Coping With Trauma-Related Dissociation

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My Psychotherapist recommended a new book she wanted me to read called Coping With Trauma-Related Dissociation by Suzette Boon, Kathy Steel and Onno Van Der Hart. I can honestly say it is the best book I have read on Dissociation and Complex PTSD. It is beautifully written, accessible, up-to-date and is written for patients and therapists. It only costs AUD$47.99 and is available at Bookdepository.com or Amazon or I’m sure your own favourite online bookstore. Highly recommend it.

Below I have quoted a section that really struck a chord with me on the Inner Life of the Dissociative Individual.

People with a complex dissociative disorder have a dissociative organisation of their personality that is comprised of two or more dissociative parts, each having (at least somewhat) different responses, feelings, thoughts, perceptions,  physical sensations and behaviours. The inner world of the individuals involves interactions among various parts of the personality, whether or not within conscious awareness.   Everyone’s personality, as we noted before, is a complex dynamic system that, like all systems, involves continuous actions and reactions with parts of the system interfacing for better or worse. Dissociative parts may take control or influence the person as a whole to a greater or lesser extent. These parts, no matter how separate they are experienced, are not other “people” or full “personalities”, but rather are manifestations of the way in which your single personality is organised. You are still one person, although we understand that you may not always feel that way.

The Inner World of the Dissociative Individual

Images of the “Inner World” of Dissociative Parts

Many people with a dissociative disorder(though not all) visualise an inner space or world in which their parts reside, and they may also visualise an image of a particular part. They may describe inner scenes such as hallways with doors, houses with rooms, or particular scenes in which parts “live,” such as a child huddled in the corner, or a teenager with stringy hair who looks very angry. These images are helpful because they can be changed therapeutically to increase inner safety and communication. For instance, rooms may have intercoms installed for better communication, or the image of a warm blanket or stuffed toy might be added to the picture of a child huddled in the corner to increase a sense of safety and comfort.

The Basic Functions of Parts of the Personality

Although each person may have some unique features of his or her dissociative parts, there are some typical underlying similarities in the basic functions of parts. When people have been traumatised, their personality is generally organised into at least two types of parts based on functions. The first type of part is focused on dealing with daily life and avoiding traumatic memories, while the second type is stuck in past traumatic experiences and focused on defense against the threat.

The parts of the personality that function daily life often comprises the major portion of the personality. Those with Did have more than one function. This type of part usually avoids dealing with or even acknowledging other parts, though it may be influenced by them in various ways. This part may avoid situations or experiences that might evoke traumatic memories. Such avoidance originally helps people cope with daily life while keeping painful (past) experiences at bay. However, over time, it results in a life that becomes increasingly limited.

While the part of the personality that copes with daily life is avoidant, at least one other and usually more than one other part remain “stuck” in traumatic memories and think, fell, perceive and behave as these events are still happening (at least to a degree) or are about to happen again. These parts are typically stuck in repeating behaviours that are protective during the threat, even when they are not appropriate. For example, some parts fight to protect even when you do not need such protection in the present, others want to avoid or run away even though you are safe, some freeze in fear and others completely collapse. These parts are often highly emotional, not very rational, limited in their thinking and perceptions, not oriented to the present time and are overwhelmed. They primarily live in trauma-time, that is, they continue to experience the traumatic past as the present and so forth that are related to traumatic experiences.

Awareness of Parts For Each Other

Dissociative parts may have varying degrees of awareness for each other. Some are not aware at all of the other parts or are only aware of a few other parts. One part may be aware of another, but not vice versa. Some may be aware that other parts exist but do not understand the meaning, they often are not in agreement about issues at are important to the person as a whole. One of your goals should be is to develop skills for reaching agreements among parts which is different from forcing other parts to comply with you or ignoring their needs.

The Influence Of Parts On Each Other

Regardless of the degree to which parts are or are not aware of each other, they do influence each other. any part may intrude on and influence the experience of the part that is functioning in daily life without taking full control of functioning an experience referred to as passive influence or partial intrusion. You can be influenced by other parts in your thoughts, feelings, body sensations, perceptions, urges, or behaviours. For example, while in a shop people with a dissociative disorder may hear an inner voice that says, “Get out, get out, it’s not safe in here! You have to go home”. even though they know there is nothing wrong. This is more than a wish but rather a desperate inner voice that comes from another part of the personality that maybe visualised as a terrified young child. Perhaps such individuals might also hear or sense other inner voices that tell the child part to shut up or that complain about how stupid they are to go shopping because they do not need anything.

Such people may then feel confused, ashamed, ad afraid of what is happening inside themselves and might feel a sense of impending doo, as though something terrible is about to happen. And all the while, they remain aware that they are simply in a store whee everyone else is going about their business quite normally. In addition, they may hear or sense interactions among several iner parts so they feeel like a bystander to a conversation or argument in which they are not included.

These intrusions have a different quality than the normal distress some people without a dissociative disorder may experience in a crowded stores (“This stoew is crowded and I am eager to finish and leave”). Instread, it is as thoug a person with a dissociative disorder has (at least) two completely different minds that do not understand each other or are conversig about completely different topics. These intrusions may seem so bizarre or alien that you might have worried that you are insane, but this is not the case. Even though you may not fully understand yet, other parts of you have their own agendas, their own perceptions, thoughts, feelings, wishes, needs and so forth for good reasons.Your challlenge is to lean about and accept them without judgeent, even if you do not agreee with them. Only from that point of understanding can you make changes that support all parts in working together more closely.

Executive Control

In some cases, especially DID, on dissociative part may take full control of your behaviour in the world.  The process of one part taking over from another, often an involuntary event, is called switching. If you experience switching, you may lose time when another part of you is in control. Or perhaps you are aware of whar is happening, but is is as thoug you are watching and have no control over your behaviour. For example, one person lost time whener she was in a crowded store. She “came to” in her care with all her groceries but could not remember buying them. Another person experienced watching herself in the store as though she were walking behind herself or seeing herself from above, outside her body, wondering why she was being so slow in shoppping. She reported being back in her  body once she returned to her care.

Most dissociative parts influence your experience from the inside rather than exert complete control, that is, through passive influence. In fact many parts never take complete control of a person, but are only experienced internally. Frequent  switching may be a sign of severe sress and inner conflict in most individuals. However, for some patients with switching in life it is a daily occurence.

Number of Parts

People sometimes wonder how many parts they may have. The actual number is not important in itself. It is significant only in that the greater the fragmentation of the personality, the lower the person’s integrative capacity tends to be. This usually means that people with “more” parts may need to work more in therapy on increasing their capacity to integrate their experiences.

I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin