As if self-care isn’t complicated enough, how does it work when you feel like your self is separated into multiple selves? We’ve talked about the ways self-care can be challenging for trauma survivors. I think it is worth revisiting this topic to address the special challenges for those with dissociative identity disorder, dissociative disorder NOS or anyone with multiple, separate parts of themselves.
Though you may feel like you have many selves, from my trauma therapist point of view I feel the need to clarify terminology. Dissociative disorders are now seen as a fragmented identity rather than completely different personalities (hence the move from MPD to DID). I like the way Sidran speaks to this issue:
Other terms often used by therapists and survivors to describe these entities are: “alternate personalities,” “alters,” “parts,” “states of consciousness,” “ego states,” and “identities.” It is important to keep in mind that although these alternate states may feel or appear to be very different, they are all manifestations of a single, whole person.
Here are some things that come to mind when I think about applying self-care to all of you. Are these part of your self-care repertoire?
- Awareness and Acceptance: you need to accept and be aware of other parts of you before you can take good care of all of you. This seems obvious but it is worth specifying. I know many dissociative trauma survivors go through phases regarding acceptance of their others. It makes sense that this is a work in progress. It may seem to fly in the face of your old familiar coping strategy of not knowing (aka dissociation). That helped your survive but will not help you heal and thrive.
- Internal communication: you cannot take care of each other if you cannot communicate with each other! Are you open to hearing what other parts of you feel and need? Keep in mind that it is best to start the conversation with neutral topics. Communicating about trauma memories or really loaded issues will work better once you establish a good working relationship with yourselves. If some form of internal communication is already in place, terrific. If not, this is a very important goal for phase one of complex trauma treatment. In time you may be able to hear each other as you go about your daily life, but that can take time to develop. Some find journaling or using guided imagery as good ways to begin to get in touch with other parts of you. Some prefer to start this process while in therapy sessions. Some like to work on it privately. Do whatever works for you!
- Be mindful of different ages and issues. You may have parts of you that experience themselves as much younger than your chronological age. This can be challenging for survivors who feel very disconnected from the child they were, or worse, who harbor very negative feelings about their child self. This is such a big topic I think it needs its own post! For now, let’s acknowledge it is important to learn how to protect, nurture and in a sense parent your younger selves while maintaining as much adult functioning as possible. In addition, some parts of you may hold specific trauma experiences and/or intense feelings. Knowing this can help you tailor self-care activities to address these issues. Ignoring them really tends to back fire eventually.
- Sharing one body: I know not everyone agrees with this all the time, but work on accepting that you all share one body. This has very practical ramifications that can improve your life. Accepting that no matter how separate you feel, you share one body that requires a certain amount of sleep, nutrition, physical activity and medical attention is a crucial self-care basic.
- Internal conflict: sometimes people with dissociative disorders blame other parts of them for the abuse they experienced, for the fact that they are separate, for many things. Remember that no part of you is responsible for the abuse or neglect that you experienced. Likewise, no part of you deserved it. Period. Learn not to direct the blame and anger at each other that actually belongs elsewhere. Blaming other parts of you is the multiple version of internalizing the self-blame that is so common for trauma survivors. Replacing anger and blame with compassion for all parts of you will be a huge step in your healing process.
- I am also thinking about the need for trauma survivors to engage in self-care around online activities such as participating in survivor forums, blogs or social media. How do you balance and remain mindful of the needs of all parts of you? But more about that in a later post!
Overall, keep in mind that the very heart of dissociating into separate selves is about self-care and protection. You did what you needed to do to live through atrocities no one should have to face. That is quite the accomplishment indeed!
This is of course just an overview and a beginning of a complex topic. If you think I have left out something, I’d love to hear about it! Others may benefit from reading about how you are learning to care for all of you!