Sunday, November 29, 2009

Childhood Experiences and Parts Psychology

Parts Psychology is a psychotherapy approach which works with the internal parts that make up the total of a complete personality. These are the parts we are talking about when we say things like, “A part of me wants to get up and clean the house, but another part wants to sleep all day.” We see these parts also in statements such as “A part of me wants to watch football all day, but another part of me will feel guilty if I do.” Doing therapy with these parts means identifying them and then talking with them about what is stressing them out. Whatever a part’s problem is, it is only partly about the current issue. It is also about past history. And that is the subject of today’s blog.

We are the product of our experiences. Our experiences are recorded in our brains as memories. These memories continue to affect the way we experience our lives. For example, many of us will visit our parents over the holidays. When we do a large number of us will be unhappy when our parents treat us as if we were still children. For example, our mothers might remind us to wipe our feet when we come in the door, just as they did when we were 8 years old. We are annoyed because the memories of our mothers’ scoldings still bother the child parts of us who got in trouble when we were kids. Or our fathers may ask us if we finished the backyard landscaping we were planning. We are annoyed because the question triggers memories of our fathers checking to se if our homework was finished. We become just as annoyed, or feel just as guilty, as when we were 12. It’s pretty obvious that our childhood experiences continue to affect us in a multitude of ways.

Because the connections between our childhoods and our adult lives are so obvious, it is distressing when psychiatrists such as Joel Paris, author of Prescriptions for the Mind, suggest that therapy should be about current issues and rarely about childhood. He argues that because many people have horrible childhoods and grow up to be fully functioning adults, this proves that bad childhoods do not cause psychological problems. But this is like arguing that the fact that some people can smoke for 50 years and never get lung cancer proves that smoking is not bad for your health. Focusing entirely on current issues during the therapy hour will often help patients to cope with life’s stresses. But permanent healing only comes from neutralizing the continuing power of childhood memories.

Sunday, November 22, 2009

Parent Introjects in Normal Dissociation

Normal dissociation is the normal multiplicity of self states in the average person. These self states, parts, or subpersonalities (all synonyms) influence the self from within. These are the parts we are talking about when we say things like “A part of me wants to tell my boss to shove it, but another part of me reminds me that I need a job and it’s a tough market out there.” Abnormal dissociation is present when internal parts take executive control from the Self, and then the Self doesn’t remember what happened during that period of control by a part. If this happens it is likely that the person has DID (Dissociative Identity Disorder).

Parental introjects are internal parts, usually formed in childhood, who represent a person’s understanding of the point of view of a particular parent—especially an abusive parent. When doing Parts Psychology and the therapist discovers a parental introject, the procedure for working with the part is largely the same as working with other parts. The difference is that the therapist must take the time to ally with the introject. Often the therapist will want to suggest that the part “take off” its parent costume and just be the child underneath the costume. But this scene has to be carefully set up.

Here is an illustration from an actual case of a hostile mother introject during the getting acquainted stage of working with a part. The patient is a 45 year old woman. The mother introject internally visualized by the patient appears to be in her mid 30s, as she was when the patient was about five years old. Both the patient and the mother are named Maria. During a recent session, Maria spoke inwardly to the mother introject and found that she claimed to know Maria’s name. She demanded of Maria, “What do you want!” When Maria asked for the name of the introject, the response was brutal: “Don’t you fucking know my name? What fucking name you want to call me? ‘Maria,’ you asshole!” An introject typically functioned, when the patient was a child, to remind the patient of the power of the parent even when the parent was not physically present.

Sunday, November 15, 2009

Treating Rejection in Normal Dissociation (Subpersonalities)

This week’s blog focuses on work with an internal part which we could not have worked with early in therapy because there were too many other extreme parts that required attention. At the later stage of therapy, however, we could work with the Little Girl part without interference.

The problem became apparent when the adult female patient became angry when her husband told her to go home with the kids (they were tired) while he took care of a drop-in social obligation. When she objected and insisted that they should both go, her husband said he should take care of the obligation because the hosts were his friends and not hers. She became incensed. As the result of the intense argument which followed, neither went to the social event. Later, the patient agreed that she had overreacted to the rejection she felt. When she focused inward in search the part of herself who experienced the rejection, she found a miniature image of her adult self. This part’s earliest memories were of being excluded in elementary school from the clique of popular girls there. Later, she experienced exclusion from similar cliques in junior high and high school. Most recently, the Little Girl part was triggered when the adult patient and her husband were not immediately accepted into an exclusive country club. All of these events had in common the theme of rejection by a group of others. When her husband had wanted her to stay away from the social event because the hosts were his friends, the Little Girl was triggered and the patient felt all of her previous rejections again. Treatment was straightforward: neutralize the set of memories of rejection felt by the Little Girl. At the conclusion of the session the miniature version of the patient had grown to a mid-size version of her; she identified the image as a child of junior high school age. The patient now explained that she understood that the original image of herself in miniature was because she was a child, although the image she had was of herself as a tiny adult. The important part of the story, though, is that by healing the child part, the adult healed herself of her intense response to the perception of rejection.

Sunday, November 8, 2009

Parts Managers in Normal Dissociation

This will be another short blog because I am still recovering from a hand injury.

My patient is Ariel, a 38-year-old mother of two who came to therapy for marital issues. What is interesting about Ariel is the unusual way her internal world of parts is organized. It is the most highly structured system I have seen. In all, there are nine parts, or subpersonalities. The center of this internal world is Sarah, a part who carries Ariel’s mother’s name. Sarah conceives of herself as the center of this internal world with eight tentacles extending outward from her to the eight other parts she attempts to control. Although Sarah is Ariel’s mother’s name, Sarah does not resemble Ariel’s mother in appearance, even without her tentacles. According to Ariel, Sarah as a part is similar to her mother in that she conceives of herself as a typical “Jewish mother”. This manager Sarah says that it is her job to look after and care for the eight parts she attempts to control. She is especially concerned to look out for Ariel, the Self. Most internal systems have more freestanding parts than this one and there is usually no single manager part with control over all other parts. Most frequently there may be two or three parts that claim to be managers.

Sunday, November 1, 2009

Myths in the Study of Dissociative Disorders

I am continuing to recover from a hand injury and so this is another cut-and-paste from my files.

Top 10 myths in the Study of Dissociative Disorders.

10) That is there is a significant discontinuity in the distribution of dissociative symptoms such that pathological dissociation as found in DID stands in sharp contrast (as a Taxon) to the experiences of normal individuals.

9) That there is a consensus in the field acknowledging a continuum of dissociation ranging from normal dissociative symptoms at one pole to pathological dissociation at the other pole, as represented by DID.

8) That healing of dissociative disorders necessarily involves extended periods of painful abreactions.

7) That ego states are artifacts of hypnosis.

6) That the vast majority of DID cases require a phased approach to treatment whereby processing of trauma must be delayed until after an extensive period of therapy devoted to “stabilization.”

5) That the differentiation of and interaction with ego states (including naming) poses a danger of reification of such states such that healing is compromised.

4) That neither host nor any of the internal self states of a DID diagnosed person has a greater claim to self priority than any other.

3) That the ego states of normal individuals lack a sense of self, an enduring self representation, a sense of ownership of some but not all of a person’s experiences, and their own set of autobiographical memories.

2) That the presence of a multiplicity of selves necessarily signals pathology.

1) That the best solution to DID is a state of fusion of selves into a single, unitary self.