different from their own outside parents, and strive to be the best parent they can be.
19. Parts that were involved in abusing others. This is a very difficult area for survivors to reach, but it is more common than not. Especially for those people who have been abused by organized perpetrators (ie: cults, sex slavery groups, etc) there will be parts who were forced to have the perpetrator role and required to do things that harmed other people.
20. Parts that contain a specific skill or talent. Certain parts can be created to develop positive talents and abilities, often as a way to help manage or express or avoid the pain that is felt so deeply by the others in the system. Maybe one part is better at playing a musical instrument than anyone else. Maybe someone else learned how to write poetry. Or maybe someone was created to be an athlete and to run, jump, excel at sports, etc.
As you can see, there can be a large system just by having parts to fulfill the different roles that are often needed to get through the abuse. Some parts may have a variety of these jobs, overlapping from a variety of categories.
But don’t be surprised if you have a variety of parts in each of the categories listed above.
Many survivors do.
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By:
Kathy Broady LCSW
June 13, 2009
Body Memories – The Body Remembering
In the television show “One Life To Live” — Bess tried to rescue Jessica one more time by taking baby Chloe and going on the run. Their secret had gotten out — baby Chloe belonged to someone else and the dear little one was not Jessica’s baby at all.
Tess was angry with Bess for trying this last stunt. Every time Bess looked in the mirror, she would see Tess’s angry face making comments to her. Tess had plenty to say — she was not at all impressed with Bess.
Meanwhile, Jessica was tucked way down inside. She had no awareness that she had driven hundreds of miles away from her home. She didn’t know she was in trouble or that she was about to lose her baby. She wasn’t aware of much of anything.
Despite Tess’s protests, Bess was determined to do what she defined as protection of Jessica. It was Bess’s mastermind plan to switch the babies so that Jessica would never know that her own baby had died at birth. She was determined to never let Jessica feel the pain of having lost her baby. She really believed she was helping by hiding out of town.
But they were found. Their safe person, Broady, found them. (That’s quite an appropriate name for the safe person, don’t you think?!!!) 
With the secret out, Bess had no other option but to let Jessica remember the truth of what had happened. Bess did not know if Jessica was strong enough to handle the emotional pain, but there was no more blocking out the reality or dissociating away the truth. Jessica was going to remember.
And Jessica did remember.
Painfully, reliving minute by minute, even having body memories of giving birth to her child, Jessica remembered detail after detail of the incident that had previously been totally dissociated from her awareness. For months, Bess had completely held those memories from Jessica, but the dissociative walls between the two of them were no longer necessary. Bess was letting Jess remember.
Jessica remembered going into labor, birthing the child, and seeing that her child had been stillborn. She recalled the plan of switching her baby for another newly born baby, and she knew that she had to return baby Chloe to her rightful mother.
Jessica was addressing her pain. She was remembering in an emotional and physical way. She felt the labor pains, and recalled the birth of her baby as if it was happening all over again. She felt the emotional agony of losing her child. She remembered all that had been dissociated from her awareness.
And she was strong enough to handle the pain. And by doing so, she will be able to heal.
The writers of “One Life to Live” provided a fairly accurate portrayal of this process, for sexual abuse survivors with dissociative identity disorder even if it was fast-forwarded in typical soap opera fashion. But for a television show, they did pretty good.
In real life, body memories are a common occurrence for trauma survivors.
For most survivors, the body memories are much more involved, and occur as a much longer process. They will happen more frequently, and not come in such a neat package. But the point is, the body will remember the trauma, and the body will feel the same physical sensations all over again as it “tells the story” of what happened.
Body memories are the body’s way of remembering, storing, and telling the trauma. The survivor’s mind may have blocked out the pain and created dissociative walls around the traumatic experience, but the physical body itself can remember the trauma through cellular memory.
Sometimes survivors experience the body memories separately from intellectual understanding or emotional remembrance of what happened during the trauma. Dissociative survivors will feel intense body pain and have no idea why they are hurting. When the body remembers the traumatic incident at a different time from when the mind remembers the incident, it can feel very crazy making. The therapeutic goal is to put the various pieces together so that the survivor can work through, process, and heal from the memory as a whole.
The body feels the trauma in much the same as in the original incident and the various physical attitudes occur as if the trauma was happening all over again. The physical pain, shaking, trembling, jerking, physical reactions, intensity, and various body responses happen in a similar fashion as in the original trauma.
For most sexual abuse survivors, body memories will also involve feelings of pleasure or physical response. This creates a particularly difficult emotional dilemma for the survivors, as it is difficult to reconcile the pleasure responses that occurred during the middle of an abusive event. But the body, being a biological entity, cannot distinguish safe touch from abuse, and if stimulated correctly, it will naturally respond. Survivors often feel a great deal of shame about this reality, and will need to discuss this situation in their therapy.
Body memories are an important piece of the healing work. The body can say a lot about the incidents of abuse, and it really is impossible to re-create a body memory when there was no memory in the first place.
Because of that, body memories are often helpful in breaking through the denial layers of dissociation. The body may remember moments of the abuse that were too emotionally difficult for the survivors to manage, but by truly listening to their bodies, survivors can learn a great deal about their histories.
What is your body saying to you?
What does your body remember that your mind refuses to think about?
What does your body remember that you don’t want to hear?
What will it take for you to listen to your body? Your body was there for the abuse too. Maybe it knows more than you think it does.
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By:
Kathy Broady LCSW
June 7, 2009
12 Tips for Reducing Shame
One of the hardest areas of healing work in trauma disorders is dealing with shame.
For many survivors of sexual abuse, healing work involves learning about a lot of intense memories that leave them feeling a great deal of shame, humiliation, and embarrassment. These are difficult emotions to process, and the memory material is typically very overwhelming.
Some survivors feel immersed in shame from the very beginning of their abuse. They are appalled at what is happening for them and hate every minute of it, even if they can’t get away from the predators. With every incident that happens, they feel worse, and worse, and worse. The more degraded the survivors are during the abuse, the greater shame they feel.
Shame can become all consuming. It drowns any feelings of self worth and erodes at self-esteem. It leads to self-injury, increased dissociation, suicidal thoughts, suicidal behavior, depression, PTSD, anxiety, addictions, etc. Shame, at its most intense, can destroy lives.
Survivors will internalize the harsh destructive words of their abusers, and if they hear those messages with enough repetition and intensity, they will believe the negativity as truth.
For the host alters of the dissociative systems, there could be nothing further from the truth than hearing what the other alters in the system are saying about abuse. The fronting, daily-life dealing alters are typically not at all aware of the depths of the abuse, and the horrors expressed by the parts much further behind them does not feel real.
However, the alter parts hidden deeper in the dissociative system often have a very different experience than the front alters. Dissociative walls and consistent amnesia keep their two worlds apart from each other.
Sometimes the abuse-laden parts have become so entrenched in their abusive worlds and so blocked from any kind of participation in the outside world that they do not understand the extremity of the worlds they know. For dissociative survivors who have been sold into sex slavery or prostitution or pornography, this dynamic can be all too true.
System parts that are taught by their perpetrators to feel pride in being used as sex slaves know that to be their world, their truth, their reality. They own that pride, and do not think twice about it being a difficult or questionable lifestyle. They have been encouraged to handle the pain, they learn to believe they like the pain, pain becomes associated with pleasure, and they have a sense of accomplishment for completing various sexual tasks, no matter how extreme.
These alters strive to make accomplishments in that world. They may feel quite successful at their “jobs” and have few feelings of shame.
Reclaiming those parts from their abusive worlds means that these parts will eventually connect with the horror and shame that they pushed away years ago. The parts that have been sexually passed around from person to person to person will start realizing how much that trauma actually affected them. What once gave them pride, will lead to painful agony, shame, and distress. They will realize how much they have been hurt.
However, once they realize they are being abused (or have been abused), they can make decisions to stop the abuse.
They can work with their therapists and the host parts of their system to get away from the abusers, inside and out. This is done through internal system work, freeing each part from the ways they have been trapped in their memories. (Remember, people with DID tend to keep internalized realities, dynamic re-enactments of the abuse with introjects of abusers in what feels like the current day timeframe.) This work can also happen in freeing the dissociative person from a real-life, current day abuser.
Once survivors feel more distance between themselves and the abuse, they can begin to heal from the barrage of shame-inducing, horrific traumas that happened. They can gradually begin to understand what things belong to the perpetrators vs. which things are truly about them. They can begin to develop a separation between themselves and the world of sexual abuse.
Healing from that internalized sense of badness is a big part of the therapy work. As survivors learn they are truly victims of crimes, and that they are not to blame, they can begin to let go of the sense of shame that has surrounded their lives for years.
As survivors remove the overwhelming trauma from their lives, they can then, in turn, fill their lives with positive activities from their own unique preferences. They can begin to feel better about their lives. They can feel healthy pride in what they are doing, and feel pleased in their accomplishments. They can replace the feelings of deep dark shame with a sense of happiness and self-worth.
Overcoming shame is not easy. It is hard, grueling, intense emotional work.
The intensity of the shame felt by a trauma survivor can be a type of emotional barometer for the amount of healing work that needs to happen. The more that shame overwhelms the survivor, the more healing work is still needed. As the depth of this shame lightens, the more the survivors have progressed in their healing journey.
1. As a trauma survivor, know and understand that you are not a bad person.
2. Come to terms with how the abuse was not your fault.
3. Be brave enough to look honestly at the trauma that happened in your life.
4. Find the strength you need to get away from your abusers.
5. Work hard to be safe and to end any and all abusive relationships in the current day.
6. Realize that you will be able to build a happy life that you are proud to have.
7. Believe that you don’t have to let your shame destroy you.
8. Recognize the perpetrators for what they are – nasty violent sex offender criminals.
9. Let the perpetrators keep the responsibility for their own behavior. Don’t take on what belongs to them.
10. Do your healing work – process your trauma, grieve the way it has affected your life.
11. As you heal, be willing to let the resolved issues settle into the past.
12. Fill your life with activities and people that you genuinely like.
__________
By:
Kathy Broady LCSW
May 23, 2009
One Life to Live and Jessica’s Integration
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
April 12, 2009
Reclaiming the Holidays
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Do you remember the DiscussingDissociation article from December 2008 called “Holidays for DID Trauma Survivors… Making it Nice for the Littles”?
If you have not yet read that article, please check it out. It was written in reference to holidays during the Christmas season, but the points are still very much applicable today on Easter, and during Passover.
We have seen the numerous comments from people about how the Spring time holidays are difficult, painful, emotionally challenging, etc. I have been listening to dissociative trauma survivors for many years, and that is a consistent theme for survivors with DID/MPD.
While you cannot change the past, you can make a few things happen that will help you to feel better in the present.
At some point that works for you — don’t put this off forever! – do the memory work that is connected to the pain you feel about the Easter / Spring time holidays. Find the ones inside that have those horrible memories, listen to what happened to them, look at whatever images they need you to see to understand, address their concerns, and help to move them forward to the here and now.
Remember, as long as your internal parts stay stuck in time, and are internally locked in the past, they will continue to re-live and re-live and re-live those memories.
For survivors with Dissociative Identity Disorder, memory work also includes doing internal system work and making changes in your internal landscapes. Read the January 2009 articles, “Using the Internal Landscape to Increase Internal Communication” and “When It’s Dark and Scary on the Inside…” as guidelines for working with trauma memories.
Also, since many trauma memories are related to or contained by child parts, it is also important to refresh your memory on how to work with child parts. Have a glance back at “Thinking Ahead – Preparation for Working with your Child Parts” and “Understanding the Child Parts in the Dissociative System”.
Working with the child parts that hold the painful trauma memories, and helping them to find ways to reconnect with the here and now, both internally and externally, is crucial in your healing process. If you are still hurting today, and your trauma happened years ago, a great deal of that pain you feel is coming from the child parts that experienced the pain and abuse in real life.
Don’t avoid those little ones just because they are hurting.
That’s not going to help. It’s not going to help you feel better, and it’s certainly not going to help those little ones feel better. It’s not ok to repeat the patterns of neglect and avoidance that you might have seen from your own parental caregivers while growing up.
Be courageous as best you can, and do some kind things to help your child parts to heal.
Find ways to give something positive and fun to your child parts today.
Give them a piece of Easter candy, especially if they have never had the chance to have safe, and yummy “real” and actual candy before.
Let them have a picture of a little duck or a baby chick and spend a few minutes coloring or drawing a pretty spring picture, with fresh grass, safe flowers, colorful blossoms, etc.
Play a few fun games (not hurting games) with Easter eggs or colored toys.
Let them sing some favorite spiritual songs or say some prayers today.
Let them do anything that is fun for them, something that does not get to happen just any day, ie: watching a favorite show on tv, having their favorite snacks, etc.
It doesn’t actually matter what you do with your kid parts as long as you do something nice, memorable, and positive for them, with them.
Give your kids a pleasant, positive memory today. Let something good become part of their life experience. The more you build something positive for their lives, the sooner your negative memories can be less enormous in proportion.
What good times are you going to have today?
__________
By:
Kathy Broady LCSW
January 26, 2009
Emotional Intensity, Safety and Memory Work
Here is a quote from my article “Overcoming Instability Issues and Unsuccessful Memory Work,” posted on January 3, 2009.
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“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.”
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It has come to my attention that I need to expand on these statements.
A. Your Normal Voice
To clarify, speaking “in your normal voice” does not mean to be devoid of all emotion. A dissociated, numb, detached voice is not your “normal voice”. A “normal voice” can and does have plenty of emotion — otherwise, we would all sound like robots.
Pick a safe topic (one not about trauma), but a topic about which you have passionate opinions. For example, what was your opinion about Bush vs. Obama? Did you have a strong preference for which man you wanted to have as the next President? How much emotion was in your voice when you expressed your opinions about the election?
Or, think of your favorite funny movie – one that really makes you laugh and leaves you feeling good for the rest of the day. When you talk about that comedy show, reliving the funny plots to your friend, do you have emotion in your voice?
In each of these situations, most people will have a relatively strong emotional connection to the topic, but they will be able to use their “normal voice” and incorporate a healthy amount of emotion in their speech.
Reaching up to (but not beyond) this level of emotional intensity is my recommendation for early stages of trauma work.
B. Emotional Intensity
I do not recommend that the first steps and stages of addressing memories and trauma be experienced in the extremes of emotional states. To go from blocked, dissociated, amnesiac non-awareness of traumatic material to full-fledged, full-voiced screams and cries is far too big of a jump. That’s a black vs. white approach, and neither extreme is going to be helpful for you.
Of course there are times when more extreme and intense emotion needs to be expressed – that is absolutely true. However, I do not think it is in any survivor’s best interest to start at that level of emotional intensity. Expression of that kind of emotional intensity happens way further down the line in treatment chronology. If you jump there too soon, there will be problems.
Why?? Because of the backlash. If you have no awareness of certain traumas for years of time, and then, within a short amount of time, you get flooded with a tidal wave of emotional information about that trauma, you can bet that there will be struggles with self-injury, self-mutilation, and physical pain as a backlash response to the sudden and excessive emotional pain of remembering.
The strength of your dissociative walls – the years of not knowing about certain traumatic information, emotion, and physical feelings – clearly and without question indicates that there is, and will be for an extended period of time, system conflict about that memory information surfacing.
While some parts will be very relieved at the chance to talk about their trauma, you will also have some insiders upset and angry that the memory surfaced in the first place. Some insiders could be so upset if memories surface or are talked about that they might threaten punishment or harm, or they might forego threats and simply act on their own beliefs and their own feelings. You will have some insiders re-living the physical pain, and others trying to deny the whole shebang. With all the opposing responses going on within your system, you won’t be able to sit with the emotional intensity for very long. An internal war will follow. That’s not very healing. That’s quite traumatizing.
It is much better and safer to approach emotional intensity in graduated steps — to build your tolerance and emotional endurance, and to make sure that there is no internal backlash. While some parts of you might want to scream and shout, there may very likely be someone else inside who will believe that kind of behavior should be punished.
If you don’t have sufficient system cooperation to be expressing such intense emotion, and to maintain your safety in the days following, then it is not safe for you to be pushing for that level of intensity.
C. The Here and Now
When doing trauma work, it is absolutely critical to have a solid connection to the present day, the here and now. All too many dissociated insiders actually think / feel / believe they are still living in the time frame that they are most connected to. Just because you – the adult host — know it is 2009, does NOT mean that your inside parts have that solid awareness. They are more familiar with other time zones. They may fully believe they are still there, in those times, living in those places, near those perpetrators, etc. They will be frightened of ongoing abuse, and will react accordingly.
Check that thoroughly. If for any reason, your insiders still think they are in that traumatic time frame, they will still be too afraid to address the issues in the most effective ways. They will still believe their perpetrators can hear them, or can see them, or will be showing up again at any moment. (Working with internal introjects of external perpetrators is a huge issue, but will be addressed in at a different time.)
As you show the current time frame to your insiders and prove to them that they are living in a new time frame (2009), and that they are living in your current house, that the perpetrators they fear are far far away, you are giving your memory-holding parts the ability to get grounded back to the current day once they begin memory work. This grounding to the current time frame is critical for them to know they are safe.
D. Current Safety
ALL parts must know they are safe enough to talk about their trauma, but this is especially true for child parts. They have to know that it is ok, and that the perpetrator isn’t going to show up and hurt them for talking. They also have to know that the other insiders will not punish them for talking about their memories.
Before starting any memory work with young parts be sure to address the following issues with them:
- Are they still connected to now – 2009? Show this, prove this, in any way that they can.
- Can they still see the room that you are physically in?
- Can they see that you live in this house now?
- Can they see that the house looks different? Can they see how the yard, garage, grounds, barns, etc look different from when the places where you grew up?
- When they are talking about the scary things that you remember, can they come back to being right there, in the current-day place where you are – the place that is far, far away from where those mean people live?
- Can they see your therapist’s office? Do they see the couch there? The pictures / decorations that are there? Do they know that your therapist’s office is also a very very very long way away from where those bad people are?
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Reassure all child parts that you can and will keep them safe, both inside and out. If you cannot promise that you will be able to keep them safe from mean insiders and outside perpetrators, then address those issues first, before attempting to make the hurting parts talk about trauma.
Everyone needs solid reassurance about safety BEFORE talking about their trauma.
Safety First!!!
__________
By:
Kathy Broady LCSW
January 18, 2009
Using the Internal Landscape to Increase Internal Communication
Trauma survivors with Dissociative Identity Disorder have an internal world – an internal landscape that is visible, tangible, and very real for the different internal parts. No one on the outside can see this internal world – it is within the mind of the DID person and it belongs totally and completely to them.
Many times, this internal landscape is an internalized replica of what happened in the outside world. For example, you might see a house that looks just like the place where you grew up. Or you might see rooms that appear to be the same as rooms where you were hurt. When you first look within your internal world, it is not uncommon for most of the landscape to parallel your trauma history. It is, in fact, during the traumatic times that your various parts were split off.
However, the internal world belongs to you, it was created by you, and it does not have to stay “as is”. If you can visualize something new, you can change your internal world. If you want to create and develop nice internal homes, you can do that. It is your world, and you can surround yourself with whatever you choose.
This internal world can be changed and affected by work done with external people with the internal parts. Like any other situation, if the interactions are with a safe person, the changes to the internal world will lead to greater healing and stability. If those interactions are with a not-safe person, the changes in the internal world will be done to serve the offender / abuser, and will not benefit the DID survivor.
The internal landscape comes naturally with the concept of dissociating because the other people that are split off from the natural born child have to have a place to be, to exist, to live. They have internal homes – their own place be – when they are not out presenting in the body.
When the host person is in a lot of denial about the DID system, it is not unusual for that host part to not be able to see much of the internal world. Hosts with denial very often say, “It’s dark inside”, or “It’s all black”, or “I can’t see anything.” When this is the case, it is a very clear indicator that there is work to be done.
The host person of your system may not be the best person to go to when you are trying to work with your internal worlds. The host typically has the job of dealing with the outside world. Hosts are great for that, but someone else in your system could be better prepared to work with internal worlds. For that matter, if the host person has a great deal of trouble accepting that there are internal worlds, you might have to side-step that debate, and work on the issue separately as an internal group. Invite your host to join in with you, but don’t stop doing this work if the host personality finds this too difficult.
You will have internal leaders as well – they may or may not be the same leaders that deal with the external worlds. These leaders will likely be aware of who is in their area. They even be aware of other areas that are separate from their own “world”.
Those of you that can see each other can create an internal meeting place – a neutral area, much the same as a living room or den of a house. Create this place as an area that belongs to everyone and is created to be shared between whoever shows up. This makes for a good place to practice overall group communication.
Use this room to have general group meetings, to talk about daily events, to discuss decisions, to make plans. Check in with each other – ask how the others are, how they are feeling today, and what’s going on for them. The more your group as a whole participates in life issues, and becomes aware of each other, listening to each other, the more cohesion and cooperation you will get. Developing a group consensus – where insiders can agree to do various issues, will significantly improve your overall stabilization and ability to function.
Besides group meetings, make it abundantly clear that it is also ok for everyone to speak with everyone else. This is important, as breaking the “no-talk rules” is critical in your overall healing. Encourage each other to spend time together, to get to know each other, to talk on a regular basis. Do not base these kinds of communications on trauma material – base these on typical outside interactions, where you get to know the person, what they do, what they like, who they are before you start asking about crisis or traumatic material.
When you look around your internal world, you will get clues from the actual landscape that is there. If you see a locked door or a walled off area – there could be someone else on the other side, specifically separated from the rest of you. If you see black fuzzy shadowy areas, there are very likely groups of other people hidden inside of those. If you see a house or a building, there will likely be people inside those areas as well.
Explore. Walk around. Look deeper into areas that you haven’t gone into before. Look in the hidden areas – you’ll find all kinds of internalized parts if you look for them. Think about where you used to hide as a child. If you look in those same kinds of places on the inside, you’ll find some of your internal kids hiding there in your internal worlds. These hidden kids may also know where other hidden children are. Be sure to ask.
If you are leery about doing these walk-arounds on your own, take someone with you. The buddy system works well and be sure to inform the others inside that you are exploring, and ask them to come check for you if you’re not back in a certain amount of time.
Your inside world will be a mini-version of what your life has been like. What happened externally will have been internalized. In many ways, your internal world will be a version of your life story, and all the insiders needed to get through the different events. The places will be the same. The stories will be the same. It’s you and your life – just on the inside.
Remember, as you find someone inside, approach them the same as if you were looking at an outside person in that situation. If they look hungry, give them something simple to eat. If they look thirsty, share a favorite drink with them. Give them clean clothes, warm blankets, a warm wash cloth, and small teddy bear for comfort if they are young. First meet their physical needs. Your first priority is to help them feel safe and protected.
Once these parts feel safer with you, they will begin to talk with you a little more. Do not push for memory content. This will overwhelm too many people too fast, and it’s not necessary. If the hidden ones you find will move to a new area closer to the safe common ground, that is great. It might take a lot of work, before they are comfortable enough to do that, but let them know the option is available whenever they are ready for that.
Start with getting everyone connected more in the here and now. Let them peek at the external life to see that they live in a new place and time. Many of these insiders will have been locked in their traumatic worlds all their lives. They need time to see that it is now (2009), and that it will be news to them that they can live in a safer place. Build nice areas for them to stay, so they don’t have to go back to their traumatized “homes”. The longer they can stay in safe neutral areas, the better.
(To be continued…..)
__________
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.
__________
by:
Kathy Broady LCSW
