Located in

Portland OR

Integrating psychotherapy, medication management, body work & mindfulness for an encompassing and empowering approach to healing.

Month: March 2015

Dissociative Identity Disorder & Authenticity

Dissociative Identity Disorder (DID)


The Question of Authenticity

Many of us find ourselves contemplating the question of “who am I” at some point or another; perhaps we are pursuant of a spiritual connection to our place in the universe or may be hoping to connect with ourselves veritably. Evaluating the supposition of authenticity highlights the fact that fidelity to self is layered and complex.  The foundation is characterized by a knowing; awareness of internal strata and facets of one’s constitution.  Secondary to knowing is acceptance of one’s characteristics; only with knowledge and acceptance of who we are can we begin to navigate our relationship to the world around us. Presenting ourselves genuinely without fear or regret is risky and requires significant ego strength; the venture of rejection of true self is more painful than that of a disingenuous self.  Relating to others in a real way while being accepted simultaneously is a challenge for all of us; individuals with Dissociative Identity Disorder (DID) are faced with a normal question that is complicated by multiplicity (and it’s functions).

The basal layer of authenticity poses a problem to dissociative individuals; the function of fragmenting can be to hide selves from the self.  Presupposing this is a protective process, how does one connect to who they are if overwhelming information is held in the answer to the question? Parts or “alters” are often hidden from view or are “behind the curtain” of consciousness in order to protect the rest of the system.  Self-awareness can seem commensurate to emotional gambling.

The second layer of authenticity requires acceptance. Assuming trauma is the etiological base behind DID, acknowledgement of some alters can feel parallel to an acceptance of unacceptable events.  Protective alters who hold anger, self-injure, engage in addictive, or violent behavior are often completely rejected by the rest of the internal system.  Child alters (who often hold the traumatic memories) are sometimes viewed by the rest of the system as pathetic, shameful and weak.  Managerial alters do find external belonging, but become fatigued from their overwhelming task of hiding and pushing for success. Recognition of a fragmented identity may equate to acceptance of the past, acceptance of a controversial diagnosis, and acceptance of an experience that many people will find challenging to connect to.

A common theme that arises in working with DID reflects this quandary; how can I be myself if my self changes?. Essentially this is a logistical question; how does one establish an authentic connection to the outside world when it feels like one’s demographics are in flux? Age, gender, and race are significant determinants of who we relate with and how relationships develop.  Small children like to play in very different ways than teens or adults do; men develop different relationships with women than they do with men and adolescents think adults are ridiculous. What if you are male sometimes, a five year-old at other times, or an adolescent girl at others?  This is an experiential truth for those with DID and it is very unclear as to how to be real and accepted under the umbrella of fragmentation.

When asked the question of how to relate to others in a way that feels real, my response is likely fairly inadequate.  I can only acknowledge the reality that DID is difficult even for some mental health professionals to accept (although research is making this more and more challenging); friends, family members, co-workers, and strangers are even less prepared to navigate such relationships.  There is truth in this experience and I have not discovered the right answer to living authentically in a world that is accustomed to and expects continuity.   It could be argued that we all are multi-faceted and are accustomed to disguising our vulnerability or less acceptable components of personality. Authenticity is a collective challenge, although it is a far more complex aspiration for those whose experience of who they are is relatively fluid.  Someone who lives with alters may say that in order to be genuine, they may require acknowledgement of all parts of self, to accept them, and to interact with the world from varying perspectives.

Massage, Acupuncture, Reiki & Mental Health

After watching the relationship between the mental health and the body be conceived as somehow distinctive from each other and thus the assumption is to treat them as separate entities, I thought it might be interesting to offer adjunctive treatments to folks. When I opened Integrative Trauma Treatment Center, that was a large factor in what drove the design of our model. We have massage therapy, acupuncture, medication management and psychotherapy available in one location. These services can be utilized together or a la carte. The goal is to provide a safe place for folks to get body work done, where they know their practitioners will tune in to them and have a nurturing but empowering presence. I also wanted to acknowledge the despair, suffering, and isolation that can go with trauma, depression, anxiety, or other mental heath concerns and to create a community that was open, welcoming, playful, and safe. A place for people to spoil themselves. I suspected that clients would appreciate it. I knew I liked the concept. What I didn’t expect is how I feel comforted by the fact that there is a team working with me and my clients in their process. I am not only surrounded by other like-minded therapists, but other practitioners who can approach the same challenges from different angles. This provides me with a safety net that I appreciate so much and did not expect that I would feel comforted by them. I feel less isolated as well. Hopefully, the gift to me as equally meaningful to those who visit ITTC.

Social Media & Trauma

Social media has become so interwoven into the details of our lives, turning our private (and occasionally mundane) thoughts into public domain. In order to remain connected not only socially, but professionally, Facebook and other forms of social media are less optional than subtly compulsory. Not surprisingly, Facebook is a topic of conversation in therapy for many clients. Navigating the cultural expectations for continuous connection and unbridled access to each other is a challenge for everyone; trauma survivors are confronted with another layer of consequences for communication (or a lack of communication) on social media.

Continue reading “Social Media & Trauma”

Stress Management Group!

Mindfulness Based Stress Reduction
Thursdays April 16-June 4, 2015
4:00 pm – 5:30 pm, $300

Learn how to sit down, slow your mind and change your brain. This
8-week course will allow you to learn and practice a researchproven
method for reducing stress and building a sense of calm in
your life. The course consists of 8 weekly meetings with guided
meditation, a home practice guide and audio meditations for daily
practice. Contact ITTC at the phone number below to schedule a
free 30 minute appointment with facilitator Sarah Lebo, LPC.
Integrative Trauma Treatment Center 811 NW 19th Ave., Ste 102
Portland, OR 97209 971.266.6910 main | 888.972.3623 fax

Welcome to ITTC!

Welcome! Integrative Trauma Treatment Center (ITTC) is an outpatient mental health organization housed in NW Portland, Oregon. Our mission is to provide progressive therapy alongside adjunctive treatments, including acupuncture, massage, reiki and medication management. In addition to providing a progressive approach to mental health concerns, we also offer a safe place to receive body work. Some will shy away from acupuncture or massage due to the discomfort associated with practitioners who may be less informed about mental health (especially those with post-traumatic stress disorder or PTSD). Our practitioners work from a trauma-informed perspective and approach body work with sensitivity, awareness, and compassion. Acupuncture, massage, and reiki are available to those receiving therapy and medication management at ITTC as well as to the general public.

The foundation of our work is to approach healing from the perspective of empowerment, choice, and collaboration. ITTC has a diverse group of practitioners who espouse varying styles, are trained in alternative modalities, and have differing specializations. Some of our therapists’ specialties include adolescents, couples and families, addiction, complex trauma, simple trauma (such as a motor vehicle accident or MVA), and dissociative disorders (such as Dissociative Identity Disorder or DID). The common thread is that we all are invested in providing care that is creative while housed in efficacy in a setting that is warm and welcoming.