Treatment options / do you need a specialist T?

TheGangsAllHere wrote:That's a very important thing for you to get her to understand. She only knows what she sees on the outside, and I think T's tend to think that we experience the most pain when we're crying and upset on the outside, when it's really more painful to be alone with it on the inside. For me, letting it show is a sign that I'm feeling more connected and I'm willing to try sharing a feeling that I would otherwise just keep inside.

But they can only know that when we explain it.

I'm glad the book was helpful for you. I haven't finished it yet--I'm on the second of the 4 skills. But the concept alone has changed a lot of things for me.

Yeah, that is what it is like for us also.

I really love the book. My favourite thing about it is feeling in my body that it works, that it IS safe to think/notice positive things. That I can do that inside and no one has to be involved or notice.

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It was an intense T session. It worked out moderately well. In the future we will experiment with using a sandtray/creative techniques during session, to show the movements inside. In the hopes that the T will be able to get more of a clue without us having to talk or move the body to show body-language.

She asked a lot about L. Ironically she also asked if he is about 3 years old - but he is about 10 - 14, so that was awkward. That happened the other day as well, when she met M. and asked her if she was 6, when she is 12!!! I don't know why she expects these young parts, when we would clearly work hard to prevent them from fronting (as we consider young parts to be more vulnerable). Plus, she must have heard about the responsibilities that they have. With a 3 year old or a 6 year old that would be impossible.

I talked about the work I did with L. a while back. It was based on a solution-focused intervention for children. I treated the system as "the parents/family" and him as the child. It worked really well. The outcome was similar to what you'd expect, based on what I read. The T didn't have anything to add, which I thought was too bad. She said that sharing it in a therapeutic relationship is beneficial in itself... but... I've noticed that with memories, not so much with daily/normal things. Or system work. I guess system work calls for me to be in a T-role inside, so then I expect/would like supervision-type feedback. Maybe it is too much to expect.

Things are relatively quiet inside. In a good way.

fireheart wrote:She asked a lot about L. Ironically she also asked if he is about 3 years old - but he is about 10 - 14, so that was awkward. That happened the other day as well, when she met M. and asked her if she was 6, when she is 12!!! I don't know why she expects these young parts, when we would clearly work hard to prevent them from fronting (as we consider young parts to be more vulnerable). Plus, she must have heard about the responsibilities that they have. With a 3 year old or a 6 year old that would be impossible.

Maybe they seem younger emotionally to her? You can ask what it was that made her think that, so you can correct any misunderstandings she might have about them. And you can remind her of the responsibilities they have. I've learned it's a good idea not to assume my T remembers every detail I've ever told him, or that he puts things together the way I would expect him to.

fireheart wrote:I talked about the work I did with L. a while back. It was based on a solution-focused intervention for children. I treated the system as "the parents/family" and him as the child. It worked really well. The outcome was similar to what you'd expect, based on what I read. The T didn't have anything to add, which I thought was too bad. She said that sharing it in a therapeutic relationship is beneficial in itself... but... I've noticed that with memories, not so much with daily/normal things. Or system work. I guess system work calls for me to be in a T-role inside, so then I expect/would like supervision-type feedback. Maybe it is too much to expect.

The T doesn't have a way of knowing what you would expect or like unless you tell her.

And interestingly, it's the complete opposite for us in terms of sharing things. Right now, it's only beneficial for us to share current activities and things that happen in the system, and of course, what happens in the relationship with the T, and almost never helpful to share memories. We spent years talking about the past with a previous therapist, without having a real emotional connection with him, and it re-traumatized us in a big way.

Glad that you're finding resources that are helpful to you, fireheart. In the 21.5 total years we've gone to T for DID-related therapy, we've never used a sand tray. It's not been a priority for us, but it's also not something we'd decline if offered it.

Interesting that the T thought that your older littles were younger than they are. We agree with Gang that it might be helpful for you to ask what made her come to that conclusion.

And also like Gang, we rarely talk about specific memories. We mainly talk about improving our communication and cooperation with each other, and about our need to be heard (and know that we're accurately heard) accurately by the T. A lot of meta-communication.

MDs

It is actually not helpful to get the suggestion that I should discuss things with my T, nor that I should tell her about my expectations. "This ain't my first rodeo," comes to mind.

We discussed the reason she thought they were younger right that moment and it is solely because I call them "very young". It merely shows that my perspective on a 12 to 14 y/o is that they are very young (still have quite some growing to do), and that she would expect a much younger presentation.

It isn't quite helpful to share memories with her yet either, but I have past experiences with different Ts in which it reduced a lot of trauma symptoms to put words to what was coming up (flashbacks, etc.). It was helpful to learn how to do titration and to do EMDR.

I'm curious to see what the creative work will bring. It feels like the right path to pursue for now, so I am excited that it is possible.

fireheart wrote:It is actually not helpful to get the suggestion that I should discuss things with my T, nor that I should tell her about my expectations. "This ain't my first rodeo," comes to mind.

Okay, thanks for letting us know.

MDs

I'm interested to hear how things go with the sandtray or other creative techniques. We made our own sandtray at home, although we haven't gotten it out for awhile--it definitely has helped us get a sense of what might be going on nonverbally.

fireheart wrote:It is actually not helpful to get the suggestion that I should discuss things with my T, nor that I should tell her about my expectations. "This ain't my first rodeo," comes to mind.

Sorry. When you said, "I don't know why she expects" those parts to be so young, or you say, "maybe that's too much to expect," about wanting a certain kind of feedback from her, I thought that you hadn't asked her why she thought those parts were so young, or that you hadn't told her specifically that you would like "supervision-type feedback" from her about your work with younger parts.

I know that sometimes I assume that something will be "too much" to expect without actually checking it out, and then when I do articulate my needs, it's helps the T do and be more of what I need. It seemed like you were speculating about what the T thought or would do rather than asking her. But I'm sorry that I misunderstood and that it wasn't helpful.

We already tried scavenging the house for objects that could represent certain parts. We found some stuff, but it does still feel weird to potentially show the T, or to try to link all that is going on to the objects. I also have cards with emotions on them. That feels a bit more realistic. Or maybe using clay/playdoh.

I guess that makes sense when you put it like that. There might be some inner division on my part - in the moment of writing I probably forgot that I asked those things already. To me it felt a little condescending to receive the suggestion to tell her, because I know what it is like to do therapy, and I know that the key is to be open about things. Plus, I remembered that I'd actually already asked both those things. It feels like when I was writing I was probably more looking for a place to express the underlying frustration/fears. Maybe some of us still feel that sense of being unseen/unheard by her. We're really still experimenting with ways of navigating this new relationship and our goal of remaining the main attachment figure for the littles.

fireheart wrote:There might be some inner division on my part - in the moment of writing I probably forgot that I asked those things already. To me it felt a little condescending to receive the suggestion to tell her, because I know what it is like to do therapy, and I know that the key is to be open about things. Plus, I remembered that I'd actually already asked both those things. It feels like when I was writing I was probably more looking for a place to express the underlying frustration/fears. Maybe some of us still feel that sense of being unseen/unheard by her.

Thanks for explaining more about this, fireheart. After we responded to you, it occurred to us that perhaps we were not properly engaged with what we'd been reading. We're sorry, and we take responsibility for this. We want to show support. But we have to be fully present and aware when we do so.

We too strive to be the main attachment figure for our younger ones. It's challenging, because our older ones have attachment needs too, perhaps more so than our younger ones. We hope that you find ways to meet this goal, and we're interested in hearing more about how you do so, if you feel like sharing.

MDs

Thank you for such a kind reply, MDs. It does really make me feel like you have our back.

I gathered a bunch of figurines and objects to represent the system, and set them up in therapy.
The T took them in attentively and asked some questions. She said something about how I am taking responsibility for them, in contrast to what my parents did.
She looked at me meaningfully and was unsuprised when I responded to the statement. I wasn't sure what she meant. I think there was influence from a part, because i also couldn't remember the meaning of the word "responsibility". So i asked her and I guess I must have sounded very young, because she asked if there had been a switch. I shrugged and she backed off.
I tried to think about it more, but I kept thinking of "learned helplessness" and that if I'd say I'm responsible now, it would mean that I hadn't been responsible earlier and then it would've been like learned helplessness (and bad). I tried to explain it, but even after 5 tries the T didn't get it.
Then finally, when i went really really slowly she maaaaybe sort of got it? The only thing she said was that she wouldn't think of me as "learned helpless" at all. More like the opposite, assuming too much responsibility.

Another rupture happened when she responded to our email in-session, but in such a way that she didn't address anything about it. I didn't notice it at the time, but apparently that was distressing. I'd say she probably just forgot what it said exactly. Maybe she'd read it some days ago and had been busy with other things.

There was also another rupture earlier in the conversation where she had misheard a pretty big detail.

And there was no time left to discuss the one topic that I'd asked to discuss. She apologized for that last thing. I told her that it was perfectly fine, that i can also find a solution on my own - but I can tell that M is quite upset inside.
I guess it keeps me busy (on my feet).

The positives are that the T seemed quite present, and that we were on the same page regarding showing the parts in a visible way.