Massive backfire in therapy - don't know what to do

[beaneeboo]

I worked with two therapists who specialized in DID--both with radically different ways of doing it--and I honestly don't think I could ever have made any progress without that work.

Great you had that therapeutic experience

Just my opinion, but I think a therapist needs a strong understanding of and training or work in dissociative disorders in order to effectively treat them.

Thanks for your thoughts... I'm getting the same vibe from others.

 

[beaneeboo]

I can’t speak to OSDD, but I can tell you that with DID, when you first start communicating with parts, it’s almost universally immensely destabilising. People, coexisting in the same body, who genuinely loathe each other, and disapprove of the way the others deal with stress and potential threats.

Yikes.

Some of my parts went to war with each other when we opened that door. And it was flat out dangerous, and I had to be hospitalised to stay safe a number of times (read…a lot of times).

Sounds horrific. Glad you're more stable now

That’s why, certainly with DID, I wouldn’t do parts work with anyone who doesn’t specialise in it. Because they will know that’s coming. And they will be ready for when things inevitably blow up, with DID-specific strategies, to keep you safe.

Makes sense. And I guess this reasoning is partly the type of thing which got me thinking about introducing more DD specific approaches to start talking specifics like this... but I think my own research (also being here) has got me further down the line than him with understanding the basics of therapy for DD (and I mean basic). Which is an odd position to be in. And I wonder if slightly threatening to him because I'm bringing up concepts he doesn't really know about. I don't want in any way to threaten him. I just want to sort what's going on in my life.

But again, that may or may not apply with OSDD.

From what little I've heard is the therapy approach for the two are by and large the same. But I couldn't say for sure.

 

[beaneeboo]

Oh yeah...so true. And not only in how they relate to each other but just the very idea that you are hearing from others *inside.* Freaked me out big time initially.

Funnily enough this was one of the criticisms of T towards the video I showed. In it, the T in the video talked exactly about people freaking out initially and being terrified of having parts as well as the fact that this confirmed to some people they really did have a DD which isn't a great thing to have. To my T, these words were insensitive and he questioned why would you want to get anyone to do something which might terrify them in T? My take on it was that if I were to start hearing from my parts and get a response, I would freak out and it would likely send me into a difficult place because it would be harder to deny which is what I've done the last 7 years. So I understood what the T in the video was saying and thought it was truthful. But my T saw it as poor practice.

Can I ask you (and anyone else with DID/OSDD), when you started hearing from others inside, how did that manifest? Voices? Thoughts? Both? Neither? What is a response for you? I know this likely is a little different between OSDD and DID

 

[whiteraven]

Funnily enough this was one of the criticisms of T towards the video I showed. In it, the T in the video talked exactly about people freaking out initially and being terrified of having parts as well as the fact that this confirmed to some people they really did have a DD which isn't a great thing to have. To my T, these words were insensitive and he questioned why would you want to get anyone to do something which might terrify them in T? My take on it was that if I were to start hearing from my parts and get a response, I would freak out and it would likely send me into a difficult place because it would be harder to deny which is what I've done the last 7 years. So I understood what the T in the video was saying and thought it was truthful. But my T saw it as poor practice.

Yeah, this sounds to me like he just has no clue. I mean, if we can't do this in therapy, then where? The therapist should be able to help you through it, help explain what is happening, help you make sense of it, and help you figure out how best to respond. Fwiw, I came to appreciate my insiders. After learning how to communicate and manage the more difficult times, it didn't bother me at all. And now, I seldom get input from anyone inside.

I ask you (and anyone else with DID/OSDD), when you started hearing from others inside, how did that manifest? Voices? Thoughts? Both? Neither? What is a response for you? I know this likely is a little different between OSDD an ne DID

So--both, but the voices were the scariest for me. I also got a kind of visual sense at some point for some of them, and I got a lot of information (confirmed in conversations with my therapist) from dreams. I often just listen(ed), although sometimes with the ones who were crying or loud and abusive, I worked with my therapist (and through research I did) on the most useful responses.

 

[Sideways]

Thanks @Sideways .. sorry I didn't understand this. You mean it's been immensely helpful to work with Ts who don't have specific experience in it?

Yeah, sorry!

I’ve done DD-specific therapy with DD specialists. And I’ve done (way more) non-DD therapy with trauma-specialists, and non-trauma mental health practitioners.

All of it was helpful.

CBT and ACT in particular have been the backbone of a lot of my coping and recovery. And I did those with Ts who specialised in those (not DD), and I absolutely wouldn’t be where I am now without that. So, therapy with a non-DD specialist can be pivotal to recovery.

At the same time, I also needed, separately, to work with a DD specialist. It’s a seperate disorder to my PTSD, so not surprisingly, has required different therapy, from different treatment providers.

the therapy approach for the two are by and large the same.

True. But there is also more than one way to approach DID.

Treatment is anywhere near as refined for DDs as it is for PTSD. They’re a far newer concept in psychiatry, and tbh, evidence is pretty hit and miss on what works and what doesn’t.

There are a number of treatment modalities which DD-specialists essentially borrow to treat DDs. Therapies that were initially designed (and studied) for other disorders, which can be helpful in managing DDs. But our understanding of DDs is almost non-existent. Treatment approaches still reflect that.

There are also some treatment approaches for trauma that can make DDs worse depending on how they’re delivered. And there is some evidence that certain therapy approaches (like IFS) can essentially create the belief (and dysfunctional) of a DD in patients with complex trauma that don’t actually have a DD.

We really need a lot more research to properly understand what’s going on with DDs and more evidence into effective treatment.

I would freak out and it would likely send me into a difficult place because it would be harder to deny which is what I've done the last 7 years.

Yeah, and this is just the beginning!!

 

[beaneeboo]

Yeah, this sounds to me like he just has no clue. I mean, if we can't do this in therapy, then where? The therapist should be able to help you through it, help explain what is happening, help you make sense of it, and help you figure out how best to respond.

Yep this is my thinking. The thing is I think he could do it. If he were educated on it.

Fwiw, I came to appreciate my insiders. After learning how to communicate and manage the more difficult times, it didn't bother me at all. And now, I seldom get input from anyone inside.

Sounds like you're quite far in your journey?

So--both, but the voices were the scariest for me.

I can well imagine.

What i would like to know is if it's well known if people don't get voice responses (but more thoughts / dreams or writing) whether this could be considered actually hearing back from parts with DD. Voices to me just seem so final and definite...

I also got a kind of visual sense at some point for some of them, and I got a lot of information (confirmed in conversations with my therapist) from dreams. I often just listen(ed), although sometimes with the ones who were crying or loud and abusive, I worked with my therapist (and through research I did) on the most useful responses.

Again do you mind if I ask were these all clear voices? Or thoughts? I'm not sure with me whether they are Voices or thoughts but think they must just be Voices because I would know the difference...

 

[beaneeboo]

Yeah, sorry!

Don't be!

I’ve done DD-specific therapy with DD specialists. And I’ve done (way more) non-DD therapy with trauma-specialists, and non-trauma mental health practitioners.

All of it was helpful.

CBT and ACT in particular have been the backbone of a lot of my coping and recovery. And I did those with Ts who specialised in those (not DD), and I absolutely wouldn’t be where I am now without that. So, therapy with a non-DD specialist can be pivotal to recovery.

Right, gotcha... that all makes sense. I guess I'm at the stage where I've done lots of non DD specific therapeutics over 20 years... my current T is by far the best trauma therapist I've had ever... but is not DD specific trained..

At the same time, I also needed, separately, to work with a DD specialist. It’s a seperate disorder to my PTSD, so not surprisingly, has required different therapy, from different treatment providers.

This makes sense when you spell it out. Though to me (before i started my current therapy) i didn't see an obvious difference. Because I didn't have the education.

True. But there is also more than one way to approach DID.

Treatment is anywhere near as refined for DDs as it is for PTSD. They’re a far newer concept in psychiatry, and tbh, evidence is pretty hit and miss on what works and what doesn’t.

That was the point of my T and one reason he's less up for training in it I think

There are a number of treatment modalities which DD-specialists essentially borrow to treat DDs. Therapies that were initially designed (and studied) for other disorders, which can be helpful in managing DDs. But our understanding of DDs is almost non-existent. Treatment approaches still reflect that.

So this is interesting because in a way perhaps reflects the thoughts/ beliefs of my T?

There are also some treatment approaches for trauma that can make DDs worse depending on how they’re delivered. And there is some evidence that certain therapy approaches (like IFS) can essentially create the belief (and dysfunctional) of a DD in patients with complex trauma that don’t actually have a DD.

Very important to know this. For years I've thought that I lied to get a DD and denied it for a long time. I'm coming out of that more now to accept it (ironic given T is less supportive of the diagnosis) but I think what you've said here is a really good argument for why clinicians need to know their boundaries around what they don't know e.g about DD disorders and at least know what could make it worse.

We really need a lot more research to properly understand what’s going on with DDs and more evidence into effective treatment.

Yup.

Thanks

 

[whiteraven]

The thing is I think he could do it. If he were educated on it.

Hm...so, I'm an editor, but I strictly do copyediting. I don't do developmental editing, which involves helping the author create the flow of the book, moving things around, and a lot of rewriting. I know I could do it, and I know I'd be good at it, but I just prefer copyediting, cleaning up a manuscript that the author has fully created. I also haven't been trained in developmental editing.

So maybe he just doesn't care to focus on dissociative disorders, for whatever reason?

Sounds like you're quite far in your journey?

In terms of the DID, yes. I am learning new things every day, and I deal with a huge amount of depression, anxiety, and PTSD-type symptoms, but the DID is fully managed at this point.

What i would like to know is if it's well known if people don't get voice responses (but more thoughts / dreams or writing) whether this could be considered actually hearing back from parts with DD. Voices to me just seem so final and definite...

I much prefer the voices, because it makes everything so much clearer. Not everyone gets actual voices, though.

Again do you mind if I ask were these all clear voices? Or thoughts? I'm not sure with me whether they are Voices or thoughts but think they must just be Voices because I would know the difference...

Both. I've heard *very* clear voices, as if they were in the room with me, and I have gotten thoughts, which to me are not as clear or definitive. I mean, if I am hearing someone talking to me inside, it makes it clear that I'm not "making it up."

 

[beaneeboo]

Hm...so, I'm an editor, but I strictly do copyediting. I don't do developmental editing, which involves helping the author create the flow of the book, moving things around, and a lot of rewriting. I know I could do it, and I know I'd be good at it, but I just prefer copyediting, cleaning up a manuscript that the author has fully created. I also haven't been trained in developmental editing.

So maybe he just doesn't care to focus on dissociative disorders, for whatever reason

Yep I think you're right.

In terms of the DID, yes. I am learning new things every day, and I deal with a huge amount of depression, anxiety, and PTSD-type symptoms, but the DID is fully managed at this point.

Interesting that the one considered perhaps the more unique and less well known about diagnosis (harder to treat) is fully managed and the more common ones less so...I wish you well with your recovery

Not everyone gets actual voices, though.

Do you happen to know of any info on this? Any strategies? I also feel it would be easier to accept if I heard voices. Though not sure I'd want them. But if if have to work with non voices I'm not sure how easy this is to do.

Both. I've heard *very* clear voices, as if they were in the room with me, and I have gotten thoughts, which to me are not as clear or definitive.

so how do you manage the parts who have less distinct voices and who communicate with thoughts? How do you know what are your thoughts and what aren't?

I mean, if I am hearing someone talking to me inside, it makes it clear that I'm not "making it up."

Yeah I can see that

 

[whiteraven]

so how do you manage the parts who have less distinct voices and who communicate with thoughts? How do you know what are your thoughts and what aren't?

I think communication is key. It's really tough to be able to discern the differences in thoughts, and sometimes I was (am) never able to do it. Sometimes it's not important, and things work out on their own. Other times, communication with the ones who actually talk can reveal further info on those who are silent. And honestly, I think it's critical to find someone who can help you develop those skills.

 

[beaneeboo]

I think communication is key. It's really tough to be able to discern the differences in thoughts, and sometimes I was (am) never able to do it. Sometimes it's not important, and things work out on their own. Other times, communication with the ones who actually talk can reveal further info on those who are silent. And honestly, I think it's critical to find someone who can help you develop those skills.

Thank you so much for your time and input... I've found so many people here so helpful and I'm very thankful..your info on the DD stuff has been important, along with @Sideways' input ... thank you

 

[Liljulz67]

Thank you...I needed to hear this...

And this... you're very wise...

This. This is the hard bit... but you're right and this is what I need tu work on...

Thank you for your input and keep going...

Welcomed.