from the therapists tool box

We'd still like to hear what you have to say about it. Even if we've tried it and remain stuck, it would be good for us to re-examine what we've been doing.

Thanks,

MDs

the classic answer would be titrated mindfulness. like tiny steps of focussed awareness that will bring down the hyperarousal. if its overwhelming the step was too big.
if you hate mindfulness with a fierceness... you would still stick to the idea of titration for every other approach
what I feel would be the most appropriate for the situation is assistance from a co-regulating other to calm down together.
if that works a little bit the next step would be play therapy. sounds stupid but play is like on the edge between hyperarousal and safe&social so that is a good place to practice. also with another person for co-regulation and fun.

mind approaches are going to suck. because they try to convince you of something you can't feel with your body and that usually doesn't work so well.
body anchors could create a motivation to be more grounded through positive reinforcement. it means noticing small moments when you are more grounded that feel pleasant and make sure to remember how that felt. its a slow and steady way to shake up the old feeling that only hyperarousal feels safe...
the other mind approach that might help is look at the long-term effects of chronic hyperarousal and get emotional about that. like... create a bit of fear of chronic pain or heart disease as most common effects. that is a bit terrible but it can be a motivation as long as you don't hit false helplessness... or for positive reinforcement, get emotional about the negative effects on relationships and feelings of connection. that one works really well for us. we want to feel more connected. so we bother to be more present.

the thing is, if there is no motivation, you need to get it somewhere. otherwise why change anything?
and then the bottom up stuff works better with hyperarousal than thinking about it...

I can watch out for better solutions when we learn more stuff.

Thanks. It's helpful that you've approached this from a few different angles.

It's hard when a person isn't willing to change. Living by what you've called "the rules of war," meaning not the belief that the specific incidents are still happening, but that everyone and everything is like the traumatizer.

Children globalize. If what they experience makes a severely indelible imprint, it's not surprising that they would end up living in this mindset, even much later in life.

MDs

our T lets is keep a calendar/journal for time tracking where the kids get a sticker for every day that none of the old stuff happened.
to show how time passes and prove that in reality nothing is happening.
still waiting to see how helpful that will be.

Hi
our T is super systematic when it comes to treatment.
she says there are 3 stages of dealing with flashbacks
1. is re-orientation, like the whole mindfulness and grounding stuff
2. she calls trigger disarming and it's thorough discrimination. we will go over what we know about that next time to see if we do it right and then focus on that more
3. is re-processing with tools like EMDR

it's kind of neat that she is having a plan. and that there is a step 2, somehow most Ts seem to miss that and go from orientation to processing right away. or well they don't because the patients are not stable enough for that and so its endless re-orientation without anything getting better.
Asti will share the worksheet for discrimination with you as soon as we get it.

so our T went over the technique for discrimination and trigger elimination with us.

you need to be able to pinpoint the trigger and the memory needs some substance to it. so JUST a body sensation with no idea how that happened will not work.

first you do what we call 'same but different'
collect all the similarities between the trigger situation with the trigger in it and the neutral situations that are triggering today. (work one trigger at a time!)
when you have that, find all the differences and make really sure you can tell the situations apart.
for simple grounding you might continue finding small differences in the similarities.

for the trigger elimination you would pick the differences in the situation that seem the most convincing to you, like it makes you feel that of course this is different.
then you do a controlled trigger exposure. that is not trauma exposure! you are not going into any memory. the goal is to just sit there in the presence of your trigger and notice that nothing bad is happening. that way we create a new memory that competes with the old memory of that thing.
stress levels will totally rise when we confront a trigger. so we need to stay active in the situation, using self-talk to remind us of the differences, like constantly telling ourselves why this is not the trauma situation but a neutral situation. the first few minutes can be tough but then it gets easier.
after about 30 minutes the brain has changed stuff and the thing won't trigger the trauma memory anymore. not in this situation, not in the future.
sometimes triggers are in their nature short events and then we have to repeat the exposure more often, but it will work eventually.
it is not good to wait until the trigger happens to show up. we are usually not sufficiently prepared for that and can't face it properly. so we need to plan and do it on purpose.
this doesn't process the memories. but it can help to neutralize triggers so the memories won't get triggered so often.

when we work with DID we best work with the part/s who are experiencing the flashback. we can help each other with finding differences. when we do the trigger exposure it is important to have the triggered part at least co-con. everyone can help with the supportive self-talk, ideally the part stays active and doesn't just 'endure' it all, that would be trauma pattern, not successfully creating safe memories to compete with the trauma. when we lose co-consciousness with that part and they withdraw, we can stop the trigger exposure because basically it is of no use that way. back to grounding and orienting for that part.
it is really important that they walk through this themselves so they will get a relief. other parts will find it a lot easier because they don't really need any of this, they are not the ones being triggered...

we will find a nice way to put that on the blog soon for an official version that has a step by step guide

birdsong87 wrote:it works really well and it is more fun than the usual mindfulness stuff. we put it into words in the way we want to use it. in case you are interested. https://www.dis-sos.com/calming-racing-thoughts/

That's wonderful! Thank you for sharing that.

I like that idea of how to work on triggers. I know more about what causes some of them, so I can start working on similarities and differences. Thanks!

birdsong87 wrote:(sometimes hosts get into hyperarousal because they are overwhelmed by the inside experience and maybe that means there is need for a break from that)

How does the fronting member accomplish this if not by containment? For us containment only prompts those in distress to transmit their trauma feelings even more loudly.

Charity and others

MakersDozn wrote:

birdsong87 wrote:(sometimes hosts get into hyperarousal because they are overwhelmed by the inside experience and maybe that means there is need for a break from that)

How does the fronting member accomplish this if not by containment? For us containment only prompts those in distress to transmit their trauma feelings even more loudly.

Charity and others

I may be missing the whole point of this or completely not understanding what you mean, but to me, it sounds like those in distress are confusing containment with repression or dismissal of their feelings. If someone feels like their feelings are validated and accepted, even if they can't be dealt with right now, that is a calming process. It's only when someone feels like their feelings are being dismissed or blocked, or their need for comfort isn't being understood, that they get louder in an effort to let someone else know how important and urgent their feelings are.

One can tolerate a lot of pain if they know that someone understands that they are in pain and feels sorry that they're in pain, even if the means to alleviate it isn't available right then--even if they have to wait.