Latest / System Speak: Complex Trauma and Dissociation / Guest: Lynne Harris

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Guest: Lynne Harris · System Speak: Complex Trauma and Dissociation

0:23
Speaker 1: Today I speak with Lynn Harris, is a licensed professional counselor in the states of Georgia and Florida in private practice. She's worked in the mental health field since February and in health care for over fifteen years. Her postgraduate specialty training includes advanced trauma training from the Institute for Advanced Psychotherapy Training and Education, Somatic Imagery and Ego State Psychotherapy from the Center for Healing and Imagery, Dialectical Behavior Therapy, EMDR, Sensory Motor Training and Training for the Treatment of Trauma, and sensory motor training for the treatment of attachment and development. Her clinical experience includes a wide range of settings and populations. She has experienced working with young children, adolescents, adults, families, and groups.
1:15
Prior to private practice, she worked for ten years as an outpatient family therapist in an adolescent treatment facility and as an addiction counselor, where she was involved in treatment at different levels of care: detox, day treatment, outpatient, and residential. She has extensive experience conducting assessments and leading group therapy. Earlier in her career, she helped positions in psychiatric hospital and school settings. In addition to clinical work with clients, she enjoys doing clinical supervision. She's provided supervision for interns seeking their graduate degrees and currently supervises graduate level master's candidates in their practicum work.
1:59
Prior to becoming a therapist, she worked in health care management and earlier in international relations with a focus on former Soviet countries. She is also an artist. Welcome, Lynn Harris.
2:13
Speaker 2: I'm Lynn Harris. I'm a licensed mental health counselor. I'm, licensed in Florida. I'm also licensed in Virginia and Georgia and I, am a specialist in treating complex trauma and dissociative disorders. I am in a full time private practice.
2:33
I have a practice in Ponte Madre Florida and St. Mary's Georgia so some days in one location some days in the other and in addition to that, I have been doing some consulting work with Voices for Florida which is a nonprofit organization. They're based in Tallahassee and they've been doing a lot of really innovative work in the mental health field. And in the past couple years, they started an initiative to work with survivors of trafficking. So children and young adults up to the age of 24 who are being trafficked to help get them out of the trafficking relationships and to provide resources for them in whatever way they are willing to accept them.
3:24
And that's been really interesting. What I've been doing for them is I help them with the trauma piece. When you are working with obviously victims of trafficking, there's you're dealing with people with complex trauma. And in addition to that they employ survivor mentors. Their model is clinician, a survivor mentor and a regional advocate all work together as team and the survivor mentors are all adults who have come through their own experience with being trafficked and so I've been helping them put together how you support the survivor mentors and how you work with the children who are being trafficked and what you look for like how you work on the trauma piece when someone's maybe not even ready for treatment but you have to kind of be aware of that stuff.
4:16
So that's been sort of a sidebar thing I've been doing for the past two years. And I also spend time professionally presenting at conferences and writing about basic things related to the what I do. For example, I just did a article for trauma psychology news that'll be forthcoming and it's a case study with a client that I work with who has dissociative identity disorder. I try to be really as active in the field as I can in those different ways.
4:52
Speaker 3: That's amazing and I didn't realize that we had some of those layers in common or some common experiences. I'm licensed in Oklahoma and Kansas. Oh, wow. So that's it's a very rural area, but because of the where the cities lie, really, just geographically, I have to be licensed in both states to be able to work and so you're the first person I've met who is also licensed in other states. I know there's more out there but you're the first person I talked to that has shared that experience.
5:25
Speaker 2: It's kind of an interesting thing, you know, and then I have I still have some clients, like I do some telemedicine sessions, and I still have some clients from Virginia that so, you know it's a more and more these days you know there's that ability to have a broader reach and in terms of providing services it doesn't it's not all just in in person and in people coming into an office. And but then there's that tricky stuff, like, as you know, about how you have to each state has different requirements for licensure and all that.
5:59
Speaker 3: Right. And different timelines for turning everything in, renewal.
6:03
Speaker 2: Yes. Exactly. It's sort of a lot to juggle.
6:07
Speaker 3: Do you have any clients that travel a long way to meet with you?
6:12
Speaker 2: I well, yes. I so I have I have had clients. So in Saint Saint Mary's, Georgia is a just for the record, is a small small coastal town in Southeast Georgia, so the south most Southeast part of Georgia, like right across the river from Florida and fairly rural area around it. And so I have had people that have come from Savannah to meet with me there, so it's like an hour and a half each way. I've had people who have come from more rural parts of Georgia to meet with me there.
6:51
And then in Florida, I have people who come up every week from Saint Augustine to Ponte Vedra, which is near Jacksonville, and I have people who have come from Orlando to meet with me just three hours away. So people will I have had some people who will travel distances for appointments.
7:11
Speaker 3: Wow. The the other thing that we have in common or or that I was surprised that I actually didn't know about you was the trafficking piece. And we my husband and I were foster parents for many years, and we had our oldest daughter was trafficked here from Honduras. And so we had some unique trauma issues with her, where she had the trauma experiences, but working with her was unique different than other trauma I had experienced before that. And, know, we helped her get her green card and get established on her own and get her GED and all of those things, but those were functional pieces.
7:51
And the trauma pieces she had were so specific and so unique.
7:55
Speaker 2: Yes. It is, isn't it? It's very unique. It's and so it sounds like there was a learning curve for you with that, like how you how you address it, how you worked with her with that.
8:05
Speaker 3: Right. It got it got me in the field, I guess. Where we live in Oklahoma and Kansas, there's a pretty heavy route of trafficking. And so I've been able since then to get more training and learn more about it. That was my introduction to it.
8:25
Speaker 2: So do you see are a lot of the people you work with people who have been trafficked?
8:29
Speaker 3: More and more. More and more the more people become aware of it and the more it's exposed and the more people are able to ask for help, I'm getting more referrals for that for sure.
8:42
Speaker 2: Yeah. It is kind of an amazing thing to me how it's it just feels to me like recently, like maybe within the past six months to a year, there's a lot more attention being paid to trafficking in the media and just in people's sort of general awareness. A lot of times people feel like have this idea that trafficking is something that's just happening, you know, at the very fringes or only in other countries, but they're not even realizing there's so much of it in The United States. And I am surprised to hear that in Oklahoma and Kansas that that's a route where people come through.
9:21
Speaker 3: It's a big thing here. And I also think there's an aspect of sort of understanding how it's defined and what counts as trafficking and and not it has its own stigma, I think. And as people become more educated, they are able to identify cases differently and earlier and intervene differently than before. And so I think it's making a difference. I hope it's making a difference.
9:47
Speaker 2: I know. I hope so too. And I think a lot of it is training people who tend to have contact with people the first contact with people who are being trafficked, police officers or schools or hotel employees. Like, there's really a lot of need for education, like, across all sectors so people can spot it and, you know what to do.
10:11
Speaker 3: Right. Right. So you specialize in treating trauma dissociation. Can you tell me how you explain dissociation to new clients who are just learning about it?
10:22
Speaker 2: Yes. I can tell you. So what I explain to people is that dissociation is really a mental ability that that everybody has and that everybody uses to some extent. So even there's that there's a spectrum of dissociation. So on the low end, it's things like sort of daydreaming the way like a kid would daydream during math class and sort of miss part of what the teacher was saying.
10:55
And it progresses up through the way a professional might performer, let's say, like before they step when they step on stage, have to kind of push out some information out of your conscious awareness so you can do what you need to do. Or like first responders use a form of dissociation when they roll up on the scene of an accident for example. On up through post traumatic stress, complex post traumatic stress and on the higher end dissociative disorders and dissociative identity disorder. So what I explain to people is that what the spectrum indicates is the frequency of how, you know, how frequently someone is employing that mental ability to sort of be check out to be present, but not be present at the same time. The frequency and the intensity of it, meaning that how much there's almost like an amnesia aspect to it where you lose time or you can't remember something.
12:06
So I usually explain to people how everybody employs the ability to dissociate, meaning to mentally to physically be present, but mentally go away a little bit for a lot. It's really important to normalize it and to understand that the way people wind up on the far end extreme end of the spectrum with dissociative disorders is because they had to use more of it earlier in their life. Usually having to indicate that there was a lot of duress or stress in a child's life. Because all children are naturally, it's very normative for children to use dissociation and usually around the point of adolescence, we start to use it less because the part of our brain that can mitigate circumstances has developed more by around the age of, let's say, 12. But when a dissociative disorder is present in somebody, it means not that there's something wrong with them, but that they had a certain life circumstance that really required using a lot a lot of the brain's natural ability to disconnect for chunks of time and that it gets kind of codified in our brain.
13:37
And when we become adolescents, instead of using other coping mechanisms, we've continued to rely on dissociation so that it gets really automatic as even into adulthood. And that's kind of generally how I describe it.
13:55
Speaker 3: So you really normalize it for them?
13:58
Speaker 2: Yes. Because I I really believe that it's it's true that it's something that every you know, that it's not something it's not an illness. It's not something like, a lot of times people will say things to me like they don't tell anybody about the fact that they dissociate. They might not be aware of it or they might know it, but they don't talk about it because they feel like it's really weird or that it's crazy. Like, a lot of times people will say to me that I'm just crazy, and I insist gently but firmly that they are not being mean, that it's a learned thing to rely so heavily on dissociation.
14:48
Then it gets wired in the brain so it becomes sort of like on autopilot. It seems outside of our control, but it isn't. And it might seem really weird, but it also is not that. So I really, really emphasize how it's not at all crazy, that it's actually kind of this amazing thing that our brain can do. And, clearly, there was a need for a lot of dissociation, which is really never any child's fault.
15:20
Speaker 3: So I heard you speak in Florida.
15:22
Speaker 2: Can
15:23
Speaker 3: can you explain what you said or or just again in your own words, tell me or explain about the difference between functional dissociation and maladaptive dissociation?
15:37
Speaker 2: So functional dissociation is when again, like let me think of a good example. So if someone is a firefighter, right, and they are called to a scene of where, you know, a house is on fire and they have to put the house out. You can't there's so much think of like, there's so much sensory input. I mean, I'm not a firefighter, so I don't really know this firsthand but think about it terms of there's so much sensory input, right? There's like so much happening all around you.
16:15
There's a lot of sound. There's a lot of visual stimulation. There's a lot of urgency. Like things are really, you have to be able to like focus and be on it and do the things you've been trained to do, and you have to do it quickly. You have to push out a lot of sensory information in order to do that, to get your brain to just focus and do the task that you need to do.
16:44
Me, more like an actor walking on the stage where you are doing a performance, you can't take in all the in all the sensory information, looking at it, all the faces, like hearing the sounds in the audience, like really you know, you have to really push a lot of information out of your conscious awareness so you can do what you need to do. So to me, that's what I mean when I say functional dissociation.
17:11
Speaker 3: Okay.
17:13
Speaker 2: Maladaptive dissociation is when, like I was saying before, some stimuli, some circumstance sets in motion that process of just to like, kind of like it's like you just are not there anymore. Or you're still, like, maybe walking and talking or looking at someone or carrying on with whatever you're doing, but you're not there. You're using another part of yourself to manage the interaction. And what makes it maladaptive is that it's not completely not completely it's not a life or death situation necessarily. Know, it's it could be a much more subtle stimuli that sets that in motion.
18:11
Then the other part of it is that sometimes I mean not sometimes, always when we're not connected to our frontal cortex, that's the part of our brain that you know, rational thought and problem solving, sequencing. Like then we're if we're not really fully connected to that part of our brain, which is always true when we're, you know, dissociating a lot, it means that we're like, a lot of things can happen. We're not it makes someone very vulnerable. So that's where a lot of negative consequences can come from if someone stays in a dissociative state a lot of the time. It also inhibits someone's ability to just do day to day things, you know, and and it's also also what causes a lot of repeated trauma.
19:12
Because again, if it's a situation where it requires that you act in some way or you're self protective in some way and your part of your brain that governs those kinds of decisions isn't available to you, like really anything can happen. And a lot of times what happens is people have just repeated trauma after trauma if they're not really present enough to like take care of themselves so to speak.
19:41
Speaker 3: So in those cases the brain is literally not online to help?
19:46
Speaker 2: Yes the part of our brain that the well lots of parts of our brain are not fully available to us when we're really heavily dissociating, but the part that is kind of the inhibits impulses, the problem solving, more analytic, more rational thought, the part that governs all of that is not fully your mind and neither is the hippocampus, which is the part that stores narrative memory. So that's why when someone dissociates a lot. Like, there's little bits of maybe bits and pieces of memory available, but not a full narrative memory. Sometimes people have no memory available to them. It's not that it's not getting recorded, because it does, it gets recorded more on like a body level or an emotional level, but very often, I mean, you find this is true like with the people you work with, but that they all people will say, you know, I know this happened, but I don't really remember any of it.
20:53
Or so and so told me that I did x y z, but I don't remember it.
20:58
Speaker 1: Wow.
21:00
Speaker 3: So how does that play into seeing symptoms as strategies rather than pathologies? That was the other thing I heard you talk about in Florida.
21:12
Speaker 2: Yeah. So it's I mean, if you the way I think about it is that it's a way the association is a way that we have to protect ourselves when whatever is going on is so overwhelming that we can't process it in the moment. Right? So when we can't make sense of things in the moment, we can't it's just either too frightening or it's overwhelming in some way, but we still have to get through the moment. We still have to survive the moment somehow.
21:47
So it's a very protective strategy to be able to just kind of go offline for a little while and then come back. And especially, it's especially strategic for children because when, you know, when we're children, we're physically small, and And our brain is not fully developed until and it doesn't completely develop until we're like 26 or 27. So if you're like four, five, six, like you're working out of, you know, a brain that's growing very quickly, but it's not fully developed. So you have very much fewer resources intellectually and emotionally, and physically you're smaller. So, like, what are the options there when there's something that feels like life or death or is actually life or death or is really overwhelming.
22:42
There's not a lot of options, right? So dissociation is a really helpful strategy because it helps people survive things that they can't make sense of, that they can't function through, and they just have to get through it. So I think it's, you know, I tend to think of it as like our in those moments, and especially in children where you can't, you know, when you're bigger and stronger, you can fight, you can flee, you can maybe assert yourself in other ways that you cannot when you're physically small. Also there's a big power differential, like a child to an adult, for example, if the power is not with the child in those circumstances. So again, association is a strategy that allows anyone, children and adults, to kind of survive the moment when we don't really have another way of doing that.
23:48
Speaker 3: So even with children well, you mentioned the frontal cortex. What is happening in the brain? I I know like, I've read about the amygdala and and these pieces, but what's happening in the brain? How do you explain that during dissociation?
24:06
Speaker 2: Well, you know, that's a that's a really interesting question. And there have been some studies done, a lot of studies done, and I so there's a there's we know something about what's happening in the brain when someone's actually dissociating. Like, they've done studies where they do scans, you know, where they can see which parts of the brain are lit up and which parts of the brain are more dormant. And and I should preface this by saying I am not neurobiologist or neuropsychologist. I just am really interested in this stuff.
24:43
I I like I think about that all the time. I'm like, what is really actually happening in our brain when we're just listening? So what I know and by the is that the frontal cortex gets dimmer, like there's less activity in the frontal cortex, there's less activity in the hippocampus, and the amygdala is very active. So the amygdala is the fire alarm part of our brain. It signals our nervous system very, very, very quickly when there's a threat or danger present.
25:19
So even if it's perceived and it's not actually anything threatening or dangerous happening, it can still fire. And what the amygdala does is it sets it sets in motion the whole sympathetic nervous system cascading thing where signals are sent to the brain and throughout the body, and chemical neurochemicals get released to help up to help us stir up first for fight or flight. And if we can't fight or flee, then there's a free there can be a freeze response or a submit response in the body. And and that means different neurochemicals get excrued. But, also, once the threat has passed, our nervous system gears up for defense and which is its function, and then the threat the perceived threat is over or it's passed, then different neurochemicals get excreted in the brain to help our body slow back down again.
26:18
So slow the heart pain and breathing back down. Sometimes there's, like, a letdown in the muscles, like a shaking that happens or a gut a feeling in our gut because all of that gets affected by by the sympathetic nervous system doing its thing. So when our so the part of our brain that gets really active is our amygdala during an event where we feel like there either is a real perceived threat. And then there's this cascading effect in the body, the nervous system gearing up for defense. And then the other thing that happens is that that sometimes when there is a lot of trauma, our body, our nervous system gets acclimated to being dysregulated.
27:17
So in other words, the amygdala is off firing. Right? Instead of just kind of turning on and off when we need it, it's just kind of it gets sensitive very sensitized. A lot of trauma throughout life causes often I see this all the time where people have very, very sensitized amygdala that signals either constantly is signaling, you know, danger, danger, danger, or when it gets triggered, it just is really hard to turn it off. Right?
27:52
So that is very taxing on one's body and can be really exhausting, and it's very unsettling. Like, it's just like, you know, if your body is always signaling you danger, it's very hard to rest. It's very hard to feel calm. It's very hard to think straight. So that's that's a part that whole the amygdala and the whole effect it has over time is very profound in people with trauma and dissociation.
28:31
Is
28:32
Speaker 3: that actually impacting perception or limiting perception in some way then?
28:38
Speaker 2: Like perception about
28:40
Speaker 3: Well, just in general, if it's no longer an accurate filter because it's overworking or underworking, which I know simplifies it. But
28:49
Speaker 2: No. That's a good way to put it. It's yeah. It does because it it's it's like you're getting misinformation all the time. You know?
28:59
So it's it increases things like feeling like you have to be hypervigilant even if there's nothing happening, impulsivity, like, just kind of sometimes, like, a lot of there's a lot of suspicious kind of thoughts and feelings of a lot of times, it'll just make people wanna withdraw from any social interaction because it's just too much, you know, it's just like too too much to deal with all the time. And if they can't turn it off, just a lot of times people will choose to withdraw and become more socially isolated and or the other thing that happens all the time with chronic nervous system dysregulation is substance abuse. So, I mean, this is something that is very, very frequent is the combination of trauma and substance use, because if we don't feel like it's in our control to regulate our body, then we'll, you know, turn to chemical substances of one kind or another to help us do it. So that's another complicating factor is if our if the perception is that either all people are dangerous versus, like, this one person is not safe for me to be around or I'm always feeling shut down because our nervous system either speeds up or shuts down as a defense mode and shutting down, I think I talked about this in Florida too, like, is equally a defense.
30:46
So the shutdown can be, like, feeling numb or disconnected or sort of zoned out, not really there, more passive, kinda can't feel much or think straight. Like, that's that's where a lot of people, like, live all the time is down down there. And that and again, like, dissociation is part of that. And so sometimes what happens is people will use substances to help bring a little more stimulation into their nervous system or so that they can feel something, because feeling nothing is that does not feel good. So does it affect people's perception?
31:29
Yes. It's kinda like you move through the world with this anticipation that something bad is gonna happen. And in this like constant state of readiness, you know, for something.
31:44
Speaker 3: How do you approach treatment for that? Do you have a staged approach or a phases or you just take one piece at a time that's presented as it's presented?
31:57
Speaker 2: It's complicated, right? Because you're dealing with many things on many levels all at once. But I do take a staged approach in treatment. I think I follow what it'll come from me. So staged approach in treatment where you have stages of trauma recovery and then just stage it's to That's what it's asking.
32:25
Due to the permanent, in 1992, as far as I know, was the first person who really talked about the treatment of trauma in this way, where you have to start with safety and stabilization. And safety and stabilization means both someone's physical and emotional safety, so not in an abusive situation, have adequate housing, have adequate income, have some means of support, but also safety in the body. Because if the person is used to is this chronic, constant, kind of normalized sense of I'm in danger all the time and the nervous system is sending that message all the time, it's really hard to process anything or to really do any real work in treatment. So one of the first tasks in treatment, the way I approach it, is to teach some, first of all, do the education about why that is happening and to, again, like you said earlier, to depathologize the symptoms. The symptoms are telling the story, but it's not pathology.
33:41
It's a normal body response to chronic stress. If you take any animal and you put them in a circumstance where there's chronic stress, their body is going to adapt to that circumstance. So a lot of psychoeducation about that, a lot of normalizing and depathologizing the symptoms that are present. But then there has to be some actual ability. We have to build the capacity and the ability to self regulate that stuff.
34:12
So that means building the ability to observe when someone is either triggered or what their body is telling them, And not just observe it, but then have actual practical skills. And I tend to use ones that are both cognitive and somatically based. I find that we can't just work on the cognitive level. We to have also somatically based skill set to self regulate. That's kind of the first stage in trauma recovery is establishing safety and stability, and that means both in some you know, externally and internally, like to be able to restore a sense of, like, okay, I'm safe in this moment.
35:00
And it might be fleeting at first. It might just be, like, moments of feeling that way, not a sustained sense of safety, but that's what we work towards. Stage two is actually kind of processing some aspects of the trauma. Don't ever find that it's necessary to start from day one and say, and then when I was one, and then when I had like, don't have to it's not working through the narrative of what happened, although certainly sometimes people want to share the narrative of what happened. But not really necessary for recovery to go through the story.
35:41
It's really more important that I find that there are always a few really significant memories, whether it's a narrative memory or it's just a felt sense or a little sliver of a memory that keeps popping up, because there's always the ones that are more intrusive than others or that have more of an impact for some reason. In the second phase, the goal is to actually try to metabolize what happened and metabolize the trauma so it can get kind of integrated into this is part of my story, it doesn't define me, but it's part of my story, and to have start to have a sense of separation from past and present, where something can be remembered rather than relived. Reliving means that when we think about it, we have all the attendant reactions emotionally, physiologically, as if it were happening now. So that is part of the intrusive symptoms with trauma. And so in phase two, what we work towards is having the ability to let things kind of lie down in the past more.
37:07
Remember how I said the hippocampus is the part of the brain that puts the date and time stamp on things, but remember if we're dissociating or if we're in the middle of something that's really overwhelming, the hippocampus starts to go offline. So there's no date and time stamp on a lot of these memories or these experiences. And so they show up in these as flashbacks, really, like little slivers of memory that work their way into the present. And so rather than constantly reliving little bits of memory, what we wanna do is be able to identify that as it's in the past now. This is not happening now.
37:45
Even if sometimes it feels like it. And so working to process through what happened, but also the differentiation that that is something that is firmly in the past. Like, that's a really key part of the second stage. And then the third stage is really kind of coming to terms with your post traumatic self, like figuring out who you are now without having to be preoccupied all the time with trauma. Like to sort of be able to make meaning for yourself and your life in the here and now, to have healthy intimacy, decide what sorts of things are meaningful to you that you want to maybe pursue personally or professionally.
38:36
So really more about making meaning for oneself in the present without everything being dictated by the old stuff because it's very, very preoccupying when there's both a lot of dissociation happening and a lot of intrusive symptoms happening when those people have both of those. It just takes up all one's energy, and your day is all about managing that stuff. And so if that stuff gets quiet and can lie down, then what? Then what do you want to spend your time on? How do What do you want to direct your energy towards?
39:14
So that's stage three.
39:18
Speaker 3: I know that you also talked about sensory motor. How do those skills redirect the attention to the body as a resource instead of the body being in the way of doing that work?
39:33
Speaker 2: So sensory motor psychotherapy is a body oriented form of talk therapy. It's not hands on, although I think some sensory motor therapists sometimes incorporate touch into their work, but I do not. So it's a form of talk therapy, but it's where you're incorporating information all the time from what your body telling you. So the first obstacle there, of course, is that for a lot of trauma survivors, what was safer was to never be in one's body. So it's a tall order to start trying to talk to someone about trying to even to notice anything.
40:24
Like what's your what's your breathing like right now? What do you notice? You know? What sensation can you feel? Like it's even that in the beginning is like not you have to kind of work we have to work our way towards even being able to tolerate that.
40:39
And then the screen motor says is we don't wanna just pay attention to thoughts or cognitions or try to draw insight and analysis. That's helpful, but we need to know all the information that's coming from our body. Slight movement in an impulsive instinct, an action that tendency that is not doesn't we feel it but it doesn't get acted out. Like all those things are part of sensory motor and incorporating that into into the work. So the way that our bodies can be a resource is well, it's a lot of ways.
41:28
But, like, for as a fairly simple example, remember how I was saying earlier that overcoming that chronic dysregulation in the body. And so let's say someone is chronically hyper aroused in their nervous system. That means that there's like a lot of nervous system activity, right? A lot of arousal in the nervous system. So tension in the muscles, facing thoughts, heart rate, like all the autonomic nervous system functions like breathing and heart rate are usually heart rate's usually elevated, breath maybe even more shallow, like there's like a sometimes just a feeling of pervasive restlessness.
42:22
To work with that using the body as a resource is to focus on grounding and orienting. So grounding could be anything that kinda helps you be more connected to your present moment physical environment. So as an example, sometimes I'll ask someone if I can see that they're dissociating and having a hard time in the session is will I'll just work to bring their attention as much as I can back into the present moment. Listing things they see around them in the room. I might say, you know, tell me five green things you see in the room right now.
43:06
Five sounds you hear right now. Five things you feel not physically, but, like, tactically. Like, what's the texture of the couch you're sitting on? Can you feel your toes and your shoes? Like so using the, you know, the connection for the physical environment as a way to reground and reorient to the present moment.
43:29
Or even something really simple like turning one's head to one side and noticing what you see on the right side and then turning your head to the left side and seeing what you see on the left side. Another example of like your body is a somatic resource is posture. So if someone tends to go into more of a collapsed posture when they feel like, oh aroused, which is on the low end, right? So that's the shutdown kind of low energy disconnected state. So sometimes I'll ask someone to just, if it's comfortable, I really have to know my person well, like I wouldn't just do this without knowing someone who can handle it, is you know, I might ask them to just, like, first of all, make sure they're really present in the room and then just bring a little bit more, a little bit, like, sit up just a little bit more.
44:33
You know what I mean? Just to bring a little bit of postural support. Because when we engage our core muscles, when we sit up a little straighter, it changes the way we interact with our people and our physical space. And so sometimes that can really help someone feel more like solid in themselves in the moment.
44:58
Speaker 3: So not just grounding but also really being aware of the visceral experience in the moment as part of the grounding.
45:07
Speaker 2: Exactly. Like, really using your senses, but also your physical, like like, physical body. Like, something even simple like pressing your feet into the floor. Like, most of the time, we're not thinking about that. Right?
45:25
Like, while I'm talking to you, I'm not really thinking about what my feet are doing. And if I shift my attention to my attention to my feet and I just ever so slightly press my feet into the floor, I can feel the solidity of the ground underneath my feet and become aware of, like, my feet and my shoes. I can feel how the gravity is, like, holding me down, which is really cool thing, and how the earth is pressing back up against my feet when I press them down into the earth. And it might sound dumb, but, like, when you do that, it's like there's just more of a this, like, really quick visceral connection to, like, my physical body in this space and time.
46:12
Speaker 3: Thank you for explaining that.
46:14
Speaker 2: You're welcome. Yeah. So sensory motor is probably the thing I use the most, the tool I like, that's what I use the most when I'm working with complex trauma and dissociation. I know there's there's never one thing in treatment, you know, you have to have a lot of different tools in your toolbox, I find. So what if how about if I close out with kind of a a funny anecdote?
46:45
Speaker 3: That would be lovely.
46:48
Speaker 2: So I so I have someone I've I've been working with for a couple years, and this is someone who is in their early forties, very severe history of trauma as a child and as a young adult and who has dissociative identity disorder and is doing really, really well. Like, she's worked very, very hard in therapy. And one of the things I just wanted to share with you is that we just came up one time with this funny catchphrase that we there was a one time she was she has a regular routine on the weekends where she goes to, like, Dunkin' Donuts and picks up donuts for herself and her son, her partner, and her partner has this very special request, and they've always honored it. And one time she went in to get the donuts on a usual Saturday, and person, for whatever reason, behind the counter said, nope. We are not Can't do that.
47:51
And she described to me how in that moment, her body went into this complete and utter sensation of terror. And she froze and she dissociated and took, like, a a couple of days to kind of recover. And when we were talking about it, we were exploring kind of somatically what was the response, you know, of going in, like, full. She could feel the sensation of terror in her body. She could feel that she was frozen.
48:24
She knew that she was dissociating, but she couldn't do anything about it. And so we worked on starting from the sensation, like, first, we worked on grounding and coming back into the moment and then to explore the sensation of fear as just sensation because she could at the same time feel it, but also use her present moment adult self to notice like there's not actually an emergency here. And then I said, yeah, it's just a donut. And she laughed and she said, it's that's right. It's just a it's just a donut.
49:10
And so now whenever there's something we're working on and she can feel that sort of nervous system response, and it's a really intense one, that's our way of differentiating that, you know, that old learned response, defense and terror, even when it's not something that's life threatening. And so we laugh about it all the time, and we apply it to all these different circumstances and she'll be like, yeah, it's not life or death, it's just a donut. And I'll be like, that's right, it's just a donut.
49:46
Speaker 3: That's amazing.
49:50
Speaker 2: Yeah, so that's we even thought about getting T shirts made. So it says, like, the idea was to put like, I don't know how we would do this, but, like, maybe trauma survivor on the back and on the front. It says it's just a donut.
50:06
Speaker 3: That's pretty funny.
50:07
Speaker 2: I know.
50:08
Speaker 3: It's so true that feeling though when something finally clicks of that understanding and being able to finally hold both at once.
50:17
Speaker 2: Yes And that is really a that's exactly right. That's like such a a big moment to experience that.
50:25
Speaker 3: That's powerful. And I love that it came with doughnuts. That's great.
50:29
Speaker 2: I know. So whenever I always picture, like, some reason, a doughnut with pink sprinkle no. Pink frosting and rainbow sprinkles.
50:39
Speaker 3: Right. There you go. That's pretty fancy.
50:42
Speaker 2: I
50:43
Speaker 1: love it. Well thank you
50:45
Speaker 3: for talking to me today.
50:46
Speaker 2: You are welcome Emma, it's been my pleasure. Thank you for inviting me to speak with you today.
50:51
Speaker 3: Sure, I appreciate it and I appreciate your time.
50:54
Speaker 2: I really this has been a great experience for me so thank you for inviting me.
50:58
Speaker 3: I'm grateful! Thank you very much. I really do appreciate it.
51:07
Speaker 1: Thank you for joining us with System Speak, a podcast about dissociative identity disorder. You can listen to the podcast on Spotify, Google Play, and iTunes, or follow along on our website, www.systemspeak.org. Thanks for listening!