Latest / System Speak: Complex Trauma and Dissociation / Guest: Kim Elbirt

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Guest: Kim Elbirt · System Speak: Complex Trauma and Dissociation

• 0:11
  Speaker 1: Welcome to the System Speak podcast, a podcast about dissociative identity disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to longtime listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 0:58
  Today, we welcome guest clinician Kimberly Albert. Kim has been a licensed mental health counselor since 02/2004 and currently maintains a private practice with a primary focus on client centered holistic treatment of trauma and dissociation. She worked as a mental health clinician in outpatient community mental health for sixteen years before transitioning to full time private practice in 2020. She is certified in DBT, nutritional integrative mental health, and as a clinical trauma professional. She has a PhD in biochemistry and molecular biology, and after a career in academic research and teaching, she recognized a desire to move into a career with more immediate impact in helping people heal.
• 1:47
  She obtained a master's degree in counseling psychology and became a licensed massage therapist. She draws on her experience as an integrative professional, as well as her lived experience as a person with DID who has been on both sides of the room in various levels of care to help move others toward healing and well-being. Kim appreciates her various roles as partner, mother, cat lover, rider, and volleyball player. She makes time to be silly, play games, enjoy nature, and to do puzzles and various forms of art. She recently presented at the Healing Together Conference in 2024, sharing ways to build and improve internal communication and compassion to help manage the difficult experiences of DID.
• 2:34
  Welcome, Kim. I am so glad you're coming to talk to us. Thank you.
• 2:42
  Speaker 2: Thank you for inviting me.
• 2:45
  Speaker 1: You have such a story of your education and how you even incorporated all these things with your holistic experience and practice. Where do you even wanna start?
• 2:57
  Speaker 2: So I am a licensed mental health counselor and a licensed massage therapist, and I have a small private practice in Massachusetts where I provide therapy primarily for people with a history of trauma and dissociation.
• 3:11
  Speaker 1: How did you get interested in helping with trauma and dissociation?
• 3:16
  Speaker 2: Well, I've been on my own healing journey, since I was 20 when I got myself into therapy. And I was diagnosed with complex PTSD and major depressive disorder, and I've actually still been seeing the same person for thirty years. My first career was actually in biochemistry and molecular biology, and I did some research in biochemistry and became the program coordinator for the tobacco treatment specialist and training program at University of Massachusetts Medical School. And as part of that program, I was teaching the biology and pharmacology of nicotine dependence. And what happened was there was another person that was teaching motivational interviewing.
• 4:07
  And this seemed like a perfect way to really help people. Research is very slow. It just doesn't get to people, and I really wanted to help people on a more one to one basis. So I decided to go ahead and take some psychology courses and went back to school and got a master's in counseling psych and then became a licensed mental health counselor.
• 4:31
  Speaker 1: And you've incorporated these different things into your practice. What does holistic practice mean to you?
• 4:41
  Speaker 2: So, I have a background in biochemistry, and I was always interested in very much about thoughts and thinking and the mind. But for myself, growing up, what was really, really helpful was connection to my body as I was an athlete as a student athlete. And so I actually also went back to school and got certified in massage therapy. And what I've learned over time is to incorporate the mind and the body, and then I became certified in nutritional integrative mental health. And so I'm looking a lot at when people come in, what are their self care routines, and how does sleep and food affect Lulu, and how does it affect your day to day experience, as well as what are you doing with your body, and how are you in touch with your body.
• 5:53
  So a lot of mindfulness, nutritional integrative, self care routines, also certified in DBT. So a lot of the emotion regulation strategies for setting a baseline for mood and emotion regulation.
• 6:10
  Speaker 1: Could you introduce people in case they do not know what DBT is? How would you explain about that in context of trauma and dissociation?
• 6:22
  Speaker 2: Okay. So I my first internship was with an agency where they had a DBT, dialectical behavior therapy, program. And it was based on Marshall Linigan's model of dialectical behavior therapy, which incorporates mindfulness ways to become more present in the now. It incorporates emotion regulation skills, which help to reduce vulnerability to negative emotion in terms of setting up self care routines. And it also incorporates distress tolerance skills, which are ways to handle those daily times when we become overwhelmed and distressed and really need to work on grounding and orienting.
• 7:11
  And it also incorporates interpersonal effectiveness skills, which are really important for communication, setting boundaries, and having healthy relationships. So in terms of trauma and dissociation, mindfulness is a core skill, being aware of where we are, being present in the moment. Many people with trauma and dissociation have a really hard time with that. So mindfulness skills can be very helpful with that. Distress tolerance helps with the really hard experiences, that get sort of blown out of the more, proportion for people when you have a trauma history and get triggered in a day can bring up urges to self harm or suicidality or eating behaviors.
• 8:03
  And distress tolerance skills help to ground and orient to the present time to make, to help settle and manage those crisis type situations. Emotion regulation skills are exactly what what they say, and a lot of people with trauma dissociation have a difficult time with self care and establishing routines that are helpful to maintain and regulate their emotions and interpersonal skills, finding ways to build a healthy support system and healthy relationships. And in particular for people with DID, those skills can also be translated to internal communication and promoting safety and stability within a system.
• 8:53
  Speaker 1: Thank you so much for that. We are going to come back to internal communication in just a minute because that's what you talked about at Healing Together. I first have a question about putting those two pieces of your background together. So with the context of, sort of that body awareness and what's going on physically or biologically and the mindfulness from DBT. What do you recommend for people who struggle with mindfulness because they're dissociating as opposed to being present?
• 9:30
  How do you help them get grounded so they can mind do mindfulness in an effective way?
• 9:36
  Speaker 2: So mindfulness in some ways has a bad rap. And when people come into my office, I work with them in just asking simple questions. What what are you noticing right now? And people who are really dissociated sometimes say, I don't know. I'm numb.
• 9:56
  And then I will walk them through grounding. So do you notice that your feet are on the floor? Do you notice your body is in the chair? What does that feel like to you? And that really is the beginning of it.
• 10:12
  And as people move along, in therapy, they become more aware of emotions. They may not know where they come from, but they'll all of a sudden tense up, and they'll say, what are you feeling right now? And they'll say, oh, I'm feeling anxious. And then I will direct them to say, and what does that feel like in your body? And that is really helpful in practicing that.
• 10:36
  And then I ask them to practice that, not just for the kind of negative emotions, states of depression, or anxiety, but I ask them to also apply that to the positive times in their life. So working back toward what is something that's really comfortable for you. In my office, I have a lot of sensory options, and some of my old one, and I'll say, what is it like? What does it feel like? Describe it to me.
• 11:08
  And so that that's a way of introducing people and moving them forward and becoming more mindful of their bodies, more mindful of their emotions.
• 11:17
  Speaker 1: I love how what you're saying felt congruent to me in my experience of you. I love talking with other lived experience clinicians, and often, we are in such a place of having to advocate for ourselves and or or in that fight response just because of collective trauma or things like that. But you were in this very, I wanna use the word zen, very zen calm state where when you're talking at Healing Together about internal communication and how to do that effectively, I felt, like, at a neurological level, I felt in my body that I could believe you or trust what you were saying because how you were talking to me was a very calm and nonactivated place. Does that make sense?
• 12:15
  Speaker 2: Yes. And that was my goal. So I'm I'm glad I got there. I just want you to know I was extremely nervous.
• 12:22
  Speaker 1: Right. It's hard. It's hard when we present. And even I know in advocacy work and we get big feelings sometimes, all of us, but especially with everything going on with lived experience clinicians right now, I I wanna be sure that I'm clear. I don't mean to be shaming that.
• 12:39
  Like, people have reasons to be upset, and we feel things in response to wounds. And I get all of those layers, but, oh my goodness, to see you modeling the work of this calm and effective state, even though you're trying to include all these different parts, even though you have valid feelings that just the jitters of presenting besides anything else. And to see that modeled and to see the examples of it, oh, that that is what opened up the space or provided safety enough that as you shared about what is possible inside, it made me more willing to hear you and to listen and even to believe that it's possible rather than just, oh, this already doesn't feel good. I'm gonna shut that down.
• 13:32
  Speaker 2: Wow. That is a great endorsement. Thank you for sharing that with me. And my preparation for the talk, that was my intention, and that's what helped me stay more present was I sort of I I remember explaining this to my partner, Terry, who's very supportive, and I'm very lucky to have him. I explained to him, I want this to be, like, a big, huge therapy session for people.
• 14:02
  Speaker 1: Yes. Yes. It was intense, but it was possible, which is different than it being overwhelming or you being activated and not activating me or me having defend myself against what you're trying to defend yourself against. Like, it was not that kind of experience. It was fascinating to me, and that's what got my attention and why I asked you to come on the podcast because there was something very powerful about that that I witnessed the possibility of communicating effectively, whether that's internally or externally, even while including all the parts of me and all the experiences, like, I'm going through or enduring or what I want to accomplish.
• 14:48
  Like, all these layers played into it. So I really just wanted to thank you for that. And where do you even wanna start with sharing with about that today, that internal communication piece?
• 15:02
  Speaker 2: Well, I think one of the biggest pieces of that internal communication piece and first of all, thank you for sharing your experience with me. It really does make a difference, and it and it is very helpful to me as well. Absolutely. I think with the communication, one of the main components was making sure that we ask permission and give permission, and also the component of safety and taking into consideration what is safe and what is safe enough, I think that's the place to really start. Because if if parts aren't feeling safe enough, then they're not going to be very willing to communicate.
• 15:48
  Yes. Does that make sense?
• 15:49
  Speaker 1: That does make sense. And I think that when we're talking about internal communication, that sort of being an approach that is an invitation, that is about consent is part of what makes it safe enough. And then in the same way, externally with others, like, I think that's the difference between effective communication where there is consent and invitation as opposed to just trauma bonding. So it's almost like I don't know. I'm just noticing these patterns because we just come out of healing together.
• 16:30
  Right? So there's these patterns, I think, in our community online because that's how we have access to each other for which I'm so grateful, where when there's not consent or it's unsolicited or it's only activating, then it's it becomes about intensity instead of intimacy. And there's something that becomes trauma bonding about, yes, these are all the things that are hard and terrible as opposed to the socializing of what is safe enough, what is it that you need, what is it that I need, what am I attending to, how can I tend to you, And those kinds of conversations and making like, seeing that difference and seeing like, getting clarity on that so that I could also apply it internally? Because internally, instead of trauma bonding, instead of socializing, I feel like in like, if that's what happens, at least what I've seen externally, internally, I get that avoidance instead of socializing. Like, I don't even have a desire to communicate internally.
• 17:41
  But also having done enough therapy and trying to build relationships, like, in our community or at healing together and those kinds of things and seeing when I don't get it right or when I'm only avoiding that communication or I'm not doing that communication, it actually causes harm, not maliciously, not intentionally, but I'm hurting people and not aware of it. I'm hurting myself and not aware of it. And so even to get to the conversation of what you presented took me through this whole process of, I guess, leading up to what you talked about, connecting communication and compassion. But but of even even wanting to communicate internally. Right.
• 18:29
  So the compassion piece, I'm glad you brought
• 18:32
  Speaker 2: that up. The compassion along with communication was part of that bidirectional triune diagram I presented. Right? Safety, communication, and compassion. So being safe enough is really important for building that communication.
• 18:48
  The compassion piece is really, really important because it provides a container and a way to be present with other parts and with other people to be able to be curious. What you said about willingness and the fear of other parts is is a is a big deal. It's a big barrier to internal communication. And one thing that I approached in my talk was about willingness and checking in with your own willingness and then first being curious with yourself. What is it really that I'm afraid of?
• 19:31
  And then the compassion piece comes in and says, well, that makes sense. I make sense. And so first, having compassion with yourself then allows you to practice compassion with your parts.
• 19:46
  Speaker 1: I don't know if that's part of safety in me or just where I'm processing, but, again, I feel like I'm getting both an internal application and an external application. Maybe that's part of pacing even approaching that internal communication. But when I think, what am I afraid of? When I ask myself that for these external connections with other people's lived experience, I think what am I afraid of? I think for me, it goes back to just core trauma things of when we tell that we get in trouble or when we were threatened about telling or things like that.
• 20:34
  So to get into an advocacy space feels really scary because it's hard to know that's not just a reenactment. It's hard to know that that could be something powerful or effective and also safe or those kinds of things. When I but that makes sense once I put it back in the context of trauma, why it's hard to trust people or engage with people or why I would be afraid of other people's activated states. Because as a child, that always meant danger. But when I'm acting that out to myself internally, what is it I'm afraid of?
• 21:20
  I know it's all more complicated than this, but the first thing that comes to mind is simply that it makes it all more real. It does. I've and I think, I I don't wanna be curious about that. So I go backwards to what? Back to safe enough.
• 21:44
  What would make it safe enough to be curious about? How can I have compassion? I think the last few years, one of the biggest things that has helped me have compassion for myself is realizing that when I'm not tending to other parts of me, that I am doing to me what others already did to me. And that was sort of an accountability sucker punch of I really need to tend to these parts. And when I can hold that a little bit even, then that can give me compassion enough of, like, why it matters to get to that curiosity place.
• 22:27
  I don't know. What do you think for you? So,
• 22:33
  Speaker 2: absolutely, there is usually, when asking what is it that I'm afraid of, it is definitely a trauma based coping pattern of avoiding some expectation of something horrible that's gonna happen. Either I'm going to be, you know, hurt or punished or completely ignored or invalidated on both ends of spectrum, right, the neglect side and the abusive side. So the difficult thing in trauma treatment and the trauma recovery is being able to hold both the past and the present at the same time. So acknowledging, yes, those years made sense in the past when I was a child, when I was young, and I didn't have the skills, the supports, and the resources that I have now as an adult. And being able to both validate and challenge at the same time.
• 23:45
  So, yes, those fears make sense in the past. They don't really make much sense now. Oh, I have no resources and skills and supports now that I didn't have as time. So when
• 24:04
  Speaker 1: we're talking about being an adult with adult resources, that's the kind of stuff we're talking about. We have mindfulness skills. We have interpersonal skills. We have access to help. We're not alone anymore.
• 24:17
  We're grown up. We're not children. So all of those fears were absolutely valid and playing out in real time when we were young in memory time. But in now time as adults, there are so many more things we have access to that it's actually enough to help support us in being able to face some of the things that were so overwhelming when we were children.
• 24:47
  Speaker 2: Right. Being able to hold it now. That's why, though, it is important to pace because those things were overwhelming then, and they can feel overwhelming now. So taking it little by little, we can hold those pieces and heal them little by little.
• 25:08
  Speaker 1: So tell me more about that. That is that that little by little that's part of pacing, what does that look like in therapy with trauma and dissociation?
• 25:19
  Speaker 2: So this is, again, where mindfulness skills come in, and I can sort of bring in different models. I'm not necessarily gonna do that. But, for other people that I have worked with with clients, it can be my noticing that their body is getting really, really tense. Or sometimes clients have worked on mindfulness enough that they're able to say, I'm feeling really dizzy right now. And this is a warning sign that maybe what's being shared is too much.
• 25:57
  And to say to them, okay. Let's hold on. Let's ground. Let's notice your feet on the floor. Take a nice deep breath.
• 26:06
  Why don't you drop your shoulders? And then how are you feeling? Are you feeling more back in the room with me? That is part of pacing. And then we'll I'll ask them what part of what we're talking about started to cause you to feel dizzy.
• 26:22
  And is that something that you feel like we can still approach, or do we need to put that away for a little while and pull out something else or pull out something different? So really making sure that people are still here in the present while then looking at a trauma memory from the past. And sometimes, the emotions of the event will be too much, but the thoughts about the event are okay to talk about. So for instance, I'm remembering, you know, the closet door. I can talk about the actual event.
• 27:01
  This is what happened in that room, but not be in touch with the feelings. And that's okay. We can talk about just what happened. And then the next time around, if it feels safer, we can say, so what were you feeling during that experience? Or ask agent part to share what did that feel like for you, and let me hold that with you.
• 27:21
  That can be another piece. So those trauma memories that gets split off into beliefs, healings, perhaps somatic body sensations, we can take them piece by piece and incorporate them back together.
• 27:36
  Speaker 1: I am thinking about what you said earlier about what we're avoiding when we have avoidance, that what we're avoiding is the expectation of trauma. And without pacing, I feel like the same thing happens that we push through too much too fast or we try to see and feel all the things all at once. And pacing not only breaks down, like, being able to look at different aspects of it or only doing a little bit at a time, but it also breaks down that expectation of trauma. Like, therapy is going to be hard, but it doesn't have to be harmful.
• 28:33
  Speaker 2: Correct. So another thing is asking inside for parts to share in a titrated way. So I want to know your story. Can you tell it to me little by little, piece by piece instead of all at once? That's another way to pace.
• 28:55
  And parts do know how to do this, and they can do this.
• 28:59
  Speaker 1: That's profound. I didn't even think about that as a conversation. So that brings me back to compassion maybe even for myself that maybe there are benefits to internal communication.
• 29:15
  Speaker 2: Right. And, definitely, self compassion. And I and I do want to just, like, validate, yes, if things are brought back all at once, it can be retraumatizing. And that's a lot of research shows that back in the day when the treatment for a trauma was exposure, let's tell your story over and over and over again, it was harmful, not helpful to people. So there needs to be this awareness of I'm here with you.
• 29:47
  You're not there anymore as one part of that dual awareness. There also needs to be pacing of, okay. It was too much back then. Let's make sure it's not too much again in the present. Let's titrate it.
• 30:05
  Let's slow it down. Let's take it piece by piece, and we can all hold this together.
• 30:10
  Speaker 1: Is that part of what's so hard about younger parts or more traumatized parts? Is that part of what makes it slippery to work with younger parts or more traumatized parts that be because they are so in memory time that it's harder to hold on to now time for that dual awareness? It gets harder to do both?
• 30:38
  Speaker 2: I think that that and and this is sort of my perspective and thoughts on the matter. I think that it has to do with safety. And I believe, one of the questions I was asked at the seminar sort of asked about this, about parts being stuck in trauma time. And we talked about having your internal helper or leader or healer part in conjunction with the therapist going back to trauma time with them and doing a sort of a rescue mission and bringing with them the knowledge of the present to trauma time and then working with the part to say, what is it that needs to happen for you to feel safe right now? And actually reworking the memory so that something is safer.
• 31:43
  And I believe you've actually mentioned that in some of your podcast episodes about the attic making putting Christmas lights and things so that it wasn't scary anymore.
• 31:54
  Speaker 1: Does that make sense? Yes. Yes. It also gives that relational piece going back to being an adult with adult resources because we're not doing it alone.
• 32:07
  Speaker 2: Exactly. Okay. We are there with the heart. They are not alone anymore. We are from present time.
• 32:16
  Speaker 1: Which helps hold on to dual awareness as well.
• 32:19
  Speaker 2: Correct.
• 32:20
  Speaker 1: This is really interesting to me, and it's interesting you brought up that episode about the attic. We have been spending the last year putting back up the original episodes of the podcast, and it has been a fascinating thing to listen through some of those early therapy experiences. And we actually lost the therapist that helped us with that, and it took a while to find another therapist. And we have one now, and it's one that we can stay with and keep. But I think that is where we kind of left off.
• 33:00
  And so to hear about it now in the present and reconnect to, oh, yeah. That's a thing that we actually have practice with or know how to do. Remembering that even as a resource, it's not just my therapist having that resource, but I myself have that resource with my therapist. Like, that therapy work is mine to keep.
• 33:21
  Speaker 2: Yes. Absolutely. And a lot of the things that I presented at the Healing Together Conference, I hope that I got it across that these are things that you can eventually do on your own, that doing them with the therapist if there's especially concerns about safety or intense difficulty with dissociation as one of the, well, tough stuff, behaviors that we were talking about at at the conference. Doing it first with your therapist gives you the practice and the skills to then be able to do outside of therapy time with a leader part or supportive part that's inside that can be in that role with the therapist or without the therapist and go back and help parts.
• 34:15
  Speaker 1: I am thinking about the lived experience community online again, and I feel like this is a piece they're really good at talking about and also is a piece that sometimes feels really foreign to me. Not because they're wrong or I'm wrong, but because sometimes I feel like I'm not there yet. And so I appreciate that reframing of it's something I can get support with practicing before I can do it more on my own or as part of learning to do it on my own rather than it being, oh, here's a skill some people are really good at, and you're failing.
• 34:53
  Speaker 2: Right. It is definitely not a failing thing. So No. It's something that that we really need help with because of all the attachment wounds. We really need someone to come and help us and be with us and show what what's possible before we can then sort of take it on ourselves.
• 35:12
  That's something we really missed growing up was having somebody teach us to do that. So, to be able to make connections and to be able to learn how to regulate our emotions and to help ourselves. If we didn't have that growing up, We really do need a therapist or a helping person outside of ourselves to help us learn that we can do that ourselves.
• 35:37
  Speaker 1: I think for me, that would fall under that question about what is it I'm afraid of is that I was already so alone for so long. I feel like I don't want to let go of the supports I have, and it makes it hard to connect externally with others sometimes because it's so much to regulate. And I can only regulate so much. Like, my regulation skills are here, and they're I can't overextend myself that way. And just being able to be patient with, it's okay that I have limits, or it's okay that I'm more introverted, or it's okay that, like, whatever the thing is that we don't compare ourselves to others online or with lived experience, that everyone really has their own unique journey and is where they are.
• 36:33
  Speaker 2: Exactly. And people, with DID have can have a a wide range of being comfortable in relationships, and different parts can have a wide range of what's comfortable in relationships. So it can get really complex with somebody with DID because some parts may be really wanting social interactions and connection, and other parts can be extremely afraid of it. And other parts, again, can be just fine with no relationships and feel like they they don't really need those connections as much. So there's a wide range even internally with what is comfortable in a relationship.
• 37:20
  Speaker 1: I think I also have a discrepancy. I don't know if that's the right word, but there's a difference between my willingness and my desire to connect with others in a healthy way and my actual capacity to care for myself while doing so.
• 37:38
  Speaker 2: Can you say a little bit more about that?
• 37:43
  Speaker 1: Like, there are some people I have known long enough now that I'm like, I know you are a safe person, or I do want to be friends with you, or I do want to have whatever kind of relationship the relationship is. Right? And then, also, it is so hard for me and that my capacity of what I can actually do. And I think there, my what are you afraid of is that I can't get well enough, fast enough to meet needs of others enough for them to stay long enough for me to figure it out.
• 38:24
  Speaker 2: Okay. So feeling limited by our own where we are on our healing journey Right. In terms of what relationships can I tolerate and actually be able to foster and grow versus where the other person is at?
• 38:48
  Speaker 1: And also being okay with boundaries. Right? Like, if saying no or no, I can only do this one thing. I can't do those other five things And things like that that it's not something I have to keep up with at other people's pace. I can really just do my best, and that is enough, especially, and most importantly, maybe, if I am communicating about that, whether that's externally or internally.
• 39:15
  Speaker 2: Right. We are always, doing our best, and that's a key thing to keep in mind. And if that means that the other so I'm I'm gonna talk about external relationships. If the other person is not okay with that, we may lose that relationship. And that's okay right now because that's not where we're at, and we're still making progress.
• 39:43
  That's an important piece to remember. We're still making progress. There will be other relationships, and people will meet us where we're at. And those are the relationships that are most supportive and safe. And it also brings up I don't really wanna get too much into it, but it also brings up, like, how much do we disclose to people?
• 40:04
  Do we do we let them know that we have DID? And that brings in the communication piece of boundaries and what am I willing to communicate with the other person and setting up boundaries of because I'm coping with other things in my life, I'm not able to engage in this much, and are you okay with that? And maintaining that communication process. Internally, it's a little bit, it's a little bit different, but it goes back to the permission piece, the permission to share what you can or share what you're safe enough sharing and the permission to not share, to take your time and to communicate what you're willing to communicate or just stand. I think I mentioned in the top, I invite parts to just watch, not necessarily engage in an activity or a relationship, but to observe if they'd like to In order to address those fears of, well, if you do this or you say this, this bad thing is gonna happen.
• 41:20
  And it's important for them to have some observation or some experience maybe of our relationship going well. And if I do say this or do this thing, it doesn't mean this bad thing is going to happen. Yes.
• 41:37
  Speaker 1: How do you apply that, like you said earlier, when there are sort of safety issues with some parts internally? How do you communicate about that and remember the bad thing isn't going to happen or doesn't have to happen the way it always has in the past?
• 41:54
  Speaker 2: So it depends on the safety issue. And in the talk, I also brought up coping plans. So a coping plan is is really helpful, particularly when there's safety involved. So self harm behaviors or self injurious behaviors or even substance use, or eating or spending. Like, any of these that can potentially be destructive to our lives in the present.
• 42:23
  Having a a coping plan of when parts start to show up, trying to build a a dual awareness, and providing communication to those parts through writing, through maybe external communication means instead of just inside to let them know that the behavior and setting boundaries that that behavior is not okay. However, I'm willing to listen to why you're feeling that way. And can we talk about what the trigger was, and what do you hope to accomplish through this behavior? So that really gets down to having increased internal communication and having then compassion for those parts, urges to engage in that behavior, and then addressing what do they hope to accomplish through this, what triggered it, and then helping them see that in the present, that's not really needed. Another piece is communicating to those parts that they are part of a system and that there are consequences both internally and externally for whatever they decide to engage in, that they're not alone.
• 43:52
  So whatever they do affects the whole system. And that can be very, very helpful for those parts because parts that engage in those behaviors are really doing so because they feel like they're protecting or helping somehow. And so finding, oh, wait a minute. That that's not helping anymore. What is another way that we can help the system to live, to survive, to function?
• 44:24
  Because that is the whole point of those behaviors to begin with.
• 44:27
  Speaker 1: So the compassion comes into rather than, oh, that's the bad one or they're doing a bad thing. Compassion is, I know that you're responding to something that's hard. I know that your feelings are valid. Recognizing the struggle of it. Those kinds of things to understand their experience a little bit.
• 44:52
  Speaker 2: Right. So understanding while those behaviors can feel very scary to us and to other parts, like, for instance, I have a part that can become very suicidal, and that is very scary to the younger parts because they don't want it up. Right. So becoming aware when though when that part becomes more present and say to that part, oh, I see you. You're here.
• 45:23
  What happened? Why are you feeling this way? That's the curiosity. That's the curiosity piece. And then the compassion for that makes sense.
• 45:36
  I can see how, you're feeling overwhelmed or exhausted. And then what do you need to feel better? Because we have more resources and skills now, and we can help you feel better. So I might say to that part, look. The world isn't all bad.
• 45:57
  Look. I have this this cute little kitten in my lap. Would you like to pet the cap with me and see how that feels? Or, I actually have multiple parts that can engage in suicidal ideation. Another part might be very, very exhausted.
• 46:16
  And I would say to that part, okay. Is there a way that you can rest and another part can take over? First, finding out what what what was the trigger, validating that, validating the feelings, and then asking what would be helpful or offering and negotiating other ways to manage whatever it is that's going on in the present.
• 46:42
  Speaker 1: So we end up offering those parts attunement rather than being afraid of them and avoiding them or shaming them and punishing them, both of which would make things worse.
• 46:55
  Speaker 2: Yes. Exactly. Because they didn't have a treatment before. They were stuck alone trying to cope with overwhelming situations and circumstances. They're not alone anymore and letting them know they aren't alone and attuning to their needs and wants and helping to meet them in the present.
• 47:16
  Speaker 1: Wow. Thank you for that. What what other pieces about internal communication or anything else that you wanted to share today?
• 47:31
  Speaker 2: That those difficult behaviors, they are a form of communication.
• 47:36
  Speaker 1: Oh, tell me about that.
• 47:40
  Speaker 2: So when there are more parts popping up with urges to self harm, urges to suicide, It is typically a sign that there is something not going right in the present. Something about your current life and your current environment feels overwhelming or too much and likely needs to be addressed. Or there are triggers going on, and we need to identify the triggers and start to reduce the number of triggers in our environment. So that might be making more boundaries or making a change in our environment or in our self care routine, balance of work and personal life, for example.
• 48:33
  Speaker 1: Yes. It's just hard to absorb, but not because it's complicated. It makes sense. It just brings me back to that curiosity piece again of okay. So this is coming to the surface.
• 48:46
  So it means I need to look and see what is overwhelming or what is not going right or what needs are not being met.
• 48:54
  Speaker 2: And they can be so a trigger can be something that's external. It can also be something that's internal.
• 49:01
  Speaker 1: Woah. Say that again. So a a
• 49:05
  Speaker 2: trigger when when parts are triggered, they can be triggered by things that are outside of us. So, things like a date or an anniversary. Does that make sense? Yes. A situation or a place, or it can be an interaction we just had with someone that ended up feeling invalidating or hurtful.
• 49:30
  It can also be sensory input. So it can be a scent or it can be something that somebody that we heard, like a noise we heard. Those are external triggers. Internal triggers could be a memory or an image that gets brought to mind. It could be a a particular thought pattern or an interpretation of something.
• 49:54
  It could be an emotion. So a lot of times, people with a trauma history will feel a very natural, normal emotion to whatever event's going on, but then it gets exaggerated and blown way out of proportion because of internal triggers. So that initial emotion becomes a trigger for an increased emotion or for thoughts or for a memory, and it can also be sensations inside the body. So if if we have a pain, like an upset stomach, that can bring to mind past events where we had upset stomachs.
• 50:31
  Speaker 1: Anything else? Or what what were there any other pieces that you wanted to share or to talk about
• 50:39
  Speaker 2: today? No. I think I've pretty much, covered everything. Just be open to ways and means that part communicate and provide a lot of options and opportunities. And having a regular, time and space where there's an invitation to communicate can be very, very helpful now for me.
• 51:03
  Speaker 1: Oh, so that's an example, again, where being too busy or not making that or avoiding that time and space becomes a kind of flight all on its own.
• 51:13
  Speaker 2: Yes. And and so that can also be when those tough stuff behaviors start to increase. That would be an example of what I was talking about. Wait a minute. Something needs to change.
• 51:27
  We don't have enough downtime. We don't have enough time to communicate. You're not listening to us.
• 51:33
  Speaker 1: Wow. I think that's probably one of the most important lessons of all. We have to have time and space for ourselves before any of these other things can happen or as part of ensuring that these other layers are happening.
• 51:50
  Speaker 2: Exactly. If there's not a time and a space where things are so busy on the outside, we have walked safe enough, and there won't be time and place for the communication to actually happen. And the communication helps promote the healing.
• 52:08
  Speaker 1: Thank you so much for that. Is there anything else you would want to say about lived experience clinicians or to other clinicians or to survivors who may be listening?
• 52:20
  Speaker 2: Thank you to everybody who's listening, and keep working really hard on healing. It does happen. It is possible. And clinicians with lived experience, absolutely, your experience can be helpful in your practice.
• 52:38
  Speaker 1: Thank you so much for sharing with us today.
• 52:41
  Speaker 2: Thank you so much for having me. I told them to listen to your podcast anyway.
• 52:46
  Speaker 1: I didn't know that. I'm so glad. But thank you so much for taking the time, really. I'm so grateful. It really was very powerful what you did.
• 52:56
  Speaker 2: Thank you so much. And and this is amazing. It's an amazing experience for me. So thank you.
• 53:01
  Speaker 1: Oh, good. Good. Thank you. Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before, not like this.
• 53:28
  Connection brings healing, and you can join us on the community at www.systemspeakcommunity.com. We'll see you there.