What advantages are there to having a trauma therapist specializing in Dissociative Disorders?
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, especially trauma work related to Dissociative Identity Disorder, 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, as a Clinical Social Worker (MSW), I can provide clinical therapy for any area of my choosing, but in my 30 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 often 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.
As always, I wish you the very best in your healing journey.
Warmly,
Kathy
If you need help or have questions, expert Consultations by experienced DID trauma therapists are available here at Discussing Dissociation.
DID Phone Consultations with Kathy
DID Expert Email Consultations with Laura
Copyright © 2008-2018 Kathy Broady MSW and Discussing Dissociation
Hi Kathy!
So my experience with trauma therapists thus far has been that the trauma therapists (I have tried more than one) will work with everything from PTSD to C-PTSD but when it comes to DID, they will not work with me and recommend I see a psychiatrist. Like meds is going to fix me having DID. It wasn’t that they could not see I had DID or did not know I had DID, because they spotted it fairly quickly. They just refused to work with me because of having DID.
The therapists I have had success with so far is a sex therapist (and no we do not work on sex issues–she just has had a fair amount of clients who have histories of sexual trauma). I’ve also had quite a few that had no experience working with DID clients but were wanting to learn–which by the way I appreciated very much. There have been a few that have had experience working with DID clients but that has been a work in progress because I notice they get in the mindset that all DID clients are the same.
At the end of the day, I think you have to find a therapist that is compatible with you, they need to know their limitations and competencies, and if they are willing to learn then yes give a therapist a chance. Who knows they may actually find they like working with DID clients.
From people’s whom have been through the gauntlet of many different therapists:
We would like to express that we have found more help (for us) from therapists whom have had te willingness to work with us. Those whom have stayed with us no matter what angry insiders dished out. Their comment has meant more to us than we can possibly express in a few short words.
We have seen so called trauma therapists, even saw a ‘DID specialist’. Those simply were not good theraputic fit.
We saw one therapist who “stuck with us”.. Found she would retire soon. It took all of the leaders of our pack to take a serious hard look at therapy and where we wanted to go. We found that there had been litttle to no progress with that therapist.
That was one of the most difficult and painful things we have had to do.. Leave that therapist…. We did.
The current therapists we have now have lead us to more healing. Neither of them are DID specialists. We don’t believe a therapist has to be a self proclaimed specialist. We believe that the theraputic fit is first and formost important quality.
We are listening to the parts that have the most realistic, honest, and even critical views as far as therapy goes now. We can see progress (finally)… And isn’t that what therapy is supposed to be for.. No matter whom gives you that?…
Ummm… I didn’t see the part about “faking it”. For us.. It kind of makes us angry. We have had others online who have accused us of “faking it”, pretending to be more dissociative than we were”.
What a bunch of BS! how in the world would any one know what a “fake” is” there is no way people on the outside world know what lives on the inside of a persons head. How would they know what is thought or felt?
Guess that comes from many many times of not being believed when we told people things. Not heard and not believed. Gets the feathers ruffled.
Are we again going to be disbelieved saying.. Oh,, faker! Gesh! Had enough of that BS!!!!!! Grrrrrr.. Don’t want any one to disbelieve again…
In all honesty, Jill, it’s been a lot and a lot and a lot of years since I’ve seen anyone that is faking DID, in the way you are describing. It makes no sense for people to fake the pain of DID just to pretend they have DID. The people I saw — those that were faking it — in my experience, had very different motives for doing so.
One type of DID faker is someone who is actually a predator, who is trying to fake DID to gain trust and entrance into the DID survivor world, in order to snatch up some unsuspecting dissociative survivors and lead them off down the garden path into darkness. This kind of thing can happen online a little easier than in person, so it’s really important to be aware of that. Not everyone online who says they are DID may be DID… be very very very careful who you trust online.
Another situation of “faker” is someone who was using the fake DID diagnosis to try to set up mental health professionals — to try to create situations where they could then flip on the professional and discredit them for whatever yada, yada, yada. Again, a DID faker, covering up their predatory role and intent.
Most trauma survivors I know that legitimately have DID are in far too much emotional and physical pain to be “faking it”. DID is just not “fun enough” to be a lifestyle that people who are truly hurting want to fake. And frankly, it’s really really hard to fake, especially for any length of time. Even professional actresses (like Tony Collette from US of Tara), can’t really look multiple, even tho’ she played different “characters” of a DID system. She did ok, but she did NOT look multiple. So let’s face it, if even some of the best Hollywood actresses can’t genuinely look DID, then it’s a lot harder to “fake” in real life.
And yes…. when you are speaking the truth, and still not being believed, that is definitely a painful topic. Very painful experience. And highly irritating – I agree!
So many layers…. it does get complicated!!
Thanks for your comment.
Warmly,
Kathy
You said: “I’ll be the first to admit I’ve seen people faking it, and trying to pretend they were more dissociative than they were… or trying to over-dramatize their trauma history for manipulative gain… or lying about their trauma for extra attention etc. etc.”
Every now and then this concept terrifies me. That because I am conscious when the parts take over, that I might be controlling the whole thing somehow. Sometimes it feels as if I am putting on a performance. I don’t really think that I am but at least one part is telling me in my head to stop putting on that act when it happens. But I don’t know how to stop doing it while it’s happening. Actually I did try to stop someone taking over last therapy session but they did anyway and then another one came out right after. And yet I still felt like I must be acting even while it was happening. I don’t know how to test the validity of the experience.
When I was a kid I never told anyone when my injuries stopped hurting if I was at hospital because I didn’t want the trip to have been for nothing and I liked feeling special. I keep remembering these instances lately as “proof” that I exaggerate for attention and therefore must be doing it now. I think someone is trying to shame me into stopping switching. How can I tell if I am exaggerating or not? Sometimes even the switch itself (or my attempts to switch back) feel so dramatic I think it must be comical to observe, though I haven’t asked anyone. And I think to myself, if I’m not faking, why is it so dramatic?! Also, I have occasionally heard myself saying things that are not totally true when describing my experiences. Like as if I’m saying what I think I’m supposed to say. And then that makes me doubt the whole thing. Like if I know that I’m not sure of the truth of one thing I said then how can I trust the other things I said?
Also, I keep thinking why are these obvious switches only happening now? Why are these parts that were apparently so long hidden and don’t know how to ‘act normal’ only coming out after my previous therapist told me I have DID? That seems suspicious to me. Is that suspicious to you?
Sorry for all the long comments. I don’t know if I trust my new therapist and I feel like I can trust you more because you know what you are doing. I’m starting to think she is just encouraging this whole charade. I mean, I do believe I have parts but I don’t know if they are really this delineated. I think they want her to think they are. They have been scrambling to talk to her ever since the first session with her. It’s almost pathetic how they want to be seen as real people and they know she will play along.
Im contradicting myself all over the place here, sorry. This is apparently H and CH alternating writing and having different opinions. Gah……! H apologizes for CH’s disrespectful attitude.
I would love to have a consultation, as soon as I can pay I will!
Kathy,
My mom suffers from MPD and she has gone through a significant amount of institutional abuse while seeking help. She has been bounced from therapist to therapist all with the promise of acceptance, believing, and that they will help. Yet time and time again she is let down or quit on. I have found a trauma therapist but I don’t know how to get her to agree to try someone new yet again just to be disappointed yet again. Any suggestions?
Thank you.
My therapist helped a lot with my trauma and I am very very grateful to her. I didn’t think that I need help after I stopped the drugs, I was happy and proud for a while, but I was so ashamed of my behavior early, I stopped going our with my friends, I could not watch in the eyes my parents. I was so unhappy and depressed, but Carol bring the happiness and motivation back in my life. Nobody should be afraid to look for help. Here you can read more about the sessions are silbergeldlcsw.com just-suffered-a-harrowing-experience-and-need-help-processing-it . be strong!
OK, you got me some thinking to do 🙂
“WordPress pulls the link in from somewhere on its own.”
LOL, now THAT was real tech savvy LOL!!!!
I dunno why mine don’t bold, mebbe security settings 😉
Thx
How a person to find a christian therapist thats a safe one cuz somes kinda whacked and wanto to do mumbo jumbo. Or mebbe they just think they can do stuff they can’t.
But I would like a T that is of my religion cuz that is super important to some parts.
I just quit old T, and she was good, but parts can’t trust her and I can’t make them.
Also, some names on posts here is bolded and it goes to their blogs. How they do that?
Thx.
We sad.
Hi Muffled Ones…
Well…. Christian therapists come in all shapes and sizes, and from all kinds of different perspectives. Not all Christians believe the same as other Christians, but yes, having someone of a similar religion is very often important. Keep searching – there will be someone out there that is a good fit for you.
And / or…. maybe the challenge is to work on those trust issues with the parts of you that are struggling with that? You are right – you can’t “make them” trust anyone, but maybe they could work on whatever that is about so that they can figure out more on their own? You’ll figure it out… there will be an answer that works for you all…. And if you found a good t… it is often important to stay connected to them. Good t’s really are hard to find!
As far as the bolded names – that’s something done automatically by WordPress. I think it’s based on some profile information from somewhere. My bolded name links to my AbuseConsultants.com website . I don’t do that on my individual posts — WordPress pulls the link in from somewhere on its own.
I wish you the best – thanks for the comment.
Kathy
I have worked with 3 T’s: One who claimed to be an expert but, was really just obsessed with religion and integration, one who had almost no experience with anything, and you, Kathy, who actually IS an expert. And it definitely makes a difference. Having a T who really gets it makes you feel so much safer, and it makes the hard work easier to do because you feel confident that the T has a good reason for “making” you to do it.
Hi Kathy,
Another question for you if you’re up for it – what should a trauma client/patient ask a potential new therapist to assess whether they are up to the task? I ask because I have recently terminated an unsuccessful therapy with a non-specialist, and am now looking for someone who can take the work forward with the right kind of processes and knowledge and feel confident in their abilities not to make the splitting and trauma a whole lot worse!
Many thanks as always,
BTC.
Hi btc,
That is an excellent question, and I’ll be glad to make a post about that. Let me think on it for a bit, and I’ll get a post up here as soon as I can.
I hope you’re having a good day —
Warmly,
Kathy
Hey Kathy,
You’re more than welcome. I get very excited when I find a great well-written blog that is of use to me and as I **am** my audience I feel it my duty to tell people where to find such resources!
The question you answered here is very important as I am about to lose a non-trauma therapist and attempt to find more trauma-focused practitioner… with any luck!
Thanks again for such a great blog.
BTC
Kathy,
I was wondering about the specialization you’re talking about here being a two-edged sword: specifically, that to someone with a trauma specialization, everything looks like trauma.
This question probably sounds a bit more prickly-pear than I want it to; I’m just not sure how to say it.
Thanks!
Wynne
Hi Wynne,
Good point. Of course, the more familiar a person is with something, the easier they recognize it.
At the same time… becoming really familiar with something also means you can be more comfortable in recognizing fraudulent things. I’ll be the first to admit I’ve seen people faking it, and trying to pretend they were more dissociative than they were… or trying to over-dramatize their trauma history for manipulative gain… or lying about their trauma for extra attention etc. etc.
I’ve seen enough of that through the years that I don’t automatically believe everything I hear. Sometimes things just don’t smell right. And when the pieces don’t fit, I’m willing to consider other options.
Kathy
Kathy, thanks for taking the time to respond to my question. Right now, it’s incredibly important to me.
BTC.x
Hey BTC,
Well, you were kind enough to give me a wonderful shout out to help get this new blog rolling. I have had 4-5 x’s as many site viewers since you posted your very supportive link to this blog from your blog. You have been an amazing help in getting this blog off the ground, and your comments meant a whole lot to me. The least I could do to thank you was to answer a question!!! (or two, or three… keep ’em coming!)
I’m glad my response meant something to you as well. 🙂
Kathy
KB
Have you worked with clients that have ‘extreme torture’ trauma history in cult-RA and/or mind-control (governmental experiments)? If so, what has worked?
Ravin
Oh boy, now there’s a big question!
I’ll put that one on my “make a blog post about this” list. 🙂
Thanks, Ravin. I hope you’re having a good day —
Kathy
I am also interested in that question. Have you wrote an article about it yet?
What an excellent and well-considered answer.
Personally, I strongly believe that matching the client’s needs with the therapist’s area of expertise is a crucial component to healing, although given the choice between an excellent trauma therapist with whom I did not have a particular rapport, and an open-minded Jungian analyst whom I did trust, I’d go for the Jungian. But even there, the philosophy and ethos of therapy would have enough crossover to certain aspects of trauma therapy that I think significant benefit could occur.
I went through eight therapists before finding a trauma therapist, and she has been the only one who was able to help me at all. The others often blamed me for being uncooperative when I didn’t show results, even though I was following their recommendations exactly. None of them even realized I had dissociative trauma, despite my describing my DID to them extremely clearly. I can’t believe what a difference it’s made to actually be with a therapist who understands exactly what is broken, and has a compassionate, intelligent, and time-tested approach to fixing it.
Hi David,
Thanks for coming back!
I very much agree with your comments — couldn’t have said it better myself. I have met DID clients who were so blatantly DID that it was really and truly hard to fathom how none of their previous therapists recognized their dissociative issues. But, that was simply because those therapists were not trained in how to recognize dissociation, and so they didn’t.
And, the flip side is also true. Once you know how to recognize DID, it’s really not that hard to see it at all.
Thanks for your input — I appreciate that.
I hope you are having a good day —
Kathy