Coping With Trauma Related Dissociation
This document contains all of the exercises and advice written in Coping With Trauma Related Trauma, a book I’ve been working with in therapy for over a year and find very useful so when I got a PDF copy of it I decided to share it! I did my best to organize everything but since it's copy/pasted straight out of the PDF parts of it might seem confusing so feel free to copy the document and edit it yourself!
Here is the the full copy of Coping with Trauma Related Dissociation
I decided to make this public because the book can be hard to come by and you’d get the most use of it with the guidance of a therapist but it still has a lot to offer. Please be mindful of how you use it as a lot of the content can be very confronting (I got my first migraine while reading the first 3 chapters) but casual browsing should be fine.
Here’s the disclaimer made by the authors:
“We strongly recommend that you use this manual only in the course of individual therapy or in a structured skills-training group run by trained clinicians, so that you will make the most of your experience and will receive adequate support. This manual is not intended to be used by yourself when you are not in therapy, although some content may be helpful. “
• Notice three objects that you see in the room and pay close attention to their details (shape, color, texture, size, etc.). Make sure you do not hurry through this part of the exercise. Let your eyes linger over each object. Name three characteristics of the object out loud to yourself, for example, “It is blue. It is big. It is round.”
• Notice three sounds that you hear in the present (inside or outside of the room). Listen to their quality. Are they loud or soft, constant or intermittent, pleasant or unpleasant? Again, name three characteristics of the sound out loud to yourself, for example, “It is loud, grating, and definitely unpleasant.”
• Now touch three objects close to you and describe out loud to yourself how they feel, for example, rough, smooth, cold, warm, hard or soft, and so forth.
• Return to the three objects that you have chosen to observe with your eyes. As you notice them, concentrate on the fact that you are here and now with these objects in the present, in this room. Next, notice the sounds and concentrate on the fact that you are here in this room with those sounds.
Finally, do the same with the objects you have touched. You can expand this exercise by repeating it several times, three items for each sense, then two for each, then one, and then build it up again to three. You can also add new items to keep your practice fresh.
Examples
• Sight: Look around the room for something (or even someone) that can help remind you that you are in the present, for example, a piece of clothing you are wearing that you like, a particular color or shape or texture, a picture on the wall, a small object, a book. Name the object to yourself out loud.
• Sound: Use the sounds around you to help you really focus on the here and now. For example, listen to the normal everyday noises around you: the heat or air conditioning or refrigerator running, people talking, doors opening or closing, traffic sounds, birds singing, a fan blowing. You can remind yourself: “These are the sounds of normal life all around me. I am safe. I am here.”
• Taste: Carry a small item of food with you that has a pleasant but intense taste, for example, lozenges, mints, hard candy or gum, a piece of fruit such as an orange or banana. If you feel ungrounded, pop it into your mouth and focus on the flavor and the feel of it in your mouth to help you be more here and now.
• Smell: Carry something small with you that has a pleasant smell, for example, a favorite hand lotion, perfume, aftershave, or an aromatic fruit such as an orange. When you start to feel spacey or otherwise not very present, a pleasant smell is a powerful reminder of the present.
• Touch: Try one or more of the following touch exercises that feels good to you. Touch the chair or sofa on which you are sitting, or your clothes. Feel them with your fingers and be very aware of the textures and weight of the fabric. Try pushing on the floor with your feet, so that you can really feel the floor supporting you. Squeeze your hands together and let the pressure and warmth remind you that you are here and now. Press your tongue hard to the roof of your mouth. Cross your arms over your chest with your fingertips on your collar bones and pat your chest, alternating left and right, reminding yourself that you are in the present and safe.
• Breathing: The way in which we breathe is crucial in helping us to be present. When people dissociate or space out, they are usually breathing very shallowly and rapidly or hold their breath too long. Take time to slow and regulate your breathing. Breathe in through your nose to a slow count of three, hold to the count of three, and then breathe out through your mouth to a slow count of three. Do this several times while being mindful of how you breathe. Notice whether there are already ways in which you ground yourself in the present.
You can expand from the exercise above, to be present in the here and now, and tailor it to your specific needs. Practice this exercise in your own home, finding anchors to the present in each room. Always begin this exercise when you are rested, preferably during the day, as light helps you stay more present. In fact, all new exercises should be practiced at times when you are at your best, because this is when you are most able to learn from them. Once you become more practiced, it will be easier to employ them when you are stressed.
Walk around your home and in each room concentrate on the various things you can see, the sounds you hear, the smells you can smell, the things you might taste in the kitchen, the things you can touch or hold. What is important is that you find things that are neutral or pleasing to experience, that is, to see, hear, touch, and that connect you to the present.
For example, look at a picture or poster on the wall, listen to music that you like, taste something pleasant from the kitchen, and so on. For each room, choose three things you can see, hear, feel, or touch. Consider whether you might want to make a written list of these anchors to have available when you need them, because people often forget to use their anchors when they are under stress. You may even ask someone to record a list of these things for you on audiotape, so you can listen to them when you feel stressed. The point is for you to concentrate on objects that help you to realize that you are in the present, and for you to have these available when you need to ground and orient yourself in the present in your home. Thus, every room of your home should now have anchors, familiar places or objects that ground you and remind you to be present.
When you are having a hard time, use these anchors repeatedly to help keep you, and all parts of you, in the safe present. You might even want to buy a little something for yourself that reminds you of being in the present and give it a special place in your home, for example, a photo, a stone, a statue, anything that may help you or parts inside to connect to the present. Every time you look at it or pick it up, you remind yourself that this object is from the present and you are here and now with it. Some parts of your personality may find different items more important or helpful for grounding than you do. And some may not like something you choose.
For example, some parts who experience themselves as younger may want to have something that adult parts may believe is childish. Yet it is often these young parts that have the most trouble staying present and need help in doing so. Try to be inclusive and respectful, so that all parts of yourself get what you need to feel safe and comfortable.
When you have posttraumatic stress symptoms, it is important to learn how to reduce your stress and feel calmer and more present. The exercise that follows, or a variation that you create yourself, may be helpful to you. You will need a stress ball, also sometimes called a squeeze ball—a small soft ball that fits in the palm of your hand and which you can squeeze. These are very inexpensive and are readily available in a wide variety of stores or online. You will also need a small object to hold in your hand that represents healing and calm for yourself. Perhaps this may be one of your anchoring items, which you developed earlier, or a rock, a stuffed animal, a book—whatever you can hold in your hand and that feels right to you.
Find a position that feels comfortable, preferably sitting or standing, both feet on the floor. If you are standing, place your feet slightly apart, in line with your shoulders and keep your knees slightly bent, that is, do not lock your knees. Begin the exercise by holding a stress ball in your nondominant hand (for the right-handed person, this is the left hand and vice versa). Concentrate your attention on your nondominant hand. Squeeze the ball as hard as possible while you imagine that you are letting all the tension and unpleasant feelings converge from all over your body and begin to flow toward your arm, down your arm, down into you hand, and then flow through your hand into the ball. You can visualize the ball as working like a magnet, drawing all the tension towards it, through your shoulder and your arm, your hand and fingers. Watching the ball and noticing your squeezing motions may help you stay focused and present. When the ball is saturated like a sponge with your tension and unpleasant feelings, you can open your hand and let go of the ball, allowing all your tension to be held in the ball, away from you.
As soon as you let go of the ball, the tension leaves it and dissipates into the air, disappearing from the room. You can practice this exercise several times until you feel that all negative tension has been released out of your body. You might remind all parts of yourself that they are also welcome to use the ball to release their tension, too. When you feel calmer and less stressed, let go of the ball one last time and turn your attention to your dominant hand (that is, the hand that you use most often; for most people, this will be the right hand), and follow the suggestions below.
Choose an object that you can easily hold in your hand, and which symbolizes a sense of well-being or healing for you, perhaps one of your anchors to the present. Hold this object in your dominant hand. Imagine that this object holds all the well-being and healing that you need: a sense of safety and contentment, of peace and calm, of mental and emotional clarity, free of tension and conflict. Now allow these feelings of well-being and healing to radiate warmly and gently from the object through your hand, your arm, your shoulder, all through your body. Allow it to gently flow through your body, your mind, and your heart. All parts of you can take in this well-being and healing in their own way, in a way that works for them. With each breath in, allow more well-being and healing to flow through you. With each out breath, let any remaining tension go. Whenever you wish to remind yourself of this sense of well-being, your dominant hand can automatically recall the feeling of the object, its shape and texture, its temperature and color, and you can fully experience those positive feelings and sensations of well-being and healing once again. As you practice more, your dominant hand can almost automatically close as though holding the object of your healing, and at any time you wish or need, you can once again experience that sense of well-being and healing
Using the section above and Homework Sheet 8.1 as guides, you can practice developing an inner sense of safety and a safe space now. In group, you can help each other as desired, and you may use your group trainers as resources as well.
a. First, describe a situation in which you can experience a moment of inner safety and/or calmness. Would it be at home alone, with another person, outside in nature, listening to music?
b. Next, allow yourself and all parts of you to experience that inner sense of safety. Describe your experience of it, that is, your thoughts, emotions, sensations.
c. Notice what, if anything, disrupts your inner sense of safety and describe it below. Is it a thought, a feeling, a sensation, a shift away from being present? Is it another part of you that is not yet able to share in this sense of safety in the current moment?
d. Imagine that experience of inner safety now and notice again what it feels like.
e. Try to create moments of inner safety every day. Regular practice improves your ability to create your inner sense of safety.
Sit or lie down somewhere quiet and pleasant and breathe quietly, closing your eyes safely. Remind all parts of you that you are safe and that you are working to help each part of you feel better. Invite all parts to participate. If some parts do not wish to do so, they may watch from a distance or go to their own safe place. Gradually direct all parts of you that want to participate to an imagined scene. This place is a quiet and safe spot in the open air with beautiful scenery, just the right temperature, in your favorite season of the year. And around you, you see magnificent trees, resplendent in their green finery. Look around slowly for a tree that appeals to you, one that almost seems to invite you to become acquainted. Perhaps it is a tree standing alone, tall and proud, or perhaps a tree in a forest, one of many in a wise and strong community of trees. Your tree may be short or tall, fat or thin, young or old, firm or willowy.
Take your time to choose your tree and remember that you can always change to another tree if and when you wish. Some parts of you may want to choose different trees, each having their own, and of course, this is just fine. Once you, all parts of you, have a clear image of your special tree, take your time to examine it carefully. Notice its shape and texture, its warm wood scent and palette of colors. Become aware of the branches spreading out to shelter you, the leafy, soothing green that extends an invitation for you to relax and rest. Take your tree in until it becomes a natural memory, indelible in your mind. Walk up to your tree and get acquainted. Begin by exploring the trunk and all its nooks and crannies. Run your hand over the bark. Notice any knotholes or hollows. Put your arms around your tree; notice if you can get your arms right round it, or whether it is so thick you cannot encircle it. Lean up against your tree. Feel its strength, solid and unyielding, protective and grounding.
If you wish, you can sit under your tree, with your back comfortably against it, with confidence that it will support you no matter how hard you lean. Now notice that your tree is not standing on its own. It has powerful roots that go deep and deeper, and deeper still into the earth, anchoring it to the ground, and drawing sustenance up and up, all through the tree, to the tiptop. Your tree is always grounded and dwells in the present, its rich history inscribed in its rings, and its branches ready for the winds that blow. It fears neither fair weather nor foul, bending with the storm, swaying with the breeze, resting under the heavens when all is quiet and still. In rain and wind, sun and snow, storm and showers: always steady and grounded. Feel this stalwart and faithful presence in your mind, in your body, and in your heart. Let you and all parts of you feel rooted to the earth with your tree. Let you and all parts of you feel the power and strength, the grounding and readiness to meet what is, and what shall come, unwavering and constant. Let yourself feel the power of your tree with its enormous root system, connected to the earth. Now draw your attention upwards, to the branches and boughs, to the limbs and leaves. Each branch is unique, each weaving with the other to design beautiful foliage that is never exactly the same from day to day and year to year. The leaves take in light and create energy. They provide you with shelter and shade, safety and soothing, their gentle rustle a pleasant sound in your ears. The play of shadow and light as the branches move is pleasant to your eyes, giving you a sense that all is right with the world. You may even want to climb your tree and sit on one of those branches, gleefully swinging your legs or thoughtfully surveying your world from up there. Perhaps you take a nap in the shady haven of your tree. It is a good, grounding, safe feeling, being with your tree. Your tree is a refuge where birds may safely nest, small animals may shelter from the elements, where a tree house might be built, or a swing hung from its boughs. It is a hideout that no one can see, that is just for you, where you can retreat whenever you wish. The strength and beauty and peacefulness of your magnificent tree give you a feeling of protection and sturdiness. You, and any parts of you, can go there whenever you like; you can picture it in your mind and look at it, lean against it, or hide in it, as you wish or need.
Imagine a beautiful pool of water with just the right surroundings. Perhaps you discover it in a quiet forest, or nestled in the mountains, or in the midst of a meadow. The air around it is fresh, clean, and just the right temperature for you. The season of the year is your favorite. Perhaps it is spring, with all living things blooming and growing. Perhaps it is summer, lazy and languid. Or perhaps it is autumn, cool and crisp. Or perhaps it is winter, a soft blanket of white on the ground. The water is beautiful, inviting. Perhaps it is still, gently fed by deep springs, reflecting back to you the sky or trees above. Perhaps it is flowing and bubbling, at the bottom of a waterfall or fed by rivers or streams. It may be shallow or deep, or both at once. It is pleasant to watch, its freshness smells joyful and clean. So pleasant that you feel almost drawn to its safety and soothing. The sounds around you are delightful: rustling trees or meadow grass, the bubble and babble of water, happy little animal sounds, and birds calling out joyfully. Notice what is right for you. Take your time to notice your pool, its shape, its surroundings, its depth, whether there are little fishes or just clean, fresh water. Perhaps it is a shimmering blue or sparkling green, or clear as a crystal. The light dances and skips across the water and back again to you, inviting you to take it all deeply in.
This water calls you to relax, to feel utter and complete contentment and safety. It is healing water, the kind that soothes the sorest body and satiates the thirstiest soul. It refreshes the worn-out mind, a balm for wounds of the heart. When you are ready, allow all parts of yourself to explore your pool and take in its healing energy. Perhaps some parts of you would like to sit thoughtfully next to the water, while some might dangle their feet, their toes dabbling in the water. Some might get in and sit or even float. In fact, you become aware that the water in this pool is the most special you have ever encountered. It buoys you up so you cannot sink. It supports you as you sit, as though you were leaning back into loving arms. It nurtures and soothes, calms and restores, filling you with a peace and a lightness so sweet and splendid that you take it deeply within yourself, to each part of you, to every nook and cranny of pain and stress and sorrow. Let your tension and fear, your burdensome shame and worries be drawn from you to the water and carried away. Let the water surround you, flow around you, refreshing, relaxing, restoring every part of you. Let the water surround you, flow around you. Feel it soothing your body, your mind, your heart. You may remain as long as you like, until every part of you can feel its gentle healing power.
This is your pool, where all parts of you can come as they please. It is your special place of healing and hope, soothing and safety, relief and release. It is yours and yours alone to have within you, a wellspring of well-being. If it is hard for you to use imagery for relaxation, try this exercise:
Sit or lie comfortably. Take a deep breath in through your nose to a slow count of three, hold for three counts, and breathe out slowly through pursed lips for three counts. Repeat three times. Now take in a deep breath and tighten every muscle in your body as tight as you can from head to toe, hold to the count of five, and let go, breathing out as deeply as you can and intentionally relaxing your muscles as much as you can. Repeat the three deep breaths from the beginning of the exercise. Then again take in a deep breath and tighten all your muscles for the count of five, let go and relax, repeat the three deep breaths. Continue until you feel physically relaxed.
The following exercise is a well-known technique that might help you gradually relax your entire body. When you are anxious or fearful, your body becomes tense and you may experience symptoms such as pain in your neck, shoulders, or back, tension headaches, tight jaws, tensed muscles in legs or arms, and sometimes your whole body may seize up. To train yourself to progressively relax, you will begin by tensing specific groups of muscles and then releasing the tension; focus on the differences between the feelings of tension and relaxation of each group of muscles. You will practice with one area of your body at a time: head and face, neck, shoulders, back, pelvis, arms and hands, legs and feet. If you have any injuries, skip that area of your body if needed. Parts of you may or may not want to participate. As always, pace yourself and do not force any part of you. Spend some time collaborating internally to reach an agreement that is acceptable for all parts of you. Sit or lie comfortably in a quiet and safe place where you will not be interrupted. You will tense and relax each muscle group twice, taking a short break of about 30 seconds between each cycle, and then move to the next area. When tensing a muscle group, hold for about 5 seconds, then release and rest for about 10 seconds. If you wish, you can combine this exercise with one of the ones described earlier or with your inner safe space.
• Begin by focusing on your hands. Clench your fists, feel the tension of your muscles for 5 seconds, and then release 10 seconds. Concentrate on the differences between tension and release. Repeat once more.
• Now focus on your arms, draw your forearms toward your shoulder, feel the tension in your biceps (5 seconds), and then let go and relax (10 seconds). Concentrate on the differences between tension and release. Repeat once more.
• Tighten your triceps—muscles on the underside of your upper arms—by stretching your arms out straight and locking your elbows. Feel the tension in your triceps and then let go, relaxing your arms. Concentrate on the differences between tension and release. Repeat this once more. As your arms relax, just let them lie by your side or rest on the chair.
• Next, concentrate on your face. Tense the muscles in your forehead by raising your eyebrows as far as you can, feel the tension in your face and eyebrows, hold and then relax. And again, concentrate on the differences between tension and release. Repeat a second time.
• Tense the muscles around your eyes by squeezing them tightly shut and then relax. Observe the different sensations when you tense and when you relax your eyes. Repeat.
• Tighten your jaws by opening your mouth as wide as possible, hold and then relax. Repeat.
• Focus on the muscles in your neck, bow your head, your chin on your chest, then turn your head slowly to the left, return to the center line and lean your head back as far as it will go, then again return your head to its normal position. Turn your head to the right and then again to the normal position. Repeat this slowly and carefully, since there is often a lot of tension in your neck. And again, concentrate on the differences between tension and release.
• Focus on your shoulders. Raise them as though you were going to touch your ears, hold and feel the tension, and then relax. Focus on the different sensations between tension and relaxation of your shoulders. Repeat.
• Then focus on your shoulder blades; pull your shoulder blades back as though you want them to touch them together. Tense and release. Notice the difference between the tension and release. Repeat.
• Stretch your back by sitting up very straight, tighten and let go, then relax. Repeat and focus on the different sensations between tension and relaxation.
• Tighten your buttocks by squeezing them together, hold, and then relax. Repeat.
• Hold your breath, pull your belly in, tighten it, and relax. Repeat and feel the difference in your stomach and belly.
• Now focus on your legs. Stretch your legs out and feel the tension in the muscles of your thighs, hold on, and then relax your legs. Notice the difference between tension and release. Repeat.
• Now extend your legs and point your toes back towards you. Feel the tension in your calves and feel the relaxation after you let go. Repeat.
• Finally focus on your feet. Point your toes down as far as possible and feel the tension in the muscles of your feet; tighten them and then relax. Observe the different sensations when you tense and when you relax the muscles in your feet.
• Now scan your whole body mentally and look for any residual tension. If a particular muscle group is still tense, return to this area once more.
• Now imagine that relaxation is spreading through your whole body; you body may feel warm, a bit heavy, and very safe and relaxed.
The following is an exercise that may help you experience more of the positive aspects of life. This kind of experience is not meant to deny or minimize your painful and difficult times, but rather is one of many ways to soothe, calm, and reassure yourself, so you feel stronger and better able to cope. This exercise uses the image of a necklace or armband made with various beads. If this image is not suitable for you, try another, such as weaving a tapestry with threads of positive experiences, or imagine a garden of flowers or beautiful mosaic, or a book with beautiful pages. You can find the right image for you. You can make a scrapbook or piece of art as well, if you would like something more tangible.
Imagine that you, and all parts of yourself, are making a beautiful necklace or armband for yourself. It is crafted from lovely beads. Wooden beads, glass beads, ceramic beads, metal beads, beads of light, beads of water, beads of stone—you can use whatever material appeals to you. But in addition, these beads have a very special quality: Each one represents a good, positive, enjoyable experience in the present. These experiences do not have to be big, just simple things that have added a moment of contentment, satisfaction, happiness, or calmness to your life. For example, it could be a nice cup of tea with your feet propped up, a walk in the woods, a good night’s sleep, a dinner with a friend, a feeling of being accepted and understood by your therapist, a sense of progress in your healing, satisfaction in finishing a project. Let each part of you add beads. You might add proud beads, poignant beads, hopeful beads, happy beads, silly beads, playful beads, safety beads, loving beads, funny beads, or friendly beads. And also beads of strength and serenity, perseverance and peace, courage and kindness, resilience and rest. You are making your creation just as you want it. You can even turn it into a vest or coat or blanket that covers you! You can look at your creation, wear it, hold it, see the light glint off the various beads. Feel their weight, whether they are light or a little heavy; feel their texture, whether they are smooth or rough. There may even be beads that make sounds like little cheerful tinkling bells or soft clicks and clacks. You are completely free in the design of your creation. And if it helps you, you can also imagine that you have a very special box in which you can keep it. If you have such a box, or choose to make one, you can also keep notes or other mementos of special events or moments in your life. In this way, you can return time and again to experiences that are good and pleasant. After all, our memories are not only of painful experiences but also of good and positive ones.
Imagine a place where you and all parts of yourself feel safe and where you can gather to make important decisions. This may be your usual safe space, or it might be a special room, a place in nature, or any other place that feels comfortable. Once you have imagined this place—its sounds, sensations, smells, and sights, its dimensions and shape, and all that it contains—allow yourself to imagine a table in this space that has room for all parts of you to sit, should you choose. This table is specially made just for you. Perhaps it is of beautiful wood with intricate inlays, a magnificent slab of marble or granite, or sleek glass and chrome. Imagine it just the way you want: a solid table to support solid decisions. Parts are not required to sit at the table: Perhaps some may feel more comfortable hiding under the table, in a special niche or corner, or other safe spots that are not too close and not too far from the table.
Still, you may invite all parts, as they are able, to be seated in the comfortable chairs around the table. Each part of you has just the right chair: the right height, the right color and texture, the right support. Some might swivel, some might rock, some might recline, some might be sturdy executive chairs, some might be tiny chairs for children on special platforms that adjust for their height. Some parts of you may be willing to listen in but not (yet) participate in the discussions around the table, or they may designate a particular part of you to speak on their behalf. When you can image that all parts of you who are able to join are seated at the table, choose a part of yourself to be the moderator of the discussion.
This part of you will structure the meeting, allowing each part to have a fair turn and be heard respectfully. This part of you is able to reflect on what is discussed, is able to take the various perspectives of parts into consideration, and is dedicated to helping all parts of you reach inner agreements that serve the best interests of you as a whole person. If you desire, you may write down the discussion, assign a “secretary” who can take minutes of the meeting, or simply write down the discussion as you are able. If you choose, you can imagine that helpful people come to join you at your table, such as your therapist, a loving partner, a good friend, or someone from the past who may be no longer with you but whom you trusted to have your best interests at heart. Begin with a relatively small issue in order to practice your inner meeting skills as a team.
For example, you might want to discuss how to spend the evening or the weekend, using some of the decision-making strategies mentioned in this chapter. If at all possible, allow time for inner follow-up meetings in which the results of your decisions are evaluated. The more parts of you are assured that you take them seriously and do not ignore or judge their needs and wishes, the more they will be willing to cooperate. Initially, these inner meetings might have the character of business meetings, such as those that take place in work teams and organizations. Eventually, they may also be used constructively for more personal, emotional encounters, such as inner sharing of joyful or healing experiences, and even sharing of painful memories as all parts of you become ready for that aspect of your work.
This exercise will help you learn to empathize with all parts regarding their position on relationships. Use the meeting place technique from chapter 27 (or some other method) to gather all parts together.
Begin by getting yourself comfortable and calm. In your mind’s eye, imagine your meeting space, the one just for you, and allow all parts that are able to attend. Some may sit closer and some farther away. Some may prefer to be outside the room, listening in. Each part of you can find a comfortable place. Begin the meeting with a statement that all parts are welcome and are invited to be heard. Also emphasize that all parts will be respected, and that no criticism is allowed during this meeting. Then begin to find some common ground upon which you could all agree about relationships.
For example, you can surely understand that when you have been hurt, no part of you would want to be hurt again in a relationship, and some parts might thus avoid them. You can begin to understand their worldview, their core beliefs, their feelings of fear and anger and isolation, not an easy inner world to experience. Walk in their shoes for just a moment and feel empathy for how difficult it is. And you can surely agree that all parts of you have been alone and lacked much necessary care and support from others, and thus some parts would quite naturally want to seek out the comfort, support, and enjoyments of what they have missed. You can begin to understand their worldview, their core beliefs, their feelings of loneliness and need and desperation, not an easy inner world to experience. Walk in their shoes for moment and feel empathy for how difficult it is. Be aware that you are all struggling so hard, each in your own way, and have your own suffering and needs. Perhaps all parts of you could agree that you do not want to be hurt and that you would like to feel better. See if that is so. And perhaps all parts of you could agree that if you could know for sure that a relationship was trustworthy, it would be worth having. See if that is so. Now you are beginning to find some common ground. Just stay with what you are able to agree on, no matter how small, and leave the rest for another time. Experience what it feels like to be in agreement, all together. Savor this moment for awhile. Now, in the same way that parts need to feel safe, secure, and supported in relationships, free from hurt, free from criticism, free from rejection, each part needs to feel the same with other parts inside.
The more all parts of you practice treating each other as you would want to be treated by other people, the more safe and calm and ready to cope with relationships you will be. This meeting is a good start. Come back often to this place and reexperience the common ground upon which you can all agree. Work together, respect each other, take your time, and you will begin to feel better, safer, more stable and strong.
There are a number of ways to help yourself when you are feeling overwhelmed. You can temporarily distract yourself and all parts of yourself. You can contain particular feelings or memories or parts of yourself in a safe place. You can express your emotions appropriately. You can reassure and soothe parts of yourself. And you can practice grounding exercises to help keep you in the present. You will receive the most benefit from the following tips when you are able to reflect on what has evoked your hyperarousal and begin to develop awareness of the struggles of various parts of you that contribute to feeling too much. Empathic understanding of your inner struggles and a willingness to seek out healthy coping strategies to help all parts of yourself are essential to your healing. Without inner awareness and empathy, most coping strategies are not very effective.
Temporary distractions help everyone who is feeling overwhelmed from time to time. But it is important for all parts of you to understand that conscious and voluntary distraction as a temporary coping strategy is not the same as persistently avoiding the needs of parts of you. Temporary distraction is just a way to slow down your hyperarousal, like using a “reset” button. It gives you some time where you can take a deep breath and rest, so you feel more able and ready to cope with your feelings. An apt analogy is staying busy to take your mind off of a strained muscle while you continue to do the right things to help it heal, since focusing on the pain will not alleviate it and will often make it seem worse. You do not ignore the need to tend to your injury, but once you have done all you can, you may distract yourself as you heal. Distract yourself with healthy activities and support all parts of yourself to refocus on something other than what you are feeling. However, avoid working too much or engaging in other compulsive distractions that will further stress you. When you distract yourself, always make a promise to yourself that you will return later to what is overwhelming, as soon as you are able. What works for distraction may vary according to the way in which you are feeling overwhelmed.
For example, if you feel overwhelmed with anger you might find a physical activity like walking, running, or gardening helpful. But if you, or parts of you, feel intensely sad, you might chose a soothing activity like watching a nice movie, reading a (children’s) book, listening to calm music, or going to your safe inner place. Try choosing activities that match what you are feeling and that are agreeable to all parts of you. Following are additional suggestions for distracting activities.
• Exercise or take a brisk walk; changing your physiology can change how you feel. Encourage all parts of yourself to experience the walk.
• Listen to music while singing the lyrics.
• Do something pleasant or fun that all parts of you can enjoy.
• Call a friend and get together. Talking with another person (not about the problem that is overwhelming you) can take your mind of yourself for a while.
• Engage in an activity that requires concentration, for example, a hobby, a crossword puzzle, or a computer game. Try to encourage all parts of yourself to concentrate on the same thing at the same time.
• Read an interesting or nice book that is not upsetting to any part of you.
• Watch a comedy program or read a funny book. Again, encourage all parts of you to focus on the same activity at the same time. Laughter is a great distracter, and it helps you feel better, too.
Contain, but do not ignore, feelings and parts of yourself.
Containment is entirely different from “getting rid” of your feelings. When you contain a feeling or memory, and thus often a dissociative part of yourself, you are saying to yourself, “Not now, but I will return to this later.” You are making a promise to all parts of yourself to make the time and energy to deal with it in the right place at the right time.
Be sure to take the time to check for internal agreement among parts to contain an experience temporarily. You can use countless containment images: a bank vault, floating up in a balloon floating high in the air, a submarine, a computer file, a video, and so on. Use your own images that fit for you or parts of you. A different way to contain is to write or to use art to express what you are experiencing. If this evokes too much for you, there are other ways to contain. But some people find it helps to put their experience on paper or canvas and then leave it there for later.
You may allow some parts of you to use this method if it is helpful, while other parts need not be present, for example, by staying in their inner safe place. You can put away these writings or drawings or take them to your therapy appointments to help you move forward in your healing.
When you soothe and reassure yourself, you are not telling yourself to stop having negative feelings, for example, “Shut up and don’t cry. Put your happy face on.” This critical approach does not really make any part of you feel better, even though it may be a long-standing habit. Soothing and reassurance are much more effective in calming all parts of you.
Soothing includes an empathic acknowledgement of the feeling, for example: “I am feeling sad and angry, and that is a hard combination. I am doing my best to deal with these difficult feelings. It is in the best interest of all parts for me to focus on what I am doing right now and then deal with them when I get to therapy. That way I feel good about how I function in life and also have support to work on these feelings.” This empathic acceptance also includes supporting all parts of yourself, for example: “Since I am feeling so bad, I will do something nice for myself that all parts can enjoy. It is OK for any part of me to have feelings, but I don’t want them to overwhelm any part of myself. I will take care of all parts of me.”
Following are some tips that help you to calm and soothe all parts of yourself:
• Listen to all parts of yourself and try to reassure and comfort any parts that may be anxious or upset; a little inner communication and empathy go a long way.
• Practice calming, deep breathing exercises. Imagine that all parts of you are breathing together, in perfect synchronization in your safe place.
• Invite upset parts of yourself to go to a quiet, undisturbed safe space where they can be soothed and helped, while promising you will return to what is bothering them as soon as you are able.
• It may also be helpful for you to take a short “time-out” to rest.
• Ask a helpful inner part of yourself to support parts that are anxious or upset.
• Try to slow your thoughts down and each time you notice you are thinking about the problem, shift your thoughts to something else. Help parts of you share thoughts at a reasonable pace.
• Get some rest. Encourage all parts of yourself to rest. If parts are critical, for example, “You are lazy and need to be doing more” try to negotiate with those parts of yourself for a period of rest to see if it actually helps calm you down.
• Listen to soothing music and take into consideration what all parts of you might find calming.
• Use all five senses to ground yourself and be aware of the present moment. Say out loud to yourself what you notice with your senses.
• Try just noticing the experience of being overwhelmed, slow your breathing down, and each time you feel the urge to do something about the experience, allow that feeling or thought to pass through you mind, like a train that does not stop the train station.
• Remind all parts of you that feelings are normal, a part of life, and that it is safe to feel intensely in the present.
• Remind all parts of you that all experiences, no matter how unpleasant or intense have a beginning, middle, and an end.
• Notice what was happening when you began to feel overwhelmed. This may help you determine what triggered you. It also reminds you that the feeling had a beginning, and before which you were feeling something else.
• Recall times in the past when the feeling finally passed, that is, remember its ending, as a reminder that this feeling will also end in time.
• Ask your therapist to help you with additional ways to cope.
• Talk to people you know and become curious about how they handle intense emotions and what they do to calm themselves down. You can learn from their experiences
To avoid feeling the kind of intense hyperarousal described earlier, you, or some parts of yourself, may cope through avoidance and numbing; thus, you experience too little at times. This is called hypoarousal. You, or avoidant parts of you, may evade situations that would evoke too much feeling, which often means you avoid being too close to people, since relationships evoke some of our most intense feelings, positive and negative. Sometimes a part of you may completely shut down for brief periods, going to sleep or being unable to think. Some people may even become unresponsive, unable to hear or respond to someone speaking with them. You might tend to avoid thinking about anything painful or unpleasant, which means you are not able to resolve issues that involve pain and conflict.
Dissociative parts of yourself that feel numb and detached may have little to no empathy for, or even awareness of, other parts of yourself that very much need support and help with feeling too much. It becomes easy for these parts to label certain feelings or experiences as “bad,” and thus to be avoided. Such avoidance strongly maintains dissociation and prevents healing.
• Because shutting down is often the result of feeling overwhelmed, most of the interventions used for feeling too much are also appropriate.
• You, or a part of you, may tend toward hypoarousal when you are stressed. A major solution is to first become physically and then mentally active. If you, or a part of you, feel sleepy when you are faced with something overwhelming, try to get up and get moving. You must resist the tendency to become more and more still.
• Help inner parts feel safer in the present by reassuring, calming, and orienting.
• Try a brief, vigorous activity to get your heart pumping and your energy level up, for example, jumping jacks, push-ups, or running in place.
• Do not allow your eyes to focus in one place, or you will trance out. Notice your environment. Use all five senses and name the things you notice out loud, in order to ground yourself in the present. If a part of you tends to trance out, you may try putting a little temporary distance between you and that part of yourself, for example, imagining actual physical distance between you or allowing that part of you to go to a safe space.
• Use mental stimulation to get your brain more engaged and active, for example, count backward from 100 by threes or sevens, or go outside and count trees or cars.
• If you have a feeling of being paralyzed, ask inside whether a part of yourself can help you move. You can start with a very small movement, such as moving your little finger just a bit, blinking your eyes, or twitching your nose. Next try to make other small movements in another part of your body. Focus on moving as much as possible. Think of someone whom you may trust—a friend, your therapist, your partner— and imagine that person helping you. Sometimes a particular part of you is immobilized and other parts of you can help by tending respectfully and empathically to that part, giving orienting information, comfort, and safety.
• If you feel cold or freezing (a common experience in hypoarousal), try a warm bath or shower (not too hot). Or wrap yourself in a blanket and place a hot water bottle or heating pad on your stomach to warm your core. Then imagine soothing inner parts as you warm up, using some of the other resources available to you.
• If you, or a part of you, have physical numbness, note where in your body it begins and ends, or whether you are completely numb. Many people have at least small areas of their body where they can feel. If you have such a place (for example, your forearm), touch it gently and intentionally, saying to yourself, “I am touching my forearm.” Scratch your back with a soft, long brush; rub up against the door frame as a bear rubs up against a tree; or wrap in a blanket to feel your skin.
• If you are emotionally numb, notice whether you can feel just a little bit of emotion, perhaps a 1 or 2 on a scale of 10. Concentrate on the feeling, say it out loud, and draw the attention of all parts of yourself to it. Remind yourself that emotions can be safe; they are merely signals.
• You might ask whether any part of you could “share” a little emotion with you, no more than you think you can tolerate, for example, a teaspoon, a cup, or 5%. Also set a time limit, so you can feel a little of the emotion just for a moment, say to the count of 5, or 10 seconds or 30 seconds. As you feel more able, you can increase both the amount and time you experience an emotion. Notice as much of your inner experience during this time as possible: what you think, feel, sense, what you predict.
• If you are aware of certain parts of yourself that are severely shut down, see if you can become more curious about what they might need in order to be less shut down, and how you might provide for some of those needs. Sometimes merely the reassurance that you are really interested in tending to them is enough to help these parts become more present and alert.
To resolve pervasive shame and guilt, you will find it helpful to learn more adaptive ways of coping instead of using the shame scripts described in the previous section.
• Recognize shame and guilt reactions, and name them. Learn your typical thoughts and feelings that are shame based. For example, you, or some part of you, might often say, “I could never do that; I would fail, so I won’t even try.” That fear of failure is shame based. Or you often compare yourself with others and always come out “less than.” If you believe that other people are always smarter, kinder, work harder, are more efficient, and are better at relationships than you are, then you likely are shame based. And the reverse is also true: If you always view yourself as superior to others, you are also likely to have a lot of shame.
• Learn your patterns of coping with shame, that is, how you use shame scripts. Do you mentally attack yourself, or do you tend to attack others? Do you avoid situations, thoughts, feelings, and memories that might evoke shame? Do you isolate and withdraw from others? Each part of you may have used a different shame script to cope with shame.
• Recall how often you tend to feel shame on a scale of 1–5, with 1 being never or rarely, and 5 being every day or almost all the time. This scale will help you determine how much and what sort of work to focus on to cope with your shame.
• Notice what body sensations you have when you feel ashamed or guilty. Are they different for shame and guilt?
• Once you notice your patterns, try to interrupt or shift them. You may find you need to practice this in small steps. For example, wait a short while to engage in attacking yourself or someone else instead of immediately doing it. Then try changing small aspects, for example, remind yourself that you are experiencing shame and that criticizing yourself will only make it worse.
• Ascertain which cognitions you might need to correct, for example, “I am worthless. I don’t deserve to have good things. People find me disgusting.” Find possible counterarguments, such as, “No one is completely worthless; each person has some merit.” “Having good things is not about deserving them. It is part of life to have good things.” “There are people in my life that do not find me disgusting.”
• Notice specific beliefs related to shame and guilt that may be held in particular dissociative parts of yourself.
• Recognize and begin to work with the strategies employed by other parts of yourself. Try creating dialogues about shame and about what all parts want to accomplish with those strategies. For example, respond to critical parts of yourself by saying, “I know you have my best interests at heart, that you want me to be competent, successful, and well liked. I want that too. Shouting at me or ridiculing me only makes me lose what little confidence I can muster. Let’s work together to find a different way that is more effective.” And to a very shameful part, you might say, “I know that shame is an awful feeling and I am going to help you with it. I know you feel ashamed about what happened to you, and I want you to know that it wasn’t your fault and that there is a way we can deal with this together. I am glad to listen to what you have to say, whenever you feel ready. I’d like to point out what is different in the present from the past, so you can feel more at ease.”
• Be willing to talk about shame in therapy. You can begin by just talking about what it is and how it affects you, rather than talking about particular shameful events. Practice talking about it until you become more comfortable with the topic and know your therapist can talk about it, too. Help all parts of yourself learn to talk about it in therapy.
• Notice your present experience, and whenever shame or guilt is evoked, ground yourself in the present, remind yourself that much of what you believe about yourself when you feel shameful or guilty is greatly exaggerated and not valid.
• Work with your body to shift your physical experience of shame. For example, if you feel frozen, try to move around a little bit, take in some breaths, and squeeze your toes in your shoes.
• Gradually share with yourself, among all parts of yourself, and with your therapist the events in your life that bring so much shame to you. When shame is shared in the presence of an accepting other, it is most likely to resolve. You may not be ready to do this yet: That is fine. This is just a reminder to do so when you are ready. The timing should be discussed with your therapist.
• Shame is typically alleviated when you can develop a positive or joyful experience to pair with the shameful one. For example, if you feel “unworthy,” recall or imagine a moment when you felt cared for by another person. Or if you feel like a failure, recall or imagine a time when you felt good or proud of something you had done, for example, when you made a good grade in school, learned how to use a computer program, finished a project that was difficult to complete, or were able to make a change in therapy.
• Chronic guilt is best managed by developing increasing empathy for yourself and all parts of you. It is also helpful to begin to realize (with help from your therapist and others) that some of your guilt may not be realistic. The more empathy you develop, and the more you can fully realize the true circumstances about which you experience chronic guilt, the less you will feel.
• Realistic guilt is best managed by (1) accepting that you are fallible and make mistakes and do not always behave perfectly just like everyone else; (2) making a realistic appraisal of what you have actually done (or not done) (this may require the help of a safe other); (3) helping all parts inside come to an inner acceptance in which the offending behavior can be fairly judged but also the human being that you are can be understood and accepted; (4) making amends or restitution if possible; and (5) learning from your behavior so you can do things differently in the future.
• Anger occurs in many gradations, from mild irritation or annoyance, to anger, to rage. The sooner you are able to make these distinctions and can become aware of mild anger, such as irritation, the easier it is to intervene before anger becomes overwhelming.
• You can learn to be aware of your own physical signs of anger. Anger is typically associated with a tight or tense feeling in your body, clenched jaws and/or fists, feeling flushed or shaky, breathing heavily, rapid heart rate, a feeling of heat, or a surge of energy throughout your body. Noticing your body sensations can be a powerful way to know whether you are angry. You may have learned to automatically react to physical sensations that accompany anger as triggers to avoid angry emotions or thoughts.
• Angry parts may seem like internal “enemies” or “troublemakers,” but actually they are not, even those parts that act like perpetrators. They are simply one way in which you try to cope. You must learn to empathize with their plight of having very limited coping skills and being shunned by other parts, alone with their hurt and fear and shame, while not accepting their inappropriate behavior, whether internal or external.
• Once you feel some empathy toward these parts, you can begin to communicate with them, listening with more understanding about what is “underneath” the anger. And you can also ask your therapist to help you communicate with angry parts.
• It is important for angry parts to realize that you will not “get rid of” them, that they have protective functions, and are invited to participate in therapy along with all other parts of you.
• Angry parts are strong parts that can be gradually encouraged to use their strength in more positive ways, such as helping you to attain important goals in your life, and helping you be more assertive when necessary.
• It is not wrong to feel angry. Anger is an inborn, normal, and inevitable human emotion that is universal. It is only important how you express it outwardly or inwardly. Does it help you get what you need without hurting anyone? Is it respectful? Is it within your window of tolerance? Does it lead to positive experiences instead of more negative ones?
• Notice whether the intensity of the anger that you, or some parts of you, feel is appropriate to the situation. It might help to check how other people would respond to the same situation. For example, you might notice whether you are the only person in a meeting that consistently gets angry because people seem so incompetent, and if so, become more curious about why others do not seem to be struggling with anger in those situations.
• Try creative and healthy nonverbal ways of expressing your anger: writing, drawing, painting, making a collage.
• Physical exercise may help as an outlet for the physical energy generated by the physiology of anger.
• Reflect on your anger, that is, try to understand your anger rather than just experience it. You might imagine observing yourself from a distance and being curious about why you are so angry. It is easy to blame circumstances or others for the way you feel, but really, it is your own internal thoughts, perceptions, and predictions that fuel your anger. Noticing them and being able to change them will be enormously helpful, instead of focusing on the external object of your anger.
• Give yourself a time-out, that is, walk away from a situation if you feel you are getting too angry. Count slowly to 10, or even to 100 before you say or do something you will regret later. Practice calming breathing. Distract yourself. Help inner parts calm themselves.
• Of course, what works for one part of you may not work for another part. It is important for each part of you to have ways to calm down that work. While some parts may benefit from distraction or soothing, others might find it more helpful to engage in vigorous physical activity. Listen to yourself, to all parts of you, and take into account the needs of each part of you.
• Have an inner conversation with parts of yourself about anger and how to express it. Allow all parts of you to share their fears and beliefs about anger. Negotiate toward small and safe ways to express anger that are agreeable to all parts of you.
• Anger, like all emotions, has a beginning, middle, and end. Notice when it starts. Notice what intensifies or decreases it. Notice your inner thoughts, sensations, perceptions, and predictions. Notice what various skills and supports are needed by different parts to cope with anger more appropriately.
• Watch safe people in your life and see how they handle their own anger. Do they accept being angry? Are they respectful and appropriate with their anger? Are there particular strategies they use that you could practice for yourself?
• Healthy anger can give positive strength and energy. It can help you be appropriately assertive, set clear boundaries, and confront wrongs in the world. Anger can pave the way to other emotions, leading to the resolution of relational conflicts.
• Learn the most common triggers of your anger. Once you learn these triggers, you can be more aware when they occur and more able to prevent an automatic reaction of anger. Establish inner communication among parts of yourself to recognize triggers and negotiate possible helpful strategies to cope with them rather than just reacting.
• You can try allowing yourself to experience just a small amount of anger from another part of yourself: a drop, a teaspoon, 1% or 2%. And in exchange, you can share with angry parts feelings of calm and safety.
In previous chapters we have described many tips and techniques to help you cope with intense emotions: Virtually all of them can be used to cope with fear. In the list that follows, you will find some of the most essential steps toward reducing fear in yourself, and in all parts of you.
• Take some time to reflect inwardly and check with parts of you about whether they feel fear.
• Try to identify the trigger(s) that evokes fear in you or other parts of you, that is, notice what you are reacting to internally or externally that makes you afraid.
• Try to gauge your level of fear and determine whether it is appropriate to the situation. Is your fear based on an inaccurate perception of the present situation, perhaps a perception based in trauma-time? If so, support all parts of you to accurately perceive and become more oriented to the present.
• After reorientation to the safe present, calm yourself or parts inside, using any techniques that are helpful for you or different parts inside. Remember that all parts may not be helped by the same technique. Be flexible with yourself.
• Practice some of the exercises you have learned in this manual (or any others that you know) to regulate yourself.
• If you feel frozen (hypoaroused without being able to move), you may begin by making small movements, perhaps first by blinking your eyes, moving your fingers and toes, and gradually moving your arms and legs. If you feel cold, warm yourself by wrapping in a blanket or having a hot drink or bath, or putting a heating pad or hot water bottle on your chest and stomach. Use safe space and relaxation exercises to help solidify a sense of calmness and safety for all parts of you.
• If you know in advance that a certain situation is likely to evoke fear, you can make a plan to deal with it ahead of time. Help parts of you go to your inner safe space, so they do not have to endure a potentially frightening experience, such as having an uncomfortable medical procedure, until they can be more oriented to the present. In other situations it is helpful to gather all parts in an inner meeting place and explain the situation ahead of time and make plans for safety. Once parts are able to reflect, they will be able to change their habitual patterns of response, including fear reactions.
• Dissociative parts that do not feel fear may be helpful in many situations, for instance, being able to visit a doctor or dentist, or cope with other potentially triggering situations without undue fear. While some parts of you may still be stuck in trauma-time and are not yet oriented to the present sufficiently, such parts can be of great help in these situations.
• If parts engage in reckless behaviors, you will need to begin communication with these parts to decrease their risky actions. If needed, you can enlist the help of your therapist to deal with these parts of yourself.
• As always, the first step in overcoming a problem is to reflect on it. Take some time (with or without the help of your therapist) to have an inner meeting among parts to begin talking about isolation and loneliness instead of just experiencing them.
• Begin by asking all parts to participate, as they are able. Even if some parts cannot, you may be able to sense or know something about how that part experiences and deals with isolation and loneliness.
• Notice conflicts among parts of yourself about being isolated or lonely.
• Are there parts of you that prefer to be alone? If so, do they enjoy alone time, or are they avoiding other people or stressful situations? Do they ever feel lonely? Are they aware of and attend to the needs of other lonely parts who may not want to be isolated? What do they feel and think about these parts of yourself? Is there any communication among these two types of parts?
• Are there parts of you that are very lonely and want to be with other people? If so, what keeps them from reaching out to others? Are they stuck in trauma-time, fearful of other people, socially anxious, lacking in social skills? Are they aware of parts of you that might prefer to have alone time or be isolated? Using an inner meeting space, try to encourage parts that isolate to communicate with parts that feel lonely without judgment, and visa versa. Can they find common ground; for example, is there agreement that it is good for all parts not to feel afraid, ashamed, or lonely?
• Notice what prompts you to isolate. Does it happen when you are stressed, after a hard therapy session, when you want to avoid a conflict, or when you feel ill? Are there other alternatives for you to take instead? For example, calling or e-mailing a friend about your stress or problems, being assertive in dealing with a conflict, asking someone to help you if you are ill. Notice any inner obstacles to making different choices than your usual ones.
• Pay attention to what you and all parts of you experience when you are isolated. Do you feel panic, disconnected, shameful, lonely, or numb?
• What happens in your body when you feel lonely; for example, do you feel tense, cold, paralyzed, or frenetic?
• Notice your thoughts and core beliefs.
• Are parts of you able to empathize with each other in their need for isolation or their yearning not to be lonely? How might you and your therapist further facilitate and strengthen that empathy, which can lead to cooperation and resolution of the conflict?
Tips for Coping With Isolation and Loneliness
• Begin with grounding yourself, using the exercises in this manual and other ways you have learned to help yourself be in the present.
• Next, reflect inwardly (using the previous section as a guide, if you want) to determine your conflicts and what all parts of you need and want.
• First focus on internal isolation and loneliness. You may use all of the skills in this manual to support yourself and all parts inside in becoming less isolated and lonely internally: accepting and connecting with each other; reflecting; orienting parts to the present; helping parts develop empathy, communication, and cooperation; soothing and calming parts; developing safe places; developing pleasant or fun activities that all parts of you can enjoy as a whole person.
• The more you connect with all parts of yourself, the less overwhelmed you will be, which will help you feel more comfortable in connecting with others.
• The more you can accept yourself and all parts of you, the less ashamed and afraid you will be to connect with others.
• If you have severe problems connecting with others or making friends, begin with what is easiest. Is it easier to talk with one person, or with more than one? Does it help you to have a shared topic (such as volunteer work or a hobby)? You might consider taking a class to learn something new, where you will have a chance to meet new people, or volunteer where you will be with others.
• Some people with a dissociative disorder prefer to meet people on the Internet and chat or have a pen pal. This is not ideal, but it is a start.
• Some people find having a pet helps them to feel less isolated. And a friendly pet is a great source of conversation with other people if you go out for walks.
• Isolation can be a habit. Make an effort to get out or be with friends on a regular basis, even though it may be hard to do. If needed, encourage overwhelmed parts of you to stay in a safe space while you connect with others.
• Make necessary alone time pleasant (for example, with nice music, a good book or movie, healthy and tasty food, a walk, etc.) and productive.
• If you have religious or spiritual preferences, make use of mediation or prayer during your alone time to feel more connected to God or the universe. (You might reflect on whether your concept of God as loving or vengeful reflects your past experiences with other people.) And of course some people feel supported by attending the religious house of their preference or by spiritual meetings with others of like mind.
• Stay present so you can at least connect to the world around you. Walk outside and listen to the birds or look at the trees. There is life all around, and it will help if you can feel at least a little connection to it.
• Make an effort to reach out to others instead of waiting for them to call you.
Reflection: Empathic Understanding of Yourself and Others Reflection helps us understand our own reactions rather than just being in the middle of them, and reflection supports us in changing automatic reactions to chosen responses. It also helps us more accurately predict what another person might be feeling, thinking, and what he or she is likely to do next in a relationship. When we can understand and predict ourselves and others, we naturally feel more secure and more “in sync” with those for whom we care. In other words, reflective skills involve the capacity to make sense of our own minds and the minds of others (Allen, Fonagy, & Bateman, 2008; Fonagy, Gergely, Jurist, & Target, 2002). Most animals simply react to emotions and impulses. Their emotions direct their behaviors: Anger evokes fight or attack, hunger evokes a search for food, fear evokes freezing or running away, and so forth. With a very few exceptions —such as some primates, elephants, and dolphins—animals do not seem to have self-awareness. But as humans with self-aware minds, we have the opportunity to add richness to our experience by understanding the meaning of our mental activities, challenging narrow beliefs, and changing how we respond to what we hold in mind, and to what we believe others are thinking, feeling, or perceiving. We take in what we perceive and make sense of it based on our accumulated experiences, knowledge, and beliefs, and on our needs and goals. Reflection helps us understand the nature of feelings, our patterns of thoughts, our emotional reactions, and our habitual movements, so that we can change them and act in ways that are more effective. Reflection also helps us realize that other people also have their own minds and their own needs and goals, which may involve quite different perceptions, thoughts, feelings, motivations, and intentions than we have. Of course, we cannot “read” people’s minds by assuming we know what is there, but we can make some fairly accurate predictions based on our experience of that individual person. We can weigh different alternatives and points of view.
Tips for Developing Reflective Skills
To be reflective, you will be learning how to gradually have more awareness of the present moment, of all parts of yourself, and of other people.
Be in the Present
It is impossible to reflect on your inner experience if you avoid or are not aware of it. Likewise, it is hard to reflect on your current situation if you do not feel present. Reflection begins with being as present in the moment as much as you are able, which takes consistent and concentrated practice. Use your anchors for the present (practice the exercises on anchors in chapters 1 and 2).
Notice Your Inner Experience Without Judgment
Take time to turn your attention inwardly to your thoughts, feelings, sensations, and other parts of yourself. If you do not understand what you notice, do not judge yourself; just do the best you can and move on. If you do not notice anything, do not judge yourself; simply note that you do not notice anything and move on.
It helps for you to be curious about yourself, about what is going on inside, and why you think or feel or behave in particular ways. Even though you may try to understand your mind and that of others, some of your perceptions, assumptions, or beliefs may be inaccurate.
Your reflection may be limited by past experiences that are no longer relevant to the current situation (for example, having a prereflective belief that your therapist is going to yell at you in anger, because your parents did so, even though your therapist has never yelled) or by inaccurate beliefs and predictions (for example, believing you are crazy and will “be put away” because you hear inner voices). In fact, each part of you likely has a particular set of reactions to other people, many of them inaccurate. Notice these beliefs and thoughts, as well as the feelings and behavioral tendencies that accompany them. Write them down so you can reflect on them more easily.
Notice Similarities and Differences
It helps for you, and all parts of you, to notice similarities and differences—in your inner experience, in others, in situations. That is, you can begin to separate the past from the present, your inner fears or beliefs from external realities. You can notice that you react similarly each time you feel lonely, rejected, sad, or angry. You can notice that you have patterns of reactions that go back to your past history, that have become automatic. You can begin to notice what is different about the current circumstances that might call for a different response from you (for example, your friend will never hit you, so you need not expect it).
Be Empathic
You must be empathic with yourself, including all parts of yourself, each toward the others, and also empathic with other people’s foibles and struggles. You can develop the capacity to “walk in the shoes” of another and of different parts of yourself (for instance, noticing yourself with empathy when you feel angry, incompetent, or ashamed). Over time, you will be able to recognize all parts of yourself as you. And you will learn much more about successfully developing and maintaining secure and safe relationships with others.
Assertive behavior offers people a number of important benefits. Assertive people tend to have fewer relational conflicts, and thus less overall stress. And because they have fewer conflicts, assertive people often have more stable and strong relationships with others. They get their needs met more consistently, and they can help others get their needs met as well, which further strengthens relationships. How you view yourself and others is central to whether you are able to be assertive; thus, reflection is a major part of assertiveness skills. You must reflect on your own opinions, thoughts, feelings, needs, and also on those of other people. Assertiveness requires some self-confidence, but you can learn it with practice even when you do not yet feel completely at ease with yourself or others. Assertiveness includes being able to do the following:
In this section you will find a series of steps that will help all parts of you become more willing to experiment with being safely assertive and become more proficient at it. These steps require time and practice and thus cannot always be used when a decision must be made in the moment. They are best used for times when you know you need to be assertive in an upcoming situation, and you have the time and willingness to prepare for it. But the more your practice these steps, the more quickly and automatically all parts of you will be able to be assertive when the situation calls for it.
• Make a list of your current boundaries. Once you have written them down, add additional ones you would like to have, even if there is inner disagreement.
• Make a list of boundaries you would like to set but have not yet been able to.
• Use your inner meeting room. Gather all parts of you in your inner meeting room (see chapter 27), or use another way to have inner discussions that works best for you. Help all parts be as oriented to the present as possible, so you can have a dialogue about boundaries and resolving the inner obstacles to them.
• Engage in inner reflection. Listen respectfully to all parts of yourself and learn more about what each part needs and wants about boundaries, even if you do not agree. Notice how various parts of yourself react to situations in which setting boundaries would be helpful. And notice how parts react to each other.
• Understand inner conflicts about boundaries. When parts of you have differing opinions, emotions, and behaviors regarding a particular boundary, it may be hard to find a balance. For example, some parts want to be touched and hugged, and others do not want to be touched or even close to another person. As a first step, acknowledge and respect both sides of the conflict, and find common ground (for example, all parts want to be safe and feel OK). As you become more aware of the inner conflicts that prevent you setting healthy boundaries, you can begin the process of resolving them, using the steps that follow.
• Challenge dysfunctional core beliefs and thoughts. As you become aware of the beliefs and thoughts that support a particular unhealthy boundary (too lax or too rigid), try to establish communication and have an inner dialogue about those beliefs, for example, “I believe that if I share something vulnerable, people will use it against me, so I never share” or “I don’t like being hit and called names, but you have to put up with a lot to get love.”
• Negotiate empathically. Work toward inner agreements on what boundaries to set in general, as well as in specific situations or with a certain person. Remember that some of your boundaries can be different with various people. It is helpful to find boundaries that all parts can agree help you feel safe and respected.
• Agree on which parts of you deal with boundary setting. Work toward obtaining sufficient inner cooperation so that more rational adult parts of you with relational skills can set boundaries firmly but without being punitive. Prepare your message, so that you know exactly what you want to say. For example, “I want you to stop yelling at me when we have an argument. If you yell, I will leave the room and do something else until you are calm enough to talk and stay connected. If you continue to yell, I will have to consider other options, including ending the relationship.”
• Preparing parts of yourself to set boundaries. Various parts of you will need time and attention in order to be ready to set some boundaries. Start where you can, and in the meantime, help all parts be oriented and calm; learn more about assertiveness skills to help you set boundaries, and more about healthy boundaries. If parts of you are still quite reactive, you might try to help them go to an inner safe space during situations in which you need to set boundaries. This requires a level of inner agreement that boundaries and limits will be helpful for all parts by keeping them safe. Begin by explaining why boundaries are effective, by encouraging all parts of you to read the chapter together, or perhaps read it out loud to them (reading out loud helps you retain the content). Ask whether all parts are willing to allow an “experiment” in which an adult and more rational part of you practices setting a small boundary in a minor situation, while these parts remain in a safe place. Afterward, bring all parts of you together to discuss how the situation turned out for you. Be sure to listen respectfully to feedback from all parts.
• Use imaginal rehearsal. Visualize yourself successfully setting healthy boundaries (see chapter 15). Also try to envision various responses of the other person and prepare yourself to deal with them. It also may be helpful to role play the situation with a trusted friend or partner, or your therapist. Gather all parts together and imagine they are supporting each other during this situation, so that you feel stronger and of one mind. You might also imagine a safe and trusted other person standing beside you to support you.
• Blending. Various forms of blending, which were discussed in chapter 25, can be useful in helping parts set clear and firm boundaries. More fearful parts could be supported by stronger parts, and perhaps temper the aggression of stronger parts.
• You are able to say “yes” or “no” to others.
• You are OK with someone saying “no” to you
• You respect yourself.
• You share responsibility and power in a relationship. You are neither controlled nor controlling.
• You can identify or be receptive to hearing about your mistakes or role in a relational problem, and you take responsibility for them.
• You share personal information gradually in a mutually sharing and trusting relationship.
• You do not tolerate abuse or disrespect.
• You know your own wants, needs, and feelings.
• You communicate your wants, needs, and feelings clearly to the other person.
• You know your physical and sexual boundaries and are able to keep them.
• You are responsible for your own life, and you allow other adults to be responsible for theirs.
• You value your opinions and feelings and those of others.
• You respect the boundaries of other people and expect them to respect yours.
• You are able to ask for help when you need it and can manage on your own when appropriate.
• You do not compromise your values or integrity to avoid rejection.
• You are willing to follow through with consequences if a person continues crossing your boundaries.
Unhealthy boundaries are either too lax or too rigid. Lax or “collapsed” boundaries leave you at the mercy of other people’s wants and needs. Rigid boundaries isolate you and prevent people from being close enough to have a significant relationship with you. Next you will find basic characteristics of lax and rigid boundaries.
• You cannot say “no,” because you are afraid of rejection or abandonment or the anger or disappointment of others.
• You are so unclear about your own identity that you let others define who you are and what you do.
• You tend to be either overly responsible and controlling, or passive and dependent.
• You take on other people’s problems and feelings as your own.
• You share too much personal information too soon in a relationship. You do not know how to pace personal sharing.
• You cannot say “no” to unwanted sexual contact; find yourself in sexual relationships you do not really want; or think that it is OK to always agree to have sex if the other person wants it.
• You have a high tolerance for, or ignore, being abused or treated with disrespect.
• You have trouble identifying your needs, wants, and feelings.
• If you are able to identify them, your wants, needs, and feelings are almost always secondary to those of other people.
• You feel responsible for the happiness and well-being of other people, and you ignore your own.
• You rely on the help, opinions, feelings, and ideas of others more than your own.
• You rely on other people’s boundaries instead of having your own.
• You compromise your values and beliefs to please others or to avoid conflict.
• If you do set a boundary, you back down if the other person pushes a little. Rigid Boundaries
• You say “no” far more often than “yes,” especially if the request involves close interaction.
• You avoid intimacy by failing to communicate, picking fights, working too much, and otherwise being unavailable.
• You have a phobia of attachment (getting too close) and perhaps of attachment loss (being rejected or abandoned), which keep you at a distance.
• You rarely share personal information and feel uncomfortable when you do.
• You have difficulty identifying your wants, needs, feelings, and in response, you distance yourself from others.
• You have few or no close relationships. You spend the majority of your free time alone.
• You rarely ask for help.
• You are not curious about or respectful of other people’s boundaries if they do not fit with yours.
• You do not want to get involved with other people’s problems.