Kerro commented:
I have a question about stability. I accept that I need to be reliable, motivated, responsible and willing to delve into things I generally don’t want to delve into. As for stability – I can see how a stable client is easier to work with for a therapist.
However, what if the beginning stages of therapy have resurfaced old issues or retraumatised the client to the extent that they are now “unstable”?
How would this fit with your schema? And what should the therapist’s (and client’s) roles be in re-stabilising?
Typically trauma survivors, particularly those with Dissociative Identity Disorder and PTSD enter therapy because their life is already full of emotional complications, symptoms of depression, anxiety, self-injury, internal chaos, flashbacks, confusion, memory loss, time distortion, time loss, body numbing, nightmares, voices, etc.
As a whole, people do not enter therapy because their life is already stable.
They go to therapy because they have some awareness that they are starting to fall apart. There is something wrong, something very uncomfortable, and something very unmanageable about their life. They may not be able to define it, but they can feel it and see it in the way their life is unraveling.
And yes, Kerro, you are right.
There are various stages of therapy that can be quite destabilizing, yet maintaining stabilization is a fundamental building block of therapy.
Sometimes the path seems like two steps forward, one step back. And, yes, there are times when it feels more like one step forward, two steps back. It is a very fine balance.
To do the healing work required for trauma survivors to gain overall life stability, these survivors have to address painful difficult issues that are potentially destabilizing.
So, not doing the work leaves people destabilized.
But doing the work also can cause people to be destabilized.
Some days, it feels like the line between the two is nonexistent.
Now what?!
Take it slowly, one step at a time.
Look ahead, increase your self-awareness, try to maintain the stability that you have, and try to predict the areas of your stability are the shakiest and and prepare for them ahead of time. This is important.
What is stability?
Stability consists of a lot of different elements all at once.
Some examples of stability are when survivors:
- manage intense emotions without using self-injury to cope.
- can be challenged with something emotionally difficult without making it “the end of the world” or an unnecessary crisis.
- are willing to move forward by learning about new areas of life and using new coping skills, instead of self-destructing from the same old place and/or blaming others for their lack of progress.
- do not consider suicide as a realistic problem-solving solution to difficult situations.
- manage feeling depressed, and even suicidal, but absolutely know they won’t actually do anything lethal or harmful.
- take their medication as prescribed, regularly and consistently.
- eat regularly, without starving themselves or without bingeing repeatedly.
- get a regular, sufficient amount of sleep, rest, and personal down time.
- have a steady source of monthly income that meets their basic needs.
- incorporate painful trauma memory work into their lives without self-destructing or attacking others.
- work cooperatively with their internal system without attacking each other from within.
- maintain a safe and consistent distance from and/or can establish boundaries with people that repeatedly abuse them.
- keep their regular job/employment, even while working on therapy issues.
- use their dissociative skills to their advantage, instead of to their detriment.
Sometimes therapy is like walking through a minefield.
If you know you have to get through the minefield to survive, but there is the potential that you will set off one of the mines on your way through, you would tread very carefully. You would check everything you do, in smaller and more detailed increments. You would listen and watch for clues every single step of the way.
In the therapy process, once you start feeling a little too de-stabilized in a particular direction, back off and stop pushing that issue at the moment. Give it a break for an hour, a day, a week, a month — depending on the circumstance.
Get to know yourself and what you can handle. Learn your own red flags for when you are starting to fall apart and getting too overwhelmed. Give yourself the space and the time to do your work.
There’s no need to rush headlong into things that particularly de-stabilize you.
Remember, when healing from trauma, there are usually many, many different areas of healing. Remember the list of 50 different treatment issues for DID/MPD?
If you find one area too difficult to deal with right now, simply put that issue on hold, and work on a different area. They ALL have to be done. They ALL have to be addressed. You can decide when something is genuinely too difficult, or too tangled, or too emotional, or too destabilizing for right now.
As a general rule of thumb, put internal communication work and system work as the first steps to focus on.
If you cannot even speak to your insiders, you certainly will not be able to tolerate their intense emotional trauma memories.
In years gone by, the mental health profession used to promote abreactive memory work as valid and necessary. I absolutely, unequivocally disagree with that.
Abreactions are often hypnotically induced, and they are basically inducing a flashback — putting the person back in time and directly into the intensity of the trauma. Most survivors find they do not even recall abreactive work, so as far as I am concerned, it is an absolute waste of time, and just leaves the person feeling more traumatized than healed.
If you cannot speak, in your normal voice, discussing your trauma memories from the safety of the here-and-now while still connected in the present, then don’t even try to address your memories. It is too soon.
In my opinion, memory work is NOT the core of the healing from dissociative disorders.
I believe that developing the internal communication, internal cooperation between parts, and system teamwork is a much more important element, as well as being crucial to a person’s stability.
Decreasing the dissociation and separation between the inside people has many facets to it. The trauma is only one area of separation between insiders.
Build strong connections with each other first and then, much further down the road, address the memory / trauma issues, and you will likely find that the memory work is much less de-stabilizing than it once was.
Memory work has its role, and yes, survivors do have to process their trauma. Please know that you are not getting a “free pass” on not addressing that.
BUT, memory work is not the first goal of treatment, and it is certainly not the main focus of the therapy.
In your outside life, when you first walk up to someone new, as you are first meeting them, do you say, “Hi. You don’t know who I am. I don’t know who you are. But I want to know your most painful memories. Tell me all your deepest, darkest secrets RIGHT NOW.”
Of course you don’t approach people like that. SO, please don’t approach your insiders that way either.
Get to know your system as people first.
Find out who they are, what they are like.
Build a relationship, a connection, and a rapport with them first.
Focus on building connections in your internal system, building that teamwork approach, improving communication. These are the main and most effective stabilizing factors that I know.
Once you truly can connect with your insiders, and you care for them and have relationships with them, you can hear their trauma through an entirely different perspective. You will have compassion for your inner people, and that will help you to heal.
Jerking their memories out of them before you even have a relationship with them isn’t good for anyone.
Here are some Dissoci-ACTION Steps:
- Focus first on relationship building with your parts.
- Get to know them.
- Talk to them.
- Learn their names.
- Overcome your fears of who they are.
- Appreciate their strengths.
- Develop friendships with them.
- Read the follow-up article: Emotional Intensity, Safety and Memory Work
- The Saddest Little Bear Dissoci-ACTION Story Pack will give you extra help, and information for when you are meeting new parts in your dissociative system.
I guarantee that your overall stability will greatly improve as you are more connected with your internal system on a genuinely friendly, caring basis.
As always, I wish you the very best in your healing journey.
Warmly,
Kathy
Copyright © 2008-2020 Kathy Broady MSW and Discussing Dissociation
We have been doing a ton of research on dysregulation because its a big symptom of ADHD. Is regulation sort of the same thing as stability? We have been reading articles and watching therapy videos on youtube the last few weeks to try to help ourselves with this.
many years ago, during a lengthy stay in psychiatric hospital we were subjected to group therapy during which the abreactions you mentioned were encouraged, which of course was terribly traumatizing to us and this was long before we were aware that we had DID. it took a long long time before we could trust in the therapeutic process again, thanks to a very wonderful counselor at our local CMHA.
it often take people to remind us that we have in fact been making progress in our journey, and difficult to recognize, probably because change occurs slowly. we know, for example, we are now better equipped to deal with self-harm urges when they arise, a couple of years ago such an episode would have ended up with us in the hospital for a week.
we for sure have better inner communication, for the most part, though when new alters arise it is always a real challenge. sometimes we think we’re never going to stop finding new insiders!
we have come to accept that this is a life long condition, something we just have to live with, and have learned that validation is vital to our wellbeing.
kathy i dont no if it be just my computer but the quote at the top of the post by somewon be wrote all funny. it be in a weird font and we cant read it. it culd be just us mabey. but i wanted to let you no
OOOOH, whooooopsie! I fixed that now. You should be able to see the quote now.
Thanks, Rachel.
this whole thing is just way too much to take in. was recently diagnosed with DID well long story short, I got mess going on. This whole thing SUCKS. I feel like a freak, nobody talks to anyone. I got someone different popping out at bad times. On top of there are some serious SI problems, depression, anxiety, suicidal thoughts. I keep to myself because I don’t trust myself or them, I’m not even sure if I trust my therapist. No disrespect to anyone else dealing with this but for myself…I need it to stop.
Hi Jess,
DID sure does suck … especially when you are first diagnosed. You think … “WTF are you telling me – I am some out-of-control, psycho freak with a bunch of deviants living inside of me!” But, then you start to realize that receiving your diagnosis is not a life sentence but the start of your liberation from “serious SI problems, depression, anxiety, suicidal thoughts” because now you know where they reside and where they come from and, most importantly, you can start to heal. I tell you this because it is crazy scary, horrifying, panic-making nuts at first. It is like you have opened the door and found a bunch of out-of-control selves running around inside. But, in time, you start to build communication, cooperation and understanding with your inside folks and things do get better.
I know that it sounds impossible and you wish that you had never heard the words Dissociative Identity Disorder but … I have to think that the chaos that you were living not knowing was not any better then knowing. With knowing, you have hope. You also have a community here that understands and is always willing to listen. You are not alone!
ME+WE
03/29/19
Indeed…it is “scary” to finally realize and “see” parts Inside as “people”….but it also helped to make a bit more sense out of how my life has been…..to get slammed with suicidal waves that seemed to come out of nowhere….and you “watch” yourself write “I want to die” on a college exam question, calmly fold the test and put it on the teacher’s desk, walk out of the room and end up in another state several hours away….suddenly realizing, “Oh no! I’m supposed to be in class!”……You can feel VERY “crazy”……
To finally “see” the part who is the source of that wave (although I still don’t know her story) is scary – yet freeing….. When I feel the SI waves NOW….I now know that something has triggered her and she is giving me a tiny glimpse of her story again….I would suddenly see her “collapse” to the Inside “floor” and the only “option” she sees is “to die” and I would feel her “waves” on the Outside…..I now try to “backtrack” and see what was taking place in my Outside life that could have caused her to trigger…..It seems to be connected to a sense of “overwhelm” and massive confusion…. my “brain” literally feeling like it is shutting down because “I” cannot comprehend and am unable to know what to do….just massive “overwhelm”……..
Sometimes it is something “simple” on the Outside that would trigger her…..a decision needing to be made involving multiple “options”…..but there are HUGE undercurrents of Which one is “correct”? Which is the “safe” one? What do I do to be “OK”?……It all gets mixed up causing confusion and a massive sense of “overwhelm”……I am STILL waiting to “see” where THAT is coming from…..
But now “seeing” that the SI waves are coming from “her” (the suicidal one) is helping me to stay more steady on the Outside…. not “acting” or “feeling” so crazy….that “I” can step back and “watch” her more “objectively” – aware of her “wave” – but not so swallowed up in it….knowing that in her own way – she is giving me a glimpse of her story again…..
The journey into the “unknown” is indeed a VERY slow journey……
MissyMing
03/30/19
Wow … what a powerful story and message MissyMing. I really appreciate you sharing that. It touches my heart in so many ways.
Just speaks so eloquently and poignantly to how opening up the channels of communication with our inside folks is vital to our understanding and managing living with DID. Life with DID is much easier the more that we know even if what we need to hear is painful.
ME+WE
04/01/19
Thank you both for replying and sharing. I was a little worried about the freak comment. I usually get 1 of 2 reactions. Everyone either get’s quiet or they gasp and say you don’t mean that. Or well there is a third, and that’s people just stop talking to me at all, you know? They shy away. That when you need a friend, there aren’t any around.
Definitely a few WTF moments. I tried to explain it to someone the other day that it’s sort of like a tower defense game. The body and mind are the stronghold and you have warring factions that are trying to seize the stronghold and take control and command.
It is better knowing where this is coming from, it’s still chaos, but it’s a little more of a controlled chaos. Not much, but a little. We’re still not all talking but I have found that sometimes when some of these feeling pop up, reminding everyone that we’re all ok and safe helps a little. Let’s not all over react. Triggers are the hardest.. sometimes it is the simplest thing. A taste, a smell, a sound. The anger, SI and suicidal thoughts.. that come out of no where. Well I know who they come from now. Now we need to talk about it and come to some agreement. An understanding.
Thank you again, Everyone. I appreciate both your reply’s.
Yup Jess! I totally get the “controlled chaos” and the “triggers are the hardest”…..it seems to come out of “nowhere”…….Being swept away by the trigger is EXTREMELY hard to explain to any Outsider….it just leaves you looking really “weird”……plus when you are trying so hard to look “calm, cool and collected” in your Outside life and you are so aware of all the Internal commotion going on (i.e. Internal “mutiny”)…..it leaves you feeling like you are “losing your mind”……and trying to find someone you can “trust” – who won’t reject or abandon or betray your attempt at “trust” is REALLY, REALLY hard sometimes……
I am glad you “know who they (anger and SI) come from now” so ya’ll can “talk about it and come to some agreement”…one thing I have noticed with DID….you don’t ever seem to run out of “opportunities to practice” ….sometimes you “succeed”….sometimes you are “still learning”…..
Hope you have a good, “calm” day!!
MissyMing
04/07/19
Way too overwhelming. Time to go.
So what about the memories that get thrust on you before you feel ready? That’s basically how the baby, the 2 year old and 3 year old introduced themselves. I knew their memories before I knew who they were. Actually I still know very little beyond that about the littles. When memories come up unexpectedly, is there a way to handle them best? I’m going through your posts from the beginning so maybe I’ll find an answer later. Thank you for this amazing resource. I thought the DID Sourcebook was helpful but your blog posts and the comments and responses are the best thing I’ve found yet. Thank you.
Thank you, Helen. I am really proud of the resource WE ALL have built here. The comments are so very important and helpful. They bring a bunch of boring articles to life !!
Memory work is so very difficult. I really need to do a long answer for your question — (or did you find one yet as you’re reading through??!!) — it’s such a complicated topic.
However, to be brief…. For sudden and unexpected memories, it’s really important to get grounded again as quickly as possible. I know it’s impossible to completely prevent flashbacks, but it’s not necessarily helpful to stay lost in them. It’s important to know whose memory it is, and to figure out what the trigger was to set it off. Reconnect to “now” as quickly as you can. Grounding techniques are really important.
As you get to know your system better, you’ll be able to foresee triggers coming, and then you can learn to manage those triggers, prepare for them, or avoid them all together. Getting to know your insiders really will give you the information you need to lessen the sudden memory flashes.
Hope that helps.
Thanks for reading…. Lots more to come… 🙂
Warmly,
Kathy
I hope you have not stopped writing this blog! It’s excellent!!!! Thank you so much. I have only made it to this post, but I will be reading every word! It’s so helpful!
~tany
The examples are everywhere and this induced suffering is not only unnecessary, it is cruel and inhuman. See for yourself. If working therapists who truly care would see with their hearts and stop hindering people, so much terrible suffering could be avoided.
This lady says it quite well. Obviously an extremely intelligent woman. An intelligent and beautiful soul, in a flesh and blood human body, who has been abused by a corrupt and willfully blind societal ‘healing’ system. The therapy system is very, very sick. The comment section is very illuminating. If you can take off your therapist hat and read it with your heart and soul, you will see what I mean.
http://rosesonthemoon.wordpress.com/2009/01/28/this-again/#comments
Hey Kathy, another great post. Thanks!
Sometime (if you have time!) could you do a stability list, similar to the one you did for SI? Or maybe some of the stabilising processes you have seen used?
Thanks!
BTC
Thank you for this post, Kathy. It was very, very helpful. My therapist and I have been working with my internal world for the better part of a year. I still find my insiders to be uncooperative and difficult to get in touch with. How can I get them to be more willing to come forward and work with us? Any ideas? Also, sometimes it seems like there are certain people inside. Other times it seems like there are others. Still other times it seems like whoever comes forward is just a metaphorical figure, never to really be heard from again. Only once did I “see” distinct persons and only one has admitted to having a name. And that was on my own, so I really didn’t “work” with them. Does this sound typical? I don’t mean to bombard you with questions, but perhaps they might be questions others have as well.
Thanks,
ljane
Hi ljane,
Thanks for posting. I’m very glad to hear that my articles are helpful for you — that’s great!
And actually, your questions come with good timing — I’ve already started writing a series on internal communication, which should address some of these questions. In fact, part 1 of this series will be posted later today. 🙂
Yes, a lot of what you are experiencing is quite common, so yes, I’ll have some ideas to pass along your way.
Thanks for your questions, and I hope to get some answers out your way soon.
Kathy