A Conversation with Aerial Long,
CMF, CT,
by Victor Volkman
Aerial is a Personal
Growth Counselor and Certified Traumatologist in
private practice and has been counseling since 1977. She is founder and board member for Trauma
Relief Services of the Northwest (TRSN) in Beaverton,
Oregon, a non-profit educational foundation
providing counseling services and education in the field of trauma. Her training includes certification as a
facilitator in Applied Metapsychology.
See also www.aeriallong.com
I asked Aerial to share her experiences in using TIR with
clients who have been diagnosed with Dissociative
Identity Disorder. See What is DID? below
for more information on this diagnosis.
VV: What should practitioners know before taking
on clients with DID symptoms? Imagine
that you are a Technical Director and you are setting up a case plan for a
practitioner.
Aerial: They should be an advanced Metapsychology
practitioner or have some prior training in DID. I wouldn't say that TIR Facilitator training
is sufficient. They would need Certified
Metapsychology Facilitator training. It
would be better if the facilitator is a mental health professional who is
already trained in DID as part of their background.
It's too complicated to do TIR on DID people as a general
rule. I have only taken on clients who
had quite a few years of DID therapy and wanted to handle their trauma. Even as an advanced Metapsychology
practitioner, I have referred out several clients with DID symptoms because
they didn’t have the ego strength to do TIR and I didn't feel I could serve
them.
What is Dissociative Identity Disorder?
Recently considered rare
and mysterious psychiatric curiosities, Dissociative
Identity Disorder (DID) (previously known as Multiple Personality Disorder-MPD)
and other Dissociative Disorders are now understood
to be fairly common effects of severe trauma in early childhood, most typically
extreme, repeated physical, sexual, and/or emotional abuse.
In Diagnostic and
Statistical Manual of Mental Disorders-IV, Multiple Personality Disorder (MPD)
was changed to Dissociative Identity Disorder (DID),
reflecting changes in professional understanding of the disorder resulting from
significant empirical research.
“Personality” is no longer used to describe these entities. 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 appear to be very different, they
are all manifestations of a single person.
(From: The Sidran
Institute www.sidran.org)
VV: What kind of results have you achieved with
clients who have DID symptoms?
Aerial: I've only had three clients who told me they
were diagnosed with DID. Since I don't
diagnose, I cannot confirm that there were more. The results that I've had have actually been
fairly positive. Two of them that I saw
reached what I call "full integration". These clients had already had years of
psychotherapy. They were at the point
where they could stay centered and be the witness or controller of their other
identities.
VV: From the DID
theory I've read, a typical person has four or five identities and one of them
is usually a "helper"...
Aerial: Well, there is one that they center in and
that one helps handle all the others.
They have to have a place to center or they get lost. Usually in prior therapy, they've already
been able to ascertain which persona or identity they can center in to help
them with the work. Then we just ask
them from that point of view, to talk to the other identities and ask,
"Who is willing and ready to step forward to handle some of their
traumas?" Someone always steps
forward and is eager for healing.
Whoever is the first identity to step forward is the one that we take
(because that identity is the one most accessible). I treat that identity as I would treat the
client and find the traumas that could have caused the "split".
VV: So you look specifically for the trauma which
precipitated the split?
Aerial: I usually ask for traumas because it's
sometimes too hard for an identity to find "the trauma". I have to work backwards just like I do with
a regular client. I take incidents
closer to that identity’s present time and then go earlier as the client's
confront comes up. We either take themes
with Thematic TIR or we'll use Basic TIR and ask for a specific trauma that
could have caused the split.
VV: Are there any
ways in which the DID clients differ from those with typical PTSD issues.
Aerial: Yes, I've had to be very,
very careful at the end of the session to make sure that everybody (meaning all
the identities) is OK. Sometimes when
working with one identity, it will restimulate upsets
and trauma in other identities. I check
with all of the parts involved to make sure that nobody else has gotten restimulated, that they are all OK. Whereas with a typical non-DID client, you
know when you've finished the trauma that they go away resolved. The client gets their end point and they are
fine with it. In the DID client, it’s
like having several people in the room.
I would check with those other identities (parts) that are there to make
sure nobody else has been restimulated.
VV: And how do you handle it if they are restimulated?
Aerial: I don't necessarily use TIR with them. We will do run some other kind of lighter
technique to get them into present time.
This insures that they all leave session feeling released and resolved
from that session. When they are ready,
we'll take up their trauma from their point of view.
VV: I gather that memory loss or amnesia is a big
part of DID. Do you find them recovering
a lot of lost memories?
Aerial: Actually yes.
When an identity remembers a particular time period (for example ages 8 to 10), that time period has often been
occluded from the whole. When TIR is
used to help that identity resolve the charge and regain conscious memory of
their trauma(s), then those memories are available to all the other parts. That's the beauty of the integration.
VV: What unique
challenges are there for working with DID clients either with TIR or in
general?
Aerial: It's like having five people in the room, not
just one. You've got one person that's
the leader and he or she is helping you with the others. It's a little more challenging I believe in
that respect: keeping track of who is
speaking and making sure that the client stays really focused. You don't want to be talking to somebody else
all of a sudden. You really need to have
a client who can manage this kind of work.
VV: How do you handle it when clients
"switch" in the middle of an incident?
Aerial: I find out who is talking to me. I ask, "Who is speaking to
me?" They know who they are and
they identify themselves. I just treat
it like an origination from an ordinary client.
I might ask, "Is there anything you need to say?" or
"Tell me what happened?"
Someone might have gotten upset and I sort it out. So I would handle that and go back and finish
what we were doing with the original identity I was working with prior to the
upset.
One of the things that happens also using TIR with DID
clients is that it promotes a tremendous amount of compassion and understanding
from the other parts. They're watching
this 8 to 10 year old go through their trauma and come out the other end. All of a sudden, there's more connection and
that's part of the integration. It
creates understanding with the other parts:
"Well no wonder", they'll say, "look what happened here
with little Joe". TIR raises conscious awareness and promotes integration
VV: Have your clients
experienced a loss after their parts had been integrated?
Aerial: When we got
to the point where all of these identities or parts were integrated, the person
became whole. So there was nobody to
talk to anymore. It was very strange
for the client since they were used to having quite a bit of internal
chatter. Their world became quiet and
lonely. I handled this by Exploration
and allowing them to talk about it. I also
used some grounding procedures.
VV: It wouldn't go so
far as to be a grieving process?
Aerial: It would
depend on the client. With the DID
clients I worked with, it was just the strangeness of it and having a chance to
be able to talk about it was enough to heal it.
VV: Do you ever
need to run the other parts through the same incident?
Aerial: No, because it wasn't their experience. I may have to handle their upset about it,
but I don't have to run them through it.
As a caution, one of the things that might happen is that some of the
identities are in conflict. For example,
a critical adult and another identity that has a more childlike viewpoint might
become at odds with each other. The
adult keeps trying to tell the other one what to do all the time. That creates complications. You want to
handle the ability of the different identities to communicate with each other
before you ever address trauma. They
have to be able to at least tolerate and respect the fact that there are other
parts there.
VV: Do you have some method of building up
understanding between parts?
Aerial: It is very much like
group counseling or relationship counseling.
With the DID clients helped, they had gone through a lot of prior
counseling and their identities had resolved much of their conflict prior to
our sessions. One of the things from TIR
that happens which promotes understanding is that it is a tremendously freeing
thing for them too to realize why an identity was set up. When they go through the trauma, they become
aware of why that identity was set up.
There's some need that wasn't being met, such as safety. Behind each identity is an intention or
reason why it was set up and assumed.
VV: Part of the TIR
theory is that there is intention that you are trying to fulfill and you carry
it around because couldn't complete it.
Is the intention most often to be safe?
Aerial: Well of
course that's a very basic thing in trauma:
to be safe. It could even be to
have peace. Sometimes there are chronic
traumatic patterns. People go along and
they reach a breaking point. Chronic
traumatic patterns can be addressed with TIR also and I have used TIR on an
entire time period using TIR or Unlayering
(repetitive procedures).