Transcript: Episode 27
Guest: Susan Pease Banitt, LCSW
[Short piano piece is played, lasting about 20 seconds]
Hello, this is Dr. E and I have an interview to share with you today, but before I share the actual interview you have to listen to this excerpt from the conversation I had with our guest before the interview. It was very powerful for me and something I need to talk about with the therapist, but I want to share it here first. Listen.
[No sound for approximately ten seconds]
***Excerpt Begins***
Interviewer: Bold Font
Interviewee: Standard font
Hello.
Hi, Emma.
The audience really is a lot of therapists, also trauma clients, both specifically dissociative clients and people working with dissociative disorders.
Okay, and then what region of the country do you get most of your listeners from?
It’s actually pretty global. It started out just as a small kind of learning process thing and really took off. Word spread which was completely unexpected for me. So, that’s my own issue [chuckles] I’m having to process. But, there’s people from… I mean, a lot of people from Canada and the United States, but then also we have regular listeners from Nepal and Japan and Argentina and Brazil, the Netherlands and Sweden. It’s gone crazy.
I first heard you speak on another podcast and I only heard a snippet, because I was with someone else and we were driving, but you were sharing in your background that originally… or at the beginning at some point you had worked with kids with autism. And, I have a son who’s autisitic and so I was like, what?
Oh.
So, I went and found you and I found all this other stuff and it was like a treasure trove. So, thank you for your work.
Okay, nice. Okay, so I’m just reading here that you’re a DID Survivor. So, you really understand dissociation in a very intimate way, which is great actually.
***End of excerpt***
So, did you hear what happened? We started out talking about things about the audience and the podcast, which is very common when you’re preparing for an interview, but then she had found the podcast and noted that I was a survivor, which none of the other people I’ve interviewed have done. It really shook me up, because I was surprised. Not that it’s a secret, but that’s the first time it has ever been presented back to me professionally, mirrored back to me professionally. Even though this is not an office setting, I don’t even know how to respond, even now and it’s been several days.
But there are two things I want you to know and it’s one, I just need to be vulnerable and share about what a big moment this was for me. It was really my first experience ever. Even though it’s just on my own podcast, in this setting, sort of being out and direct about my own diagnosis. Immediately it left me in a very vulnerable state. It is a true statement and it is something that is real and it is something that I’ve worked a long time to grapple with. And, learning about it and educating about it and fighting stigma about it is part of the whole reason of this podcast. This was not a third hand, outside of myself, focusing on someone else or listening to other parts kind of experience. This was me specifically, Dr. E., having a conversation about my own DID experience. I mean, it was just a split second, but it was a powerful moment and significant. I will never forget this moment, but the second thing I want to point out, especially since recently we’ve been talking about attachment and shame theories and different perspectives on trauma and fighting stigma and healing. Because look what she did and how well she handled that in such a compassionate way. She did not at all shame me about it. What she said was that I was a survivor, that I understood dissociation in an intimate way, and she even used the word good. I have to tell you that moment, which wasn’t even a full second long, I can literally see it on the timeline, that moment that was not even a second long was like the opposite of shame. It was bigger than healing. It was an entire paradigm shift within myself that I could physically feel when it happened. I don’t even have better words to describe it than that. But, it was so significant I needed to include it on this podcast. Both so that I would hear it again so that others would listen and also so I could talk about it with my therapist.
Here’s the next piece of what happened when I had to respond to her. I stumbled a little bit, but I really wanted to own that part of myself and recognize the vulnerability and stay present with it instead of escaping it. And it was really hard for me actually and I was very shaky, but I did it, and I responded. And she stayed right there in that moment, and it helped me stay there in that moment. And it was just a powerful experience. So, listen to what happened next.
***Excerpt Begins***
Interviewer: Bold Font
Interviewee: Standard font
So, I can share more about that. I...yes, I am a survivor. I have my PhD and I was licensed and in private practice for 20 years and through several events that included the deaths of my parents, I sort of ended up falling apart basically. And struggled to find...this is one of the things I loved about what you wrote...I struggled to find a place to get help just with those issues before I even knew the rest of it.
Yeah.
Because I had either supervised every one or trained every one or knew that they were not safe to go to. And really struggled just to get help with just normal grief of my parents died and I want to talk to someone about it. And then everything sort of exploded from there. And so now, where I live, I actually have to drive four hours every week to see my therapist and that’s a good thing. It was worth the work to find her and worth the commitment to do that work. But, you really talk about this for any level of provider of needing to do some self-care and the whole healing.
I had a similar explosion of internal events in my forties, after I’d been in this business for a really long time, which I touched on a little bit in the introduction to Trauma Toolkit. So, it’s public knowledge that I’ve had PTSD, but it’s really shocking, isn’t it? And it really changes one's work, because you understand it so much better from this real place.
It’s true and understanding both sides of it, because then there was also...like I had been very pro-fighting the stigma against everything and then when this all happened inside of me or the discovery of what was going on and explaining so many pieces, but also at the same time, there was this automatic shame of I’m not supposed to be one of them. I’m supposed to be one of these people...I’m a provider and not a client. And it has really been a struggle, honestly.
Yes, which that’s part of my mission. You know? And I talk about that in the second book, help...there is no them and us. It’s only us.
Right.
We all have these traumas and there’s a lot of therapists who haven’t really come into their trauma’s yet. Potentially...not always, but potentially dangerous for clients with a lot of dissociation, because they’re defending against something. Technique and the therapy training will carry us a long way, and I don’t feel like I did any harm. I’m sure you didn’t, but I just didn’t get it at the level that I get it at now. So, it’s like that before and after really a distinct thing. I’m on a listserv with ISSTD with a lot of therapist survivors of ritual abuse and mind control and there’s several of them. And it’s so helpful to have them on a listserv, because when I’m working with those kinds of clients, they are hugely informative of my work. Or validating...in just many cases, validating my work. You know? Which we need. Because we can feel really de-skilled with extreme abuse. So, in my experience, that organization is full of people...therapists who are surviving some kinds of trauma within themselves or dissociation within themselves all the way up to very extreme forms, but I have so many friends in that organization. It’s amazing. I mean, these are brilliant clinicians who are also just like brave hearts who just make themselves vulnerable and put themselves out there. It’s really beautiful.
Wow. There’s such grace in there. And that’s very encouraging. The podcast...I started the podcast because when I was trying to look for more information and more educational stuff. There were a lot of YouTube videos, but I don’t have time to just sit around and watch YouTube.
Sure. [Laughs]
I don’t mean that at all disrespectful to anyone. It totally has its place and it helps a lot of people and I’m glad they have that support. But we’re not Instagram kind of people and we’re not [laughs]... we don’t have a lifestyle where we can just sit and listen to or watch videos. And so I was looking for podcasts and there were a few specific episodes, but I couldn’t find any that were just ongoing about this topic. And so I started it and then it and it became something different entirely than what I thought it was going to be, but just trying to let that happen and let it be and learn in the process. So, it’s really exploded - both for myself and then for the audience.
That’s cool. This is...I’m really looking forward to this.
***Excerpt Ends***
Beautiful. The word she used was beautiful for the shared experience of surviving of finding ways to bring healing both to ourselves and for others. It was such a powerful experience. I share that because I wanted you to feel the level of authenticity and compassion that she shared with me even before the interview started. This is not someone who’s just doing a professional job. This is a healer and it really made a difference from the start of our interaction.
Let me introduce to you finally Susan Pease Banitt, a social worker, psychotherapist, and author who specializes in the treatment of severe trauma and PTSD. She has worked in the field of mental health for more than four decades in diverse settings - inpatient, outpatient, and medical with adults and children and trained in the Harvard Medical Teaching Hospitals in Boston. Susan’s book, ‘The Trauma Toolkit: Healing PTSD from the Inside Out’ won several rewards, including The Alumni Media Award for written work by Simmons College of Social Work and a Silver Novelist Award for the Health and Healing. Susan speaks internationally on the psychological and holistic treatment of PTSD. She lives and has a private practice in beautiful Portland, Oregon with her husband and a menagerie of pets. Her second book, ‘Wisdom, Attachment, and Love in Trauma Therapy: Beyond Evidence-Based Practice’ has just been released last year.
Here’s the interview.
Interviewer: Bold Font
Interviewee: Standard font
I’m Susan Pease Banitt. I’m a licensed clinical social worker and pardon me, I’m also a registered yoga teacher and I have a variety of certificates at different healing modalities including Reiki and I have a lot of training in Celtic Shamanism and kind of got born out of my own natural abilities coming to the fore when I was in my thirties. I trained in the Harvard Teaching Hospitals in Boston, Massachusetts in the Longwood Medical area for listeners who are familiar with that area. So, my training was very rigorous and very, very solid and very open. A lot of people don’t realize how open the Harvard Teaching area is to complementary and alternative modalities of healing, so I was encouraged even in the early 1990s to sit on a complementary therapy committee with David Eisenburg, who went on to do a big study about how much money people spend out of pocket for complementary therapies.
Wow.
So, I get a lot of people with dissociative disorders, have a lot of extreme trauma and because of that, they have a lot of physical disruption and I write about that in the Trauma Toolkit - about the hypothalamic-pituitary-adrenal axis. So, all of my clients pretty much need multi-dimensional healing, meaning they need to address the body and they need to address their mind and they need to address energy flow within their body and those kinds of things.
Whole body experience, not just the brain or just the memory or just this piece?
Right. The model that I work with as a yogini is this 5-dimensional model from yoga training which is the koshas - the physical body, the energy body, the cognitive mind, the higher-intuitive mind or they call wisdom mind, and then something they call the bliss body which we only have a reference for in the last...when we talk about flow or peak experiences kinds of states.
So, how did you get all of that into that book? [Laughs]
[Laughs]
All of those pieces and all of that profound experience and your practice into...here are some very practical tools.
[Laughs] Well, that’s a great question. I really struggled with it for a while [laughs] because I wanted to present the... I feel the understanding of the basic yogic philosophy and view of the human isn’t itself a healing experience, because what it tells us is that we’re not just our brokenness. What it tells us is that every human being has a substrate that is becoming completely whole and consists of human-consciousness. And if we can just unblock that spring that’s inside of us, then healing can just proceed through all these dimensions. So, I wanted people to have that awareness, but then what I did is I took each dimension or they call it...kosha means sheath or body in sanskrit...so I took each kosha and put interventions that heal and unblock that kosha in a chapter. So, each kosha has its own chapter with all these different modalities that help to heal that level of the human being.
How did you figure out that...well, I mean through observation and practice, I know, but intuitively, how did you figure out the trauma was underlying so many different disorders and that we weren’t clinically sort of treating it from a full perspective?
I think that doing my training in Boston where there’s so many brilliant minds...well, the relaxation response...I’ll give you a little history. The Relaxation Response, the book, was written in 1977 I want to say by Dr. Herbert Benson. He was a deaconess which is... so, Longwood Medical area...there’s like several hospitals within just a couple blocks of each other. So, you’ve got Children’s, you’ve got Dana-Farber Cancer Center, Beth Israel, Deaconess, Brigham and Women’s, all these Harvard Teaching School hospitals and because of the proximity, the ground rounds at each hospital is attended by lots of people from the other hospitals because it’s within walking distance.
That’s amazing.
It is amazing. It was a really amazing place. So, I had amazing trainings and ethics and all these things and even some of the earliest work in DID was being done there. I went to a workshop on DID in 1990 or 89 and also working on the hotline, I worked on the hotline all through graduate school - so from 1988 to 1991. That sat right in the middle of that area and covered the entire state after hours for children and I was one of five supervisors who covered the whole state, so there was a lot of very sophisticated conversation that was going on with our supervisors with us trying to understand the impact of trauma also our staff because it was a lot. You know, I heard 15,000 stories of child abuse in four years. Which is a lot to try to digest and live with. So, we really had these long conversations about where this all went and how it seemed like...I remember somebody in a training there at that time said something to the effect of…”trauma’s hard to diagnose because it looks like everything.”[Chuckles]
[Laughs] That’s so true.
Right? Because you could...so many disruptions caused by trauma can look like every disorder in the DSM.
So, this is why people are so easily misdiagnosed?
Exactly. Yeah, because the dysregulation of PTSD or dissociative disorders can...rapid switching can look a lot like bipolar disorder even if it’s actually not technically bipolar disorder and vice versa. So, it’s tricky.
So, now you do specialize in trauma and dissociative disorders. How do you define dissociation?
Well, I talk about dissociation as being on a continuum. I think that’s pretty much how my colleagues talk about it too. So we all have the capacity to dissociate. It’s an innate human ability and it runs all the way from what they call highway hypnosis, where you’re driving along and you kind of lose track of where you are and you miss your exit because you were thinking or you were singing along with the music or whatever.
[Laughs]
You’ve got highway hypnosis and there’s a continuum that gets increasingly more dissociative all the way up to Dissociative Identity Disorder, which of course used to be called Multiple Personality Disorder. And everybody falls on a continuum somewhere and it’s a little tricky because I do...for recreation I do improvisational comedy, so I’m around a lot of comedians.
No way!
[Laughs] Super fun. Yeah and so really artistic people, and there’s a lot of really artistic people in that community, are inherently dissociative. High creatives go into dissociative creative states all the time and sort of pull down stuff from the ethers for their art. And sometimes you can watch them on stage doing that, if you think about it.
Wow.
Yeah. Right? So, you’ve got what I call high creatives and then you also have people who have sort of innate shamanic abilities and I want to use that word even though that word is not a global term. I use it because I’ve got to pick something to use as a global term. Because each culture has their own word for that and shamanism comes from Russia. From the Russian Steps. But, this sort of idea of people who can enter into non-ordinary reality at will for healing purposes or to get information, which we might also call psionics or physics or intuitives, right? We have all types of names for people who can do those things and that’s real and it’s always been real and part of indigenous cultures from the beginning of time. So, that also is a human ability. It’s a natural human ability. Some people have more of an abundance of that talent than other people and I believe that’s largely based on genetics and training.
That’s fascinating.
Yeah, like other abilities like athleticism.
Wow.
Yeah, so I don’t view dissociation as inherently pathological either. Yeah, and so as a reiki energy healer and I have a strong intuitive ability myself, I’ve had some lessons around that. That what we think we understand or what I call our two-dimensional academic understanding of these things actually could be understood in more dimensional realities in a shamanic lens. So, that’s been a really interesting journey for me to see how those worlds which were previously just...when I started doing yoga that was kind of separate from my clinical work, but then as time went on I’m like...why not integrate this and the same with Reiki and other modalities? So, now it’s all...there’s nothing that’s really outside my work in the sense of the abilities and trainings that I’ve had.
Well, I feel like what you’re saying is very congruent with my experience of you already. You are the first person to ask me about why I was interviewing you and you’re the first person who connected to my own survivor piece which actually feels pretty distant from me and so already, just in our conversation, I didn’t at all mean for it to be my intention, but you’ve already presented me with this healing experience of that I’m not the only one. And there’s other people out there and here’s how to find them and here’s why it’s normal and here’s how to do it healthy and [laughs] just in our first minute before we started the interview. I already feel that and appreciate that. Thank you.
You’re so welcome. This is really a part of my mission, because our Western culture...okay, I’m going to get a little meta on you for a second, but…
That’s okay!
[Laughs]
Western culture I feel is very dissociated in general.
Yes. Yes.
And fragmented and basically up until very recently our child-rearing practices were kind of designed to create dissociated and or sociopathic individuals in the sense that we were expecting infants to sleep alone and soothe themselves when they couldnt and basically the opposite...a lot of the practices of western society for generations have been the opposite of what indigenous or tribal cultures...how they would administer to their children and expecting children to kind of almost fragment and then heal around that and create a kind of warrior or conquering society where we can sort of tolerate a lot of really intolerable things.
But, that doesn’t make intolerable things okay.
Yeah, like war for example.
Right. Right.
Or you know, extreme poverty or whatever it is. And so as I have this mind, I keep asking why. I was that kid that drove my parents crazy. Why? Why? Why? [Laughs]
[Laughs]
And so that mind, I either have to listen to that part of myself or go nuts with it. So, I just tend to follow it. [Laughs] And I was like why are Northern Europeans so different from everybody else? Like why? It kind of traced back to me to the imposition and to 300 years of genocide on the indigenous healers of that society, which were called witches or other bad names. But, these were the wisdom people. These were people who had generations of healers in their family, but the genocide went on for 300 years. Like three hundred years. That’s longer than we’ve been a country and it was like ten generations of wiping out and weeding out our wisdom people basically from Europe. So, other cultures didn’t do that. So, if you go to China or India, you can meet healers who have had healers on broken teachings in their family for 20 or 25 generations.
Wow.
Which is amazing. Their abilities are off the chart and we are just now...this is interesting because my Reiki teacher came to the same conclusion and she works very closely with the head of our organization. She meets a lot of people. But, she also says, ‘Oh, we’re just coming out of the inquisition now.’ That’s just happening now. As we reclaim these very human and indigenous abilities ourselves.
I see this in all kinds of ways, even the pop culture for lack of a better phrase. The obsession with the oils. I’m like there’s so much more to healing than just the oil itself and people are all of the sudden, “Oh, oils. That’s helpful. That’s cool.” [Laughs]
Are you talking about Essential Oils?
Yes. Yes. Just an example of this is more than a fad, you guys. There’s more to this tiny example. I don’t mean to go off on oils. I just mean that the society is so hungry for it that that becomes a fad.
Yes.
Because they’re so hungry for healing.
Yes. Oils are actually a great place to start, because it opens that door. But, there’s also this very strong physical basis because the olfactory bulb is actually a part of the limbic brain. It’s a part of the limbic brain, so a lot of people don’t realize that when you inhale something it’s going directly to your brain. Like, literally touching your brain.
Wow.
And that’s our mammal brain, right? The limbic brain is our...we have this triune brain, right? We’ve got the reptilian brain, the mammal brain, and the cortex, which is the human condition. So, essential oils goes right to our seat of our emotional selves, which is why they are so powerful for healing.
You said that people can...if people will acknowledge their own traumas and seek out their own healing that that itself disrupts the cycle of abuse and that if everyone would do this, it would change the world overnight. I heard you say that on an interview.
It will change the world over night. Yes. The Dali Lama said something similar in that he said...I think he said, “If every eight-year-old was taught to meditate, the world would change over night.” Meaning because when you meditate, you reregulate your system and you develop an observing ego which leads to the healing of all these things. So, I thought that was amazing to see him say that too. That these things are just...you know, they seem so far away. The world we want to have seems so far away and yet it’s just so close.
It’s such simple things that make a big difference.
Yes.
So, what does it take to acknowledge your own trauma?
It takes courage. [Laughs] It takes courage to look at our trauma and the second word that came was it takes help. We really cannot do this on our own. This is too hard. This is too hard. To heal our trauma’s on our own...I always like to say the mind on its own is a dangerous place to hang out and in by yourself.
[Laughs]
Right.
Right? And that’s why I’m a strong advocate for parents or primary caregivers being at home for a long period of time in a child’s life, because even though a child can physically survive being alone for long stretches, mentally it really takes a toll on them and it creates a lot of anxiety in them and anxiety disorders, because they’re just not equipped to hang out in our own mind without help and a sort of a holding environment or ego from somebody else. And when we get into our trauma’s, it’s very dysregulating, right? Because that’s the nature of trauma itself - to dysregulate the system. And so we need to be able to sit with somebody who’s more regulated than we are and talk story or share experience with them. And that dynamic regulates us and helps us release our trauma.
So, not just the courage as an internal resource that we need to be brave and strong and face this fiercely, but also it requires that external connection.
Yeah. I really believe that into the depths of my being that we’re so blessed in this time as crazy as the world is right now. We’re so blessed in this time to have people who have identified trauma as a thing and who know how to work with it and who know how to sit with people who have it without like what they did in the past days - locking them up in hospitals and spraying water on them or putting them in the stockades or something, you know? We have people who are kind and compassionate healers of all kinds, not just therapists either. There’s yoga healers and there’s Reiki healers and there’s acupuncturists - all kinds of disciplines who are coming to this understanding of trauma. It’s so beautiful to see that happening.
The opposite of that is what is perpetuating some of those cycles of abuse, whether as a society or as a person. Because now you’ve sort of changed my perspective. So, when I think about trauma and how the dysregulation that happens internally, there’s also that isolation because we can’t tell, can’t talk about it, or maybe the parents themselves don’t have the resources or support they need. And so you become isolated and you are left in your own brain to deal with that and if you add layers of abuse or neglect or whatever. And so the system keeps going because people are not healing. And so that perspective is really required to connect with others and have compassion for yourself and the courage to do something about it.
Yes. Yeah, it’s a severe injury. It’s like we don’t expect people with broken hips to somehow heal themselves, right? Or spinal cord injuries or you know, mashed up internal organs, to just lay in bed for a week and you’ll get better. No, you won’t. You need surgery.
Right.
You know trauma’s an extreme injury and it requires skilled help to get better from.
And you do...you say consistently that people can heal and that people don’t have to live with PTSD or DID their whole life. How is your approach...I mean, tell me about that.
What I realized as I was working with these clients and it kind of started out before my own realization of my own history, but I realized from my clients was that all of my clients were doing a lot of other kinds of healing while they were in therapy. So, they were eating organic foods. They were taking supplements. They were seeing nature-pathic doctors. In many cases, they were going to acupuncture and this was pretty universal. In part because first Boston and then Portland are both very progressive areas with lots of those kinds of healers in schools.
Right.
And the communities of healers are very accepting of those modalities. Other parts of the country, it can be a lot more challenging. So, I was fortunate to be into places where it is common for people to be getting those kinds of therapies. And then when I had my own experience of trauma and it just blew the lid off of everything I thought I knew about trauma, in terms of the physicality of it. I was physically almost disabled by it - the amount of pain and sleeplessness and digestive issues and all the things I talk about that come along the hypothalamic-pituitary-adrenal axis, otherwise known as the neuroendocrine system. And I realized I needed to get help on all these dimensions of healing. And so at that point in time I was working with a Shaman, because I had had this explosion of intuitive abilities in my thirties, which I think led to the realization of my own trauma history, which happened when I was very young and sort of out of conscious memory. So, in working with this shamanic healer, I was noticing wow, he can bring me out of states almost immediately. It was crazy. [Laughs] I used to describe it as the Foobar Scale.
[Laughs]
[Laughs]
Like the DEFCON scale. I’d become a nebular 3 today, you know? But, I would leave sessions...he’d be like, let’s get on the table, you know? And I’d come out of sessions completely re-regulated and in a normal mood. From going from gagged up trauma mood dysregulated to a completely normal mood, within an hour - sometimes within 15 minutes.
Wow. That’s amazing.
It was amazing and it taught me what was possible. And it taught me that what was going on was more than just a cognitive understanding, because what was happening wasn’t like I got new understanding. What was happening was that he was working with my entire energy system to very many different dimensions of healing and also my physical body. So, that was really a huge teaching for me and it made me really rethink what’s required for healing, because in that system of the kosha’s, modern psychology, traditional modern psychology at its best, deals with maybe two, you know? The cognitive mind and the physical body through psychiatry.
Even that is a limited perspective physically.
Extremely limited because you’re just dealing with one system in the body. So, right. And so within a kosha of course, there are many systems within each system. Right? So, the body has many systems - circulatory, respiratory, nervous system, vagal system. So then the systems within the systems need to be address and that’s actually true energetically in the energy body, because acupuncture is a very complex art and so is Reiki healing and other energy arts take a lot of time to learn how to do well when we’re working with the cognitive mind it’s a complex system of course. And then some of the depth psychologists like psychoanalyst or Jungian psychoanalysts I believe do go deeper into the wisdom mind and they start to work more intuitively or acknowledge that as a factor in healing. But, really, in my experience to heal fully, you have to heal...I show it like a Russian Nesting Doll, all those layers sit around and inter-penetrate each other and the trauma is like a sword that pierces all of them. So, all those layers have to be healed in order for people to heal fully and I believed that...like I went to...I remember I was at a yoga workshop at the Group House Center years ago and it was a lot of abreaction. There was a lot of sort of going deeply into our being and freedom to express in ways you would not in a therapist’s office and this women who I was partnering with said...literally, she said, “I’ve made more progress this weekend than I’ve made in ten years of therapy.” And it really kind of rocked me back on my heels for a second as an aspiring therapist. And it got me thinking about why is that, because I could feel that was true for me as well. And it was because all these different dimensions were being addressed for healing.
And the image you gave of the dolls of how the injury affects all of them and goes through all those layers was a powerful image. That helped click into place for me.
Yeah. What I tell my clients...because you know, a lot of therapists, well meaning therapists, will say things like, “You’ll have to learn to live with this. Nobody heals fully from PTSD or it’s not possible to heal fully from dissociative disorders. You’ll have to learn to manage it.” Somebody said, “You’ll have to walk with it as a friend.” And, my client was like, “I don’t want this as a friend.” [Laughs]
Yeah, that’s gross. That’s gross to me.
Yeah, it’s gross, and it sends people to despair. I have to live with my PTSD for the rest of my life, like no thank you. I’d rather not be here then, you know? So I think, first of all a therapist if you’re listening, please stop saying that. [Laughs] It’s really not helpful, and it’s actually not true, and I and many others are living proof that it’s not true. So, the thing is that I tell my clients is if a therapist or provider says that to you, that you can’t heal fully from this, what I tell them is this - all they’re telling you is that they can’t help you heal fully from this. You’re not with the right person for healing.
I think that also provides a context even for survivors to recognize that when it doesn’t feel right, like when it’s not a match, even when you can’t explain why, it’s okay to look for someone else.
It’s okay and it’s necessary.
Yes, you have to.
Right, and there’s a lot of reasons why therapists say things like that. You know, obviously countertransference issues and where they are at in their own journey of healing and their own journey of understanding things.
So, their own journey in acknowledging their own trauma?
Right, because what I’ve found is that often people don’t really come into their awareness of their worst trauma’s until they’re late thirties or late forties, late forties, fifties, sixties, and people have to be at a place of readiness in their life and have enough support and structure in their life to contain them when they go into this healing process. And it takes time to build your life to a place where that’s true, right? And when people come into that awareness too early in life, they tend to have poor outcomes - like hospitalizations and things like that.
Oh, interesting. There’s a developmental component even as an adult?
Oh, definitely. Definitely.
But when they are in the place, they have that structure and that support they need to do it, you have framed it as a matter of cultural competence.
Yes. Well, yes. [Laughs] Yes. Well, also in the process of the healing itself as one engages in these other modalities, you start to realize that you are just a talking head and it will actually make you a more culturally competent clinician, because you’ll start to realize the reality of these other dimensions of the human being that other cultures never forgot about.
So, you’ve said also in the past that the relationship with your client is your number one tool. What does that mean and what does that have to do with attachment healing trauma?
In the beginning of therapy...in the beginning of western psychotherapy...the relationship was always considered to be the most important thing anybody was working on and so I have sort of this list of clinicians - old timey sayings about the container, mother child holding environment, these different ways that the people we consider our forebears, like Winnicot and Bion and Freud and Sartre. You know I could just kind of go on and on and it’s only very recently that we have...in my opinion...kind of dropped the ball on focusing on the relationship as the essential healing aspect of therapy even though all the meta research...all of it is very clear on this. I used to get the Harvard Mental Health letter. They wrote about it. Because there is no evidence-based therapy that has been more effective than looking at the quality of the relationship in therapy.
Wow.
So, in other words, it doesn’t matter as much what you do, even though we put a lot of emphasis on that. It doesn’t matter as much what you do as how you do it with your client. And that’s why sometimes in very, very beginning therapists can make very excellent therapists because they don’t have a lot of attachment to how they are doing what they’re doing, because they don’t even know yet what they’re doing in a certain kind of way. But, if they’re very compassionate, connecting people who are open to their client’s experience, they can be extremely healing for people.
So, tell me...I mean we talked about your perspective of dissociation and you did a great job of explaining that, but tell me about your work with DID and what you know about DID specifically.
As I mentioned earlier, I was introduced to the concept of DID quite early in my career and took a really good workshop on it in the teaching hospital area where they pretty much laid out the assessment criteria that are still being used today and instruments like the Dissociative Experiences Scale, which I find to be a very helpful instrument in getting an early impression about DID.
Right. Right.
So, you know, there’s basically two kinds of DID. I think of it this way, there’s two kinds of DID - there’s what I call ‘organic DID’ that just is a natural fracturing of the mind that happened under extreme duress and abuse and then there’s something called engineered...that I call engineered DID. Other people have different names for it where there are...and to some of your listeners this may be a shock, but there are some sort of evil elements in societies and countries that want to deliberately create DID in children for the purposes of manipulating them and using them.
Right.
So, that’s a very complex, tricky kind of treatment, because the people who design those systems design them to be impervious to the therapists. That’s very tricky and so that’s why I’m part of an online group through the International Society for the Study of Trauma and Dissociation. I’m on a listserv with about 150 therapists. I lost count. From all over the world, but mostly England, USA, UK, and Canada who have been working on this for quite a long time and it’s helped. Their input has been extremely helpful.
Okay, yeah so, there’s this special interest group called...they have several special interest groups...there’s one in dissociation. But, there’s also one...the one that I’ve been the most involved in is the Ritual Abuse and Mind Control Organized Abuse special interest group and what’s amazing is that up until recently, there was no organization that would even touch that topic and ISSTD has completely embraced it from the top down. In fact, they encouraged members to give talks at the national conference coming up in March and I’m giving a talk on attachment rupture and repair in a ritually abused client, which is…
Wow.
Yeah, I feel like that’s kind of a first for a major trauma conference that’s not specifically for that population. Yeah, it’s kind of a big deal that this is happening.
That’s a really big deal. I interviewed Colin Ross and he of course talked about a lot of those things and I know he’s done a lot with that. But, then hen I talked to Warren Middleton, he was the first one that I have ever heard. I don’t mean the first one out there. But, that I encountered who talked specifically about other kinds of organization ritual abuse besides just SRA or RA in general. But..
Oh yeah.
Using that phrase that you used - organizational...that gave me a broader context to explain some things I had seen clinically that I didn’t realize were the same things as things I had dealt with personally. In different formats and different presentations of it, but that it was still organizational abuse. And so that is a big thing and that’s powerful that you’re going to go talk about that in the context of attachment.
Yes, because trauma always ruptures attachment. That’s like the first thing that it does. [Chuckles] Right? And so a lot of things that traumatize us are ruptures in attachment or our caretaker abuses us for example in some way or neglects us in some way. You know, some very profound way where we’re left floundering and we can’t manage our feelings about it. And then I really love the work of the group that came up with the Strange Situation where they talk about the child’s dilemma about if they’re being abused by a caretaker, they need to get away from that - the caretaker. But, they also need to move towards that caretaker to get soothed, so it creates what they call ‘The Strange Situation’ where they want to go away and yet come back towards and they observe this in some of their studies - clinically as a child who might...you know when an abusive caretaker came into the room, might walk backward toward the caretaker.
Wow.
Because they’re poised to run away, but they need assistance. And I’m not laughing because it’s funny, but it is strange when you see the presentations. They sort of saw that as the foundation of dissociation in the mind, where the mind is pulling apart two directions - of wanting to go towards and at the same time go away from and how do you manage that. How does the brain even manage that?
That makes me think of the old still face experiment.
Yes! Exactly. And in how much distress...you know, I’m going to actually be showing a clip from that, or some pictures from that in my upcoming talks. Because I think that’s so important for people to understand how much...how quickly children get dysregulated in the absence of an empathic presence. And that’s totally where our clients are at. They need us to be present and compassionate with them or they fall apart.
Wow. It seems like such a simple thing and yet it’s so profound.
It’s so profound.
It opens up...like even the fact that we can talk about repair, there’s hope in that.
Yes, there’s so much hope and there’s a lot of clinicians who aren’t trauma therapists who… they can do a lot of damage and not really realize that they’re doing damage. But, I hear about it and I know other trauma therapists hear about it and the more...I think that the more that we acknowledge that trauma is a really tricky specialty area. It really does require a lot of training and knowledge to work effectively in it. And even when you’re good at it, it still can be kind of a time bomb. [Chuckles] You know? And it can still blow up in your face at times, because it’s just that tricky. It’s like my husband’s a cardiologist and he does interventional cardiology and he’s really good at opening up peoples’ hearts, but it’s not 100%. I mean, people die on the table. People have adverse outcomes sometimes, because there’s so much damage. That when you’re going to repair that much damage, adverse events can happen. And I think becoming comfortable with that in a way...like he’s never happy to lose a client, but he also doesn’t take it personally. And when we’re working with such extreme damage and our clients aren’t getting better or they hurt themselves or god forbid, they commit suicide. You know, I started looking at this through the lens of my oncologist. I was a medical social worker for a while. I started looking at this through the lens of oncology work and I didn’t expect my stage 4 clients to always make it. I wanted them to make it and I gave them good care up until the end, but some didn't make it. And some of the most...we might not see these people in private practice or we may, but you know, our colleagues who are working in community based clinics and inpatient hospitals and places or prisons - places where you sort of find these intensely injured and dysregulated people. Some of them aren’t going to make it just because the damage is so intense, right? And how do we practice really pristinely and compassionately and with the awareness that we can’t...even though I said we can heal fully, and I still hold to that. But, there are some very extreme cases where the injury might be very severe or they come to this very far along in the dissociative addiction process and how as clinicians do we hold the possibility that some of our clients might not make it. That they won’t heal fully. They just might not make it.
What does that mean? Dissociative addiction.
Oh, so like in the addiction world, I’m finding that people who are very, very severe addicts also seem to be very, very severely dissociated.
Oh, yes!
Yeah.
Okay. That model makes sense when I received my diagnosis and realized what was going on. I thought I cannot treat clients right now. It is not an okay season, and so I closed my private practice, not forever, but for a season. And to pay my bills and continue working and feel like I was functioning in some manner, I worked as a chaplain in a hospital for awhile, and I thought, Oh, this will be easier because it’s only physical. And then I encountered exactly what you’re saying, that my job then became helping all these people who were helping people regulate. So, I sort of walked into the storm I thought I was escaping a little bit.
[Laughs]
Right? It’s just a different...yeah, yeah, that happens. Well, right, if you look at disease and how disease....Dr. Gabor Mate has written a lot about this, how disease could be related to trauma or untreated trauma or untreated trauma through generations of people and can show up as different kinds of patterns of disease or illness in the body. And it’s all very fascinating, right? And even Chinese medicine looks at that. I have a friend who’s a master acupuncturist and he would say stress is at the root of all diseases and what I taught at the Oregon College of Oriental Medicine a little while and I realized that the ten interview questions that students were being taught were all related to the HPA axis. They were all questions about the function of the neuroendocrine system. I was like, wow, this is fascinating. Ancient Chinese doctors knew that that’s where it was at. That’s where things kind of go off the rail and if you can re-regulate that system the body would start to be in a state of health and support. It was fascinating.
That is fascinating. Tell me about your second book.
So, my first book, ‘The Trauma Toolkit’ was written for lay people. It was written because I saw this massive amount of trauma coming down the pike for the world and I wanted a book that people could have in their hands to help heal with and from and the second book, because Routledge approached me about a talk I gave at ISSTD in 2016 and they said would you write a book for us on that topic. And I said yes and so that ended up being ‘Wisdom Attachment, and Love in Trauma Therapy’ and a book for clinicians. It’s both for people who’ve been in practice for awhile but might be new to trauma therapy and also for beginning clinicians and I hope that a lot of beginning clinicians get to read this book. I think it’s going to help orient them to the importance of relationship and healing and I kind of want to pull our field a little bit back from this sort of brink of mindless adherence to evidence-based practices. That’s going to irritate some people that I just said that, but what I realized while I was going to conferences was that evidence-based practices rarely look at outcomes past a year, and mostly between three and six months.
Yes. Yes.
And as we know in trauma work, you don’t really even know what kind of trauma your client has until a year has gone by because different anniversaries and times of year bring up different things.
Yes.
And just randomly speaking, you could get a good three month outcome, even in a very severely traumatized client, they might have just a good three month period over the summer or something. So, I’m not convinced that what we call evidence-based is as evidence-based as I would like it to be. And there’s a lot of evidence that the relationship and long term relational therapies have really great outcomes and are rated by clients as being very, very beneficial to them. So, I really want to refocus us back on that. Get away from these superficial techniques and back more into the heart and soul of what real psychotherapy is. Honestly, it is deliberate in some places. The commodification and the privatization of prisons and of mental health...it’s a problem. It was not pervasive when I stared. In fact, most agencies I worked for when I started work were very good, well meaning people. They weren’t trying to make a buck off of peoples’ mental illness, but I’m sorry to say that there are many agencies and in Oregon we have them too...that are not being run by mental health people. They’re being run by business people, and they are in it for making money. And they are making money off the backs of suffering, and when they use branding and catch phrasing like that, it’s often in an attempt to corner our market for themselves and their ponies. Rather than provide compassionate care for people. And this is a huge monstrous problem we’re dealing with in this time and it’s very disillusionary and hard and again that was part of my motivation behind this book was to also say...in some ways that emperor has no clothes. Like it’s fine to do research and it’s fine to look at techniques that may or may not be helpful, but that does not automatically invalidate other ways of healing at all. And there’s certain things that are just infeasible to study for various reasons or may never really show up well, because they are longer term and the variables are hard to control for. Like relational variables or energy healing or those kinds of modalities. Doesn’t mean they don’t work. Doesn’t mean they don’t even work better. It’s just hard to measure them. So, they don’t get great quote unquote outcomes. And we need to think more deeply about this issue. Because this sort of scientific approach, in my opinion, has been somewhat un-scientific. I really think there’s corruption in our industry, and nobody’s talking about it. And we need to talk about it. People go where the money and power is, and we have to not be naive. We have to expect that people who are greedy are going to look at mental health survivors as a commodity. Like we have to expect that, especially in this time where we have this sort of unbridled capitalistic force moving through our society in healthcare and in prison and justice and places where a lot of us argue it shouldn’t be at all. So, it’s problematic but it’s also because this is a population, like children, who is not really able to advocate for itself very well.
So, more easily exploited?
Yes, exactly. So, yeah, it’s like these are all conversations we need to be having and not just accept like, oh, I guess that’s just the way it is. I get that if I practice here then I have to do this. I encourage people to push back a little bit on these systems and ask why. Why are we doing this? Who’s really being served here? [Chuckles] Right? And is this enough? Is this adequate what we’re doing? And can I really form a relationship with a severely mentally ill person if I see them 30 minutes, twice a month? You know, what do we really need for the healing to happen? And then come back to basics about those kinds of things and rework them and look at them. Because it's like raising children. There’s this great book called the Irreducible Needs of Children [chuckles] and I love that title because children can’t actually reduce their needs for adults. They can’t. And neither can mentally ill people or traumatized people. When we’re healing, we need what we need and if we don’t get it, we’re not going to heal. Period. End of story.
Wow.
So, how can we give people what they actually need to heal and how can we advocate for that? It’s a really important conversation.
That feels like it goes back to the shame piece like Patricia DeYoung, but they’re not wrong for needing healing.
No. Absolutely not. Any more than you’re wrong for needing healing if you break your hip. Or you need a knee replacement or something. Yeah. Healing is healing.
So, your book...your second book breaks down into wisdom, love, and attachment?
Yes.
The three sections.
The three sections, yes. Because as I was writing it, I realized that these were breaking up very evenly and they’re all part of that relational healing, right? Because when you’re healing with...so I make a distinction between intelligence and wisdom, that intelligence or knowledge unattached to wisdom can be a problem. It’s kind of like what we’re talking about - these mental health agencies. There’s knowledge. So we’ve got these evidence-based practice, but how to apply the knowledge requires wisdom and so I compare it to what’s going on in science. Science is great as long as it’s being used with good judgment and wisdom, otherwise it will end up destroying the earth quicker than ever before with it. [Laughs] Right? So, we can use science to help heal or to hurt.
And then the love is the connection. And the attachment is where the repair happens?
Yes. Attachment...I think attachment is foundational. I don’t think that people really can engage in therapy without feeling attached to their therapist. It’s just too painful otherwise.
Thank you so much.
Thank you. This has been really enjoyable talking to you.
I appreciate it.
Check out my website. It’s www.suepb.com. I have a lot of blogs. I have a media section. I’ll be putting this podcast on my podcast page. My books are up there. You can take a look at them more and also where I’m speaking and classes I’m giving and all that stuff will be up there.
That’s fantastic. Thank you!
Thank you for joining us with System Speak - a podcast about Dissociative Identity Disorder. You can listen to the Podcast on Spotify, Google Play and iTunes or follow along on our website - www.systemspeak.org. Thanks for listening.