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Understanding Trauma and Dissociation with Erin Lewis · Finding New Waters

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A lot of people defined Association based on
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symptomatology when really, it's really a way that you encode
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memory, like you're storing memory into the body.
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So you have like flashbulb memories.
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You have like your stereotypical like you.
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Both are looking at me right now and then like it's going into
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your working memory. Maybe I'll throw it out later.
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You won't remember this moment potentially or maybe a hold onto
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it forever who's to say like but essentially when you have
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dissociation, it's imagine kind of like a great in front of View
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of your perception and like, the picture of my face, for
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instance, that you're looking at goes through.
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And then it feels like it's like, it's like a million little
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pieces. Like a million is probably like
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an under store understated because of the brain, right?
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Like but either, or essentially like you're not getting the
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snapshot. Like, we don't record and video.
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A lot of people are like, oh, I see baby.
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Like, no, like you have snaps but then when your average
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snapshots of your memory, actually, like, goes through a
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great, all of a sudden. It's like, okay.
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Well, the sound might actually store somewhere else than where
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the picture and image stores and then like the feelings that you
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semantically held Our goal in creating finding new
1:33
water system, provide a resource for families to help navigate
1:36
the complexities of supporting a loved one through the struggles
1:39
with substance use and mental health.
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When we find ourselves in a crisis due to one of these
1:45
issues, most people have no idea where to turn, we hope to shed
1:49
some light into what is often The Darkest Hour for many
1:53
families. So today on finding new Waters,
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we have our guest, Aaron Lewis joining us today.
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I'm also joined by dr. Harold Hong, the medical
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director at new Waters recovery and as we were discussing many
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other things as well, Aaron Lewis, Ms. L cmhc in a RM and
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master therapist is a somatic, psychotherapist specializing in
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dissociative disorders, and Trauma treatment.
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Aaron began her career in healthcare working in.
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Seeing homes primarily on the dementia care, unit and
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Rehabilitation Unit as a certified, nursing assistant.
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This is where she became passionate about, mental health,
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care and letter later began. Working in residential,
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transitional group home, for individuals with acute psychotic
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disorders for several years. Aaron became passionate about
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the trauma treatment clients were receiving which resulted in
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their, choosing it resulted in her choosing a specialty in
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trauma treatment, upon having worked In different levels of
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care, Aaron became intrigued with clients who reported
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experiencing dissociation are, and then decided to receive
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training and specialized in dissociative disorders,
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primarily focus on dissociative identity disorder or D ID.
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Aaron is the co-owner of NC cutting-edge counseling and
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Advance an advanced trauma treatment outpatient group
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practice that Bridges. The gap between research and
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clinicians to give individuals with trauma the Effective
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treatment to date Aaron lives with the ID and runs Community
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groups for people with d ID, she is involved with d, i d research
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and educate strains and consults with clinicians on how to treat
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dissociative disorders are in lives with her husband and three
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dogs in North Carolina, where she enjoys connecting to God.
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Through Bible study running comedy, nature, dog, walks,
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hiking and music, love it, what kind of music do you like it?
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So obviously Eminem is the greatest rapper of all time.
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I'll just go on record saying that but also I mean the raft on
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ra. Okay.
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Here we had Colts just like so chant like Acid Rap you go back
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to like throwback Tupac and Biggie.
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I like them both all of it holes.
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He's good too. Okay cool.
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I love that, love that. So I know we've read a little
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bit about your background but maybe we could start with you
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just said in a little bit more color, right?
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Like why did you become a therapist?
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Why why the interest? Yeah.
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So I actually was one of those people that was like I hate
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therapist. I hate therapy.
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I hate the whole like Burn It To The Ground, kind of a person.
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And then I think it was because I being in the nursing home
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specifically, I would see all of these really like problematic
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clients or patients really residents of the nursing home,
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and it wasn't that they were problematic.
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They were just weren't receiving the right treatment and they
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were really being An overlooked, I mean, from bipolar to
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schizophrenia to PTSD. And I was just like there has to
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be a better way for like, especially at the end of life
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towards the end of life or, you know, even if you've had a
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stroke and I have to live in one of these facilities to help, I
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feel like there had to be some like what is missing and then
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like I looked at the staff roster because I was actually
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going to go into an administrator type of position.
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I was looking into going To that, like running, not
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hospitals necessarily but more nursing homes, where my focus
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and then I was like, where are the staff?
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Therapists fun fact. Know where like there's
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occupational therapists and I was like, that's the wrong kind
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of therapist. It felt like so I was like okay
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well what's what's the Gap here? What's missing.
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And then when I went and started working at as a case manager or
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like it's a called a care coordinator at That plate.
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It's a case manager though. Position at a group home, that
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was specific to acute psychosis and it was really like the
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testing ground. If you're going the state
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hospital for an extended period of time many years, or if you're
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going to be able to ever go back out in the community, we were
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that testing ground. So it was like very high and
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Leah cute. And I was like, okay, crisis
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work is all right, you know, like, I, it was just like that
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adrenaline and I was Oh I didn't realize at the time that was my
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own trauma. Things that like I love being in
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crisis, not me personally. But like helping people through
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crisis. I have this calm that starts to
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like oh thanks Phil, Right? Which is the opposite I learned
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of like a lot of the you know someone's like setting the house
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on fire or somebody's throwing chairs and I'm like alright well
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like let's just figure it out and I was like I think that I
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want to be a trauma therapist. And so then you know So many
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years later after the schooling and think I'm actually going
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back to school and two weeks for my PhD.
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Let's start specializing in trauma, which is kind of silly
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silly because it's like, I already specialize in it and I'm
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sure I'm cheating. I don't know.
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I was like maybe I should do a dictions or something like mix
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it up a little. So that's really how I got into
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like the therapy world. Before that I was Also like
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pre-med. I was very much like
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biochemistry nerve code and then I was like, oh I think I want to
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sit and talk to people actually, you know, like also organic
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chemistry is the worst hats off to?
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Those are tough days. Dark days and doesn't days.
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Actually, it's. There's trauma there.
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Actually, you could probably talk about that and probably
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some disassociation certainly. I believe it is.
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Are these covalent bonds and I was like, oh no.
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Yeah, yeah goodness. So trauma.
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So, you know, so one thing that comes up for me is dissociative
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disorders is, you know, maybe even just starting with like,
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what is dissociation, right? Like, what does that even look
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like? Where does it come about?
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Right? So a lot of people defined
8:17
Association based on symptomatology when really, it's
8:21
really a way that you encode memory, like you're storing
8:23
memory into the body. So you have like, Memories, you
8:26
have like your stereotypical like you both are looking at me
8:29
right now and then like it's going into your working memory.
8:33
Maybe I'll throw it out later. You won't remember this moment
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potentially or maybe a hold onto it forever who's to say like but
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essentially when you have dissociation it's imagine kind
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of like a great in front of you of your perception and like the
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picture of my face, for instance that you're looking at goes
8:50
through and then it feels like it's like it's like a million
8:54
little pieces, like a million is Bubbly like an under store
8:58
understated because of the brain, right?
8:59
Like but either, or essentially like you're not getting the
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snapshot like, we don't record and video.
9:04
A lot of people are like, okay, I see buddy.
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Like, no, like you have snaps but then when your average
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snapshots of your memory, actually, like, goes through a
9:14
great, all of a sudden, it's like, okay.
9:16
Well, the sound, my actually store somewhere else, then where
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the picture, an image stores. And then like the feelings that
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you semantically held or like your body feelings can store
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some, Else and then like, so then you have all these
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fragmentations. So let's say you went through
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like a trauma. I don't know, I clap my hands.
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This is traumatic for some reason, right now.
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Right? So there's a part, like, if
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we're dissociated right? Like so a part is going to hold
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that like sound of clapping then there's going to be another part
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that's going to hold my voice likely and whatever I am
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actually saying and then there's another part that's holding
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that, like body memory. Like, that's as simple as I can.
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I can break it down, essentially.
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It's the way that you store memory and it happens commonly
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in PTSD. Actually happens, commonly in
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every disorder. There is if honestly.
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So, when we look at, like, even major depression, like, severe
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major depression, where it's like, I can't get out of bed.
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Every day is the same day over and over again.
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What month is it? Like, there's a level of
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dissociation there. Now, when you look at it from,
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like more of a trauma lens, there's different types of
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dissociation. So, Let's say I was handcuffed
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to this chair and I'm just so saving or something, right?
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Like, potentially later on when I'm processing with my therapist
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or something, my actual left hand could go numb completely
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not my whole entire body necessarily that could happen as
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well, right? Like so then it's like very
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selective like dissociation of like, oh now, I now my hand is
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numb. I can't feel anything.
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Interesting. So there's so many different
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types of dissociation but it's Like so depersonalization
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derealization for instance an episode of that happens to 52%
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of the United States population at least once.
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So it's very common is that a type of dissociating D.
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Personalizing do you realize that those are specific types?
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Yes, the dissociation definitely, it's definitely over
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time. So it's kind of like also I
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since I had my start of my career in psychosis, I love And
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they'll be like, oh it's kind of like that but so it's not like
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psychosis just to say but like I'm making this comparison of
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like so essentially like once you have certain delusions and
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you have like a psychotic break, let's say.
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And let's say it's you think you're God or something
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delusions of grandeur that you're having, then you come
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back to reality you're on medication or whatever you
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stopped taking your meds or something.
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Then you go back to that same delusion, usually it's along the
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same lines. So dissociation, sometimes
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people to search dissociate from their body, specifically, or
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even their identity were just like, am I a person like what's
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happening? Sometimes it's the environment
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though, right? Like it's like oh this isn't
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real, you know or maybe it it like in everything kind of feels
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like farther away. So if you think of like shocked
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this is your body is taking in too much at one time to really
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like take it in. Yeah so it has to store in other
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places. So those are unprocessed
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memories. Yeah, I love memory.
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I can go into memory forever, but yeah, for four people out
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there who aren't professionals. What are some signs that like a
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loved one is decisioning. So it can actually be very
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difficult to catch. Okay?
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You might not know it or it can be profound.
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Everything's on a spectrum. So slight dissociation.
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I mean, even, You driving, like, let's say on a long road trip
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for 100 miles, you don't remember 60 of those Miles
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because you're thinking about spaghetti.
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Now, I'm thinking about spaghetti, but or whatever food
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that like you're thinking about her daydream about like,
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wherever you're going to be your destination and now like you've
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not encoded that entire strip of land which is 60 miles, right?
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Like, that's a test of like it's kind of a can also be kind of
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like daydreaming so it's just like they're kind of not there
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or they They can like have this stair.
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It's like the thousand-mile stare.
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We're just like, what sometimes if you talk to them as what
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like, this is more on the profound and sometimes when you
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talk to them, they take a while to respond.
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So it can be like, hey, how are you?
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And there's like, The really like, it's taking them some time
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to get that cognitive awareness because there's somewhere else
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so it can look like that. Hell is kind of look it can I
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treat like a lot of the severe side of dissociation.
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So what I'm thinking is, sometimes people are so afraid
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and terrified and frightened, just like talking in a room with
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somebody that they're almost nonverbal or completely
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nonverbal. That can be that their
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Associating. It's just too much for them.
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They're too afraid, right? It can look like all of those
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things sometimes. It looks like so because like, I
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have dat, right? So I'd associate fairly often
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all the time, right? Like so my husband for instance,
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I'll be like, oh yeah, we're going to a party Saturday, like
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cuckoo cuckoo, and then it'll be like 30 minutes later.
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And I'll be like, hey, Saturday. I was thinking that we would
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like go to this place or do this thing.
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He's like, so we're going to that party.
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He's like, oh, this, let you know.
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And I'll be like, right, right, right.
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Right, right. So I like, if you're planning
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something, you got to write it down, kind of a thing, but
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that's like a common one. It's more than mindlessness
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though. So, if you think of mindfulness,
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the opposite mindlessness is like, you leave cabinets open or
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something. That's kind of, like your mind
15:06
is somewhere else, but that's not necessarily dissociation,
15:09
just to like, Bridge that gap of it.
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Yeah, yeah those are some ways that because there's there's
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been distracted, right? So if my wife is talking to me
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about errands for the weekend but I'm thinking about like
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being on call for the weekend. I might just miss a detail.
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Yeah, that's distraction that decision.
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Yes, the association's. Like oh I'm paying attention to
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you. I'm like yes I'm in it with you
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and then All of a sudden it's like so it like a lot of times
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with dissociative identity disorder, specifically, or like
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more even OS DD on the size of dissociation.
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That's more profound. It's like, they're listening,
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it's not, they're not necessarily even distracted by
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anything there listening and it's just gone.
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And a lot of times they don't know that it's gone until you
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start doing like these timelines and it's like oh they think that
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they remember everything they're like yeah like they're covering
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A lot. Yeah.
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And they might not even know that they are covering because
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this is really a disorder of hiding.
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All right. So then you do these timelines
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and then it's like, oh yeah, I don't remember.
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Second grader, third grader, fourth grader and all of a
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sudden, it's like, oh, you don't remember Ten Years of your life,
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you know and or however long right?
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Like, you could be even more or less but yeah.
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This direction is different than dissociation for sure.
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So I'm wondering. What's happening?
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Like neurologically they're like is there something that's kind
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of going offline or like any thoughts on that?
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Oh yeah, I am a neuro nerd. Okay.
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Yeah. We find a couple of interesting
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things and a brain with the ID, we don't know everything that's
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happening. It is why leaving research and
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has been for the tenant the last 10 years or so.
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However, so there's this Pebble thalmic pituitary, adrenal axis,
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8 HPA axis, right? Like in the brain that upticks
17:13
with trauma specifically, but think of it, like, almost like a
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gear that's turning for everybody.
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It's just like, okay now you've had some trauma and it's going
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and it's like, okay, well now you have a decision and it's
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just like, your amygdala is firing your hippocampus is
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firing, your hippocampus is over generalizing things.
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Your amygdala is like everything is a threat, because your
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hippocampus has over-generalized.
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It, the amygdala, think of That is like your threat response a
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little bit. It's just like you're a little
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alarm bells. And so what we see over time
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with that creates these neurological differences in the
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brain, is that from PTSD to D ID?
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Because there's a trauma Spectrum, what we see in people
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with d IDs, they actually have larger matter, white track
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matters and their brain than gray.
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So you have white matter and gray matter, there is a reduced
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level of gray matter in the brain.
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Increased white matter. What is really interesting?
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I'm really into this biomarker right now.
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It's called to necrosis Factor Alpha, and it's actually reduced
18:16
in people with d ID, which is like weird because it's
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increased people of PTSD. A lot of the research is showing
18:25
so it's like what some very interested in that specific
18:30
because there's really a lot of interesting PTSD research being
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done. Done.
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And what is that responsible for that particular biomarker?
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Yeah, so it's involved in everything, in my opinion,
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there's so many things that's involved with.
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But there's inflammation is an inflammatory speaker, okay?
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But it's reduced, which is interesting because trauma
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increases it over time and in North America even more,
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interestingly, because I treat in multiple different countries.
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If I can treat their right Germany, I can't.
19:02
They have certain licenses that I don't have.
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The UK is different anyways but if you look across the globe,
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PTSD is kind of joked to be an Americanized disorder because
19:15
like there were such high rates here versus anywhere else in the
19:18
entire world. So there's lots of theories
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behind that, we don't 100% know, but there are some theories
19:24
anyway. So like with the dissociation
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Association specifically, I think what is super interesting
19:31
from a global level is When I read it, I was like that.
19:36
Can't be right? I was just like I disagree with
19:38
this statement and then I had to do a lot of digging and I was
19:41
like, oh I'm wrong like that, the research, you know, I'm
19:44
always going to like go to the research.
19:45
So essentially people in North America with d ID they have more
19:49
psychosomatic symptoms so like body something.
19:52
So these are like pseudo seizures you can have parts that
19:57
have Parts personalities, I think of them as neural networks
20:02
myself but whatever you want to call them.
20:04
Some can have diabetes. They actually process drugs
20:08
differently in the, which makes it incredibly.
20:12
You could likely speak better to this hard to treat medically.
20:18
It's not like it's a serotonin reuptake situation, just pens.
20:23
Your cells are moving dependent on the neurological Network.
20:26
That is online essentially or whatever part is fronting.
20:30
Whatever language you. Yeah sure.
20:31
Yeah. Trauma is it?
20:34
Has not just how we think and how we feel, but our bodies.
20:38
Yeah. Right.
20:38
Like our brains, there was in just a couple months ago, the
20:42
American Journal of Psychiatry had this wild study where they
20:46
looked at brain, scans of different races and different
20:52
mixtures of trauma in their history and the the Earth
20:58
shaking fighting of this was that The brain volumes for the
21:03
part of your brain that controls like emotion, regulation
21:06
planning executive function trauma makes that smaller,
21:10
right? And also other parts that are
21:12
involved in emotion, like the amygdala all those wives get
21:15
smaller and races and ethnicities that are more likely
21:20
to be traumatized. Have more brain volumes but wipe
21:25
a white person who was as stressed as a black person they
21:28
have like similar brain volumes in this.
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The sense of trauma, it physically affects how our
21:35
brains are and it's dragging. And then when you have trauma
21:41
and stress, your cortisol levels, go up and that
21:43
suppresses inflammation, by suppressing, the immune system
21:47
and we know people who have high trauma scores are more likely to
21:51
get cancer. Because we know that cancer is
21:55
in some ways that a disorder of your body not detecting and
21:58
eliminating mutated cells correctly.
22:02
So these are, these are profound things.
22:04
And I think only now is the science and our awareness of
22:09
just our everyday living coming to to make sense and connect
22:13
with each other but like for you know the there's so much that
22:20
our our listeners can benefit from by understanding like their
22:23
histories and their bodies and their relationships, more deeply
22:29
and I get really excited about I mean work because this is where
22:33
it all connects, right? So I know that our patients, our
22:38
clients, are they use alcohol to deal with pain like to
22:45
disconnect from stresses in life and there's a lot of parallels
22:52
between that and Other Stories of her about children being
22:55
abused and, and they create like this magical world in their
22:59
mind. And, and when When their parent
23:02
is out of control and the the abuse begins, their mind goes to
23:08
this magical place and they don't feel or remember what
23:12
happens. And so, I see a lot of
23:14
parallels. But you being a therapist who
23:17
specializes in this world, I would just love to see if you
23:20
see something like this. And if so like, what's going on?
23:24
Oh my God, that is dissociation, like we got it all smiling.
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So I was like oh yeah, like that.
23:32
The other world or is kind of like this isn't happening.
23:35
Like it's, it's so it's not just an aisle as much as its
23:40
profound, right? Like, it's like, it's not
23:42
happening right now. That is throwing something
23:45
across the room. It's like, well, no, that's not
23:47
happening. Like, look at me and this family
23:49
that I'm sitting in. The can have created a whole
23:52
different family. It could be, we see this
23:57
especially in Foster Care Systems where they have like at
24:00
this imaginary family. Ali, that really loves them and
24:02
cares about them. And in, it's really helpful in
24:06
terms of coping, because sometimes it's like a kid, is,
24:09
sometimes in just a really horrible situation.
24:13
They don't have the resources to get out.
24:14
They don't have like, usually, you know, unless they're like
24:17
child stars, right? Like they don't have their own
24:19
homes and jobs and they can't set those boundaries.
24:22
So that dissociative factor is so helpful.
24:26
It just becomes too leaned on and all of a sudden, it becomes
24:30
not helpful in adulthood Good, right?
24:32
Because then it's also hard from a somatic sense to I always ask
24:36
this question to my clients of one did, you know it was over.
24:42
Like, when did you know, the abuse was over, whatever it is,
24:45
when did you know it was over? And a lot of times, they're
24:47
like, Why are you talking about? And I'm like I mean you're
24:54
sitting here in front of me right now because there's so
24:57
much trauma memories that are unprocessed by that point that
25:02
they get to you as an adult the it's just like they're really in
25:05
this heightened State like on edge.
25:07
It's never ended right? Yeah, interesting.
25:09
And then once you they say it out loud like oh I guess I knew
25:13
quiz and asking them that it's kind of like a Trixie way of
25:18
trying to break down this amnesty.
25:19
Stick barriers in the brain between like their memories
25:22
essentially or those neural networks that they've created
25:25
these amnestic barriers, which is just like the barrier between
25:27
like this horrible information and your life experience and
25:31
where you are today, so then you're asking them to reflect
25:34
any time. You're asking reflective
25:35
questions, they actually have to go back into their memories and
25:38
think about it. A lot of times you'll see them
25:40
answer very quickly and they don't think about it at all
25:44
because they don't want, they don't want to be like, oh, just
25:47
take a, you know, well it's not done.
25:48
Okay. Well, Take a second and like
25:52
would that be okay to sit with just for a minute?
25:54
This question, when did you know it was over?
25:57
And then a lot of times once they can track it back, they
26:00
might be like, oh, I guess when I went to college and now all
26:03
the sudden the remembering that they went to college, you know.
26:07
Like and that's with the more profound Association.
26:10
Like PTSD dissociation is more like they know they went to
26:13
college they just might not. I think compete ESD.
26:18
I see a lot of times the emotions removed quite a bit
26:22
unless they're like, very volatile because they've been
26:24
triggered, but with social disorder, sometimes it was like,
26:28
yeah, I got this four-year degree and it's like, who got
26:31
it? You know, like, someone in here
26:32
dead and it's that level of Disconnect really.
26:38
It's the narrative phobia is what I would say in that client
26:41
as well that you were talking about scenario.
26:45
The narrow phobia I think is really Dated clinically because
26:49
interesting. So I'm thinking as you're
26:51
talking. So I've done some EMDR don't
26:56
really practice currently but so as you're talking them, I am
26:59
seeing through that lens. The question I guess I'm getting
27:02
to is like, how do we treat this, right?
27:03
Or how do you treat this? But I guess I'll lead with do
27:07
use EMDR. I okay, so in my practice, we do
27:11
have like my business partner, does the MDR?
27:15
For instance, I personally do not treat with EMDR because I
27:19
can't get my saccades are off in my eyes actually.
27:22
And that would it would probably make me suicidal actually if I
27:27
were ever to have EMDR therapy. So it's hard.
27:30
Like, I got some neurological testing done because a part of
27:33
having the ideas like, this isn't, I don't have this, this
27:36
is a bunch of Lies, like, so you want to just prove it no matter
27:40
what. So, I went through all of this
27:42
like neurological testing and they're like, oh, don't get EMDR
27:47
and I He's like, oh, why not? You know, because like seems
27:50
like an, all right, it's a trauma modality and she said, my
27:54
saccades were off and that I wouldn't be able to process the
27:57
trauma that was coming up it would just flood me essentially,
28:01
okay. I think that's why there's
28:03
potentially like these hitter messes with EMDR.
28:06
Sometimes it's like the best thing you've ever had with
28:09
clients is just like Breakthrough breakthrough, so
28:12
much peace. And then other times they leave
28:14
and they have a suicide attempt and it's like I am not an EMDR
28:18
clinician. I don't think there's anything
28:20
wrong with it. I think that I don't, I don't
28:23
know how you would test the saccades or whatever.
28:26
Right, like in the eyes, but how I treat all trauma, it really is
28:33
through like an attachment ones. First of all, I'm sonar Master
28:38
trained, so that's the neuro effective.
28:40
Relational model of therapy, very attachment oriented and
28:44
ifs. I think ifs has gold And I'm us
28:50
for for people who don't know, oh, yeah, five that internal
28:55
family systems model. It's created by Dick Schwartz.
29:00
And I think with, when I look at D ID, there are so many
29:05
different neural networks. It's like sometimes CBT works
29:07
for people, right? Like I think we're trauma.
29:10
There's a lot of like CBT is very top-down processing brain
29:15
than to the body. I think you also have to do the
29:17
body to the brain, which is that somatic and sonar meets in the
29:21
middle, like doing both of those.
29:23
But people with the ID usually have Shock Trauma which I think
29:27
is better treated by an SCP. I'm not in sap, somatic
29:31
experiencing practitioner. But I think people with d, i d
29:36
have to be treated with several different modalities.
29:39
Just like DBT, great, not great a standalone though.
29:43
Like dialectical behavioral therapy.
29:47
So a lot of times I'll send in with d ID, a lot of times in a
29:51
lot of other sit dissociative disorders like, oh, STD.
29:54
There are comorbid eating disorders or substance use.
29:59
And it's like, we can't be a specialist in everything.
30:02
So if they have substance use a lot of times, I'll send them out
30:05
to like coach. Were you in like who Whoever
30:10
specializes in substance you house on them to a clinician for
30:12
substance use. I'll work on the trauma, peace
30:15
or in eating, you know, the eating disorder side of things.
30:19
I've seen people offer that all the time.
30:21
And then we treat them at the same time because you can't just
30:23
treat one or the other through the trauma.
30:26
The eating disorder is going to increase truth, the eating
30:28
disorder. It's just like, then you're not
30:31
treating the trout, and then it's like the issue is still
30:32
there. So, I had to essentially a
30:37
depends on like what the client is wanting.
30:39
But usually Go to is internal family systems.
30:43
Neuro effective, relational model and then other kind of SE
30:48
somatic experiencing practices and how do those things help
30:51
your clients move towards recovery, right?
30:55
So, defining recovery is probably the first step of that
31:00
quote. What I'm really sitting with
31:02
those like a lot of practitioners or like full
31:06
integration Fusion, that's where we're going with the ID.
31:09
And it's like, I mean, would you tell someone with anxiety?
31:13
Like this is what I plan for you and your life, it's like, yeah
31:18
can consent first. Yeah.
31:22
So essentially DBT dialectical behavioral therapy, I send
31:26
people to those groups all the time because like they do need
31:30
skills actual taught skills. A lot of times they come from
31:33
families that it's like they were taught alcoholism.
31:36
They were taught self-abuse or Talk to abuse others.
31:41
And like, that's how you cope and it's like, okay, well here
31:43
are these very concrete skills that you can do like dunking
31:47
your head and ice water or something when you starts to
31:50
build up. So that helps in terms of
31:53
actually being able, like there's a learning part of this,
31:56
for sure. Like there's a learning curve of
31:59
way, not everybody like drinks at 9 a.m. all way.
32:04
Not everybody Stars themselves for 15 days at a time like
32:08
there's a lot of That kind of distance.
32:12
So they do need to learn the skills first to even be able to
32:17
process the trauma that helps with the stabilization phase,
32:21
you always have to make sure someone stable before you just
32:24
go diving into their deepest, well of trauma, right?
32:27
Yeah. Or else is they'll go poorly.
32:31
Absolutely and there's like a 70%, the statistic from the DSM
32:36
as 70 percent of folks with didd.
32:39
A serious suicide attempt, so it's like it's very high.
32:44
So it's, you gotta go slow, treatment slower is better and
32:48
then half of that speed and then like five times slower than
32:50
whatever half of that speed is. And that's the speed you need to
32:53
go with somebody who has tid dissociative disorders in
32:57
general like oh STD as well. So yeah, the DBT helps with the
33:02
skills. The ifs helps with defining the
33:06
neurological networks or the parts are right?
33:09
Like so Ifs. Languages Parts, everyone has
33:11
Parts. Whether you have a boatload of
33:14
trauma or not, you have Parts. Like, you know, you talked to
33:17
your mom and a different voice than you talk to your best
33:19
friend. Then you talk to your
33:21
significant other than you talk to your boss like all these
33:23
different parts coming into play.
33:26
So the research on parts are really interesting, this type of
33:29
therapy because it provides distance that you can actually
33:33
start having compassion again. It's like too much to have
33:38
compassion for the cell. Afraid because I know you've
33:40
been built on a shame model, so it's like, okay, well, this part
33:45
of me. Oh yeah, that little kid part.
33:48
Ah, well that's a rough, go and then you can have some
33:51
competitive, the startings of that.
33:55
I think it's great for that. It makes compassion, less
33:58
daunting because sometimes compassion feels like, Horrible
34:02
to someone who has the ID if they really really believe that
34:05
they are bad, inherent e, inherently, even with PTSD.
34:10
Yep. Trauma in general.
34:14
So those the ifs I don't agree completely with any theoretical
34:19
model. Actually, I side with some more
34:22
than the other so then I think we're ifs.
34:26
I leave off. I focus on more of the immediate
34:30
moment with narm of like well, Well, what it like, let's talk
34:33
about quality of life. Like what are you wanting for
34:35
yourself? What is your recovery look like?
34:37
What is your treatment? Look like?
34:39
What are your goals here? Sometimes it's like I want to
34:41
get a job or I want to talk to people or.
34:44
Yeah. Whatever.
34:45
Their or I just don't want to have flashbacks every day.
34:49
Okay. Well like, let's start working
34:51
towards those steps of whatever this looks like for you.
34:53
Some people are like I want Fusion.
34:56
If they've been on the internet a lot, you know, like I want
34:59
feet ached. I Kumada got a large pizza, I
35:06
love to use Tick-Tock for like, dog videos.
35:10
Those silly like those Parkour videos, where it's like they're
35:12
jumping over water and then the and on something.
35:15
Yeah, I've had a lot of conversations with patients
35:19
saying, I saw this on Tick Tock. I want to get checked out for
35:22
it, so I mean it's there's a lot of and usual perspectives out
35:26
there but it's getting people out of their chairs and
35:31
Interferon I guess face-to-face with the in providers so think
35:35
if people can handle the curveball of redirecting, The
35:39
Tick-Tock momentum, it could actually be really really great.
35:42
But I agree. It's not like the usual best
35:46
first step for people to take. Yeah.
35:49
Yeah. If you don't want to just
35:50
necessarily take your mental health advice from that, right?
35:53
Yeah. Talk to a professional.
35:55
Yeah. Yes.
35:57
I think the, I think my reaction was like, oh Tick-Tock is
36:01
because The dod Community. Specifically, I steer people
36:05
away completely from read it completely from techniques.
36:07
No, Kenny. So there is about a 12 to 24
36:11
percent rate of malingering. With the idea, it's being very
36:14
fetishized right now. So at higher levels of care,
36:17
you're looking more around 20% or the higher ends.
36:21
Wow. And I think a lot of times like
36:25
I have a lot of compassion for it does make me angry on one
36:27
end, right? Like and like, sure, but like,
36:30
if we take a compassion lends, a lot of Times people have been
36:32
neglected and now it's like, oh look at, look at this, look at
36:36
me, totally meet this part. Meet that in like it's true
36:42
because there are a lot of families where they're so busy
36:46
that you can only get attention when there's a crisis, right?
36:51
And there is, these are not bad parents.
36:54
These are not malicious parents. These are these are busy parents
36:57
who have a lot of parties, many of which are their children's
37:00
well-being, But sometimes they're missing like what the
37:05
child's wanting or needing my kind of over prioritizing.
37:09
You know I got to say for college, I gotta pay the
37:12
mortgage but you know a lot of times the kid they just want
37:15
your attention. Yeah.
37:17
And they can only get it through crisis sometimes since.
37:21
So it's I see why it's happening.
37:25
It's also like because they could have a different
37:28
dissociative disorder or they could have higher levels of
37:31
suggestibility T. Which now they really believe
37:33
that they have D ID and like there are people out there
37:37
self-diagnosing with d ID, which is just like it doesn't make
37:40
sense like you can't diagnose your own time loss if you've
37:43
lost the time. Right?
37:44
Right. Oh yeah, I've had a lot of
37:46
interesting interactions with people who are.
37:49
Like I remember all of these things that I forgot.
37:53
I think I have dementia. And there's always like a really
37:56
fun conversation to have and then we'll do the objective
37:59
testing and give some reassurance but But sure, you,
38:04
maybe drive dementia, but there's something going on,
38:07
right? So maybe it's not the ID, maybe
38:09
start dementia, m, not ADHD but there's certainly something
38:14
treatable here, but the consent piece is huge.
38:18
Like can we agree to treat what's actually underneath these
38:22
things that it's showing up as yeah, the I think can son is
38:27
like the biggest thing total period and any treatment.
38:32
But that agreeing piece because I've had to because of my
38:36
practice being so specialized and Eid, the triangle area,
38:40
essentially even people from out of state out of the country.
38:43
They look to us to diagnose a Cess, D ID, and what we've we've
38:49
had an influx lately of definite malingering.
38:53
And so like there are certain tests for that like the Sears,
38:57
there's them fast. There's there's a lot of these
39:00
tests that we do. To kind of point us out of like,
39:03
okay, there are some things going on here.
39:06
However, if they don't, if you look at terms of prognosis, or
39:11
like, are they going to recover? Like what are the rates of this,
39:15
if they don't admit essentially like that they're purposely
39:20
doing something? The rates are very low in terms
39:23
of recovery and treatment. Like there's a lot of treatment
39:26
failures over and over and over again and people become addicted
39:29
to higher levels of care and it's a very specific issue and
39:33
that is not my specialty. I do not specialize in treating
39:38
that I'm just like Do you have d?
39:41
I d do not have d. I d is 0 SD D like what
39:44
dissociative disorder or trauma is this?
39:47
And then I can treat that dependent on like what they end
39:51
up having with my specialty but or if they don't I usually send
39:55
them out because this is not the place than but if anyone wants
40:01
to you know, treat malingering and specify like it would be
40:06
helpful for the area to have. I don't know anyone that Eliza's
40:10
on it in malingering. Yeah.
40:12
Uh-huh, I can tough one. It is tough.
40:18
Definitely a conversation to be had.
40:21
I know that McLean is really great about that.
40:24
It's a Harvard Affiliated right Hospital?
40:26
Yeah, yeah. It's just like, we don't have
40:31
McLean here, right? So, but yeah, concerned I think
40:37
is the huge piece and any kind of Everywhere.
40:41
I think the clinician is coming up to the clients being like,
40:44
well, we have to integrate, we have to fuse and it's like, if
40:47
you don't have consent, like I've some of the support group I
40:50
run about half. Let's say, little maybe a little
40:56
less than half but about half or so are deciding towards like
41:02
healthy multiplicity. It's called which is just kind
41:05
of like nope. We don't want to integrate like
41:07
horrible things happened and let's just function in this.
41:10
Is life. We want to have a job.
41:12
We want to have a home and these are our goals and we don't want
41:15
to go beyond that. It's like, okay.
41:17
Like I think about 65% of the clients I have without D ID or
41:24
dissociative disorders. You know people come in for
41:26
depression or like I want to go to bed.
41:27
I want to do what I used to do. It's not that we always heal
41:33
from like the underlying they heal as much as they want to and
41:36
they're like yeah I'm good for right now and I'll come back a
41:39
couple of years or something. You know, like, yeah.
41:41
It's like okay. Like, that's that's consent.
41:44
There saying, I want this much. Cool.
41:46
Cool. Cool.
41:47
Cool cool. Yeah.
41:48
Right gonna meet them where they're at, right?
41:49
Yeah. Yeah.
41:51
So if you are if you're in a short on time, but if you were
41:54
talking to someone who's who feels a lot of gratitude about
41:58
their progress and they're about to say, I think we can meet last
42:03
frequently or maybe we don't need a meat anymore and they
42:06
were to say here's how I felt when I started.
42:10
And here's how I'm doing now. I'm curious.
42:14
What might they say? So I've had its All right, so
42:21
I'm talking specifically with dissociative disorders and
42:24
that's okay because like, oh that's big, I mean, depends on
42:27
what you're treating. But with dissociative disorders,
42:30
a lot of times they're like, I feel more grounded.
42:32
I feel more present with my family.
42:34
I feel more here or like a lot of times, it's bringing us the
42:39
ability factor in, like, okay. Well, now you have a job or now,
42:42
you maybe they don't have a job but now they have friends, they
42:45
never had friends before and they feel more grounded and able
42:48
to pay their bills. And go to their doctor's
42:52
appointments and they're like, yeah, this is enough and it's
42:55
like, okay, like if this is what is enough for you like, who am I
42:59
to judge that? Like you're the expert of you
43:03
and this is your life your treatment like all right?
43:05
But sometimes they'll also say things like, well, it depends
43:09
like if they've done integration or not, right?
43:13
Like sometimes I'll be like, I feel like a more whole version
43:16
of myself and that's that's huge.
43:20
Huge, huge and sometimes it's like very scary.
43:23
So sometimes they do want to take treatment breaks of like I
43:26
just need to like do nothing for the next three months and just
43:29
go to work pay bills, like just live.
43:31
Like a very normal stereotypical go get the groceries, you know,
43:35
like like okay sure like the doors open if you want to come
43:40
back but that's some of the things that they might say.
43:43
Usually it's about being grounded and remembering and
43:46
just participating in life instead of just a lot of I have
43:50
this like observe observation or this Observer kind of effect,
43:56
and it's like, oh, I feel like I'm here in my body.
43:58
Oh, look, I can look at my son and like, I actually feel the
44:02
joy in my chest. Instead of just like in my eyes
44:05
or smile or it's like, okay, it's a more full embodied
44:09
experience. That's awesome.
44:11
Even if they still do have like neural networks are split.
44:16
Yeah. All right.
44:18
That's progress, right? So maybe in closing if there's a
44:25
family member of someone that maybe they're concerned that may
44:29
be struggling with this or knows that they're struggling with
44:32
with trauma or maybe there's an individual that's that's
44:34
listening to this. That is relating to some of this
44:37
and say I'm like oh maybe this is what's going on with me?
44:39
What would be kind of like a advice or First Step that you
44:43
would encourage someone to take advice won't stay off the
44:46
internet. Okay, there you go.
44:50
Um, advice to seek a trauma. Specialist, specifically, a
44:54
trauma specialist and I they don't have to be a specialist,
44:59
even in dissociative disorders, honestly, like anyone that
45:02
really treats trauma. And like, that's their focus.
45:06
They understand that there are different parts, they under
45:08
there, you know what they're looking for.
45:09
And if it's something they haven't seen before, a lot of
45:11
times, I'll have, you know, people in the community
45:16
therapist in the community be like, hey, can I have a
45:17
consultation, like something's going on?
45:19
So even If you can't find a dissociative disorder,
45:21
specialist in your area, which you might not be able to.
45:24
That's okay like seek out a trauma.
45:26
Specialist specifically a therapist.
45:31
Yep, that's it. In terms of family members like
45:34
kudos to you, if you're listening to us as a family
45:36
member, right. Like and there are support, I
45:42
think new Waters has support for families.
45:45
We sure do every Wednesday night.
45:47
Yep. From six to seven.
45:49
Look at that. There is an amazing resource
45:53
honestly so I think it's a real gift for the community and all
45:57
are welcome. Yeah.
45:59
And and see cutting-edge counseling.
46:01
That's right. Oh yeah, definitely.
46:03
We have support groups. I do a lot of research and we're
46:07
I have a research team than we were creating new treatments for
46:10
group therapy specifically for D ID.
46:12
Okay? And then my business partners
46:15
working on new treatments for BPD.
46:19
Personality disorder. Yeah.
46:21
So how many clinicians do you have in your practice?
46:25
We just hired some somewhere between 9:52. 9:52, ish great.
46:31
And we're hiring more, we have to turn away work a lot, okay?
46:36
Actually, so we're still hiring for trauma, specialist
46:41
specifically, or anyone interested in drama, treating?
46:44
Ya trauma. That's great.
46:46
Yeah, and that worked out of a network.
46:48
Oh, Blue Cross Blue. Sheldon Network.
46:49
All the way. Nice.
46:51
Yeah. I you know, Blue Cross Blue
46:53
Shield in this area is huge. Absolutely.
46:57
Yeah, so definitely be crore. We have self-pay.
47:01
Okay, you know, but definitely, yeah, check this out.
47:05
If you feel like you want assessment, I do assessments
47:07
even if I can't. Usually my caseload is full, but
47:12
I do assessments and send people back to their primary therapist
47:15
and then talk to the therapist like, hey, this is what This
47:19
this and this test has said and stated, and this is likely
47:23
what's happening, and we can tailor a treatment plan even if
47:27
they don't work with me. Also, Natalie struck also a
47:32
specializing in dissociative disorders, as well.
47:35
So like the personality disorder / D ID kind of crossover.
47:42
Yeah, if you look us up, just be like hey I need an assessment.
47:45
Cool, cool. Yeah, you know, we do this all
47:47
the time. It's awesome.
47:49
Well Aaron, thank you. Really appreciate you coming to
47:52
hang out with us today. Thanks for having me and this
47:54
little Studio. Yeah, and dr.
47:58
Hong always pleasure, always. Yeah.
48:00
Thank you, Aaron. He's so glad I met you and I
48:03
think this is, this is so important.
48:05
What we're talking about here and I hope that people are
48:07
plugging in. Yeah, I appreciate the lens.
48:10
Y'all are taking towards, trauma and treatment and Recovery in
48:14
general, it's silly. It's needed.
48:16
That holistic version. Yeah, yeah.
48:19
That is very passionate about that and I feel like we just see
48:23
that more and more with people right as I mean I think it's so
48:26
easy to focus on the current presentation or the current set
48:30
of problems that someone is struggling with.
48:31
But you know, if we can just kind of pause a little bit, look
48:34
a little bit deeper. I think that there's just so
48:36
much commonality with a lot of things being driven by trauma or
48:40
just a deeper place in general, right?
48:42
Yeah, yeah. Yeah.
48:44
We had one day. I love about this place, is I
48:47
think their truck there sir? Therapist or a cut from like
48:50
different cloths. And like, so once, once you have
48:53
that trauma like perspective, like one says, gotten into like,
48:58
how you see and hear. And for when they're true and
49:01
plan you cannot unsee it, right, right?
49:04
Like, there's something about your, the way you experience.
49:07
What it will always be different now.
49:10
And and then it's really interesting when you're working
49:13
alongside their Pursuit doesn't see it, right?
49:15
Well, we've all been there. Yeah.
49:17
And, and it's, and it's It's like you feel, you, feel
49:21
yourself, like containing like something that really wants to
49:25
get out, right? And it's not the best feeling to
49:28
be honest. But when you're working with
49:30
other people who see it it is, it's very exciting.
49:34
Yeah. Right.
49:34
It's like energy. Yeah.
49:37
Right. And, and that's, that's
49:38
definitely the lens that that we're bringing here because
49:43
like, there's another therapist page and she shared this thought
49:47
that, you know, where there's Addiction.
49:50
There's drama. Yeah.
49:52
Because like the addiction is a way of, in a lot of ways, the
49:55
way of disconnecting from reality, which has a lot of
49:58
overlap with dissociating, because they are trying to
50:02
medicate, the severe pain of ordinary living, that's happened
50:07
in their daily life and I can't blame them for that, but we're
50:12
here to help them find like new ways to deal with that pain in a
50:18
way that's peace. All like, sustainable healthy
50:21
creates connection. And it's terrifying people
50:25
though because they're thinking like, what the heck are you
50:27
talking about? But if no one can see it and at
50:33
least like bringing them to a Vista Point to look at what's
50:37
possible. I don't know if they're going to
50:39
find it, right? And so this is like a huge like
50:42
step forward in getting people to where they actually want to
50:46
be much faster and much safer. So that's that's why I love
50:51
being here. There you go.
50:52
Yeah. That trauma lens is so important
50:54
when she have like you said you just like you see the world
50:57
through that lens Elmo And I think it provides so much more
51:00
compassion for Humanity like yeah completely.
51:03
Yeah. And we do a lot to to
51:05
destigmatize. Trauma and say trauma is is
51:10
something that gave you a dysfunctional set of rules for
51:14
how you experience yourself, how you experience the world around
51:16
you and it could be something. No violently criminal, that
51:20
happened to you like, you know, God forbid, but it could be
51:24
something as seemingly non-traumatic as I can over
51:29
involved over supportive parent. Yeah, and yeah, and
51:34
over-involved over supportive parent, like we've all many of
51:37
us have been there and we know how annoying it is and bright,
51:41
angel Trail, a lot of pain like because it's a form of control,
51:45
right? And being controlled by another
51:47
human is unsafe. And danger creates tension and
51:51
stress. And that is pain, right?
51:54
So this is there's like a direct line from that to, to drinking
51:58
to self-medicate in this pain. And I think it's, it only helps
52:02
our patients to be just realistic about about that.
52:06
Hmm, right, I agree completely. Yeah, thank you.
52:12
Yeah. Thanks for having me.
52:13
Thanks sir.