October 15, 2010
Self-injury is a problem all too common for trauma survivors with dissociative identity disorder (DID / MPD) or borderline personality disorder (BPD). For that matter, self-injury (SI) is an issue for other populations of people as well. This discussion will focus more on the effects of trauma and abuse and how self-injury can be addressed effectively. However, because self-injury is actually a very complicated topic, this particular blog article will reach only a few of those layers.
In my years of working as a trauma therapist, I have noticed that many DID survivors self-injure when they are in emotional pain. They are hurting, their heart feels broken, they feel betrayed or abandoned, or they feel incredibly sad (but can’t cry). Turning to various forms of self-injury and self-harm sometimes helps to temporarily relieve their emotional pain. (Trauma survivors also self-injure when they believe they need to be punished, or when they are extremely anxious, or when they are feeling strong compulsions or hearing internal instructions, etc.)
One of the reasons self-injury works is because the brain cannot distinguish between a self-caused physical injury and any other type of physical injury and upon recognizing a body injury, the brain releases all the necessarily chemicals and hormones. Dopamine, serotonin, and neural structures are significant in this process. I’ll refer all the complicated medical explanations to others more qualified, but the point being is that the act of self-harm creates a reaction in the brain that allows the hurting person to feel a little more calm and numb.
In other words, when self-injuring, survivors are trying to feel better. They know they are in emotional distress, they recognize the emotional pain, and they know they are hurting. And they want to feel better, or at least to feel differently.
Self-injury can be a quick fix for these intense feelings. In that sense, self-injury is not a lot different from having a few shots of whiskey, or a shot of heroine, or a plateful of doughnuts, or a pound of chocolate. Many addictive behaviors are centered around finding a way to feel better when hurting.
Typically speaking, this has been a life-long issue. From even their youngest days, most dissociative trauma survivors were neglected or ignored when they were hurting. They were not comforted, and their pain was not acknowledged. Even as very young children, they were left alone with their pain and injuries. All too often, they were not properly tended to, they were not cared for, they were not hugged, they were not given medical aid. They were hurt – physically and emotionally – and they were left on their own to manage.
In my opinion, this lack of comfort and the years of neglect are some of the biggest crimes committed against young children. Neglect is as significant in causing harmful life-long effects as any direct trauma.
So, when working with trauma survivors who experienced significant pain and next-to-no comfort, a critical and crucial part of their healing process is to teach how to accept and create healthy and positive comfort.
Children who are injured in healthier environments are very much comforted by their mothers or fathers or other caregivers. Their hurts are recognized and acknowledged appropriately. These children are given hugs and gentle affectionate kisses. They get band-aids — sometimes they get the fancy special band-aids with Snoopy or Spiderman or pretty flowers on them! They are checked on repeatedly, they are allowed to sit close to their caregiver, they are given other little treats (such as stickers, or the chance to watch their favorite cartoon), etc. These injured children learn that positive forms of comfort can help them feel better.
Since traumatized dissociative survivors were typically not taught these ways of receiving comfort, this becomes an important treatment goal in their healing process. They need to know their wounds can be tended, that their hurts matter, that someone hears them, and that they can be treated gently during times of pain.
Tending to the hurts and the wounds often has to be modeled to dissociative trauma survivors. In many situations, this will be completely new experience for them, and the process of having their hurts be important, can be a profound experience.
As trauma survivors start to experience genuine comfort and caring from others (this may start first in the therapeutic office setting), these survivors will eventually learn to copy these same kinds of behaviors and apply them towards themselves and their other insiders.
Emotional pain is no different, and in some ways, addressing and comforting emotional hurts is even more important.
Teaching trauma survivors to sit with their emotions and to increase their ability to endure intense emotions is an essential part of the healing process. In early stages of therapy, most DID survivors can barely touch their feelings. In the later stages of the healing process, DID survivors can sit with their feelings, no matter how intense they feel them, and not turn to anything destructive or harmful.
In order to sit with those feelings, survivors need to learn what to do during those moments. They need to know and understand that they matter and that bringing more harm and pain to their selves and their bodies is not the answer. Learning how to comfort themselves – how to self-soothe, instead of self-injure – is a significant process in their healing.
Self-soothing means that the person is doing something that brings comfort in a helpful, positive way. Feeling better can become about comfort instead of numbing. Survivors can learn that they are worth being comforted, instead of being feeling unvalued and ignored.
Each time trauma survivors are comforted in their pain, instead of ignored or injured more because of their pain, they are experiencing a corrective emotional experience. Correcting the neglect by experiencing proper comfort, including self-soothing comforts, is incredibly significant in the healing process.
Comfort actually works much better than numbing, especially in the long run. Comfort allows for pain to heal. Numbing (or self-injury) means that the pain is just postponed until it comes back again.
Ways to Self-Soothe Include:
Self-soothing is unique to each person, just as any other preference is unique to each person. There are dozens and dozens of healthy options — explore a variety of different options to see what works best for you. Some ideas to try include:
- Listening to music that matches your mood – if you are feeling sad, listen to music that will help you express that sadness.
- Sing to yourself (even if this means making up your own songs, or singing sounds), or play musical instruments as a way of expressing your feelings.
- Wrap yourself up in your favorite comfy clothes or in a warm blanket and snuggle up somewhere safe, quiet, and protected.
- Hold or hug a pet, a stuffie, or a pillow.
- Sit close to someone safe. Lean against their shoulder, or find some way to have physical contact that is in no way sexualized or dangerous.
- Sip on your favorite tea, or any other gentle beverage, and treat yourself to a few simple snacks that are not heavy, but are tasty and nutritious.
- Rock in a rocking chair, or sit in a swing, and let the movement relax and calm you.
- Walk slowly or sit quietly in areas of nature that are beautiful and inspirational.
- Make your room, or your home feel particularly cozy – have nice smelling candles, or soft lighting, or bring out your favorite treasures to look at, sit by a calming fireplace (not for injury purposes! But yes, sitting by a warm fireplace can be very beautiful and calming). If you need to clean up an area first, that is ok, because it is important to be in an area that you can feel calm and quieted.
- Take a warm shower or a warm bath, using very nice smelling soaps and body washes. Dry off with your favorite most soft towels. The more you can make this a “spa-like” experience, the better.
- Bring in fresh flowers, or fresh greenery, or pretty leaves. Looking at something beautiful from nature, even while you are indoors, can be calming and soothing.
- Allow yourself to cry, uninterrupted, when the feelings come. Crying really is allowed, it really is ok, and it is a natural expression for pain. Use soft tissues, and don’t punish yourself for having real human emotions. Give yourself permission to feel, permission to heal, and permission to respond naturally to your pain. The more you can express your emotions in natural ways, the healthier you are.
Trauma survivors — you really can help yourself to feel better without bringing more pain and injury to yourself. The key is to surround yourself with lots of nice, positive moments that help you feel better through the course of the day. Practice self-soothing every single day, especially on painful days. It will get easier, even when if it doesn’t feel easy or natural to you at first. You can learn this, and when you do, it will make a huge difference in your life.
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
March 8, 2010
This set of picture-postcards demonstrates a passage through time for a trauma survivor with dissociative identity disorder (DID / MPD).
These pictures show different phases of the dissociative healing process, and illustrate how healing occurs. Notice that they move from a more shattered, painful, chaotic place to a calmer, structured, organized place. Where there is originally nothing but a fragmented sense of self, there later becomes a clear sense of personal identity.
The first picture-postcard has a mixture of colored pieces of all different shapes and sizes. Some pieces are more jagged, some are rounded. The mosaic nature of this design would automatically lead to many of the same questions as asked about the DID “Self Portrait” picture. For example, I would ask what the different colors represented, what the different shapes represented, if there was communication (or not) between the different pieces, if the black stitching between the colored blocks had a specific meaning, etc.
For this top picture, there are two specific shapes that I would ask more questions about. There is a definite triangle that points upward and spreads out down towards the bottom of the picture. Triangles can have a variety of meanings, and I would like to hear what this DID artist had in mind. The triangle also has layers to it. Does this have anything to do with the internal system layering?
For example, in the triangle shape that I see, the top two layers are yellow, followed by a green / blue layer, followed by a black layer, followed by a red layer. The placement of these colors could be purely metaphorical or accidental, but I could see this layering as representing important system functions and emotions.
A purely hypothetical system description could include the following ideas. The yellow layers are the happy front parts – the façade layers, the denial parts, the “I’m fine, nothing is wrong here” type of system parts. The blues and the greens could be parts of the system that know a lot of information, do a lot of the everyday work / functioning jobs of the system, etc. These parts know plenty of the historical trauma information but have to keep helping everyone manage life. They can feel some emotions, but work hard to not get overwhelmed or overloaded with emotions. The black layer could be a layer of depression, sadness, grief, anger, or amnesia, dissociated information, deeper internal controls, etc. The red layer could be more intense amounts of pain, anger, fury, trauma information, details about the abuse, etc.
The second shape that could have particular relevance is the large black shape with the blue tip. These pieces have an obvious phallic appearance to them. I would ask the artist if they intended this to be the case (chances are, they hadn’t even noticed that!), and then I would ask them questions pertaining to sexual abuse issues. If this symbol does specifically represent sexual abuse, it is clear how the abuse has been such a huge part of their lives. Just like this black piece is, in some ways, the foundational piece of the whole picture, it might feel like the sexual abuse has been the defining issue in this person’s life.
I see a lot of pain in this picture. The artist does not give the sense of happiness, of calmness peace of mind. The jagged pointy edges remind me of cutting, and I would be asking a lot of questions about self-injury.
There has been clear movement from the first picture to the second. Notice how the like colors are starting to get grouped closer together, creating a more cohesive look. There is much more green in this picture, and while the real meaning of that depends on how the artist interprets the colors, to me, it represents a lot of growth. I see a lot of progress being made in this picture. The trauma survivor has clearly been working on their healing issues, and they have been doing a lot of dissociative system work. Things are starting to come together for them.
In phase two, to me, the person is still feeling broken and dissociated, but she is not nearly as overwhelmed with the pain as before. The blue can seen as representing the teamwork efforts being accomplished by the internal system. There are still some missing chunks of time (as seen in the gaps of the blue), but the dissociative person is truly building good internal communication and has built solid connections between the internal parts. This dissociative person is starting to find herself, and she is building a sense of self-esteem, self-worth, and self-identity. As a system, they are definitely doing good work!
There are still several big jagged sharp points, possibly indicating a lot of pain, upset, questions, intense feelings, etc. The phallic shaped pieces in this picture are more obvious, which could be interpreted to mean that the DID artist is clearly addressing their sexual abuse issues. This survivor is aware of the sexual abuse issues, and the healing their sexual abuse trauma is the center of their healing work. While the trauma is still prominent, it is not overwhelming them as much as it used to. They aren’t finished with their healing, but they are making excellent progress. There is less black, and more brown, which feels to me like this person is becoming aware of more and more of the information related to their trauma. They “aren’t in the dark” as much as they used to be and life is feeling much more hopeful.
Even with all the progress, I would still ask this survivor about their suicidal feelings. The sharp points are very painful, and while the survivor may not be using self-injury behaviors as much, they may still have intense moments of suicidal ideation. It appears they are building good coping skills, and not in as high risk of following through with these suicidal thoughts, but the feelings are still there from time to time.
This third picture represents the final stages of healing from dissociative identity disorder and sexual abuse. It is hopeful, and shows how everything is coming together for this person. Notice the strength of the center of the picture. All of the colors connect with the other colors and the ability to share information is accomplished easily. Time loss, time distortion, memory gaps are not likely to be a problematic issue anymore.
The C appears to represents the host of the system, or the main “front” person, the leader of the system, or who the person wants to be as a whole. Notice how the front is a whole self, and is clearly and firmly planted in front of any of the others. This C person is now confident as the leader of her system, and presents well out in the external world.
The internal system behind the C is cooperative, quiet, calm, organized, peaceful, etc. The ability to work together, and provide information to the front C self, seems abundantly clear.
I would ask this survivor if the colors still represent the same things as they did in the earlier pictures. The meanings may or may not have changed at this point.
What I see is that the survivor is more aware of all the things she feels. C doesn’t dissociate like she used to anymore. For example, if the red still represents her pain or anger, C is aware of having those feelings, and she can acknowledge their existence, sitting with them, without letting them overtake her, or without having to dissociate them away. C has built the ability to connect with her intense feelings, and this is an incredible accomplishment. C might have times of dark depression or sadness, for example, but again, these moments do not overtake her ability to live her life as she wants it to be.
Notice that there is no obvious phallic shaped symbol in this picture-postcard. The trauma issues are resolved in a much more quiet way, and while C knows about her past, the idea of being a sexual abuse survivor doesn’t have to be the center of her life anymore. She has been able to resolve many of her trauma issues, and lay these to rest, moving on with her life.
The front of the C is facing the yellow and greens, indicating growth, progress, healing, movement, happiness, and enjoying life. C is moving forward into better times! The darkness and pain are more behind her (the black, red and brown are towards the back of the C). While life is probably never going to be perfect for this person, she is hopeful, and she is doing well.
The Moral of the Story
Will C create a fourth picture-postcard?
We’ll have to ask her!
The point of these wonderful hand-made picture postcards is obvious. The healing process for dissociative identity disorders works. It helps. Trauma survivors lives can become better. Healing does happen. It takes a lot of work, and a lot of time, but you really can feel better, and have an improved quality of life.
Take the point from C – if she can do it, you can too!
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
February 10, 2010
Lots of trauma survivors with dissociative identity disorder are just starting their healing process. Other dissociative survivors are not new to their healing process, but they might realize that they haven’t yet covered all the basics.
DID therapy can feel huge, daunting, difficult, and overwhelming. There is so much to do and so many areas of work. For a broader overview of the many areas of DID healing, please refer to the article, “50 Treatment Issues for Dissociative Identity Disorder”.
For individuals building the foundation for their work with your dissociative system, here are some of the first things to do.
DID 101 involves:
1. Get to know your system. Build the courage to find and meet your insiders. Remember, they were formed and created to help you – even if it doesn’t feel like it, you are (or can be) on the same team. Who are your inside parts? What jobs do they have? What kinds of things are they able to do? It’s really ok for you to build positive relationships and actual friendships with your insiders. If this feels scary for you, explore those feelings. What makes it hard for you to get to know your insiders? What fears or resentments do you have? Understanding your resistance to these ideas is important.
2. Become more comfortable with your diagnosis. If you don’t understand what dissociative identity disorder (DID /MPD) is, be sure to speak more with your therapist or psychiatrist about what it means to be dissociative. There are lots of books, websites, blogs, articles, conferences, etc that can help to educate you about the basics about DID. Understanding DID will help take out some of the mystery and confusion for you.
3. Build a support system and capable treatment team. It is very helpful if you can surround yourself with a few other people that understand trauma dynamics, preferably at least one or two other people, besides your therapist and doctor that understand that you are working on healing from trauma. These support people don’t have to be experts in DID – if they are just willing to spend some time with you when you need a safe distraction from your healing work, that will be helpful. Please don’t lean on lay-support people for the heavy issues. Leave the complicated treatment issues for your therapist to work with – your support friends are not therapists, so be very careful about not pushing them too far or demanding too much of them.
4. Once you have recognized at least one or two other parts, work on building communication with these parts. Internal communication is one of the very most important factors in DID therapy, and the sooner you can interact cooperatively with your other parts, the better your healing progress will happen. Approximately twenty of the articles in the Discussing Dissociation blog reference tips for building internal communication. This link groups these articles together. Learning how to talk to your other parts is the most important factor in your healing.
5. Connecting with your internal landscape. What can you see inside? Can you see the other insiders? Do you have an internal safe place? Internal visualization work is an important skill as it builds a way to connect with your insiders. Even if you can’t see the others inside, there will likely be someone else who can. Maybe ask if that insider will draw a map of your system for you? The sooner you can see inside, the better. And of course, if you see insiders that are not in positive, healthy, clean living conditions, you and other helpers in your system will need to do something to help them.
6. Working on limiting or preventing self-destructive impulses and self-injurious behaviors. Learning how to address self-harm urges is particularly important for your stabilization and progression in therapy. You have already been hurt enough – adding more hurt may feel like it helps you to cope in the short-term, but using behaviors such as cutting or burning is not any more helpful than using a shot of whiskey or a hit of cocaine. Explore better ways to cope with your intense feelings, develop more grounding skills, build positive containment strategies, and methods to reconnect with the here-and-now. A grouping of articles about preventing self-injury can be found here.
7. Live in a safe place both inside and out. If you live in a violent environment, address this issue as quickly as you are able. If you are continuing to be abused or sexually assaulted in any way, your dissociative walls will stay strong, and your system will have greater trouble trusting you and your treatment team. Of course, when anyone is fearful of abusive repercussions, it is much harder to disclose the real issues. Dangerous environments can include everything from domestic violence, abusive parents, organized perpetrators, to internal system perpetrators and angry introjects. Building more and more current-day safety is vitally important for your overall healing process. If you aren’t safe, make this a priority in your therapy process. Building an internal safe place is also critically important. However, please remember that in order to build an internal safe place, you have to have a genuine belief that safety can happen, at least part of the time. Making an internal safe place for your insiders is much more difficult when you are still concerned about external safety.
8. Start building options for positive self-comfort, self-soothing activities. The therapy process can be so very painful and emotionally difficult. Having a variety of options to do that are comfortable, safe, gentle, soothing, and stabilizing is important. What can you do when you want to have a break from the hard work of therapy? What can you do when you need some quiet space to think – or to not think? When you are hurting, what can you do that will help you to feel better? Soothing your pain in ways that help your healing (vs. using self-destructive options) is an important skill to develop.
9. Create healthy options for expression of feeling and emotion – use art, music, journaling, collage, blogging, forum posting, sculpting, painting, poetry, play therapy, sand tray therapy, scrapbooking, etc. DID therapy involves processing a lot of flashbacks, violent images, intense feelings, overwhelming thoughts, body memories, body pain, etc. Building a repertoire of artistic avenues to describe your feelings and experiences will be very helpful. You might not always have words that you can use so it is important to find non-verbal ways to safely express what you feel.
10. Create your own personal space. In this space, let it be ok for your insiders to come out, to be themselves, to be out in the body, and to exist. Out in the world, and when you are around other people, most of your daily life will be about keeping your insiders tucked in and acting socially inappropriate. But somewhere in your private time, your insiders will need time to surface, to know that it is ok for them to come out. Having the freedom to switch without reprimand is important as each of your insiders will need to do some personalized healing work of their own.
Not 11. Please note: I am specifically not including memory work or skills to do memory work in my top then list of DID 101 skills. The reason for this is that if you are just beginning DID therapy, it can be very destabilizing to focus on heavy-duty memory work. Yes, of course, doing trauma work is an important part of your overall healing process, but in the beginning of this journey, you need to build these basic skills before you begin to put a lot of energy into memory work. It is much safer and more stabilizing to have these foundational therapy skills in place before focusing on the trauma content of DID therapy.
DID therapy is intense, long-term, exhausting, and difficult. But your healing is worth it. As you truly address the painful conflicts, unmet needs, and internal confusion caused by your years of trauma, abuse, and neglect, you will feel better within your own self.
I wish you the very best in your healing journey –
Kathy Broady LCSW
December 12, 2009
Do you know people that truly want to hurt you?
Do you know people that are willing to hurt you on purpose?
Do you know people that would hurt you over and over, again and again?
Did this happen to you when you were a child?
Is this experience still happening for you as an adult?
What a scary concept.
What a horrifying way to grow up.
It’s one thing to know that you have been hurt by mean people.
It’s a completely different thing to know that there are people that want to hurt you on purpose. And that they’ll do it – and that they have done it. And that they’ll do it again and again and again. As many times as they can, whenever they can.
That’s a completely different concept than to say, “I got hurt once.”
For something to be a “one of” experience, it can be terrible, but it’s a one-of. It doesn’t have to happen again. It happened. It’s over. That’s it.
But to know that there are vicious, sadistic people in the world who want to hurt you, and to know that these people are so incredibly cruel that they want to hurt you many times… and they will hurt you every chance they have…
THAT is a completely different situation.
There is no safety in that situation. There is no reason to believe it won’t happen again. There is not end in sight, and there is no place to rest. You can’t let your guard down. You can’t relax. You can’t stop preparing for the next time. You can’t get away from it.
There is danger, insatiable danger. Life becomes equal with danger.
How very different it feels when the perpetrators are insatiable. How very exhausting it feels when you know that you might have gotten through it today, but they’ll do it again tomorrow, or the next day, or the next.
Repeated, ongoing, incessant danger, trauma, abuse, and neglect changes a person.
It changes their view of the world.
It changes their view of themselves.
When your reality is knowing that abuse will be there, that the abusers are not going away, that the abuse will continue, that the abuse will always continue – that abused person has to learn a new way of survival.
In order to get away from the abuse for awhile – which of course, is important, because if you can’t mentally or emotionally escape the presence of the abuse or its effects, it would be far too much – many survivors create other selves.
If you can’t separate the abuse from you, separate yourself from the abuse.
Create a self that knows nothing of the abuse. Create a self that doesn’t worry or stress that the abuse will be around the next turn, or that it will happen again later tonight. Create a self that can enjoy the now, the day, the work, the school, etc. Create a self that can think about academic things, logical things, creative things, fun things, everyday normal things. Create a self that can enjoy petting a cat or enjoy sipping a cup of tea or reading a book or dancing to the radio.
In the situations of chronic, unending abuse scenarios, a survivor with the ability to dissociate and to split into other personalities is tapping into an absolutely incredible psychological defense. It makes a place to go in your head and in your life-experience where you can feel safe. It makes a place where you can be far from danger. It makes a place where you can get through the day without having to worry about being hurt five minutes from now.
I understand that creating this kind of separation from and denial of the abuse can, in the long run, become a troublesome issue when it becomes time to recognize the abuse in order to stop the abuse. But that point belongs in a different article.
At this point, I am just appreciating the value of being able to separate yourself from ongoing, repeated, unstoppable abuse (and the constant knowing of that abuse, and the constant fear of more abuse) by creating a place in your head that allows the abuse to be stopped.
This has been important. It has saved your sanity in many ways.
Living in constant fear, in constant worry, in constant dread, in constant hypervigilence of more pain and more abuse results in adding more and more problems to already existing problems. The body doesn’t do well under this kind of stress – medical illness increase, stomach issues increase, headaches increase, etc. When the body feels like it is constantly fighting for survival, it responds by secreting chemicals and hormones that it wouldn’t normally do if it felt safe. A body in constant fear is different from a body that feels safe.
Emotionally, the person who feels constant danger is going to have more depression, more anxiety, more self-injury, more extreme fear, more panic attacks, more mental health issues, etc.
Waiting in between blows has it own cost.
It doesn’t feel safe in these in between times. It feels on edge. It’s waiting. It’s wondering. It’s knowing it will happen again. It’s a long ways from feeling safe.
Having people in your life who want to and will hurt you over and over and over has affected you in more ways than you might realize.
It emphasizes, to me, the importance of learning what safety is, and what safety feels like.
It emphasizes how important it is to find someone in your life who doesn’t hurt you over and over.
It emphasizes how important it is to keep safe people safe – including both children and adults.
It emphasizes how important it is to not let anyone or anything interrupt your need to have someone genuinely be safe with you.
It also shows me how hard it is for DID survivors to believe that safety exists in the first place.
For Trauma Therapists:
As therapists, if we do nothing else, we need to provide a sense of safety for our clients.
We need to prove to our dissociative trauma clients that each time they show up in our presence, they will be safe.
We need to provide a consistent place of safety to counterbalance a life full of constant danger.
We need to be understanding, compassionate, patient, and gentle with their fears.
Sure, there is a place to confront and challenge, but do this in an atmosphere of safety. Make sure your clients know they will not be hurt, even if they are being confronted.
And if you meet a traumatized client who was able to feel safe with another therapist or another person, do NOT ruin or delete the sense of safety the survivor built with that other person. It is amazingly important that any sense of safety was built in the first place. That was not built easily, so respect the effort that went into that relationship. Don’t ever take that away from them.
Dissociative trauma survivors have not felt enough safety in their lives.
To destroy or damage or delete any sense of their safety causes them harm.
Build more safety for your clients – don’t take away what they had.
Safety is precious. The more, the better.
Kathy Broady LCSW
October 23, 2009
There is a young woman who will always be precious to me. I haven’t spoken to her in years, but she forever changed my life.
This date – October 23rd — had specific meaning for her.
And every year on this date, I specifically think of her.
Back in the 80’s…
Annemaria was a 13 yr old wildly aggressive but enormously quiet girl that kept setting fires in the residential treatment center and starting fist fights with grown men. She was a complicated child, and was court-ordered to have an assessment by a psychologist. Fortunately for Annemaria, the psychologist had just attended a presentation about multiple personality disorder (MPD), learning about the symptoms of dissociation and trauma. Annemaria was quickly diagnosed with MPD and due to the variety of extreme acting out behaviors she demonstrated within the custody setting, she was given an unusual opportunity.
It was clear that Annemaria was acting out her child abuse history. She openly admitted to purposefully committing violent crimes so she would be taken out of her abusive home. It was a brilliant plan for finding safety from her offender-parents. Unconcerned about the long list of legal charges against her, she knew she would be safer living in residential treatment centers, and she was glad to be there. No one doubted her abusive past, and a long string of child protection workers advocated for her safety.
As requested, the Court agreed to give Annemaria the longest sentence possible so she could remain in the residential treatment center instead of being forced to go home. They did this for the preventive safety of the people she would be willing to assault in the future, but also for her own current-day safety and protection. The Court also ordered that she be given specialized treatment and intensive therapy.
Since she was so violent towards men, she was to be assigned a female staff member, and this staff member was to devote the vast majority of her time to working individually with Annemaria.
This is when Annemaria changed my life.
I was assigned to be Annemaria’s personal staff member.
I knew about sexual abuse, but I didn’t know a thing about MPD. I had been trained to work with family systems, but I didn’t know anything about internal systems. But I was thoroughly pleased to have been given the assignment of working with Annemaria. I knew it would be fascinating work, and frankly, Annemaria and I already had a little bit of a connection. Afterall, I was the only person in the entire treatment center that she would speak to.
I had two years to work with Annemaria. We did hours and hours of therapy every week, and even more hours of everyday life-skills work. She blossomed in that safe, healing environment but for such a young child, her stories of abuse were more than any of the treatment staff could fathom. Eventually, a non-threatening but strong young man was assigned to assist me during Annemaria’s acting out or heavy-duty memory flashbacks. She bounced a lot of male anger in his direction, but he handled that like a pro. The work was tough, and we leaned on each other a lot. Even so, I developed secondary PTSD, and experienced numerous nightmares after listening to Annemaria’s stories of trauma. I really hadn’t known such horrors existed. Talk about a learning curve… They hadn’t explained ANY of that in grad school!
I had so much to learn. I had no idea anyone could be abused in the ways that Annemarie described in such vivid detail. She was only 13. It had just happened. She had been abused her whole life, but still… it had just happened! Even though she was dissociative, she knew a lot about it.
She and I taught each other about two very different worlds. She taught me about her world, and I taught her about mine. We both ended those two years in a very different place.
I was truly never the same.
I hope that I impacted her life in the same way.
I also wish I could re-do those two years with Annemaria. Now that I have had 20 years experience working with MPD – currently called Dissociative Identity Disorder (DID) — I would do those first two years very differently. I’ve learned more about self-injury and how to manage those behaviors effectively. I’ve learned about depression, anxiety, PTSD and vicarious traumatization. I’ve learned about flashbacks, amnesia, body memories, and internal system communication. I’ve learned about organized abuse, the sex slave industry, pornography, and ritual abuse. NOW I am properly prepared to address the issues that Annemaria was speaking about.
I just didn’t have a clue.
And how sad was that.
Today is Annemaria’s day.
And today, while I was recording my BlogTalkRadio show on Internal Communication, I thought of Annemaria.
While I felt confident in explaining how so many things work for DID / MPD, I thought of Annemaria.
I just wish I knew then what I know now.
I could accomplish so much more with Annemaria in two years at this point in time than I could have back in the 80’s when I was new to the field. It saddens, me in that respect, because I didn’t give to her then what I could give to her now.
But she changed my life.
In fact, she changed the entire course of my life.
I would not be where I am if it were not for Annemaria.
And for that, I owe her a few years of decent therapy.
Annemaria, if you ever find me again, you’ve got yourself a therapist for as long as you need one!
And thank you, Annemaria.
Kathy Broady LCSW
September 9, 2009
To those of you that have been having a very difficult day today – please know that you can fight that.
You don’t have to do anything dangerous.
You don’t have to hurt yourself.
You don’t have to do anything harmful to yourself.
You don’t have to go to places where you get hurt.
You don’t have to go to places where your insiders get hurt.
You don’t have to go to places where someone else wants you to hurt.
You don’t have to give yourself to something that is dark and harmful.
You don’t have to go where you get stripped naked.
Find someone safe. There really are safe people out there.
Stay by them. Stay with them. Stay near them.
Learn about protecting yourself, and your insiders.
You can be safe from all that hurt, you really can.
I wanted you to know that there are kind helping people that understand why you are having such a difficult time today.
You are not alone in your struggle today.
I’m not going to explain much out here on this public blog – I know that far too many of you will already know what I mean.
But yes, you can get help and support and understanding…
From gentle people who will not strip you naked.
You can be who you want to be.
You can be who you decide that you are.
You don’t have to be who they say that you are.
You can be who you say you are.
Kathy Broady LCSW