The 6 Therapeutic Tools I Found Most Helpful for Dissociation
Creative strategies to heal from Dissociative Identity Disorder.
Posted July 20, 2011 | Reviewed by Abigail Fagan
The more I think about it, the more I marvel at the skill of the psychiatrist who helped me heal from Dissociative Identity Disorder. As I look back on our work together, I can spot a number of creative strategies that he used.
Let's call him Dr. Summer. I don't know whether Dr. Summer drew upon his experience working with other survivors of abuse or spontaneously invented some tools in his work with me. Some of these techniques must have been specific to my circumstances and should be understood in that context before adapted to others. Here are the tools I found most helpful.
1. Helping me to trust him
Trusting people is very hard to do when as a child you were abused by the people who were supposed to protect you. The betrayal is so deep and those relationships so critical that it's hard to imagine trusting anyone ever again.
I'm not talking garden-variety trust here. For longer than you'd think, I scrutinized Dr. Summer's every word, however casual, and weighed it against the facts known to me. When he invited me in that first day and told me I could sit anywhere I wanted, I spotted deception. He didn't want me to sit in the chair behind his desk, for example.
But for the most part, Dr. Summer spoke to me in very literal terms and avoided the little niceties that smooth most social interactions, the ones that would have distracted me by their inaccuracy.
I paid attention to the things he said he would do to find out if I could trust him. When he said he would be available, he was. From our very first meeting, Dr. Summer committed to walking the journey with me and he did.
He created a safe environment in his office and in our interactions. He established a structure that helped me feel safe by knowing what to expect. I've never been big into surprises. I met with him twice a week and our sessions generally ran the same way with only slight variations. The routine of our greetings and the course of the therapy became more and more comfortable for me. In that structure, I found the safety I needed to face what I had been so afraid of before.
2. Illustrating the healing process through stories
When I'm stressed or challenged emotionally, my abstract thinking abilities go way down. When our theoretical discussions about what I needed to do in our sessions didn't sink in, Dr. Summer creatively used books and stories to help illuminate my path.
For example, early in our work, I felt defeated by the sheer volume of new painful memories and panic attacks that threatened to overwhelm me. I was skeptical that facing my past would help me have a better future and was exhausted by the effort. Dr. Summer suggested that I read "There's a Nightmare in My Closet" by Mercer Mayer. I read the story of a young child that went to bed with a popgun aimed at the closet in his room. As you probably remember, when the boy finally mustered the courage to face the nightmare in his closet, he saw that it wasn't as big and scary as he thought.
Reading about the boy's discovery helped me to understand what I needed to do: open the doors to the rooms I had created in my consciousness. These were my parts. I was in the process of facing my own nightmare, letting my parts come forward to share what they knew about the abuse I survived.
Offering me a children's book was brilliant, inadvertently or not. All of my parts paid attention to the story, both young and old, and learned together about the process of healing from DID and becoming more whole.
3. Using hypnosis to help keep a safe distance from the memories
When a new memory of an attack or humiliation surfaced, I often became so panicky that I dissociated — my natural response to stress or pain, of course. But I often became stuck there, lost in a memory that I could no longer pretend not to remember, unable to go either forward or back.
Dr. Summer offered me hypnosis as a safe way to describe what happened so that I could move through it. Unlike dissociation, which took me out of the present altogether, under hypnosis I felt like I had one foot in the present and one foot in the past. I could face knowing what I had endured without feeling the full brunt of it. Hypnosis also helped me develop new habits of facing difficult emotions and thoughts while staying present.
4. Flexible pacing
Dr. Summer carefully adjusted the pace of our work to my needs. Early on, our slogan was "slow is good." But some parts inside weren't very patient. At one point, they couldn't stop coming forward with memories, pain and emotions. I pleaded with Dr. Summer to hospitalize me. I just wanted to go to sleep, take a little break, and not deal with all the pain.
Instead, Dr. Summer proposed that we have 90-minute sessions five days a week. We agreed to try this schedule for a while before jumping to hospitalization. His strategy helped me to keep working, stay in my home and maintain contact with my friends. It worked.
5. Not taking things personally
When I got upset with Dr. Summer and confronted him with suspicions, complaints or a sense of betrayal (remember how I spotted deception everywhere?) he worked hard not to be defensive. Instead, he listened thoughtfully. He often said to me, "I can see why you feel that way." I found that statement very powerful. Sometimes he apologized for a mistake, sometimes I came to see that I had misunderstood, and sometimes both.
6. Checking in with me before talking directly to parts
Even though I once had many different parts, or aspects of my consciousness, I've always been the mediator of those parts: the authority, the central self. My work with Dr. Summer was geared toward making me more whole, so when he noticed a part he acknowledged her presence to me first, giving me and the part the choice of talking to him.
He would ask, for example, "It seems that there is a part present. Is that true?" Or he'd ask me to relay messages. "Could you let everyone inside know that this is 2011, you are grown up, and you are safe?" Dr. Summer recognized the importance of me having control over my mind and body. He found many small and large ways to reinforce this sense of control in the years we worked together.
Dr. Summer was a real gift to me and I hope that his insight and respectful strategies help others going through a similar process.
In my next post, I'll describe ways that you can help those in your life who have survived abuse, whether not you are a therapist.