August 30, 2009

Protecting Your Therapeutic Relationship and the Therapeutic Community

Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, Self Injury, therapy, Therapy and Counseling, Therapy Homework Ideas, Transference Issues, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 2:44 pm by Kathy Broady


There are thousands of clinical therapists in the world.

However, of all the therapists in the world, only a few work with trauma and PTSD.

Of all the trauma therapists, only a few work with the areas of sexual abuse and severe trauma.

Of those therapists, only a few work with dissociative disorders, DID/MPD and DDNOS.

Of the DID therapists, only a very few work with issues relating to organized perpetrator groups.

And in that small subset of therapists, only a few work with more than two or three dissociative survivors at any one time.

And it is the rare therapist among that already vanishingly small number who stay in the field for more than a few years… or long enough to gain the experience they would need in order to be most helpful to the population of clients they serve,

So of all the thousands and thousands of therapists in the world, there are relatively very few who will have the kind of knowledge and experience that you are looking for when you need a specialist in the areas of trauma and dissociation.

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Why do so many therapists refuse to work in this area when there is so much need?

And why do so many therapists leave the field after committing years of dedication to dissociative survivors?

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It’s time to be honest.

First – please remember, I am one of the rare few who has stayed loyal and passionately dedicated to the fields of trauma and dissociation for more than 20 years.  It is hard to find trauma therapists with that much commitment to the dissociative population.  I am on your side – I will prove that over and over – but I am going to be honest.

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DID’ers are a very difficult population of people for a therapist to work with !!!!

Now don’t get me wrong.  Some of you are absolutely wonderful – without question, the most incredible heroes and the very most courageous people I have ever met.  Those of you in this category are absolute diamonds, and I really cannot say enough positive things about you.  You all are truly inspirational, and I am honored to work beside you.

Unfortunately, those who are genuinely dedicated to their therapy and who work hard to achieve their deepest healing are all too often undermined by the few survivors who are willing to do anything but work on their healing.

Oh, these survivors will SAY they are working in therapy…. They will CLAIM they are dedicated to their healing…. They go through the motions, and they spout all the right words.  To a point.  And then they don’t anymore.

Because in reality, this small number of survivors is more interested in hurting other people than they are in healing their own pain.  They are more interested in destroying others than they are in helping themselves.  They are willing to lie about anything or anyone just to get attention drawn to themselves.  They are very destructive and they are very sick.

And these destructive survivors could be costing you a lot more than you realize.

Ouch.

I am sure as a population, this is not pleasant to hear.  Please know that I am not saying this to all of you.

Those of you that are genuinely dedicated to your healing know exactly what I am talking about – I’m sure – because you have most likely already witnessed your healing resources being used up, beat up, and exhausted by fellow survivors whose intentions were far from honorable.  The survivors that do this are sabotaging those of you that are truly trying to heal, because the therapeutic field gets completely burnt out by “them” and ends up not having the time or energy or interest to work with you.  Many good therapists simply will not be willing to risk working with other survivors after they have had some bad experiences with these destructive survivors.

So… the survivors that are undermining your therapists are doing harm to themselves, to the therapists, and to you.  They are attacking, abusing, and destroying your therapeutic resources, leaving  you with less.  These “bad apples” are giving the whole dissociative population a bad name, and frankly, this kind of behavior should not be tolerated by any of us.

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Now what?

If you all want mental health professionals to stay working in the fields of trauma and dissociation, it is important to make that work worth it to them, and not a “nightmare” for them.

I am not saying that you have to feed the egos of the therapists, or provide support for them, or do any freaky weird boundary violations.  Therapists became therapists for intrinsic reasons of their own.  We don’t need y’all to “make it worth it” to us by what you give to us.

Therapists want you to make their work worth it by allowing them to genuinely do their job.  We want you to address your issues, work on your healing, stay focused on your system, be honest with your feelings, etc.  If you will do your job of focusing completely on your own healing, we as therapists will be thrilled with that.  Your genuine progress will be our reward.

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That being said, what can you do to protect the relationship you have with your therapist in particular? And how can you do your part to protect the resources available in the therapeutic community, so that therapists are more motivated to enter and remain in the field, and more survivors have the opportunity to work with truly skilled professionals?

How can you separate yourself from those survivors that are destructive?

How can you make sure you are helping the problem, and not creating the problem?

Here are some ideas of what NOT to do:

  • Don’t lie to yourself and expect others to believe you.
  • Don’t lie to your therapist.  How can you heal if you are not honest in your sessions?
  • Don’t lie about a therapist.  Don’t believe lies about a therapist.
  • Don’t gossip about a therapist. Don’t believe gossip about a therapist.  Don’t spread unfounded false allegations.  Don’t chase off or destroy therapeutic resources with false accusations.
  • Don’t forget to examine your transference feelings, and recognize them as transference issues.  Don’t forget how projection, transference, displacement, and amnesia can affect your thinking. Work openly and genuinely on these issues instead of blaming the therapist.
  • Don’t attack a therapist because you are too afraid to address the real source of your anger.
  • Don’t let therapists become the “bad guys” in your definition.  Therapists are your helpers. They are there to help with your healing.  Learn quickly how to define the helpers from the hurters, and address that confusion as often as necessary.
  • Don’t assume that all “survivors” are automatically being honest with you (or themselves) when they are trashing a therapist.  Remember, they may be in the “hate” cycle of the love-hate dynamic.
  • Don’t assume that all “survivors” are working for the betterment of the survivor community.  Some so-called survivors are truly moles from the dark sides of the world, and are here to cause trouble in any way they can.
  • Don’t let your jealousies and insecurities consume you and destroy your focus.  If you want your therapist all to yourself, hire them to work 40 hrs per week at their full hourly rates.  If that is not an option, be mature enough to know your therapist is going to have other clients.

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Here are some ideas about what TO do:

  • Be genuinely honest with your yourself. The more honest you are, the more healing you will accomplish.
  • Be genuinely honest with your therapist. Your therapist can help best when they genuinely understand the issues.
  • Remember that your healing is to be focused on you, your behavior, your feelings, your mistakes, your strengths, your weaknesses, etc.  Your therapy is about you, so keep the topics focused on you, even when it is hard to look at yourself.
  • Do your own internal system homework in between sessions.  Your healing will progress as you put your own time and effort into it.
  • Be kind, appreciative, thankful, and polite.  This doesn’t mean to grovel or do penance.  Just use normal social manners and social politeness.
  • Remember that your therapist does not have to be your emotional (or physical) punching bag. If you are hitting too hard, redirect your anger towards your abusers, where it belongs.
  • Give yourself adequate time to work through the complexities of your healing process. An experienced therapist will not rush you, and it is truly ok for you to take as much time to heal as you need.
  • Separate yourself from other survivors that are troublemakers and instigators of negative drama.  Just like school days, if you hang out with people causing harm, you’ll end up doing the same, or being tangled in their web. Their poor behavior will cost you.  You can decide if that is worth it to you or not.
  • Ignore the drama queens determined to cause trouble in front of you.  If you refuse to buy into their antics, they will move on to other pastures.  If you give drama precedence over your own healing, you will not be progressing in your own healing.  Protect the entire dissociative community by supporting your therapeutic resources.
  • Remember to think for yourself.  All too often, survivors listen to any strong, authoritative voice that tells them what to do.  If someone is telling you negative things about your therapist, set a boundary, stop, and re-evaluate all sides of your situation.
  • Talk openly with your therapist about any concerns you have.  Give yourself the chance to problem-solve any difficulties or conflicts that arise.  Working through conflicts is an important part of your healing process, and it does not necessarily require a therapeutic rupture.

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If you can truly apply these guidelines, you will be honoring your own healing. You will also be showing respect to your individual therapist, protecting other ongoing therapeutic relationships, supporting the greater survivor community, and enhancing the larger therapeutic community.

Maybe most of you think that you are not actively involved in the destruction of the therapeutic resources, but if you support it, believe it, allow it to go on by your “friends”, etc, then you could be more involved than you realize. You can either help to maintain effective therapeutic resources, or you can allow their destruction.

It’s a conscious decision that each one of you has to make.

Everyone has to do their part in protecting the few therapeutic resources available for dissociative survivors.  You can choose to support the destructive people, or you can choose to kick them to the curb, and get along with your own healing.

Remember, if you genuinely focus on yourself and your own healing, then you are doing all you need to do.

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By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

March 15, 2009

Addressing Depression in Trauma Disorders

Posted in Depression, DID Education, DID/MPD, Dissociative Identity Disorder, mental health, therapy, Therapy and Counseling, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 11:53 am by Kathy Broady


It is no secret that trauma survivors get depressed, and depression is the most commonly known and experienced mental health disorder.

Typical depression symptoms include:

  • Suicidal thoughts, recurring death thoughts, death wishes
  • Suicidal behavior and suicide attempts
  • Self destructive behavior, self injury, self harm
  • Feelings of worthlessness, guilt, self hatred, or not deserving to live
  • Loss of energy, fatigue, excessive sleeping
  • Little or no interest or pleasure in anything or anybody
  • Inability to think, or to concentrate, or to make decisions
  • Significant but unintentional changes in weight loss or weight gain
  • Significant but unintentional changes in appetite
  • For children, not making normal and expected weight gains and physical growth

For trauma survivors, depression can have layered meanings beyond the typical medical symptoms.

Repeated patterned depressions can be very much related to a specific or recurring trauma, or to a significant loss.  For dissociative survivors with DID/MPD, the information detailing the specific loss or trauma may be hidden away or blocked off by dissociative walls.  Someone in your system might know why you are feeling depressed, and they might know what the loss is, but the host / front personalities might not have a clue.

Do you have a pattern of depression occurring at the same time of year each year?

Think back through all the years. Do you have any hints that tell you how far back this pattern goes?  Do you repeatedly feel the need for hospitalization at the same time each year?  Do you find yourself struggling more than usual at the same time each year?  Do you find yourself having thoughts of suicide or self-injury more often at a specific time of year?  Do you know how long this pattern of depression been happening?

If you have Dissociative Identity Disorder, be sure to check inside and to ask your various inside parts what they have noticed as well.  Some of your insiders might have a different awareness of patterns and events than you do.

For repeated patterned depressions, it is important to find the original starting point of this depression pattern.  Once you do, you will get more clues as to what it is about.

My general approach to repeated depressions that follow a pattern is to “assume” that there is a trauma-based reason for it. Unless you have a better explanation, in terms of a bipolar type depression pattern, or a seasonal depression pattern, then quite possibly it is a trauma-based pattern.

Look around inside, ask around inside, to see if there is anyone that knows the depressed time of year to be a particularly bad time for them.  While you are talking with your system, be sure to pay attention to the following ideas:

  • Who inside feels the depression the most?
  • Do you see anyone inside who is showing the depression in the way that they are sitting, standing, laying, not communicating, not being “their usual self”, etc?
  • When you look at your internal system, who is showing / feeling the biggest list of depression symptoms?
  • If you can’t automatically see an internal someone who is depressed, take a broader look at your internal world.  When you walk around your internal landscape, can you find-feel-sense the center of it?
  • Is there a place inside where the depression feels the most intense vs. the generalized depression of everyone (similar to finding the eye of a hurricane).

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Other trauma-related questions you can ask your insiders include:

  • Were there any significant losses that happened at this time of year?
  • Who in your system has experienced these losses?  (Do not assume that everyone in your system is aware of the same losses!)
  • Did you or anyone inside lose a child /children, or a close friend, or a loved one at this time of year?
  • Are your feelings of grief and loss repeatedly surfacing as a type of depression?
  • Was anyone inside specifically traumatized or abused at this point in time each year?
  • What happened?  What do you know about that trauma?

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For dissociative trauma survivors, a significant period of depression can be a very important clue that there is an unresolved trauma waiting to be addressed.  If you have the room in your life to explore its foundations, and to address how the trauma issues are related to that recurring depression, you will be able to interrupt and resolve the depression itself.

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By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

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