The anxiety in her voice was unmistakeable. “I had to go out and look for her,” she explained. “She doesn’t know where she is or what she is doing when she’s like that. I had to go.”

This was not an unusual conversation. Many supporters and partners, as well as survivors and therapists, phone the PODS helpline or contact me via email. I am not the fount of all knowledge but sometimes just speaking to someone else who has been there, who understands and can empathise in this world of disbelief and denial, is helpful. Over time, patterns begin to emerge, conversations similar to this one and I have begun to recognise some very powerful dynamics at work in the support of people with complex trauma.

This is what I refer to as the risk of rescuing. The scenario involves someone, usually with DID, supported by one or more huge-hearted people in their community. This alone is something to be celebrated as the vast majority of people with DID who get in touch with us have little or no support. Partners, spouses and family members are not always understanding. Therapists usually have boundaries and limitations on their time and availability. More often than not it is church communities who offer the kind of support that helps a person in the midst of dissociative chaos and offers them a lifeline and a place of safety. But there are risks, and there are very real reasons why these relationships all too often go disastrously wrong.

I want to offer some of my experiences from various angles: I am the husband of a dissociative survivor, I am a qualified counsellor, I run the PODS helpline, and I also have experienced damaging pastoral care within a church setting. I don’t have all the answers, but, having learned the hard way, I do have some sense of why relationships which we intend to be healing and reparative can so often end up as a further source of hurt and shame to people whose lives have already been so blighted by abuse and trauma.

The backstory to this particular phone conversation was familiar. The caller was supporting a lady with DID whose partner was unsupportive. Dissociative fugues were common, disappearing off not knowing where she was or what she was doing. Self-harm and suicidality figured prominently. The lady’s safety was questionable, especially at night. Shame and fear meant that she didn’t want anyone else to know. The supporter, moved by compassion, offered help, love and confidentiality. There were regular phone calls, texts, emails, visits, increasing over time as the flashbacks got worse, the switching became chaotic and threats to life were commonplace. Then the trigger event: Easter, or equinox, or Halloween, or Christmas, or a birthday, or an anniversary of a particular event. The DID lady arranged to stay the night at her supporter’s house to help keep her safe. In the early hours of the morning she disappeared. “I had to go out and look for her,” the supporter explained to me once again. “She doesn’t know where she is or what she is doing when she’s like that. I had to go.”

At first glance, of course she had to go. Who wouldn’t? You feel responsible: you are caring for this person, she is staying with you so that you can keep her safe, she disappears … if anything happens, how do you explain it to her partner? She is your responsibility. And that responsibility comes at the cost of tidal waves of anxiety and increasingly frantic attempts to help make things better by not leaving her alone, by responding more promptly to her distress cries, and by taking charge of dangerous items in her possession such as tablets and knives.

This is a scenario that I have witnessed first-hand as well as more indirectly through numerous phone calls, emails and conversations. What starts off with the best of intentions in a desperate attempt to help someone in the most wretched of circumstances becomes for many supporters over time impossible to sustain. Rather than improving the situation, it just seems to get worse. But that’s okay, you reason, because things often get worse before they get better, don’t they? You just hadn’t anticipated how much worse. You begin to wonder if you can keep offering this level of support and living half-worried to death all the time. Others around you – your own partner for example, or friends – begin to disagree with the level of your involvement and the impact on you of repeated nights of broken sleep and the constant stream of texts or emails that mean that evenings, nights, Sundays, holidays are constantly disrupted by a crescendo of crises.

“You don’t understand,” you cry, torn between these two realities. “This person has no-one but me, she is desperate, she has suffered the most awful things.” You put it down to your partner lacking compassion, not realising the level of suffering that has led to this lady’s current crisis. And after all, you promised not to leave her, or abandon her. You told her that it was alright to tell you, that it wouldn’t drive you away, that you didn’t think she was bad, that you weren’t going to walk away. Surely the escalation of symptoms is a sign of progress: the night is darkest just before dawn. She is on the verge of a breakthrough. You can’t turn to anyone for help as you have promised confidentiality and the mere mention of involvement with a GP, let alone psychiatric services, makes things ten times worse. You seem to have no choice but to keep going, keep praying, keep believing, keep hoping.

But supporting someone and carrying the weight of responsibility for their safety, their life, and their recovery exacts a heavy toll. Sooner or later, even if for only a moment, compassion gives way to irritation. At times you begin to feel that you are being manipulated. She vents unspeakable anger at you when you fail to respond quickly enough to a cry for help. She seems ungrateful for all the other times you dropped everything to run to her aid, and the cost to your relationships, your work life, your family. You feel hurt and unappreciated. And then you catch the feeling and remind yourself that she cannot help it because she has DID and she doesn’t even know what she’s been doing. You berate yourself for your lack of love. You try harder. Perhaps you decide to take a slightly firmer line, and you counter every one of her negative confessions with preacher-like exhortation: “You mustn’t say that. You’re not bad. You’re good. You don’t need to hurt yourself. You’re good. You say it: I’m good. Come on, you say it: I’m good.”

If only she would realise that she’s not bad. If only she would accept what happened. If only she would ‘go there’ and remember properly. Flailing against the powerlessness you feel, the despair that creeps in at your most exhausted moments, you rally yourself with lists of things that will turn the situation around, milestones that need to be achieved, things that she must do if she is going to get better. You start to feel desperate with her level of desperation. You worry for her in a way that she doesn’t even worry for herself. Alienated from your own support network because of their disapproval at your involvement in this lady’s life, her recovery becomes paramount, not just for her sake but to vindicate you and prove you right.

And before you know it, you’re not just supporting her. You’re rescuing her, and even controlling her. And you’ve stopped helping her at all.

If the required breakthrough doesn’t come soon enough, anger and frustration can mount as you face the impossibility of your situation. “I can’t help you if you don’t even want to help yourself!” Compassion vanishes and in floods irritation bordering on rage – that you had to go out to find her again last night, that despite promising that she hadn’t been storing up tablets she had managed to overdose again. Eventually, perhaps, you crack under the strain of helping someone who doesn’t seem to want to help themselves (or at least that’s your burnt-out assessment of the situation), and you decide that enough is enough. The relationship is over. You can’t take it any more and you’re out. It is your turn to go and see a GP and you leave with a prescription for anti-depressants and you begin the slow work of trying to restore your marriage.

Yes, it happens.

Many supporters do come alongside people with complex traumatic symptoms and do a fantastic job. They provide just the right level of input and neither stand at a distance nor become dangerously enmeshed. But it requires a lot of wisdom and a very firm sense of self, with good boundaries and a clear understanding of their limitations. It is not an easy balance to strike. I have spoken to dozens of people, either supporters or survivors, who have experienced the level of enmeshment described above and where the relationship has gone disastrously wrong. I have seen it with some of the ‘help’ that my wife received right after her initial breakdown, and I experienced it myself in another ‘helping’ relationship. Numerous survivors have told me of how they had a ‘wonderful friend’, ‘an amazing lady from church’, even a therapist, who was there for them all the time, who was absolutely brilliant, who saved their life … and who then ‘abandoned’ them. The confusion and hurt from that, lasting as it does many many years and infecting and threatening all future relationships, seems to outweigh any initial benefit there might have been. So I have become very wary of the risk of rescuing.

So what goes wrong and what are the dangers?

There are many facets to the problem, but I believe that the fundamental issue is one of powerlessness and control. We saw in the scenario above, which is a composite of many different situations, how the initial compassion and genuine desire to help is usurped over time and replaced by frustration and control. There are two dynamics here at play: why does the survivor need rescuing? and why does the supporter need to be the rescuer?

At first glance, it seems obvious why the survivor needs rescuing: their life is chaotic and out of control. They switch between parts of their personality and have no memory of what has just taken place. They are not able to decide for themselves on a course of action and they need a safe adult to take care of them. Psychiatric care is out of the question as they are so afraid and so ashamed, and surely it will only make things worse. Many people, in all sincerity when faced with such a scenario, would respond with a heartfelt, gut-wrenching “Of course they need rescuing!”

But the person in question is a survivor. That does not mean that they are weak, and incapable, and powerless. It means that even as a child they survived things that most of us cannot even imagine. If they survived overwhelming trauma as children without any support, surely they can survive the aftermath of it now as an adult? Support is vital, but we cannot do it for them. We have to recognise their autonomy, their responsibility, and their capability. Many survivors struggle to see this for themselves and are convinced that they are ‘crazy’, ‘pathetic’, ‘weak’ and that they ‘can’t’. But the powerlessness that they subjectively feel in relation to their current circumstances is a symptom of trauma, not an objective reality. Somehow, they have managed to survive thus far, and somehow they will continue to survive. Although I take very seriously the risks of self-harm and completed suicide, I do continue to believe in the resilience of survivors: they have had good reason, every single day, to kill themselves, and yet somehow they are still alive. And that should be a source of huge encouragement both to them and everyone around them. If miracles of survival have already taken place, there is no reason why they shouldn’t continue.

What I have found is that the profound powerlessness that survivors feel is entirely understandable in light of the powerlessness that they experienced as children. But it is an echo, a memory, an affective flashback of how they felt back then. It is a communication. It is vital that we hear and respond to that communication, but that we understand it in symbolic terms and do not respond to it as if it is the truth. The reality is that the survivor you are supporting is no longer powerless, however much they feel it. It is when we are sucked into believing their reality – the reality that subjectively they feel with the force of a gale force wind – that we cease helping them and start, unwittingly, controlling them for our own benefit. We have to be able to retain our own boundaries and our own frame of reference, and slowly invite them to reassess themselves and the world around them and see if they really are still powerless and if they really are still under threat now as an adult.

Trauma disrupts a survivor’s sense of time, making it difficult for them to distinguish between past and present. So the powerlessness that they felt there and then is experienced powerfully by them here and now. It is possible to affirm the reality of their subjective experience whilst also gently pointing them towards the new reality of life now.

Every child enduring trauma and abuse wants to be rescued: that is understandable, normal and of course entirely adaptive for their survival. The reality is that they endured repeated instances of trauma and abuse where they were not rescued, where no-one came to help. Coming to terms with those feelings of abandonment and outrage is a vital part of therapeutic work, but often it is hijacked by acting-out rather than learning to tolerate and process those feelings. Survivors often unconsciously re-enact traumatic situations and look for the rescue that never came as a child. If a supporter fulfils the role of rescuer, coming out for example to search for them in the middle of the night, then that can set up a highly addictive loop: instead of working through feelings of abandonment and victimisation as a child, the survivor tries instead to meet those needs by a real adult in the here-and-now.

It is not therefore surprising that crises become more frequent when there is a supporter to jump in to rescue. Instead of realising the need to learn to swim, the survivor can shout repeatedly for the lifeguard. In the early stages, this actual rescue is sometimes essential, but it can quickly develop into a pattern. There will always be triggers and difficulties in a dissociative survivor’s life, especially in the early stages, which can lead to crisis situations. If they are rescued every time from those crises, they will never need to learn to manage the triggers better or trust themselves for the answer. Rescuing sets up a pattern of behaviour that precludes new adaptive and positive ways of behaving. The survivor is confirmed in their belief that they are powerless and unable to care for themselves. But at the very same time, they are made to feel satisfyingly powerful as their actions, or those of their alters, elicit a response from people around them. Perhaps for the first time in their lives, survivors begin to see that they can control others’ behaviour, and this is a strong antidote to the terrible discomfort of powerlessness that they have always had. It is not therefore surprising that they allow themselves to wander into dangerous circumstances, with the double reward of both being rescued (alleviating the awful feelings of childhood) and of being powerful (by eliciting a reaction). None of this is necessarily conscious, but it is real.

Some supporters can also err worryingly into the realm of invading the ‘safe space of free will’ between two people and can become controlling in their attempts to help. Many of us thrive on ‘needing to be needed’: it is reassuring and pleasurable to our own egos to be the hero-rescuer who helps the most damaged people, those who have been spurned and rejected by all others. We need to constantly ask ourselves why we feel the need to play that role. The reality is that we can provide support that is boundaried and able to be sustained long-term, but we should never overstep the mark and leap into rescuing. Often, if we are honest, we can see that that is more about our ego and our need to be heroic than it is in the survivor’s best interests.

At all times we need to respect the survivor’s free will, their autonomy and their responsibility for their own life and recovery. If the supporter takes on that responsibility, either by wresting it from the survivor or by accepting it as the consequence of the survivor’s abdication, there can be no recovery. People only recuperate from childhood abuse and trauma by regaining their sense of self-agency, their own sense that they are responsible for their lives and can direct them as they will. A recovery ‘programme’ that is based on treating survivors as children (perhaps even naughty children who cannot be trusted) is fundamentally flawed and will only make things worse in the long-run.

What I have also found is that ‘crisis’ in a survivor’s life can be caused by a range of factors, one of which is their adaptation to the relationships around them. One survivor told me that she would phone her supporter in the middle of the night under the guise of ‘crisis’ because it was the only time when she could be assured of her full attention. The supporter in fact encouraged this, saying that she wanted her friend to realise that she was no longer alone as she had been as a child. All that happened was that they both got very little sleep and the survivor came to believe that she could not survive without her supporter on the other end of a night-time phone call. The survivor’s ability to tolerate aloneness or to manage independently was severely undermined. Looking back afterwards, the survivor said that those night-time phone calls had actually done more harm than good. “It encouraged me to believe that I couldn’t do anything about my insomnia or my nightmares except ‘phone a friend’. I didn’t have the answer myself. I couldn’t work towards an answer. I was helpless.” When the supporter went away on holiday, the survivor had no other strategy to cope with her disrupted nights and regretted not having developed other resources. What helped in the short-term actually became a long-term hindrance to recovery.

Thinking that 24-hour availability will help, supporters often plunge into a survivor’s chaos and become equally chaotic themselves. What they need to do instead is to maintain their own order and empower the survivor to learn to manage life better, without doing it for them. They need to offer regular swimming lessons rather than being available as a lifeguard. Many fall into the trap of infantilising, or treating the survivor as a child – of course, with DID and the reality of ‘child parts’ this is particularly easy to do. Rather than encouraging the survivor to improve internal communication between parts and to take responsibility for the actions of the whole person, regardless of which part is ‘out’, supporters and therapists can sometimes unwittingly encourage further dissociation or disconnection between parts, by treating the survivor as if they can never have any control or influence over their younger or more self-destructive parts. So instead of helping the survivor to come up with strategies for managing night times or difficult periods of their life through internal communication and collaboration, through encouraging the survivor to have to work with their internal team of alters or parts, the rescuing supporter can actually reinforce the divisions and collude with the dissociative splits. While there is someone to bail out a younger part, or a suicidal one, the person doesn’t need to take responsibility for themselves as a whole. In reality sometimes it is better to allow pain and difficulty to drive people towards addressing the roots of their dissociativeness. As supporters we must always be wary of any course of action or offer of help driven solely by our own discomfort at seeing someone else’s difficulties. We must do what is in the best interests of the survivor, not what best alleviates our unease.

With or without DID, it is common for supporter and survivor to fall into adult/child roles, which at best are patronising (“I’ll do that for you …”) but after a build-up of frustration and exhaustion from constant crisis can quickly become punitive and controlling. It is a no-win situation when a supporter feels responsible for someone else’s life and recovery and yet has no power to enact the change necessary. Once this happens, it is a classic ‘drama triangle’ scenario and the role shifts from being the rescuer to becoming the perpetrator: however well-meaning the supporter has been, the survivor can end up seeing him or her as just another person who has robbed them of their free will, and is telling them what to do. It is frighteningly common for the relationship to actually become abusive at this point as well – mounting frustration and the need to control the outcome on the part of the supporter can lead to them acting out their anger through verbal or even physical assault. A very enmeshed relationship which has involved a lot of physical touch under the guise of comfort and reassurance can also quickly blur into a sexual relationship, especially when there is not the same level of awareness, supervision and restraint from organisational ethics (eg BACP Code of Practice) as there is for therapists. It is a minefield that unfortunately too many people blow up on.

So what should a supporter do? I am in no way suggesting that people back off and refuse to get involved with people with DID: quite the opposite. Survivors need as much support as they can get and healthy, balanced, supportive relationships can have a hugely positive impact on recovery. But ‘too much commitment can equal no commitment’ and extending beyond what is sustainable for the long-term can mean abandoning the very person you have been trying to help and causing them far more damage than if you had never come alongside them in the first place.

So supportive relationships need to be sustainable and consistent. Offer only what you can continue to offer for the long-term, and ensure that you are supported in your supporting too! Doing it at the expense of your own relationships will only lead to resentment and burn-out and is not modelling healthy relating and good self-care to the survivor. At all times, leave responsibility for their life and recovery with the survivor and do not promise confidentiality that you cannot keep – it is all too easy to be sucked into not calling for extra help from appropriate services, such as a GP or mental health team, because you promised not to in the early days. Your commitment should be to the survivor’s long-term recovery, not to making things easier for them here and now. You will need bucket loads of compassion and care, but at times you will also need some tough love.

Keep believing in recovery, keep believing in their capacity to survive (especially considering what they have already survived) and keep believing in their capacity to recover too. Maintain a safe space for free will to operate, and if you find yourself saying, “I had to …” then step back and consider where that duress has come from. Is it because you need to be a hero? Is it because the survivor is asking you to enact their recovery and maintain their safety for them? Your boundaries are your responsibility, not the survivor’s. When things become enmeshed, it is the supporter who needs to take responsibility for it because they are the one who holds the power in the relationship. Supporting is about giving freely, not under compulsion, and the survivor should also be free to receive what you have given, or even to reject it. The only way to recover from abuse is for all parties to be operating out of free will.

Supporting a survivor with DID to recover from trauma is challenging, but it can also be hugely rewarding and even life-changing – both for the survivor andfor you. Just remember that it’s about supporting, not rescuing, and you probably won’t go too far wrong.

(c) PODS 2012