Latest / System Speak: Complex Trauma and Dissociation / Guest: Robert Cox

Transcript

Guest: Robert Cox · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over:
• 0:11
  Speaker 2: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to long time listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 1:03
  Robert Cox is a licensed professional counselor in Missouri, and he works with clients with dissociative identity disorder. You can see his website at liferecoveryconsulting.com. On his website, he states, it has occurred to me that some of my future clients might wonder who they are hiring to help them through some very rough patches and trusting to walk with them on some very vulnerable journeys. I understand that because I have been many of the places my clients have been and will go. I have my own history of addiction.
• 1:40
  In 1988, I used for the last time, and I have been clean since. I know what it is to struggle with trauma, anxiety, and craving. I know what it is to feel so raw all the time that all you want is for things to stop hurting and to be willing to do anything to escape that. I know what it is to feel you have disappointed and hurt everyone around you, but not know how to stop. Those experiences have deepened my ability to help my clients know that I feel what they feel, that I have known what they know.
• 2:14
  I also know the promise of recovery. I know that we can learn to live vulnerably in an uncertain world with real joy, connection, and courage. It does not mean that we no longer feel pain or that we are not frightened by the vulnerability we face at times. It means that we have learned new methods of coping with those feelings rather than running from them. We have learned to live with fearlessness and a core belief in our own ability and promise.
• 2:42
  It means that we have learned at last to live life abundantly. In 2011, I completed my bachelor's on social psychology with Park University. In 2015, I completed my master's in counseling with Mid America Nazarene University, where I now occasionally teach graduate courses. After twenty years working in the mental health field in multiple capacities, I now am an LPC in the state of Missouri who is nationally certified counselor specializing in the treatment of trauma, addictions, and autism. In December of twenty seventeen, we opened a new base location, our trauma treatment center located in Richmond, Missouri.
• 3:24
  From this location, we dream of being able to spread healing from trauma throughout the rural communities of North And Central Missouri. I would like to thank Robert Cox for being on the podcast and for letting me interview him. I would also like to say that this was recorded according to our appointment we had already scheduled for the podcast episode on the morning that the troll incident happened. So prior to recording this episode, we were already pretty shaken up and in a very vulnerable place. And then throughout the recording, there were several times we were really triggered by different issues that we were discussing, by different things that Robert shared.
• 4:06
  But as agreed for the podcast, we did not edit out those dissociative moments where we struggled to stay present during the interview. We appreciate the patience of Robert, who is an experienced podcaster himself, and continued the podcast. So while there are many things that triggered us in this episode, some of them actually very neutral examples he was using, there were many very important nuggets and gems that we thought were important enough to include and go ahead and share the episode. It did take us a whole extra week to be able to edit it, but I'm glad to share it now and very much appreciate the time and sharing from Robert Cox. Here's the interview.
• 4:54
  Hello. Thank you for talking to me.
• 4:57
  Speaker 1: Sure. Well, have a practice with offices in Liberty and Richmond, Missouri. My group name is Life Recovery Consulting. I specialize in trauma, addictions, and autism, but it's really the dissociative and personality disorders that kind of rock my world.
• 5:17
  Speaker 2: They can rock some worlds for sure.
• 5:21
  Speaker 1: I have an LPC in the state of Missouri and a master's degree in mental health counseling.
• 5:27
  Speaker 2: I know that because you focus on trauma so well that you notice it in different ways, even with people who don't necessarily come to therapy originally for trauma that they're aware of, but that it impacts our like it impacts everything. You even talked in your podcast about how autism has its own trauma as far as the experience of being autistic and in a world that's so overstimulating.
• 5:56
  Speaker 1: Right. And the interesting thing is that it shapes the brain nearly exactly the same way.
• 6:02
  Speaker 2: It's fascinating to me for several reasons. One is just personal because I have two sons with autism. And two, I actually know a lot of survivors who have also been diagnosed with autism.
• 6:17
  Speaker 1: I think it often gets misdiagnosed and that's exactly why. Because the brain gets shaped. In fact, I did a training with KVC hospitals, their psychiatric staff, the Children's Hospital at Prairie Ridge. I went out there to train their staff on how do you know when it's trauma and when it's autism because it is often misdiagnosed. I've had more than one patient come to me diagnosed with autism and what they really had was trauma, right?
• 6:45
  I've had cases of individuals who were trafficked from very early on from the age of two to 14 and were diagnosed with autism and wasn't autism, it was trauma, right? But trauma makes you hypervigilant to your environment in the same way that autism makes all the sensory stuff magnified, right? So it looks like it because I had someone call me one time and say I think my grandson has autism. And I said well, makes you think that? And she said well, he startles very easily.
• 7:22
  He can't seem to filter out different noises in the environment and if someone unexpectedly touches him, he goes in a complete meltdown. And I said, do you mind my asking why your grandson's living with you? Oh, because his mother was an abusive drug addict.
• 7:37
  Speaker 2: Oh, there you go.
• 7:39
  Speaker 1: And I said, well, doesn't sound like autism to me. It sounds like trauma, but it's going to play out very much the same way, you know?
• 7:47
  Speaker 2: Yes. So how would you define trauma?
• 7:51
  Speaker 1: Well, think they're you know, the mistake that's made is that people think about trauma. They think about the big T traumas like rape or war or a car crash or natural disaster. And those are just big T traumas, right? What what we've learned in the past decade is that the little t traumas, things like not being able to feel safe in your environment twenty four hours a day, even though you're not at that moment under assault, being followed around and criticized all the time, right? Being bullied in school.
• 8:25
  These are little t traumas, but they are just as effective as the big t traumas even more so. I compare it with my patients to the Colorado River. In Rocky Mountain National Park on the on the west side of the park is the headwaters of the Colorado River. At that point, I fly fished at many times. Can stand in the river and wade across and not get much deeper in than your knees and it's only about 20 or 30 feet across.
• 8:52
  But 600 miles later, it carves out the Grand Canyon.
• 8:55
  Speaker 2: Wow.
• 8:56
  Speaker 1: Those are little t traumas, right? They don't seem like much but that trickle effect adds up and it shapes the brain in a nervous traumatized way. So you end up with people who are reactive. Little t trauma is the patient who told me I remember staying awake at night to listen for my father to come in because he would always come in between twelve and two and I could tell by his footsteps if he was drunk and that told me whether or not I need to hide my little sister under the bed to protect her. Right?
• 9:30
  Your entire childhood, staying up listening for the footsteps would indicate things were gonna get really terrible for you. Right? That's little t trauma.
• 9:41
  Speaker 2: That counts as little t trauma?
• 9:44
  Speaker 1: Yeah. Absolutely. So it's kind of like think of it as a slot machine. Right? Slot machines are very addictive because they're on what's called a variable ratio enforcement plan.
• 9:54
  Right? You don't know how much is gonna fall out or when it's gonna fall out, but you know it's coming. So you keep pushing those buttons and waiting for it to come. Right? That's an extremely addictive process to the brain.
• 10:08
  In the same way the brain becomes addicted to the negativity and the anxiety created by not knowing if dad's going to come home drunk tonight, if I need to hide my sister knowing eventually it will happen again, just not knowing if this is the night. Right?
• 10:25
  Speaker 2: I'm sorry. I'm trying to process all of this because that's so it's so intense. I had never thought of that as little trauma like little t trauma.
• 10:33
  Speaker 1: Those are little t traumas, right? And they have a profound effect. I can't tell you how many patients I have had tell me, I would rather my father just kept his mouth shut and just hit me because it was the criticism and the shame that wilted me. Now that is not to discount some of the horrible trauma that some of my patients have been through. And in the case of DID, this is often the worst trauma.
• 11:02
  That's why the personality structure splits.
• 11:05
  Speaker 2: Well, I just I don't mean to be so unresponsive. You just have really blown my mind with this because if those are things that count as little trauma and it impacts you so intensely, when you add up a lot of little traumas plus big things like with DID, no wonder there's
• 11:28
  Speaker 1: Right. That's how we get complex trauma, right? It's one on top of the other, on top of the other, on top of the other, right? What we know about veterans who come home is the ones who were supported in childhood and learned from their parents resiliency and how to come back from hardship and they knew they were loved and supported come back with PTSD at a much lower rate than the individuals who suffered childhood trauma because they did not learn resiliency and they had all this trauma built up already. So they go into combat and they come back unable to then handle that trauma and the complex trauma that follows and they begin having PTSD.
• 12:16
  In many cases, they already had it before they went off into combat. It just made it worse.
• 12:24
  Speaker 2: Wow. So, oh my goodness. I'm processing. I'm sorry. Sure.
• 12:31
  I'm really not. This just feels so big. So when, when a person is triggered with something or when something happens, it's just neutral in the environment. It brings to context even just normal things. So when you talk about being in an environment where a person is actually safe, but there's a loud noise or something that triggers them or like when you're trying to do the hard work of therapy and someone comes into therapy to work on things, it really does feel like too much because it's all stacked up like that.
• 13:09
  Speaker 1: Well, and that's why my job as a therapist is to keep you integrated, right? And by that I mean when trauma occurs, your brain cannot process it all at once. It short circuits. The amygdala takes over for your own safety. And when the amygdala takes over and that trauma can overwhelm your hippocampus, which is responsible for forming those new memories, they don't form correctly.
• 13:35
  So the only thing that gets formed is the memory that is gets stored in your body as physical sensations, emotions, things like that. But you never get like the timestamp you would have on it if it were stored in your prefrontal cortex the way it should be the top part of your brain. Right? Right. And so that's what PTSD is.
• 13:55
  It's something that triggers it and it comes back and I feel it happening again and all of a sudden it's happening again and that pushes then the dissociation button. So as a therapist, I watch very closely for my patients. They all have signals that they give when they dissociate. A lot of them will their eyes will shift to one place, right? Right before they leave the room mentally.
• 14:20
  And so my job is to try and keep them integrated and keep that prefrontal cortex active so that then they can process that memory and take the power out of it. And then it's a memory and not a reliving experience, Right?
• 14:35
  Speaker 2: You mean the present experience and the memory integrated?
• 14:40
  Speaker 1: Yeah. So now when I think about this car wreck that happened in my past, think, oh, that was horrible. But I remember it as a past event and I don't feel it happening again in my body. I don't feel my body turns up in the panic and the oh my God, you know, that kind of thing. Pat Ogden talks a lot about this in her book Sensory Motor Psychotherapy.
• 15:00
  And one of the things she says that I think is really, really true is if you're not careful, you know, it's not important for every client to relive every experience or talk about every experience. It's important to teach them how to handle those memories as they come up. But sometimes if we push too hard, people dissociate in the room. And then what we've done is re traumatize them because they've re experienced it without reprocessing it. Do you see what I'm saying?
• 15:28
  And so because it really is when the patient begins to recall these things, it really can be like living through it again. It can feel that way. And so we want to prevent that. We don't want you to dissociate into a space where you're reliving it. What we would rather do is you integrated so that you can process it in the way it was supposed to be processed the first time and then kind of take the power out of it.
• 15:53
  It doesn't mean you'll ever forget what happened. It means that when you think about it, it'll be more like, yeah, that sucked. Then it will create, you know, instead of creating a panic attack.
• 16:06
  Speaker 2: How does that? How do we as clinicians help someone stay present enough to remember something when their brain has split it up into different parts or bypass the amygdala?
• 16:17
  Speaker 1: I use mindfulness a lot for that. And I start with that. Before we ever dig into what happened when, dig into mindfulness practice, right? Especially like the body scan stuff to start with. So body scan what that does and you know Bessel van der Kolk kind of wrote the book on PTSD.
• 16:41
  He wrote The Body Keeps the Score where he talks all about this stuff. And he recommends mindfulness and yoga because in both cases what this does is it reconnects the mind to the body. So much of what happens during really horrible traumas is and dissociation is that I separate my mind and body. Right? I go on mental vacation somewhere.
• 17:07
  I've had multiple patients tell me it was like they were watching this happen to them from somewhere else in the room.
• 17:13
  Speaker 2: Right.
• 17:13
  Speaker 1: Right? Because mentally they've dissociated from what's going on. But what happens then is you'll see people with what if they if it was autism, we would call them proprioceptive issues. So they have a lowered kind of awareness of where their body stops and the rest of world starts. So they like bump into walls a lot.
• 17:32
  They seem very clumsy. They may not feel like comfortable in their body. They may dissociate from their body a lot, right? So that mindfulness and yoga both are tools that we can use to reintegrate the mind and body so that when we start this work, we're very aware of what's going on in our body, what those feelings are, and we've learned how to manage them with breathing and with the kind of self soothing that we do during those exercises. The other thing I do is I teach what are called grounding exercises, right?
• 18:04
  So one of the basic ones I use is I call it the three things. A lot of people call it the five senses, but I just use like three deep breaths in and out. And then I ask the patient to look around the room and tell me three things they see And then two or three more deep breaths and then look around you and listen for three things you can hear. And then two or three more deep breaths. What this does is it's impossible for your brain to focus on the here and now and what happened in the past or what might happen in the future.
• 18:36
  It can only be located in one place in time and space. And so if I can use that exercise to force it back to the here and now, then I can let go of that anxiety. You see what I'm saying? Yeah. That seems to work in the moment pretty well with my patients who have panic and anxiety attacks.
• 18:54
  Then I pretty much push for a daily practice of two or three times a day for this body scan mindfulness kind of exercise to begin with. So we reintegrate. And then we we go on to more exercises like creating a safe space. Right? One that you just in your head, whether it's in the woods or to the beach or wherever it is creating a safe space for me so that I can use that during my mindfulness meditations.
• 19:21
  Right? So there are a number of things that I use in office, but the idea is to keep people integrated and feeling safe because as long as they're in that mindful space, their their mind and body are connected.
• 19:33
  Speaker 2: How are they able to be in now time and process things from memory time if they can only be in one?
• 19:43
  Speaker 1: So what I mean by that is that you're you because I can think about what happened to me as a memory but still be aware I'm in this space. Right? But what's happening when I have a flashback or my PTSD is triggered is that all of me is back in that space. My entire brain is back in that space.
• 20:03
  Speaker 2: Is that why it's so overwhelming?
• 20:05
  Speaker 1: That is exactly why it's so overwhelming because you're reliving that experience.
• 20:10
  Speaker 2: Oh wow. Right? How do you teach that to different parts of a DID system?
• 20:17
  Speaker 1: It's the same. Now the interesting thing is that different parts of the DID system may have different disorders. And so how I teach that is less dependent on what part of the system showed up than what disorder I might be dealing with right now.
• 20:34
  Speaker 2: What do you mean? Tell me more about that. About them having different disorders.
• 20:39
  Speaker 1: Like, I've I've had disorders that were extremely OCD, and I and I might want to go about explaining the the exercise differently to that person, a client who was OCD, than I did with someone who had borderline personality, for instance. Right? Directions for someone who has OCD might need to be very clear and very like structured where I would be more worried more with a borderline patient about making sure they felt validated in the space, that they knew I was on their team, not giving them any indication that they needed to be afraid of or suspect me at all.
• 21:21
  Speaker 2: So are you talking about comorbidity or are you talking about different things?
• 21:28
  Speaker 1: It's interesting because it is kind of comorbidity except that one personality may not have this expression of OCD at all while the other one does. And so is that really comorbid? Not to those individual personalities structures, right?
• 21:45
  Speaker 2: Right.
• 21:46
  Speaker 1: So DID is just dealing with who comes in and sits in front of you that day every day.
• 21:53
  Speaker 2: How do you explain DID either to your patients or to your classes?
• 21:58
  Speaker 1: I explain it the same pretty much. A couple of ways. First, start by saying all of us have different personality structures, right? It's just that the neurotypical quotes individual integrates that very well. Like I'm not the same on this podcast as I am talking to my peers or other therapists or PhDs in neuroscience or I'm very different there.
• 22:25
  I'm much more geeky, right? And I'm not the same there as I am when I'm out fishing with my kids, you know, or hunting with my son. That part of me I call hillbilly Bob. Right? Because I and I enjoy it, but it's not at all the same type of person in those situations.
• 22:47
  I'm not the same with my students as I am with any of those other places, right? But all these sides of my personality integrate very well. I understand them all. The difference is had I suffered an immense amount of trauma early in childhood, It's like having a glass sphere with all these parts that fit together. That trauma takes a hammer to that sphere and then all those integrated parts end up separate and each one holds a different trauma or a different pain because if they had stayed together, it would have been so overwhelming they probably would not have survived it.
• 23:27
  Wow. I see it really as the highest form of survival skill. Right? I say to my patients all the time with DID, you don't understand. Most people don't survive what you went through.
• 23:46
  Most of them die in the process or they end up drug addicts and OD from the trauma.
• 23:55
  Speaker 2: That's true.
• 23:56
  Speaker 1: But you know, interestingly very few of my DID patients suffer from substance use. Right. Right? Because they found this other way to cope with that trauma and separate from it. So numbing it out interestingly enough is less
• 24:16
  Speaker 2: They don't need numb
• 24:20
  Speaker 1: it out, right? They can just dissociate from it. It creates other kind of problems in their lives, right?
• 24:29
  Speaker 2: Right.
• 24:29
  Speaker 1: This is why we call it a disorder because it disrupts their daily living in significant ways. But it's actually a very unique and specialized survival skill.
• 24:46
  Speaker 2: How do you connect? Or what is let me rephrase my question. How do you teach someone who's already good at dissociating mindfulness and when does that help or does it You
• 25:04
  Speaker 1: work really, really hard to keep them in the room and you go very, very slowly. Especially if they've had significant sexual traumas, I find that connecting to your body when you have such horrible body memories can be very hard. So you go very, very slowly. You have to be patient with people and understand that no one comes in your office without wanting to get better, right? And so while you may meet resistance and they may have defense mechanisms, they came there to be helped.
• 25:41
  And so you have to start with that and just keep slowing down and keep changing your methods if they aren't working, right? An example is someone with schizophrenia who is also blind and so their hallucinations are tactile. So the last thing I want to do with that individual is say to them that we want to just notice the sensations in our body that that will trigger hallucinations often. So we have to go about a different way.
• 26:13
  Speaker 2: Right.
• 26:14
  Speaker 1: Right?
• 26:16
  Speaker 2: That makes sense. That makes sense.
• 26:19
  Speaker 1: So it just it just depends on, like I said, whoever comes in the room that day, we adjust to that.
• 26:27
  Speaker 2: How did you first learn about DID?
• 26:31
  Speaker 1: You know, it's I've been pretty fascinated with trauma since my own started, you know? So just was kind of along the way. I don't even remember where I first heard about it. I was probably a teenager and I'm in my mid 50s now. So it's been so long.
• 26:47
  What really began my fascination with it as a disorder from a professional perspective was I really found out I had a knack for dealing with trauma and really found out that it kind of rocked my world to be able to do that. I have very hard days at work. I never have bad days at work. You know, I have to work very hard to make sure I put a stop to my day and go home and be with my family, right, and separate those two because I really, really enjoy what I do.
• 27:23
  Speaker 2: How do your students in these days how do they understand or receive DID?
• 27:30
  Speaker 1: I haven't taught a lot of students. Mostly what I teach is the addictions course. But we do talk about it. And just exactly the way I told you I use this fear that's kind of crystalline and how most of us are integrated in that sphere, but the trauma takes a hammer to it. And so the personality split off.
• 27:47
  There are some core structures that we see in every individual. There's almost always a protector, right? There are often almost always children that represent the trauma that happened at those various ages, right? I'm finding it very common to have someone who handles the sexuality and promiscuous side of the individual, Right? And these are all structures that are there very commonly.
• 28:14
  So even though someone may have only six or dozens, often they fall into those categories, it seems to me.
• 28:22
  Speaker 2: Interesting. So sort of different roles in that protection and what
• 28:28
  Speaker 1: Yeah. And I think they follow very closely the developmental stages, right? So the young ones are holding the trauma that happened when I was young, and the teenagers are holding the trauma that happened when I am a teenager and the adults are the functional adult that I never had that I can develop to help protect me, that kind of thing.
• 28:48
  Speaker 2: What resources are there for clinicians who want to learn more about how to help people DID?
• 28:55
  Speaker 1: There are a couple of good books. One of the books that I use a lot is called Coping with Trauma Related Dissociations. It's skills training for patients and therapists. That's a pretty good book, and I've had patients that have really enjoyed that too. The workbook one that
• 29:11
  Speaker 2: The workbook?
• 29:13
  Speaker 1: No. It's just the book. It's kind of expensive. It's like $45. It's very thick.
• 29:19
  It's it's skills training. It does have, like, specific exercises in it, but it's it's more than just a a workbook.
• 29:27
  Speaker 2: By Kathy Steele and them, that group.
• 29:31
  Speaker 1: Suzette Boone is the writer.
• 29:33
  Speaker 2: Oh, yeah. Yeah. Yeah.
• 29:34
  Speaker 1: Yeah. And then there's a really good book by Deborah Haddock called the Dissociative Identity Disorder Sourcebook. And she does a pretty good job of explaining what it is and how it happens. But there are a lot of good books out there on DID now. It's becoming more understood.
• 29:52
  I'm always surprised though when I run into people who are clinicians. I will use that title loosely. And I ran into someone just a couple years ago who was like, I still don't believe DID exists. And I'm like, well, it's in the DSM, so I don't know what else to tell you. You know?
• 30:13
  Right. Because you're having a hard time handling it from a cognitive level does not mean it doesn't exist.
• 30:23
  Speaker 2: Right.
• 30:24
  Speaker 1: Right? That's that's your issue, not your patient's issue. Please God just refer these people out. Right? Right.
• 30:32
  Right.
• 30:33
  Speaker 2: So And what about your podcast? How did you get started doing your podcast?
• 30:39
  Speaker 1: I haven't done episodes in a long time on that because there's been so much going on in my life outside of work that I really haven't had time for it. I hope to get back to it soon. But essentially I got involved with, just started thinking about, you know, I've survived trauma. I've survived addiction. And now I have this degree which gives me the knowledge I need to to treat other people.
• 31:01
  I think I would like to share that. And then I came across Melvin Varhees who was starting a group called Healthcasters for people who wanted to start therapists who wanted to start a podcast. And it just kind of took off from there. I joined his group and won a drawing that he was doing. So he sent me a brand new like super microphone set to get started with.
• 31:25
  And that was it. It took off from there. And even though I haven't I I kind of stopped developing at about a 20,000 downloads. But since then, over the past year, I'm up to over a quarter of a million downloads in about 90 countries. So it's hit the mark with a lot of people.
• 31:44
  So I really want to go back to it, but I just have not had time.
• 31:49
  Speaker 2: You talk more about the mindfulness and even do some relaxation exercises. And there are several things that I think would be useful for our listeners to hear, even if they are replaying it and replaying it and replaying it.
• 32:05
  Speaker 1: Right. Yeah. Well, some of the exercises I do on there are ones that you can use over and over and over again. I do want kind of an inner child exercise on there that honestly I stole from John Bradshaw and I give him credit in the in the episode I believe too. He was brilliant.
• 32:23
  He but it's basically envisioning your child or this child in front of you. Create the safe space first and then we move into these other visualizations. And one of them is sitting in your space safe space and being approached by a child, right? And what would you say to that child? What does that child need to hear that you never got to hear?
• 32:47
  Things like I'm really glad you're in my life. I love you unconditionally. You're perfect the way you are. Right? You're safe here.
• 32:57
  These things are things that needed to be said to that child that never were. And so we kind of recreate that experience. And yeah, that's one that gets used over and over again by patients.
• 33:07
  Speaker 2: That's really powerful.
• 33:08
  Speaker 1: It is. It it tends to be an extremely powerful experience. I know in in about 1989, '19 '90, I took a workshop with John Bradshaw and and I tell people it it literally saved my life. Wow. So and it was all that inner child work, you know, his book Homecoming and his book Healing the Shame that Binds You.
• 33:31
  These are really powerful, powerful books. They're not easy, but they're really, really powerful.
• 33:37
  Speaker 2: How do some of the things we learn from shame theory, like even attunement or misattunement and shame itself, his work, Patricia De Jong's work, even at a surface level, some Brene Brown stuff is popular. I know her show has just come out. But how does that change some of the brain structure or process for people who have been through trauma?
• 34:06
  Speaker 1: Well, it is a trauma, right? To be told that you're worthless, you don't have value, to be treated like an object, right? I mean the trauma is what drives that sense, right? My parents treat me like an object because I don't have value. Children internalize that.
• 34:22
  They don't have the ability because their brain has not developed yet to think rationally about this situation and realize no, my parents are just really broken people. And so what must be broken then is me, right? Children internalize everything. This is why divorce is so hard on children. If I'd have been a better kid, my mom and dad would have got along and they wouldn't have divorced because they don't have the capacity to think logically to really, you know, mull the situation over from various angles.
• 34:54
  All they know is it's personal. It's always personal. This is why bullying is such a horrible thing too. It's always personal, right? It's got to be about me.
• 35:04
  There has to be something broken. So we end up with the young woman who's watched her father abuse her mother and abuse her repeatedly. And she becomes convinced with the new spouse that if she can just figure out what is wrong with her, she'll be able to be enough for him to change just like with her dad.
• 35:27
  Speaker 2: Oh wow. So this like
• 35:29
  Speaker 1: repeating Exactly because that child inside is still convinced that there's something broken in them that is creating this situation. And that's the driver of the shame. I can't figure it out. I'm ashamed because it's obviously something so wrong with me that I can't even see it. When the truth is it was never wrong with you in the first place.
• 35:56
  Right? We're you know, I tell my patients all the time we are all broken. That's where we need to start. But brokenness is not a bad thing. You know pain is a guaranteed part of life.
• 36:10
  Suffering is a choice. I choose suffering when I try and avoid pain. It doesn't mean I go looking for it. It just means that I'm not going to pick up a needle full of heroin to numb it out anymore. I'm going to welcome it in and learn what I can from it while it's here.
• 36:31
  Speaker 2: So if some of what's traumatic in our experience is trying to avoid our own shame, how do we face it? How do we not use heroin or not dissociate or
• 36:44
  Speaker 1: I think we have to start with and again, I use mindfulness for this. We have to create a holding space in people where they can sit with the little pieces first and then the bigger pieces later and develop resilience, develop the ability to sit through the uncomfortableness and say, ah, okay. I made it. Right? I made it.
• 37:04
  And now the next time it happens, I'll know I can make it. Right? Even if it's more intense. I like to tell them that brokenness is not your enemy. It's actually what makes you beautiful, right?
• 37:18
  I have this big poster I made on my wall in my Richmond office that says, Our beauty is birthed in our brokenness. I don't know if you've ever seen Kintsugi pottery or not. But
• 37:30
  Speaker 2: Yes. I love this story. Tell the story.
• 37:32
  Speaker 1: Yeah. It's a Japanese form of pottery, and and they will make a pot that is pretty much perfect and then they will take a hammer and carefully break it. And the reason they break it is because they understand this fundamental truth that our brokenness is what makes us beautiful because when they put it back together, they seal it with gold and now you have this beautiful pot that has these gold seams through it. And it's even more beautiful than it was when it started. And that's what I'm trying to explain to people.
• 38:04
  Right? That it is painful being broken apart and we don't like it very much. But if we numb it out, we never get to the beauty part. We just stay in the middle of it. It's kind of like I also compare it to, you know, my kids and I, we had a deal where if you can teach me something I don't already know, then that's worth $5 because I want to teach you that education should be valuable.
• 38:29
  And I want you to know that it is valuable to me. Now I had to limit that because Google exists and they'd have broke the bank in a week if I hadn't, you know, limited it at a certain amount. Right? But one of the most interesting things that I ever learned from my daughter was how butterflies actually form. It's not just the the caterpillar crawls into the cocoon and pop goes a weasel.
• 38:53
  Out comes the butterfly. They actually melt while they're in the cocoon. They turn into a liquid goo at all but a few neurons that tell them what they're going to be when they reshape. And I tell my clients that you're getting ready to go through that melting process. But if you have the courage to stick with it, you're going to get wings.
• 39:18
  Right? It's very, very it's not fun. I tell people right up front. Some weeks it's going to feel like I your these sessions have stripped all the skin off your body and you don't want to be touched or talked to or see any light. You just want to hide in a hole somewhere.
• 39:35
  You have to be able to sit through that space and you have to do it with the faith that your wings will come.
• 39:42
  Speaker 2: You've given me so many visuals today.
• 39:45
  Speaker 1: Yeah. I like using my visualizations a lot.
• 39:51
  Speaker 2: It's strong presentation on your podcast as well, the different interviews you've done and different things you've done. There's a lot of really good information for practicing some of those skills.
• 40:03
  Speaker 1: I think I just tend to be a story visual thinker, you know?
• 40:08
  Speaker 2: That's actually where I heard you first. It was not even on your podcast. I had to look up your podcast and found it because I was listening to a different podcast you were on about storytelling and connection.
• 40:23
  Speaker 1: Oh, was that on Connectfulness? Or
• 40:27
  Speaker 2: Yes. Yeah? I'm trying
• 40:28
  Speaker 1: to remember the name. With Rebecca Wong?
• 40:30
  Speaker 2: Yes. Yeah.
• 40:33
  Speaker 1: Yeah. I she's got an awesome podcast. Yeah.
• 40:37
  Speaker 2: Is there anything else you can think of that you would want someone with DID or someone who treats DID to know or understand or hope in or anything you would wanna add?
• 40:48
  Speaker 1: I I I really wanna get the point across to survivors that they're not a freak. Right? What what I hate more than anything is even the A and E shows that have come out about DID, even though they're a little more accurate about it and and their documentaries type things, they add all this suspenseful dramatic Hollywood music in. Right? Mhmm.
• 41:15
  And and and and the whole point is just they're mystifying it or making it more exciting for the public. But all that does is it pushes the sideshow kind of persona on this disorder, you
• 41:28
  Speaker 2: know? Right.
• 41:30
  Speaker 1: And I want people with DID to understand that what you're going through is really miraculous coping device that most of us could never have developed. And while it's affecting your life in some very adverse ways, it can be manageable. And it's the reason you're still alive. Right?
• 41:55
  Speaker 2: But it's also okay to come out of a cocoon.
• 41:58
  Speaker 1: Oh, absolutely. Yeah. I mean, the thing is, at one time, that was needed to survive. Hopefully, it's not anymore. You know?
• 42:09
  Hopefully, we're in a place where we're safe enough. We don't need to dissociate anymore just to just to get through the day. And and if we are still in that place, then then we need to be talking with our therapist about how how do I extricate myself from that. Right?
• 42:24
  Speaker 2: How how do you do that as far as breaking the habit of it when it's such a default mode? That feels so parallel to the addiction process even though it's a different thing.
• 42:37
  Speaker 1: It's the it's kind of the same as you do with anyone, really, whether they have DID or not. Again, I'm meeting the person who comes in the room. So I'm leading with, you know, what do you want from your life? Right? And then if they're in an abusive relationship, of gently bringing them to that realization.
• 43:01
  Well, how do you feel when he says those things to you? Right? Do you think someone should make someone else feel that way? You know, is that what a relationship is for you? So kind of in a gentle way challenging these spaces for them so that then maybe they'll have the courage to break that.
• 43:21
  Often what I see is often what I see is that the the real damage is to the ability to connect at all.
• 43:33
  Speaker 2: You mean in an attachment kinda way?
• 43:36
  Speaker 1: Yeah. That they they don't trust connection with anyone at all. So this is why DID patients are often diagnosed with borderline or bipolar disorders, you know, because it's very hard to trust attachment at all. There's a very reactive attachment there. And what I have found really, really helpful in that space is animals, especially if I can get people out volunteering with animals somewhere so that the real point is to take care of the animals, but they're bumping into other people too.
• 44:18
  And they're bumping into other people who also like animals. So they're bumping into people who seem a little safer, and then we're able to start connections that way. You see what I'm saying?
• 44:29
  Speaker 2: That's powerful.
• 44:30
  Speaker 1: Yeah. It's it's worked. It's been a healthy way to do it. Right?
• 44:36
  Speaker 2: It's a way to practice that's safe and without other motivations and also reflecting their own experience. Like even they talk about equine therapy or other connections with animals. That makes sense, you're saying.
• 44:52
  Speaker 1: Absolutely. Well, because mammals, especially dogs and horses, they contain they produce the same chemical that we do when there's connection, oxytocin. Right?
• 45:05
  Speaker 2: Oh wow, I didn't know Yeah,
• 45:08
  Speaker 1: and so they are socially bonding creatures also. Yeah, in mammals, oxytocin is produced when there is breastfeeding and when mother is taking care of child, it's a bonding thing, right? Bruce Perry talks about it in one of his books and he says that it's really the drug that keeps us here as a species because this first six months, we tend to forget that this thing is just a screaming poop bag and so we don't leave it in the woods, you know. And and we see it as we look at its face and ensure it's just a screaming mess, but we go, oh, isn't he cute? And the oxytocin flows, then we want to keep him around.
• 45:49
  Right? And it and it's developed in in mammals heavily. Now from the research I've read, not so much in cats, which kind of kind of reinforces my view of cats, that they are mostly sociopaths. They're mostly sociopaths with fur.
• 46:06
  Speaker 2: That's funny. I'm normally much more interactive, but you have given me so much to think about from a different perspective. It is all just processing. Good. And there's a lot there.
• 46:18
  So I appreciate that.
• 46:20
  Speaker 1: Good. And, you know, I mean, there are clinicians who may disagree with me. That's fine too. I'm not always right. But this is what has worked for me thus far.
• 46:30
  Speaker 2: How do you notice when a client is starting to be able to attach differently and able to connect? And what does that look like when they start coming out of the cocoon?
• 46:41
  Speaker 1: They become less reactive to those to those attempted connections by others. They start reaching out a little more on their own without then recoiling with the reactivity. Their reactivity level goes down, right? It's this in borderline personality and well, in anxious attachments, this often looks like I love you. Get away from me.
• 47:10
  Speaker 2: Right? Right.
• 47:11
  Speaker 1: And so that starts to lessen. And they start seeing the person as other and as potential, right?
• 47:24
  Speaker 2: Not just trusting the moment, but also trusting that that moment's going to continue.
• 47:28
  Speaker 1: Or that if it even if it doesn't, I can survive it, right? So the problem we run into is that pain again is a guarantee in life. Nothing lasts forever, friendships, not human beings, none of it. So eventually every connection we make is going to come to an end. And that's something we have to work through too.
• 47:49
  We have to be able to trust that we can survive that ending. Right? And so, you know, often I will have people who have attached to animals and the animal dies. And my own daughter, we had a therapy lab that I had trained that he lived to be about 15 years old. And and you know, she's we're both broken up sitting on the couch talking about it.
• 48:16
  And her question is why does this crap have to happen? You know? And I said, know, if I could reach inside your head and take all the pain away that this has caused, but it also means taking every memory of Hank away, would that be okay? No. Right?
• 48:40
  Some things are worth the pain. Connection is one of them. And if it and if it lasted forever, we would just take it for granted anyway.
• 48:53
  Speaker 2: Right. So that's part of the attachment issue because when there's only pain but it's not worth it, then they
• 49:00
  Speaker 1: will Exactly.
• 49:01
  Speaker 2: Consent to attachment. But when
• 49:03
  Speaker 1: Well, it's not worth it or it seems unending. Right?
• 49:06
  Speaker 2: Right.
• 49:08
  Speaker 1: I I I love this. I'm I'm a big Winnie the Pooh fan. And there's a meme going around out there of Winnie the Pooh and Piglet sitting on a dock. And Piglet says, you know, Pooh, someday we will die. And Pooh says, Yes, we will.
• 49:24
  But every other day we shall not. Don't be so afraid of the day that you will that you give up the ones you're not.
• 49:31
  Speaker 2: It would be like I mean, once you do that work of coming out of the cocoon and you're gonna going to have wings, right, then you still want to fly.
• 49:39
  Speaker 1: Yeah. There's no going back. You know, Rumi in one of his poems said something just like that. I can't remember the exact wording, but essentially it was him asking the reader, why would you want to crawl when you have wings?
• 49:53
  Speaker 2: So So healing is progressive.
• 49:56
  Speaker 1: Yeah. Absolutely. There's no going back. Once you've overcome that next step, there's really no going back because you want more, right? Because we all want to be better.
• 50:08
  We all want to. It's fundamental in us. Our brain is designed for connection. Disorder of the brain happens when we lack connection. Real healing from addiction doesn't come from just getting clean and staying clean.
• 50:23
  It comes from getting clean and staying clean and making healthy connections in the process. The real power of 12 Step meetings was never that I sit here and somebody shows me the way to get clean. The real power of 12 step programs is I can sit in a group of people and tell them how broken I am. And instead of them shaming me, they're going to say, I get it. I've been there.
• 50:45
  And then connection can happen. Right? Real recovery happens not because I've been clean five years, but because I've built a life in that time that I don't want to give up anymore.
• 50:58
  Speaker 2: So connection heals shame.
• 51:02
  Speaker 1: Absolutely.
• 51:03
  Speaker 2: And it's healing because the trauma of the past was disconnection was pain without it being worth it.
• 51:14
  Speaker 1: Exactly. But when you
• 51:15
  Speaker 2: bring healing, you have connection. Healthy connection
• 51:25
  Speaker 1: is the light that dispels all darkness, whether it's shame or trauma, whatever. Healthy connection is the light that heals all of that.
• 51:36
  Speaker 2: In that podcast you were on with those girls, they said that light never makes darkness darker.
• 51:45
  Speaker 1: Right. Here's here's the flip side. Right? It is only the darkness in life that makes the light important. Right?
• 51:56
  That doesn't mean I seek out pain, but the purpose of pain is that it makes connection important. It shows me the value in life.
• 52:06
  Speaker 2: I think that's true of anything. I think that's why we seek out spouses and why we have children and the things that we learn from those experiences that really are so hard and awful sometimes.
• 52:20
  Speaker 1: Oh, man.
• 52:21
  Speaker 2: There are things we would learn from being married or from having children that we would not learn in any other setting.
• 52:29
  Speaker 1: Years ago, twenty years ago, I used to do parent education and deal with mentoring kids who had significant trauma and things like this. By the time I got married to twelve years ago and inherited two kids in the process, I thought, wow, I've got all the answers down already. How great. Took about a week to realize that wasn't true.
• 52:51
  Speaker 2: Right.
• 52:52
  Speaker 1: Right?
• 52:55
  Speaker 2: So the connection really matters. Connection is everything.
• 52:58
  Speaker 1: It's it's everything. It's fundamental. Know people who will go to their graves never having been able to make a healthy connection, always having that attachment problem and never able to face it. And for me, that is the saddest thing to see.
• 53:18
  Speaker 2: So is this, right? Yeah, it's terrible. And it leaves you alone and everything that was awful.
• 53:25
  Speaker 1: Yeah, it So
• 53:27
  Speaker 2: is that why when you make connections that are healthy and safe and appropriate and healing, healing happens so quickly and get it's so solid, like you can hold on to it longer and longer and better. Right. And it just becomes who you are instead of what the trauma was before.
• 53:46
  Speaker 1: At a certain point in our recovery, we stop being afraid and we start seeking out healthy connection. And we become more and more adept at questioning ourselves about, am I ignoring red flags? Am I seeking connection out of my trauma or out of my health? Right?
• 54:06
  Speaker 2: That's beautiful.
• 54:07
  Speaker 1: It's sticky, but it's definitely worth the journey.
• 54:12
  Speaker 2: That's so powerful.
• 54:13
  Speaker 1: Here's a big secret about therapy.
• 54:16
  Speaker 2: Okay. I'm ready.
• 54:17
  Speaker 1: We talk about modalities like psychodynamic therapy or cognitive behavioral or dialectic behavioral therapy or what. Do you know which model is the most effective? None of them. None of them matter nearly as much as connection. All of the research says that about 80% of what works in that room is if you are able to connect with your client and make them feel that they are in a safe space.
• 54:46
  Pick your model then.
• 54:48
  Speaker 2: So that's why it's so important to be a healthy therapist and doing your own work and so important for you
• 54:56
  Speaker 1: to find It's important to do your own work. You don't have to be fixed. Like I would never have started if I had to be fixed. But I think that's a lot of the fear of therapists going in is they're like, oh, I'm just not good enough myself self yet to help someone along the path. You don't have to be.
• 55:15
  You have to be you should be fearless about approaching your bro approaching your broken spaces. Right? You I will say courageous and not fearless because we all feel fear. But you have to be courageous about diving into your own broken spaces. Right?
• 55:38
  At a minimum. I have to be able to look at them for what they really are because I may have a client come in who has issues that are pulling at strings that is gonna just make me really ineffective for them. And so I need to refer that patient out. And then I need to do my own work on that space. We're never done.
• 56:00
  Never finished. We're never perfected.
• 56:03
  Speaker 2: That's why too it's such a disaster when you get a therapist that isn't a good match or it doesn't there's not a good connection.
• 56:11
  Speaker 1: Man, that can be such a mess or a therapist who has their own attachment issues and ends up sleeping with their client.
• 56:17
  Speaker 2: Oh, yikes. Yeah.
• 56:18
  Speaker 1: You know, I mean, that can be such a mess, you know. Countertransference is a very big and real deal in the therapy office. Right? Countertransference is the client is projecting emotion and, you know, ascribing motivation to me and on me. And how am I going to react to that.
• 56:40
  Right? The client comes in and they say they're really disappointed with the last session. Suddenly, I'm blowing up at them because the counter transference is they sound too much like my mom. Right? So we have to be very careful of those spaces and watch them, especially with things like DID, especially where the really significant traumas are because people that come into your office with significant trauma histories are coming into your office with an entire bag of hurts.
• 57:10
  And you really want to be careful not to add to those.
• 57:13
  Speaker 2: But then for the client, that same thing applies as far as rather than like you have a negative experience with a therapist. If it's not an unsafe thing, like staying in therapy and working through that, or when it really is a connection issue or a safety issue, rather than quitting therapy altogether, continuing to find like seek out until you find a good therapist.
• 57:40
  Speaker 1: Right, right. Or maybe just bringing it out in the open and discussing with him what's going on. The other thing you have is transference, right? Often as an older male, patients tend to put me in the father role. Now I can use that to my advantage, right?
• 57:58
  But I have to get past that place where they are expecting me to judge them critically or hurt them. Like I've had plenty of clients with addiction issues who had fathers who were hypercritical of them. They never could get anything right. Never said they were proud of them, right? Just a constant barrage of criticisms.
• 58:20
  Oh, sure. You hit three home runs in the ballgame, but you struck out twice. Right? That kind of thing. And so they may begin projecting that energy on me.
• 58:32
  Right? Like I know I didn't do my homework. I I'm sure you're disappointed. Right? That kind of stuff.
• 58:39
  They they may begin projecting how I handle that matters a great deal. I've seen clients just like their chest puff out because I would say, you really handled that situation well. I'm really proud of you. Right? Wow.
• 58:54
  And it's the first time they've ever had a father image say that to them.
• 58:59
  Speaker 2: So using what was hard for good?
• 59:02
  Speaker 1: Yeah. Basically. Rewriting being that corrective experience in the room in that way. Right?
• 59:09
  Speaker 2: And for therapists who have had their own traumas, the same thing if they're being healthy and have good support connections and doing it well, being able
• 59:22
  Speaker 1: to use their trauma for good. Yeah, absolutely. I'm not saying you can't treat addictions if you haven't been an addict, but I am saying that at times it really helps my patients when I can look at them and describe craving on a gut level and they know I get what they're going through.
• 59:44
  Speaker 2: Right.
• 59:45
  Speaker 1: Right?
• 59:46
  Speaker 2: Makes sense.
• 59:47
  Speaker 1: I don't think you have to have had a broken leg for a doctor to be able to set a broken leg. But I think it makes the doctor more empathic when he's doing that if he has.
• 59:56
  Speaker 2: So a therapist using appropriate self disclosure not necessarily in detail but in expression of I understand your experience and where you're at.
• 1:00:06
  Speaker 1: Yeah. And I think the difference is this. It's very simple. Am I saying this because I need to say this or am I saying this because I feel my client needs to hear this?
• 1:00:16
  Speaker 2: Well, and I think that using it in a connecting way to connect with someone who struggles with connection makes you it adds vulnerability, which opens up the opportunity for healing because they can connect with you as a human, whereas it's more difficult to connect when you're just a flat person sitting in the chair.
• 1:00:44
  Speaker 1: I lead therapy groups. And the interesting thing is, you know, everybody wants to joke around when it comes to the really heavy, serious stuff like when were you bullied in school or how has trauma affected you or and they kind of want to make jokes and be surface y about all of it until one person in the group opens up and says this is how I was hurt. And then everybody else comes behind them and supports them. And then they all start to open up. It just takes that one courageous act in a group to really open that space.
• 1:01:20
  Speaker 2: That's so beautiful. Thank you for talking to me today.
• 1:01:23
  Speaker 1: Sure. Thanks for having me on.
• 1:01:25
  Speaker 2: Thank you so much. I really appreciate it.
• 1:01:28
  Speaker 1: Sure enough.
• 1:01:37
  Speaker 2: Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before, not like this. Connection brings healing, and you can join us on the community@www.systemspeakcommunity.com. We'll see you there.