Listen in to our Q&A episode with Melissa and Bridger!
“Hi, I have a client with complex PTSD, and we are just beginning EMDR processing. When we try to do calm safe place, she starts to feel very tired and heavy and her emotions seem to be keeping her from creating a calm place. It seems like just imagining a space to relax is overwhelming for her. Any hints on how to handle this?”
- It sounds like she could be a dissociating-complex PTSD component. A part of their personality that becomes very anxious with the idea of relaxation. Their nervous system has decided that safety is not a possibility so it elicits a threat response when trying to do so.
- What if I’m not going to be ready when a threat occurs? Hypervigilance is overtaking her ability to enter to the calm safe experience.
- We need to be creative and extend our resourcing by helping them feel neutral without having relaxation.
- Teach them the in between skill; the activation it takes to sit, cross legged against a chair. Notice the activation that is not tension.
- Another installation technique is the idea of a total neutral room that is completely empty with no character or focus on the absence of sensation in a particular body part.
- Try to understand what their nervous system is portraying and what state they tend to move into (dorsal shutdown or sympathetic activation). Calm safe place may not be the best choice for a dorsal state individual.
Do you speak directly to parts, or do you have the apparently normal part (ANP) speak to them?
- Both. It depends on the structural needs of the system as it currently is.
- Eventually, the goal is that the ANP is the “loving parent” to all EPs. So we want the ANP to be the primary interacter. Their primary personality may think they’re ready to step into this role. However, people with complex PTSD, had significant attachment rupturing and don’t know how to nurture and care for the EPs. This is why the primary personality is not usually ready to take on the parental role of the others EP.
- Healing the ANP has to occur before having it interact with the EP.
- Giving responsibility when they’re ready.
What does speaking to parts look like in a non DID client, and do you do it? If yes, is there a way to do this without feeling super woowoo and awkward?
- This usually occurs when a therapist is concerned about appearing professional while also presenting as a caring and empathetic therapist.
- Introduce ego state in scientific language; ego state an anthropomorphized version of their nervous system.
- The duality of allowing ourselves to feel the awkwardness while also feeling the other feelings with the experience.
- Context and consent!
- Use the beginning stages of meeting the client by introducing the idea that we have an entire world of memories, thoughts and emotions floating around in our system and that we should develop a language to use to understand our parts and the feelings associated with them.
- Yes, you can use it with non-DID clients and use self-exploration to help with the feelings of awkwardness.
And, when used as a prep for EMDR, what indications do you look for that signal the (presumably dissociative CPTSD) client has done enough ego state stuff to move into reprocessing?
- Create a space for all of us to meet internally, where all the parts that want to be around are able. They all bring an experience to the meeting place.
- This can look like memories spontaneously emerging. Simply ask if there’s a part that feels safe enough to come through. We must also ask if all parts are okay with observing the work.
What part do we want front and center when reprocessing a target? The emotional part (EP) related to that event or the ANP??
- Both. If they are in a good relationship with each other, then we want the ANP to be present. This is great for integration and building compassion and understanding within the system.
- Don’t do any processing unless the ANP is present. When the EP is holding a memory, this means that it was intolerable for the ANP. It’s all about feeling safe, secure, seen and soothing within the system.
What is your go to interventions used when talking about parts with clients? With EMDR do parts integrate or do they stay parts but work together? I am experiencing many of my clients seem to have protective parts that keep them from allowing positive or moments of connection in. A few clients seem to have distractive parts that keep them from certain memories. I feel like I am just learning about this so I am not fully wrapping my mind around the goal or where it lands….Parts can keep someone from processing trauma, and have kept them safe during the trauma.
- The goal of Ego State Therapy is the same as EMDR, to integrate the disintegrated.
- The experiences, parts of self, emotions and beliefs that are experienced as unexceptable, shameful, overwhelming etc. are what we are wanting to integrate.
- Helps us work with implicit memories and integrate them rather than have disintegrated parts.
- All about communication within ourselves. The real goal is that all the parts are loved, accepted, appreciated and cared for.
- The distracted parts were created for the sake of keeping the disintegration ongoing. The whole reason the parts were created was that the experience, emotion, thought etc., was too overwhelming for the ANP. The ANP removed these memories so that is why the game of distraction occurs. “Is this a real memory or is it not? Well, let’s think about something else.”
- The same parts can be present during the trauma and keep them from reprocessing the trauma. Their system determined that reprocessing is unsafe.
- It’s so important to validate this experience. We don’t need to try and figure out and convince them that the memory did in fact happen, but just to validate their feelings and part that brings it to our attention.
I’d love to hear you talk about how you connect ego state work to energy modalities, if so! AIP as well. Do you have a sense for how many parts might exist within one person? Lastly, how about a client unable to buy into Self as a resource?
- It’s a beautiful pairing with the energy systems.
- AIP- past shapes present and future, and shapes the current presenting nervous system. We utilize AIP within the energy modalities through understanding that memories are energy. We are always interacting with memory.
- There can be as many parts as needed. However many parts are there are how many parts are necessary for that system.
- Without DID, there could be 3-10 parts. With DID, possibly around 5-12 parts. The number doesn’t necessarily matter, it’s still all about forming relationships.
- Totally okay if the client doesn’t buy into self as a resource. Be the resource until they are ready or find something else that they are comfortable with.
Looking forward to this conversation! I would love to know your thoughts on the overlap & integration of ego state theory with the Enneagram (levels of health, moves in stress & security, wings, etc). Thank you!
- We rely on the enneagram a lot, in many realms of our existence.
- Ego state theory with enneagram is a wonderful pairing, but we need to be careful about not overwhelming the client.
- Don’t introduce both enneagram and ego state at the same time, unless the client is ready and knowledgeable of enneagram already.
- Knowing the stress path of your client will be so helpful. Their growth path is great for resourcing.
Have you heard our other episodes on Ego State? Check them out!
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