How to Identify and Treat Dissociation (Even When It’s Subtle)
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with Peter Levine, PhD;
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with Peter Levine, PhD; Ruth Lanius, MD, PhD; Stephen Porges, PhD; Bessel van der Kolk, MD; Thema Bryant-Davis, PhD; Kathy Steele, MN, CS; Janina Fisher, PhD; Bethany Brand, PhD; Pat Ogden, PhD; Ruth Buczynski, PhD
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Wonderful full of knowledge second part – even better than the first – although the first was excellent. I have a question to Ron Siegel – why the trauma survivors hear negative voices that accuse them and threaten them – is it not better to have a calming supporting voice inside of your head when you feel overwhelmed. And is it because when the voice is harsh and negative this keeps us in alert, vigilant state that helps us to cope better? (not in the case that ask her to harm ourselves or the others) And I would like to ask Ruth Lanius – can she explain more about this putting her client on a swing – did she do this exercise in the beginning of the session or ask the clients to imagine it when they have problem breathing at their home? And about the dials (pecing therapy?) – the client imagine theses dials when they are in the session or at home? …….
I bought your gold package last week. trying to read materials when I get time off. I need to familiarize with your materials and how to access.
1. how can I get a receipt for my payment?
2. when you release test in November, how long do I get to finish the course?
Susan Cherian 10/28/2020
sucherian@verizon.net
In particular have been using Pat Ogden’s words’a thought is just a thought, rather than truth’.This has made a lot of difference and enabled me to get back into my body more with less fear, when I use it. I have been suffering from severe disabling trauma on so many levels for years, hydrocephalus recently, with infant and child states dominating and found theses sessions invaluable in understanding and guidance for self help. In Uk and difficulties in seeing practictioner.
Are there any scholarship opportunities for a “Gold Pass” for this series?
These speakers impart so much wisdom, but it is not always possible to access the live broadcast, but the series are beyond my reach financially.
If you feel you missed parts of the lecture I am finding that reading and taking notes on peoples’ comments is an excellent way to refresh your memory and re- learn what you may have missed.
One thing that I did not hear addressed (and had really hoped would be, in the part addressed to medical doctors) is how to help distinguish between body memories and true medical problems. It was kind of alluded to when it was said that medications may not work or may work in reverse. Also, is it common for DID patients to not feel pain? Or to have pain and no reason for the pain? When blood work is done, to not get consistent results?
What I found useful was the piece around co-regulating with another person. Feeling their confusion and incompetence within myself after our session. Also the piece about noticing if I am getting into conflict with the client which can happen given the challenge of working with such clients.
Many thanks for the opportunity to view these webinars for free.
Kind regards
Ursula
Sally Bennie, Counsellor, Adelaide, South Australia
Thank you for making these sessions available free of charge. The Roadmaps and succinct summaries you are giving as well as suggestions for therapy sessions are very helpful. I enjoyed seeing Janine Fisher in person after reading her book last year and will be looking at Kathy Steele’s work, too.
Frustrated that I missed session this week. My private practice does not allow me to tune in at these times. Only free after 7:00 AST. Tried but unsuccessful
Thank you for this presentation. That covered a lot of ground regarding structural dissociation and DID. One thing that I was curious about pertained to the notion that feeling confused and spacy with a client might indicate that the client might be experiencing structural dissociation. What happens if the client feels that whenever dealing with a therapist? In my situation, many years ago, the therapist just said that it is normal to be anxious in therapy. How long does this confusion usually last? How does one identify if it is exchange or one’s personal traumas being triggered? What is the best way to relate to this if it is exchange? Can it also be a mutually triggering situation for a client especially if he or she is highly empathic, e.g. INFJ. What is the neurobiology of exchange?
Wonderful presentation??
I got so much knowledge that really help me to improving my skill to help client and my understanding about trauma/complex trauma as a clinical psychology student.
Really comprehensive, easy to understand and detail.
Thank You.
I have been a trauma bodyworker for 33 years. There is always more to learn and integrate. I enjoyed hearing other ways in which to observe and particularly statements of observations to make. “Oh, the spaciness part of you is here” and about the nervous system getting energized. Yes, the client does not have to take that personally and feel guilt or shame that they are doing something wrong. Good session. Thank you.
Thank you! I found the information about watching the client for their response to expressions of empathy and how it might be triggering memory of trauma very helpful. It gave me a way to understand what might be happening. The advice to go more matter-of-fact was useful too. I remember noticing this dynamic in a session and backing up to matter-of-fact instinctively, but not having much understanding about what was happening.
I wish I had this session 30 years ago when I was dealing with a full blowen DID client. I did some mistakes, but also some good work, and what I learned today actually confirmed much of the ways I worked with her partly by knowledge but a lot from intuition. I am writing a book currently about the journey we went on together for 5 years. Hope to share it with the wporld to tell her story and to look back from today’s knowledge at the steps and missteps I took.
Great presentation. So clear and to the point. I like the point that the clients that have “been around the block” and have not been helped are often DID but called personality disordered.
Thanks so much! After 35 years and thousands of dollars spent on therapy that “didn’t feel right”, this description & approach totally resonates with me!!
I am a lay person, working on healing from trauma and the biggest takeaway for me this week are the explanations that trauma can and does fragment the sense of self. I’ve had that feeling of being in thousands of pieces and also finding piece by piece of the puzzle that makes me whole. Thank you. Great series.
Excellent presentation!!!!!!Thank you for making everyone feel welcome. Lay people and all.
I found the gold membership materials on the first session to be exceptional. The discussion of counter-transference was fascinating, and brought to mind the end of the third chapter in “A General Theory of Love.” For those that haven’t read it, they observe (I paraphrase): “The nature of the therapeutic relationship is as follows: The therapist walks the patient up to the moment of their trauma, and in the critical moments offers ‘No, go this way instead.’ There are two essential factors in the success of every therapy: the courage and moral clarity of the therapist. If either of these fail, the therapist becomes trapped in the trauma.” From this, I understand that no one should be mystified by the seeking after escape described by the commentators in the videos, and more deeply appreciate the work of heroes such as Judith Hermann. The current preference for psychopharmacology is also understandable.
Thank you excellent and useful presentation. Currently, I do not work on trauma but I have some clients with personality disorders that have some fragmented parts. I learned what is effective and the most important is that the client feels safe and grounded. Thank you Ruth for your synthesis. I appreciated that you are offering these presentations free.
What I can share as a patient, is that I take away from this session that I probably do not have DID.
I never loose track of time. Although i have multiple parts, that get lit / get activated by inner or outer stimuli, I never, ever loose track of anything, I am always hyper vigilant, as if even the “benefit” of DID (zoning out, occasionally drifting off, sinking into something) is not given. (I obviously don’t consider this a true benefit, please don’t get me wrong).
I do however, despite ever-hyperawareness, realise that I experience a very confused (sense of) reality – and lack thereof -, and herein, of the multiple parts, that have very, very different energies and states of consciousness (perception of how things are).
I think the hypervigilance comes from an estimation that both vigilance and the intellect in itself are going to save the situation (that’s why drifting off is an impossibility).
I recently discovered that I was gaslit (by an only and extremely abusive parent with NPD) in the most incredible, simply enormous way.
I was in therapy for years and now realise that, as with any interaction, I only pleased the therapist (this I realised, but not réally… – as with everything: realising it but not réally), from psychiatrists to psychologists and any type of physical therapist.
I of course entertained very pleasant relationships with each of them and I made sure I could be their ‘break’ (when i sometimes looked at patients in waiting room, I concluded the therapists had tough and long days). With physical therapists, the self-harm went as far as going there for years while the truth was I absolutely couldn’t stand anyone approaching my physicality. But letting them down was so much not an option that I simply suppressed hyperventilation, always thanked for session, oftentimes saying it had helped, and not even realising how biased all of it was. It was simply my mode of functioning. That’s why, even extreme abnormality, patient doesn’t see themselves as abnormal. We don’t know anything else.
In all these years of therapy, nobody ever got to me – and I don’t blame them.
I hope you don’t give up on your well-being and continuing therapy. Although few there are therapists out there who treat and understand DID/OSDD. I know it’s easier said than done. And in my experience, people with DID/OSDD tend to have caregivers or family members with NPD if not full blown sociopathy/psychopath. Learning how to distance from them without bringing additional harms is the art one must learn to get safer. A book titled, How We Heal and Grow by Jeffery Smith, MD has good tips on that. Also, I learned a lot from reading “Coping with Trauma Related Dissociation” (no tips on how to deal with NPD, but excellent book on dissociative disorders – Kathy Steele, one of the authors was in the today’s program). Best of luck to you.
Hi Eva, thanks for the tips and the literature. Also, I hadn’t heard of OSDD.
No.. I ab-so-lu-te-ly won’t give up on my well-being.
Take care
Since many lay people are viewing these webinars as well, would you please offer a word or two on what a lay-person can or should do (or *not* do) if someone they know (family, friends, co-workers) is exhibiting what appear to be signs/symptoms of dissociation.
Is it “safe” or advisable for a lay-person to apply some of these strategies in the moment when dissociation might be occurring in an inter-personal setting (i.e., using a matter-of-fact voice instead of empathy, suggesting some breathing or walking to help ground)?
For that matter, what do therapists do when they encounter dissociation in personal settings or interpersonal interactions?
It’s great to see how dissociation can be handled in therapeutic settings, or with health practitioners, but what’s the advice on how to respond appropriately and safely (for everyone’s sake) in the course of typical interactions in daily life?
Where is the line between a safe and positive response that anyone can apply — and when professional help is needed, either for the dissociative person or the person dealing with a dissociative friend or member of the family?
You seem like really invested in learning about dissociation. We need more allies like you in this world! It would be a much safer place for people who are living with OSDD/DID to come out. I suffered from DID. I am no longer suffering from PTSD symptoms and I no longer experience lost times. I am considered to be “cured”. I even worked in a public mental health service system.
What I can say to family members and friends of those who are diagnosed with dissociative disorders is to not change your relationship or a way you relate to the person afflicted unless otherwise requested. That’s the kindest thing one can offer. Be a good friend. Any mental health diagnosis bring about such stigmas and mistreatments to people who are suffering from them. People with DID/OSDD are not with hostile/pshychopathic “hidden” personalities. That’s made up in Hollywood. They are not delusional, either. They are deeply traumatized people, trying to cope with the unimaginable in only ways they knew how. Unfortunately, friends and families leave them (sometimes take their children away for unfounded fear) when they learn they got dissociative disorders – much akin to what happened to people who belong to LGBTQ community earlier in the days.
If your friend or family member is in need of a DID/OSDD therapist, help with the search. If one is already in therapy and disclosed one’s diagnosis, then be there, and ask to learn more from her/him instead of internet search. Internet is full of misinformation. There are books on the topic to learn more together. I recommend The Body Keeps the Score by Bessel van der Kolk, MD for understanding trauma in general. Engaging Multiple Personalities by David Yeung for understanding more on DID for families and friends. And lastly, don’t seek to meet all of the parts. That’s like asking them to get totally naked in a public, and never an appropriate request.
I forgot to mention another resource: Go to “Healing Together” conference (annually in Florida) on DID by An Infinite Mind (non-profit). They have support groups for family/friends, therapists and people with DID. Great presenters as well.
Thank you so much for sharing all your expertise. Thank you! I teach children. I ‘m
studying everything related to group dynamics, systems, trauma and building safe relationships. Working with a special group of children right now, two children with severe trauma. Your knowledge is very helpful.
Thank you dear Ruth and all the doctors and Kathy, for your up-to-date knowledge, insightful comments, and wisdom, last week on Freeze and this week on Dissociation and DID. You touched deep and deeper layers of trauma, mental health and personality, and also human weaknesses and human nature, more in the understanding from neurological perspectives. Many things puzzled professionals and clients for years. Now they can be understood more from scientific lens. These new understanding and breaking new grounds force us to examine the traditional approaches — how much they were/are effective and really working in psychotherapy and counseling treatment….Thank you all again. Daniel Li, from Toronto
Working with DID, I have found it helpful to avoid either pole of having the client become flooded with feelings versus just returning the client to present time. Instead, I try to find a way help a young part release terror or grief while using the adult part to help the scared part to feel safe with me. Finding the balance that allows release of tears or shaking or angry sounds usually leaves the client refreshed and relieved that they can flow through the feeling to completion without getting lost in it. Thanks so much for your useful insights!
The strategy you are using with people with DID sounds awesome! I guess the advantage that people with DID have is a trauma work can be done and contained within the parts who are holding them without bringing unnecessary dysregulations and traumatization of the parts who don’t have the knowledge yet.
This presentation was fantastic! I found myself drawing comparisons between the Structural Dissociation Model and Reactive Attachment Disorder. I wonder if they are one in the same or if RAD is the symptom of the Structural Dissociation. The Structural Dissociation Model is definitely a helpful framework in working with children and adults to better understand their parts.
Fairly early on one speaker (may have been Pat Ogden) mentioned the “Four Cs” to deal with dissociation in session… one was “cooperative.” Can anyone enlighten me about the rest? Cheers, Lorna from Canada
I, too, am a counselor who found this information very useful.
I believe the four C’s were: cooperative, coordinated, coherent, cohesive?
Thankyou for treating us to this free of charge. Greatly appreciated! It was a very interesting hour.
My take home was about – slowing down not rushing to explore and going at the clients pace. Understanding whether it is Dissociation or DID. Working towards healing- the visibility instead of erasure of self, honour of self, being present to self – towards the authentic acceptance of self. I love this word pic for the client of “Coming home to myself”
Thank you this was a valuable set of tools and information. Because if my own childhood trauma it is sometimes more difficult to walk with others though theirs.