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:
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.
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?
Be sure to write your comments below.
Warmly,
Kathy
Copyright © 2008-2017 Kathy Broady MSW and Discussing Dissociation
Hello Again Kathy,
I had a couple of questions I am hoping you may have some advice for!
After 24 years with the same therapist (off & on but consistent for 3 years now 2 to 3 times a week), how can you determine your own progress, tell if your therapist is really helping and how affective the therapist is truly being? Is there a way to tell if your therapist is actually to “close” to the situation to be actually helpful?
Do you have any suggestions when a client feels way too attached to their therapist causing significant amount of frustration, anxiety and this is all they can think about? I do know a client is to refocus/distract themselves, discuss this with their therapist and try to determine the cause, but what if “logically” you know the cause and because the feelings are so overwhelming, this is all you can think of as a person cannot focus on other things to try and help themselves?
Is there a way to break down “Overwhelming ANXIETY” so you actually know what you are feeling?
I am in a unique situation as I have been diagnosed with a progressive neurodegenerative disease and by my understanding at this point in therapy I normally would have work or other things to help me distract and work on some of the social interactions and because of my situation I unfortunately spend most of my time alone. I spend a lot of time trying to find things to do to keep busy but I find this very frustrating as other than my therapist visits, phone sessions and once in awhile time with a friend or two, and am having a hard time with this and trying also to work things out inside. It is like being in constant chaos within which again is very overwhelming.
As I have written before I have done so much reading on trying to get better but sometimes feel this is a task that will never happen. Also, with the complications and changes of the disease, coping with all of it, well, again very overwhelming.
I have spoken to my therapist about # 2, 3 and 4 and never seem to get very far with the answers I receive. Not that there is anything wrong with her answers but they tell me they are not that creative and leave this in my hands which can be very frustrating at times. Not all the time but I must say a lot of the time.
Thank you again for any advice you may be able to offer as I greatly appreciate it!
Is it recommended to have a backup therapist for a DID patient when your leaves on vacation? If so, would it be better for a client to meet this person at some point before the “T” leaves? Usually I have no backup person available.
I did refer my current therapist to this blog. Whether she actually took an interest and read it is not in my control.
Unfortunately the therapists I have come across are concerned about their own time constraints to want to educate themselves about DID.
It is a sad place .. the area I live in. I found no one who had any previous experience with DID.. let alone had any knowledge of SRA.
This has left me feeling like I need to educate my therapist.
I want to thank you though.. Kathy. I AM glad I found this blog. It has finally given me a place to not feel alone and odd.
earhearts –
I completely agree — it is really sad – there are not nearly enough therapists that understand DID / SRA. And then unfortunately, when there are therapists that work in the field, there is sooooo much trouble and hassle sent their way, that it is hard to keep people to stay working in the area once they finally got there.
If you have found a therapist that you can work with, even though it is lop-sided to have to educate that therapist, hopefully, as you work together as a team, the focus can still be about helping you to heal and more forward.
I am very glad to hear that this blog helps you to not feel alone or odd. I assure you, you are not alone, and you aren’t any more odder than the rest of us. 🙂
Thanks for the kind comment,
Kathy
Did someone say “odd”? I have been told I dance to the beat of my own drummer. Does that qualify? 🙂
First, t’s just don’t take the time or effort to learn about DID. They have these ideas of grandure telling clients that they do research, go to seminars, ect. However, when asked, the t will proclaim there are no seminars that deal with that.
How in the world are they ever going to know how much time to give a person with DID unless they take the time to read things like this blog?
There is also the thing that t’s have that I have found. A lot of t’s say they want to empower and not add to the helplessness. They develop ideas about boundries based on assumptions that we as DIDers will become overly dependant on them.
I hate to be the one who sais this but.. you know what.. some of the insiders NEED to have someone they can depend on. The littlest insiders NEED someone who can help guide and direct them.. someone they can depend on.
If there needs to be some boundries drawn for what ever reason.. why can this not be discussed in therapy prior to even starting?
I wish there was a majic number where I could say… ok t… I want x amount of time and that would do it. It just doesn’t work that way.
There are days that I am ok and can discuss things on a reasonable level and then the next I am a mess.
I wish that the consumer (individual) had control over how much time, how often ect. However.. I think I would definately be broke if I spent as much time as I really NEED.
Having said all of that… I wish that insurance companies would get on the ball and discover that not every client is like the last one… some of us need more than others. It truly IS an individual thing.
We might have many personalities… but when it comes to our past, our feelings, our therapy… we are each and every one of us unique individuals that require our own unique type and time needed in therapy.
Earhearts….
I hear ya. Thanks for the comment – you’ve said it very well.
I really think a lot of the most effective DID therapy happens off the beaten trail of regular therapy. Sure, basic therapeutic elements are necessary, but the issue I have is that tooooo many rigid boundaries can take effectiveness and throw it right out the window. So of course, there has to be a healthy balance, but in my opinion, the limits required for non-DID therapy are very different than the limits needed for DID therapy.
And earhearts – please feel free to refer every DID therapist you know to this blog. Maybe we can get the word out one way or another! 😀
Kathy
i think our therapist would be willing to give us as much time as we need but we would never be able to afford it. we are lucky to have found someone as willing to find ways to work with us as she is but we pay for everything out of pocket and we are not rich.
*”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.”
Yeah, it is hard to define it as helpful. I mean, i HAVE learned a lot… learned to talk, to sort of trust some, to know i was living in an abusive situation, learned to understand what real community is and know what it means to be apart of one, to understand boundaries and that i had grown up with messed up boundaries, how to set and keep boundaries… now i am learning about “needs” and I think it is the hardest one yet. But still haven’t delved into the CSA yet. Trust is not that deep yet… and time is waaaaaaaaay to short for that. Once that pandora’s box is opened… @_@ it may kill me!!! Each alter holds different knowledge, different memories… 2 have no bad memories, lucky them. The shame, guilt, fear, self hatred that various alters hold… 60 minutes… what is that. One week to us is like 2 or 3. So much happens in a given day with alters coming and going.
*”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.”
I’ve learned to speak (when I first started in 1996/97, I literally couldn’t speak as soon as anything turned serious at all). I spent the first 4 years (three different therapists; 1996; 2002, 2003-06), like this. With therapist #4 I knew what i wanted to work on, but she triggered me so badly every session and did increase to 2 a week, but it felt like it still wasn’t benficial because we were being pushed and certainly not at choice about our comings and goings. So, it seems like there is a delicate balance between time needed, a skill level needed, and willingness. When I first started, 90+ minutes would not have been useful. In fact, my first year, one day I couldn’t speak a single word, and the man said “Well that was a waste of my time and yours”. So it also seems important to have more than one modality (talk therapy). I know specifically now that one alter is selectively mute. so for her to communicate there need to be crayons and paper. Some need books read to them to feel safe. Therapists may not think this theraputic, but it IS because it creates a bond, safety, makes the office safe for the internal kids to know they are included.
*”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.”
Especially when beyond all the hard core trauma stuff, there is trust to be built between alters and the therapist, and trust is so flimsy that any fluxuations cause major chaos within and all alters suffer. Trust, stability, consistancy; all things missing in the lives of DD/DIDers – the therapist often doesn’t have any idea about just how important those things are, and that if those aren’t there, they can forget doing deep work – yet alone trauma work or communication work between alters.
*”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.”
There’s SOOOOOOO much i want to say there… and no words.
*”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.”
And that there’s just no time to get back to some functional core self who can be in the world/drive home. There’s so so so many things I’ve not even tried to bring up because I don’t think I’d be safe afterwards. And I know she can’t help me ground for more than about 2 minutes. Or I have to be “fine” as I get shunted into the big wide adult world of noise, traffic, people, driving. She’s not even met most of our alters, in three years of being with her.
*”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.”
Oh no joke. It really seems like (for us) 90 minutes would be so much better; 15 min to get situated, 60 to do work, 15 to get grounded before leaving. But that’s kind of a “normal day” where nothing major has happened, no major swap outs of alters have happened, no pile of triggers swept into the corner are about to fall on us and crush us. Our therapist tells us that we are often in crisis… whatever that means – it’s just life to us.
*”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.”
Yesssssss so very true it is painful, depressing, scary, seems hopeless. I’ve been with my current therapist for three years. We’ve still just barely touched the trauma stuff. Often she is not wanting to because I cannot guarentee that we can be safe. I have finally been allowed to join groups just 7 months ago because i can finally self contain when triggered, either by taking time out and getting grounded, going home, saying something that will help me, etc.
*”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?”
I think a lot is going to depend on the therapist; are they really actually knowledgable about dissociation? About DID? Have they worked out their own insecurities so they don’t start taking on transferrence, or counter-transferrence? Are they capable of handling long sessions? Really, it seems like 3 hours would be a major drain on all involved (but that is just my opinion). It isn’t healthy for either client or therapist to get exhausted, overworked, overwhelmed, or bring out more information than can be handled and safely contained.
*”In case of a disagreement between the client and therapist, who should have the final say in length of sessions and frequency of sessions?”
I feel like I can accurately say I KNOW who will have final say 🙁 But that to me feels just like the parent being in charge, denying needs. Yet when I state these things, the therapist says “I am NOT your (mother, father)”. Well, thanks for that input, but I’m fairly sure I knew that. Yet, it simply shows me that once again “the adult” (when you’ve got 6 internal kids to three internal adults and several fractured parts, most people seem like “the adult” compared to me), “the parent”, “the authority” in charge and I have no REAL power. I think things need some negotiation, for example: yes i can do THIS sometimes, but I can’t do THAT… perhaps when I have x extra time, we could add more… there could be an extra phone call or we can set up that you have these secure resources you can call on when needed… etc.
I think most trauma survivors would like lotsa sessions, but they don’t got alotta money for T, so they only gonna get little bit anyhow.
Thats why they goto take care of self, less they rich, cuz it LOTTA money for T, even little bit of T.
So THAT part is not clients choice attall. It about money and nothin else attall.
Just money is all.
Kathy,
What about medication? i am having the hardest time right now dealing with my psychiatrist and medication compliance. i am up to 10 pills at night, and it’s too much for me. i want it lowered or compacted or something, but every time i speak up about it, i am dismissed and my medicine dosage is upped, or something is added. there are two sides to this story of course, but if we are talking about DIDers having more say about their treatment i would really like more say about medication.
now i see my therapist twice a week sometimes three times if needed for 50 minutes, and i also see an art therapist if i can afford it. my insurance pays for therapy but doesn’t cover art therapy, i wish it did. i often don’t want to start talking about something in therapy because i know we’ll run out of time and i’ll have to immediately stuff it back in in time to leave. on the other hand i don’t think i could ever have enough time in therapy. if i start talking i might not be able to stop..
i’m just bouncing some things off my head.
kryssi
claire, can you draw some pictures?
you got older ones inside too?
maybe they be nice and talk to you sometimes?
cuz those T’s, they ain’t around much.
I like to know the T is there, even if we can’t see her much.
bad parts behave better.
guess we feel kinda safer even if we don’t trust her (cuz we don’t trust NOboddy).
maybe T help you find somes inside what’ll be nice, then you don’t need the T so much.
cuz there ain’t never gonna be enuf T time and thats for sure.
but some is ok, bettern nothing.
it’s good to know she there anyhow.
we send her emails, but we kinda sad cuz we think she don’t allus read them so well and we try real hard to make them good and right.
oh well.
HI!!!
🙂
hi this be claire
pepol usd to tell us focus on 1 topic that wud help
speshally are old T, use your time better
spehsally if mae was talkeing
but i think pepol dont no that if you got lots of inside pepol then it do be relly hard to consintrate on 1 thing
cos like if jodie be talkeing and her say somthing then it remind me of somthing that i wish i culd talk bout
so then i relly relly want to talk
but then what jodie say also remind mae and tuck of somthing them wants to talk bout so then they relly relly want to talk bout that thing evn thowe they alreddy did have somthing portint to say
so now they got evn more to say
and then if T say somthing maebe a word or a sentense
it reminds jadie of somthing scary and now her need time rigt then to talk and we cant stop her from comeng out now it be jadies turn and we all have to wait for her to be done.
but then jodies turn dint get finisht cos her got intruppted.
and from 1 word sombody say it go all out big like a spider web
and take lots of twists and turns to fast and to big and now evrebudy is wateng
missy say it be like ADD all out of controle.
it be hard to figyer out how to skwish all so meny pepol into 1 ower. or even 2 owers. when there be so mutch talkeng to do. even wehn we go 2 tims a week we always feel all to full up with stuff to say that we cant get it all out
bye from claire
Oh man, and that’s just the thing. Never enuf time 🙁
I struggled w/that.
But the thing of it is, is that I friggin gotot take care of myself(like I allus done).
But seriously, I goto do the work and T more like a witness and mebbe she point stuff out.
But manoman, there ain’t NEVER ever gonna be nuff time.
🙁
Pretty much sucks to know that, but now I made adjustments.
Screw the stupid T. Sure she help and all I s’pose, but we ultimately do it ourselves. Just the way it is.
Yep, sucks.
But that reality.
Leastaways we gots each others, which not everybody does huh?
When we used to have only 1 hour sessions with our old therapist, there was no point in even going to therapy. It made things worse every day than better so it would have been better to not go at all. We would be talking and all of a sudden it would be time to leave, but all this stuff that had been built up all week would feel like it was going to burst. We’d end up having to walk out, and go home feeling like we needed to self injure just to get the rest out that we didn’t get the chance to say. Even longer sessions go by way too fast because we switch so much and we don’t have much sense of time passing. Too many people need the chance to talk and so even a longer session doesn’t feel very long. When there’s 10 or 20 of you, its hard to share your therapist for 1 segment of time and you might only get a few minutes, then you have to wait again til next week, even if you have something big to talk about, you know you only get a short turn… because if you take a longer turn, you have 12 people in line behind you waiting THEIR turn. And when someone else is talking, you are waiting in line hoping you get your turn today. But sometimes it doesn’t come–not this week or even next week. Shorter sessions just make the frustration too much to take. Its so frustrating and scary that I don’t even want to think about this anymore right now 🙁
jodie
I mean ultimately, the client *should* fully be in control of *their* therapy. THEY hire the therapist, they are the boss.
Thats if everything were ideal etc.
But lifes not like that. It’s complicated. One of the reasons they are going to therapy is because they lack control either internally/externally, or both.
So then the therapist has power.
ALOT of power 🙁
And thats scarey indeed.
And people who have been abused know already, that those who should protect them, don’t always 🙁
And they are used to allowing the more powerful to have that power unquestioningly 🙁
And it’s SO very hard for some to speak up, in ANY situation, let alone in an imbalance of power situation.
So ya, ideally clients need to keep their eyes open, talk to others outside of the therapy room (eg online), and DO question the T as to why she(he) does what they do. And the T should NOT take offense, cuz this NEEDS to be in the open this stuff. The T needs to keep his(her) personal ‘stuff'(neg countertranferrence)(-get supervision!!!)) OUT of the therapy room. And if they DO screw up(they always will, they are human after all), they should be willing to talk openly about it, and especially APOLOGISE to the client. This is huge.
I could go on and on….
” And when things are unique….. who gets to make that decision?”
Thats where working *together* cooperatively is best. (internally AND w/T LOL!).
Hmm, this post wanders somehow in my mind but then, my mind has been wandering, lol, so perhaps its me!
I think its not easily answered these questions. Each client is different.
So there are not going to be any B&W answers.
Therapists are people with their own strengths and weaknessess also. And this is the frightening part. Because therapy generally takes place behind closed door btwn two people, one of which has much greater power over the other.
This is where I think support websites can be valuable(yet challenging) cuz then clients have a way of ‘checking out’ their therapy w/others, and potentially being warned of dangerous or odd behaviours on the part of the T etc. Also support in being able to say stuff etc. I think these online support groups(once you find a good one) can be so helpful.
So in my wandering way….I guess what I am thinking, is so much depends on the dynamics btwn T and client, what I might call ‘fit'(as in it’s a good(or bad) fit w/clent and T.
I also strongly beleive that often, a client can have done good work w/a T, but then they have gotten from that T, all that that T has to offer, and then it’s time to find a different T, try different things. This is not always the case, but seems to happen fairly frequently. And leaving a trusted T is SUPER hard to do 🙁
I think ideally a client should call the shots, but its not always *possible* for the client to call the shots-there is a reason I call DD “confusion disorder”. If I knew what to do all the time I wouldn’t need a T!!!!
I think being a T for DD’ed clients has got to be insanely challenging, and that there are few who can mentally/emotionally handle it, and also just have the mind power to juggle all that is going on !!!! CONFUSION all around!
I agree that 50 mins sessions are way too short 🙁 It usu takes me a fair while to settle, and so I really only end up generally with maybe 15 mins of quality session time, cuz the rest is spent dithering and settling.
However, DD therapists tend to be very expensive(if you can even find one…), so who can afford longer sessions???? Who can justify that huge of an expense? I have kids, do I take all the family money for therapy? I function, so I cannot justify but basic therapy to keep me from spinning out into space. To actually do any real hard work is too disruptive and expensive.
Interestingly, I have finally discovered that more is LESS. Cuz if I can’t afford more than 50/mins/wk, then I am better off bi-weekly, because weekly was just keeping me in a perpertual state of internal uproar(for asst reasons), and I can’t be calling my T all the time, so what to do? I get paralyzed and much less funtional. So now, I just go bi-weekly, it gives my parts a chance to ‘be’ with a person who accepts them. We do a bit of work, and thats enuf to keep me going. I do some work off and on at home, but not so much I am frazzled. So for me, this is not the best, but the only solution I could come up with.
As far as client control of session length/frequency etc, I think that needs to be ‘negotiated’ with the individual therapist. Some T’s have more flexibility than others. Some have room for sliding scale clients, some don’t. Some are willing to take insurance, some won’t. Etc etc. I think that just needs to be talked about….tho that can be hard to do. Its hard to ask for stuff 🙁
This is based on my experience w/therapy. I know others in other areas have different experiences and constraints.
I think a good therapist should keep this stuff in mind (lol, along with the thousand other things they sposed to be keeping in mind as well….sigh….) and maybe check in w/client now and again about the overall therapy ‘picture’. I think DD T’s avoid this cuz it’s can be very discouraging, but I think if handled with care and thot, it can be a good thing. Just HOW? What with all the confusion… I once read that working w/DD clients is sometimes like herding cats!
This is a huge topic(as usual), I could say alot, but I’ll leave it at this for now. My kids are calling for their breakfast!!!
Hope this isn’t too disjointed.
Hi muffledones — yes, your point about there being no B&W answers because every person / every situation is unique is absolutely and completely valid and crucial to remember. I’ve known clients who could handle no more than 10 minutes of therapy time, and then I’ve known other clients who couldn’t as much as get started on anything of any significant value within a 50-minute time-limit.
There really is a lot to keep in mind, and because different things work for different people, this is why I’ve brought up the topic in this blog. It seems there is no one single “cookie cutter” way to address DID and to stay effective for everyone. And when things are unique….. who gets to make that decision?
I’m glad you have found a combination that works for you – keep up with the good work!
Kathy
Totally. I have a blocking system for therapy and literally can’t remember anything about my life on days I go to therapy, so we have to work on getting me to switch to someone who actually has information for the first 30-45 min. This isn’t easy because when my T starts trying to help me switch, I stop being able to hear/process anything lmao…
Personally, I won’t ask for any extra anything my T doesn’t offer first. If she offers extra time, then I usually take it, if she offers for me to text her about some particular thing, maybe I will. I don’t like to be an imposition in any way, so I try not to do anything I’m not invited to do. I get punished when I text information from other parts that comes up right after therapy, cry, or share certain info which makes me think I’m doing something wrong a lot, so I need to be told directly and honestly the guidelines of what is okay and what is not from the beginning and repeatedly so everyone inside knows.
this is a tuff one. Not all therapist are honest and not everyone knows for sure whether their therapist WOULD be honest under some circumstances. I lucked out. My T is honest. I don’t remember most of who is out and who’s not, so when one of them was there, you are right, it took me a while to “regroup” afterwards. My T recognized he couldn’t let a 10 year old leave with the intention of driving my car home – I nearly wrecked the first time that happened. But that brings up the other question you mentioned above – it took my T weeks (probably months) to convince me that I was the expert. He was honest from the beginning and told me he didn’t have a lot of experience with DID and that every person with DID is so different. We made a few mistakes along the way and dependending on the mistake, one of us usually suffered for it, but we both hung in there. I’m glad we did.
Thanks for the comment, Ivory. You’ve made great points about so much of the decisions being based on the therapeutic relationship itself, and the need to work out conflict or differences. That’s very true. Also – being sure that someone is safe to drive home afterwards is a very important point as well — and this doesn’t necessarily happen quickly. When DID survivors have intense or time-distorted sessions, it can be difficult to find someone inside who can drive safely, and/or there need to be a few options for how to handle this. I’m glad to hear that you and your t worked successfully through those difficult places.
Thanks for the good points –
Kathy
Hi Kathy,
I had to take a few hours to think about this post. Ya know if I was given the opportunity…my parts would take up all of my T’s time and he would see no other clients…there’d be no time left. My little parts would like to follow him around all day if they could..everyday-try to get him to color and read to them with his arm around them. I know that I am in need of his services and time and not always clear headed on this subject. Because I live it maybe I can’t be objective? My wants and needs are great and my parts don’t know about boundries and being reasonable. My parts are so needy of the real and good safe stuff in life. Maybe no matter how much they get they will want more. Also while they will transfer and project their needs onto him that their parents should have filled he can give alot but not what my parents should have given to them back in the time. I hope that makes sense.
I know my T understands me andmay have insights into my issues that I have not seen yet. It is always a work in progress. We talked some about the time constraints and he offered me another day a week if I needed to but said he wasn’t set up right now to have two back to back hours. He is in private practice and he has to have success at his end of things too. I will save the idea of adding another visit in…I already go twice a week. I am talking to my parts and explaining to them that we have to be respectful of what he has to do to survive as a business and make things work in life at his end. AND he gives us alot…he is available to us day and night. I even have his cell phone number when he is on vacation and he will email me if he can. I have never used this option with him…yet. We are saving it up for when things are real bad. Maybe they never will be that bad that we can’t handle it. I sure hope so.
But these are my thoughts after reading your post. My parts will have to adjust and learn how to reach out in the time we are given with my T. He is available to them too and when they are ready they’ll take part in the sessions. WOW…this post really made me think. I feel better about this subject now. 🙂 Thanks.