The Phrase My Therapist Said That Helps Me Cope With Dissociative Identity Disorder

Tears were silently pouring down my face, soaking the front of my dress as I gasped for air, choking on emotions that felt too big. Every few seconds, my upper body spasmed and my shoulders jerked as though I was experiencing a case of the hiccups, my body reacting to a trauma memory that threatened to consume me. My therapist put both hands in front of her and asked me to choose which side represented the past and which the present. I was skeptical, but selected the left as the past. Someone inside said, “Why is she making us do this?” and I said, “I don’t know, but I wish you would be quiet for two seconds.”

I have dissociative identity disorder (DID) and having parts (or alters) speak up inside or take over the body is an all day, every day thing. Some days I complain because the constant dialogues feel oppressive, but when it’s quiet, I miss them. After all, DID is a a creative strategy my brain developed to help me/us survive abuse that began in early childhood. At this point in my recovery, I’m grateful to all my parts and I no longer reject them.

“OK, watch my hands,” my therapist said, as she brought her hands together in the center of her body and then proceeded to slowly move them apart as though parting a curtain. Her palms cupped the air purposefully and I imagined she was pushing back against the memory that, moments before, flooded the room. A couple of times she called me back, reminding me to keep watching her hands, tracking my response in the calm and fully present manner she has. It was hard not to be lulled into dissociation, something my brain does out of habit, particularly when feeling emotions and being confronted by painful memories. With her left hand tucked behind her back and her right one facing me palm-forward, she softly said, “That was then, and this is now.” Her hand seemed to float on its own with a serene certainty as I fixated on it, this time not looking away. “That was then, and this is now.” There was a pause as she allowed space for those words to sink in. A peaceful stillness seemed to fill the room and reach inside of me, if only briefly.

A few minutes before this, I had just shared a trauma memory. But as usual, it didn’t feel like a memory, it felt real in the here and now. After all, shouldn’t a memory feel more distant, something carefully stowed away you get to pull out of and reflect on when it feels like the right time to do that? Isn’t a memory something you can choose to consider, rather than something that consumes you? Unfortunately, trauma memories have a sneaky way of making the past feel present, overriding the nervous system and making us feel we are in immediate danger. Little did I know, “That was then and this is now” would become a mantra of sorts any time I felt a memory or flashback start to well up inside me. Does it always work? No, but it’s a start. It’s skills like this that are slowly but surely helping me to feel more grounded. When I first began doing somatic experiencing and trauma work with my therapist, I don’t know if I fully believed any of what I was doing with her would help me. I don’t even know if I realized how much help I needed. But I desperately needed help.

What does it look like or feel like to be caught up in a flashback? It’s so hard to put into words. Anyone who has experienced it knows immediately what you mean, but how to convey it to people who have never experienced it is difficult.

One particular experience where I was so overtaken by intrusive memories (which for me, include emotions, physical sensations and other sensory inputs) as well as the pain and confusion of disorganized attachment, happened last April and sticks with me to this day. I had been having a terrible week, trying to keep going even after one younger part shared an extremely upsetting sexual abuse memory. For me, sometimes memories can build inside for quite awhile before they fully surface. It’s almost like I can sense them coming, or rather, some parts feel them and start reacting to them — some dying to be free of the burden of them and others recoiling and pulling back with shame. For weeks I had been showing up early to my therapy appointments and staying in the waiting room until my therapist was done for the day. I didn’t really know why, I just knew it was the only place I felt safe. I couldn’t tolerate being away from my therapist. What if something happened to us? What if something happened to her? I had to stay close. The week this trauma memory emerged, everything peaked. Looking back, I’m not surprised how everything unfolded because things had been building up.

The day after the session where this particular trauma memory was voiced for the first time by one of the younger parts in our system, I had an appointment with my psychiatrist early in the morning. She had no knowledge of what was shared in my therapy appointment and there was no way any one of us was going to tell her. We were still pretty untrusting of her at this time. She knew something was wrong, but we shut down, refusing to believe she could possibly help. I was also rapidly switching, which happens when my system is  flooded. I ended up getting badly triggered, by what I’m not sure, and ended up running from her office, dissociated from my body, legs carrying me as if on their own to my therapist’s office.

I was hours early. I had no sense of time. My body was shaking and I was crying so hard, my head and stomach hurt. I faded in and out, at times not knowing where I was. Other times, I’d “wake up” and notice my therapist opening her door to wave someone in. Time
and memory seemed to be joining forces to torment me. One minute I was thrown back someplace distant, threatening and inescapable, the next wrapped in the security that, in this second, I was safe in my therapist’s office and as long as time stood still, I would be safe forever. Were people coming and going? Didn’t my therapist just wave someone in? How many times had she opened the door? Did she open the door? How much time had passed? Why was this happening to me?

Suddenly, I snapped to attention when I saw a therapist I knew, someone I see once a week to work on dialectical behavior therapy (DBT) skills and for extra support, enter the waiting room. Hours must have passed already. This therapist originally started connecting with my primary therapist to discuss how I was doing, but then started seeing her for supervision for somatic experiencing work. I wasn’t happy about this; parts of me felt very threatened and betrayed by this. I had expressed these feelings and concerns a bit, but also stuffed them down because I felt no one was listening or cared. I know both of these people care for me/us very much, but in this moment, only what I felt in the past — terror and helplessness — felt real.

This particular day, stuck in a perpetual flashback, I felt in desperate need of help. When my therapist waved this particular therapist into her office, I felt completely abandoned and unseen, but more than that, I felt in danger. I couldn’t see at the time how the past was altering reality, distorting my perceptions.

How could they leave me here? How could they let this happen to me? How could they not help? Didn’t they see I was suffering? Didn’t they understand what had happened to me? How could they just let it happen? I was going to die. I felt like dying. I was flooded with emotions, sensations and memories.

The room fell away. I needed help. I needed help now. I was only a small child. I curled up on the bench crying and shaking. I didn’t see any of the other therapists or clients coming or going. I was somewhere else completely. At one point, I started pacing by my therapist’s door, wanting someone to know I was there and let me in. How could they do this? Another part eventually took over, determined to get help, wanting them to know. They knocked on the door. No one answered. They kicked at the bottom of the door with their foot. Eventually in total despair, they fell against the door. The door shook. We could hear the sound from the door, but it sounded far off, too far away for anyone to hear it and know we needed rescuing. The part that was out sat down on the bench. “No one is coming,” someone said. “I can’t take that anymore,” someone screamed. A very young part cried, “We are going to be in trouble. I’m scared.”

My therapist came out of her office in what must have been seconds, but what felt like hours. Was she finally coming to save us? Instead, she told us we would have to leave and come back if we couldn’t be quiet. All we saw was her standing in the doorframe looking scary and mean, towering over us. All we heard was her telling us to go and not come back. She didn’t love us. We couldn’t move. We couldn’t think. We didn’t understand. Someone denied kicking the door. Someone else said they did, but they only knocked quietly. Someone else said they did make a noise, because we needed help and how dare everyone leave us here. Some parts were confused, lost as to what was happening. Internal chaos.

We fled to the bathroom and locked ourself in a stall, sobbing and dissociated. We were dying. It was happening again. I don’t remember what happened next. I’ve only been able to piece things together from the bits and pieces other parts have told me, from my therapist, from other people in the office who were there. Even now, pieces of this day get all tangled up.

My session that afternoon was one of the most painful ones I’ve ever had. I don’t remember everything that happened, but I do remember how I felt. My therapist asked me if I was angry. I yelled, “Yes!” and began crying and hyperventilating. She said, “I know,” with great empathy in her voice. She had me slowly and intentionally hit a cushion, releasing some of the trauma stuck in my body in a safe way. I wanted to rage. “You have every right to be angry. What happened to you in the past was not OK!” my therapist said as I choked on tears and fought back urges to tear the pillow into hundreds of pieces. I was exhausted.

The intense flashbacks and body memories continued that night. We ended up having an unplanned session the next day to further work on the material that was coming up. It was a difficult point in therapy and one I didn’t think I’d get through. I was worried my therapist would give up on me and I couldn’t imagine not working with her. “We’ll get through this. Months from now, you might even see the significance of this and what healing can come from this,” my therapist said. I wanted her to be right, but I was terrified nothing would ever be the same again.

And things did change after this. For one thing, my therapist established a boundary where I couldn’t arrive at the office more than 30 minutes before my session or stay longer than 30 minutes after a session. It felt like the end of the world. I thought she was punishing us. I was humiliated. We must be bad. She said if I couldn’t follow those rules, that would suggest I needed inpatient care somewhere there were experts in DID and trauma. I thought she was threatening us. But now I know she was protecting and caring for us in a way I struggled to do for myself. She was safeguarding our relationship too so we could keep working with her. I get emotional every time I think back to this time. I can finally see how much of the past was over-coupled with the present.

It’s not always possible, but dual attention is what we’re aiming for. This means I neither dissociate the pain of the past or relive it in the present, but instead recognize that was then and this is now, and in the now, I am not in the same danger I was. And even though I might have emotions and sensations surfacing, telling me I’m not OK, I can recognize the purpose they serve and know I can work through them in therapy because that was then and this is now. And in the now, I am safe.