December 9, 2008
Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, sexual abuse, therapy, Therapy and Counseling, Trauma tagged Add new tag, Addiction, Amnesia, Anxiety, Bipolar, Body Image, Body Memories, Childhood Sexual Abuse, Depression, DID / MPD, dissociate, Dissociation, dissociative, dissociative disorders, Dissociative Identity Disorder, Emotional Abuse, Emotional Crisis, Emotional Healing, Exploitation, Grief, Healing, Hurting, Integration, Isolation, multiple personality disorder, pain, Physical Abuse, Pornography, Prostitution, Relationship, Ritual Abuse, sadistic, Safety, Self Esteem, Self Injury, sexual abuse, Sexually Abused, Social Anxiety, Social Skill, split personality, splitting, Stabilization, Suicidal, Suicidal Behavior, System Work, Therapeutic Process, Trauma Bond, Trauma Survivor, trauma therapist, traumatic history, treatment, treatment for DID, Violence at 7:06 pm by Kathy Broady
“How long will it take for me to feel better?”
As a clinical therapist, I hear that question frequently. It’s a reasonable question. I certainly understand that when someone is deeply hurting and struggling in their life, they want to feel better as quickly as possible.
However, the clinical treatment for someone with DID / MPD is long term. Some research has said that the treatment can be completed within two or three years, but in my clinical experience, that is far from the truth.
Dissociative Identity Disorder is a result of long-term, chronic, severe, sadistic child abuse. As children, these survivors witnessed and experienced a myriad of heinous crimes. They typically describe repeated consuming abuse by multiple perpetrators, and then were otherwise emotionally neglected, starving for comfort, consolation, or attention. They were left alone, even while very young, to process and contain their pain by themselves. For these children, the splitting process became their way of coping with emotional intensity, conflicts, huge distress, and intense pain that were otherwise far too difficult to manage on their own. They blocked off their pain, locked it away from themselves, and left it there. Sitting, waiting, piling up for years.
When you understand how much pain and abuse has occurred in order to create the dissociative splits in the first place, it is no wonder that the healing process is also so very long. All areas of dissociative survivors’ lives are touched and profoundly changed or affected by the abuse. It simply takes a very long time to address everything properly.
Some of the treatment issues are:
- Stabilization of the person – both internally and externally
- Managing and eliminating self-injury and self-harm issues
- Examining and obtaining current-day external safety from abuse
- Internal system safety
- Developing effective internal communication
- Calming internal noise and chaos
- Working specifically with child parts
- Working specifically with adult parts
- Working specifically with teenage parts
- Learning about the other system parts
- Working with internal perpetrator introjects
- Creating emotional separation from external perpetrators
- Working with triggers
- Correcting cognitive distortions
- Addressing gender confusion, male vs. female issues
- Processing emotions
- Body image issues
- Reducing time loss, memory loss, amnesia
- Time confusion, time distortion
- Trauma processing – memory work
- Body memories and kinesthetic issues
- Understanding re-enactments and trauma bonds
- Healing sexual abuse issues
- Healing physical abuse issues
- Healing emotional abuse issues
- Healing ritualized abuse issues
- Healing exploitation, pornography, prostitution, sex slavery issues
- Managing family, marital, parenting issues
- Addressing addictions
- Managing eating disorders
- Household management issues – improving daily functioning
- Relationship issues and teaching social skills
- Understanding the effects of trauma on the brain
- Improving self-independence and self-reliance
- Improving self esteem issues
- Leaving disability and regaining employment
- Depression and medication management
- Bipolar disorder and medication management
- Anxiety / Panic and medication management
- Post-traumatic stress issues (PTSD)
- Reducing phobias
- Social anxiety and social isolation
- Safely eliminating suicidal ideation and suicidal behaviors
- Homicidal ideation and anger management
- Exploring spiritual confusion
- Philosophical issues
- Detachment and separation issues
- Treating sleep disorders
- Treating medical complications and physical harm resulting from the abuse
- Reaching integration, blended states, or effective system team work
That’s a tremendous amount of work. And most of these issues surface again and again and again, requiring in-depth attention on a regular basis for years of time.
Emotional healing on such a wide scale just does not happen fast. Forcing the issues or pretending to be “done” sooner than realistically possible is not helpful.
Simply put, years of severe injuries will require years of intense healing.
It takes as long as it takes.
__________
by:
Kathy Broady, LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
Like this:
Like Loading...
Permalink
December 7, 2008
Posted in DID Education, DID/MPD, Dissociative Identity Disorder, mental health, sexual abuse, therapy, Therapy and Counseling, Trauma, trauma therapist tagged Abusive Relationship, Add new tag, Anxiety, Child Abuse, Childhood Sexual Abuse, Coping Strategies, Detachment, Dissociation, Dissociative Identity Disorder, Emotional Crisis, Exploitation, Healing, High Risk, Pornography, Promiscuity, Prostitution, Safety, Self Injury, sexual abuse, Sexual Compulsivity, Sexually Abused, Therapeutic Process, Trauma Bond, Trauma Survivor, trauma therapist, Violence at 4:38 pm by Kathy Broady
Current safety is a building block of therapy for clients who have been sexually abused.
It is a known fact that children are being abused and exploited on a daily basis by sexual predators. Any child trapped in an abusive situation will naturally continue to use trauma-based coping strategies. They need safety in order to develop healthier strategies. If children are not given safety, they often do not learn how to find it on their own, no matter how old they become. Often a childhood filled with abuse continues into a lifetime filled with abuse. Sometimes it even continues right into the next generation of children.
An important part of working with adults who have been severely abused is to check thoroughly about their current safety. People who have been severely abused as children are often still deeply tangled in abusive relationships as an adult. This comes in many different forms.
People who have not resolved their childhood trauma issues are at high risk for adult relationships full of abusive dynamics, many of which parallel their childhood abuse. These include physically or sexually violent partners, sexual compulsivity, using sex as a weapon, promiscuity, and sexual repression. Due to the power of dissociation, some people continue to be victimized by perpetrators well into adulthood.
Some people continue to act out their childhood sexual abuse, with or without their conscious awareness, by repeating the patterns of the original trauma bonds. Survivors may find that their adult relationships mimic the dynamics of the original perpetrator relationship. People might harm themselves in the same manner that they were abused, or a child who was raped by a variety of offenders might become extremely promiscuous as an adult.
Due to this reenactment process, it is not uncommon for adult survivors to be involved with prostitution, sadism, masochism, or pornography. Dissociative survivors may have whole other lives involving these activities of which they are unaware. Such involvement is not universal, but the frequency with which the issue occurs means it must be thoroughly and repeatedly checked out. It is absolutely essential that any repeated patterns of violence be addressed thoroughly in the therapy process.
Self-injury, self-induced abuse, and self-directed violence also undermine safety and stability. “Self-injury” ranges from cutting and burning, to breaking bones, to crashing cars, to refusing appropriate medication. When people are actively hurting themselves, they are undermining their healing process. However, self-harm is a very common issue in the treatment of severe sexual abuse and dissociative disorders.
No child or adult will be able to make significant progress in their emotional growth, stability, and healing if they have frequent contact with a perpetrator. The constant anxiety, extreme stress, emotional paralysis or emotional chaos, and hypervigilence of being perpetually on alert for the next abusive incident interferes with the ability to make treatment gains.
Each violent episode causes medical and emotional crises, detachment, and destabilization, so it is imperative that therapists and support people pay consistent attention to the safety of the abused person.
People of all ages need to feel safe in order to talk about and heal from abuse. Ensuring a person’s safety is the first step in the therapeutic process. It may be a very long step, but it is absolutely essential.
SAFETY FIRST.
__________
by:
Kathy Broady, LCSW
www.AbuseConsultants.com
www.SurvivorForum.com
Like this:
Like Loading...
Permalink
Previous page
