Latest / System Speak: Complex Trauma and Dissociation / Guest: Laura Brown, PhD

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Guest: Laura Brown, PhD · 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 longtime 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
  Our guest today is Doctor. Laura Brown, who received a BA cum laude from Case Western Reserve University and a PhD in clinical psychology from Southern Illinois University at Carbondale. She completed a pre doctoral internship in clinical psychology at the Seattle Veterans Administration Medical Center. She served on faculties of Southern Illinois University, the University of Washington, and the Washington School of Professional Psychology, and she has taught and lectured throughout The U. S, Canada, Europe, Australia, Taiwan, and Israel.
• 1:42
  In the early 1980s, she hosted one of the first radio call in shows by a psychologist. On her website, Doctor. Brown says, Everything that I do is motivated by the drive to create social justice, whether it's the way that I practice psychotherapy or the manner in which I teach. This principle of infusing social justice into everything that I do is visible and known to everyone who interacts with me and is a focus of the training clinic I founded. I make the construct of tikan olam, the Hebrew term for healing the world, central to my work, teaching my trainees that psychotherapy is tikan olam, one hour and one life at a time.
• 2:26
  Thus, I try to inspire by example and by continuously asking the question, What is the one small thing that we can do to empower another person? She says, The bulk of my scholarly work has been in the fields of feminist therapy theory, trauma treatment, lesbian and gay issues, assessment and diagnosis, ethics and standards of care in psychotherapy, and cultural competence. I have authored or edited 14 professional books. Doctor. Brown has authored or edited 14 professional books, including the award winning Theory in Feminist Therapy, as well as more than 150 other professional publications.
• 3:10
  And she has been featured in six psychotherapy training videos. And in the February, she was the on-site psychologist for the reality show The Australian Outback. And our interview was that exciting. Welcome, Doctor. Brown.
• 3:29
  Hello. Hi. Thank you so much for talking to me. I am grateful for you talking to me. I'm grateful for Peter sending you to me.
• 3:38
  I I have appreciated your exchanges and and getting to know you just a little bit even though we missed California and all of that.
• 3:48
  Speaker 1: I know. That was, at the very last minute, I even before they canceled, I thought, you know, I should not go to this conference.
• 3:56
  Speaker 2: Well, I'm glad you were listening for you and did what you needed to do.
• 3:59
  Speaker 1: Yeah. And how is your daughter doing? Oh, that's so
• 4:03
  Speaker 2: kind of you to ask. We are waiting on surgery still, and so we are running out of time. They don't open up and let her have surgery really quickly, we are we're going to lose her. It's a bit harrowing, but
• 4:16
  Speaker 1: Oh, I'm so sorry to hear that.
• 4:18
  Speaker 2: Thank you for asking. It's it's a hard thing, but also one of those things there's not much we can do about. And so we are in a holding pattern here, which feels very inside out with the almost a metanarrative of a metanarrative of a metanarrative. Yeah. With these layers of we're in lockdown, but we're in lockdown for this, but also we're in lockdown like this.
• 4:44
  Mhmm.
• 4:46
  Speaker 1: So Where where are you physically located?
• 4:49
  Speaker 2: Kansas City. Mhmm. I'll try to stay in English for the podcast, but We have had so many languages in our exchanges. It's been so delightful. Yeah.
• 5:05
  If just to get us started, you want to go ahead and introduce yourself just a little bit generally so they can hear your voice and get oriented a bit. Okay.
• 5:15
  Speaker 1: So, my name is Laura Brown, and I am a psychologist who has lived and worked in Seattle for the last forty four years. And I was a psychotherapist for forty of those years. I retired from being a therapist in December of twenty eighteen. And I, like many people of my age cohort, I'm in my late sixties, I fell accidentally into working with complex trauma and dissociation because when I went to graduate school, neither of those terms were in the curriculum. I was fortunate that as a feminist psychologist, I had the tendency to listen to what people told me and to believe what they were telling me and to believe what I was seeing and hearing in my office rather than what the official party line was.
• 6:17
  So, like, a lot of people who are, you know, late baby boomers, I fell into it and discovered that it was the work that I was meant to do. And so most of my clinical work was with people living with the results of complex childhood trauma, many people living with dissociative coping strategies. Since I retired from my therapy practice, I do forensic psychology. I do expert testimony in cases involving trauma or discrimination. And I do a lot of supervision and consultation to more junior therapists.
• 6:56
  And before this epidemic, I did a lot of traveling to teach as well. We'll see what happens with that.
• 7:02
  Speaker 2: How would you describe I know there's so much to unpack, but how would you describe your journey from those early days of learning about complex trauma to how that evolved over your career?
• 7:13
  Speaker 1: Wow. I remember actually, before I went to graduate school the year before I went to graduate school, I was working as a psych tech at University Hospitals of Cleveland at a place called the Hannah Pavilion, which is the psychiatric hospital there. And it was the psychiatric hospital. If you had to be hospitalized, you wanted to be at Hannah Pavilion. And because I was a psych tech, I worked the afternoon shift, and I worked weekends because I was a low person in the food chain.
• 7:47
  And I was assigned to do an intake and orientation, and a woman was admitted, and she was in a state of utter terror and panic. And so I walked with her to her room, and I sat down with her. And probably for the next two hours, I heard her tell me about having intrusive recovered memories of incest that were brought on by her daughters coming to her to tell her that their grandfather, her father had sexually abused them. So I faithfully wrote down because we were supposed to write practically word for word. I faithfully wrote down everything she told me, and I believed her.
• 8:30
  I completely believed her because everything about what she was saying made sense. I had never encountered someone speaking of incest before. I certainly had never encountered someone describing, delaying the dissociated recall. On Monday morning, I got called in by the head nurse and reamed out for encouraging this person and her quote, unquote delusions. I was forbidden to have contact with her again.
• 8:58
  And I thought, oh. And I was already discovering feminist psychology at at around the same time, read Phyllis Chesler's book, Women in Meds, and so I knew that psychiatry was silencing women, speaking about sexual assault, sexual victimization. I thought, is this what Chesler's talking about? Wow. And so I just sort of kept that periodical base even before I went to graduate school, as I've heard this, I've seen this, and then no one talks about it in my training programs for low those many years.
• 9:38
  But with a number of my sister feminist psychology graduate students, we created a sexual assault crisis center, and I also volunteered at what turned out to be a battered women's shelter while I was in graduate school. And I also ran what we called sexual assertiveness training groups where it turned out that the thing that united every woman in the group and her difficulties setting limits, saying no, asking for what she wanted was a history of childhood sexual trauma.
• 10:13
  Speaker 2: Wow.
• 10:14
  Speaker 1: So I kept hearing these things. I kept hearing these things, and once again, it was like, no one's talking about this officially. There was no diagnosis of PTSD. No one ever said this doesn't happen. It simply wasn't mentioned.
• 10:32
  And so I finished graduate school. I went into practice. I was the first openly lesbian licensed psychologist in Washington State. And so I thought, My the group of people I'm gonna serve is my community. So I'm the lesbian psychologist who can take people's health insurance.
• 10:54
  And I started hearing these stories and hearing these stories and hearing these stories and realizing that I was hearing something that my training had not prepared me to hear and with which I wasn't quite sure what to do, but I knew I needed to pay careful attention. And then in the early eighties, a good colleague of mine began to see someone who she learned was a person living with dissociative identities. I try not to use the term disorder anymore because I don't think of dissociative coping as a disorder. I think it is an extreme coping strategy in the face of extreme conditions. But that doesn't make it a disorder.
• 11:49
  That makes it, a coping strategy, but like many others that we develop early in life, create some difficulties later on. And I was the backup therapist for my colleague. And so when my colleague would go out of town or go on vacation, I would see this person. And after the second session, I thought, a, I've seen this before and I didn't realize it. And b, I better start learning something about this on purpose.
• 12:20
  Because if I keep doing what I'm doing, someone else is gonna walk into my office, and this time, I don't wanna miss it. Because I had missed it with my second private practice client who I misdiagnosed with borderline personality disorder. I completely missed it. Because I didn't know what I was looking at. I didn't know what to see.
• 12:42
  And so beginning in the early eighties, I read everything I could get my hands on and continued to be the backup therapist to this person and continued to see people who had really severe complex trauma in their childhoods. And then around 1988 or so, someone walked into my office, and I knew what I was seeing this time. That person did not know that she was living with dissociation. In fact, she was pretty adamant that she wasn't, and I didn't argue with her because that's foolish and ridiculous. But the studying I had done and the experiences with my colleague's client, everything that person had taught me prepared me to know what I was seeing when that next person walked into my office.
• 13:44
  And then I became a person who did that and kept doing that and kept doing that because, as I said, it's the thing to which I seem called. I figured out somewhere in my forties that my mother was a survivor of complex childhood trauma, and she was dissociated from her body her entire life, my entire knowing of her. And I have a fair amount of information from my late aunt who died back in March about what that was all about. And so this is something that I was prepared to do from way earlier than I knew. That's the long answer to the short question.
• 14:31
  Speaker 2: I think that is amazing, though, from the recognizing of something that you had not seen before that you were already advocating for in a way and how that unfolded into the treatment you ended up providing to others?
• 14:46
  Speaker 1: Well, I think one of the things about me is I was raised to be iconoclastic. I was raised to question. Some of that's cultural because I'm Eastern European Jewish in origin. Some of that's familial. And I knew working in that psychiatric hospital that we were doing wrong by many of the people there.
• 15:14
  And I was not in a position to do much about it as a low person on the food chain, But that was part of what encouraged me to keep applying to graduate school till I got in. Because, my consciousness raising group said, you need you need to become doctor Brown so that people will listen to you.
• 15:33
  Speaker 2: Did that work, becoming doctor Brown? Do people listen to you now?
• 15:38
  Speaker 1: Oh, yes. That worked, extraordinarily well because I have the authority of my doctorate and also at this point, the authority of having spent way too much time writing things. But, frankly, I'm a channel for the authority of the people who I have worked with because I can say things that they are marginalized from saying, that they are silenced for saying. And part of my commitment as a person who wants to weave social justice into my work is to act as that ally. I'm not the expert on living with dissociative identities.
• 16:33
  The people who do that are the experts on it.
• 16:36
  Speaker 2: Wow. How do how do people you're helping, how do they respond to that?
• 16:42
  Speaker 1: Well, it it's interesting. It's variable, because what I say to people when they come in to see me or what I said when I was still working as a therapist is this is a process where there are two experts. And I'm an expert in creating the conditions in which change it can occur. And I have some very specific things like EMDR and brain spotting and mindfulness and so on. I can create conditions that I can offer those tools.
• 17:16
  I'm not the expert on what's going on inside of you. I'm not the expert on what's right and wrong for you. What I'm really good at is helping you to know what you know, to reclaim your power, to know what you feel, and what you think, and what's happening in your body, and what your values are. And at teaching you to assess people starting with me, to assess whether this particular human is worthy of your trust and to what degree. And a lot of people's response to that is, what do you mean?
• 17:57
  You've gotta be kidding. And I said, well, you know, you know, we therapists are crazy. But but this is this is how I see it. And I am in this with you for the long haul. Even when I retired from my work, I gave people a full year to work through the fact of my retirement.
• 18:20
  And I retired because I wanted to go out with at least a quarter tank of psychic gas. I did not want to be running on fumes, and I told people that, that I wasn't going to subject them to me burnt out because that would destroy what we had done. So I said to people, I'll be here with you for the long haul. I'll be open to your suggestions. I learned EMDR because that first person I worked with who was living with dissociation needed me to learn EMDR.
• 18:51
  I've had people say, why don't you read this book? And I was like, okay. I'll read this book. Wow. This is really useful.
• 18:59
  I've had people say, could you learn this thing? And I've said, in some occasions, yes. And others, when it got very close to the end of my career, I'm I'm not gonna do that because it's it's too close to the end of what I'm doing. For me to acquire yet another skill that's gonna take a lot of years of training. I had really clear boundaries about what I wouldn't do, like, you know, you never have sex with someone now in this universe, in this lifetime, in another lifetime, which for some people who are survivors of childhoods from hell, is really terrifying because the only way they knew they were safe when they were kids was to offer themselves sexually to the dangerous adult.
• 19:41
  And and when they would do that with me, and I would say no, that would terrify them for, you know, many, many years of having to work through what this was about. I am one of these therapists who was really clear about that I always started on time, and I always finished on time, because that was about keeping my commitments to each person I worked with to start their session on time and be emotionally available and clear when that session started, which if you run over, you can't do. And so to look at making the boundaries a part of therapy because a lot of the people with whom I worked had grown up with either irrational not boundaries so much as rigidities or no safety, no no holding or containment at all. So it really was very much a give and take between me and the person I was with. And I mean, Laura is Laura is Laura.
• 20:37
  I you know, what you see here is what you get in life. And my style would be to a certain degree, not consciously, intentionally, but I would modify to be with the person energetically, which is also something many people hadn't experienced. They hadn't experienced energetic attunement.
• 20:59
  Speaker 2: I'm sorry for interrupting you. Explain that some more, the energetic attunement, because I can feel what you're saying, but I want to hear it in words. So, I'm a practitioner of
• 21:10
  Speaker 1: the martial art of Aikido. We talk about ki, the energy of the universe that runs through all things. And even before I started to study Aikido seventeen years ago, I would notice that I that people broadcast their energy. In fact, one of the challenges for me in life has always been that my radar doesn't turn off very easily and that I kinda have to get myself away from human beings to not be picking up everything on the the psychic spectrum. The people give out energy.
• 21:44
  And part of what children and infants get in good enough families is that the adults are attuned to them. They're paying attention to what's happening energetically. And in the childhoods from hell of the people with whom I worked, there was misattunement. There was no attunement. There was anti attunement.
• 22:04
  And so paying attention to people energetically and being with them. So, you know, I tend to be a little bit fast, slowing myself down to be with people energetically if that was where they were, sitting silently with people. I have one memorable experience. For a long time, I have an office in my home, and the restroom was on the other side of the wall from the office. And one time, someone came in, and this was a survivor of complex trauma.
• 22:40
  And that person decided that they didn't feel safe in the office, and they went and sat in the bathroom for the whole session. And I sat there paying attention to the energy coming through the wall for the whole session. And they came back just before the session was over and said, you were really with me. And I said, okay. Good.
• 22:58
  I'm glad you could feel that.
• 23:00
  Speaker 2: I think it's amazing. Say why. Maybe because it's in contrast to not being seen at all to then be so deeply felt like that, attended to.
• 23:15
  Speaker 1: That's what I mean by energetic attunement, that I would say to my students, you want to listen in therapy as if your life depended on it and if as if your client's life depended on it, because in fact, that's exactly the case. And when I forgot to do that, when I got distracted by my own wittiness or brilliance, that's when I screwed up. Always.
• 23:46
  Speaker 2: What helped you know how to help someone in those moments when you were once you were so attuned with them, how to respond to them or what they needed or what they were processing?
• 23:59
  Speaker 1: Listening, listening, listening, listening, sensing, and then oh, then there's there's my inner jukebox. So before I was a psychologist, I was a singer, and I still sing some. And my unconscious speaks to me through songs that come to me from the upper right quadrant towards here. And so I will be sitting with someone, and a song would show up from here. Words and music.
• 24:29
  Words and yeah. And that would allow me to know something about what was happening with the person. So there was that. There's inner jukebox. And then there was this thing that's technically called projective identification, which means that the person is feeling something intolerable that they basically give it to you to hold.
• 24:53
  And so I would be sitting with someone, and all of a sudden, this emotion will come over me that I knew was not my own. And that, therefore, I could educatedly guess was being given to me to hold. And so I could say, you know, I have a hunch. I could be wrong. I could be foolish.
• 25:17
  In fact, at some points later in my career, my clients would say, you could be foolish it? I was like, yes. Because I always wanted to give people a free pass to tell me, no. You're wrong, Laura. I'd say, I'm wondering if hex could be going on, or sometimes it would be without words.
• 25:36
  And I would say, do you need me to move my chair further back? Do you need me to come sit next to you? So I would feel the push or the pull. And so listening with all those parts of me that aren't my auditory cortex. And the other thing I had was very helpful, which is for a period of thirteen years, I had the world's best therapy dog.
• 26:11
  And Schmullet, who was a Staffordshire bull terrier, like many terriers, was quite attuned to changes in breathing and scent and all those things. And he taught me what to pay attention to because he responded to things that I didn't know were there yet because, you know, dogs have these amazing senses of smell. They smell things that humans can't. And so I learned to follow his cues. And when all of a sudden, he would change his behavior, I would notice, okay, what subtle thing oh, some other ego state has taken center stage.
• 26:55
  And it would be very subtle. And then I could say, I am curious. Does Shmuela trying to tell us that there's a different ego state in the room right now? It's like, how did he know? I said, because he has a really good sense of smell.
• 27:09
  Speaker 2: That's amazing. I've never gotten to work with a therapy dog other than, they have one at the school where my children are actually. They know the school has been very good to us, very good to us. And they have they are aware of the situation with our family and our daughter, and they have brought the dog every week. And so she has stayed in the front of the driveway, but has let the dog come, and the dog comes up to the porch and has attended to the children.
• 27:45
  And it's been amazing to watch some things happen. And so that was really my first experience with a therapy dog at all. What was that like in sessions besides the switching? Or how how did you know when that was going on or what the dog was picking up on or
• 28:02
  Speaker 1: I didn't know for a little while. And so I got him at eight weeks and he immediately came into my office. He sat in my lap. He went in his crate. He grew up in the therapy office.
• 28:15
  And I began to notice that he was picking up on things, that his behavior would change. And sometimes it would change in really radical ways. And that I followed his lead because he was one smart bull terrier and because I knew that, ironically, because staffies are among the most predatory of all dogs. So predatory dogs really have great senses of smell. They're good at smelling things out.
• 28:46
  Terriers are hunters. And so I knew he was picking up on something. And I trusted that he could smell something I couldn't. And maybe that meant there was something I could not know yet, but that if I was at least willing to say, humor me for a moment, I could be full of shit. But and the more I did that, I I got more hits than misses from him.
• 29:14
  It's interestingly because the the the person I encountered the I encountered a colleague in the late nineteen nineties who was truly evil, and that person was the only person Shmuelik tried to bite ever in his entire life.
• 29:28
  Speaker 2: That's amazing. I got bit by a dog in a therapy office once, but I was it was my first interview, and the dog was not trained at all. And so it was I was just talking to Peter about this story actually because I thought I'm not a dog hater and I love dogs but this I was not comfortable with the person that the clinician and the dog was not trained. And I think the dog felt the same thing I did. And Mhmm.
• 29:59
  It was fascinating.
• 30:01
  Speaker 1: Well, you know, I didn't know this person was evil because this person did such a good job of covering themselves up. And I wish I had paid attention to the fact that this is the one and only person Schmulich ever bit. And I didn't to to my great, distress later on. But, yeah, he was, he never met any human being in my office or for the most part out of it who he didn't immediately want to love.
• 30:26
  Speaker 2: How did people respond to the dog?
• 30:28
  Speaker 1: Well, it was variable. I what happened is so he would be in his crate because he was quite comfortable in his crate. And I would tell people when they first came to see me, oh, I have a a therapy dog. He will be in his crate when you get there, and you get to decide if he joins you or not. And even if he does, if you want him to go to his crate, you just say crate and he'll go to his crate.
• 30:53
  And some people wanted him to stay in the crate, and that was fine. Some people wanted him right next to them on the couch at all times. Some people had very young ego states that wanted to play with him or that mistook him for the dog of the age they had been when they'd had a dog. One person who was not a patient, but someone I was evaluating in a forensic case, a person living with dissociation. I had told her I had a dog in the office, and the ego state I spoke with wasn't in communication with the ego state who had watched dogs have terrible things done to them.
• 31:37
  And so she came in and immediately switched to that one. And so I took him upstairs so he wouldn't be around because that ego state was able to tell me what was frightening them. But the ego state with whom I'd arranged the appointment didn't have communication with the ego state that got activated by him. And he was, like I said, really quite attuned. When somebody needed to be left alone, he left them alone.
• 32:06
  When somebody wanted to distract us from the topic, he would start to roll on his back and be silly. And I would say, I'm wondering if you would prefer that we not be talking about this topic right now. It's like, yeah. Yeah. Shmuelik's right.
• 32:20
  Yeah. So there was the whole human range, and he was he was what they needed him to be. He really was. That's right. As a great diagnostic diagnostician.
• 32:35
  How clever. How And he's been gone he's been gone since the February, and I have not had another dog since.
• 32:43
  Speaker 2: My. How did you explain dissociation to people, to clients? Well,
• 32:52
  Speaker 1: that it is the coping strategy of someone who is very small and very trapped and has nowhere to go because they can't go, and that they developed dissociative coping because they have a talent for it, for starters. It's not everybody has a talent to dissociate. Some people simply cannot, to save their own lives, dissociate. And that this was what they did to survive the hell they were in, and it worked well enough that it became a habit that got utilized even when they weren't necessarily trapped or in terror because it worked so well. And that probably nothing that we did together would ever work quite as well and that they wouldn't lose the ability to tap into that skill, that the goal of therapy was to have it less in charge of their life so that they would know what they were feeling and thinking and doing most of the moments of their waking life.
• 34:02
  Speaker 2: I'm just gonna let that sit for a minute. That was really good. Thank you. What do you think that clinicians need to know if they're new to helping people with dissociation?
• 34:15
  Speaker 1: Well, first of all, stop freaking out. I would get these calls that I would call the eek. There's a multiple in my practice call. Like, oh my god. This person switched, and I don't know what to do.
• 34:26
  And should I should I refer them? It's like, no. Do not refer them, particularly if you've been seeing them for five years. Get training. Thank god for the ISSTD online training.
• 34:36
  Get consultation. There's a bunch of us here in town, internationally, nationally, you can talk to, get training from one on one. Do not destroy this connection. This person has gotten to the point where some part of them feels attached enough that they're letting you know what you didn't know. They've come out to you.
• 35:01
  So don't freak out. Do not freak out. Almost everybody living with complex trauma has some dissociative capacities, plus us unitards have ego states. There's no such thing as a person who doesn't have ego states. The difference between someone like me and someone living with dissociative ego states is that when I'm in a different ego state, I know it.
• 35:30
  I'm pretty conscious for it. I'm like, oh, crap. I and sometimes it's hard to pull myself out of it, but I I'm aware of it at all times. So remember that this is a thing that human beings have and are, that the disordering of it is very much a Western culture phenomenon. It's about finding pathology in the ways that children cope with childhoods from hell rather than in the childhoods from hell themselves in the ways that those children were treated, in the cultures that turn unseeing eyes and unlistening ears that look away.
• 36:15
  So remember that this is a person who survived with the tools that they had available. And for very, very small people, dissociation is an excellent life saving coping strategy that works until it doesn't. So remember that. Get trained. Get trained.
• 36:34
  Get trained. Don't freak out. Lather, rinse, repeat. And also, don't declare yourself expert in this. For the first ten years, I've seen people come out of graduate school and say they're expert in working with dissociation.
• 36:50
  I think, oh my god. Seriously? Really? And don't work with more than about three actively dissociative people at any given time in your practice, particularly people who are the early stages of their work. If you have somebody who is much further along in their work, fine.
• 37:12
  Take on someone new who is actively dissociative. But this is hard work that requires you to be all in with an open heart, and you're gonna hear things that shake you to your core. Don't do that hour after hour. You know, start by practicing self care so you can maintain in this work for a very long time.
• 37:37
  Speaker 2: What would you advise to a client or a survivor who does have to change their therapist?
• 37:43
  Speaker 1: First of all, use your assessment skills. Pay attention to yourself. What feels right or wrong to you? Don't necessarily go to see someone just because someone you know likes them because they might not be a good fit for you or because they're a famous person because famous people aren't necessarily good therapists. There is some overlap in the Venn diagram, but not 100% overlap.
• 38:19
  Find out what they know. Interview them. If a therapist isn't willing to tell you whose models of dissociation and complex trauma inform them, or or if they say, you know, I don't know much about this, but I I can probably figure it out. You want someone who either has a clear model who says, okay. I I am really informed by the structural model of dissociation, which in in my case, that is the case.
• 38:51
  Or they say, you know, I don't know very much about this, and I will get consultation from I I'm gonna start calling right now to get consultation if you decide you wanna work with me, but why don't you go home and think about this? And one of the hard things for survivors of complex trauma is a lot of the highly experienced people are full, like, right up to here. Always have very, very full practices. And so you start with people who are newer. And if it's someone newer who, like, the people who consult with me, are getting regular consultation and are taking the ISSTD online trainings and, you know, I send them home with the the latest book, on structural dissociation to read.
• 39:37
  Then you know you've got you're being held up by someone who's holding up your therapist as well. But pay attention to your gut. If your gut says danger warning, say, you know what? I don't think you're the right therapist for me. You don't have to know why your gut is saying danger warning.
• 39:54
  You may not be at the place to know that yet. Listen to that. Listen carefully to that.
• 40:01
  Speaker 2: The way you listen to the dog.
• 40:04
  Speaker 1: Yes. If you have a dog, bring your dog with you to the first meeting and see what happens. How does your dog respond to this person?
• 40:14
  Speaker 2: Wow. What does a survivor who's just now learning and and you've given that good counsel about what dissociation is and explaining that? What do they need to know about the therapeutic journey and and what that's going to look like?
• 40:31
  Speaker 1: Well, it's long. You don't unlearn a really successful coping strategy that's past its pull date in six weeks or even two years for the most part. So it's long. There's times when it will be absolutely terrifying, not because the therapy is frightening, but because you will know the fears that you couldn't know when you were one and two and seven. And so you will feel them now as if they were happening in the present.
• 41:08
  That it is complicated. That you may need one therapist for part a and one therapist for part b because therapists are not all things to all people, that you will have to work at it really hard. You'll have to be willing to do the experiments in tolerating the things that your child self could not tolerate and knowing the things that your child self could not know. And from what the people I've worked with have told me that it's worth it, that it is worth it, and it is not simple. There's no quick fix for having had the adults who threw you into hell when you were little.
• 42:03
  There's no quick fix for the effects of what that did to you because that affected your entire nervous system, your body, your brain, everything about you. And we're addressing all of those parts and pieces. You also wanna know that you'll probably do a big chunk of therapy and then go away for a while, then you might come back because something new in life happens that brings up something that you didn't know you needed to address. For a while, I had a group of people who were coming back because they were aging and having the many chronic illnesses that are really common in people who grew up in the childhoods from hell. And dealing with illness meant that they couldn't do some of the things they were doing to keep themselves feeling okay.
• 42:48
  They couldn't run anymore, swim anymore, And they needed to come back in and learn to grieve the loss of the healthier body and learn to love the body they were aging into. So it's it's a process. It's worth it.
• 43:09
  Speaker 2: My favorite author one of my most favorite authors was Clarissa Pinkola Estes. And Mhmm. She says she talks about in one of her stories standing what you see. And I've heard you and also Christine Forner talking about knowing what you know and feeling what you feel. How does someone learn to do that and learn to tolerate that?
• 43:34
  To know what they know and to feel what they feel?
• 43:37
  Speaker 1: Well, knowing what you know is a little easier sometimes, and I have people practice it with me and on me. For example, if I wasn't particularly feeling well that day, will come and say, you know, I'm not feeling great. I'm probably a little off. And if it is, if I am, it's not about you. And they would say, oh, no.
• 43:54
  No. No. I'd say, no. I want you to notice. Practice noticing.
• 43:59
  And then fifteen minutes, and they'd say, oh, yeah. That. I'd say, ta da. And I would also have people practice feeling what they feel by doing the thing of practicing getting angry at me, because I would I would rupture something because therapy is about rupture and repair because I'm not a mind reader. So I would engage in a rupture, and I would say, you know, that was a rupture.
• 44:26
  Oh, no. It's it's like, no. It's not okay. It's not okay. I'm sorry I did that.
• 44:32
  Oh, it's fine. No big deal. Let's say, you know something? Some part of you has got to be really angry at me and really frightened of being angry at me because you're afraid that if you get angry at me, I will go away or punish you. So we'll just keep practicing me noticing that you would you would be angry at me right now until you actually do it.
• 44:52
  And so after time two ten sixty would be the rupture. It's like, wow. How did you do that? It's like, yay. You got angry.
• 45:01
  And they would look at me like, are you out of your mind? Like, oh, I'm so chappy. You got angry at me. Oh my gosh. Oh, I'm so proud of you.
• 45:11
  Because so practicing it with me. And then sometimes doing micro practices. So having people, for example, watch something on TV or a movie and notice how they felt about what the characters were doing. That's a really relatively safe way to do it because there's the character on the TV screen doing something. And so we would say, okay, let's pick one and you're gonna watch it and come back in and tell me what did you feel, and you're gonna take notes.
• 45:48
  And and when streaming came along, we could do it in the office together. So and then I would have them go out and observe people in the world that were strangers, and they were at a distance they were not really engaged with. So little tiny steps. I had an exercise I would have people do. So, you know, you can go to the paint store or the home improvement store, and you can get these paint chips strips that have, like, all the colors on them, and you can have as many as you want for free.
• 46:22
  I would say, okay. I want you to go to the paint store, the home improvement store, and I want you to get lots and lots of paint strips. And I want you to sit with them until you know exactly what your favorite color is. And they go, oh, that sounds easy. Oh my god.
• 46:36
  No. That was so hard. And people will come back and say, that's so hard. I have no idea. And so we would talk about what made it hard for them to know what it was that was giving them visual pleasure.
• 46:49
  And we would do the same thing with other sensory inputs. And so we would practice it in ways that were safe, either just them, them with themselves, or them in my office. And then sort of notice okay. Notice your sympathetic nervous system is activated or you've gone into your dorsal bagel and shut down. Okay.
• 47:09
  Let's breathe. Let's put our feet on the floor. Let's get up and dance the hokey pokey. Let's sing. Whatever we needed to do to help to have people be fully in themselves while they weren't knowing what they knew.
• 47:23
  In one of my books, I wrote a checklist about how to assess if someone was trustworthy. So I would, you know, photocopy that out and send people home with that to read and have them practice again on, you know, characters in TV and the movies, and then getting closer and closer into someone they actually were interacting with. So lots and lots of practice in ways that did not have interpersonal risk involved. So by the time they took the skills into interpersonal situations, they actually had more trust in their own capacities because you don't throw someone into the deep end of the pool when they can't swim. So start in the, you know, kiddie pool with that touch your toe in the water.
• 48:08
  How does that feel?
• 48:10
  Speaker 2: Those are beautiful examples. You mentioned rupture and repair. What are some ways that a clinician can work through a repair with someone?
• 48:21
  Speaker 1: Well, you start by owning that the rupture is there. And if and most of the time, we cause the rupture. Not always. Most of the time, we cause the rupture because we misread something. We get too interested in our own interpretation.
• 48:37
  We our attention drops. There's micro ruptures and there's big ruptures. So the first thing is to own the rupture. It's like, okay. This happened.
• 48:50
  And I did this and didn't do it on purpose. And I am now going to listen to you talk about and process the rupture, and we will process it as long as you need to process it, not because I said, I'm sorry. We're done. So modeling for people that they got to stay mad. I had one person who was mad on and off at me about something for three years.
• 49:18
  And, part of her would be mad, and then other parts would shove that one off the stage. And then the mad one would come back. It's like, hi. Okay. We I knew we still had some conversations to have.
• 49:30
  And there's a point where she said, okay. I think I'm done. I said, are you sure? Are you sure? This is not like, you know, a one time offer where you have to be done.
• 49:40
  It's like, yes. I am sure. Okay. Well, if you if you change your mind, you know, you can change your mind. I'm not holding you to that, which was a very interesting piece of a long rupture repair.
• 49:58
  With some people, I knew I had made rupture, and they didn't know I've made a rupture. And some people won't hear or weren't ready to hear I've made a rupture, but I would notice changes. And so I would engage in repair behaviors. It really has a lot to do with who's in the room with me and where they're at and what their capacities are. Sometimes, there's times in almost every therapy where we as clients, when we're the client, we need the therapist to be perfect and wonderful.
• 50:33
  We don't wanna know that they screwed up. And what they say, I screwed up, that that's that could be frightening. And there's sometimes when we as clients really need the therapist to say I screwed up and to not be defensive about it and to just say, you know something? I screwed up. Not on you.
• 50:54
  You didn't make me screw up. I did it because I'm a human being, and I apologize. And what do you need from me going forward? And you don't need to know it right now, and you don't need to know it today, in the next session, or the next session. But at some point, what do we need to do?
• 51:13
  And also normalizing it, which is what I say to people is relationships. All good enough relationships are about rupture and repair and rupture and repair and rupture and repair because we are stronger at the broken places.
• 51:28
  Speaker 2: We are stronger in the broken places.
• 51:31
  Speaker 1: Yeah. It's a line from Hemingway, and it's also a true thing.
• 51:34
  Speaker 2: Yes.
• 51:34
  Speaker 1: And it's also happens in secure enough attachment that the caregiver misunderstands the wordless cry and the infant feels a rupture and the caregiver says, oh, sweetie, I guess it's not that you were wet, it's that you were tired. So in good enough caregiving of children, there are lots and lots of ruptures and repairs. So too in good enough therapy and in good enough friendships and romantic partnerships and everything we do with other humans.
• 52:09
  Speaker 2: When there has been enough repair either internally or in context with different relationships, how can you tell when someone has is well? How can you tell when someone is well?
• 52:23
  Speaker 1: Well, I don't tell. They tell me. Those people say, well, how will I know when I'm ready to be done? I say, well, something people have told me is that they started realizing that they had something else they would rather do this hour, and it wasn't because they were avoiding the topic. It's because they were really feeling fine.
• 52:42
  And so so I said, so when you start to notice that, let's talk about it because then we'll maybe begin to talk about the process of winding down knowing that until the day I retire, I will always be available when something comes up. And people would say, oh, I'm never gonna feel like that. And I said, yep. I don't know. I'm not I'm not you.
• 53:02
  I won't know you. And then somewhere two, five, ten years down the line, say, you know that thing you told me about? Where I wanted to go out for coffee with my friend instead of coming here, not because I was avoiding, but because I'm really fine? That's that happened. Like, okay.
• 53:18
  Let's talk about that. So I didn't decide. And I think one of the hardest things about my retirement for all of us was that I decided I was done. And I decided I was done because I could feel my capacity lessening. And I thought, you know, I could keep on doing this till I was 80 and get away with it, but I would start to destroy everything I had done after another couple of years.
• 53:49
  I wanna end the therapy the way therapy has been, which is in the service of everyone else's well-being and being honest about the fact that me retiring is something I'm doing for me as well as for the therapy. That it, in fact, is my timing because pretty much nobody was ready for me to be done. What other And that's why that's why I I gave everybody a full year.
• 54:21
  Speaker 2: That was so gracious. So so important. How else is self care so important for clinicians?
• 54:28
  Speaker 1: If you do not engage in self care, you will fry to a crisp. And when fried to a crisp, you will enact all your worst selves with your clients. I have known therapists who have screamed and yelled at their clients, or people forget sessions, or chronically double book, or show up late, or fall asleep. And that's not okay. It's really okay for me to be a human being and come into the office and say, as I said to my clients early in 2013, so both my parents who live in Israel are beginning to die.
• 55:13
  And I'm going to be more distracted this year, and I'm going to be abruptly canceling sessions and running halfway around the world. And I want you to know that in advance because I'm gonna need you to call me moron if I'm distracted because I'm gonna be more distracted than usual. And then I will be abruptly canceling sessions for Monday, Israel and back. And that went on for a year. I gave everybody the warning, and so people were, like, essentially furious at me about it.
• 55:44
  And others were, thank you for telling me. And I did a lot of online sessions while I was in my hotel room in Israel. But I didn't just let it drop onto people. And back in the late nineties when I encountered the sociopathic colleague who did terrible, destructive things to me, I actually took a year off from being a therapist because I knew that I was about to fall into not being able to hold the space. And I just did not trust myself no matter what to be present in a compassionate manner with people when I was so dismantled and distracted myself.
• 56:30
  And so I just took the year, and I called it a sabbatical. I didn't tell people why, but I could feel myself so fried and my heart was getting so hard. And that and people were having many more crises that year because I wasn't there. They could feel that something was going on, and I wasn't talking about it. And so they were having more crises because what do you do when someone's attention slips away as you like, hello?
• 57:05
  Hello? Hello? And I was not being the therapist I had committed to myself or to them to be. So self care isn't an indulgence. It is an ethical commitment to being able to be fully present with human beings who have put their lives in our hands.
• 57:30
  Speaker 2: I think that is such a tender thing. I have experienced that before where I started therapy with someone and in the middle of that process, just as I was starting to sort of attach and respond to what I was learning in therapy, the therapist, became involved in a different project with different people and continued in the office but it was not the same as before and it took me a long time to recognize that this time the problem wasn't me.
• 58:13
  Speaker 1: And
• 58:14
  Speaker 2: to know what I know and feel what I feel of I could feel the distance, I could feel the distraction, I could feel the lack of focus, I could feel the shift in energy towards something else and even though those something else's and the other people were all good and wonderful things, it triggered in me feelings of abandonment and why was that chosen over me sort of confusion when especially at the beginning before I figured out what was going on. And I think it would have been very different if we had just had a conversation of this is what's going on and I'm focused on these things or I'm doing this or I think it makes such a difference. A more neutral example would be I had a couple of girlfriends that all went out of town together at the same time, but none of them told me that's what was happening. And I was not in a position to go with them. It was not about me not getting to go with them or not being with them, it's that they all went quiet at the same time and I didn't understand what I had done wrong because all of them stopped responding and all it was was that they were out of reach of cell service but no one told me that they were leaving and they all went at the same time and I was not it wasn't about jealousy or that I couldn't go or that I had to be here instead it was literally that my entire support system disappeared all at once together and it was really really difficult and took me I really stumbled because of it and it took me some time to sort of recover my feet under me I don't know how you say in English and
• 1:00:14
  Speaker 1: to
• 1:00:13
  Speaker 2: trust
• 1:00:14
  Speaker 1: them
• 1:00:14
  as
• 1:00:14
  Speaker 2: To
• 1:00:14
  Speaker 1: get into bearings again.
• 1:00:15
  Speaker 2: Yeah, yeah and to feel oriented to them as a group. I could individually but as a group it didn't feel safe because it had all been taken away at once and it was hard to rebuild that even though it was just a simple communication.
• 1:00:30
  Speaker 1: Mhmm. And, you know, therapists are told not to self disclose. Right. So the fact that I said, so my parents live in Israel and they're dying and I'm gonna be running back and forth, That's not common or typical, although in feminist therapy, which I've written about and practiced my whole career, that is an in fact, self disclosure in the interest of the therapy is something we support doing. And I learned really early that, like, when I'm concentrating hard, I look angry.
• 1:01:04
  And people would say, you're angry at me. I'd be like, no. No. No. I'm not angry.
• 1:01:07
  And then I saw myself on video. It's like, oh my god. That's what they're talking about. And that was the beginning of learning to say to people, here's something that knowing might help with. You know, that when I'm really concentrating hard and listening to you intently, some people think I'm angry.
• 1:01:25
  So check it out. I also learned to say back in the days when I still had periods, I'm having a horrible case of PMS today. So if I seem a little off, I am. It's not you. And those kinds of things reduce they're they're really, I think, particularly helpful for people who were gaslighted as children or abruptly dropped as children, which is true for everybody who grew up in hell.
• 1:01:57
  And so I don't talk didn't talk with clients about the details of the struggles of my life, which is why I didn't talk about the sociopathic colleague. But I do talk about things that affect how I am in the room. And I think that the more therapists who do that, and everyone I've trained has learned how to do that, the the less mystery there is and the more we give people the capacity to trust their own reading of what's going on.
• 1:02:31
  Speaker 2: I think that's true in any relationship. Even with my children since I've learned about this, even with my children I approach it differently of tonight I have a podcast interview and it's at this time because of this situation. So I know it's movie night because we don't have a TV in our house. So on movie night is a big deal. So I know it's movie night.
• 1:02:53
  You're still going to get your movie and you're still going to get popcorn and papa will be there. But I'm going to miss it because of this. But when it's over, I will still be there to sing with you and to rock with you and to put you to bed before we're finished. And just communicating upfront about this is what's going. It's not that you're in trouble.
• 1:03:13
  I'm not mad at you. It's not that I don't want to be there. Just this is what's happening. Precisely. And I think I think you've hit on something as well about the gaslighting and I would add the layer of it can trigger a feeling of like tiptoeing through secrets.
• 1:03:34
  Like I know something's wrong or I know that I can sense something but because we're not allowed to talk about it, it feels like a secret and so it feels like a trigger as opposed to just putting it out there and saying this is what it is, and so it's fine. And I don't even need the details then, like, it's that solved the emotional dissonant the dissonance there that was getting in the way. So I actually don't even have a need for more information then because you've answered the question. It it wasn't about me or us. Right.
• 1:04:10
  That's powerful. What a simple thing to just communicate.
• 1:04:14
  Speaker 1: Well, I think the thing I wanna close with is to say that the people who teach us best about complex trauma and dissociation are the people living with it. And some of those people are therapists, and some of those people are clients, and some of those people are both. And that it behooves all of us in our professions to stop distancing ourselves from the pain and terror of the people with whom we work, to stop pathologizing it, to honor it as the coping strategy or coping strategies that it has been, and to realize that this is a business of being open hearted. It doesn't mean we also don't have boundaries and techniques and all that stuff. But this is really a business of having an open heart.
• 1:05:19
  Speaker 2: That just feels good. I'm just sitting here holding it. I wish my camera was working so you could see. I'm just I'm just sitting here holding it, embracing that. It was such a lovely thought and such a energetic feeling that I could feel the way you were talking about at the beginning of just being present in that.
• 1:05:38
  Thank you so so much for sharing with us.
• 1:05:41
  Speaker 1: You're very welcome, and I'm so glad we finally were able to make this happen.
• 1:05:45
  Speaker 2: Oh, I am too. We really talked about it for so long.
• 1:05:49
  Speaker 1: I know.
• 1:05:51
  Speaker 2: I am so grateful. Thank you for taking time out on the weekend to talk to me.
• 1:05:56
  Speaker 1: Alright. Well, take good care of yourself. Stay safe. Thank you so much. It's been my pleasure.
• 1:06:17
  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 at www.systemsspeak.com. We'll see you there.