May 24, 2010
In response to some questions asked about my previous blog article about Mother’s Day, I’ve decided to follow up with an additional post on the topic of transference. Transference isn’t necessarily an exciting topic, but it is fundamentally important to understanding the dissociative therapy treatment process. Hopefully, this article will help to clarify more about the importance of these issues.
What is transference?
How do you recognize it?
How do “mother issues” become a common transference issue for female therapists? (And likewise, how do father issues become common transference issues for male therapists?)
Is transference healthy?
Is it important?
Yes, transference issues are a common part of the healing work done with every trauma therapist / dissociative client. The frequency of transference issues makes them very important topics to talk about and to understand. Transference issues surface all the time in the DID therapy process — in a variety of ways — often in simple and unexpected ways. It would probably be fair to say that some kind of mother transference can potentially show up every week in therapy.
Addressing transference issues appropriately are fundamental to healing, so if it seems I write about them a lot in this blog, it’s because they are important. Transference issues are when feelings about an important person in the past become “transferred” onto another person in the present. It can be as simple as a little reminder, or in the case of some dissociate trauma survivors, it can go as far as the client literally seeing someone else’s face put on to the other person in a flashback type fashion.
Transference happens when something connected to Person A significantly reminds clients of Person B, or to their relationship with Person B, to the point that Person A can be viewed as the same as Person B. Person A is not Person B, but clients deeply tangled in their transference issues may not be able to tell the difference. In essence, it becomes a type of relationship psychodrama where clients address their complicated, complex feelings about Person B by acting them out with Person A. At some point, clients need to recognize Person A is Person A, and that Person A is not Person B. Only Person B is Person B.
In the therapy process with survivors with dissociative identity disorder, the therapeutic goal of working with transference is to allow clients address emotionally painful material with Person A while having that safe distance from Person B (the alleged “bad guy” or traumatic figure). However, therapeutic progress will occur only as clients see that Person A is simply the “reminder” of their feelings and memories regarding Person B. By exploring the issues about Person B with Person A, clients can achieve deep healing on their genuine trauma and simultaneously successfully separate Person A from staying in that “bad guy” place.
If clients do not transfer the feelings back to Person B, but keep them stuck on Person A, they have prevented healing from occurring. Person A is only a temporary “substitute”. The real issues belong with Person B. Staying focused on Person A prevents and distracts the real healing from happening.
Understanding complex details of the actual relationship between clients and their mothers is important to recognizing specific instances of transference, but some common examples of how mother transference issues can be seen in regular DID therapy session situations are:
- The therapist cancels a session (or two or three) and the client fears the therapist will never come back, or that the therapist hates her, or that the therapist is abandoning her. (re: mother abandonment)
- The therapist doesn’t call or email a response quickly enough and the client feels like the therapist is ignoring her, or refusing to speak to her, or hates her, or is mad at her. (re: mother neglect)
- The therapist wears a green shirt that reminds the client of a traumatic situation when the mother was wearing a green shirt, and the client becomes fearful that the therapist will abuse her the same as the mother did. (re: mother trauma)
- The therapist hands a male co-worker a file containing conference information and reference materials but the client becomes convinced that the female therapist (mommy) is telling the male therapist (daddy) all kinds of bad information about her so that the client will end up getting in trouble and abused. (re: mother betrayal)
- The therapist shows genuine kindness, acceptance, and compassion with the client and the child parts. The child parts attach to the therapist and wish with their whole heart that the therapist could be the mommy they never had. The client clings excessively to the therapist and pretends the therapist is her mother. (re: mother fantasies)
Survivors struggle with transference issues all the time, and there are many survivors that find it “safer” to blame a therapist instead of really looking at their family dynamics / actual trauma issues. While it may feel safer or easier to displace the issue onto a therapist, those same survivors can spend a lot of time not actually addressing their real issues because they are obsessing about the wrong person. It can create a lot of wasted therapy, wasted time, wasted resources, ill feelings, etc.
However, it is important realize that some people really will not (or cannot? Or chose not to?) face their real issues, so they transfer and project their issues onto someone else instead for an extended period of time. There can be a number of motivating factors, and addressing why someone wants to (needs to) focus on the wrong target is a critically important part of the healing process too. Why are they stuck at this point? What else is going on for them? What are they avoiding? What secondary needs are they meeting by obsessing on the wrong person? What’s the rest of the story? There has to be more going on somewhere.
Obviously, one of the role of therapists is to help someone build the skills / ability to look at their real issues, and to weed out or steer away from the incorrect focus on distractions / displacements. For a therapist to encourage a client to stay focused on a surrogate target would be a disservice to the client. That would be like medically treating someone for a broken pinky finger when in reality, they had bone cancer. The diagnosis of the problem has to be correct, or it is not proper treatment. This is true in understanding the complexity of transference issues. Accurately recognizing what is being transferred from where to where is critical in resolving the issues.
If someone wants to address their healing, it typically is much more effective for the clients to genuinely address their mother (or father) issues directly instead taking it out on a therapist (or a co-worker, or a neighbor, or a friend, or a spouse, etc etc.). No one will find healing on Situation A if they are obsessed about Situation Q.
It is fair to say that female therapists are frequently put into that “mother role”, far more than the average person would be, especially with traumatized clients. This is even more true for DID survivors with child parts. (Most child parts have bunches of unresolved mother issues, and understandably so.) Yes, working on mother transference issues is a natural part of the therapeutic process, but it is only the starting place, not the ending place.
There is a very fine balance of working with the transference, and not getting caught in them, or stuck in them.
If your therapist is not your mother, but she reminds you of your mother, what can you do to sort out your deep painful feelings?
If your therapist is not your mother, but you wish she were your mother, what can you do to meet those unmet needs?
Do your feelings for your mother effect how you view your therapist?
Have you discussed these feelings openly with your therapist?
The very best remedy to keep from getting caught in a negative transference dilemma involves a lot of detailed, honest communication between you and your therapist. Talk about this. Talk LOTS about this. Sort out who is who and what is what. Don’t be afraid to approach this topic with your therapist, as it is fundamentally one of the most important areas of your healing work.
Good luck – and keep working at this. It’s important!
Kathy Broady, LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
November 28, 2009
It’s Thanksgiving weekend here in the US, and besides the wonderful traditional family meal and pleasant times with my kids, this time frame reminds me of something else.
Discussing Dissociation has been up and visible for nearly one year now. Yep, in a few days, it will be a year already!
Wow. Where has the time gone??!!!
There is truth to the saying that time flies, or is it because time flies when you’re having fun … or maybe I’m just getting older, lol.
Anyway, I’m being silly, but I do want to say today how much I appreciate all of you that have been readers here at this blog. The number of faithful, returning readers has been utterly amazing to me. If you look back through all the pages, you’ll see well over a thousand excellent comments from a wide variety of the readers. Wow! The input you all have made in this blog has brought it to life and given it a life-filled energy that I certainly couldn’t create on my own.
For the way each and every one of you have contributed to the positive, educational nature of this blog, I sincerely thank you. I truly appreciate your involvement, your thoughts, your comments, your questions. You’ve helped to make this little site a safe, comfortable community for dissociative trauma survivors. I think it’s a job well done, and once again, I do sincerely thank you for your part in this process. Writing a blog wouldn’t be nearly so fun without hearing comments from the readers! You all rock!
Many of you have questioned why I started this blog in the first place. The original reason is not as mysterious or worrisome as some of you may have thought. It’s a widely stated and highly recommended common practice for therapists to use blogs for marketing purposes. Marketing experts recommend to write what you know about, and to respond to the comments you receive. Blogs get quickly listed in search engines, and they are an easy, economical way for your target audience to get to know you, and to see what you do, and to become more familiar with the work that you do. It’s a simple as that. Check the blogosphere for blogs by therapists. You’ll see that most therapists write about their fields of work the same as I do.
I just happen to know about a very specialized topic – dissociative identity disorder. And my readers are a very distinct but wonderful population – dissociative trauma survivors or trauma therapists. (There aren’t very many of us out here — it’s no wonder that we are congregating together!) And yes, practically all of my blog articles have been very specific to DID, not that the topics couldn’t also apply to other populations, but the point of this blog is to “discuss dissociation” so I do tailor my articles to being about dissociative disorders, and the DID population. There’s no mystery there, lol. I think I’ve said that pretty upfront.
But something much bigger has been happening besides my having found a very effective marketing tool.
With all the positive sharing and support that has been created here, this blog has provided a deep sense of hope and healing for so many people. Having that absolute knowing that others are progressing along their healing journey as well, many survivors don’t have to feel so very alone. You might learn things from my articles, but you can also learn from each other, the same as I learn from you as well. It’s a wonderful circle of positive, helpful information, and that in itself is priceless.
Building a sense of safety, knowing you are not alone in your struggles, and learning from others who have been there too provide emotional foundations that so very crucial to healing and can augment your therapeutic process. Please remember, this blog is in no means a substitute for actual therapy, but it does provide a lot of educational support for survivors working on their own healing, or for therapists learning about working DID / MPD.
Again, you all have immensely helped to create that healing, informative atmosphere, and I am grateful for that.
We have to create and protect places of healing.
Even survivor-led blogs such as the truly incredible BTC blog have become targets for destruction by the “hazing / flaming / insaniacs” of the world. Do we really want the haters and gossipers to take over and ruin all the places of healing and support? How sad is this?!!
I know that you know there are predators and perpetrators out there in the world. For some of you, your abuse stopped years ago. For some of you, you are still smack dab in the middle of fighting your abusers. Some of you are being hassled and manipulated by internet predators (whether you know it or not), and some of you are safely away from any direct attack from anyone. No matter where you are in your life, there are abusers and predators out there in the world, (including those wolves in sheep’s clothing hiding within the dissociative population itself), so the importance of having safe retreats amongst all the danger and destruction is more important than you might realize.
Those of you that feel the loss of BTC’s blog can understand what I’m talking about. It’s a real shame that abusive people continue to ruin the good places and run off the good people. I think that is a tragedy. But it happens.
- Are you one that sits back quietly, doing nothing even though you see others destroying places of support?
- Do you believe the lies and negative gossip spread about helpers and healers?
- Are you so angry from your own abuse that you are willing to take that out on people who have helped you?
Surely the survivor population can see through the manipulations of abusers. You are adults now – you can start seeing through the tricks that are being played out there. Please remember to think for yourself the next time you hear some negative hogwash about someone who has dared to be a helper / healer. You can take a stand against that.
Complacency only allows abuse to continue.
Trauma survivors, I encourage you to ban together in protection of your valued and positive healing resources.
So many of you grew up without any safety or comfort or support. You learned to pull deep within yourself or to block out the world entirely. You survived it alone.
But it doesn’t have to be that way anymore.
Most of you are still learning about how important and helpful it is to have places of safe connection, genuine relationship, and gentle bonding. It may be scary to be around people, but building a positive, healing, trustworthy community is a way of overcoming the need to be isolated in order to avoid abuse.
Again, I challenge you to protect your places of healing. Protect those that are your helpers. Stand firm around your leaders that fight against abuse.
Don’t fall into the trap of complacency or destructive participation.
Your healing resources are depending on that.
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
April 25, 2009
Long-term, chronic, and severe child abuse causes a variety of medical and emotional issues for the survivors of such extensive abuse. Dissociative identity disorder (DID/MPD) is one long-term issue, but medical complications are extremely common as well.
In addition to addiction issues and mental health issues, most survivors find that they have numerous medical issues as either a direct or indirect result of their severe childhood sexual abuse.
INCREASED MEDICAL COMPLICATIONS
- Numerous medical complications or physical ailments from the years of internalized stress, anger, bodily harm, etc.
- Increased risk of stress related diseases, including depression, bipolar, PTSD, anxiety, etc
- Colitis, high blood pressure, heart disease, gastrointestinal problems, fibromyalgia, etc.
- Frequent headaches and migraines
- Numerous dental issues, including harm to the teeth, especially if the survivor experienced a lot of drugging
- A history of shaken baby syndrome, whiplash, broken bones, head injuries, etc.
- Bizarre illnesses or medical conditions that are difficult to explain or diagnose
- Inability to thrive – failure to grow
- Physical or mental impairment due to early childhood injuries
- Brain development affected – people who are severely sexually abused in childhood have permanent changes in their brains, specifically in the left hemisphere. These changes cause increased difficulties in the way they think, react, feel, and behave.
Long-term, severe, chronic child abuse causes long-term, severe, chronic medical issues, with both physical health and mental health.
Who pays for that?
One of the most frustrating negative effects of childhood sexual abuse is that the survivors as adults, on their own and struggling through each day, are left to manage the costs of their medical and mental health treatment by themselves, with minimal financial assistance from the people that actually caused the harm.
Going the legal route in terms of suing for damages is typically unrealistic. Besides, dissociative survivors often need long-term therapy and treatment prior to being ‘emotionally together enough’ to even consider a lawsuit. Either the survivors have not yet sorted out their trauma history / information in order to be able to present an organized, sequential legal suit, or they have too much internal conflict going on about what to tell, who to tell, etc. And, of course, being angry at the perpetrators is such a frightening thought that taking their perpetrators to court can be completely impossible.
So by the time dissociative survivors are able to deal with the legal world, they have already had to find a way to get years of therapy in the first place.
It’s so very frustrating to see the perpetrators walk away, comfortably well off after demolishing and destroying the lives of the survivors. Just like the pimps on the streets are comfortably rich in comparison to the beaten up, drug-addicted, stressed-out girls they sold on the corners, organized perpetrator groups are wealthy in comparison to the girls they’ve sold, abused, and used up.
Sometimes, perpetrator fathers will pay for therapy costs / medical bills as a quiet “under the table” compromise to their children. The “I’ll pay for your medical bills in exchange for your ongoing silence and not taking this to the public arena” exchange does happen, but it does not come without its own complications. Perpetrator fathers are very good at guilt-tripping their daughters, and having an ongoing connection to their perpetrator creates a constant tension and conflict in their healing process.
Insurance companies and disability policies are providing less and less coverage.
No one wants to pay for the crimes done by sex offenders, yet these offenders have created horrible life-long wounds for children all over the world.
One of the costs of long-term, severe child abuse for survivors is dealing with the complications of getting proper healing in the first place.
POOR MEDICAL AND THERAPEUTIC ASSISTANCE
- Excessive monies spent on medical bills, treatments, therapies, etc.
- Years of misdiagnosis, poor medical treatment, inappropriate therapies
- Hospitalization after hospitalization after hospitalization – It’s not at all uncommon for survivors with DID to have over psychiatric 30 hospitalizations in their lives.
- Costs to insurance, government medical funds, unpaid medical facilities, etc.
- Finding appropriate therapeutic help is extremely difficult, and too often non-existent, leaving the victims to suffer even longer
- Maintaining appropriate therapeutic help for the years it takes to overcome the depth of the damage is complicated and expensive. The treatment is heart wrenching and grueling work. And yet, intense therapy is required to improve a survivor’s devastated quality of life
- Expensive medications are often needed for years to assist with stability
- Psychiatric medications, though helpful in many ways, have many disturbing side effects that are also difficult to live with
- Psychiatric medications are not prescribed in an exact science type of way. Survivors will go through years of trial and error to find what works for them and when. Different doctors prescribe medications differently.
So who pays for all of this?
Unfortunately, for the most part, survivors have to pay for their own healing by themselves, which means more sacrifices made by people who have lost quite enough in their lives already.
Is that fair? Is that right?
No, that is not fair. No, it is not right. Not at all.
But it is typically the only way for survivors to get the healing they need.
Is your healing worth this for you?
Kathy Broady LCSW
March 22, 2009
We’ve had some very interesting discussions on the “What do you think about Suicide?” blog article. Thank you to everyone who writes and comments on this blog – your participation is valued and appreciated.
One of the topics that surfaced on that thread is the idea that trauma survivors with Dissociative Identity Disorder (DID/MPD) may have child parts within their system that can be suicidal, and that the ability to control the suicidal behavior of these child parts seems overwhelmingly difficult, even for the adults of the dissociative system.
I’d like to write an official response to that.
Typically, one thinks of child parts as a permanently young child – an inside part that holds the trauma memories, feelings, rememberings, and experiences that happened when the body was of a young chronological age. These child parts act like children, think like children, reason like children. Their thinking is often very concrete and their grammar / spelling / speech is child-like as well.
So, how does a child part, who is likened after an actual child, have the ability to be suicidal when typically, children do not even understand what death is?
How can these child parts have the ability to act outside of the control of the adults in the system?
There is at least one possible answer for that.
For dissociative trauma survivors, their childhood was filled with abusive perpetrators. Some — not all — DID survivors have experienced an organized type of abuse by organized groups of perpetrators. These organized groups could have presented themselves as sex slavery groups, or cult groups, or governmental / mind control experimental groups. Any which way, the abuse was more than home-based, chaotic dysfunctional family-crisis abuse. With organized abuse, there would have been a goal, a purpose, and a long-term plan for ongoing and continued abuse and total control of the victim by the offenders.
Organized perpetrators very often purposefully split off child parts and attach suicidal programming to these children. Even while the children are at a very young age, these organized perpetrators demand complete control of the mind and behavior of the child. These perpetrators know they are committing horrendous crimes to their victims, and are invested in keeping the children silenced about these crimes. They instill these controls early in life, and then have every intention of keeping this level of control over the victim for as many years into adulthood as possible. Organized perpetrators actually want life-long control. They begin their domination during the victim’s childhood with the intention of being able to keep that child under their control for their entire life.
Using suicidal programming as a way to control and manipulate behavior is one of the most effective ways for abusers to protect their secrets. Perpetrators have a variety of horrific techniques that they use to accomplish this goal.
The result is that a child part can be cued or triggered into suicidal thinking, can have a suicidal plan, and could potentially follow the instructions planted in their brain with the same level of intensity as any other mind-controlled person. The child part does not have to understand what they are doing, nor do they have to understand what death is, nor do they have to understand the effects of their behavior. They just have to know what to do, step by step. These child parts have simply been taught clearly defined, specifically detailed behaviors to follow upon command, and they have been taught to follow those controls without thinking.
Perpetrators attach suicidal programming to young children not only at the earliest point of intervention, but also because it goes to their advantage that these child parts genuinely do not understand what death is. The children know what obedience is and the mind control trainers take advantage of that. Children cannot reason past the orders to understand that they are being told to do something that is harmful to them. They cannot grasp the concept of death enough to fear it the way an adult would, but they know what happens in they don’t obey, so the programming is attached to this level of thinking without any risk of interference by “fear of death”.
In effective trauma therapy, these controls can be removed safely, and the person — both the child parts and the adult parts — can reclaim their own power and control of their behavior. However, as long as the programmed responses are hidden secretly within the child part, the person is at risk for suicidal behavior.
If you are experiencing these kind of suicidal controls, please work with an experienced trauma therapist while addressing these issues. It is imperative that you handle suicidal programming with great caution, and do not assume that just any therapist can do this level of work.
Find a genuine trauma specialist to help you remove suicidal programming from your child parts.
Your safety matters. And yes, you can reclaim the control of your own life.
If you are considering individual therapy work to address these issues, please contact me through AbuseConsultants.com. Be very careful about exposing too much of this kind of personal information on a public blog site.
Your safety is important.
Kathy Broady LCSW
February 19, 2009
I read this poem on the web, and thought I would share it with you all. It seems to be very fitting with the healing process of dissociative trauma survivors.
THERE’S A HOLE IN MY SIDEWALK
Autobiography in Five Short Chapters by Portia Nelson
I walk down the street.
There is a deep hole in the sidewalk.
I fall in
I am lost……
I am helpless
It isn’t my fault.
It takes forever to find a way out.
I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I am in the same place.
but, it isn’t my fault.
It still takes a long time to get out.
I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in….it’s a habit.
my eyes are open.
I know where I am.
It is my fault.
I get out immediately.
I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.
I walk down another street.
My challenge to you all —
Think about the holes in your life.
Where are you in this process?
What step are you on?
Moving from step 3 onto step 4 is very very big…. Many people get stuck right there.
What will it take for you to walk down another street?
Kathy Broady LCSW
January 12, 2009
Creating a collage is another way of allowing your internal system parts to tell more about themselves.
Pictures can be a powerful way of communicating. And a collage – a collection of pictures – can tell a lifetime of stories.
Most trauma survivors were repeatedly told by their abusers, “Do not tell”. Violence, threats, abuse, and pain often accompanied these rules. How many times did you hear “don’t say anything to anyone” or “don’t talk about this” or “you better stay quiet”? All of those directives involve restrictions on being able to talk. Years later, even in the safety of therapy, the intimidation of the no-talk rules can still feel as powerful and real as ever.
One important aspect of healing and therapy is learning to work around the negative, confining rules and those scary points that keep people stuck. If some of your parts are too scared to tell what happened, maybe they could show what happened instead. Pictures can be a way of communicating when talking is a hindrance.
A picture paints a thousand words!
Sometimes writing is too complicated and can also be “against the rules,” especially in the early days of treatment. Thinking creatively, you can work around these rules too. Typing, for example, is actually different from writing. Cutting out printed words is also different from writing. Using stencils, stickers, and rubber stamps are also ways to show wording without having to write.
Collage allows the artist to show a mixture of pictures and words to tell stories without officially breaking no-talk and no-write rules. Collages can be made with a specific topic in mind, or they can be another useful format for the system descriptions.
To create your collage, use a variety of magazines, newspapers, advertisements, and telephone books, etc. Look through these printed materials and cut or tear out any picture, word, or phrase that seems relevant.
If you are sufficiently computer savvy, you can also create a collage from computer pictures. The web certainly has a wide variety of images available for collage purposes. If you can copy-paste and arrange pictures on a document, you can create an incredible collage without so much as lifting a piece of paper.
Let your internal system help pick out these pictures and words, and pay close attention to their interest in selecting pictures, even if you are not sure why they want that particular one. It is very important to not edit or limit the choices of pictures made by your insiders – let them pick whatever pictures they relate to. Each of your parts will have their own things to say, and everyone inside will relate to pictures in a very different way.
Don’t be alarmed or hesitant if you don’t understand why some of the pictures are selected. Chances are, you won’t understand the meaning of all the items picked. That’s ok – that means your insiders are getting ready to tell more about life from their own perspective. Be open to this new information – getting new communication is a big part of why this exercise is helpful. Besides, as you get to know the insiders that selected those pictures, and as the time is right, they will tell you the relevance and meaning of all their selections. If your insiders are picking pictures they relate to, they are completing the assignment, and that is a good thing. Don’t interfere!
Even though you might want to know why the various collage pictures are being selected, be very careful not to push your insiders to talk about everything at once. Not only will that put the others on the spot, and potentially chase them away from the assignment, but you could also easily overload and overwhelm yourself if you start demanding explanations for every picture or phrase that is selected. Select the pictures from a comfortable emotional distance and save the “talking time” for later. There will be plenty enough time on different days for your system members to explain their choices to you.
If you find that lots of your parts are doing this exercise at once, you can either make different piles for the pictures that belong to different folks, or just cut out everything you see and separate the piles of pictures into themes at a later point. I have known people to be working on dozens of tiny collages all at the same time. I have also known people to assemble gigantic collages on huge poster boards. Use whatever style works for best for you! The important point is that your parts are creatively showing you what has deep meaning for them.
The purpose of the collage is to provide another way to tell without telling. Using groupings of pictures and cut out words or phrases can help to say things that you are not allowed to say directly. Any form of expression is helpful in the therapeutic process, even if some of it stays unclear for a long while.
Another added benefit to this exercise is that you will get to know your system parts better. You might recognize patterns for who leans towards what type of pictures. You might hear a new voice that you don’t recognize insisting on a picture that has absolutely no relevance to you.
Collage work can help with the processing of traumatic memories. You might see entire story-lines displayed right in front of you in the groupings of magazine pictures. You might develop a greater awareness for who in your system dealt with what types of abusive situations.
Tending to everyone, listening, and allowing everyone in your system to have an unedited say in picture selection is important. As with any exercise that includes your whole system, it can lead to greater trust, system cooperation, and internal connection.
Kathy Broady LCSW
December 23, 2008
Hello to all my Readers,
I hope this day finds you doing well.
The first part of this article certainly caused a little stir, and maybe raised a few eyebrows along the way. Please know, my intention in posting these blogs is not to offend anyone. If you have any questions or concerns about anything I’ve posted, please comment and let me know what you’re thinking! And here’s a big Thank You! to the folks who did comment to the “Part 1″ post. I appreciate that.
Let me try framing the context of this article. In previous blog posts, we’ve been discussing questions to ask a new therapist. This article is, in some ways, a follow-up to that idea, because these are the kinds of things a therapist is going to be thinking about / assessing in new clients as they arrive at their door. These are also the strengths that you want to emphasize when you are meeting a new therapist.
If you approach your therapy keeping these qualities in mind, you will honestly find that more therapists will stay interested in working with you for the long haul. That is not to say you have to be perfect. Who is???! It means, work on these things. Be mindful of them. Developing these strengths will make you a better person overall, and that is very much the goal of therapy.
These qualities, in my opinion, have nothing to do with mental illness. I have worked with some very disturbed people with huge issues, and yet, they possessed these qualities, and they made huge progess in their healing. I’ve also seen some folks who appeared to be rather high-functioning, and yet, they did not, or could not grasp some of these basic ideas.
I agree with the brave soul who commented that these qualities are an important part of everyday life. The more that survivors strive to incorporate these strengths into their approach to everything, the better. Your self esteem will improve, your self-dignity will be solid, and people around you will appreciate you more.
I don’t expect every trauma survivor to have a solid grasp on these qualities, but I do hope every trauma survivor strives to.
Intermingle these strengths into your life everywhere that you can. You’ll be glad you did!
And here is part 2 of the article, “10 Qualities Therapists Recognize in Good Clients”:
6. Honesty and Trustworthiness
- Are you willing to be honest with yourself?
- Are you willing to lie to your therapist, or hide information, or lie by omission?
- Do you gossip and tell lies behind people’s backs?
- Do you gossip about your therapist?
- Do you lie to your inside parts? Does anyone in your system try to trick or deceive the others in your system?
Therapeutic relationships are built on honesty and trust. Your therapist will need to know you possess these qualities as well.
- Will you treat your friends and family members with kindness and respect even if they have done things you do not like?
- Will you loyally protect your internal system from predators and perpetrators, putting the safety of your inside parts as a priority?
- Are you loyal to your therapeutic process and will you keep clear boundaries around the therapeutic process?
- Will you respect your therapist’s trust in you to the same degree that you expect your therapist to respect your trust in them?
- If you and your therapist experience a conflict, where do you look to resolve that? Do you expect to resolve the conflict within the context of therapy, or will you spread the conflict outside the therapeutic relationship and draw others into it?
Your therapist and support team can be your greatest allies in your healing journey. However, a deep level of mutual respect is expected and needed in order to progress in therapy. It is crucial that you thoroughly differentiate the “good guys” from the “bad guys”. Therapists understand the concepts of transference and projection, and they will work with you in those tender moments, but there will be limits to that. I can promise you, your helpers do not want to be thrown under the bus any more than anyone else.
- Are you determined to do the same things over and over again?
- Are you open to trying new options?
- Can you think outside of the box instead of being boxed in?
- Do you help to problem-solve the various dilemmas that surface?
- Will you work on ways to reach even the most difficult of insiders? Even if this involves several failed attempts before you successfully connect with these parts?
We’ve all heard the saying, “the definition of insanity is doing the same things over and over again, expecting to get different results.” A huge part of the healing process is learning new things and doing different things.
9. Gratitude and Appreciation
- Do you appreciate what people do for you?
- Do you recognize when someone is doing something for you?
- Do you thank them for helping you?
- In relationships, do you overlook smaller imperfections in appreciation of bigger strengths?
- Do you thank others in your dissociative internal system for the ways they have helped you to survive through the years? Do you recognize their strengths and talents in the current day?
Gratitude and appreciation are key elements of any healthy relationship. Don’t take the goodness of others for granted. Be thankful for what you receive from others.
- Are you a safe person?
- Do you use threats of violence, or threats of harm to others, or threats of emotional blackmail, or threats of any kind to destroy or control other people or to get your own way?
- Do you threaten self-harm or suicide as a way to manipulate others or to get your own way?
- Are you willing to hurt yourself or someone else in order to get your way, including others in your internal system?
- How far is “too far” to go to get what you want or prove you are “right”? Do you think there is such a thing as “too far”?
Therapists will model safe behavior. If you are acting in ways that are unsafe for yourself or manipulative of those around you, your therapist will set boundaries with you — just as you should set boundaries with someone who is unsafe in your direction.
If you follow these guidelines, you will have a much better relationship with your therapist and others around you. If you are looking for a new therapist, remember that the more you can genuinely offer in the areas listed above, the more those therapists will view you as a client with potential — and the more positive potential you demonstrate in these areas of your life, the greater interest more therapists will have in working with you. It goes to your advantage, your healing, your self-respect, and the amount of respect others will feel toward you to learn these things.
All people, including trauma survivors with Dissociative Identity Disorder (DID/MPD), can claim these strengths as their own. Work hard to be a “good person” in your therapy, and you’ll be amazed at how much difference this can make in your relationship with your therapist and with your system. Remember:
Maintain your stability the best you can.
Be dependable in what you do, and do what you say you will do.
Maintain your motivation and your willingness to work hard.
Be courageous, even when it is scary.
Stay clear and upfront about your personal responsibilities.
Be honest and trustworthy at all times.
Stay loyal to your helpers.
Be creative in the hard times.
Have gratitude and appreciation for the good things and good people.
And be a safe person. Be safe for yourself, and be safe for others.
You can do it. I’m just sure of it.
Kathy Broady LCSW
December 13, 2008
I am writing this post in response to a question asked by BehindtheCouch.
BTC wrote, “do you think that a “trauma client” (ie one with PTSD or a dissociative disorder) should necessarily be treated by a specialised “trauma therapist” or, in your opinion, could any therapist who has the skills that you mention in your post do just as good a job with the client?”
This is a good question.
My first thought is yes, a client that has experienced a significant amount of abuse should (hopefully!) receive better therapeutic care from a trauma specialist. If you have the option to work with an experienced therapist who specializes in trauma disorders, snap up that opportunity as quickly as you can.
Trauma therapy is very much its own area of study, the same as with any other medical issue. In trauma work, the therapist must understand dynamics of traumatic relationships, trauma bonds, wide-ranging effects of trauma, layered complications of dissociative disorders, issues of external safety, self harm, system work, memory work, etc. There are dozens of issues specific to trauma disorders, with dissociative disorders being the most highly complex and requiring the greatest clinical skill. (Please see my article listing 50 Treatment Issues for Dissociative Identity Disorder.) The terms “trauma specialists” or “trauma therapists” imply these clinicians have invested significant chunks of time learning about trauma disorders. They should be more comfortable than the average therapist in terms of recognizing, understanding, and addressing the details of trauma work.
Please remember there are many areas of clinical expertise for mental health professionals. For example, I am licensed to provide clinical therapy for any area of my choosing, but in my 20+ years as a therapist, I have not worked with autistic children. However, I have worked with families with traumatized children who also have some very definite and particular needs. Sure, I could apply my basic, fundamental clinical skills with autistic children and their families, but once it became necessary to understand specifics related to autism, I would fail miserably. I would be scrambling for information, and fast! Even though I am a good trauma therapist, would these autistic children receive the same quality of clinical treatment with me as they would with a clinician that specialized with autism? I am quite sure they would not.
Who is a trauma therapist? For most clinicians, there are no regulatory boards that specify exact qualifications. Trauma therapists are self-proclaimed experts in the field, and clients are left hoping the professionals they are trusting are actually qualified to be specialists. Unfortunately, I have seen far too many problems caused by well-meaning professionals who simply did not know as much about trauma issues as they claimed. Their lack of understanding of trauma-related complexities, timing, processes, etc. caused significant harm, damage, and confusion.
On the other hand, finding a trauma specialist is difficult, and you simply might not have many therapists in your area that work with severe abuse issues. It is imperative that people suffering from Post Traumatic Stress Disorder (PTSD) or any of the Dissociative Disorders receive treatment in order to heal from their traumatic experiences. If your only option is to work with a “general practitioner” instead of a specialist, then that is what you do. Good basic therapy is certainly better than no therapy at all.
Select therapists who are open-minded to the effects of trauma, honest about their limitations, and willing to learn more. As long as their clinical skills include active listening, deep understanding, gentle compassion, effective communication, recognition of family dynamics, emotional tolerance, clear boundaries, etc., you will be able to progress in your healing.
However, it will be highly important to augment your treatment with additional information. Read books, search online, get regular and ongoing consultations with trauma specialists, join trauma / DID support groups, attend conferences, consider online or distance therapy with a trauma therapist as an adjunct (secondary) therapist, etc.
Don’t assume that general therapists will learn enough on their own to get you through the most difficult and complex places in your healing. You will have to take charge of your own work. Make sure to do extra homework!
Your greatest therapeutic gains will be with a therapist you trust. Therapy is about you. It is your looking at your life, your history, your feelings, your reactions, your truths, your beliefs. When you feel safe enough to be totally and completely honest with yourself, you will be able to look at your painful wounds and all the resulting affects of the trauma. You will be able to bring down those dissociative walls that you built for safety and separation from “all the hard stuff”.
Pick a therapist you can connect with, build a solid foundation, and keep going from there. You’ll feel better for it.
Kathy Broady, LCSW