Sunday, June 28, 2009

Rage, Porn Addiction, Eating Disorders

This week’s blog will be a short one. I thought I would just remind readers of blogs I have previously written. For the topics I list an interested reader can consult previous blogs.

In the field of psychotherapy there are now “cottage industries” that address certain problems widely experienced across the American landscape. These include problems with rage (anger management classes), pornography addictions (12 step programs), and eating disorders (dozens of stand-alone treatment centers). I am sure that these programs help some people some of the time. However, in my opinion these programs rarely provide permanent healing. The problems are generally chronic. The Parts Psychology approach about which I write, however, offers permanent healing. That healing comes about through the healing (neutralizing) of the painful life experiences that created the problems in the first place. The healing concept is so simple: neutralize the negative life experiences that brought about the problems. With Parts Psychology the neutralization of negative life experiences takes place through working with the parts, or ego states, that constitute the normal multiplicity of mind characteristic of being human.

Sunday, June 21, 2009

Symbolism of Internal Self-States

The most frequent images our internal part-selves give us of themselves are pictures of ourselves at different ages, or with different clothing, or with different expressions on our faces. But sometimes our parts present themselves as people who don’t look like us at all. Sometimes they present themselves as demons, monsters, or animals. These sorts of images make it clear that all internal parts should be considered to be metaphors, and not separate people. They are aspects, or parts, of the Self. Neither they, nor the Self, stand alone.

A recent client, Thomas, came to therapy for help with his impending divorce. He and his wife had agreed to divorce, but Thomas had so far been unable to get himself organized to take care of his part of the process. At the end of just four sessions he was able to find and activate the parts of himself who needed to find an attorney, stand up to his wife’s continuing spending, and make arrangements to move forward. His wife seemed to be unable to take any further action after stating that she wanted a divorce.

The first internal part Thomas differentiated was his angry part, which represented itself as a large reptile with the name, “Rex.” Rex was angry at the wife for her out-of-control spending and her accumulation of credit card debt. A second part presented itself as a monk, and wanted Rex to forgive the wife. Together, they contributed to inaction by Thomas through their stalemate with each other. A third part was a younger, more muscular version of Thomas. This was the part who would take a stand. A fourth part was 10 years old and timid, mouse-like—pink and furry. A fifth part was spider-like and scurried into the corner when addressed. What needed to happen was for the angry part and the monk to step back and allow the younger Thomas to take charge. The mouse had to give up his fear of being alone; and the spider needed to stop being passive-aggressive and let the younger Thomas take direct action. By the end of four sessions Thomas had everything under control, with all internal parts working with him. But there were no animals or people inside his mind; only metaphors for different ways Thomas had of being himself.

Sunday, June 14, 2009

Risistance to Normal Multiplicity

For those who have worked with their inner world of part-persons, this new way of understanding the self is nonspectacular, even obvious. But for those with an investment in viewing the mind as normally unitary and indivisible, the idea of parts psychology is an extreme threat. Recently, I posted several examples of the normal multiplicity I often talk about on this blog to a listserv of professional clinicians. These professionals include clinical psychologists, psychiatrists, marriage and family therapists, licensed professional counselors, and clinical social workers. Most are the “in-the-trenches” clinicians who supply the needed therapy for troubled individuals throughout the United States and Canada. Some are from as far away as Australia, New Zealand, and Europe. Some of them are recognized as world experts in the field of trauma and dissociation. With a few bright exceptions, the overwhelming response to my posts is one of harsh criticism and rejection. A few resort to name-calling, with suggestions that I am incompetent or ignorant about the field of trauma and dissociation. Often these critics seem to be angry that I would challenge their accepted wisdom.

It is not at all unusual for those with entrenched ideas to resist change. Nor is it unusual for them to label those who present innovative ideas as ignorant, incompetent, or just plain “stupid”—as one world expert recently said of me. In the case of normal multiplicity, however, the problem is worse than usual because it is so easy to test the concepts directly for validity. One can test the ideas among friends and family members if the clinician lacks sufficient skills to make use of the concepts in the therapy room. Here is how to do it. Think of someone who causes you to feel a strong emotional reaction. For most of us that is someone who irritates or angers us. But other emotions such as sadness, anxiety, or joy will also work well for the experiment. Then focus on the emotion you feel—or the body sensation you experience when you think of the targeted person. Then, speaking aloud or just with your thoughts, say to the emotion or sensation something like this: “Give me a picture of you, please; show me an image in my mind of the part of me who feels this way.” I have found that in 60 to 75 percent of cases, this simple request is all it takes to allow you to visualize the part-self who feels the feeling you began with. From this point all you have to do is to hold the image in your mind and treat it as if it were an actual person rather than a subpersonality within your mind. You can ask such questions as, “Do you know who I am?” “Do you know that you are a part of me?” “Do you have a name?” “How old are you?” Or, “How old do you feel?” “What is your job in my life?” With only a little bit of persistence you can have a conversation with a part of yourself. This is normal multiplicity. Virtually everyone can do it (at least 90 percent of us). Yet professional clinicians fear to go there.

Sunday, June 7, 2009

Dissociatively Normal and Abnormal

For this week’s blog I want to return to the example of Richard, about whom I wrote last week. Just scroll down to that blog if you need to. I said that Richard was dissociatively normal. By that I meant that his internal parts, or ego states, did not take executive control, and he did not experience amnesia when he was influenced by these internal parts, such as in incidents of anger when Richard would find himself shouting at his wife in describing the demands and restrictions of work. I also meant that he did not experience the world as through a fog or as if he were watching a movie. Nor did he find himself observing himself as if he were outside himself. In short, when I say he is dissociatively normal I mean that he did not have a dissociative disorder. This is not to say however, that he was normal in all ways. He was depressed. He cried frequently. He was on high doses of two different antidepressant medications, an anti-anxiety medication, and an atypical antipsychotic for use as a “mood stabilizer.”

Although he was dissociatively normal, that does not mean he lacked subpersonalities, or ego states. We all have ego states. It is the nature of ego states that each has a sense of self, a sense of continuity, its own agenda, and a desire to continue its existence. In most cases, when in the treatment room we work with a newly differentiated ego state, that part is aware of who the person is. In Richard’s case the angry part claimed not to know who he was. Usually, our internal self states know who we are, but it is not unusual for a part to be briefly unaware or disoriented when making the initial connection with the Self. In almost all cases with dissociatively normal people, when a part doesn’t recognize the Self, it readily does so either following an explanation of parts or through a simple demonstration. For example, in Richard’s case I coached Richard to ask the angry part to look through Richard’s eyes to see what I was doing with my right hand. I was waving it. Then I asked Richard to close his eyes and ask the part what I was doing with my hand then. In this way the part came to realize that it could only see what I was doing by looking through Richard’s eyes. Thus, it had to be a part of Richard and not separate from Richard. In contrast, in cases of dissociatively abnormal persons suffering from Dissociative Identity Disorder, the ego states (alter personalities) often refuse to recognize that they are parts of the person even after such demonstrations. They are committed to their separateness.