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Using energy psychology with Dissociative Identity Disorder
Phil Mollon writes: Over twenty years ago, working in a psychiatric setting, I began to encounter one or two patients suffering with a Dissociative Identity Disorder [DID]. This is a condition, usually resulting from severe and repeated childhood trauma, in which the normally integrated and communicative processes and parts of the psyche have become dissociated. Different personality states and behaviours may appear at different times, sometimes with separate distinct identities and names. The different parts may express quite different attitudes, beliefs, mannerisms – and basically appear like different people inhabiting the same body. Work with such people can seem like family or group therapy but with just one physical body.
Some degree of dissociation, in terms of detachment, withdrawal, or compartmentalisation of experience, is a very common response to sustained childhood interpersonal trauma, such as extensive sexual abuse. The more extreme form, of DID [which used to be called Multiple Personality Disorder], is not common, but nor is it entirely rare. It is a means of coping with extensive emotional damage that otherwise would have rendered the person non-functional. The damage is sealed off in compartments within the mind. This protective survival strategy can often work well for a number of years, but may gradually break down. Then, for example, a seemingly successful professional person may suddenly have the experience of feeling like a frightened and confused small child whilst in their work environment. DID is a hidden form of severe developmental post-traumatic stress disorder – the traumas, and the ways of dealing with them, through withdrawal, compartmentalisation, and pretence, have become structured into the developing personality system. In addition, in identification with the original perpetrators of abuse, the person may have, in part, turned against the self – and thus the original traumatic situations are continued internally.
There can be varying amounts of awareness between the compartmentalised parts of the mind. Some people may be aware that they have a multiple personality system. Others may have only partial awareness. Within the same person, some personality states may have a broad awareness of the internal system, whilst others have none. Typically there are traumatised child states, adult coping states, and a variety of parts with various functions within the system. These different parts may be manifest either in terms of taking over executive control of the body at different times – i.e. appearing in the outside world as a particular identity – or by internal hallucinatory voices. During the course of a psychotherapy session, there may be sudden shifts from one personality to another, with radical changes of voice, bodily demeanour, attitude, beliefs, and memory.
At the time when I first saw one or two such patients, there was basically no British literature on the subject, although some American books. I found out as much as I could, studied the area deeply for some years, and eventually wrote the first UK book on clinical work with DID. It was called Multiple Selves, Multiple Voices. After it was published, I often received letters from other psychotherapists whose clients had shown these problems. Certainly some partial understanding of the nature of dissociative states was emerging. However, over the years subsequently, I became disillusioned with the possibilities of helping people with DID. My experience told me that these conditions were often extremely complex and that therapeutic work was hazardous. Although people with DID were often suffering greatly and in need of help, psychotherapy, even of a gentle and cautious nature, could sometimes stir up more problems. For a person with DID, even talking about their inner world of dissociation and traumatic experience could be further destabilising. Furthermore, the worries about fostering 'false memories' of childhood experience added to the anxieties of such work – even though the aim was never one of crude 'memory recovery'. Gradually I began actively to avoid work with people with DID, even though they would still sometimes come my way. I felt I simply did not have the personal resilience for such difficult and psychologically demanding therapeutic work – although I know that some colleagues around the country do undertake this kind of psychotherapy with some success.
More recently, as I have learned to use energy psychology methods, I have become cautiously optimistic about the possibilities of helping some people with DID. Before describing how energy psychology modalities may be applied, I would like to mention some general principles and cautions regarding work with DID or other severely dissociative conditions.
Having emphasised these cautionary points, I can now explain my impressions so far of how energy psychology methods can help. Basically, the use of tapping or other energy modalities is soothing, helping to reduce tension and terror within the client's system. This can at times be done in a non-specific way – just tapping sequences of points without any particular focus. Ordinary EFT points can be used, or, if the practitioner is able to sense sequences of points (as with TFT), then these can be applied. As the client becomes used to this procedure, he or she will experience increased confidence that anxiety and trauma can be contained. This will enhance feelings of safety, especially if there is no pressure from the therapist.
I have found it sometimes helpful to suggest that we can tap with the aim that any of the personality parts may make use of it in any way they choose. This is followed by tapping without words – a process that is calming because it is often words that stir up emotion and anxiety. It probably works best if the therapist has become able to sense sequences of meridians – i.e. being able to sense the flow of energy through the client's meridian or chakra system. This skill comes with practice, especially if built upon a basis of knowing the TFT method of diagnostic muscle testing for meridian sequence.
One important possibility to be alert to is that where a person has a background of extensive violence in childhood, tapping (especially on the head) may take on the meaning of abusing the self – bashing oneself on the head. For such people, holding the points, in a 'touch and breathe' manner may be more helpful.
As the client begins to explore and talk about external and internal sources of anxiety, he or she can be guided to tap – so that the anxiety and distress that begins to emerge is continually countered by the energy tapping. In this way, the negative affect is kept at a manageable level.
Although specific traumas can be addressed, if the client is able to tolerate this, a better way is often to combine multiple traumas, using phrasing such as “all the traumas suffered by X”, where X is a particular part of the personality – or “the most significant trauma behind what I am feeling at the moment”. Words can be used in this way to target traumas, or patterns of traumas, without evoking particular events in full awareness in ways that would be too disturbing.
When working with these modalities, the mind-body-energy system does start to shift. The client may report an awareness of another part pressing for expression – in the form of an internal voice, or a physical sensation, or involuntary body movements, or sometimes in the form of mounting panic. At such times it can be important to have the person keep tapping, perhaps without words. As internal tension begins to lessen, the person becomes more open to hearing communication from dissociated parts.
Sometimes a client will fight against the pressure to communicate that is coming from a dissociated part – as if regarding this other part as an internal enemy. For example, one client declared angrily that 'she' has always wrecked her relationships and that therefore the client wanted rid of 'her'. At such times, it can be important to point out the obvious – that the dissociated part is an aspect of the person as a whole. The dissociated part may be very angry at having been used as a dump for all the pain and distress of traumatic experiences that were disowned by the 'main' personality (although in severe cases there is not a 'main' personality). It is the therapist's task to acknowledge the valid and legitimate perspectives, agendas, and aspirations of the different parts of the system – just as would a family therapist or an 'honest broker' working with warring factions at a peace table. Commonly, one part of the client may assert that a particular abusive event took place, whilst another part insists that it did not. Almost never is the therapist in a position to know the truth of a client's historical experience – and it is wise for the therapist to stand firm on this solid ground of uncertainty.
The client can learn to use EFT, or other simple methods, to regulate affect and reduce anxiety and panic when alone. Energy methods are excellent self-help tools for affect regulation.
If the client is comfortable with muscle testing this can be invaluable in guiding the work and in providing clear answers to hypotheses and questions, such as whether a particular issue is the priority to address, whether a part of the personality is willing to be healed, or whether a constellation of perturbations have been cleared. Enabling the body to speak, through muscle signalling, can provide a crucial additional source of information. The only important caution is not to assume it is entirely objective or fool-proof.
None of the energy modalities replace the need for experience, skill, and knowledge in work with those who have suffered extensive childhood trauma. All the other usual aspects of a psychotherapeutic encounter remain relevant – but the addition of energy methods does seem to make the work easier, and thus enhance the therapeutic possibilities for those who suffer from the potentially very disabling condition of DID.
Phil Mollon is the developer of Psychoanalytic Energy Psychotherapy.
Mollon, P. 1996. Multiple Selves, Multiple Voices. Working with Trauma, Violation, and Dissociation. Chichester. Wiley.
Mollon, P. 2002. Remembering Trauma. A Psychotherapist's Guide to Memory and Illusion. 2nd Edition. London. Whurr.
Mollon, P. 2005. EMDR and the Energy Therapies. Psychoanalytic Perspectives. London. Karnac.
Mollon, P. 2008. Psychoanalytic Energy Psychotherapy. London. Karnac.
Sinason, V. 2002. Attachment, Trauma and Multiplicity. Working with Dissociative Identity Disorder. Hove. Brunner-Routledge.