How to work with different parts

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When a patient comes in with several parts that all want different things, you have to explore a myriad of possibilities. One part might have a goal that is completely different then another`s goal. All these goals must be understood and explored, and with many parts this can be a real challenge for any therapist. Imagine a part that has experienced abuse, and always had to be strong to not get hurt. Then you have a part that is like the abuser, who hates everyone, even the other parts. As this wasn`t enought, there is another part inside of you that feels vulnerable and afraid.

The therapist has to slow down, and try to take every element and respond to it. For example, if a part says: “You don`t listen to me”, the therapist could respond “So you feel I don`t listen to you?”. The part will then respond with a yes, that immediately create a consensus between the therapist and the part. If the part continues with “You don`t respect me” the therapist again reflects back what the part feels, and maybe asks an extra question based on curiosity: “What is the worst thing about not feeling respected” ? The part feels understood, and one can continue with this collaboration. The therapist offers to look at every core concept, or belief, the part offers, so that the part can be understood and feel validated. Once a part feels validated, the “pressure” to get validated in self-destructive ways, will go down.

This is not easy, since you have to be intoned and empathetic in even in emotional situations that might be hard for the therapist, too. For example, an agressive part can provoke uncertainty and fright, that must be adequately controlled, to be helpful. Every person has their own insecurities and weaknesses, and if a part find those, we might respond in an emotional, automatic way that can be unhelpful. This might scare us, but actually the most important thing is to know your own weaknesses, so it`s possible to recognize them and take a step back. We can take a step back by taking a deep breath, and observe what`s going on: “I recognize that I`m feeling upset right now, so I must take a deep breath to regulate myself”. This is not only good for yourself, but also for the part who can observe a good role model. For parts that have lived among role models that act out their negative emotions even if they hurt others, this is completely new. The part needs this. It needs to be met in a new way, that proves that he or she isn`t all bad, for example. It`s easy for a part to “create” a self-destructive pattern that confirm it`s expectations. Every part has its own memories and reasons for feeling like they do, and the therapist`s task is to respect and understand this.

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4 thoughts on “How to work with different parts

    Cat's Meow said:
    November 29, 2013 at 03:14

    Do you mind if I comment from the point of view of the client who is dissociative, but not DID? I very much appreciate your writing about working with parts, because so many therapists know nothing at all about dealing with parts. However, I hope that you don’t mind my saying that I think that you need a series to tackle this subject, because it is so incredibly complicated. Even in just this one small area (engaging with parts about conflicting emotions/beliefs/needs/desires) I found myself wanting to say, “But what about X, Y, and Z?” I think that a series (perhaps one with a posting a week) could be a huge service to the therapeutic community. If you should decide to do something like that, I think that it could be particularly valuable to pair each of your postings with a posting from a dissociative client’s point of view, on the same subject, using a variety of collaborators.

    This would be a huge project and it may not be something that you would want to take on, however if you don’t want to, could you please keep an ear out for someone else who might and pass it on? I really do think that something like this could be of value and would love to see it implemented somewhere.

      mirrorgirl responded:
      November 29, 2013 at 08:05

      Dear ‘ cat’

      This was a brilliant idea. I do think you are right. What I posted yesterday was a piece of the lecture I’m on now, and indeed, it’s just a little part of a complex whole. I like the idea with writing a series, and it would really be good for both therapists and others to see a integrated post with client and therapist. Would you be interested to add your view and perspective after my posts? Btw: you find all my posts on dissociation by trying the tag ‘dissociation’ on my site. I should actually make a new page focusing on complex trauma and dissociation, since it’s what I’m most interested in 🙂

      Again, thank you for this creative and intelligent comment:) I will try to use some of your ideas when I have time to sit down 🙂

        Cat's Meow said:
        November 30, 2013 at 01:09

        I would be very interested in doing that. 🙂

        I’ll go and take a look at your other posts…

    brokenbutbeingrepaired said:
    November 29, 2013 at 11:55

    Really interesting post, again Nina.

    It’s particularly resonating with me/we after difficult session last night where a ‘difficult’ part told difficult truths to my t and was given the feedback that ‘it’s ok’ to express their feelings and memories and her support won’t be withdrawn because they say something ‘wrong’.

    The suggestion made by ‘ cats meow’ is a really good one and I’d happy to volunteer to give a ‘clients eye view’ too.

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