A Visual Depiction of What is Important in Therapy for Complex Trauma and Dissociation
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- เผยแพร่เมื่อ 11 มี.ค. 2024
- In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) offers a visual approach to show the way that key elements of trauma therapy combine. Mike looks at both tangible and intangible components of therapy to highlight how they can combine and produce the right outcome for conditions such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID), among other trauma-related conditions.
I cried at the end of the video because this is exactly what I have been going through. After seeing my therapist for months and months and months something finally clicked for me and I realized she genuinely has this key quality. I couldn't believe it. She's kind, thoughtful, committed, and actually cares about me (all parts!) and is invested! It's life changing to recognize I have the safety I never felt like I had before 🙏😭
This video makes me sad...sad that I am not able to find any therapist like yourself. Every time I went into therapy, all the docs did was prescribe me drugs...and diagnose me everything but DID. Once, I recounted a "trauma experience that I was able to remember, and the therapist told me "you must be remembering that wrong..." doubt! When I open my mouth and talk about the trauma that i sustained for the first 9 yrs of my life, the therapists don't believe me!!!!! So, I have given up trying to find a good therapist...the hunt for one is very anxiety ridden for me and causes me such distress...So at 61, I have given up therapy. I just watch your videos, as does my advocate, and we deal with my DID/trauma together. I have noticed that the older I get, the easier my life is, in regards to accepting my past and living with DID.
I'm glad you included the importance of consistency regarding the therapy room’. My experience is that many parts don't feel safe enough to front and participate in therapy, but they are the ones who often need it the most. Helping them to feel safe is paramount, and consistency in the environment and therapist is crucial. Inside parts (alters) watch and listen long before fronting. Consistency, consistency, and consistency equates to safety.
The videos that you share have been a catalyst and what has become a successful journey into a sense of integration and acceptance
I could not be more happy that they are helping in this way for you!
I thought I had THAT therapist. Met all the criteria you mentioned.....and then some. I'm quite certain I was his first DID client. He was able to get very close, too close, to a younger part. Spent 5 yrs with him. It came to an abrupt end when it was decided during a session, that certain parts were putting the system on lockdown due to his very strange behavior. In a nutshell, I mistook all of the red flags as kindness. That's just one of the many ways trauma can skew your perspective. It's had a devastating effect on myself, and my family.
Currently working with a new therapist with a lot of experience re dissociative disorders.However, I can still feel the pain of the younger part who had become so fond of him. Just what someone with trauma needs...another trauma. That therapist became an added trauma....hopefully my last.
Dr. Lloyd, please publish a book. Even just transcripts of your videos would be a must-read in the field.
And, thank you. Videos like these take so much to make; I am very grateful for the gift.
Maybe one day!
@@thectadclinic how would you feel about someone else writing a summary/compliation of some of your videos?
@@paradox13 hi, Plans for this are already in motion, thank you!
When I was referred for a psych eval I wasn’t aware I really had trauma and didn’t expect a diagnosis of DPDR. Granted as I’ve done more self discovery I think OSDD is a more accurate fit, but I’m not the professional and sorting out my brain is complicated and overwhelming alone. At 29 I had to cut out my entire family suddenly waking up to all the toxic behavior following a family vacation. It felt like pieces were falling into place, but it led to so many more questions and confusion. Finding a therapist here in the states that really can understand and work with me has been difficult and exhausting. I feel like many therapists just don’t know what to do with me even with the best intentions. I have to fill in the blanks and guide the session when I don’t even know who I am, what I’m feeling, or thinking. The inconsistencies puzzle them even knowing my diagnosis then I feel shameful and like I’m not good enough as a patient. I want to get better and be able to help myself. It can feel really hopeless. I continue to have hope that progress is still happening, inbetween sessions your videos have helped me a lot and they provide a lot of comfort. Thank you for all you do.
This is spot on. There are so many factors that go into effective therapy, but a solid, safe, and dependable relationship with the therapist is truly key. I know I have protectors who will not let their guard down unless the therapist proves to us that they are safe on several levels. We have to trust their competence, their dependability, their capacity to make space for our emotions and more difficult parts, and their ability to provide co-regulation. People often talk about "trust" like it's a singular thing, like either we trust someone or we don't, but there's always an implied second half to a statement of trust. I trust you [to behave in a particular way under certain conditions]. And when there are a lot of conditions that need to be met, it's not a simple binary of I trust you or I don't trust you. I might trust you to be compassionate with me, but not trust that you'll be able to respond constructively and de-escalate when an an angry protector surfaces. I might trust that you care about me, but not trust that you'll be there when I need you because the sessions are too infrequent or there are too many cancellations. All of these little things matter when you're dealing with the nitty gritty of complex trauma recovery. And that's not even factoring in that different parts can have different levels of trust. One part might trust while another does not. So developing trust with a system is extremely complicated, and that's why so many elements are necessary.
A nice way of doing things Dr Mike. We totally agree the intangibles (for example being held in mind especially when we haven’t got object permanence nor used to having someone to co-regulate) are so important. The intangibles that negatively tip the scale are external factors in the here and now that make the trauma weight heavier then it’s such a shame because we can have all the other things and then have set backs. We agree about the room - for us being overheard if we cry / make a noise is a huge trigger and enormous worry. It’s v hard to find premises that are sound proof.
Yes, getting the room right is such an overlooked necessity in many services.
I agree with you. It was finding the right therapist that has helped us open up to her the way we do. 😊
The trust for the therapist means so much. But also, following that; the clients "bravery" to tell their story: their fears, anxiety, shame. And that is chaos.. one part feels a job needs to get done, one is in love, the third angry, and the fourth to filled with selfhate it will hurt itself. That must be challenging for any therapist...so the tools of the other sorts will help( experience, the room, knowledge/education, supervision..etc)
I really appreciate you taking the time to find innovative ways to raise awareness and provide information to your viewers. I particularly find the visual demonstrations helpful to conceptualize.
So nice of you!
I love how you provide a visual of the concepts! Very helpful and practical for clinical use. ❤ Thank you!
You're so welcome!
This is a fantastic video and I’m sending this to my previous therapist 😅
Sent it to mine who is definitely that intangible for me. That’s why she knows more about my alters than me and seen more than anyone else 😇
Omg! This! Yes, yes and yes! Thank you for explaining how we feel (it makes us feel validated). Therapeutic relationship is what has made such a difference to us with psychological intervention. Unfortunately we had that and lost it 😔 But because we have experienced it, it keeps us going to believe that we can get that again, despite the immense struggle. I wish these things were shown as standard to all those who say they're 'trauma informed'!
I've been really lucky with my last two therapists that we clicked on the first appointment and I didn't have to really go looking.
Interesting that I had thought about this concept before learning about it here. Thank you for this knowledge!
Thanks for sharing!!
im a silent viewer but I want to say thank you sooo much for your work it helps me a lot! i take a lot of things with me to therapy to discuss it there
Thank you!
This example is why I keep coming to your videos. I also love the glasses one. Thank you!
Glad you like them!
Thank you so much Dr Mike, your presentation was prefect. Visual helps me take on more information, concentrate not good. That’s why is helps when you put the flash messages up too. You pace of speech and presentation makes it easier, even if I do rewatch several times 😊
Glad it was helpful!
I want to write a blog/article about this, as you have just put into words what I have experienced over the last few years, meaning that a small key component was missing from the therapy I received. It made us fall so far backwards as we used up all our therapy reliance and got lost in burnout because of it. It nearly killed as the burnout was dangerous. The shock of how some psychologist who works in the field, is alarming the lack of their care or skills for us with complex trauma is a deep concern. Thank you so much for this.
Could you please say more, jaminebellx11? I am understanding you to say that the missing piece for you is a therapist who deeply understands CPTSD and has equally deep empathy for what happened to you. This has been my experience. Therapists do not know and understand how CPTSD happens, how insidious and complicated some of the experiences can be as well as how hard it it is then to access and work with dealing with the resultant damage. They will never say your parents did this to you. They don't want to place blame and the one thing a CPTSD client needs is to understand fully how they got to where they are. Either childhood experiences caused it or the client came into the world defective and broken. Nothing happened to them. They got a sick way of perceiving life and coping with it just the same way they got green eyes.
Thank you for all your videos. This one touched something deep inside.
I'm currently going through the process of trying to find a trauma therapist, speaking to quite a lot of them for a few minutes on the phone. Even in that short amount of time you can get a feeling if they care, even for people they don't know yet. It makes such a big difference if they do.
Something else I would be really interested in is the question if (and if yes, then why) it is important to differentiate between cptsd and osdd? What difference does it make when it comes to therapy? Would be very happy to get an answer to this one.
For several years, I counseled the alters who sought me out on Discord. Later, a new one told me their "first time" therapist said it was as if they'd "been through three years of therapy." Six months later, the majority of them began to disappear and cease their daily inquiries regarding my well-being. It's possible she'd merely started a new relationship. However, I'd agree it does slowly transfer across amnesia barriers. I read James L. Spira's "Treating Dissociative Identity Disorder" and being unable to contact her (due to an agreement), I believe I did the best I could.
Thank you for these informative videos. They’re so accessible and easy to understand/share
I was just thinking the other day about how I wish I knew what therapy is like for complex trauma/dissociation, this video could not have come at a more perfect time! Thank you so much for your explanation.
I am currently wrestling with the American health care system to try to find ways to receive therapy, and honestly I have just felt really nervous about what to expect and apprehensive if it will even work. Watching this video has made me feel much better about therapy, now that I have a better idea of what to expect and look for. I am so appreciative for the work you put into making this video, thank you
Another great and educational video. Thank you.
this was so helpful and validating. I'm glad one of the factors you listed was correct diagnosis. my mother doesn't understand why getting a diagnosis is so important to me. there are so many reasons including internal validation and peace of mind. i will probably show her this video.
I find it so sad that it is so hard to find therapy and then even harder if one is not cis.
I am always just send away. looking for therapy on and off for abt 8 years by now. tried to do CBT just for the depression and ADHD symptoms, but didn't really get anywhere with that. if it isn't just depression or anxiety, AND one is also trans*.. one can basically forget about getting help anywhere. 😢
I am glad that the UK has the CTAD Clinic. Which there was a place like this in other countries too.
It shouldn't be like you describe; we have a number of clients who are also trans, and it works just fine.
yeah this is similar to my experience. the mere addition of being trans seems to be enough to prevent most - nearly all, even - therapists from being a good fit. combine that with how mental health professionals played a part in my trauma and I don't even know if it's even possible for me to find one lol
@@rhael42 oh my, I feel ya! 💔❤🩹
Thank you. Interesting video that makes the point well. Agree it’s the relationship that tips the balance and I think I’ve read the evidence base supports that regardless of modalities. I think the therapist also needs to have secure attachment style, many sadly do not because of their own back story and lack of their own healing, and clients with trauma related dissociation and disorganised attachment need that for recovery in my view. Any other attachment style in my view risks of problems and the therapist needs too much validation and a co -dependency ensues or is not consistent themselves and danger client will fragment further to cope with them! Could be wrong, my experience and reading. The other thing is the money that is usually needed to put all that together the treatment pathway. With therapy like this most have to pay for this relationship. Thanks for stepping up on TH-cam. It was and is needed.
This is SO true!
Can you please do a video about the difference in DID and OSDD and about what comes with Polyfragmentation and doesn't. Many are saying OSDD 1a and 1b can have Polyfragment alternative states and with the research Iv seen and done and heard there is no such thing as Polyfragmentation in OSDD. it's even rare in DID. please do a video talking about this if you have time. As a cult abuse survivor it's vital that the information is talked about.
Just a note on accessibility of your videos - the additional text shown on screen is hidden by TH-cam subtitles. Not a criticism on the channel in the slightest, I’m very appreciative of all the easily understandable information you make available for free - just a note in case you weren’t aware and were interested in increasing accessibility ☺️
It doesn't help if you can't get therapy.
No, that's true, and I can only hope that situation changes for you.
Hey, i somewhat recently got a diagnosis of DID and my therapist has also been strongly suggesting i have a quiet manifestation of bpd and i was just wondering about the comorbidity with that? Ive been trying to search around but most people are talking about either/or not both
Can we as patients find a way to use therapy to recover without that piece since it’s frequently missing?
It can be a necessity to do just that, sadly.
wow.
🙏🏻🥰
It’s been hard to do therapy. I had one great biofeedback specialist, and the last few have been traumatic. And school is having this effect on me where I’m doubting that anyone else is there that understands. It’s different if you had to move back with parents as an adult and they don’t have accountability.
Thanks for a great video... Do you feel with online therapy it's more challenging for clients to experience those intrinsic elements (the T's care interest, consistency etc?). I do wonder how building that part of the relationship works online! Not in a negative way - just intrigued!
Speaking for myself- people with DID or any form of severe dissociation need to feel grounded in space and time. When I dissociate into a child part who experienced torture, they are very disoriented in time and space-feeling extraordinarily insecure and fragile. Having an in-person, consistent, reliable space is a game changer.
A consistent therapist (preferably one with a Ph.D. or psychiatrist with experience in dissociation is vital for highly traumatized alters to develop a relationship. Some of my hero parts watched for years before fronting with the T.
I'm not sure an online relationship works for DID patients.
I would be interested to hear the perspective also from therapists who treat people with dissociative disorders... how has your experience been in terms of building the therapy relationship in online sessions?
Do you recommend blood work of your patients before starting so that you can separate trauma from nutritional, and hormone deficiencies in addition to gut microbiome and thyroid? I found that my ongoing trauma from domestic violence created deficiencies, gut imbalance, and Graves disease hyperthyroidism. So if these were addressed first the therapy would be more successful
The first thing my first psychiatrist did was look at medical contributors to my issues. I had none. Very very physically healthy. It was DID. You rarely see that pursuit in a non-medical provider. They assume that your PCP has this covered. And of course that is usually not the case. They toss causation back and forth like a hot potato. We are the potato. Always seek medical assessment and get good treatment. We are now seeing that head trauma from domestic abuse looks different in the brain than CTE from football or being in a car accident. And makes therapy much harder.
I need help understanding how an alter give me memories of me doing something and I believe it really happened . Until the paper trail showed that I didn’t do it? My therapist doesn’t know how that happened. I need a understanding so I can process what happened