Transcript: Episode 75
75. Guest: Robert Cox
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[Short piano piece is played, lasting about 20 seconds]
Robert Cox is a Licensed Professional Counselor in Missouri, and he works with clients with Dissociative Identity Disorder. You can see his website at liferecoveryconsulting.com. On his website, he sates, “It has occurred to me that some of my future clients might wonder who they are hiring to help them work through some very rough patches, and trusting to walk with them in some very vulnerable journeys. I understand that, because I have been many of the places my clients have been and will go.
I have my own history of addiction. In 1988, I used for the last time, and I have been clean since. I know what it is to struggle with trauma, anxiety, and craving. I know what it is to feel so raw all the time, that all you want is for things to stop hurting, and to be willing to do anything to escape that. I know what it is to feel you have disappointed and hurt everyone around you, but not know how to stop.
Those experiences have deepened my ability to help my clients, know that I feel what they feel, that I have known what they know. I also know the promise of recovery. I know that we can learn to live vulnerably, in an uncertain world, with real joy, connection, and courage. It doest not mean that we no longer feel pain, or that we are not frightened by the vulnerability we face at times. It means that we have learned new methods of coping with those feelings, rather than running from them. We have learned to live with fearlessness, and a core belief in our own ability and promise. It means that we have learned, at last, to live life abundantly.
In 2011, I completed my Bachelor’s in Social Psychology with Park University. In 2015, I completed my Masters in Counseling with MidAmerica Nazarene University, where I can now occasionally teach graduate courses. After 20 years working in the mental health filed in multiple capacities, I now am an LPC in the state of Missouri, who is a nationally certified counselor, specializing in the treatment of trauma, addicionts, and autism. In December of 2017, we opened a new base location. Our trauma treatment center, located in Richmond, Missouri. From this new location, we dream of being able to spread healing from trauma, throughout the rural communities of North and Central Missouri.
I would like to thank Robert Cox for being on the podcast, and for letting me interview him. I would also like to say that this was recorded, according to our appointment, we had already scheduled for the podcast episode, on the morning that the troll incident happened. So, prior to recording this episode, we were already pretty shaken up, and in a very vulnerable place. And then throughout the recording, there were several times we were really triggered by different issues that we were discussing, by different things that Robert shared. But as agreed for the podcast, we did not edit out those dissociative moments, where we struggled to stay present during the interview. We appreciate the patience of Robert, who is an experienced podcaster himself, and continued the podcast. So, while there are many things that triggered us in this episode, some of them some of them actually very neutral examples he was using, there were very many important gems that we thought were important enough to include, and go ahead and share the episode. It did take us a whole extra week to be able to edit it. But, I’m glad to share it now, and very much appreciate the time and sharing from Robert Cox.
Here’s the interview.
Interview Begins
Interviewer: Bold Font
Interviewee: Standard Font
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Hello. Thank you for talking to me.
Sure. Well, I have a practice with offices in Liberty and Richmond, Missouri. My group name is Life Recovery Consulting. I specialize in trauma, addictions, and autism, but it’s really the dissociative, and personality disorders that kind of rocked my world.
They can rock some worlds, for sure. [Laughs]
[Laughs] Yeah. I have an LPC in the state of Missouri, and a masters degree in Mental Health Counseling.
I know that because you focus on trauma so well, that you notice it in different ways, even with people who don’t necessarily come to therapy originally for trauma, that they’re aware of. But that it impacts -- it impacts everything. You even talked in your podcast about how autism has its own trauma, as far as the experience of being autistic, and in a world that is sort of overstimulating.
Right. And the interesting thing is that it shapes the brain nearly exactly the same way.
It’s fascinating to me for several reasons. One is just personal, because I have two sons with autism.
Mmhmm.
And two, I actually know a lot of survivors, who have also been diagnosed with autism.
I think it often gets misdiagnosed, and that’s exactly why. Because the brain gets shaped -- in fact, I did a training with KVC Hospitals, their psychiatric staff, The Children’s Hospital at Prairie Ridge. I went out there to train their staff on how do you know when it’s trauma and when it’s autism, because it is often misdiagnosed. I’ve had more than one patient come to me diagnosed with autism, and what they really had was trauma. Right?
Wow.
I’ve had cases of individuals who were trafficked from very early on, from the age of two to 14, and were diagnosed with autism, and it wasn’t autism. It was trauma. Right? But trauma makes you hypervigilant to your environment, in the same way that autism makes all the sensory stuff magnified. Right?
Wow.
So, it looks like it, because -- I had someone call me one time, and say, “I think my grandson has autism.” And I said, “Well, what makes you think that?” And she said, “Well, he startles very easily. He can’t seem to filter out different noises in the environment. And if someone unexpectedly touches him, he goes into complete meltdown.” And I said, “Do you mind my asking why your grandson’s living with you?” “Oh, because his mother was an abusive drug addict.”
Oh, there you go.
And I said, “Well, that doesn’t sound like autism to me. It sounds like trauma, but it’s going to play out very much the same way.” You know?
Yes. So, how would you define trauma?
Well, I think there -- the mistake that’s made is that when people think about trauma, they think about the big T trauma’s, like rape, or war, or a car crash, or a natural disaster, and those are just big T trauma’s. Right? What we’ve learned in the past decade is that the little t traumas, the little things like not being able to feel safe in your environment 24 hours a day, even though you’re not, at that moment, under assault. Being followed around and criticised all of the time. Right? Being bullied in school. These are little t traumas. But they are just as effective as the big T traumas, even more so.
I compare it, with my patients, to the Colorado River. In Rocky Mountain National Park, on the west side of the park, is the headwaters of the Colorado River. At that point -- I fly fished it many times -- you can stand in the river, and wade across, and not get much deeper than your knees. And it’s only about 20 or 30 feet across. But 600 miles later, it carves out the Grand Canyon.
Wow.
Those are little t traumas. Right? They don’t seem like much, but that trickle effect adds up, and it shapes the brain in a nervous, traumatized way. So, you end up with people who are hyperreactive. Little t trauma is the patient who told me, “I remember staying awake at night to listen for my father to come in, because he would always come in between 12:00 and 2:00. I could tell by his footsteps he was drunk, and that told me whether or not I need to hide my little sister under the bed to protect her.” Right? Your entire childhood, staying up, listening for the footsteps, would indicate things were going to get really terrible for you. Right? That’s little t trauma.
That counts as little t trauma?
Yeah, absolutely. So, it’s kind of like -- think of it as a slot machine. Right? Slot machines are very addictive, because they’re on what they’re called a variable ratio enforcement plan. Right? You don’t know how much is going to fall out, or what’s going to fall out, but you know it’s coming. So, you keep pushing those buttons, and waiting for it to come. Right? That’s an extremely addictive process in the brain.
In the same way, the brain becomes addicted to the negativity, and the anxiety created by not knowing if dad’s going to come home drunk tonight. Do I need to hide my sister? Knowing it will eventually happen again, just not knowing if this is the night. Right?
I’m sorry. I’m trying to process all this.
Yeah.
Because it’s so intense. I had never thought of that as little trauma, like little t trauma.
Yeah. Those are little t traumas. Right? And they have a profound effect. I can’t tell you how many patients I’ve had tell me, “I would rather my father just kept his mouth shut, and just hit me.” Because it was the criticism and the shame that wilted me. Now, that is not to discount some of the horrible trauma that some of my patients have been through. And in the case of DID, this is often the worst trauma. That’s why the personality structure splits.
Well, I’m just -- I don’t mean to be so unresponsive. You just have really --
No.
-- blown my mind with this, because if those are things that count as little trauma --
Yeah.
-- and it impacts you so intensely. When you add up a lot of little traumas, plus big things, like with DID, no wonder there’s a Grand Canyon feeling.
Right. That’s how we get complex trauma. Right? It’s one on top of the other, on top of the other, on top of the other. Right? What we know about Veterans, who come home is, the ones who were supported in childhood, and learned from their parent’s resiliency, and how to come back from hardship, and they knew they were loved and supported, come back with PTSD at a much lower rate, than the individuals who suffered childhood trauma. Because they did not learn resiliency, and they had all this trauma built up already. So, they go into combat and come back unable to then handle that trauma, and the complex trauma that follows, and they begin having PTSD. In many cases, they already had it before they went off into combat. It just made it worse.
Wow. So -- oh my goodness. I’m processing. I’m sorry.
Sure.
I’m really not. [Laughs] This just feels so big. So, when a person is triggered with something, or when something happens that’s just neutral in the environment, it brings to context, even just normal things. So, when you talk about being in an environment where a person is actually safe, but there’s a loud noise, or something that triggers them, or like when you’re trying to do the hard work of therapy, and someone comes into therapy to work on things, it really does feel like too much, because it’s all stacked up like that.
Well, and that’s why my job as a therapist is to keep you integrated. Right? And by that, I mean, when trauma occurs, your brain cannot process it all at once. It short-circuits. The amygdala takes over for your own safety. And when the amygdala takes over, and that trauma can overwhelm your hippocampus, which is responsible for forming those memories, so they don’t form correctly. So, the only thing that gets formed is the memory that is, gets stored in your body, as physical sensations, emotions, things like that. But you never get the time stamp you would have on it, if it were stored in your prefrontal cortex, the way it should be, the top part of your brain. Right?
Right.
And so that’s what PTSD is, is something triggers it, and it comes back, and I feel it happening again. And all of the sudden, it’s happening again. And that pushes then the dissociation button. So, as a therapist, I watch very closely for my patients -- they all have signals that they give, when they dissociate. A lot of them will -- their eyes will shift to one place. Right? Right before they leave the room, mentally. And so my job is to try and keep them integrated, and keep that prefrontal cortex active, so that then they can process memory, and take the power out of it. And then it’s a memory, and not a reliving experience. Right?
You mean the present experience, and the memory integrated?
Yeah. So, now, when I think about this car wreck that happened in my past, I think Oh, that was horrible. But I remember it as a past event, and I don’t feel it happening again in my body. I don’t feel my body tense up, and the panic, and the “oh my god.” That kind of thing. Pat Ogden talks a lot about this in her book, Sensorimotor Psychotherapy. And one of the things she says that I think is really, really true is if you’re not careful -- it’s not important for every client to relive every experience, or talk about every experience. It’s important to teach them how to handle those memories as they come up. But sometimes, if we push too hard, people dissociate in the room, and then what we’ve done is retraumatize them. Because they’ve reexperienced it without reprocessing it. You see what I’m saying?
And so, because it really is -- when the patient begins to recall these things, it really can be like living through it again. It can feel that way. And so, we want to prevent that. We don’t want you to dissociate into a space where you’re reliving it. What we would rather do is keep you integrated, so that you can process it in the way it was supposed to be processed the first time, and then kind of take the power out of it. It doesn’t mean you’ll ever forget what happened. It means that when you think about it, it will be more like, Oh, yeah. That sucked.”Then it will create -- instead of creating a panic attack.
So, how do we, as clinicians, help someone stay present enough to remember something, when their brain has split it up into different parts, or by [inaudible]?
I use mindfulness a lot for that. And I start with that. Before we ever dig into what happened when, we dig into mindfulness practice. Right? Especially the body scan stuff, to start with. So, body scan -- what that does -- and you know Besser van der Kolk kind of wrote the book on PTSD. He wrote ‘The Body Keep the Score’, where he talks all about this stuff. And he recommends mindfulness and yoga, because in both cases, what this does is it reconnects the mind to the body. So much of what happens during really horrible traumas is, and dissociation is, that I separate my mind and my body.
Right.
I go on mental vacation somewhere. I’ve had multiple patients tell me it was like they were watching this happen to them from somewhere else in the room.
Right.
Right. Because mentally they’ve dissociated from what’s going on. But what happens then is you’ll see people with -- if it was autism, we would call them proprioceptive issues. So, they have a lowered, kind of, awareness of where their body stops, and the rest of the world starts. So, they bump into walls a lot. They seem very clumsy. They may not feel comfortable in their body. They may dissociate from their body a lot. Right?
So, that mindfulness and yoga both, are both tools that we can use to reintegrate the mind and body, so that when we start this work, we’re very aware of what’s going on in our body, what those feelings are, and we’ve learned how to manage them with breathing, and with the self soothing that we do during those exercises.
The other thing I do is I teach what are called grounding exercises. Right? So, one of the basic ones I use is -- I call it “the three things.” A lot of people call it “the five senses.” But I just use three deep breaths, in and out. And then I ask the patient to look around the room, and tell me three things they see. And then two or three more deep breaths, and then look around you, and listen for three things you can hear. And then two or three more deep breaths. What this does is -- it’s impossible for your brain to focus on the here and now, and what happened in the past, or what might happen in the future. It can only be located in one place in time and space. And so, if I can use that exercise to force them back to the here and now, then I can let go of that anxiety. You see what I’m saying?
Yeah.
That seems to work in the moment, pretty well, with my patients who have panic and anxiety attacks. And then I pretty much push for a daily practice of two or three times a day, for this body scan, mindfulness exercise to begin with. So, we reintegrate.
And then we go onto more exercises, like creating a safe space. Right? One that you, just in your head, whether it’s in the woods, or it’s at the beach, or whatever it is - creating a safe space for me, so that I can use that during my mindfulness meditations. Right?
So, there are a number of things that I use in the office, but the idea is to keep people integrated, and feeling safe. Because as long as they’re in that mindful space, the mind and body are connected.
How are they able to be in now time, and process things from memory time, if they can only be in one?
So, what I mean by that is that -- because I can think about what happened to me, as a memory, but still be aware I’m in this space. Right? But what’s happening when I have a flashback, or my PTSD is triggered, is that all of me is back in that space. My entire brain is back in that space.
Is that why it’s so overwhelming?
That is exactly why it’s overwhelming, because you’re reliving that experience.
Oh, wow.
Right?
How do you teach that to different Parts of a DID system?
It’s the same. The interesting thing is, is that different Parts of the DID system may have different disorders. And so how I teach that is less dependent on what Part of the system showed up than what disorder I might be dealing with right now.
What do you mean? Tell me more about that.
Um… .
About them having different disorders.
I’ve had disorders that were extremely OCD, and I might want to go about explaining the exercise differently to that person, that client who was OCD, than I did with someone who had Borderline Personality, for instance. Right? Directions for someone who has OCD might need to be very clear, and very structured. Where I would be worried more, with a borderline patient, about making sure they felt validated in that space, that they knew I was on their team, not giving them indication that they needed to be afraid of, or suspect me at all.
So, are you talking about comorbidity? Or are you talking about different things?
It’s interesting, because it is, kind of, comorbidity, except that one personality may not have this expression of OCD at all, while the other one does. And so, is that really comorbid? Not to the individual personality structures. Right?
Right.
So, DID, it’s just dealing with who comes in and sits in front of you, that day, every day.
How do you explain DID, either to your patients, or to your classes?
I explain it the same, pretty much - a couple of ways. First, I start by saying all of us have different personality structures. Right? It’s just that the “neurotypical” individual integrates that very well. I’m not the same on this podcast, as I am talking to my peers, or other therapists or PhD’s in neuroscience, or -- I’m very different there. I’m much more geeky. Right? And I’m not the same there, as I am when I’m out fishing with my kids. You know? Or hunting with my son. That part of me, I call Hillbilly Bob. Right?
[Laughs]
And I enjoy it. But it’s not at all the same type of person in those situations. I’m not the same with my students, as I am with any of those other places. Right? But all of these sides of my personality integrate very well. I understand them all. The difference is, had I suffered an immense amount of trauma, early in childhood, it’s like having a glass sphere with all these parts that fit together. That trauma takes a hammer to that sphere. And then all those integrated parts end up separate, and each one holds a different trauma, or a different pain. Because if they had stayed together, it would have been so overwhelming, they probably would not have survived it.
Wow.
I see it really as the highest form of survival skill. Right? I say to my patients all the time, with DID, “You don’t understand. Most people don’t survive what you went through.” Most of them die in the process, or they end up drug addicts and OD, from the trauma.
That’s true.
But, you know, interestingly, very few of my DID patients suffer from substance use.
Right.
Right? Because they found this other way to cope with that trauma, and separate from it. So, numbing it out, interestingly enough, is less necessary.
They don’t need to use substances to dissociate.
They don’t need to numb it out. Right. They can just dissociate from it. It creates other kinds of problems in their lives. Right?
Right.
This is why we call it a disorder, because it disrupts their daily living in significant ways.
Hmm.
But, it’s actually a very unique, and specialized survival skill.
How do you connect -- or, what is -- let me rephrase my question. How do you teach someone who’s already good at dissociating, mindfulness? And when does that help and when does that [crosstalk] [inaudible]?
You work really hard to keep them in the room, and you go very, very slowly, especially if they’ve had significant sexual traumas. I find that connecting to your body, when you have such horrible body memories, can be very hard. So, you go very, very slowly. You have to be patient with people, and understand that no one comes into your office without wanting to get better. Right?
And so, while you may meet resistance, and they may have defense mechanisms, they came there to be helped. And so, you have to start with that, and just keep slowing down, and keep changing your methods, if they aren’t working. Right?
An example of someone with Schizophrenia, who is also blind, and so their hallucinations are tactile. So, the last thing I want to do with that individual is say to them that we want to just notice the sensations in our body. That will trigger hallucinations, often. So, we have to go about it a different way.
Right.
Right?
That makes sense. That makes sense.
So, it just depends on, like I said, whoever comes in the room that day, we adjust to that.
How did you first learn about DID?
I’ve been pretty fascinated with trauma since my own started. So, it just was kind of along the way. I don’t even remember where I first heard about it. I was probably a teenager, and I’m in my mid-fifties now. So, it’s been so long.
What really began my fascination with it, as a disorder, from a professional perspective was, I really found out I had a knack for dealing with trauma, and really found out that it really kind of rocked my world to be able to do that. I have very hard days at work. I never had bad days at work. You know? I have to work very hard to make sure I put a stop to my day, and go home, and be with my family. Right? And separate those two, because I really, really enjoy what I do.
How do your students, in these days, how do they understand, or receive DID?
I haven’t taught a lot of students. Mostly, what I teach is the addictions course.
Oh, okay.
But, we do talk about it, and just exactly the way I told you, I use the sphere that’s kind of crystalline, and how that most of us are integrated in that sphere, but the trauma takes a hammer to it, and so the personality is split off. There are some core structures that we see in every individual that’s almost always a protector. Right?
Mmhmm.
They are almost always often children, that represent the trauma that happened at those various ages. Right? I’m finding it very common to have someone who handles the sexuality and promiscuous side of the individual. Right? And these are all structures that are there, very commonly. So, even though someone may have only six, or dozens, often they fall into those categories. It seems to me.
Interesting. So, sort of different roles in that protection, and what [crosstalk] [inaudible].
Yeah, and I think they follow, very closely, the developmental stages. Right? So, the young ones are holding the trauma that happened when I was young. And the teenagers are holding the trauma that happened when I am a teenager. And the adults are the functional adult that I never had, that I can develop to help protect me, that kind of thing.
What resources are there for clinicians, who want to learn more about how to help people with DID?
There are a couple of good books. So, one of the books that I use a lot is called, ‘Coping with Trauma-Related Dissociations.’ It’s skills training for patients and therapists. That’s a pretty good book, and I’ve had patients that have really enjoyed that too.
The workbook?
Huh?
The workbook?
No, it’s just a book. It’s kind of expensive. It’s like $45. It’s very thick. It’s skills training. It does have specific exercises in it, but it’s more than just a workbook.
By Kathy Steele, and them? That group?
Suzette Boon, is the writer.
Oh, yeah, yeah, yeah, yeah.
Yeah. And then, there’s a really good book by Deborah Haddock, called ‘The Dissociative Identity Disorder Sourcebook.’ And she does a pretty good job of explaining what it is, and how it happens. But there are a lot of good books out there on DID now. It’s becoming more understood.
I’m always surprised, though, when I run into people who are clinicians -- I will use that title loosely. And I ran into someone just a couple years ago who was like, “I still don’t believe DID exists.” And I’m like well, it’s in the DSM, so I don’t know what else to tell you. You know? [Laughs]
[Laughs] Right.
Because you’re having a hard time handling it from a cognitive level does not mean it doesn’t exist.
Right.
Right? That’s your issue, not your patient's issue. Please God, just refer these people out. Right? [Laughs]
Right. Right.
So… .
And what about your podcast? How did you get started doing your podcast?
I haven’t done episodes in a long time on that, because there’s been so much going on in my life outside of work, that I really haven’t had time for it. I hope to get back to it soon. But essentially, I got involved with -- I just started thinking about -- I’ve survived trauma. I’ve survived addiction, and now I have this degree which gives me the knowledge I need to to treat other people. I think I would like to share that.
And then I came across Melvyn Markeys, who was starting a group called Healthcasters, for people who wanted to start -- for therapists who wanted to start a podcast. And, it just kind of took off from there. I joined his group, and won a drawing that he was doing. So, he sent me a brand new, super microphone set, to get started with. And that was it. It took off from there. And even though I haven’t -- I kind of stopped developing at about a 120,000 downloads. But, since then, over the past year, I’m up to over a quarter of a million downloads, in about 90 countries.
So, it’s hit the mark with a lot of people. So, I really want to go back to it. But, I just have not had time.
You talk more about the mindfulness, and even do some relaxation exercises, and there are several things that I think would be useful for our listeners to hear, even if they are replaying it, and replaying it, and replaying it.
Right. Yeah well, some of the exercises I do on there, are ones that you can use over, and over, and over again. I do one, kind of an inner-child exercise, on there, that honestly, I stole from John Bradshaw, and I give him credit in the episode, too, I believe. He was brilliant. But, it’s basically envisioning your child, or this child in front of you.
We create the safe space first, and then we move into these other visualizations. And one of them is sitting in your space, safe space, and being approached by a child. Right? And what would you say to that child? What does that child need to hear, that you never got to hear? Things like, “I’m really glad you’re in my life”, “I love you unconditionally”, “You’re perfect the way you are.” Right? “You’re safe here.”
These things are things that needed to be said to a child, that never were. And so. We kind of recreate that experience. And yeah, that’s one that gets used over and over again by patients.
That’s really powerful.
It is. It tends to be an extremely powerful experience. I know in about 1989, 1990, I took a workshop with John Bradshaw, and I tell people it literally saved my life.
Wow.
So, and it was all that inner-child work. His book, ‘Homecoming’, and his book, ‘Healing the Shame That Binds You”, these are really powerful, powerful books. They’re not easy, but they’re really, really powerful.
How does some of the things we learn from shame theory, like even attunement, or misattunement, and shame itself, his work, Patricia DeYoung’s work, even at a surface level, some Brene Brown stuff is popular -- I know her show has just come out. But, how does that change some of the brain structure, or process, for people who have been through trauma?
Well, essentially it is a trauma. Right? To be told that you’re worthless, that you don’t have value, to be treated like an object. Right? I mean, the trauma is what drives that sense. Right? My parents treat me like an object, because I don’t have value. Children internalize that. They don’t have the ability, because their brain has not developed yet to think rationally about this situation, and realize, no, my parents are just really broken people.
And so, what must be broken then, is me. Right? Children internalize everything. This is why divorce is so hard on children. If I’d have been a better kid, my mom and dad would have gotten along, and they wouldn’t have divorced. Because they don’t have the capacity to think logically, to really mull the situation over from various angles. All they know is, it’s personal. It’s always personal.
This is why bullying is such a horrible thing, too. It’s always personal. Right?
Wow.
Right? It’s got to be about me. There has to be something broken. So, we end up with the young woman who’s watched her father abuse her mother, and abuse her repeatedly, and she becomes convinced with the new spouse that if she can just figure out what is wrong with her, she’ll be able to be enough for him to change, just like with her dad.
Oh, wow.
Right?
So, the cycle repeating itself?
Exactly, because that child inside is still convinced that there’s something broken in them, that is creating this situation.
Hmm.
And that’s the driver of the shame. I can’t figure it out. I’m ashamed, because it’s obviously something that’s so wrong with me, because I can’t even see it.
So --
When the truth is, it was never wrong with you, in the first place. Right? We’re -- I tell my patients all the time, “We are all broken. That’s where we need to start.” But brokenness is not a bad thing. Pain is a guaranteed part of life. Suffering is a choice. I choose suffering when I try and avoid pain. It doesn’t mean I go looking for it. It just means that I’m not going to pick up a needle full of heroin to numb it out anymore. I’m going to welcome it in, and learn what I can from it, while it’s here.
So, if some of what’s traumatic in our experience is trying to avoid our own shame, how do we face it? How do we not use heroin, or not dissociate, or --
I think we have to start with, and again, I use mindfulness for this, we have to create a holding space in people, where they can sit with the little pieces first, and then the bigger pieces later. And develop resilience, develop the ability to sit through the uncomfortableness, and say, “Ah, okay. I made it. I made it. Now the next time it happens, I’ll know I can make it.” Right? Even if it’s more intense.
I like to tell them that brokenness is not your enemy. It’s actually what makes you beautiful. I have this big poster I made on my wall, in my Richmond office, that says, “Our beauty is birthed in our brokenness.”
I don’t know if you’ve ever seen Kintsugi pottery or not?
Yes, I love this story. Tell the story.
Yeah. It’s a Japanese form of pottery, and they will make a pot that is pretty much perfect, and then they will take a hammer and carefully break it. And the reason they break it, is because they understand this fundamental truth of our brokenness is what makes us beautiful. Because when they put it back together, they seal it with gold. And now, you have this beautiful pot that has these gold seams through it, and it’s even more beautiful than it was when it started. And that’s what I’m trying to explain to people. Right?
That it is painful being broken apart, and we don’t like it very much. But if we numb it out, we never get to the beauty part. We just stay in the middle of it. It’s kind of like -- I also compare it to my kids and I, we had a deal where if you can teach me something I don’t already know, then that’s worth $5, because I want to teach you that education should be valuable, and I want you to know that it is valuable to me.
Now, I had to limit that, because Google exists, and they’d have broken the bank in a week, if I hadn’t limited it to a certain amount. Right?
[Laughs]
But one of the most interesting things that I ever learned from my daughter was how butterflies actually form. It’s not just the caterpillar crawls into the cocoon, and pop goes the weasel, out comes the butterfly. They actually melt while they’re in the cocoon. They turn into a liquid goo, all but a few neurons, that tell them what they’re going to be when they reshape. And I tell my clients that you’re getting ready to go through that melting process. But if you have the courage to stick with it, you’re going to get wings. Right? It’s very, very -- it’s not fun. I tell people right up front, some weeks it’s going to feel like these sessions have stripped all the skin off your body, and you don’t want to be touched, or talked to, or see any light. You just want to hide in a hole somewhere. You have to be able to sit through that space, and you have to do it with the faith that your wings will come.
You’ve given me so many visuals today.
Yeah, I like using visualizations a lot.
It’s strong in the presentation on your podcast as well, the different interviews you’ve done, and different things you’ve done. There’s a lot of really good information for practicing some of those skills.
I think I just tend to be a story, visual thinker. You know?
That’s actually where I heard you first. It was not even on your podcast. I had to look up your podcast, and found it, because I was listening to a different podcast you were on about storytelling, and connection.
Oh, was that on Connectfulness, or?
Yes!
Yeah.
I am trying to remember the name.
With Rebecca Wong?
Yes.
Yeah. Yeah, she’s got an awesome podcast. Yeah.
Is there anything else you can think of, that you would want someone with DID, or someone who treats DID, to know or understand, or open, or anything you would want to add?
I really want to get the point across to survivors that they’re not a freak. Right? What I hate more than anything is, even the A&E shows that have come out about DID, right, even though they’re a little more accurate about it, and they’re documentary type things, they add all this suspenseful dramatic, Hollywood music in. Right?
Mmhmm.
And the whole point is just their mystifying it, or making it more exciting for the public. But all that does is it pushes the side joke, kind of, persona, on this disorder. You know?
Right.
And I want people with DID to understand that what you’re going through is really a miraculous coping device that most of us could never have developed. And while it’s affecting your life in some very adverse ways, it can be manageable, and it’s the reason you’re still alive. Right?
But it’s also okay to come out of the cocoon.
Oh, absolutely. Yeah. I mean, the thing is, at one time, that was needed to survive. Hopefully, it’s not anymore. Hopefully, we’re in a place where we’re safe enough where we don’t need to dissociate anymore just to get through the day. And if we’re still in that place, then we need to be talking with our therapist about how do I extricate myself from that. Right?
How do you do that, as far as breaking the habit of it, when it’s such a default mode? That feels so parallel to the addiction process, even though it’s a different thing.
It’s kind of the same as you do with anyone really, whether they have DID or not. Again, I’m meeting the person who comes in the room. So, I’m leading with, “What do you want from your life?” Right? And then, if they’re in an abusive relationship, kind of gently bringing them to that realization, “Well, how do you feel when he says those things to you?” Right? “Do you think someone should make someone else feel that way?” You know? “Is that what a relationship is for you?” So, kind of, in a gentle way, challenging these spaces for them.
So that, then maybe, they’ll have the courage to break that. Often, what I see is that the real damage is to the ability to connect at all.
You mean in an attachment kind of way?
Yeah. They don’t trust connection, with anyone, at all. So, this is why DID patients are often diagnosed with borderline, or bipolar disorders. You know? Because it’s very hard to trust attachment at all. There’s a very reactive attachment there. And what I have found really, really helpful in that space, is animals, especially if I can get people out volunteering with animals somewhere, so that the real point is to take care of the animals, but they’re bumping into other people too. And they’re bumping into other people who also like other animals. So, they’re bumping into other people who seem a little safer, and then we’re able to start connections that way. You see what I’m saying?
That’s powerful.
Yeah. It’s worked. It’s been a healthy way to do it. Right?
It’s a way to practice that safe, and without other motivations, and also reflecting their own experience. Even they talk about equine therapy, or other connections with animals -- that makes sense what you’re saying.
Absolutely. Well, because mammals especially, dogs, horses, they produce the same chemical that we do, when there’s connection - oxytocin. Right?
Oh, wow. I didn’t know that.
Yeah, and so they are socially bonding creatures, also. Yeah, in mammals, oxytocin is produced when there is breastfeeding, and when the mother is taking care of child. It’s a bonding thing. Right? Bruce Perry talks about it in one of his books, and he says that it’s really the drug that keeps us here, as a species, because the first six months, we tend to forget that this thing is just a screaming poop bag. And so, we don’t leave it in the woods. You know?
And we see it as -- we look at its face, and sure, it’s just a screaming mess, but we go, “Oh, isn’t he cute?” And the oxytocin flows, and then we want to keep him around. Right? And it’s developed in mammals heavily. From the research I’ve read, not so much in cats, which kind of reinforces my view of cats, that they are mostly sociopaths.
[Laughs]
That they’re mostly sociopaths with fur. So… .
That’s funny. [Laughs] I’m normally much more interactive, but you have given me so much to think about from a different perspective. It is all just processing, and --
Good.
And there’s a lot there. So, I appreciate that.
Good. And you know, I mean, there are clinicians who may disagree with me. That’s fine too. I’m not always right, but this is what has worked for me thus far. So… .
How do you notice when a client is starting to be able to attach differently, and able to connect, and what does that look like when they start coming out of the cocoon?
They become less reactive to those attempted connections by others. They start reaching out a little more on their own, without then recoiling with the reactivity. Their reactivity level goes down. Right?
It’s this -- in Borderline Personality, and well, anxious attachments, this often looks like, “I love you. Get away from me.” Right?
Right. Right.
And so, that starts to lessen. And they start seeing the person as other, and as potential. Right?
Not just trusting the moment, but also trusting that that moment’s going to continue.
Or that even if it doesn’t, I can survive it. Right? So, the problem we run into, is that pain, again, is a guarantee in life. Nothing lasts forever - not friendships, not human beings, none of it. So, eventually, every connection we make is going to come to an end. And that’s something we have to work through too. We have to be able to trust that we can survive that ending. Right? And so, often, I will have people who have attached to the animals, and the animal dies.
And my own daughter -- we had a therapy lab, that I had trained, that he lived to be about 15 years old. And she’s -- we’re both broken up, sitting on the couch talking about it, and her question is, “Why does this crap have to happen?” You know? And I said, “You know, if I could reach inside your head, and take all the pain away that this has caused, but it also means taking away every memory of Hank away, would that be okay?” No. Right?
Some things are worth the pain. Connection is one of them. And if it lasted forever, we would just take it for granted anyway.
Right. So, that’s part of the attachment issue, because when there’s only pain, but it’s not worth it, --
Exactly.
Then you’re resistant to attachment. But when --
Well, it’s not worth it, or it seems unending. Right?
Right.
I love this -- I’m a big Winnie the Pooh fan. And there’s a meme going around out there, of Winne the Pooh and Piglet, sitting on a dock. And Piglet says, “You know, Pooh, some day, we’ll all die.” And Pooh says, “Yes, we will. But every other day, we shall not.” Don’t be so afraid of the day that you will, that you give up on the ones you're not.
It would be like -- I mean, once you do the work of coming out of the cocoon, and you’re going to have wings, then you still want to fly.
Yeah. There’s no going back. You know, Rumi, in one of his poems, said something just like that. I can’t remember the exact wording, but essentially, it was him asking the reader, why would you want to crawl, when you have wings? So… .
So, healing is progressive?
Yeah, absolutely. There’s no going back once you’ve overcome that next step. There’s really no going back, because you want more. Right? Because we all want to be better. We all want to -- it’s fundamental in us. Our brain is designed for connection. Disorder of the brain happens when we lack connection. Real healing from addiction doesn't come from just getting clean and staying clean. It comes from getting clean, and staying clean, and making healthy connections in the progress. The real power of 12 step meetings was never that I sit here, and somebody shows me the way to get clean. The real power of 12 step programs is I can sit in a group of people, and tell them how broken I am. Instead of them shaming me, they’re going to say, “I get it. I’ve been there.” And then connection can happen. Right?
Real recovery happens not because I’ve been clean five years, but because I’ve built a life in that time that I don’t want to give up anymore.
So, connection heals shame --
Absolutely.
And it’s healing, because the trauma of the past was disconnection, and was pain without it being worth it --
Exactly.
But in order to bring healing, you have connection in that safe [cross talk] [inaudible]
Healthy connection is the light that dispels all darkness, whether it’s shame, or trauma, whatever. Healthy connection is the light that heals all of that.
In that podcast you were on, with those girls, they said that light never makes darkness darker.
Right. Here’s the flipside. Right? It is only the darkness in life that makes the light important. Right? That doesn’t mean I seek out pain, but the purpose of pain is that it makes connection important. It shows me the value in life.
I think that’s true of anything. I think that’s why we seek out spouses, and why we have children. And the things that we learn from those experiences, that really are so hard and awful at times [laughs] --
Oh, man.
But there are things we would learn from being married, or from having children, that we would not learn in any other setting.
Years ago, 20 years ago, I used to do parent education, and deal with mentoring kids who had significant trauma, and things like this. So, by the time I got married, 12 years ago, and inherited two kids in the process, I thought, Wow, I’ve got all the answers down already. How great.
[Laughs]
Took about a week to realize that wasn’t true.
Right.
Right?
So, the connection really matters? Connection is everything.
Yes. It’s everything. It’s fundamental.
Is that --
I know people who will go to their graves having never been able to make a healthy connection, always having that attachment problem, and never able to face it. And for me, that is the saddest thing to see.
So, is this --
Right?
Yeah, it’s terrible, and it leaves you alone in everything that was awful.
Yeah, it does.
So, is that why when you make connections, that are healthy, and safe, and appropriate, and healing, healing happens so quickly, and yet it’s so solid? You can hold onto it longer, and longer, and better, and it just becomes who you are.
Yeah.
Instead of what the trauma was before.
At a certain point in our recovery, we stop being afraid, and we start seeking out healthy connection, and we become more, and more adept at questioning ourselves about, am I ignoring red flags. Am I seeking connection out of my trauma, or out of my health? Right?
That’s beautiful.
It’s sticky, but it’s definitely worth the journey.
That’s so powerful. Thank --
Here’s a big secret about therapy.
Okay, I’m ready.
We talk about modalities, like psychodynamic therapy, or cognitive behavioral, or dialectical behavioral therapy -- do you know which model is the most effective? None of them. None of them matter nearly as much as connection. All of the research says, and about 80% of what works in that room is if you are able to connect, with your client, and make them feel that they are in a safe space. Pick your model then.
So, that’s why it’s so important to be a healthy therapist --
I think, you know --
And doing your own work. It’s so important for you [inaudible crosstalk].
It’s important to do your own work. You don’t have to be fixed. I would never have started if I had to be fixed. Right?
Right.
But I think that’s a lot of the fear of therapists going in, is they’re like, “I’m just not good enough myself yet, to help someone along the path.” You don’t have to be. You have to be -- you should be fearless about approaching your broken spaces. Right? I will say courageous, and not fearless, because we all feel fear. But you have to be courageous about diving into your own broken spaces. Right? At a minimum. I have to be able to look at them, for what they really are, because I may have a client come in, whose issues are pulling at strings that is going to just make me really ineffective for them. And so, I need to refer that patient out, and then I need to do my own work on that space. We’re never done.
Right.
We’re never finished. We’re never perfected.
That’s why, too, it’s such a disaster when you get a therapist that isn’t a good match, or there’s not a good connection.
Man, that can be such a mess. Or a therapist who has their own attachment issues, and ends up sleeping with their client.
Oh, yikes. Yeah.
I mean, that can be such a mess. You know? Countertransference is a very big, and real deal in the therapy office. Right? Countertransference is the client is projecting emotion, and ascribing motivation to me, and on me. And how am I going to react to that? Right? The client comes in, and they say they’re really disappointed with the last session, and suddenly I’m blowing up at them, because the counter-transference is, they sound too much like my mom. Right? So, we have to be very careful of those spaces, and watch them, especially with things like DID, especially where the really significant traumas are.
Because people that come into your office with significant trauma histories are coming into your office with an entire bag of hurts, and you really want to be careful not to add to those.
But then, for the client, that same thing applies, as far as, rather than -- like, you have a negative experience with a therapist. If it’s not an unsafe thing, like staying in therapy, and working through that, or when it really is a connection issue, or a safety issue. Rather than quitting therapy altogether, continuing to find, like seek out, until you find a good therapist.
Right. Right. Or maybe just bring it out in the open, and discussing it with them what’s going on. The other thing you have is transference. Right? Often, as an older male, patients tend to put me in the father role. Now, I can use that to my advantage. Right? But, I have to get past that place where they are expecting me to judge them critically, or hurt them.
I’ve had plenty of clients with addiction issues, who had fathers who were hyper-critical of them. They never could get anything right - never said they were proud of them. Right? Just a constant barrage of criticisms. “Oh sure, you hit three homeruns in the ball game. But, you struck out twice.” Right? That kind of thing.
And so, they may begin projecting that energy on me. Right? Like, “I know I didn’t do my homework. I’m sure you’re disappointed.” Right? That kind of stuff. They may begin projecting how I handle it. That matters a great deal. I’ve seen clients just -- their chests puff out, because I would say, “You really handled that situation well. I’m really proud of you.” Right?
Wow.
And it’s the first time they’ve ever had a father image say that to them.
So, using what was hard, for good?
Yeah. Basically. Rewriting -- being that corrective experience, in the room, in that way. Right?
And, for therapists who have had their own traumas, the same thing, if they’re being healthy, and have good support, and good connections, and doing it well - being able to use their trauma for use.
Yeah, absolutely. I’m not saying you can’t treat addictions if you haven’t been an addict, but I am saying that at times, it really helps my patients, when I can look at them, and describe craving on a gut level, and they know I get what they’re going through.
Right.
Right?
That makes sense.
I don’t think you have had to of had a broken leg for a doctor to be able to set a broken leg. But, I think it makes the doctor more empathic when he’s doing that, if he has.
So, a therapist using appropriate self-disclosure, not necessarily in detail, but an expression of “I understand your experience of where you’re at.”
Yeah. I think the difference is this -- it’s very simple. Am I saying this, because I need to say this, or am I saying this, because I feel my client needs to hear this?
Well, and I think that using it in a connecting way, and to --
Right.
Connect with someone who struggles with connection, makes you -- it adds vulnerability, which opens up the opportunity for healing.
Right.
Because they can connect with you as a human. Whereas, it’s more difficult to connect when you’re just a flat person sitting in the chair.
I lead therapy groups, and the interesting thing is, everybody wants to joke around when it comes to the really heavy, serious stuff, like when were you bullied in school, or how has trauma affected you? And they kind of want to make jokes, and be surface-y about all of it, until one person in the group opens up, and says, “This is how I was hurt.” And then everybody else comes behind them, and supports them. And then, they all start to open up.
Right.
It just takes that one courageous act in the group to really open that space.
That’s so beautiful. Thank you for talking to me today.
Sure. Thanks for having me on.
Thank you so much! I really appreciate it.
Sure enough.
[Break]
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