Integrating psychotherapy, medication management, body work & mindfulness for an encompassing and empowering approach to healing.
Tag: Dissociative Identity Disorder
Join us this May for a workshop on working creatively with a very gifted population: those living with Dissociative Identity Disorder.
Presenter: Athena H Phillips, LCSW
DID (Dissociative Identity Disorder), previously known as Multiple Personality Disorder, continues to be a diagnosis that is portrayed incorrectly, misunderstood, and or those living with it can be overtly treated as dishonest by their healthcare providers. Many have been re-traumatized in the pursuit of treatment (this is the iatrogenic trauma part) and have naturally become concerned about sharing in their experience for these reasons as well as others. Most people with a dissociative disorder present with anything but DID (usually anxiety is the presenting concern) including mood disorders, addiction, eating disorders, PTSD. Those living with DID have been diagnosed with all of these in addition to a misdiagnosis of bi-polar or schizophrenia.
Constructs of DID can often be fantastical; the greatest irony in this is that it is a very well-hidden disorder effecting 1-3% of the US population (if you do the math, that’s a lot of people!). It is not an extremely “rare” condition as many believe (for example, 2.6% of the population has a diagnosis of bi-polar disorder within a 12-month range; up to 3.6% within a lifetime range). Bi-polar exists as frequently, can effect behavior significantly, and is not contested as an illness. I think the difference likely lies within the cause (DID is caused by trauma, whereas bi-polar disorder is an organic illness). I could be bold and suggest this is another form of blaming those who have endured unbelievable adversity…perhaps I will be bold and suggest that.
The irony is that DID is an extremely well-hidden experience; considering this is the purpose behind dissociation (to protect ourselves from overwhelming experiences and to hide our pain from others in order to function); it is very atypical to work with someone with DID who also overtly displays or discusses their internal life. Because hiding has become so necessary, including within the field of mental health, the intricacies of this gift (yes, this is how I think of it because not everyone has the capacity to protect themselves in this way) are a very private experience. The details are rarely shared with anyone but a trusted therapist, a very close loved one, or maybe a friend or two (maybe…).
The power of groups and connecting with others who share in your experience is known to be powerful. In an effort to provide an opportunity for people with DID to share in their experience, ITTC offers a bi-weekly group for those with DID who want to be supported by and be supportive of others who understand. The group is mostly unstructured but is facilitated; the primary purpose is to create a safe space to share in experience. All participants are required to be actively involved in individual therapy.
The group occurs every other Monday @ 3pm. Contact firstname.lastname@example.org for further details.
Dialectical Behavior Therapy is an excellent tool for affect regulation and helps those who are struggling to keep their emotions within a window that feels reasonable. We often utilize it in adjunct with individual therapy for trauma survivors who want to build some of the skills that were not offered during their development as a result of a chaotic upbringing.
One of our clinicians, Sophie Toolenan, is offering regular DBT groups both for those within our clinic and in our community.
Click on the link below for the details for upcoming groups and feel free to contact us for more information:
Vancouver Integrative Counseling is hosting our next Art Therapy Workshop for those with Dissociative Identity Disorder.
This is our third workshop and each one has been very fun and safe for participants (and for the facilitators!).
The intention behind the workshop is the offer an opportunity to externalize the internal experience, to share with others, and to have a visual reference.
Contact email@example.com if you are interested in reserving a spot!
February 20th, 10am-noon
Art Therapy Workshop-2 in April.
We will use mixed media to provide a safe, fun, opportunity to map your internal family. The product will be adaptable and will be helpful in conversation treatment providers, friends and family. Attached is the flyer.
Contact Athena@traumacenternw.com for more info.
Coming Soon….Honoring your Internal Warriors: Preparing for Trauma Work from an Internal Family Systems Perspective.”
Athena Phillips, LCSW will be offering a workshop for trauma survivors who are in the early stages of recovery. The decision to engage in therapy is in itself a tough decision and in my opinion, courageous. Revisiting painful memories is counter-intuitive~avoidance is probably more natural. In order to alleviate the influence trauma can have over our lives, we need to go against what our thoughts might be telling us to do (avoid, get away from, never go back). Typically it’s our bodies that won’t allow us to leave trauma behind until we have successfully processed and made some meaning of profound experiences. The conflict between our thoughts that tell us to forget about it or get over it and our body’s unrelenting reminders that we need to tend to our past creates significant internal tension.
The beginning of trauma work should be housed in establishing safety with the therapist as well as trust in ourselves in being able to handle the material we intend to revisit within the therapeutic context. Setting this intention naturally activates our protective mechanisms; the parts of ourselves that understandably have some concern about looking at trauma again. Our internal warriors have likely worked very hard at ensuring safety, at staving off overwhelming emotion, at maintain a safe distance between people, at scanning the environment for potential harm, or at helping keep things stable through numbing and avoidance. Sometimes these efforts can take a more extreme form, like dissociating from trauma, self-harm, excessive use of drugs or alcohol, suicidal fantasy. Many of these coping strategies are cause for concern, naturally, however there is generally some sort of positive intention behind them. Understanding the intention of the parts of self who are often trying to protect (Internal Warriors) and using them to guide safe trauma work is the goal of this workshop.
Participants must be actively engaged in individual therapy and must be able to interact with other group members in an emotionally safe way. Traumatic memories will not be discussed during the workshop, rather we will focus on how to prepare to do so in the context of individual psychotherapy.
Creativity, play and art will be utilized for the workshop and our hope is to have fun.
The workshop will be held July 18th from 1-4 pm. Cost is 125.00 and must be paid in full a week prior to reserve space. Maximum of 8 participants. Location TBA (either our Portland or Vancouver location depending upon number of participants). Call 971.266.6910 ext 301 for inquiries.
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.