Transcript: Episode 70
70. Psychoeducation
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[Short piano piece is played, lasting about 20 seconds]
Okay, so there’s one group we’ve been in, online, that was supposed to only be for three months, because it was a doctoral student research project into psychoeducation online. And it’s actually been really confusing. I don’t think that english is his first language. So, I’ve been trying to be patient and generous with that. But it’s kind of a trigger for us, because the mother was a librarian, and very critical of our use of English, especially growing up with hearing issues. And I just -- I don’t even want to go into that right now, but it’s a huge trigger for us. Not that we’re super judgmental of everybody else, but seeing a lot of errors or formatting problems, or things like that can really be difficult for us, because that gets a whole different thing started internally.
So, it’s not that it’s been terrible, it’s just been super simple. Everything’s spelled okay, mostly, but there’s no paragraph breaks. So, it’s kind of dissociative just trying to read through it. It causes us to dissociate to try and stay present with that much information - only psychoeducation and nothing else. It’s like trying to read something, except without any paragraph breaks. It’s really tough.
So, the other thing that made it confusing is that he has it instead of lesson one, lesson two, lesson three, each week. He calls them chapters, but that even was confusing, because chapter one was just an introduction to what was going to happen. And it was just a letter. So we didn’t realize that the letter was the chapter. So, we thought, at first, it wasn’t starting, but when we finally clicked to start, because we were all worked up about how hard it was going to be, then it was a big deal to try to open it. And we finally clicked on it, and it was nothing. It was just this is what it’s going to be like.
And then at the end of each chapter is a couple of questions to be sure that you actually read it, except it’s not about the content. It’s just like, “Did you know this before?” And, “Was it helpful or not helpful?” But like, literally, that’s all that it’s asking. It’s not asking if we didn’t already know it. It’s not asking what we thought about it. It’s not asking for feedback on how it was presented. And so, it’s been kind of frustrating and confusing, but we’ve been trying.
So, chapter one was only the introduction to the course. Chapter two was simply about what trauma is and what counts as trauma. And it included everything, because there’s people from all over the world involved in this research study. And so it even talked about war crimes and refugees and things like that. So, that was interesting, but not necessarily applicable to us. Although we do have the school in Africa, and so there was still a lot of helpful information we could use for that, but it wasn’t necessarily personal for us.
And then chapter three was about dissociation and why that’s a thing and how it works, but not any new content for anything that we didn’t already know. In fact, we couldn’t even talk about it really on the podcast. We tried, but there wasn’t any information that was substantive enough to really share about.
Chapter four was kind of an example of what’s been hard about the whole course, because the title of the chapter was Trauma Effects Us In Many Ways, But Is Reversible. And so I think, first of all, the statement just made me angry. And so because we’re talking about avoidance with Emma’s workbook from the other group, we are trying to notice our feelings and talk about them. And so I totally noticed that that statement just made me angry. I think it’s an English error, because I think what he means is that the effects of trauma can be reversible.
So, for example, if I’m super anxious, I can use my grounding skills that my therapist has taught me to try and calm down. I can do my deep breathing. We’ve got the teddy bear, the watch, some peppermint, whatever. But I don’t like the way that it says that trauma is reversible, because it’s not. It’s already happened. And this is the problem with people not understanding the difference between anxiety and trauma-based anxiety, whether that’s DID, or PTSD, or C-PTSD, or whatever initials you want to use. Because when people are just anxious, they’re worrying about things that have not happened, and so it’s not really founded in reality in a way. And so you can sort of logically talk yourself through it, calm yourself down, and do some CBT kind of things to get refocused on what is happening in the present, and what is likely to occur, or not likely to occur.
But with trauma-based anxiety, stuff really did happen, and stuff really did go down, and you can’t undo that. And not only can you not undo it, but the memory of it starts invading the present, and feels like it’s happening again. So, we can talk about how it’s not actually happening right now, but you can’t talk about how it didn’t happen at all, because it did. And so I think that just triggered us mentally about the way it was phrased, that trauma is reversible, because it’s not. So, either it was a wording error in English or it was just really poorly stated.
But then what the chapter talked about was how trauma is subjective. And again, that felt really sensitive, because there’s so many of us who know and listens to our stories, or no one believes our stories, or no one helps us with our stories or they think our stories are too hard, when we’re the ones stuck living with them.
And so that was really frustrating, but what it was talking about is how some people can go through the same experience, like a tornado or an earthquake, for an example, for a more neutral examples, and their experience of the same trauma be different. Two children in the family may experience the same trauma in different ways. So, for example, our brother does not remember anything before high school. Hello, dissociation. Right? Except that we also just had different experiences of the same thing, as well as different experiences with who we lived with at different times. And so even though we had the same childhood in some ways, we also had very unique experiences. So, he can’t really judge what my experience was, and at the same time, I can’t judge what his experience was. He can’t get upset about what different Parts of me remember, or the different ways that I handled it, in the same way that I can’t get frustrated with him and how he handled it.
And we handled it in different ways. For example, we ran away when we were 17 and never went back home for like 10 years. He got married at 16, and that’s how he got out. And so we got out in different ways, for example. And he handled things -- I handled things by completely isolating myself from the family, and dissociating through a DID kind of way. He dissociated in whatever kind of way it was. I don’t know where on the spectrum he is, because I’m not his therapist, and we don’t have a lot of contact, and it’s a really sensitive subject. He doesn’t talk about it very much, very often, and won’t go there. But he handled it by idealizing both parents. So, the father could do no wrong. The mother could do no wrong.
And then when they both died, for me, it was a relief, like finally I can find a way to talk about this, and we can find someone to talk to about this. For him, it was like, okay this has now made them martyrs, and his whole scale of idealizing the parents just went off the charts. And now they can do no wrong, ever. They have been memorialized as they were. And so rather than mourning his childhood, or dealing with what was difficult, instead, he used the mourning of their deaths to sort of project the loss of his childhood onto the loss of the parents, and turned it all inside out in a very different way than we did.
So, it’s just different for everyone. So, what he’s saying in this chapter makes sense, but it took me a minute to get in there. And when we’re talking about avoidance, this was a good example, because just noticing how the chapter started, and how I was triggered by the very first phrase of the title of the chapter, made it really difficult to trust anything that came next. And so this is a tiny example, but it was really shocking to me as we’re trying to be aware of avoidance and how quickly even dissociation starts or switching starts. It can be such a simple, simple thing, because that totally -- I was just done. I was just out of here, except for, I am focusing on avoiding avoidance. Right? And so to stay present with it and figure out what was going on and to notice that and to talk through it and work through it was really kind of powerful, even though it was such a silly example.
The other thing I liked about this chapter is that in this one particular, they talked about how medical procedures can be traumatizing. And I think that the information on that was really relevant to some things we have been through, and some things we have been through with our children, and some things the children have been through. So, that was significant, and I was grateful that that was included in his list of examples of trauma.
The other thing that was really helpful in this chapter is that he talked about how during and after trauma, you don’t just feel frightened and helpless. People kind of assume that, and you think about that, and know about that. But it also talks about how we don’t know how to respond to what happened, and that we may feel powerless or out of control, that we may feel numb, or have no emotions at all, or even just behave as if everything is normal. And how sometimes that makes the problems in response to trauma delay months or even years after what’s happened.
So, we know trauma affects every area of our life, but it also makes the world feel dangerous and unpredictable. Trauma makes a person think that no one can be trusted. It makes people believe that they are not loveable themselves. It may make a person feel angry, and depressed, or frightened. And it may make a person try to avoid any similar situations or anything that could remind them of the trauma. So, all of that is exactly what we’ve been talking about for the last six months and learning about. And then the last one there is about triggers. Right?
So, that’s huge to see that on paper -- well, it’s a screen. But to see that, in black and white, right there, that this is why we’re not crazy when we feel crazy, because it’s a response to trauma. What feels like the world is dangerous and unpredictable, because it was. We think that no one can be trusted, because we couldn’t trust anyone. We feel like we were not loveable, and are not loveable now, because no one did love us. And we have a lot of things to be angry about, a lot of things to be sad about, and a lot of things that scared us in the past, and things in the present that remind us of those things.
So, it just normalizes what we’re going through and what the trauma response is, and what dissociation is about, and why it protects you. And this was really helpful to me, because I’ve been struggling with if it’s such a hard thing to deal with now, why did we ever do it? I don’t understand why it would be beneficial enough to start in the first place. But this helped me make sense. But this made sense, and helped me to understand it of why we would respond to trauma the way that we do.
It also talked about how it affects peoples’ bodies, and gave examples from the Polyvagal theory, and the amygdala, and hippocampus, and automatic nervous system, and how brains work. And talked about how that leaves the body very sensitive and hyper aroused, and that this is part of what makes it difficult to relax, or to go to sleep. But also how over time, the chemicals that make the nervous system do all of these things are actually not good when they build up in the body, and that these things can cause other problems, which my friend Jane and I, from Many Sides of Jane -- Jane and I have been talking about this a lot, about how it causes chronic illnesses, autoimmune disorders.
And we both have experience with these things, and know lots of other survivors who do. So, that’s one thing we’ve been talking about, and she’s going to come on the podcast again, and we’ll talk about ACEs - the Adverse Childhood Experiences. And how that can all play a part, even physically.
So, using that information -- what he does in this chapter is define dissociation as a failure to integrate the biopsychosocial experience. So, he’s talking about memories, emotions, behaviors, visual images, motor control, and aspects of identity, do not get processed in the brain the same way in response to trauma, as they do in everyday life. So, all of that is really helpful, and I really appreciated the way it was presented.
But then he made me crazy again, because he went back again to using the word pathological. And he’s talking about dissociation becomes pathological when there’s amnesia, you can’t recognize yourself in the mirror, you have flashbacks and nightmares, different identities or personality states. And so, I understand that that’s when it gets into clinical categories, but I wish there were a different way to say it than just pathological, because that somehow feels shaming, in a way. And I don’t know why that is. I don’t know if that’s me being overly sensitive and taking it personally, or if it really just is bad wording. I really don’t know, but it’s something I wrestle with and struggle with.
And it’s something that has made me have more compassion for others, whether friends or clients, with mental illness, because I think that I have had such a clinical view in the past, that I looked at it pathologically as well. Meaning, how it works and what is wrong, rather than thinking about why it’s working and what is beneficial and how it protected you, or us, me, I guess. And so that’s a new thing, and I don’t have it all wrapped yet, or how to make it settle.
But what he’s saying is that dissociation means disconnection. And so, when we are dissociating, we’re disconnected from our own thoughts, feelings, memories, sensations, or any aspect of the mind or body. And while that’s a helpful survival strategy, it can cause problems after the trauma is over. So meaning, it helped us survive in memory time, like back when everything was still happening, it helped us survive. But in now time, it actually causes problems, because that’s not how everyday functioning is supposed to happen.
Now, this is where it gets delicate again, because the way he presented it feels like -- almost like there’s some shame there. There’s some blame there, like you're doing something wrong, as if it were a choice. Now, it would be a choice if we chose to just continue living that way. And it would be a choice if we just chose to settle into this level of functioning and not learning anything different. But we’re working really hard at therapy, and we’re working really hard at learning how to do things differently. And so, I’m uncomfortable with the shaming and blaming in the language of how it was presented. But, I also don’t have good answers for how to do it otherwise.
He also points out that part of what is so traumatic is that no one rescues you from the trauma, no one helps you recover from the trauma, and there’s no emotional support during or after the trauma. So, when you apply that to a family setting, for ongoing trauma, for those of us with DID, that’s really difficult. Or even friends who don’t have DID, but also have some dissociation or family issues or patterns of relationship issues, this is all reenacting what we went through when we were young. And that’s really, really difficult to get through, and goes back to the shame theory where healing only is going to come through connection. Meaning, having a good therapist, having a good partner, having good friends who are safe and consistent and kind and who advocate for you and who support you and who are strong enough -- not to solve all of your problems, because you have to do that work. But strong enough to be with you in your problems, that changes everything. That’s attunement and that’s where healing happens - is through connection.
But what he gets to, ultimately, is that we need to remember that the human brain is malleable, and we’re able to change our brains. So even though we’re affected biologically, he’s saying that our neurological systems, not just our patterns of behavior, and not just our automatic responses, like dissociating by default, but that our actual brain itself, neurologically, still has time to be rewired. And that this is what is reversible. He says, again, that the trauma is reversible, and I just am going to have to disagree with that based on language. I think what he means is if you work through it, then it’s now an event and not a trauma. But that’s a pretty dissociative approach, even just distancing yourself from it that way.
So, I don’t always, forever in my life want to identify as DID. I don’t want multiplicity to forever be only who I am. However, it is a part of me, even as there are different parts of us, that make us multiple. But, at the same time, I don’t want to be -- and so, that’s true, and I can never make that go away. I can do a lot of healing. I can make a lot of progress, but dissociation is always going to be my default. I’ll always have to be vigilant about it. And I will always have to seek out support to help me get through it. And I can have compassion on myself in that way, and seek healing in that way, but I cannot undo the traumas that caused it, or what happened to us, or the help we never got early enough, or in time. And so I don’t like when he says that the problem is reversible. I disagree with that, even though I agree with what he’s saying about recovery is always possible.
A good example of that is one thing that the therapist says to us a lot, is that I’m so sorry it took me so long to get to you. It’s not her fault. I know that in my head. She wasn’t there when I was one or two. We did have some contact with her later as we were growing up, and that’s pretty vague to me, and out of all the thousands of people she’s helped, it’s not necessarily significant to her, but it wasn’t any failure, even if we had her as a caseworker. It still gets handed to someone else or gets transferred or decisions are made by the court. I know that even from our own kids that we’ve been through with foster care, as well as our own choices as a young adult, when we had some contact with her, and could have started with her 20 years ago. But instead, we moved out of state, and did something else, because of choices that Cassi made, which is fine and we can respect her choices.
But a consequence of that was that we didn’t find the therapist until now. And so now we do have her. And now that we do have her, she is there, and she is helping, and she is rescuing. And we are doing it ourselves, not just dependent on her, but her supporting us in our own work, and the husband as well, and now starting to make friends. All of these things are aspects of our own healing and our own recovery. None of them undo the trauma. Maybe that’s something I will change my perspective on as healing occurs in the future, and things unfold, but it’s not something I’m comfortable saying right now. In fact, it made me really uncomfortable. But also, I’m aware we’re still pretty early in the stages of healing. And so, maybe there’s just too many who are still too raw and still waiting for help for that to feel like a comfortable statement.
But then he says, just like what the workbook says, that we don’t need to process memories that are traumatic or talk about difficult things, until we have enough support and feel safe doing so. And I think that’s exactly where we are, both in life and in therapy, of things feeling better and safer and starting to be able to process some things.
So then, at the end of the chapter, when I click on it, it brings me to this little homework page, except the homework says, “The first assignment is, have you experienced some unpleasant events that have had an impact on you?” I mean, of course we have. That’s why we’re in this research study. And then it says, “Could you write down the events that affected your life. You don’t need to talk about the details, but could you write them down?” And so my answer is, “Yes,” because I could write them down. We write them down in the journal with the therapist, but it’s not telling me to write them down here. And it’s done this with all four chapters. It asks me these yes or no questions, and it’s just one line. So, it’s not like there’s actually any space to write anything or process anything, and he doesn’t reply to what we say. So, it’s not like we’re going to get to process it, which puts those walls up, and keeps it as a yes or no question.
So, I feel like that’s definitely a limitation of this study. And its efficacy for as far as how effective it is in actually helping anything beyond psychoeducation. I think the study is about psychoeducation, and some of the information is really helpful, but that’s the homework assignment, is the yes or no question. Does he want me to actually write down the events? Does he want me to talk about what was unpleasant or why or how it impacted me? Or is he really just asking could I do it? Because I just wrote “Yes.”
The second assignment says, “Recovery from trauma is always possible. Your efforts are important. A supportive environment is also very helpful. Could you identify some factors that could increase your chance of recovery? You can include both internal and external factors.” So, again, it sounds like he’s asking what those factors are, except his question is, “Could you identify some?” And so I put, “Yes” again, because yes, I can identify some. But he didn’t ask me what they were or give me a place to write them. So, that’s part of what’s been very confusing this whole thing. But I did finish it and we can talk about those things in the notebook.
So, my strengths and resources that increase my chance of recovery would be the therapist, The Husband, the podcast, my workbook, our groups, the family, being safe in our home, learning to make friends, things like that.
So then, I go to chapter five. And chapter five, again, has a little bit of information that’s helpful, but is also kind of frustrating in its limitations. So, for example, this chapter is talking about avoidance. Which I was excited about, because we’re really working hard on that chapter in the workbook, and not just the chapter. We’ve moved onto the next chapter, but we’re going to have to work on avoidance forever, because that’s a thing. Right?
So, it talks about how avoidance is helpful in protecting us from being harmed, but it also leads to other problems. And so, they’re like as you integrate traumatized parts, avoidance symptoms should be reduced. And that’s really, really oversimplifying and frustrating to even read. So, makes me not even want to read the other -- the rest of the chapter. Do you see why it’s difficult, even though it’s supposed to be helpful?
The first category it gives is hyper-vigilance, and it says, “After a traumatic event, a person may become very sensitive, easily overreacting to sounds or small things that would not otherwise disturb a person.” So now I’m disturbed. So again, I’m being super sensitive to language, and I don’t know if that’s a therapeutic issue or a blatant issue with this presentation of material. But it says that, “it’s like a fire alarm inside your body is not working. For some people it doesn’t go off when it should, and for other people it keeps beeping, even when there is no real danger.”
So, this happens a lot in relationships. This is not in the chapter. This is from me. Sometimes we get in relationships where we should be aware that there is danger or that it is not healthy for us or good for us, but those warning signals never show up, because our level of tolerance for trauma and relationship distress and unhealthy communication or dynamics in relationships that are dangerous, not good for us, any of those things. The tolerance level is so high that it takes a whole lot to really make us notice that something is off.
In the case of triggers, it made a situation where we’re actually safe, in the present time and everything’s okay, but that alarm is still going off. And so it feels dangerous even though it’s not. So, it can happen either way. But then his response is to breathe deeply five times, take a drink of water, and think of an alternative response. So, again, it feels really super short and simple and oversimplified. But practicing those things at a more specific level to you - what kind of breathing, what kind of muscle relaxation, what kind of coping skills or grounding skills. Those things need to be specific to you.
What is grounding for me is not going to be grounding for you. What is grounding for me is not going to be grounding for Sasha. It’s different for everyone, and what works for me is not going to work for Emma. What works for Jane is not going to work for me. What works for my friend, Julie, is not going to work for me. It’s different for everybody, even The Husband, who does not have trauma or DID, really. What helps him on an everyday basis is not going to be the same thing that helps me. And so there are some things we can share in common, but it really has to be specific to you.
The other category that he talks about is intrusive symptoms. This is what we learned from Kathy Steele, actually. Intrusive symptoms are memories, emotions, behaviors, feelings, mental images, flashbacks, nightmares, that involuntarily intrude into our consciousness. So, they are things that really happened or that we really experienced, or that we experienced in response to what happened, but they’re completely out of context, because they are not attached to each other. So, normal memory processing, the way your brain works to process memories, the memory of what happened, the smell of what it was like there, the sounds you heard, what you saw, what you felt when it happened, all of that gets processed as one unit.
But with trauma, all of that gets split up and is stored in different parts of the brain. So, it becomes intrusive, because you don’t want to remember it right then or experience it right then, and because it’s not associated with where the actual memory is, or where the actual time it occurred. And so it feels out of place for that reason. It’s an intrusion, not just into the present, but from the past.
It can also be an intrusion from others inside. So, whether someone else from inside is telling you something or sending a message out in some way or sharing a memory or a visual or a body sensation, those are the worst. We haven’t talked about those yet in therapy, other than knowing that they’re called body memories. But we haven’t had to deal with that a lot yet, except it’s happening more and more between sessions. So, I know we need to talk about it and we need to keep using the things that we know how to do. But that’s part of starting to talk about hard things from the past. So, even body memories are an example of intrusive symptoms.
And hearing others talking, commenting on what you’re doing or what you’re feeling, those are also intrusive symptoms. So, it may feel like hallucinations, even sometimes, because you’re seeing things, you’re hearing things, but it’s different than hallucinations, because hallucinations are not actually there and are contained to one specific thing that’s presenting. Intrusive symptoms, because of dissociation, are memories broken up into the different pieces, stored in different parts of the brain, and disconnected from the piece as a whole. And it’s a symptom in response to trauma, not something that is chemically imbalanced in your brain.
So, when those happen what helps are things like. “Now time is safe,” “This happened in the past,” “Right now, I am in my home, or I’m in the therapist’s office,” or, “I am safe.” Saying those things to yourself, grounding yourself, using the things -- like for us, it’s the bear or the watch or the peppermint to ground ourselves and be present, will help you be aware of what’s happening so it’s less frightening, even though it still may be hard.
Another category he gives is interpersonal difficulties. And he says that these are more common with those, not just with those who may or may not have been abused physically or sexually, but also emotionally neglected or had family violence around them, or when there was misattunement, meaning emotional needs not being met or connection made emotionally with the parents when you were very, very young, between being born and age two and three, or even before you were born as well. All of that impacts your attunement, and that’s the one we talked about before where you can search The Still Face Experiment video on YouTube, if you haven’t seen it to learn more about shame theory and how we continue to act it out when we’re older. Pushing away people who may be trying to help us or are good for us, or acting out emotionally or physically when we think we’re not getting help soon enough or fast enough, or in the right way. Or just going flat and completely tuning out, trying to match the level of hopelessness and helplessness to make some sort of congruence between the internal world and the external world.
But because of these complications, and because of not having good role models, and not having anyone who taught us how to regulate our emotions or interact with others or maintain stable relationships, then that’s when we get things like not only is it hard to make friends, it’s hard to keep friends. And it’s hard to handle conflicts or set boundaries unless you’re very vigilant about that and working on it together. And people who are healthy enough and safe enough to navigate some of that with you will be people that will be easier for you to keep as friends long term.
But some of the skills you will have to learn are how to stay away from abusive or toxic relationships, how to reject unreasonable demands from others. You need to set boundaries, and you get to be your own self. Other people don’t get to decide who you are. Our therapist has said -- we have in the circle notebook, a page of things our therapist has taught us, and one of them is that you know better than anyone else what you need. And we probably have to read that everyday, multiple times, everyday. You know better than anyone else what you need.
But at the same time, you also have to reflect on whether you have reasonable expectations of others or not, and make sure that you’re not depending on other people to meet needs that you really need to meet for yourself internally. You have to be aware of whether you’re repeating unhealthy relationship patterns or not, and how things in your past impact your relationships and interactions now.
So, those are examples he gives of ways trauma impacts us, and then that plays out through things like dissociative amnesia, which is not remembering what you’ve done or waking up and not knowing where you are or how you got there, finding things in your home or your room that you don’t know where they came from, losing time, losing different experiences that otherwise would have been important to you, things like that. And then again, the difference between depersonalization and derealization is with derealization you feel like your experience is not real. The world around you is not real. With depersonalization, it feels like you are not real. Your thoughts are not real. Feelings or your sensations don’t belong to you, or you feel like you’re not actually there, or maybe you’re watching yourself as life happens, those things. Derealization is feeling unreal or detached from the world around you, like reality.
So, the therapist is not real, or everything is foggy, or your house is not real, things like that. Both of these are related to dissociation and can get triggered with stress or anxiety, even while you’re in the therapy process. So, things like containment, meaning being able to hold things and wait until you’re in therapy to be able to process them and have that support, or until you can write them down in the notebook to process it a bit, and keep going until your next appointment. Or things like pacing, not doing too much too fast, in session or between sessions, so that your stress and anxiety can stay as low as possible, even though it’s still really hard work that you’re doing, but that you can remember you’re still safe even when you’re doing that hard work.
So then, again, the same thing, at the end of this chapter, the assignment is, “Do you have any of these symptoms?” Yes, that’s why I’m in the research study. “And if yes, could you select one of them and write down how it affects you and how you plan to manage this in the future?” Yes. Yes, I could. See, avoidance, avoidance, avoidance. And then the second assignment, “Have you tried any of the coping strategies described in this chapter?” Yes. It’s really presented that way, where it’s a yes or no question. So, I don’t know if we’re supposed to answer it more or not. But there are things we’re working on in the notebook anyway with the notebook and therapy so we can talk about it then.
But then, in chapter six of this study online, here’s what got interesting, is he finally said, “The journey of recovery is not smooth or easy.” Yes. Yes. Yes. And how we may be distressed by feelings and behaviors during therapy and through the process of the years in therapy, and that it does take a long time, that it really will be years of therapy. So, there’s that - a bit of dose of reality. But also, at least he acknowledged that it’s not an easy thing when some of the previous chapters felt a little bit dismissive.
He then says, “Each person has a lot of parts, and that there is no single self. Everyone’s personality is a complicated system. This personality system consists of many different parts, such as emotions, memories, beliefs, and identities. The parts may exist at the conscious level or the unconscious level.” And so then it talks about how maybe there are parts of you that are more childlike. There may be parts of you that are more close with your friends, or different parts of you have different friends. And you may have parts that are careful and nervous, and other parts who work or do homework. And all of that is healthy and normal. Everything’s under control.
So then, he presents sort of a structural dissociation kind of perspective that trauma interferes with the process of integration as you grow up. So, he says, “Everybody has an angry part. Everybody has an frightened inner child. Everybody has a depressed self.” And the problem becomes -- and so all of this is normal for all people on the planet. He says, “It only becomes problematic when these parts are not accessible. If you cannot access your feelings, if you cannot access your memories, if you cannot access your physical symptoms, or you experience any of these when you don’t want to or intend to - so the intrusive symptoms. Then that’s when it becomes difficult.
So, not being able to remember all of what happened. Only one part of you remembering parts of what happened. Feeling like a robot, which is depersonalization. Having the flashbacks or nightmares. Feeling disconnected or not having any emotions at all, even when very good or very bad things happen, which is a kind of depersonalization. Feeling out of control, or physical symptoms that can’t be explained, that all of these are a part of dissociation, and when it interferes with functioning.
Which takes us back to functioning multiplicity. At what point are we able to have access to each other enough to know and do what we need to know and do, but also still function in the world. And apart from functional multiplicity in general, as far as a lifestyle, how do we maintain functioning while gaining new access to each other through therapy and group workbook, and things like that?
That’s difficult, and is actually one of the concerns that I have that makes me hesitant to participate, because our family depends on me being able to work. And if I lose functioning or if my functioning is impaired too much, I don’t know what our family would do. And so, I feel pretty protective. And as much as I tell them that they need to work together, and as much as I tell them that now is a safe time to fall apart, it maybe is not something I believe entirely for myself, that me falling apart is not an option. So, how do we stay together and maintain functioning? That’s the challenge.
So, he says, “A traumatized person could decide not to acknowledge, respect, face, or accept the dissociated Parts. However, there would be consequences to this, such as continuing to have flashbacks, hearing voices, or other intrusive symptoms, such as compulsions or unwanted emotions, amnesia, and more and more medically explained physical symptoms.” He says, -- which is interesting, because we’ve had a lot of medical issues. And so I don’t know how that’s related there. But I do know that we’re getting better, more than what they said we could. So, it’s got to be related to therapy some, at some level, even if it’s just in a polyvagal way, or in a brain is in a healthier state kind of way. I can’t exactly explain it yet, and I’m not sure what’s happening, but I know we are healthier and stronger than we were a year ago.
So, if a traumatized person wants to fully recover from trauma, they need to process and integrate these Parts slowly. And these Parts are not referring to identities, so much as the parts of a memory. So, the memory itself, the visual part, the emotional part, the hearing part, like what you heard during the memory, and all of these pieces. So, he’s not pushing integration as far as integrating personality states, so much as integrating the memories itself. So again, it’s a very fine line with language, and I think it’s more blatant than what he intended, but that’s how it’s being read.
It’s a process of recognizing, acknowledging, respecting, accepting, communicating with, and cooperating with each part of the personality as well. It’s about joining together, not getting rid of any parts. So, that’s significant, and our therapist has said that too, that it’s not about getting rid of anyone. But even before those layers, it says, “Part of what you will have to learn to do, and part of how you maintain functioning, is continuing to be safe, and avoiding new traumas, utilizing healthy coping strategies, knowing how to calm down, even how to calm down your overreacting body.” So, that helps me remember, too, part of what felt uncomfortable in chapter four was what he was saying about the responses. And so here, he’s specifying that it’s the body that’s responding. It’s the brain that’s responding. And so calming that down is part of what’s helpful, as opposed to you’re bad, because you can't’ chill right now. You’re back because you can’t chill yourself out. So, I appreciate the difference and the distinguishing that he does there.
He then introduces the window of tolerance, which is coming up in our workbook. And it’s talking about the optimal arousal level. So, when a person is functioning well and can effectively process what’s happening to them -- so you're able to process the whole experience of what’s happening to you. Then you’re not hypo aroused or hyper aroused. You’re in that window between them so that you can tolerate what’s happening to you. You can tolerate your experience of it. You can tolerate your response to it. And within that window, you’re able to have empathy, think rationally, interact with other people properly, and be emotionally stable.
So whatever functional multiplicity looks like, it looks like living -- part of it is going to be living within that window of tolerance. However, he points out that it’s going to be really easy with someone who’s already been DID to get pushed out of that window of tolerance. That it’s going to be very easy for something to trigger us out of it, and that if we’re above the window of tolerance, we’re going to be in fight or flight. And we’ll feel unsafe, frightened, panicked, angry, anxious. And so I think we do a lot of living there. And below the window of tolerance will be our freeze response. Below the window of tolerance will be our freeze response, the freeze response is activated. So then you feel numb, or unresponsive, or depressed, or no energy, or even losing consciousness, or even losing time.
And in either of those, too much or too little, you are unable to integrate new experiences or memories. So, anytime you are out of that window of tolerance, then what is happening is not getting processed. Which ultimately means even more therapy, because it’s going to have to be processed at some point to be fully healthy and well. So, he’s talking about this is why it’s so critical to stay in safe places, to practice mindfulness, and to be aware of what is happening, and how you’re responding to all of it - all of you inside. And having healthy social relationships, because you need all of that support to be able to stay within that window of tolerance.
So, that gives me a starting place that at least answers my question of what does functioning mean? As some level of functional multiplicity, what does functioning look like? And that gives me a very good visual to start working with. So, I’m going to study that some more, and we’ll talk about it again.
Thanks for listening.
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