Lots of trauma survivors with Dissociative Identity Disorder are just starting their healing process. Other dissociative survivors are not new to their healing process, but they might realize that they haven’t yet covered all the basics. Do you need any tips for DID therapy?
DID therapy can feel huge, daunting, difficult, and overwhelming. There is so much to do and so many areas of work. For a broader overview of the many areas of DID healing, please refer to the article, “50 Treatment Issues for Dissociative Identity Disorder”.
For individuals building the foundation for their work with your dissociative system, here are some of the first things to do.
DID Therapy Involves:
1. Get to know your system.
Build the courage to find and meet your insiders. Remember, they were formed and created to help you – even if it doesn’t feel like it, you are (or can be) on the same team.
Who are your inside parts? What jobs do they have? What kinds of things are they able to do? It’s really okay for you to build positive relationships and actual friendships with your insiders.
If this feels scary for you, explore those feelings. What makes it hard for you to get to know your insiders? What fears or resentments do you have? Understanding your resistance to these ideas is important.
2. Become more comfortable with your diagnosis.
If you don’t understand what Dissociative Identity Disorder (DID /MPD) is, be sure to speak more with your therapist or psychiatrist about what it means to be dissociative. There are lots of books, websites, blogs, articles, conferences, etc that can help to educate you about the basics about DID.
Understanding the truth about DID will help take out some of the mystery and confusion for you.
3. Build a support system and capable treatment team.
It is very helpful if you can surround yourself with a few other people that understand trauma dynamics, preferably at least one or two other people, besides your therapist and doctor that understand that you are working on healing from trauma.
These support people don’t have to be experts in DID – if they are just willing to spend some time with you when you need a safe distraction from your healing work, that will be helpful. Please don’t lean on lay-support people for the heavy issues. Leave the complicated treatment issues for your therapist to work with – your support friends are not therapists, so be very careful about not pushing them too far or demanding too much of them.
4. Once you have recognized at least one or two other parts, work on building communication with these parts.
Internal communication is one of the very most important factors in DID therapy, and the sooner you can interact cooperatively with your other parts, the better your healing progress will happen. Dozens of the articles in the Discussing Dissociation blog reference tips for building internal communication. This link groups these articles together.
Learning how to talk to your other parts is the most important factor in your healing.
5. Connecting with your internal landscape.
What can you see inside? Can you see the other insiders? Do you have an internal safe place?
Internal visualization work is an important skill as it builds a way to connect with your insiders.
Even if you can’t see the others inside, there will likely be someone else who can. Maybe ask if that insider will draw a map of your system for you? The sooner you can see inside, the better. And of course, if you see insiders that are not in positive, healthy, clean living conditions, you and other helpers in your system will need to do something to help them.
Kathy’s Video Comment: Making a Calm Place Inside your Dissociative World
6. Working on limiting or preventing self-destructive impulses and self-injurious behaviors.
Learning how to address self-harm urges is particularly important for your stabilization and progression in therapy. You have already been hurt enough – adding more hurt may feel like it helps you to cope in the short-term, but using behaviors such as cutting or burning is not any more helpful than using a shot of whiskey or a hit of cocaine.
Explore better ways to cope with your intense feelings, develop more grounding skills, build positive containment strategies, and methods to reconnect with the here-and-now. A grouping of articles about preventing self-injury can be found here.
7. Live in a safe place both inside and out.
If you live in a violent environment, address this issue as quickly as you are able.
If you are continuing to be abused or sexually assaulted in any way, your dissociative walls will stay strong, and your system will have greater trouble trusting you and your treatment team. Of course, when anyone is fearful of abusive repercussions, it is much harder to disclose the real issues.
Dangerous environments can include everything from domestic violence, abusive parents, organized perpetrators, to internal system perpetrators and angry introjects. Building more and more current-day safety is vitally important for your overall healing process.
If you aren’t safe, make this a priority in your therapy process.
Building an internal safe place is also critically important. However, please remember that in order to build an internal safe place, you have to have a genuine belief that safety can happen, at least part of the time. Making an internal safe place for your insiders is much more difficult when you are still concerned about external safety.
8. Start building options for positive self-comfort, self-soothing activities.
The therapy process can be so very painful and emotionally difficult. Having a variety of options to do that are comfortable, safe, gentle, soothing, and stabilizing is important.
What can you do when you want to have a break from the hard work of therapy? What can you do when you need some quiet space to think – or to not think? When you are hurting, what can you do that will help you to feel better?
Soothing your pain in ways that help your healing (vs. using self-destructive options) is an important skill to develop.
9. Create healthy options to express feeling and emotion.
Use art, music, journaling, collage, blogging, forum posting, sculpting, painting, poetry, play therapy, sand tray therapy, scrapbooking, etc.
DID therapy involves processing a lot of flashbacks, violent images, intense feelings, overwhelming thoughts, body memories, body pain, etc. Building a repertoire of artistic avenues to describe your feelings and experiences will be very helpful. You might not always have words that you can use so it is important to find non-verbal ways to safely express what you feel.
10. Create your own personal space.
In this space, let it be okay for your insiders to come out, to be themselves, to be out in the body, and to exist. Out in the world, and when you are around other people, most of your daily life will be about keeping your insiders tucked in and acting socially inappropriate. But somewhere in your private time, your insiders will need time to surface, to know that it is okay for them to come out. Having the freedom to switch without reprimand is important as each of your insiders will need to do some personalized healing work of their own.
NOT 11. This Point is NOT on the List !
Please note: I am specifically not including memory work or skills to do memory work in my top then list of DID 101 skills.
The reason for this is that if you are just beginning DID therapy, it can be very destabilizing to focus on heavy-duty memory work. Yes, of course, doing trauma work is an important part of your overall healing process, but in the beginning of this journey, you need to build these basic skills before you begin to put a lot of energy into memory work. It is much safer and more stabilizing to have these foundational therapy skills in place before focusing on the trauma content of DID therapy.
DID therapy is intense, long-term, exhausting, and difficult. But your healing is worth it. As you truly address the painful conflicts, unmet needs, and internal confusion caused by your years of trauma, abuse, and neglect, you will feel better within your own self.
As always, I wish you the very best in your healing journey.
Warmly,
Kathy
Copyright © 2008-2019 Kathy Broady MSW and Discussing Dissociation
It is exhausting and can be very overwhelming at times. Thank you for breaking it down into these ten simple steps for us! Would you be willing to share this for the Feb edition of THE BLOG CARNIVAL AGAINST CHILD ABUSE in the Healing & Therapy section? We have a deadline of 2/17 for a 2/19 edition coming up. Thanks, in advance!
Hi Thriver,
Yes, of course!! 🙂
I’m always glad to see any of my articles used in Blog Carnivals – I consider that to be a great honor.
Thanks!
Kathy
this is a rilly good articol kathy thank you
you are so smart
you no lots and lots
I/we don’t have DID, but am a dissociative trauma survivor with ‘big splits’. So much of this applies to me, too. It’s reassuring to see how I’ve been working on so much of this with my therapist, and of course still am, and making slow but steady progress.
I used to live in East London, and substitute teach in inner London primary schools. Needless to say this embedded my relational and environmental traumas deeper, living in a violent and unsafe environment. Using what I learned in therapy, I was able to gain the courage to move to another area of London. And, it took several years, but once I’d moved I found a job in the local public libraries, where I’ve now been for nearly 7 years as a general assistant. Being in a safe external environment initially brought on a breakdown – I wasn’t used to it, and it was now safe to do so. Gradually I am building a safe internal environment with the help of my therapist. Thank you especially for that point re non violent environment, I can’t stress it enough.
[I speak as a survivor of domestic violence between my parents, and protracted daily peer abuse at school for over a decade.]
Katie
thanks,
i am trying to figure out an easier way to open up to my therapist. she was away on maternity leave for 2 months. and now that she is back she has lymphoma so i don’t see her as often, so i worry about stressing her or worrying her, or making her sick or something, so most sessions i am kind of anxious with trying to talk to her.
Part of her being away and being sick has helped me find internal strength, but it has also caused a lot of conflict because it has been difficult for us to get along and make decent decisions when our therapist was always the like mediator. ‘
i almost feel like i may need to start over with my therapist, and this terrifies me. should i start over or try to build on what we already have. i adore my therapist, and now i am afraid to talk more because i am afraid she will leave again. i’m just worried.
love,
tls
been reading a lot. someone made this possible by a link. don’t know yet what to think. got a little freaked on the 9-9 post. won’t type it all out but left a msg. there.
don’t trust anyone but others are talking regardless. doesn’t feel very good. have some awareness for 5-7? but don’t know what to do with it. T doesn’t do this work. got her through VA just because. she admits she’s kind of lost but she seems nice. can’t be her educator. don’t know what to do as it is. keep going back, huh? can’t talk anymore. need to keep some peace and haven’t slept since yesterday. endless energy or endless nothingness. quit moaning, others have it worse.
sorry.
glad this is here but don’t know what is next.
will watch and wait like always.
hope you don’t think bad things.
katie
we’re trying to make inside safe its scary but we want it safe theres lota of secret bad places inside and lots of bad guys we hav a jale they go to so they cant hurt us no mor but there are mor bad guys everytim
som of us
Thanks for the “reality check”! Sometimes (often) I get discouraged about “progress”, then I come across a post like this and it really helps. As I went through your list I realize that 1, 2, 3, 6, 7, 8, 9, and 10 are all in place and pretty strong. 4, and 5…working on that, and while I actually can’t speak with the others, we do journal, leave notes, blog, etc…so communication does happen, just not in a traditional sense. I also can not see anything inside, or really have any awareness when inside, but others have drawn, written about, described to T, etc. So I do know that there are several internal safe places, everyone who could safely (for the system as a whole) be “gotten” to a better environment, has been. The ones remaining are the cult loyal ones, and I suppose, where they are is their version of safe. And where they are is not accessible to the front because of features that were created to prevent that. So this creates more safety for the rest.
Sera
system whacked, can’t get into forum.
hate bad weather.
hate cold.
hating life right now.
mad face.
katieb
I am 46 and just recently began actual ‘therapy’ for myself and not because of some crisis. In creating a ‘safe place’ inside myself for what the therapist referred to as ‘the scared little girl from long ago who only wanted to feel safe’ I became aware of the fact that there actually was a little girl and there were times when I would try to check on her as the therapist recommended and I would ‘black out’ and ‘wake up’ in a completely different thought process or doing something totally different. I told the therapist and in speaking to me, we found a ‘we’. I am so scared to think it could be DID. I did not suffer what I would consider to be substantial abuse and definitely not of the caliber usually discussed regarding DID. Is there another explanation for the ‘we’ who were telling the therapist things while I screamed at them to stop inside my head and then they told the therapist I was angry? Please let there be another explanation. :0(
Hi Laura,
Thanks for posting, and welcome to the Discussing Dissocation blog.
I’d have to speak with you a whole lot more to know if there was any other explanation for what you are experiencing. What I can say at this point, is that you are very much describing what could be considered DID / dissociative symptoms. You are referring to time loss (“black outs” and “waking up”) while doing something you were not aware of doing, you’ve mentioned other separate parts of yourself of other ages with other perspectives doing things differently and separately from you, you mentioned having internal conversations (or the attempts at this), and you are describing a separateness between yourself and the other inside people. These kinds of experiences are consistent with having DID.
I certainly can’t officially diagnose DID for you at this point, but I can encourage you to continue to explore this option, because in my opinion, it can’t yet be ruled out.
As far as not knowing about any trauma… IF you are dissociative, it is very possible that your other insiders would know about the trauma and that you could have been blocked from that knowledge and information. Are there other ones inside speaking of trauma that they are aware of that is separate from what you know about? Does the scared little girl know what she was scared of?
I’m glad to hear that you are in therapy, and hopefully, as you work further on these issues, you’ll be able to answer those questions. I hope that you also keep reading through this blog. Besides the articles I’ve written, there are hundreds and hundreds of valuable comments posted by the best DID experts, and maybe you will recognize more by reading what they say.
I wish you the best in your healing journey.
Thanks for reading.
Warmly,
Kathy
Hi, I hope you don’t mind me sharing this on tumblr; I just found it so useful! Have credited it back to you. This is so useful, will be printing it and keeping it for future reference. We don’t have a T right now, and may not be able to find one who’s comfortable working with DID for a while, and so we often struggle or hit points where we can’t go any further but this is brilliant – so useful. Thank you.
Thank you Serenne,
Welcome to Discussing Dissociation. I’m glad you have found some of these articles to be useful and helpful. That’s excellent. And thank you for sharing them. Much appreciated.
There is a lot of useful info in this blog — and to me, some of the most useful information is in the 2700+ comments written by the readers, so be sure to check those out as well.
I look forward to hearing more from you at any time.
Good luck in your healing journey. You can do a LOT of really useful healing work on your own, even without a therapist. In fact, some of the most important work you’ll do in your healing is / will be without direct involvement of a therapist. Keep up the good work!
Warmly,
Kathy
Reblogged this on Burn The Butterfly and commented:
Found this really useful. If you’re trying to do some work with your system and don’t have a T then it’s even more useful!
Reblogged this on Discussing Dissociation and commented:
Something to think about. You might assume you know all the basics for successful DID therapy and healing, but have you truly accomplished these 10 important foundations?
This is very helpful. I can’t believe I only just found it now.
awesome. it’s being printed out and taped to the bathroom mirror and the fridge. tyvm.
Ooooh, great idea, collective!! Thanks!!
Hope it helps!!! 🙂
Kathy
Hello Kathy,
I hope all is well with you! I am wondering if you have any tips for a person with DID on having a physical relationship with a male. I have recently gotten involved with someone who is very sweet and patient and understands I need to take things slowly, but I have noticed I am no longer emotionally/physically dead, so having a relationship that I now want to be in is a bit difficult. I was wondering if there are exercises a person can do to get used to be touched, kissed, etc. that may help making interactions between us grow slowly?
My parts do not appear to be involved as other than one, the rest have gone away. I guess removing DID as a factor, are there any exercises “I” may be able to use with him so I can get used to this slowly?
Thank you for any suggestions you may have to offer!
Best Regards – Betty
i do not know where i can get help and be in a safe place, i staart to talk to my therapist and then i get crucified whe i leave from all the evil programming and i am a protector and i need a safe place. we all were programmed to no win. it is not safe when we talk. we need help.
i can say i lovey all the children the one who blogged thank you.
we r know win no matter what! i say no i m not, JESUS IS ALL WIN!!!!!!!!
Hi Sherrie,
Thanks for writing and for having the courage to reach out.
I hear what you are saying. The internal programming can truly feel torturous sometimes. Really not fun.
Here’s the good news.
Your therapist can help you to undo that internal programming, and help remove that stuff so you have more freedom to speak.
Your internal world belongs to you, and you can remove / change / add / edit it to be any way you want it to be.
You don’t have to hold / contain / keep programming that is painful to you and makes your life miserable and scary.
Ask your therapist to help with that specifically – because you can undo all that and get more freedom and peace.
Read more of the information here about internal worlds and learn how to make changes in yours.
Claim your inside space back and build more internal place of safety.
This might be new to you, but you can do it…
I wish you the best in your healing…
Warmly,
Kathy
I don’t have a therapist.. haven’t ever had one regarding my DID: We’ve gotten as far as we have right now by ourselves (and what a nightmare that has been at times) Very aware right now that things are not going nearly so well, and progress is being lost to an extent. The only person that we were ever referred to said they could/would not help unless we were all willing to integrate: but that is not something that many of us want, or could do. At the moment, we are in limbo, because we really have no idea how to resolve the problems we are having, or where to turn for help…
I dont know where to put this but i struggle with reading and understanding what you write, we switch throughout. So we read this and stoll struggling with accepting diagnosis even after all these tries – but i was wondering do people with mpd also see the world as mpd to make sense of it?
This was a very helpful article.
Thank you so much for putting it in such easy to work with language. It’s hard, being at the beginning of all of this, not really knowing where to start. It helps me understand why my T is so focused on safety and encouraging me to find ways to communicate, ways to be safe, ways to show compassion to myself.
I want to dive into all the difficult stuff so that I can be “better” really fast. Probably would get really overwhelmed if I did that. Safety first…. safety first…