I don’t think there was ever any teaching on trauma in the counselling training I did. But when I was doing my student placement during my diploma, it was mentioned that there was a person who was losing time, and they wondered if this person might actually be dissociated. I was asked if I would be willing take her on. To prepare for this, I read the book When Rabbit Howls – that was all I knew about dissociative identity disorder. The whole thing was alarming for me and so unreal and unnatural. How could anyone have more than one personality? I was also very squeamish about anything to do with Satan or the Devil – I wouldn’t even say the words. I was a vicar’s wife, and wanted nothing to do with this side of life at all. I couldn’t have been more ill-
And then more child parts came, one after the other, and I grew to love them and they became very special to me. Somehow, despite my ignorance and lack of training, we developed a therapeutic alliance, and we began to work together. We figured out that each alter had had a part to play in the trauma and had had a special job to do, with special training, under torture and duress and so on. And we went from there. Everything I knew, everything that I began to know, this client taught me. She had no idea that she was dissociative because she wasn’t in the slightest bit co-
We worked on what I would now call mapping her internal system, but the whole idea of there being a ‘system’ or a ‘family’ was entirely new to me then. We discovered more and more little ones, and teenagers, and personalities of all ages who had been forced to do the most terrible things. And the teenage parts wanted nothing to do with the little ones, so we worked on getting them to relate to each other, to understand why they were there, how it wasn’t their fault. It was wonderful when they all began to work together and listen to each other and hear each others’ needs and so on. I’ve got a theoretical framework to put that in now – internal attachment – but back then it was intuitive and I couldn’t have explained it if I’d tried.
I was horrified at the atrocities I was hearing that had happened to this person, and I was phoning my supervisor every day, really just to calm myself down. It shocked me to the core, and I wouldn’t have coped without that support. We realised that there were all these inside people who wanted to come and talk and that the session itself wasn’t enough to hear everyone, so as well as making each session longer, we arranged that once a month she would come on a Saturday morning just to play. But in her play I couldn’t believe what I was seeing and hearing: “Oh, you don’t want to go home, that’s horrible that, that’s the worst place to be.” And what she was doing with the toys was explicitly showing me sex of every imaginable variety.
Somehow we muddled along together to find ways that would help her. One of these ways was me telling a rescue story and blowing the house down afterwards, rescuing the child to make it all better and then telling off the people that had hurt her, sending them away and so on. We used to tell this story over and over again, and it helped. We worked a lot with story and toys and play, but really it was the relationship we had that got us through.
One of the leaps forward was when we went away once together, to Nicholaston House in Wales. We drove down there and it was mind-
It could only have been the strength of the relationship that got us through. I had no idea about neuroscience, and had very little appreciation of attachment theory. I have chased training ever since, beginning with Penny Parks Inner Child Therapy, then Sensorimotor Psychotherapy, and Lifespan Integration as well as a lot of CPD on trauma. And I’ve bought libraries of books – whatever was available I’ve wanted to read, to know and understand what was going on, to be better at helping, because therapy with DID survivors is such a long and painful process. So I’ve always wanted to learn anything I can that will make it easier and less arduous for the client. Many times I tried to refer my client on to someone who could help her better, not because I didn’t want to work with her, but because I cared for her and wanted her to have the best. But there seemed to be nobody, nobody at all. Fortunately nowadays there are more trauma specialists, but still too few.
Through it all I have been rocked to the core by realising the depravity that people, the perpetrators, are capable of. In contrast the DID clients I have had have been the most beautiful, the most loving people I have ever met on this whole earth. They have a compassion and a humaneness and a gentleness and they have shown me more love than I have dreamt was possible. But I’ve been appalled at what has been done to them, the calculated evil they have been brought up with, the vileness of the gratuitous violence they have suffered, and the distress of their shame and humiliation. What really took me by surprise was realising that this is organised abuse, often by people with respectable jobs and beautiful houses and smart Savile Row suits. And it is these people who in many cases are the ‘pillars of society’ who have deceived and tricked children, tortured them, and destroyed their lives and their beliefs about themselves and others. Yet somehow through it all, these wonderful clients of ours have stayed alive and had the courage to endure therapy, which is extremely painful. It takes a huge amount of courage to go through therapy with this kind of stuff, so I admire them all enormously.
I have come to understand that so much of what goes on during the abuse is a manipulation and perversion of a child’s innate attachment needs, where the child is invited to love a kitten or a puppy, and then that animal might be killed and they are forced to eat it. And the way that abusers use the magical thinking of the child to terrorise them into silence: “We’ve planted eyes in you so that whatever you do we can see you.” One of my clients was made to believe that there were hidden cameras watching her every time she was in the bath, and there was just this awful sense of humiliation and shame, of being watched and having no privacy, that messed with her mind in such a subtle yet such a damaging way.
Sometimes, with the play therapy part of things, I’ve seen child parts tell their story through acting it out with little Playmobil men, because they are under orders not to ‘tell’ with words, but they desperately need to communicate it somehow. And I can remember my horror at watching a scene unfold in the sandtray, watching a row of little people against the wall, then sitting up, then lying face down and bang, bang, bang went the adult Playmobil men, and I heard myself say, “Gang-
Some of the most challenging aspects of it for me was understanding that for this child-
Engaging so deeply with such traumatic material, in an intersubjective relationship where you can’t help but care so profoundly for someone, always runs the risk of secondary traumatisation, and I take that risk very seriously. I’m fortunate to be in a very stable, long-
But usually it’s the little things that upset me. Like the mother who knowingly lets abusers take her child off to harm her and then leaves her a cup of milk for when she gets home. Or one client who told me about the most horrendous rape and torture that went on, and then sitting at the table for tea straightaway afterwards, sitting straight, elbows off the table, that kind of thing, and someone insisting that she had another potato. She’d been forced to ingest the most awful, horrendous substances, and then someone is pretending that it’s all happy families and normal and she has to eat a second potato. That really got to me. I just get so upset about the little things, because they take me off-
But it’s so important for me to be able to cope with this stuff because if I can’t, how can my clients? I’ve got to be a secure, safe, soothing presence who can contain their ‘stuff’ and hold it for them for a little while, and give it back, transmuted a little, perhaps slightly more bearable, so that they can own it and say, “Yes, this is my stuff.” But that takes a lot of time, and a lot of courage on their part. I’ve learnt a very little about how to use the body to deal with some of it, and doing the Sensorimotor training has been absolutely fascinating because you come to realise that the body has its own story, and that if you listen to the body you can actually process stuff without retraumatising. It’s wonderful to see a transformation where the trauma doesn’t haunt them any more.
It’s always a balancing act, and too often we’re riding right on the edge of being out of control, but the concept of working within the ‘window of tolerance’ has helped me enormously, as has the three-
Attachment theory is hugely important to me now and what I really want to do right from the start with a client is to establish a safe environment, to be a secure base, to develop a relationship where the client is listened to and held and contained so that there can be some safe exploration. Obviously there is the trauma to explore, but so often there are a hundred other areas in their current life too, like relationship difficulties with partners or children or friends, problems with just maintaining some semblance of routine and normality while these intrusive dissociative states scream for attention. And there’s developmental trauma as well – all those limiting beliefs such as “I am bad”, “No one can be trusted”, “I don’t belong”, “I hate me”.
So many times it has felt that progress in therapy is signalled by destabilisation or disintegration, and at those times you really do have to have good supervision and a lot of faith in the process, a lot of understanding in what is going on, either in attachment terms or neurological terms, or both. Adah Sachs talks about how we can become a new type of attachment figure – ‘earned secure’ – but to do this you have to be there when the client is making their attachment cry. This mostly doesn’t happen during the session, when you want it to, when it would be convenient. It happens in between sessions, and – especially at certain times of the year – at night. I do a lot of my ‘work’ with clients outside the session: with emails, with telephone calls. For particular stages of therapy, usually when we’re processing trauma or there are particular threats to attachment security, the client needs to know every day that you’re still alive, because they think that you’re bound to die or to be killed, because they’ve started caring. Or they are struggling with some form of object constancy, and they can’t remember you, and there’s a panic that suddenly you don’t exist, that you’ve been annihilated – and this feels like they have been annihilated, that it’s a threat to their survival, so they spiral out of control in terms of emotions and autonomic reactions. In those instances I personally would prefer it if my clients phone me – when they’re having night terrors, or the pain has reached intolerable levels – just so that we can restabilise things, do some affect regulation, bring things back down into the ‘window of tolerance’. Then I find that gradually, over time, they learn to do it for themselves – they learn to self-
I also do other wicked things like going out for a coffee with my clients, because I want them to know that they are human. They have had all the human taboos broken, so they don’t realise that they really are human and the same as everyone else, and deserving of the same courtesies and the same pleasures as everyone else, even simple things like a coffee and a cake in Costa. They don’t realise that they are nice people because so often they hate themselves so much, so I think it’s important to normalise things sometimes, to socialise or relate on a kind of everyday level too, to make sure that it’s not all trauma work with nothing balancing it up. For some it’s in those settings that they learn that they can ‘do people’, as one client puts it, that they can be just like ordinary friends meeting for a cup of coffee, that they’re not weird and damaged and beyond redemption. Sometimes the smallest, most basic, obvious things are the most therapeutic.
The crux issue for me within attachment is attunement. With disorganised attachment, and with clients who have been ritually abused in particular, you can very quickly become misattuned. Sometimes that happens simply because you’re not seeing things from your client’s perspective – you’re clueless, you have no idea that what you’ve just said or done was triggering, or unhelpful, or has other meanings. Sometimes it’s transference and it’s just that no matter what I do, I’ll be seen as ‘bad mother’. But often it’s more than that, and I’ve failed to meet my client in the middle where we’re both bringing our experiences and understanding of the world into play – I’m just oblivious to how different our perceptions or expectations might be. For example, one of my client’s alters would say, “I’m stupid” and for a long time I would say, “No, you’re not stupid – you’re very intelligent.” And I didn’t understand why this alter would then spiral further down into shame and a sort of anguish, of disconnection from me. But then over time I began to realise that this was a double whammy for them, because now I was in effect saying to them, “You’re wrong.” So they would think, “Well, I obviously am very stupid, because I got it wrong as well.” And being wrong, getting things wrong, was not just a source of shame and humiliation but was hugely dangerous for them previously – there had been repeated instances of torture when they ‘got it wrong’. So I’m a bit laboured now and I say, “Yes, I hear you say that you think you’re stupid … my experience is slightly different” and I try to validate their view of themselves first so as not to trigger shame or terror. Another source of misattunement was misreading my facial expression, because the constant dread or the constant expectation was that I was cross. The trouble is that I frown when I’m concentrating or thinking! I had no idea that fear of not getting it right, or someone being cross, was such a deep and embedded trauma.
I do believe very much in validation. So if someone is cutting themselves, far from saying, “Don’t do that!”, I would now try to find out what the cutting was trying to achieve, because I realise that every part, every alter, is doing something for the host person, for the team as a whole. So the cutting might be to give them a moment’s respite or peace or pain relief, or it might be a way of shouting, “Something is wrong here – do something!” Or it might be a re-
This has been a developmental journey, my own process. I still don’t know the answers, but am better able to hold the unknowing, able to stay with that unknowing and still be present. There are no certainties, no black and white or “This is the way to do it.” I used to worry about the ‘either/or’ dilemma, for example “Do I either work with the parts or with the wise adult?” I know now it is not ‘either/or’ but ‘both/and’. My focus is not so much on the doing of the work, but of being in the work, the ‘I-