TIRA

Traumatic Incident Reduction Association

Interviews with Practitioners, Developers, & Researchers

The views and opinions expressed in these articles and interviews are those of the individuals speaking, and do not necessarily represent those of Applied Metapsychology International or the TIR Association.

TIR and Dissociative Identity Disorder

A conversation with Aerial Long by: Victor R. Volkman, Chair of the AMI Public Information Committee

Aerial is a Personal Growth Counselor and Certified Traumatologist in private practice and has been counseling since 1977. Her training includes certification as a facilitator in Applied Metapsychology.

I asked Aerial to share her experiences in using TIR with clients who have been diagnosed with Dissociative Identity Disorder. (See What is DID? below for more information on this diagnosis.

VV: What should practitioners know before taking on clients with DID symptoms? Imagine that you are a technical director. and you are setting up a case plan for a practitioner.

Aerial: Practitioners taking on clients like these should be very well experienced and advanced Applied Metapsychology facilitators and/or have some prior training in DID. I wouldn't say that TIR Facilitator training is sufficient. They would need Certified Applied Metapsychology Facilitator training. It would be better if the facilitator is a mental health professional who is already trained in DID as part of his or her background.

It's too complicated to do TIR on DID people as a general rule. I have only taken on clients who had quite a few years of DID therapy and wanted to handle their traumas. Even as an advanced Applied Metapsychology practitioner, I have referred out several clients with DID symptoms because they didn't have the ego strength to do TIR and I didn't feel I could serve them.

What is Dissociative Identity Disorder?

Recently considered rare and mysterious psychiatric curiosities, Dissociative Identity Disorder (DID) (previously known as Multiple Personality Disorder-MPD) and other Dissociative Disorders are now understood to be fairly common effects of severe trauma in early childhood, most typically extreme, repeated physical, sexual, and/or emotional abuse.

In Diagnostic and Statistical Manual of Mental Disorders-IV, Multiple Personality Disorder (MPD) was changed to Dissociative Identity Disorder (DID), reflecting changes in professional understanding of the disorder resulting from significant empirical research. "Personality" is no longer used to describe these entities. Other terms often used by therapists and survivors to describe these entities are: "alternate personalities," "alters," "parts," "states of consciousness," "ego states," and "identities

(From: The Sidran Institute www.sidran.org)

VV: What kind of results have you achieved with clients who have DID symptoms?

Aerial: I've only had three clients who told me they were diagnosed with DID. Since I don't diagnose, I cannot confirm that there were more. The results that I've had have actually been fairly positive. Two of them that I saw reached what I call "full integration". These clients had already had years of psychotherapy. They were at the point where they could stay centered and be the witness or controller of their other identities.

VV: From the DID theory I've read, a typical person has four or five identities and one of them is usually a "helper"...

Aerial: Well, there is one that they center in and that one helps handle all the others. They have to have a place to center or they get lost. Usually in prior therapy, they've already been able to ascertain which persona or identity they can center in to help them with the work. Then we just ask them from that point of view, to talk to the other identities and ask, "Who is willing and ready to step forward to handle some of their traumas?" Someone always steps forward and is eager for healing. Whoever is the first identity to step forward is the one that we take (because that identity is the one most accessible). I treat that identity as I would treat the client and find the traumas that could have caused the "split".

VV: So you look specifically for the trauma which precipitated the split?

Aerial: I usually ask for traumas because it's sometimes too hard for an identity to find "the trauma". I have to work backwards just like I do with a regular client. I take incidents closer to that identity's present time and then go earlier as the client's ability to confront comes up. We either take themes with Thematic TIR or we'll use Basic TIR. and ask for a specific trauma that could have caused the split.

VV: Are there any ways in which the DID clients differ from those with typical PTSD issues.

Aerial: Yes, I've had to be very, very careful at the end of the session to make sure that everybody (meaning all the identities) is OK. Sometimes when working with one identity, it will reactivate upsets and trauma in other identities. I check with all of the parts involved to make sure that nobody else has gotten reactivated, that they are all OK. Whereas with a typical non-DID client, you know when you've finished the trauma that they go away resolved. The client gets their end point and they are fine with it. In the DID client, it's like having several people in the room. I would check with those other identities (parts) that are there to make sure nobody else has been reactivated.

VV: And how do you handle it if they are reactivated?

Aerial: I don't necessarily use TIR with them. We will do run some other kind of lighter technique to get them into present time. This insures that they all leave session feeling released and resolved from that session. When they are ready, we'll take up their trauma from their point of view.

VV: I gather that memory loss or amnesia is a big part of DID. Do you find these clients recovering a lot of lost memories?

Aerial: Actually yes. When an identity remembers a particular time period (for example ages 8 to 10), that time period has often been occluded from the whole. When TIR is used to help that identity resolve the charge and regain conscious memory of their trauma(s), then those memories are available to all the other parts. That's the beauty of the integration.

VV: What unique challenges are there for working with DID clients either with TIR or in general?

Aerial: It's like having five people in the room, not just one. You've got one person that's the leader and he or she is helping you with the others. It's a little more challenging I believe in that respect: keeping track of who is speaking and making sure that the client stays really focused. You don't want to be talking to somebody else all of a sudden. You really need to have a client who can manage this kind of work.

VV: How do you handle it when clients "switch" in the middle of an incident?

Aerial: I find out who is talking to me. I ask, "Who is speaking to me?" They know who they are and they identify themselves. I just treat it like an origination from an ordinary client. I might ask, "Is there anything you need to say?" or "Tell me what happened?" Someone might have gotten upset and I sort it out. So I would handle that and go back and finish what we were doing with the original identity I was working with prior to the upset.

One of the things that happens also using TIR with DID clients is that it promotes a tremendous amount of compassion and understanding from the other parts. They're watching this 8 to 10 year old go through their trauma and come out the other end. All of a sudden, there's more connection and that's part of the integration. It creates understanding with the other parts: "Well no wonder", they'll say, "look what happened here with little Joe". TIR raises conscious awareness and promotes integration.

VV: Have your clients experienced a loss after their parts had been integrated?

Aerial: When we got to the point where all of these identities or parts were integrated, the person became whole. So there was nobody to talk to anymore. It was very strange for the client since they were used to having quite a bit of internal chatter. Their world became quiet and lonely. I handled this by Exploration and allowing them to talk about it. I also used some Grounding Techniques.

VV: It wouldn't go so far as to be a grieving process?

Aerial: It would depend on the client. With the DID clients I worked with, it was just the strangeness of it and having a chance to be able to talk about it was enough to heal it.

VV: Do you ever need to take the other parts through the same incident?

Aerial: No, because it wasn't their experience. I may have to handle their upset about it, but I don't have to take them through it. As a caution, one of the things that might happen is that some of the identities are in conflict. For example, a critical adult and another identity that has a more childlike viewpoint might become at odds with each other. The adult keeps trying to tell the other one what to do all the time. That creates complications. You want to handle the ability of the different identities to communicate with each other before you ever address trauma. They have to be able to at least tolerate and respect the fact that there are other parts there.

VV: Do you have some method of building up understanding between parts?

Aerial: It is very much like group counseling or relationship counseling. With the DID clients helped, they had gone through a lot of prior counseling and their identities had resolved much of their conflict prior to our sessions. One of the things from TIR that happens which promotes understanding is that it is a tremendously freeing thing for them too to realize why an identity was set up. When they go through the trauma, they become aware of why that identity was set up. There's some need that wasn't being met, such as safety. Behind each identity is an intention or reason why it was set up and assumed.

VV: Part of the TIR theory is that there is intention that you are trying to fulfill and you carry it around because couldn't complete it. Is the intention most often to be safe?

Aerial: Well of course that's a very basic thing in trauma: to be safe. It could even be to have peace. Sometimes there are chronic traumatic patterns. People go along and they reach a breaking point. Chronic traumatic patterns can be addressed with TIR also and I have used TIR on an entire time period using TIR or unlayering (repetitive techniques).

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