Latest / System Speak: Complex Trauma and Dissociation / Guest: Peter Maves

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Guest: Peter Maves · System Speak: Complex Trauma and Dissociation

• 0:02
  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.
• 0:43
  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. Go to our webpage at www.systemsbeak.org to join the community. We're excited to see you there!
• 1:41
  Speaker 2: Our guest today is Peter Mayes. Doctor. Mayes is a licensed clinical psychologist practicing in Colorado since 1982 specializing in the treatment of complex trauma and dissociative disorders. He is a graduate of the University of Colorado at Boulder and the former assistant director of the Emergency Psychiatric Service of Boulder. He was the clinical director of Adams Community Mental Health Center and developed and was the clinical director of Centennial Peaks Hospital's Trauma and Dissociative Disorders Treatment Program.
• 2:17
  He was the clinical director of Columbine Hospital's National Trauma Center. Doctor. Meeves has served as a practice monitor for the Grievance Board State of Colorado and was an oral licensing examiner for the Colorado State Board of Psychologist Examiners Department of Regulatory Agencies. Doctor. Meeves is a frequent presenter at national and international conferences on the treatment of complex trauma, dissociative disorders, traumatic brain injuries, and military trauma.
• 2:47
  He was a clinical instructor for twenty years, supervising PhD students in the Department of Clinical Psychology, University of Colorado at Boulder. He is a fellow and former board member of the International Society for the Study of Trauma and Dissociation, where he is currently co chair of the Regional and Virtual Conference Committee and the chair elect of ISSTD's Professional Training Program. He is a diplomat in clinical forensic counseling and a member of the European Society for Trauma and Dissociation. Welcome, Peter Maves. Hello.
• 3:27
  Speaker 3: Hello there.
• 3:28
  Speaker 2: Thank you for taking time to speak with me.
• 3:31
  Speaker 3: Well, absolutely. Thank you for including me in this process.
• 3:38
  Speaker 2: I am excited to speak with you. My favorite memory of you was in San Francisco getting to sit next to you while we ate octopus and
• 3:54
  Speaker 3: Right. Right.
• 3:55
  Speaker 2: Enjoyed a moment of sociality that would have been the opening of the conference before everything happened.
• 4:02
  Speaker 3: Right. Yes. That you know, I think about that. That was quite you know, it was really quite an event to to to have the event and have it all have it scheduled. And then the day of the board meeting, have the World Health Organization declare a pandemic and then have to fold it all down.
• 4:29
  Speaker 2: It I'm I'm currently in Seattle at the conference. It's about to start this weekend. And already just seeing people, some of the people who were there in San Francisco, it has been far more emotional than expected of that restorative process of kind of bookending that experience even though it's so ongoing in lots of ways.
• 4:53
  Speaker 3: Well, yeah. I mean, I'm I'm looking forward to seeing everybody. You know, I did I was down in Nashville for the for the conference there. And, you know, it was just nice to nice to be in some place rather than just sequestered at home and sequestered in the office and, you know, one of the things though that I think is is interesting is that, you know, I had really planned on cutting back clinically before the pandemic started and do more with ISSTD and, you know, to take over for a while the professional training program and to be together with Joe on the the virtual committee and and, of course, to stay with the finance committee. And and all of a sudden, once the pandemic hit, my goodness.
• 6:09
  I mean, I I saw people back, you know, clients and and and patients that I had not seen in years. And it it tapered off a little bit as things as as we got into vaccines and so forth and so on. But I'm seeing I'm still seeing that higher level of demand now. And I don't know if I I I think as you recall, Mark Murat and I did that that training, that webinar training over the over six months in in response to what we felt was going to be a an increase in in demand and people coming in. You know?
• 7:06
  And I and I think we're we're really are feeling the post in post traumatic stress right now.
• 7:15
  Speaker 2: I I would absolutely agree. And those trainings that you two did those months during the pandemic were incredible. I was always surprised that, more people were not accessing them. I know they're available, but it was some of the best training that I had seen and I got introduced to so many different kinds of things and so many somatic pieces that I did not know about or did not have examples of how to implement in this kind of context with people that was really, really helpful. So I appreciate that you two did that.
• 7:53
  Speaker 3: Well, you know, it's it's interesting the way that I and I may have said this the way I met Mark. I was presenting at the European Trauma Society, and they had they were in Belfast. And and I went into a seminar room and I sat down in the middle and everybody came in and and and Mark walked in and I realized that I was in the wrong seminar room. That I that I had no intention of of hearing him. I I thought that I was gonna be hearing somebody else.
• 8:32
  But, you know, I was kind of in the middle and there were a lot of people there. So I thought, well, I'll just stay. And goodness, what a difference it made. I mean, you know, he he he brought to light and and put together some techniques and ideas and ways of approaching trauma and dissociation that that I had not seen before. And, you know, really much more of a, you know, bottom up kind of approach rather than top down.
• 9:07
  Speaker 2: It it was it was really fascinating fascinating for me. It was good experience, both personally to sort of try things out a little bit and see what that was like to be trying some of those techniques. And then the complete therapeutic reframe really changed my practice over the last two years.
• 9:27
  Speaker 3: I would absolutely agree. I mean, I, you know, for on and off, maybe a for a lot more a few years ago, I was seeing a lot of I was seeing a lot of vets, and I was seeing a lot of service members that some of whom had gotten kind of sideways either, you know, you know, within their within their platoon or squadron or something and and but mostly, were dealing with PTSD. And I I saw a gentleman, and he came in and, you know, pretty much indicated that that they were wanting him to go back and that he didn't think he could. He he didn't he did not feel like it was ethical for him to to go back into being a squadron leader in a combat situation because he was it was too shaky. And so I listened to him, and I at the end of the our session, I said, you know, I I showed him a a picture of that kinda squashed figure eight that that Mark uses.
• 11:00
  And I said that I wanted him to go home and draw that on an eight and a half by 11 sheet of paper and that I would see him in a couple of weeks. And, you know, I I saw that look on his face, which was what in the world am I doing with this person? You know, what is he telling me to do? But and he is a big man. And so the next time he walked in and he sat down and he didn't sit back.
• 11:32
  He looked at me and he said he said, doc, he said, I don't know what that goddamn thing was that you told me to do, but I feel better. So, you know, kind of effective effective therapy that sneaks up on you.
• 11:50
  Speaker 2: That's so true. That's so true. We we sort of jumped right into some of our shared colleague experiences over the last few years. Catch catch us up on your story of how you even found out about trauma and dissociation. Can you go back to the beginning and tell us that?
• 12:08
  Speaker 3: Yeah. I, you know, I had I had done quite a bit of work while I was getting my PhD with the emergency psychiatric service in Boulder in Boulder, Colorado. And I became the assistant director. And so I was I I was used to working emergency, and so the the first the first position, first job that I had when I when I got my degree was to manage a mental health center community mental health center office. And and the way that they ran that at that point was that they split emergency from morning to afternoon, and somebody in the office would take, say, the morning shift on Monday and somebody take the morning or the afternoon shift on Monday afternoon, etcetera, through the week.
• 13:12
  And I and I decided and wanted to take an emergency shift because I really didn't know the community. It was North Denver, and I didn't know it that well, and I wanted to kinda get a sense of what was going on. So I took a you know, if you ever wanna know what's going on in the community, take an emergency shift on a Friday afternoon. And which I did. And I saw a woman who came in that was clearly anxious and agitated and, you know, had indicated that she was having a horrible time at home and that her sister was there with with her teenage boys, and she had three or four children, and and she was just having a terrible time.
• 14:04
  So I I had her see the the psychiatrist in the office, and I scheduled another time for her, and she didn't show up for for the next week. And so I didn't think anything about it, and then about a month later, she showed up and and she reported that things were better, that her sister had left, and the things had calmed down at home. And so I had a chance to I kinda took my eyes off of her and and and looked out the window or something. And I looked back and I had to I had this strange feeling that that there was somebody else there. And so I said to her, I said, you know, this is really gonna sound strange, but I don't I don't think that you're quite the same person that came in here.
• 15:04
  And she looked at me and she said, well, it's about time that you caught on. And I thought, you know, what have I caught on to? What's going on here? And and that's what put me in the path of starting to try to find out everything I could about, at that point, multiple personality disorder. Fortunately, there were a couple of clinicians in the Denver area that had started to work with dissociative conditions, and that's what got me going.
• 15:43
  I mean, that really blossomed for me in terms of starting to to find out everything I could. There was a psychiatrist in the area who was had had located Rick Clough and was getting supervision and consultation from him. And and that led to forming an organization at that point, which later became a a group within ISSTD. You know, back at that time, I mean, I'm talking almost thirty years ago, we didn't have there there was a lot of of formality to to much of what ISSTD did. But there were a number of study groups across the The United States.
• 16:49
  And the one that I started together with three or four other clinicians and several psychiatrists turned into 250 plus people attending monthly meetings. So we were able to to do our own conferences. We because there was there was really no way to get inform it was it was very difficult except through, like, recluff and and some of the writings. It was very extremely difficult to get information about treatment. And and we were faced with the same kinds of issues that we're faced with now, maybe not quite as prevalent, but I think still that the the diagnosis is misunderstood, and it is looked at as really a not a substantial diagnosis and and and discounted in a lot of ways.
• 17:57
  And so it was very difficult to to to find training. And so what we were able to do was we were able to start to bring people to the to the Denver area. So we brought Rick and Kathy Steele and Colin Ross and Jim Shu and Bennett Braun and, you know, it goes on and on and on. We were able to bring them Bessel. Bessel did a conference for us two and a half days that we did in the Copper Mountain setting.
• 18:38
  And so we kinda brought you know, we we started to generate training for ourselves. And and then now, you know, that all of those those groups, the, you know, the the ones that we were associated with in in the Denver area, the Rocky Mountain area, and then the New England Society, and a lot of the things that Willa, Wertheimer, and Ed were doing in Chicago. And so now that has come together, you know, thanks to to you all. Thanks to the, you know, thanks to to the to the really substantial administrative knowledge has started to bring things together into regional communities and so forth, which I'm really delighted to see. And, you know, and and and I'm delighted to be associated with Jill Fosse in terms of the virtual and regional regional because I really feel that the the the regional conferences when we can get I think we're gonna be able to do it this year, that when we can be in person really presents that get together, know everybody just like you talked about.
• 20:11
  Gee, it's so good to see somebody. And that affords us the opportunity to do training. It affords us to do the opportunity to do networking. It expands our presence in terms of of marketing and awareness. So, you know, things have really it was a pretty in the beginning, it was a a pretty small group with with, you know, a lot of the the main stages right now.
• 20:49
  But, know, ISSCD also has gone through its growing pains. And and, I mean, interestingly enough, there was a time when our conferences our conferences for ten years ten years plus were always held in Chicago. And that was because we were the main sponsor was Rush Presbyterian and that's where Rick Clough, that's where Bennett Brown was, and number of of of Kathy Fine and a number of the originators of the society were were practicing and seeing people at Rush Presbyterian. And so they they sponsored the conferences in in Chicago. And those those conferences built to a place for where it would not be unusual to have a 1,200 people coming in to the conference.
• 22:05
  So the the organization was nowhere near as cohesive and well managed as it is now, but there were still there was still a lot of interest in in what was going on. And and it was that, you know, that that was my total almost a % training in how to be able to to do the work, the annual conference. I I presented and and I listened. And it there there wouldn't have been. I wouldn't have known what to do if it hadn't have been again for bringing the people to the Denver area and then being able to go to the to the annual conference.
• 23:07
  It it it it it it had that quality of, you know, thank goodness that there's a place that we can go and and really receive informed training, but also the I think one of the things that is so different about ISSTD is the fact that, you know, we have experts, but nobody's a quote, unquote expert. I mean, everybody's it was accessible. And you could you know, I could talk to anybody. I could go to anybody, And that was really valuable and still is, quite frankly. I mean, am I'm now doing more of the consultation clinic format.
• 24:13
  What what what I'll be doing in person with Rich Lowenstein coming up here at the conference, you know, momentarily. And and to me, that is a it's really valuable because, you know, you can bring everybody can bring the the kinds of circumstances and situations that they run up against that and be because because individuals that we work with have such complexity in that these kinds of consultation clinics, I think, are extremely valuable because we can Rich and I, from our experience, we can offer ideas, but I get as many ideas from the participants who are there that that that I'm putting out. So it's it's still happening. It's still it's it's it's that that exchange of information. I mean, do you do you get a sense of that?
• 25:28
  I mean, you know, you're how long have you been with us now? Couple of years?
• 25:34
  Speaker 2: With ISSTD?
• 25:36
  Speaker 3: Yeah.
• 25:39
  Speaker 2: Least four years, if not longer, plus some years in the nineties.
• 25:44
  Speaker 3: Right. So, I mean, is that, you know, is that the kind of experience that you also get a sense about?
• 25:52
  Speaker 2: I have found that the trainings are very formative and that there is so much happening with research that it's the fastest and easiest way to get the most recent updates but also if there's anything I've learned from these trainings is how it has to be so foundational on the actual treatment for complex trauma for DID. And I think it's so, so necessary because, I mean, the reason I work so hard for the PTP program or for the webinars or help with the way that I do is because I really believe in what it's doing and part of that is because starting with my generation and the people who have come after me, their entire education has missed the psychoanalytic training and simple things like transference and counter transference and all those pieces that come into play through the process of therapy, much less being such a significant part of DID treatment. And it's just, it's so needed. It's so needed what you're doing.
• 27:22
  Speaker 3: Well, and I really appreciate the help. I think the the professional training program is an example of what now exists. I mean, in a in a in a very comprehensive form, thanks to to to Sue and Joan and and everybody who has spent so much time putting it together. But, you know, these are kind of, as you say, kind of foundational opportunities that that we didn't have in in at the at the beginning. You know, we didn't have you know, I'm I'm frankly, I'm not altogether sure how much any anyone going through graduate program now learns or has exposure to dissociation.
• 28:22
  Maybe maybe more so post traumatic stress, but even that, not so much. And so the the professional training program really provides that opportunity for, as you say, you know, making sure that we say, okay. You can you can check the box here to know, you know, what you need to know about the structure and foundation of of treatment. And I think it's extremely valuable. And and I'm not so I I'm not sure that it that I have to guess that what ISSTD is doing is is unique with other professionals from other professional societies.
• 29:21
  I mean, do you get a sense of that? I mean, are other societies do they have this kind of foundational training and comprehensiveness that ISS2D has?
• 29:33
  Speaker 2: I think that I think that so many people, especially since the pandemic, are looking for online trainings and and things like that. But when you talk about the comprehensiveness, that's part of what this has to offer because it is the actual founders of the field speaking and presenting or consulting or teaching or giving case examples or walking through the actual theory. It is a profound moment in history that is being recorded as much as the educational offering that it is.
• 30:10
  Speaker 3: Right. Right. And I, and, again, I mean, the you know, when I teach a sequence, I always learn something. You know, I'm I'm trying to impart certainly my experience and experiences, and I'm I'm I'm hearing things that I, you know, that I haven't thought about or approaches that can be useful. So it's, you know, it's that it's that interactive part of what we do that I think is so so important.
• 30:58
  And it it it really is the case that we are confronted with, you know, extremely complex and difficult clinical circumstances and situations. And so, you know, much to the benefit of being able to have the support that that that, you know, that that coming together affords us. But, you know, there were some there were some dark days in terms of of ISSTD and the field, and that, you know, it principally relates to the the the kind of onslaught of the false memory syndrome. You know, movement, pressure, and so forth and so on. And and that was you know, that I think that that really tested the the strength and conviction of of our group of ISSTD and and brought up a really genuine well founded debate about what we're doing and and what was going on.
• 32:29
  And and, I mean, it it, you know, for a while, it really diminished our ranks, if you will, because individuals were clinicians were were apprehensive about coming into the treatment of of well, we didn't at that point, we were not calling it complex post traumatic stress, but but there was there there was that reluctance. And I think it's it's as you say, it's true I I think the the positive that came from that beside beside our taking the time to to look amongst ourselves and to say, well, what are we doing here and how in fact do we substantiate our treatment methods? And I think from that, we've we're seeing the work like with Bethany Brand in terms of the top studies that we're starting to see more and more and more very thorough and very substantial research, which is quite frankly what what we need, as you say. I mean, you can you you can find information, you know, quickly by by looking at the, you know, what those who are doing the research and and the reference sites and and what they're looking at. So it's it's it was an interesting and and also difficult time.
• 34:25
  I remember that I very distinctly remember an opening day of a conference way back when when Frank Putnam stood up and said, you know, this is have to take we have to look at ourselves and we have to look at our methodology and we have to be extremely aware of of the the accusations here. And while we may feel and they they are inaccurate, we still have to look at ourselves. And and I think that that's something that ISSTD has has really been really been good about, That that we've listened to our own members and we've gone through the process, and I think we're we're certainly came out on the other side of of those of those years, but it was it was difficult. And and and I mean, were you involved on you were kind of involved maybe at the tail end of that. Right?
• 35:48
  Speaker 2: Well, it's interesting because I was a client during the memory war years and impacted in that way through some of that drama and then was becoming a clinician following that. And so I sort of had both sides of the experience and saw the impact both ways, which is actually one of the reasons I started the podcast because I felt like there were such a residual effect of the trauma that we all collectively experienced both as clients and as clinicians because of all that.
• 36:34
  Speaker 3: Right. Right. And, you know, I think that we are we're kind of we're kind of slowly building our ranks back, if you will. And, you know, every everyone has stayed the course, and and I think we've become we've become better for it. And I, again, I am I'm really delighted to see the the research and the substantiation that's coming from the research.
• 37:12
  And and that we have, you know, that we have a strong scientific com committee that they're they're really looking at again, to look at the underpinnings and and what are we doing and how can we how can we present what's happening because it's I there's an edge of what I do that is expert testimony and forensic. I I tend to work almost exclusively with public defenders because they can't they can't find people to work with them either a, because of lack of knowledge about dissociative process and complex post traumatic stress and that they don't pay very much. So, you know, it's like, well, you know, we need your help and you're gonna go into court and you're gonna get yelled at and and somebody's gonna try to indicate that you don't know what you're talking about and, oh, by the way, we're not gonna pay you very much. So it's, you know, it's not a it's not a popular endeavor, but for me, it's a it's a necessary endeavor. How and as you can well imagine, and if if there's doubt and if there's skepticism in the in the in the general group of treatment professionals about dissociative process and about dissociative identity specifically, you can well imagine and certainly understand the amount of skepticism that is in a forensic setting and and attempting to to go into a courtroom setting and and and substantiate that this person really does didn't remember and doesn't remember what happened or why it happened or who they were at that point and so forth and so on.
• 39:43
  So but that's I'm not altogether sure that we're gonna have much impact on that forensic setting, and and that's understandable. And we have some Phil Kinster, Steve Frankel, Peter Baraj, who's I don't know if he's still a member, but I know he's active in in Rich Chavez's listserv. You know, these are individuals who brought information about how to deal forensically. I I was I was testifying in a in a very, very high powered, intensely dramatic case. And the the the prosecuting attorney, the DA, at one point stopped and he he said, doctor Mabes, he said, how many years have you been practicing voodoo medicine?
• 40:52
  And I I I said, excuse me, mister Cooper? He said, oh, you know, never mind. And I said it's said to the judge, I said, you know, I'd I'd like mister Cooper to repeat that question to me, please. You know, I mean, that's the kind of that's the kind of understandable skepticism in a forensic setting, but I still think that there is a tremendous amount of of skepticism across the board. And and to maybe be gentler about that, at least a lack of understanding.
• 41:37
  You know, it it it's it's always of interest to me to hear from a colleague that I've known for years who's a senior person who, you know, has acquired someone dealing with DID or thinks that and comes to me for some consultation and and how little they know about the process. And it's I guess it isn't it shouldn't be surprising, but but it it continues to be surprising. But we're we're chipping away. And the thus, the idea of the the the regional conferences, although I I still think for the most part, we're we're we're training those who already understand about dissociation. But if we can if we can reach a few that that that haven't heard and and want training, we're we're doing one in Denver here.
• 42:49
  And I have I probably have five or six people that I'm hoping to have come to the conference, professionals that are really we're really starting to to do the clinical work and the treatment for the first time, and where I'm consulting with them and where they can where they can sit and listen to Colin and get a a very comprehensive view of what's going on. So I think we're I think we're getting there. And and and, you know, I mean, you're you're involved at the the educational level, and we're we're doing a lot, aren't we?
• 43:34
  Speaker 2: I hope so. We're trying and to hear your story from those beginnings of trying to research and teach each other while you're learning actively in the process of what to do or how to help all the way up through the top DD studies now, or the fMRI studies from Simone Reindeers, or all of these, this research that's coming out now, it's just profound transformation through this study of treatment and how to care well for people who struggle with dissociation. What would you say to a new clinician who is just learning about dissociation? How would you explain that to them or help them understand what they're seeing?
• 44:31
  Speaker 3: You know, and that's a great question in that that's much of what I find myself doing when someone comes to me for consultation. I mean, what what I'm trying to do now is, you know, if someone comes and says, gee, I'd like to see you on this and that, I'm I'm kinda hoping that they are with a therapist. And what I can do is keep the client with their therapist and that I can, you know, then encourage that therapist to to do the professional training program, and I can be a consultant and so forth and so on. But, you know, I I usually, you know, grab Judith Herman's book off the shelf and say, take this, you know, and read this as a starting point. And and I really try to put the the the dissociative process into a into her her conceptualization in terms of a complex post traumatic stress reaction.
• 45:48
  And to try to really help new clinicians understand that we we usually see a combination, one or the other, and usually both of some kind of an attachment issue, some kind of disorganized attachment so that we have so that we have, you know, a developmental history where one or both of the parents or or or primary people in the client's life has some level of problem, alcoholism, maybe more severe problems bipolar, and so forth and so on, perhaps themselves dealing with PTSD. So you've got this combination of an an attachment attachment issues, disorganized attachment, and typically abuse, as you know. And so so we get that combination. But I try to have the someone who's just beginning, I mean, again, back to where we started today to have a foundation to say, this is what your client is dealing with even though they they are not able to to talk about it. And and and try to help with some of the basics, basics, you know, that there are so many points of diagnostic confusion and so much overlap with our clients that that's how they come to us with such a need and how how we find ourselves, you know, really trying to reach out for some help and clarification and thus the consultation clinic consultation clinic and the training that that we're providing and so forth and so on.
• 48:08
  But it is that mixture. It really is. So when you start looking at the kind of common points around post traumatic stress, the the top one is the vacillation between kind of hyperarousal and and and on guard, you know, flashbacks and in contrast to that numb that very numb and constricted place. And so if you're not familiar with if if you're not diagnostically familiar with complex post traumatic stress and and with dissociation and DID, it's very easy to say this is this is a bipolar reaction. There's this.
• 49:01
  There's this. I had a on one of my treatment units that that I started, I had a a of extremely well known from the medical school in Denver come to my unit every Friday, a psychiatrist and and talk about diagnostics. But he he would come on a a trauma and dissociative disorders treatment unit and and diagnose everyone as bipolar. And so I so I finally took him to lunch and I said, look. I said, just listen to me.
• 49:42
  You know, I'm buying lunch, so you get to listen to me. And and I said, it it's it you know, it it looks like it the old you know, quacks like a duck, swims like a duck, flies like a duck, but it's not a duck. That that that that that's a that's a phenotype. It's it looks like it. And to his credit, he actually went off to become the chair of a department of a very, very well known psychiatric department and wrote a wrote a small book about the confusion between post traumatic stress presentations and bipolar disorder.
• 50:25
  But so I think for someone starting out, I want them to have a sense that, yes, you're gonna see all of these things. You're gonna see there's almost always a sequence in in dissociation post traumatic stress, again, from this kind of highly hypervigilant, overactive to numb and constricted to kind of themes of denial, to to all the hopelessness and helplessness, to a certain level of repetitive behaviors that can look and can be very obsessive compulsive. But all of this is is back to that place where we look to classic post traumatic stress as the, quote, unquote, loss of mastery and control. And so what I try to help someone who's starting out in the treatment is to say, yes, you're gonna see all of these things and you're gonna feel all of these things because one of the dilemmas that we face is that individuals who have been immersed in this inescapable trauma, this this this overwhelming attachment kinds of problems and and or abuse is that you're gonna you're gonna have a lot of characterological process come up. And, you know, I speak about this a lot, have spoken about it a lot because that complicates things.
• 52:15
  And so, you know, you've heard it. I've heard it a a million times. Well, it's not it's not dissociative identity stuff. It's it's it's just borderline. It's just, you know, some type of personality disorder.
• 52:33
  Well, there's no just to that. That that's a that that in and of itself is those conditions are difficult to work with and difficult for us as clinicians to work with because there are so many, you know, action defenses. There's so much splitting. There's there there's there's so much projective identification that we can really get knocked off of our feet. So that's another thing that when someone is starting is to say, find some type of consultation group, find someone who can help you, you know, and obviously connect with with ISSTD, you know, start to go to the conferences, start to do the professional training, start to understand the the the what's going on from a from a very comprehensive standpoint.
• 53:35
  But it's and, you know, I really do say that that you that as as a new clinician, and me as an old clinician, we're gonna be we're gonna have days where we're just flattened. My wife is an art therapist. We work she worked in in trauma for also for thirty plus years, And and and we work collaboratively. And and thank goodness for that, that I can, you know, I can come home and go, oh my goodness, you know, that I'm that I'm just flattened. And that that that's that's that's part of it.
• 54:22
  That it's that that's what happens and we just again, we reach out for the support and understanding that we get through ISSTD and and through through really working collaboratively. I because of my inpatient, you know, creating and directing units, I have a very much of a collaborative kind of sense about things. I work collaboratively with a physical therapist who was involved with a trauma program here in Boulder, Colorado for a while run by Bob Scare. And so I I'm I'm I very much like to have a more of a team approach. And, you know, and and that's that's also what I talked to someone who's just beginning to work in the area to say, you know, get some consultation, get some people that can come in and assist and help you because we we all need it.
• 55:36
  You know, I I certainly continue to to need and, you know, I'm just trying to find a way to figure it out and and to help them. So it's kind of a it's kind of a mouthful, isn't it? When somebody starts out, you're you're kinda giving them a lot in a hurry.
• 55:56
  Speaker 2: It's a lot to untangle and a lot to stay present with. And in the case with DID, it's so many threads to keep track of.
• 56:06
  Speaker 3: Yeah. It it it it it really is. One of the things, though, that I talk about when I when I do training, especially with community mental health centers, is that that we really are doing basic we're doing good therapy. And as you say, it's it's extremely important to have an understanding of the kind of basics of what we imagine goes on in in the treatment setting so that it's that it's helpful to know that, yes, we're gonna have these countertransference. We're gonna have these feelings.
• 56:52
  We're gonna we're gonna be seen in a variety of ways. We were we're gonna we are in the case of more characterological process. We we are going to feel we're gonna feel. We're really gonna feel. And in a lot of cases, we're gonna feel diminished and unsure of ourselves and so forth and so on.
• 57:15
  But but but it's really the the the core is as as it always is is a, you know, therapy approach is a, you know, is where you go for your foundation. And and I'm not particularly concerned about the a particular therapeutic approach. I think it is important to know no no matter what approach, I think it is important to know about our own reactions in terms of countertransference and how we're gonna be seen by our clients and and patients in terms of transference. But I think it's good do good therapy and then find out the the the the nuances and the amplification that we provide through through our ISSTD training. That that becomes important because it certainly is is, you know, some someone who has never been in the room when someone makes a a move from one place to another, from one state to another, that can be pretty unnerving.
• 58:44
  And, you know, they it it it's it's really good to have that preparation.
• 58:51
  Speaker 2: I just wanna close with, I think that that's absolutely true, and I appreciate you sharing both the history and the importance of us learning together the different generations, the unfolding research, all of it is so, so powerful and is what brings healing both to us as clinicians who have endured so much, as well as the people that we are trying to help who have endured so much. But thank you for talking to us today, and I am so grateful that you were able to come talk.
• 59:22
  Speaker 3: Listen. Thanks for having me. And and listen. I greatly appreciate the work you're doing. I mean, I really see, as you've heard me today, I really see that the training function is is is such a substantial core for ISSTD.
• 59:42
  And so onward and upward to both of us. Thanks for having me. Take good care.
• 59:47
  Speaker 2: Thank you so much. Goodbye.
• 59:49
  Speaker 3: See you.
• 1:00:03
  Speaker 1: 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 in our new online community by going to our website at www.systemspeak.org. If there's anything we've learned, it's that connection brings healing.
• 1:00:26
  We look forward to connecting with you.