Latest / System Speak: Complex Trauma and Dissociation / Guest: Kirsten Stach, MA, Dipl, MIACI (Part 1 of 2)

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Guest: Kirsten Stach, MA, Dipl, MIACI (Part 1 of 2) · System Speak: Complex Trauma and Dissociation

• 0:06
  Speaker 1: Welcome to the System Speak podcast. If you would like to support our efforts at sharing our story, finding stigma about dissociative identity disorder, and educating the community and the world about trauma and dissociation, please go to our website at www.systemspeak.org where there is a button for donations and you can offer a one time donation to support the podcast or become an ongoing subscriber. You can also support us on Patreon for early access to updates and what's unfolding for us. Simply search for Emma Sunshine on Patreon. We appreciate the support, the positive feedback, and you sharing our podcast with others.
• 0:47
  We are also super excited to announce the release of our new online community, a safe place for listeners to connect about the podcast. It feels like any other social media platform where you can share, respond, join groups, and even attend events with us, including the new monthly meetups that start this month. Go to our webpage at www.systemsbeak.org to join the community. We're excited to see you there! Kirsten Stock was born and raised in the former East Germany.
• 1:47
  During her college years, Kirsten volunteered for the Blue Cross, an organization offering help and support to alcohol addicts. She got involved with her whole heart and it changed her perspective again and opened up the opportunity to become a psychotherapist. After finishing the diploma in 1988, she started working in a day clinic for alcohol addicts and at the same time started her training in psychoanalysis, psychodynamic, and body oriented psychotherapy. On the humanitarian initiative of a Reverend, Kirsten, her former supervisor and a solicitor, founded a non profit organization in 1990 for the reintegration of released prisoners and inmates of forensic psychiatric units. Kirsten conducted psychodynamic group work in different prisons.
• 2:41
  From 1995 on she worked for nonprofit organizations, the Child Care and Social and Probation Services, and amongst others specialized in working with difficult, complex, dangerous, and unmanageable clients addicts. Her first encounter and subsequent interest in dissociative disorders started in 1997. In 02/2005, Kirsten relocated to West Cork in Ireland and has since moved to Malta. She established her own psychotherapy practice in 02/2007 and is licensed by the IACP. She joined ISSTD in 2010.
• 3:25
  Kirsten is mainly working with adult trauma survivors from different countries and cultural backgrounds. A high percentage of her caseloads are clients with dissociative disorders. In 2019, Kirsten was awarded an MA for Integrative Psychotherapy from CIT Cork. Welcome, Kirsten Stach.
• 3:48
  Speaker 2: My name is Kirsten Stach. I'm I'm a native German person, but I have lived in Ireland for fifteen years. And in December I moved to Malta. So now I live and work and practice here in Malta. And yeah I'm I'm 60 years old.
• 4:13
  I'm for thirty three years in my profession as a social worker and as a therapist. And I yeah. I really love my job. I think I'm really really lucky because of that. So after all the years that's still perfectly fine with me.
• 4:38
  And yeah I live here in Malta with my partner, his two dogs, two cats and I'm very interested in history, astrology. So I'm in a really right place here. Because it's an amazing history. And yeah. This probably I have the whole balcony full with flowers and plants.
• 5:08
  So I think given my job as a therapist that's actually a really good thing. Loads of very pleasant self care, I would say so.
• 5:23
  Speaker 1: That's so lovely! How did you get into studying about trauma and dissociation? How did that start for you?
• 5:31
  Speaker 2: I was from the beginning when I started in a clinic for alcohol addicts in the former East Germany in Rostock, which was actually a great clinic which would be very good today. We worked with psychodynamic approach and it was group work and individual work. So it was a really pleasant place to work. So from the beginning this working with addicts, I worked with very traumatized people. Without that it would especially be yeah called this way.
• 6:16
  I think in the eighties you know in Germany it wasn't common so yeah it was normal. You work with addicts. They had some awful things in their life and you worked with them through that and later in Germany I worked with marginalised groups like prisoners. I worked for five years in prison and did psychodynamic group work. So very traumatized, very traumatizing individuals.
• 6:52
  I worked with heroin addicts and their families with asylum seekers, with homeless people. So with punks, two full houses full of punks. They were lovely. I worked with young Nazis. I think quite successful to normalize their life and their thinking and everything.
• 7:21
  So and how I got directly into trauma was in 02/2010 in Ireland. And I remember that night because I had a client who I know now was very very severely dissociated obviously. It's a very severe DID and a lot of hallucination. Yeah, a lot of psychotic episodes. And one evening after he had left, I said no.
• 7:59
  I don't know enough. So I had to do something and I sat on the internet and I found ISSTD. So I was probably very lucky. And I wrote to them. So and eventually started my my training this ISSTD in I believe October 2010.
• 8:26
  And from there yeah I it was a very conscious yeah. Really really good journey where I could look back at all the work I had done in the past and yes I think I had mainly worked with traumatized people all my life. Yeah? But now I had the framework for that and concept. So that was great.
• 8:58
  Speaker 1: My friend, I have a friend in Germany who says that in German it is not dissociative identity disorder, that it is dissociative identity structure.
• 9:10
  Speaker 2: I don't know about that to be honest. I when I think you know the my good colleagues from and friends from the Trauma Institute in Leipzig. I think they still would call it dissociated identity disorder. So that would be new for me to be honest. I have to ask them because we have a symposium at the weekend.
• 9:41
  So I find out because the symposium is very very interesting and multidisciplinary on dissociated identity disorder. Then I know more.
• 9:57
  Speaker 1: That's interesting. I would be interesting to hear what what you find out because it made me think again about the difference between sort of structure and process and what's going on. But also even just what you just shared about a conference with multidisciplinary, like, that's really important, the whole team. They're doing something right.
• 10:21
  Speaker 2: This is, you know, and it is not, I think it's not so common to do this way of a conference, yeah, because they invite for instance, medical doctors, GPs, speech therapists, even singing teachers. Yeah. So you know it's it's amazing. So how they basically work together from a lot of different sites, yeah? And I remember two years ago the conference where there was you know the singing teacher who we all had to sing in the conference which was really really great Kraxo.
• 11:09
  And she showed us a video from a young man who was severely dissociated and he stood in different places in the room. In coloured areas. I think it was like spot rings like hula hoop rings. And he sang the same song which was a classic German song. In all his different self state and it was really interesting to see that was amazing.
• 11:46
  And the better he got yeah. The better he felt. Then all of his parts sang together and this sounded completely different. So you know to see it from that side was actually very eye opening. It was brilliant.
• 12:05
  Speaker 1: That's beautiful. That's amazing.
• 12:08
  Speaker 2: Yeah. Yeah. So I really look forward to that symposium you know and yeah look the Irina and I folk you know they are members of ISSTD as well and they are fellows. I've definitely is a fellow and look they did presentation at conferences here as well but it would be different, obvious, when they do their own conference, you know?
• 12:39
  Speaker 1: That's incredible. Even even the part about you singing, I know that when I am in America, a lot of the conferences you are sitting and you are listening. And when I am in Europe, a lot of the conferences there is there are lectures and there are things that you learn, but there's also that it can be very experiential differently than only sitting and listening. It's a cultural difference.
• 13:04
  Speaker 2: Yeah, that is, you know, that may be possible. This was actually two years ago, the first trauma conference I attended in Germany. Yeah. So, but it was really good experience. Yeah.
• 13:19
  Otherwise I attended all conferences from ISSTD and they were you know I really really enjoyed it and I'm probably eternally thankful, you know, for for everything that I learned. So I, yeah, I came every year since 2010. So.
• 13:42
  Speaker 1: It's helped us so much as well and it is really made a significant difference, like really changed our understanding of trauma and dissociation both. How would you define dissociation if you were working with a client or someone? How would you explain dissociation to them?
• 14:03
  Speaker 2: When I work with clients, I do a lot of sketching, you know, images and so and I would explain it, you know, in a way, but when somebody is really, really small, you know? So, you have no power, you cannot run away, You cannot fight back. And very often in family or other situation there is no hiding place at all. So that as a child you escape in your mind. This is the only chance you have.
• 14:50
  Basically, you know, the separation between the body and the mind that you know on the on the onset before the age of three that this is the only chance a child has, yeah? And that this can be combined with an out of body experience where they basically as an example, one young man described it. He escaped into a photograph that was on the wall. Yeah. He went into this photo and then he was in a landscape.
• 15:32
  Yeah. And I would use I find it very helpful you know to go from the attachment side as well. So I would explain the attachment theory in a you know hopefully I try my best understandable way to every client I work with. And I find when they have time to think about it at home or they you know over the week before the next session. It brings a lot of things to mind.
• 16:08
  Yeah. And so the approach to dissociation via the attachment theory would be that very oversimplified. If you have that and that is drinking heavily, yeah, the baby does know what it is. But the baby would know that is so different. And the child has to totally suppress their own needs and completely tune in to an probably erratic or violent or very angry adult.
• 16:44
  I mean this could be mum as well. So that the child adjusts to the different states that the parent displays and is basically forced to develop self states that can deal with the accordingly how the parents act, yeah? And another thing I explain as well, so it takes me a good while to, you know, sometimes different sessions to explain it is via polyvagal TOE and the window of tolerance. So I kind of combine it in my explanation and is the three different states and that in an extreme hyper arousal or hyper arousal state so the immobilized state that then the mind, the nervous system takes care that the way the brain works will change. Yeah.
• 17:48
  So that any kind of integration will be interrupted for the benefit of a child that has no other escape than to partmentalize things and put things in containers in the in the mind and I do sketches for that or I show I have some charts with brain images and that usually makes sense to them and yeah. Then that sometimes obvious it's very very harsh for somebody to realise and then maybe accept it is a possibility yeah that they may have you know a dissociated disorder which is not a nice word for it because I would really point out it's a very elaborated and creative adaptation process. Yeah, of a mind of a tormented child, if that makes sense.
• 19:11
  Speaker 1: There is something neutralizing even about understanding the brain and how it works as opposed to the shame of what's happened to me or the shame of how crazy I feel because of what's going on in my head.
• 19:29
  Speaker 2: I, you know, I feel that, you know, what helps a lot always when when you take it with some humour, yeah? Not to, you know, not to ridicule anything or diminish it, but you know, this, this, this humour, you know, it can be sometimes very uplifting and very relieving yeah when the lady I worked with for a long time after months where we very slowly and reluctantly started to work with her parts. Then she said you know I have another part and I didn't want to tell you because then you really think I'm crazy. I have a speaking hedgehog. So and I think we burst out laughing, you know, despite, of course, I take it serious, but in this moment, you know, that was somehow, you know, was a great situation and was very funny and eventually, we investigated where does the speaking hedgehog come from, yeah?
• 20:42
  And we could figure out that she took this character in out of a children's cartoon. There there was a little hedgehog and then he got angry. He had really flames coming out of his spikes and he could talk and he was very cute. But when he somebody angered him he could really defend himself. So you know in the end it made so much sense.
• 21:10
  Yeah. There was nothing crazy about it. Yeah. This is not I don't know. I don't even think.
• 21:20
  It is crazy. It wouldn't come to my mind. I think I realise that in Germany in the nineties I think at someday I realised that I totally normalized these things to the point where I had to accompany a long term client to some authority. I don't know what place it was. Either to a doctor or to the welfare office or so.
• 21:49
  And everyone in the city centre stared at us. Really. People were you know they sometimes stopped and stared about it. I thought oh my God these crazy people. What's wrong here you know?
• 22:02
  And then obvious I realised the man had total tattoo. His whole face was tattooed which was not very common in the nineties in Germany. So for me I knew him for so long. I didn't see it anymore you know. For me it was completely normal.
• 22:21
  It didn't play a role in regards to him as a person. And then I said it to him and and he said yeah yeah I know look let them you know and yeah. So it was somehow it showed me that I don't take anything as not normal in this regard.
• 22:44
  Speaker 1: If understanding the brain is neutralizing somehow of the shame because it puts in context what the natural response is, then understanding where some of those images of parts or parts of self or ego states or something, where those self states come from, like your example with the book, somehow gives context and helps it make sense. And that was an interesting example you gave of realizing, oh, it came from this and it's connected to this. And that's how it happened when there was a child seeing this and or like going into the photograph, like you gave that example. And I think that that also helps because when we have that phobia of parts, then there is this hesitancy to try or to engage or to just be afraid of what we don't even know. And being able to connect some parts to context like that help put some of those pieces into place and give a, I don't know, foundation of being able to have a context or an understanding of why that part is there or where that part came from or how a child brain would even do that.
• 24:06
  And that's been interesting as culture changes with technology because now I have newer clients who are younger, who some of their parts come from video games or movies or something instead of just books or or or other contexts that have been traditionally written about in books or something in in clinical text. And so it's been interesting to see sort of that shift in that unfolding with younger clients. But but regardless, having I don't know. There's something about just having information, whether that's context about where an alter came from or context about the brain and why it works and how it works and what's going on actually, there's something that just neutralizes either that shame or those phobias or the pieces that make dissociation so scary so enough that you can work with it and get started, I guess.
• 25:11
  Speaker 2: There is, you know, I would say, I don't know who said it or where I read it, but it it said this is a normal reaction to an abnormal situation. Yeah? And I I think that basically boils it down to the point, yeah? That everything somebody develops in their mind is a response to something that they experience. And so this is especially as a child.
• 25:48
  It's a normal response. Yeah. To whatever happens around them and I just talked to a colleague here in Malta and she said in Italy there is a very progressive approach when young children you know are brought let's say to a child psychologist or therapist or psychiatrist and there is something not right with them. They work with the parents and not with the child. So that means first of all they do everything for and with the parents.
• 26:33
  And then later then that is clarified. And the parents worked on or are working on their own issues. Then they bring the child in. And I think that is the you know really the right order yeah to put something from the head on the feet. Yeah, I found that really, really helpful and yeah, to say, you know, that everything somebody maybe the strangest OCD symptoms or reactions, yeah?
• 27:12
  Or things that don't seem to make any sense. Then in therapy when we can make sense out of it, yeah? Then, yeah, it is, you know, the whole chain goes away. Yeah, then the things fall into place and that, you know, that is big relief to see that. Yeah.
• 27:38
  That takes a huge burden of people.
• 27:43
  Speaker 1: That changes everything when you're addressing the whole system, even when that system is externally like with a child and the actual parent, not just DID.
• 27:53
  Speaker 2: Yeah. You know that it has a name. Okay. I mean, they had to put some name to, let's say, a group of symptoms, you know, that, you know come up repeatedly but yeah it's not about the name you know it's about what is behind it for a person. So it's very different.
• 28:18
  Sometimes people are relieved when they know there is a description or a name for that and sometimes they don't like it and I can adjust to that you know. The person has to feel comfortable with however name it or call it, you know, or if people are more comfortable with when they say parts or self states or so, or when they say different emotional states. It's perfectly fine. It has to, they have to be comfortable with it.
• 28:59
  Speaker 1: There is such compassion and attunement in that adjusting approach by what they're able to tolerate and what their perspective is. How would you apply that with a DID system internally? Both the that level of compassion of making the approach even safe as well as the the responsibility of actually doing that work, like, with the child and the parents. The parents really need to step up and do their work. How does that apply, like, internally to a DID system?
• 29:39
  Both of those pieces, the compassion and that piece of focusing on where that's coming from, not just what is wrong.
• 29:49
  Speaker 2: Yeah, I I think, you know, what makes, I would say, from my work experience, what makes most sense for people is when we basically talk about it like it's an internal team that saved you in a really difficult you know in difficult times in your life. Yeah. That you know regardless how twisted or strange or irrational it may appear but this internal system saved you. And made sure you would survive these things. So when people become an adult these things become I would explain maladaptive as a you know I find the expression quite helpful so I would explain that properly that things that a child developed in a desperate situation to help themselves or to somehow stay under the radar, defend themselves, go into hiding as an adult are very often counterproductive and what we want to do we want a good internal team and we may have to change the job description.
• 31:24
  For some of the parts that they are first of all functioning in daily life but it's not only about functioning. People want to be content and sometimes obvious want to be happy and want to feel safe. So yeah obvious starts a long way and I found that really helpful when Doctor Clift said some stage doing better comes before the feeling better. Yeah. But that the I would really yeah I had maybe it's better to explain it as an example.
• 32:15
  I talked on Saturday to a young man who was an IT specialist and in in Germany and he has a voice that constantly is coming in with self doubts. Putting him down. So the unfortunately typical thing. He's very scared to make mistakes despite he doesn't make mistakes but this is obvious put a huge strain on his daily work and this doesn't stop and now they want to buy a house and now the voice is saying oh you know are you sure you want the house? Are you sure you want to live there?
• 32:57
  Do you know what is when you lose your job? And we could really really figure out that the voice won't go away. This part of him because he said I hate it so much. I want to get rid of it. And so that was basically when we could very productively discuss that you can't get rid of it, yeah, because this part, when you were young, had a very important role, call it anticipatory obedience.
• 33:35
  Call it staying under the radar that you couldn't be hurt more than you already were hurt. Yeah? So but now to hate this part, yeah, you know how it is, yeah? When you have a whole school class and the teacher would cast out one child because it misbehaves and you know, expose it to the class and shame it. The child would get worse, yeah?
• 34:04
  So, it's a little bit like that. And it made sense and we agreed that he writes a letter or email, however, to himself, to this part. Everything he feels but one thing is very important. He has to write that he is thankful for what the part did for him when he was small. Yeah?
• 34:37
  So he will not forget that. He understands why it is still acting like it acts. But now it's about doing it better, yeah? To do it better than it was done to this point and so basically discuss it on eye level with that part. Yeah?
• 35:04
  With respect. Yeah. I would say if that makes sense.
• 35:14
  Speaker 1: This conversation continues in Part two. Thank you for listening. Your support really helps us feel less alone while we sort through all of this and learn together. Maybe it will help you in some ways too. You can connect with us on Patreon and join us for free in our new online community by going to our website at www.systemspeak.org.
• 36:03
  If there's anything we've learned in the last four years of this podcast, it's that connection brings healing. We look forward to connecting with you.