November 21, 2010

Freedom of Choice and Client Empowerment or Therapeutic Exploitation?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, Online Therapy, therapy, Therapy and Counseling, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 4:31 am by Kathy Broady


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I would like to make a follow-up comment from a comment made on the “What Would Your Perfect Treatment Plan Look Like?” blog.

Specifically, a portion of heartofindigo’s comment includes the following paragraph:
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a final comment: I wish that T’s would do exactly what you are doing, and ask. I have heard of so many… can’t think of a way to put this delicately… asinine demands on the patient. like the therapist doesn’t trust the patient’s process or intent or something. like the therapist has “superior knowledge.” unless one has DID, I don’t see how one can assume that they can make the judgment about what is working or not. that has to come from the patient, and so there HAS to be a partnership.
plus that will empower us to reclaim our power, which is the root of the problem in the first place.

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This is an extremely important point.

The dissociative survivor IS the expert for what helps them.

And from what I can see in reading through the comments in the previous blog, the normal 50-minute hour is far from helpful.  For most dissociative trauma survivors, it’s not sufficient, it’s not enough, and in many ways, it’s not helpful.  DID survivors simply need more time to make sufficient progress in therapy.

Should insurance panels be the final “experts” on how long sessions can be and on how many sessions a trauma survivor can have?

If DID clients are cash-paying for their therapy, can they make their own decisions about how much time they would like to have with their therapist?

Should therapists or counselors have the final say on how much time a dissociative client needs to work on their issues?

Should psychiatrists or doctors have the ultimate decision-making power to determine all treatment plans for dissociative trauma survivors?

Who gets to decide these things?  Are clients allowed to have freedom of choice and the freedom to want or request something more or different than the norm?   Do mental health professionals have the only vote about what is helpful?

In too many instances, treatment plans for dissociative survivors are designed by – and limited by — mental health professionals and insurance companies.  And all too many DID survivors truly do not get their therapeutic needs met because the mental health professionals are setting “appropriate limits” to what they are willing to offer their clients.  These limits are decided on based on the therapist opinion, and not on the clients’ needs.

In my personal opinion, a 50-minute session once per week is barely scraping the surface of what is needed to work with the dissociative population.  Most DID survivors have a minimum of 5-10 insiders that could productively use the therapy session time at any given day, and the issues that these 5-10 insiders would be discussing would not be simple issues.  Typically everyone in the DID system has complicated situations, painful issues, complex conflicts to discuss.  Is this going to happen in 50 minutes?  Not likely.  Is everyone going to get a turn in 50 minutes?  Absolutely not.  In reality, it would be more likely that each and every insider could fill up a 50-minute session!  To have to share such limited therapy time between so many inner people means that the pertinent and important issues just are not discussed in any great depth or detail.  It takes a lot longer to make progress because so much just can’t be addressed.

Because of dissociative walls, the need to switch between inside parts, amnesia between many parts, time distortion, other dissociative complications, etc., it very often takes a DID survivor longer to dig into the issues of the day, and longer to get grounded and stabilized afterwards.  Having the time to talk to a few of the insiders, to get their opinions about the topic, or to give them a chance to talk about their own issues does not happen quickly.

Part of what created and solidified dissociative identity disorder in the first place was having no where to discuss complicated, painful emotions, turmoil, and distress.  For the therapy hour to remain a drop in the bucket in terms of meeting the needs, it leaves the dissociative survivor feeling like they will never get through the healing process.   And in some ways, that is too close to being true.

But is it therapeutic exploitation to “allow” clients to have longer sessions and / or more than one 50-minute session per week?

When is too much?  If a DID client needs more than normal, even for the dissociative population, should they be allowed to have more sessions than normal?

Should therapists be “required” to set an “appropriate limits and boundaries” by insisting on short sessions, even if DID survivors say and believe they need more time in therapy?

If clients say they need 2-hour or even 3-hour sessions, should they be allowed to have extended sessions?  OR should therapists have the right and responsibility to limit these sessions to “normal limits” instead?

Whose opinion is correct?

In these situations, do therapists know best or do dissociative trauma survivors know best?

In case of a disagreement between the client and therapist, who should have the final say in length of sessions and frequency of sessions?

As heartofindigo stated, a big part of the healing process is about reclaiming personal power that was not allowed during the years of trauma.

Is freedom to decide length and frequency of sessions part of client empowerment?  Or part of therapeutic responsibility?

What are your thoughts about this dilemma?

———-

By:

Kathy Broady LCSW

http://www.AbuseConsultants.com

http://www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

July 31, 2010

Do Dissociative Trauma Survivors Actually Lose Time?

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


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

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

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

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

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

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

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

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

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

So where does the time go?

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

Yep, they’ve just switched.

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

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

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

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

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

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

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

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

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

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

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

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

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

__________

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

July 10, 2010

I Had a Great Time – Thanks for Asking

Posted in Artwork, Depression, DID Education, DID/MPD, Dissociative Identity Disorder, Domestic Violence, emotional pain, Physical Abuse, Self Injury, sexual abuse, Therapy Homework Ideas, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 5:11 pm by Kathy Broady


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*** trigger warning for dissociative trauma survivors ***

The collage and the material discussed in this blog is emotionally intense and could be triggering.  Please be sure that you are in a safe place before reading further.

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Trauma survivors with dissociative identity disorder often have to live a double life.  There is the public face, full of pretty smiles and general surface chatter that says “I’m fine”, “I’m doing great!”, “I had a good time”, “Nothing is wrong”, etc.

Recognize any of those kinds of cover-up phrases?

Unfortunately, all too often, looking the other side of these statements proves a very opposite reality.  The person is feeling anything but “great”.

Every DID survivor I have ever met has a whole repertoire of phrases and quick answers that indicate they are doing well, that everything is ok, even when they actually are not ok.  DID survivors know how to cover and hide their pain.  Besides dissociating away the evidence, feelings, and awareness of the abuse from themselves, they have also developed a variety of social skills to cover and hide the depth of their confusion, upset, emotions from others.

On the other side of “I’m fine”, there are very different feelings – depression, fear, anxiety, sadness, overwhelm, emotional pain, grief, shame, anger, just to name a few.  Sometimes there are flashbacks, body memories, nightmares, self-injuries, addiction issues, etc.  There are often feelings related to self-injury, self-destruction, and self-hatred.    Sometimes there are incidents of trauma in the current day, or domestic violence, or sexual assault, or date rape.  Life can feel pretty dark.

But still, all too often, the survivor will say, “I’m fine.”

The following collage says it well.

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I'm fine. Thanks for asking.

 

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In case they are a little hard to read, the words on the collage are as follows:

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This can’t be happening

It’s not real

It’s not real

It’s real.

It’s really happening.

To me.

What will I say?  What do I say?

I can’t breath I can’t breath

I need air.

Gravel in my hair hurts.

What will I say tomorrow?

What if I get grass stains on my dress?

I can’t breathe.

Please God help me.  Please.

Please save me.

Help me

Someone help me

Someone

Anyone

Please.

Please.

PLEASE.

There’s no on

And he’s on top

And I can’t breathe

And this is hopeless

And I think

I can’t escape

God please —

I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine I’m fine

I can never tell anyone about this

What would everyone say?  They’ll all be bragging

About what a good time they had tonight

I can’t say

This is the night

God abandoned me

That my soul was killed

That the world left me behind.

I had a great time, thanks.  Thanks for asking.

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In this collage, notice the initial dissociative statements.  “This can’t be real” indicates the need to dissociate and separate from what is happening.  Even when the artist recognizes that it is really happening to her, she separates herself with the tiny “to me”.

The middle section describes a sexual assault.  Some of the pain and discomfort of the abuse is included – for the most part, the details of the rape are not mentioned.  However, the fears and pleas for help are included, showing the desperation felt by the woman being assaulted.

Finally, at least for a short while, the abuse has stopped.

It appears, that after the assault happens, this survivor is expected to make a social appearance at a party or a dance.   The social event is supposed to be great fun, but how can a social event be fun right after having experienced a sexual trauma?

But still, the survivor says she’s fine.

  • What keeps her from talking about what she just experienced?
  • Do you understand why she covers and hides the abuse instead of telling others about it?
  • Does this survivor remember that she was just assaulted?
  • Did she build an amnesiac wall around the abuse?
  • Did one insider deal with the trauma, and another insider go to the party?
  • Is this survivor denying the abuse?

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Part of the healing process is connecting the reality of the situation with the truth of emotion.  Chances are, this survivor does not actually feel fine at all.

What could she do now?

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By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

May 9, 2010

What Did Your Mother Teach You?

Posted in Child Alters, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Family Members of Trauma Survivors, therapy, Therapy and Counseling, Therapy Homework Ideas, Transference Issues, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 10:41 am by Kathy Broady


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It’s Mother’s Day 2010.

Mother’s Day – it’s a hard day for a lot of dissociative trauma survivors.  It’s a day full of mixed emotions, painful longings, unhealed heartbreak.  This day hurts the people who were hurt so much by their mothers.

Mothers are a complicated subject, to say the least, and the impact a mother can have on her children can and does change their lives.  Abusive or neglectful mothers can teach some very damaging life lessons.  Their children will carry those scars for decades of time.

I’ve seen this over and over with the DID survivors I work with.  Years later, the ways their mother treated them affects so much of their life – maybe even more than they realize.  People who were deeply wounded by their mothers often cannot view other maternal figures (Including other female authority figures) without getting confused in that relationship because of who their mother was.  The crimes of the original mother spill over onto the relationship any children they might have, making it harder to be a good mother in their own life.

That original mother relationship affects how DID survivors see the world, how they experience people, what they believe about themselves, what they believe about the world around them, and how they interpret others.  It is very central to the very core of their being.

Working with mother-transference issues is one of the hardest parts of being a DID therapist.  It is the area where the therapeutic relationship is at its most tender.  It is the most vulnerable place.  It is the spot where issues and feelings can get messed with by people who wish harm upon that therapeutic relationship.

To explain this, let me start from further back.

For example, I was blessed to have a very good mother and she taught me a lot of valuable life lessons. She wasn’t perfect, but she was and is about as close to perfect as one could ever hope for in a mother.  She is kind, loving, compassionate, caring, generous with her time, good with children, full of wisdom, patient, gentle, and self-less in so many incredible ways.  She has been an example to me for how to interact with people, especially with children.  My mother is non-judgmental, and she is willing to dig in and help anyone that she meets.  She is a beautiful soul, and she leaves a positive impact wherever she goes.

Yes, my mother has taught me a lot.  And almost all of what she has taught me has been good.  I do much of what I do because I had an incredible mother who taught me to be kind to others.

Those that spend time with me will see this in my work with them.  They will see that kindness, acceptance, gentleness, and generosity in what I do.  They will reap the benefits of what my mother gave to me as I pass that on to those that I work with.

So what makes that so hard?

If I am pulling from a good place, what makes mother issues so complicated and difficult to work with?

It’s because not everyone can interpret today’s kindness as genuine kindness.  The past wrinkles in and rolls up into the present, and the present becomes twisted into the past in an emotional kind of way.

Sometimes the damage done to trauma survivors confuses kindness with abuse.  Sometimes the damage done by an abusive or neglectful mother is so pervasive that it colors all acts done by other females, and the perspective becomes so tainted that nothing is seen clearly.  Female therapists are seen through the perspectives of “mother figures will abuse me”, “mother figures will hate me”, “mother figures will think I’m bad”, “mother figures will abandon me”, “mother figures are to be hated”, etc.

When trauma survivors truly believe, in their deepest selves, that women are there to abuse them, it is not an easy job to overcome that belief.  The fear is too huge.  The expectation of horrible doesn’t end.  The fearful expectation of abuse can often overtake everything else.

Frequently the pain-anger-guilt-shame at not having a good mother can get thrown at the female therapist, and displaced and projected onto her as a safe place to express such deep heart-wrenching emotions.  Therapeutically, this is expected to happen, and the goal is to work through that in a healing way.  Most therapists and clients understand that, and will work through it as a team.  It can be done, and when it is, very deep healing can occur.

However, sometimes trauma survivors get a little messed up along their journey.  They truly get confused in this area, and understandably so.  It’s an emotionally complex point, and trauma survivors are extremely vulnerable in this place.   And because of those vulnerabilities, they can be easily misguided.  They can get easily confused over who is the “good mother transference figure” and who is not.  They listen to poor advice, or bad rumors, or are too unwilling to let go of their fears in order to heal.  They stay convinced that women are out to get them, and they quickly join in with thinking that female therapists are abusive.

This breaks my heart.

I found it horrifically sad that some trauma survivors are willing to hold onto such beliefs that they would bring harm to themselves and to others.  This only continues the cycle of abuse.  It is not about healing.  It is destructive.

(Yes, there are a few female therapists who are harmful to their clients, but those are few are far between, and those are not the people I am writing about in this particular article.  That’s a completely different topic, to be discussed another day.)

This article is about genuinely good therapists who are mistaken as the “bad mother”.  This article is about finding ways to heal from your abuse.  It is about finding a woman of kindness, and not confusing her with your not-so-kind mother.  It is about recognizing the differences, and not being pulled into old fears, old beliefs, and old ways, just because they are more familiar to you.

It is about learning to recognize someone that can be positive, helpful, and kind to you, and to your inner children.  It is allowing that healing to occur.  It is keeping clear on what happens in the present, and not distorting it or twisting it into something negative from your past.

It does not help your healing to project your “bad mother issues” onto a good therapist and then stay stuck in that spot.  It only confuses you, and it prevents your healing.  It brings harm to you and your system to stay stuck there.

Your female therapist can and will teach you something very different from what your mother taught you.   Don’t assume the two women will be the same, because they will not be.  Don’t project so much of your abusive past onto your current day therapist that you cannot see who she really is.  Work hard at recognizing true kindness and gentleness for what it is.

Let yourself and your inner child parts have those corrective emotional experiences with a kind therapist and don’t let anyone mess with that.  If you let someone distort those experiences – if you let someone convince you that something was abusive when it wasn’t — then you have brought emotional pain to your inner world that didn’t need to happen.  If you weren’t abused, don’t let yourself believe that you were just because that is more familiar. Separate the past from the present.

Haven’t you been hurt enough?  Why add to that?

It is important to try to believe that women are not out to get you.  Female therapists are not here to harm you.  What your mother taught you can apply to her, but it really and truly does not have to apply to everyone else.  Your mother may have been cruel, cold, uncaring and abusive towards you.  But not everyone will be.  Not everyone wants to be.

Don’t assume the worst, and please don’t treat other women as if they did what your mother did.

It is very hard for trauma survivors to come to terms with these truths.  But the sooner you do, the sooner you will find that place of genuine healing.

Don’t let the harmful lessons that your abusive or neglectful mother taught you ruin or destroy any more of your life.  You truly can heal from the hurt and the trauma that you went through – I promise!

There are lots of good, helpful, kind, compassionate, caring women out here in the world.  I encourage you to be one of them.

———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

January 19, 2010

Externalizing Responsibility vs. Internalizing Responsibility

Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, Domestic Violence, Family Members of Trauma Survivors, Physical Abuse, Prevention of Sexual Abuse, sexual abuse, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 6:05 pm by Kathy Broady


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Externalizing Responsibility

What an interesting phrase.

Externalizing responsibility is when someone fails to accept responsibility for the messes they make or for the problems they cause.  It is also failing to accept responsibility for the situations they find themselves in.

Internalizing responsibility is personally taking on the responsibility for what happens (in the past, present, or future).  It is accepting the responsibility for personal welfare or for consequences of actions instead of dumping the blame on others.

Do you externalize responsibility?

Do you internalize responsibility?

For dissociative trauma survivors, the issue of when to accept responsibility versus when to deflect responsibility is a very complicated topic.

Most DID survivors have had years of experience internalizing responsibility for the actions of their perpetrators, family members, abusers, etc.  Abusive offenders are some of the world’s best at externalizing blame onto someone else, and most trauma survivors internalize that blame, guilt, shame within themselves.  Purposeful and direct blaming of the victim, especially child victims, typically ends up with the victim feeling responsible for the abuse.

Having this convoluted, complicated history of who is or isn’t responsible makes “accepting responsibility” a very difficult topic for trauma survivors.
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Self Blame

Survivors spend years of time blaming themselves for the abuse (internalizing responsibility).  Survivors typically end up feeling like they were bad, or they did something to cause it, or it was because they were too pretty, or too available, or too easy, etc.  Survivors were usually told by their abusers that they deserved the abuse, or they liked the abuse, or they wanted the abuse, or some variation of the sort.

Perpetrators know that if they verbally blame the victim, that victim will be more likely to internalize the responsibility for what happened. Perpetrators typically do not accept responsibility for their actions.  The more the perpetrators push blame and responsibility onto the victim, the more the victim will internalize that responsibility and blame.
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Blaming Perpetrators

But typically, survivors are not responsible for being abused.  At least, they are not responsible for what the abuser does.  The abuser is responsible for what the abuser does.

However, it is very difficult for many trauma survivors to put the blame of their abuse back onto their perpetrator.  Trauma survivors will argue with their therapists that their abusive loved ones were not at fault – that they cannot be considered a perpetrator – that they are not to be blamed.

How many of you refuse to believe that your father (or mother) sexually abused you even if other parts in your system have said this clearly?

How many of you refuse to blame your perpetrator, and instead will run in circles protecting your family member from being called a perpetrator?

How many of you will argue that you have no right to be angry with your father – perpetrator?  How many of you will define criminal actions as “not a problem” in order to not assign responsibility to your loved one?
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Abuse

Children are not responsible for being abused.  Adults are responsible anytime they have abused children.  Children will internalize the blame, but they are not responsible for being abused.

What about when the trauma survivor is an adult?  What if the adult survivor is being abused as an adult?  Who’s responsible then?

Adult trauma survivors do get abused.  There are thousands of domestic violence situations where adults are being abused on a regular basis.  Rapes and date rape situations can happen to adult trauma survivors.  Dissociative survivors can still be involved in the sex slave industry or other ongoing abuses even as an adult.  Abuse certainly can happen into adult-hood.

Who is responsible in these situations?

Of course, the abusers are still responsible for their own abusive behavior.  (The topic of recognizing who abusers are will be discussed in a different blog article.)

However, these issues are not simple once the victim is an adult who has to be responsible for their own selves and any dependents. If you are an adult trauma survivor caught in abuse, it is not your fault you are being abused, but it is your responsibility to get yourself out and away from this abuse.

These adult survivor victims are responsible to get the help they need to get out of their abusive situations.  They do not cause the abuser to abuse, but they are responsible to learn how to protect themselves and to protect any children that may be involved in the situation.  It is important to build and utilize enough resources for safety and protection that will make the abuse come to an end as quickly as possible.
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Finding the Balance

The difficult part is internalizing the correct portion of the responsibility.  Even adult trauma survivors well experienced in therapy will internalize responsibility that genuinely belongs to the abuser.  Other adult trauma survivors will stay stuck completely in the victim role, refusing to accept responsibility for getting out of the mess they are in.  Sometimes survivors will cause-create-instigate-perpetuate emotional conflicts that are of their own making, and yet, claim to be the victim of their circumstances (more on that topic another time…).

So think about it…

Internalizing responsibility vs. externalizing responsibility.

What really does belong to you?

What really does belong to someone else?

Are you taking on too much?

Are you acting like a victim in situations where you are actually responsible?

———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

December 6, 2009

Compulsive Hoarding and Dissociative Disorders

Posted in Child Alters, Compulsive Hoarding, Depression, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Internal Communication, mental health, therapy, Therapy and Counseling, Therapy Homework Ideas, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 8:53 pm by Kathy Broady


Compulsive Hoarding is a cluttery mess!!

What makes this happen?

Have you seen homes that look like this?

Does your home look like this?

Compulsive hoarding, or disposophobia, is a psychiatric condition that affects millions of people.

Compulsive hoarding is an obsessive need to acquire and keep possessions, even if these items have little value, are unsanitary, or broken, or unusable.  Numerous items are kept and not discarded.  Instead of using the items already owned, or looking for items that are lost in the piles, new items are acquired repeatedly to the point that the clutter creates significant dysfunction in a variety of areas of the person’s life.

Compulsive hoarding is far more complex than it first appears.  It is connected to a variety of disorganized chaotic behavioral patterns and disorganized thinking patterns.  It typically occurs in combination with other psychiatric issues, such as depression, anxiety, obsessive-compulsive disorder (OCD), eating disorders, attention deficit disorders, addiction issues, trauma disorders, attachment disorders, etc.

There appears to be a biological base to this behavior as research is beginning to explore a genetic link to compulsive hoarding in generations of families.  As children, many hoarders were raised by parents who were hoarders, so not only is it a learned behavior, but it could also be  biologically connected. The area of the brain most significantly different for hoarders is the part of the brain that is responsible for focus, attention, and decision-making.  According to research done at the University of Iowa, damage done to the to the right medial prefrontal cortex of the brain tends to cause compulsive hoarding.

Hoarders have a great deal of anxiety when pressured to let go of their possessions.  They typically require external assistance, including professional assistance, to help with the cleaning and organizing tasks.  Feelings of emotional overwhelm, intense anxiety, and panic attacks can be paralyzing for the hoarder.  These increased anxiety symptoms create an inability to make decisions, stir up friction and emotional outbursts, lead to fatigue and exhaustion, and repeatedly interrupt the cleaning process.  Letting the hoarder have control of the cleaning process and allowing time for the harder to build trust with the cleaning crew is particularly important to successful organizational efforts.

The clean-up process is intense and slow.  Forcing a hoarder to clean too quickly will not result in long-term resolution of the problem.  The problem is not just “clean up your house” or “throw this away”.  The problem lies deeper within the person, and the struggles will manifest again in just a short-time.

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How does compulsive hoarding relate to Dissociative Identity Disorder?

Compulsive hoarding is an issue separate from DID / MPD, but many dissociative survivors struggle with hoarding issues.

DID survivors have a variety of issues that overlap with hoarding behaviors: intense anxiety, deep feelings of hopelessness, fear of being out of control, problems with focus and decision-making, attachment issues, loss and grief, depression, the need for memory reminders, disorganized thought processes, disorganized behaviors, etc.

How many trauma survivors do you know that did not have safe people to attach to?  And how many survivors of neglect were left alone, isolated with no one to attach to?  When children spend too much time alone, they tend to attach to items, toys, books, stuffies, etc.  Attaching to stuff is better than attaching to nothing.  It is an adaptive behavior in a painfully difficult environment.  However, when this continues over time, the potential for these behaviors to develop into a compulsive hoarding situation increases.

The emotional pain from not having deep personal relationships or the fear of being near people can add to the need to connect with physical possessions or animals instead of people.  Building a personal relationship with stuff, and with animals can add to a compulsive hoarding situation.  Attaching to stuff can feel much safer than attaching to people.

With all the switching and amnesia that can happen with dissociative identity disorder, DID survivors can experience a lot of chaotic thinking and chaotic behaviors.  It can be difficult to complete a task – you can be there, and then suddenly find yourself somewhere else five hours later, having never finished the task you started in the first place.  These kinds of disorganized behaviors can leave unattended messes and growing clutter all around your house.  Do your child parts pick up the messes they leave behind?  Do your teenage parts pick up their clothes?  Did anyone remember to finish the dishes?  What about the mess those angry parts made?  Who wants to clean that up?

The “I didn’t do that, so I’m not cleaning that up” concept can get very difficult for dissociative survivors.  You might not know who made the mess in the first place, or the part that did it might not be around anymore, you might not know how to call them back, etc.  You might not know who to assign to completing basic household chores.  Developing system work and system cooperation can help, but in the meantime, there can be a lot of “that’s not mine” / “I’m not doing that” arguments.  Clutter and external disorganization can build while you are sorting out these internal system issues.

How many dissociative survivors have trouble remembering if they have something?  Do you own one of those things?  Did you buy that, or just think about buying that?  Or was that last year?  Do you still have that?  Or was that way back then?  Where did you live when you had that? Or if you know you have it, do you know where it is?

Sometimes it is easier to buy the item again than find it or remember if you have it.  While this can be a dissociative symptom, this also contributes to the “Shop and Drop” behaviors found in compulsive hoarding.   Shop and Drop refers to a pattern of behavior where the compulsive shopper drops their packages and purchases in some unspecified place.  Over time, the packages and purchases get lost in the piles of other clutter, and then when it is time to use the items that were purchased, the location of the dropped items cannot be found.  It becomes easier to buy those items again, instead of finding the ones you had.

There is also the complication of accumulation by repetition. Compulsive hoarders will acquire and stash away numerous items that are basically the same.  What if you buy everyone in your DID system a stuffie?  How many stuffies will that be?  What if everyone wants their own books?   And of course, many of the different insiders will have their own shirts, their own pants, their own shoes, their own socks, etc.  While it is extremely important that the insiders have their own things, the sheer volume of each of the parts keeping their own stuff can add to the size of an ever-growing clutter problem.

The same as with compulsive hoarding, things / possessions / items can represent memories.  For DID survivors, memory is a very complicated subject.  Having items that trigger memories, or remind you of certain things can be a significant part of a growing clutter issue.  Loss and grief are hard emotions to process, and holding on tightly to the items that help you to remember certain people or events can be significant.  It is particularly difficult to let go of an item that has emotional significance to you, especially if it feels like you won’t remember someone or something if you don’t have those correlating things.

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Here are a few ideas for addressing compulsive hoarding issues:

  • Decide your current life goals, and keep only items that match with those life goals
  • Explore the various meanings that possessions have for you
  • Consider appropriate medications for anxiety, OCD, depression, etc.
  • Work hard in therapy to address your emotional pain and other emotional issues
  • For DID survivors, work hard on developing better internal communication and cooperation so clutter issues can be prevented or addressed
  • Address your fears of letting go, or letting go of control – what is that about for you?
  • Be honest with yourself about what you really need, what you will really use, what actually works, what you can actually fit into, etc.  Challenge delusional thinking.
  • Get professional help if necessary, especially if clutter is affecting your life
  • Consider taking pictures of emotionally important but logically unnecessary items.  Photo albums can be less cluttering than keeping all the actual items.
  • Donate your excess to those less fortunate than you.
  • Consider new rules to live by:  If you get something new, get rid of something old.
  • Address your deep feelings of shame, embarrassment, humiliation, fear, sadness, etc.
  • Work on building deeper and longer-lasting attachments instead of repeatedly discarding and replacing things (but keeping it just over there in case you want it again)
  • Work on building meaningful attachments to people, learning to trust, and finding ways to connect
  • Find healthy, meaningful ways to fill the voids in your life by doing more, and keeping less

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———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

November 28, 2009

I’m Thankful for the Readers of this Blog

Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Friends of Multiples, Online Therapy, therapy, Therapy Homework Ideas, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 5:23 pm by Kathy Broady


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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.

———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation

November 21, 2009

Why Do You Need a Therapist Anyway?

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, therapy, Therapy and Counseling, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , at 9:44 pm by Kathy Broady


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There have been some interesting discussions and comments from various trauma survivors about how much their therapists have meant to them.  These readers have shared some very tender moments with their therapists and have talked openly about the depths of their heart-warming connections and healing moments.

Clearly, these survivors have found their therapists to be important and significant people in their lives.  The work and the effort of developing these therapeutic relationships have clearly been worth it to them.

But why?

Why is their therapist important?

On the flip-side, other commenters in this blog have written about horror stories they have had with former trauma therapists.  It seems there is an endless supply of the “bad t” stories that get passed around and shared over and over.  I can’t tell you how many of those stories I’ve heard.  I’m sure each of you have already been told about at least a dozen bad therapists.  In these stories, the clients are angry with their therapist, they accuse the therapist of causing all kinds of harm, and they speak of these therapeutic relationships as traumatic or disturbing or exploitive.

Who are these bad therapists?!

Is there any trauma therapist that has not been considered to be a “bad t” by someone or another?  Honestly, most therapists get targeted sooner or later by someone. It happens frequently.  (Please remember the blogs about love/hate relationships and protecting your therapeutic relationship.)

So if there are allegedly so many bad therapists, or perceived bad therapists, why do trauma survivors repeatedly risk having a therapist in the first place?

Why does a therapist matter to you?

Why bother with the hassle of developing and maintaining a therapeutic relationship?

Why does a therapist warrant your business, your time, your respect, or any caring connection from you?

What does a therapist do anyway?

There are a variety of reasons why dissociative trauma survivors might find therapists to be important.  I’ve listed 50 benefits of having a therapist. This is not an exhaustive list. If you have an idea to add, please comment.
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50 Benefits of Having a Therapist

1.   To have someone encourage you to love and accept yourself to the point that you can truly live, without focusing on death and needing to die
2.   To have someone in your life that will make it ok to not have to dissociate away from your real life
3.   To have someone to bounce ideas on, to problem solve, to explore new behaviors
4.   To have someone to talk to about deeply private and personal things
5.   To have someone who can genuinely hear your pain, and sit with you when you are hurting
6.   To have someone who can give you their undivided attention, their best listening ear, even if for a specified period of time
7.   To have someone who gives you courage and hope to keep going, even in the darkest moments
8.   To have someone who provides a gentle, safe environment for the healing of your deepest wounds and painful memories
9.   To have someone who repeatedly offers positive emotional support and encouragement
10.  To have someone who sincerely believes in you and your abilities, talents, and accomplishments
11.  To have someone who truly sees you as a good person, a worthwhile person, a valuable person
12.  To have someone who will address the variety of issues that underlies the mental health difficulties in your life.
13.  To have someone who will build a relationship with you, willingly connecting with you, no matter how badly you feel about yourself
14.  To have someone who will challenge your thinking and cognitive distortions
15.  To have someone who will connect the dots of your dissociated life experiences
16.  To have someone who will encourage you to be comfortable becoming your very own self
17.  To have someone who will encourage you to build a life based on your strengths instead of the life your abusers may have designed for you
18.  To have someone who will encourage you to try new things and to stretch your horizons
19.  To have someone who will expect you to honestly work on your issues instead of blaming others
20.  To have someone who will foster your leadership skills, job skill development, educational opportunities, etc.
21.  To have someone who will genuinely accept you, warts and all
22.  To have someone who will have the courage and ability to tell you “no”
23.  To have someone who will hear your heart and the depths of your soul
24.  To have someone who will help to remove the jagged edges from your life
25.  To have someone who will help you build a tolerance and acceptance of others
26.  To have someone who will help you create personal safety, both inside and out
27.  To have someone who will help you find and connect with your very best self
28.  To have someone who will help you to build the ability to tolerate and sit with intense emotions in yourself and in others
29.  To have someone who will help you to contain the extremes of your behavior and feelings
30.  To have someone who will help you to emotionally grow, develop, mature
31.  To have someone who will help you to move past the blocks, walls, and black holes
32.  To have someone who will help you transform self destruction into self acceptance
33.  To have someone who will hold you accountable and responsible for troublesome areas
34.  To have someone who will hold your secrets with you
35.  To have someone who will listen to you, and understand your point of view
36.  To have someone who will look for the positive in each and every one of your insiders
37.  To have someone who will make it safe enough for you to express your true feelings
38.  To have someone who will offer encouragement and support, even when its tough
39.  To have someone who will offer guidance as needed
40.  To have someone who will offer opportunities to explore trust, acceptance, compassion, kindness, gentleness, patience
41.  To have someone who will push you to move forward, instead of sitting complacently
42.  To have someone who will recognize family dynamics and their impact on you
43.  To have someone who will remember what your insiders say, especially when it is too difficult for you to retain it
44.  To have someone who will set appropriate limits and boundaries
45.  To have someone who will sit with you while you face your deepest fear, shame, guilt, horror
46.  To have someone who will sort out conflict and disagreement
47.  To have someone who will stay with you, even when you expose your worst self
48.  To have someone who will talk to your inner parts, even the ones you are afraid to speak to or unable to speak to
49.  To have someone who will teach and model new behaviors, and healthy emotions
50.  To have someone who will team up with you in your healing journey

True therapy is so much more than a sequence of techniques to address trauma, or emotional containment, or cognitive distortions, or dissociative separation, or destructive behaviors.

Therapy happens with real people, between real people.  Therapy is a healing process.  It touches many levels of life. The emotional depth of true healing is founded in the solidity of the therapeutic relationship.

Unfortunately, your trauma and abuse happened at the hands of violent, hateful, destructive people.

Fortunately, your healing will happen within a caring, accepting, compassionate relationship.

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By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

November 15, 2009

Attachment to the Perpetrator

Posted in DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Family Members of Trauma Survivors, Friends of Multiples, mental health, Physical Abuse, sexual abuse, therapy, Therapy and Counseling, Therapy Homework Ideas, Trauma tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 7:53 pm by Kathy Broady


Last night, I saw another television documentary on Jaycee Lee Dugard – the young woman who was kidnapped at age 11, held captive for 18 years, and found alive, along with her two daughters on August 26, 2009.

Jaycee is now 29 years old.

Jaycee spent the past 18 years held captive in the backyard of a registered, violent sex offender, Phillip Garrido.  Garrido fathered Jaycee’s two daughters, and has been charged with numerous criminal offenses.

While most of the world was thrilled to see Garrido arrested and locked away into police custody, Jaycee and her girls had different emotional reactions.  Initially, when questioned by the authorities, Jaycee was supportive of Garrido, she refused to admit her real identity, and when the facts weren’t adding up, she claimed to be hiding from a fictitious abusive husband that lived in another state.  She had chances to tell about her perpetrator, but her first responses were to protect him.  Her two daughters cried when they heard Garrido was arrested.

Garrido spent years torturing these young women, but yet they were clearly connected to him.

How can this be?

This dynamic is called Stockholm Syndrome.  It is when victims form positive, caring attachments with their violent perpetrators.  The more victims have to depend on their perpetrators for their very survival, the more likely the victim will form an attachment to their perpetrator.

The world has been appalled as they heard this story.

But this story is not a new story.

This story happens to many children every day of the year.

Many dissociative trauma survivors have lived a life all too similar to the life that Jaycee lived while with Garrido.  As children, most dissociative trauma survivors lived – day after day, year after year – under the strict sadistic control of a sex offender.  They were repeatedly sexually abused, many became pregnant, they were given hidden identities and new names, and they were taught bizarre religious beliefs.  Many DID survivors were locked and confined in unhealthy places, made to be completely dependent upon their abusers, and the reality of their daily abuse was hidden from the neighbors.  It is not at all uncommon for DID survivors to have been sexually involved and sexually controlled by their perpetrators well into their adulthood.

The main difference between most DID Survivors and Jaycee Dugard is that most DID survivors were not kidnapped by a stranger.  Most DID survivors who have lived this kind of ongoing abuse were simply living in their family homes.

These DID survivors were being raised by their father and mother.  They didn’t have the hope that someday they would be rescued and returned to their “real family”.  They were with their real family.

In either situation, the child-victims learned to adapt to the sadistic behaviors of the abusive parental figures in order to survive.  Despite the extreme abuse, they learned to depend on the abusers.  Everything from breathing, food, clothing, water, shelter, warmth, education, medical attention, etc. was controlled and monitored by their abusers.  There was no personal space.  There was no way to get away.  There was no known place to run to even if they had gotten away.

The child-victims knew they were stuck there.

They knew that their life and basic survival needs were completely dependent upon keeping the perpetrator happy.  They learned to base their own survival on effectively meeting the needs of the perpetrator, and the perpetrator had the power to decide if they would live or die.  To survive, they became loyal to the perpetrator.

Perpetrators purposefully create this kind of dependence in their victims.  They want their victims to feel trapped, and to lose hope, and to be stuck in their abuse.  They do not want their victims to know there is a way out, or to find a way out.  Perpetrators want to be in control of absolutely everything, barely leaving their victims room to breathe on their own.

In keeping the required secrets, the surviving children often  learned that the ONLY person to turn to in time of trouble or need is the perpetrator.  To get their daily survival needs met, the child learned they had to placate, please, and depend upon the abuser.

In these long-term abusive situations, the perpetrator is both the caretaker and the abuser.  The child learns to love and hate this parent.  The child feels either trapped in the abuse, or feels tied to them in order to get their needs met.

Consequently, the child-victims have to depend on their abusers for their care.  Who else will feed them?  Who else will get their books for school?  Who else will provide clothing and a place to sleep? These children have no where else to turn, so they form a variety of trauma bonds with their perpetrator.

Since the child-victim’s life depends on their perpetrator, the victim develops a loyalty to the perpetrator.  They experience a positive loyalty when the perpetrator meets their daily needs.  They experience a fear-based loyalty when their life depends on it.

Whether the offender parent is being appropriate or violent, the dissociative child is drawn into the relationship, and feels emotionally connected to the perpetrator.

Child-victims might split off parts that keep the abuse separate from their feelings of love and appreciation.  It’s hard to genuinely care about someone who is hurting and abusing you, but child victims often have to manage both of these scenarios. They might split off parts to deny the abuse, so they don’t have to remember the violence.

And after living that dynamic for years of time, survivors lose the ability to recognize who or what a perpetrator is.  They grow up feeling responsible for pleasing perpetrators, learning how to tolerate abusers instead of learning how to leave perpetrators. They grow up believing that attaching and bonding to a dangerous person is critical for their own life.

Attachment to the perpetrator creates many layers of confusion for many years to come.  It is a critical area of healing that requires a great deal of work in the therapy setting.

Do they love their abuser?  Do they hate their abuser?  Do they recognize their abuser as an abuser? Can they recognize who in the world is or isn’t an abuser?  Can they leave their abuser?  Can they bond with a non-abuser?

Even as adults, far too many DID survivors can no longer separate who is who.  They will live a life connecting to one abuser after another, yet they won’t be able to recognize a safe person when they meet one.  DID survivors may feel more comfort in the victim role, and they may prefer the familiarity of abusive relationships over the strange unknown of safe relationships.  Or, they may assume that all people are abusers, and thus miss out on the opportunity to learn the difference between a safe person and a perpetrator.

Every DID survivor has attached to at least one perpetrator in their lifetime, and probably more than one.

It is critical to work on this trauma dynamic in therapy.  This work is essential for healing.  Otherwise, DID survivors will feel a high degree of comfort with perpetrators, and will not be able to stay connected to a safe person when they meet one.  Or, they’ll accuse a safe person of becoming a perpetrator.

There are a lot of different possibilities, most of them ending up as relationship disasters.

In order to have any chance at having successful social relationships, dissociative trauma survivors absolutely must address the attachment they feel to their perpetrators.

The health of your future relationships depend on it.

———-

By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

November 10, 2009

When You Suddenly Lose Your Therapist

Posted in Child Alters, Depression, DID Education, Dissociative Identity Disorder, emotional pain, Internal Communication, Self Injury, therapy, Therapy and Counseling, Trauma, trauma therapist tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , at 7:11 pm by Kathy Broady


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Several people that have been reading Discussing Dissociation have made posts and comments about how enormously painful and difficult it is to lose a therapist.

There are several different ways to “lose a therapist” but for the purposes of this particular blog entry, I’d like to focus on situations where there was sudden loss.

In my years of experience, I have seen a variety of circumstances that have led to clients suddenly losing their therapist.  When this happened during a long-term therapeutic relationship, the sudden loss is enormously difficult for dissociative trauma survivors.

DID survivors typically trust so few people, and there are usually very few people who are allowed to know the internal system in the way that the therapist gets to meet and know the insiders.  It often takes months of regular, frequent sessions for DID survivors to start feeling the teensiest bits of trust with their therapist in the first place. It may also take years of time before some of the more vulnerable insiders experience any feelings of trust at all.

When you find a good therapist that you connect with, it’s usually pretty important to keep that therapist.

But what if something happens and you suddenly lose your therapist?

What if you lose your therapist due to

  • An automobile wreck
  • An assault of some kind
  • An illness of some version
  • An unexpected pregnancy issue
  • A family member of the therapist is ill
  • An unexpected “personal leave” of any kind
  • An unexpected “medical leave” of any kind
  • The family of your therapist has required a move to another location

In these situations, it is very difficult, but the adult parts of the survivor can often understand the need for their therapist to have stepped out of the office, even for an extended period of time.  The loss is still there – and most of the internal system will likely still have enormous grief and struggles and emotional pain. The child parts and traumatized parts might blame themselves, but there will probably be someone in the system that can intellectually grasp that the sudden absence was related to an external issue, and not their fault.

But what about if you lose a therapist to one of these reasons:

  • Your therapist terminates with you, even if that is not your preference
  • Your therapist quits their job for any number of reasons
  • Your therapist takes a new job and can’t take you with them
  • Your spouse demands that you stop seeing your therapist
  • Another person tells you that your therapist is “bad for you”
  • Your therapist gets fired and can no longer work with you
  • Your therapist decides they are no longer working with DID

What about situations where it is less externally based and more connected to you?

What does it do to the survivor to lose a therapist?

In my experience, when a DID survivor loses their therapist, especially when there is very little time for a termination or goodbye process, there is a huge emotional fall-out from the sudden loss.  The therapeutic relationship is far too important to have a sudden ending, and the emotional overflow will be huge.

The DID survivor tends to:
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  • Act out their pain, anger, and fear in various forms of self-injury
  • Be unable to move forward in other areas of healing
  • Begin to either devalue or overly-pedestal the therapist (the love-hate response)
  • Blame themselves or other insiders for the loss
  • Cry, cry, and cry
  • Experience internal system chaos, increased internal fighting, decreased internal cooperation
  • Experience their internal landscapes and internal structures collapsing and the internal world may go dark, or feel unsafe and unfriendly
  • Express an ongoing ambivalence towards the therapist
  • Feel suicidal
  • Go into a long, deep, dark, devastating depression
  • Go into hiding – some of the internal parts may refuse to come back out
  • Go numb – become more detached or dissociated
  • Have a sudden regression in overall skills, abilities, and social interactions
  • Have lots of dreams or nightmares about the therapist
  • Hibernate within their own home, refusing to go out or interact with other people
  • Lash out with inappropriate or excessive anger at innocent people
  • Last out with inappropriate or excessive anger at the therapist
  • Leave therapy, refusing to trust another therapist
  • Lose hold of the positive gains they made with that therapist
  • Pretend that the therapist never existed anyway
  • Re-create history by remembering only the good events, making the therapist too perfect
  • Re-create history by twisting events into something negative, taking comfort by believing the therapist was “a bad guy anyway”
  • Refuse to truly leave the therapist alone (following from afar, maintaining contact, calling their phone, sending emails, etc)
  • Spend a lot more time sitting, staring, spacing out, etc.
  • Stay focused on the therapist, and their feelings about the therapist as their primary issue for an extended period of time

The termination process is as critical to the long-term health and well-being of the client as any other stage of therapy, if not more so.  In fact, a very positive therapeutic relationship can become completely tainted and twisted if the termination process is not handled properly.

Cold-turkey terminations are dangerous.

I cannot stress that enough – sudden terminations are not good.!!

They are not helpful.

They are harmful and emotionally devastating for the clients, and they set up the therapists for future problems.

If your treasured therapist has to leave for any reason, take the time to have as many termination sessions as possible.  The process of saying goodbye is complicated, but it is crucial to leave your therapist from a positive point of view.  Otherwise, you will experience an ongoing emotional fall-out that will extend much further into the future than you would expect.

———-
By:

Kathy Broady LCSW

www.AbuseConsultants.com

www.SurvivorForum.com

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