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DID Myths and Misconceptions

DID MYTHS AND MISCONCEPTIONS

    Dissociative Identity Disorder is by far one of the least understood mental illnesses out there.  It is enshrouded in misinformation, outdated coursework (for students and practicing clinicians alike), and a seemingly unending barrage of defamation attempts.  The latter sounds ridiculous, but probably shouldn't come as too much of a surprise once you consider that DID is caused by longterm, recurrent trauma in childhood - most often abuse.  There is ample motivation for entire organizations to want to squash its credibility or deny its existence, particularly when some of the founders of such organizations were accused of child sexual misconduct themselves.  But, that is NO excuse.  In fact, it's a massive reason why we exist at all and why we are so passionate about getting solid, credible information out there to everyone.

    There will be no shortage of information here on what DID is not, coupled with clarifications on what it is, but let's at least provide a brief summary for those of you unfamiliar so that you can better follow along.  DID is a dissociative trauma disorder in which a survivor has undergone longterm, repeated trauma in early childhood. This trauma, combined with other factors, results in a rather dramatic interruption of psychological development -- particularly as it pertains to identity. Through a process known as dissociation, this thwarted development results in "differentiated self-states" (also known as alters/parts) who may each think, act, and feel considerably different from one another.  These parts of the mind - who may have their own name, age and personality - are able to take executive control of the body, leaving the survivor without any awareness for the time they were gone. These amnesic gaps in memory can be for just a few moments, a few days, or even entire chunks of one's childhood.  The alters in a DID mind exist to help the survivor cope with deeply painful and unconscionable trauma, holding it outside their awareness to the best of their ability.  However, often once the survivor begins to find safety and/or enter adulthood, this once supremely creative and protective mechanism can turn into a maladaptive trait causing real life consequences.  Additionally, all of these experiences can be, and often are, happening alongside the symptoms of PTSD (eg. flashbacks, nightmares, hypervigilance, insomnia, etc), as well as symptoms of other co-occurring disorders commonly seen in trauma survivors.

    So, now that you know a bit more about the basics of DID, LETS GO DEBUNK SOME MYTHS! Since this is a lengthy one, we divided them into three parts: myths the general public tends to believe, misconceptions that even those familiar with the condition still hold onto, annnnnd then some of the truly bonkers ;)  Let's do this!

 

Part One: The General Public

 

✘ Myth:  DID is very rare.

Not even close. Its yearly prevalence rate (~1.5%) is actually more common than young women with bulimia and even on par with well-known conditions like OCD.  While it is very hard to gather statistics on a community of trauma survivors built on secrecy; who can be afraid to receive such a stigmatizing diagnosis, have or have had therapists untrained to recognize their condition, are riddled with amnesia (leading many to be unaware anything is even "wrong”), and whose self-preservation often includes intense denial of trauma — it's still inarguable that DID is anything but rare. It is a major mental health issue.

[Update: More studies on the prevalence of DID: x, x, x, x, x, x ]

 

✘ Myth:  People with DID are dangerous, villainous killers or have alters who do extreme harm.

Contrary to popular belief, survivors with DID are no more dangerous than those with any other mental health condition or the general public. The crime rate, violent use of weapons, domestic disturbances, etc. are no greater than (and often less than) the general population. In fact, due to survivors' prolonged exposure to trauma and violence, it is far more common for those with DID to be re-victimized, on the receiving end of violence and/or abuse, than to perpetrate it.  Many even take very staunch stances on pacifism after a lifetime of aggression and pain.

 

✘ Myth:  DID isn’t real. It’s a condition created by therapists / exaggerated BPD / attention-seeking / actually HPD and compulsive lying / etc.

Research begs to differ.  DID has distinct markers that separate it from all other disorders already in the DSM and it’s conclusive that DID results from longterm childhood trauma - nothing else. It’s the only condition that has such pronounced amnesic gaps ("missing time"), differentiated personality states, as well as exposure to extensive trauma; it did not just materialize from thin air or without solid precedent. Iatrogenic cases (“therapist created”) do not present the same as authentic DID and can be distinguished, just as malingerers and factitious presentations can be separated. (For more information on those: here.) More very valuable research here on DID validity: , , , .

As for the idea of it being “just attention-seeking”: It should be observed that ALL disorders, even physical illnesses, have groups of individuals who will pretend to have them. DID, however, has no higher rates of this than other conditions, and there is even a specific set of criteria that clinicians can use to confidently determine if someone is feigning the condition. But, primarily, there are far easier, more believable, more profitable, and more "rewarding" conditions to fake for attention (or to garner sympathy) than DID.  DID is a condition riddled with stigma, vitriol, and people from all corners of the world eager to call you a liar, say it's not real, or (even if they do believe you) hurl a bunch of insults at you just for the complex trauma you've been through. This is not what most are looking for when it comes to cultivating sympathy or attention. While some do try, many tire very quickly once they realize how many small quirks and minor details about their alters they must be able to recall and maintain seamlessly, and most are not trained actors to manage this. Furthermore, there are even greater hurdles to clear for anyone trying to seek treatment or therapy for DID (as opposed to just claiming it in their personal lives or online) - so most do not. 

We do not disbelieve the outright existence of eating disorders, cancer, or OCD merely because some people fake having them, do we? (...even though the rates of malingering or factitious disorders for those conditions are higher.) Why should DID be any different?

 

✘ Myth: If you have DID, you can’t know you have it. You don’t know about your alters or what happened to you.

While it is a common trait for host parts of a DID system to initially have no awareness of their trauma, or the inside chatterings of their mind, self-awareness is possible at any age. Once starting therapy, receiving a diagnosis, or becoming familiar with the condition, the entire path to healing relies on gaining access to all of that information, as well as establishing communication with parts inside. But, even without therapy, some can be aware of a few traumatic experiences, be able to recognize the signs of switching, or learn about themselves through old journal entries, photos, their wardrobe, reading old letters they don’t recall writing, and more.

 

✘ Myth:  Switches in DID will be dramatic, obvious, detectable, or involving parts who want to wear different clothes/makeup, etc. / “If you really had DID, everyone would know it.”

*buzzer noise*  False. Only a very, very small percentage of the DID population has an overt presentation of their alters or switches (5-6%). While some hints of detection can be seen amongst friends and therapists, most changes are passable as completely normal human behavior. DID is a disorder structured around concealment. Dramatic switches or changes in one's behavior or physical appearance would attract far too much attention, which could be dangerous for the survivor. Alters learn how to blend in, and many who do have considerably different personality traits, mannerisms, accents, etc., often try their VERY best to mirror the host's presentation.

For some, in the presence of loved ones or others “in the know”, some of these acts of concealment can fall away and their alters may feel more free to express themselves individually - but it still won’t be anything like what you’ve seen on TV. Child alters, however, are sometimes the most distinct when fronting in survivors who are very "adult". They've even been know to win over some the most stern of DID-doubters. But! This is one of the primary reasons that DID systems tend to keep these parts away from the front at all costs, especially in public settings. As for the act of switching itself, it can often look like an inconspicuous fluttering of the eyelids, a little muscle twitch or facial tic, or some other small movement of the body that looks like anyone repositioning themselves (or, y’know, just breathing). Switches can be detected if paying very close attention and while being aware of the condition, but it’s very, very rare for strangers or acquaintances to recognize one themselves. They’d sooner assume something else entirely.

 

✘ Myth:  DID is a disorder of “multiple personalities”, and that is what's "wrong" with the person afflicted or is what makes it an illness.

Having separate identities is merely the byproduct of something greater, not the sole disorder. The real dysfunction lies in the complex trauma and the countless effects it had on the child’s mind and their neurology -- including flashbacks, nightmares, hypervigilance, dissociative amnesia ('losing time'), depersonalization/derealization, emotion dysregulation, somatic symptoms, and heightened vulnerability to a long list of other medical and mental health disorders. Most of the healing from DID revolves around the processing of traumatic memories and sifting through the layers and layers of pain, sadness, anger, betrayal, grief and trauma that each alter holds. Yes, therapy does also address the very unique, distinct challenges of having alters -- from how to get along with one another and work cohesively, to keeping the body safe when individual parts are struggling with self-harm, to how to keep child parts from popping forward whenever you pass the toy section at a store -- but DID is ultimately a trauma disorder, NOT a disorder of personality.

 

✘ Myth:  DID happens because the mind is so traumatized that it splits into tons of alters.  The mind just shatters into pieces under all the pressure of trauma.

This was a long-believed model for DID, and one still held by many therapists today who have not updated themselves with the current understanding of dissociation and identity development. The Theory of Structural Dissociation states that DID results from a failure to integrate into one identity, NOT a whole that breaks, shatters or splits. We have a more detailed (but also very “layman-friendly”) explanation here: You Did Not Shatter.

 

✘ Myth:  DID can develop at any age.

DID only develops in early childhood, no later. Current research suggests before the ages of 6-9 (while other papers list even as early as age 4). Prolonged, repeated trauma later in life (particularly that which is at the sole control of another person, or breaks down a person’s psyche and self-perception) may result in Complex PTSD - which does have overlapping symptoms - but they will not develop DID.

It should be noted there are also other dissociative disorders, some that even mirror DID very closely (most notably OSDD and its subtypes), and age may be a very slight influencing factor in the lessened alter differentiation and/or amnesia experienced there. However, most with those presentations were quite young for their trauma as well. There are also many reasons that one may present more as an OSDD-type system instead of a DID system, but they’re a conversation for another day! Understanding DID is tough enough for most! Still, many of these myths will also apply to many of the symptoms, systems and experiences of OSDD survivors, too.

 

✘ Myth:  Survivors with DID can just switch on demand if needed for a task or if someone simply asks for them.

Plainly put, this is just not possible. Sure, for some there are absolutely moments where they can call upon specific alters for certain tasks, but there are no guarantees or absolutes (and, for any number of reasons). When it comes to outsiders trying to call upon parts, this could range anywhere from "sometimes possible" (particularly in therapy or in extremely safe relationships where that boundary has been established beforehand), to "hit-or-miss" (dependent on the person, their intent, the state of things inside, being triggered forward but not actually wanting to be there, and so forth), to "never" (it’s either completely inappropriate and uncalled for, it's unsafe, they have a highly protective reason for staying inside, they can’t even hear you, they don't know how to come forward on their own, or some other very important reason). Survivors with DID are not a magic trick.

NOTE: DO NOT TRY TO CALL PARTS FORWARD UNLESS YOU ARE A TRAINED PROFESSIONAL OR HAVE THE SYSTEM’S IMPLICIT PERMISSION TO DO SO IN NECESSARY SITUATIONS.
To not obey this is a serious violation of psychological and emotional boundaries.

 

✘ Myth:  Communication with alters happens by seeing them outside of you and talking with them just like regular people -- a hallucination.  (We can thank The United States of Tara for this one.)

Nope, not so much. While there are exceptions, this is a very rare, inefficient, and an extremely conspicuous means of communication. It also relies on a visual hallucination, which is typically a psychotic symptom that most with DID do not have.  However, it IS a possibility, and some do experience this; but it's mainly the result of extreme dissociation combined with mental visualization that feels incredibly real on the outside (as opposed to a true external hallucination of an alter). 

For most survivors with DID, "seeing" and speaking to their alters happens internally - inside the mind - often including a landscape called an "internal world". Communication may happen through passively-influenced thoughts, face-to-face (in each other's respective bodies, via the internal world), or through “voice” communication heard in the mind. This is why DID diagnoses can get so commonly mixed up with schizophrenia; these discussions and differently 'voiced' thoughts can seem like “hearing voices”, particularly if you don't know what an auditory hallucination would sound like or have better language to describe your experience. But, in DID, these voices and conversations are not actual auditory hallucinations (again, barring very rare exception). They are more like very “loud” versions of one’s own thoughts (versus, say, hearing the radio or a tea cup talking, or voices of those whom you know do NOT belong to you or share your life story). Alter communication is very much a part of you and stems from somewhere in your conscious mind - even if the thoughts, ideas, and tones are considerably different from your own inner monologue.

Other frequent means of communication are things like: journaling, art, post-it notes, non-dominant hand writing, pictures; and, now more commonly, things like online blogging, social media, voice recordings, videos, and more.

 

✘ Myth:  Parts in a DID system are all just variations of the host at different traumatized ages of their life.

Nope.  Parts can be any age, gender, or personality type. They can have entirely different outlooks on the world, faiths, sexual orientations, political views, etc. Many are even associated with no specific trauma at all but still have a very important and necessary role inside the mind. Alters are NOT merely “frozen” or “stunted” aspects of the host, marked by when a trauma took place. (Not to mention that trauma 'took place' every single day, for a lot of years, for a lot of people). This can be the case for some - and their parts’ names may even all be similar or variations of the survivor’s name - but even they typically show great variation from what the survivor was actually like at those ages.

Personality differentiation is a hallmark of the condition. Without it, it's not DID.

 

✘ Myth:  Because 'x' person lied about having DID, they’re probably all lying.

Generalizations have never gotten us anywhere in life. Do some people lie about having DID?  Yep.  Do some ignorantly use it as a crutch to try and excuse bad behavior? Sure do. Does that mean the millions who are struggling every day just to go on after an entire childhood of trauma -- who are fighting an uphill battle of perseverance to overcome sky-high suicide rates, while warring against heartless stigma and lack of access to basic care -- they're just all lying? No, no annnd no. Does it instead make the people who lied the ones we should be shaming?  ..the terrible jerks who appropriated someone else’s suffering for their own gain? Definitely.

 

✘ Myth:  People with DID will inevitably cheat on you/be unfaithful because their parts will just go be with someone else.

I know it’s hard for many to believe, but everyone is different. What one person does, their system does, or television leads you to believe is inevitable will not apply to everyone. Many exist in highly exclusive, monogamous relationships and are instead the ones living in fear of being cheated on, becoming inadequate, burdensome, or dissatisfactory to their partners; and, too often, they are the ones who are left. DID survivors tend to be more concerned with simply finding a healthy, non-abusive, communicative relationship than to "go wild" with the "promiscuous alters" (but more on them later). Flippantly suggesting otherwise is degrading.

 

✘ Myth:  You can treat DID with medication.

There are zero medications to treat DID. There are, however, medications that can be helpful in managing some of the symptoms of PTSD or other comorbid conditions. Medications to calm extreme anxiety, alleviate depression, lessen nightmares, stabilize mood, help with compulsions, quell severe insomnia, etc. can all be helpful at various points in a survivor’s treatment. But nothing exists to help the symptoms associated with DID, and many can even make them much worse. Be extremely wary of anyone suggesting they can help with your dissociative symptoms or switching through a medication or infusion regimen. They are most likely misinformed, but may also be lying to you or seeking to cause you harm.

 

✘ Myth:  Integration is a “must”, or is everyone’s goal in therapy.

Callback to our theme: everyone is different. Complete integration into a single, individualized identity - also known as final fusion - is the goal for some. But it is not, and does not have to be, for everyone. It is possible to achieve full healing by processing memories, establishing communication across the whole mind, lowering dissociative barriers, and increasing aptitude by everyone working toward a common goal - all without experiencing the fusion of any parts at all. Some may choose to integrate a few alters or aspects of self with one another or themselves - or "downsize" - but still leave a small system to go about their lives. Others may begin the process, discover it’s truly not for them, and separate again - either spontaneously or with intention. There are many, many reasons why someone may choose any of the above. But becoming singular is NOT a must, and anyone insisting that it is or refuses to accept your decision to remain distinct identities, does not have your best interests in mind and heart.

✘ Myth:  Folks with DID are incapable of being successful or living normal lives. They’re dependent on the system and just cycle in and out of hospitals unable to do things for themselves.

Absolutely false. While success is defined differently by everyone, there are survivors with DID doing extraordinary things - all at varying levels of function, system size, memory integration, and therapeutic care as they’re doing them, We have folks who are CEOs of million dollar companies, professional athletes, high-ranking members of government, leaders of prestigious non-profits, as well as trauma surgeons, lawyers, military servicemen, professional actors, entrepreneurs, college professors, and even therapists — all with dissociative identity disorder. We know many with PhDs, masters degrees, small businesses, and brilliant technology patents. For some, their DID helped them succeed, with different system members able to take on separate tasks, memorize notes, rotate sleep schedules, or offer new creative solutions;. Others found it an obstacle, but more because of how they were treated or inhibited by those around them. While some found success after reaching a place of more complete stability, others were still in therapy twice a week, wrestling with difficult flashbacks and alter switches, but still excelled nonetheless and were content with their choice to do so at that time.

But, more importantly, success isn’t required, nor necessary for anyone with DID. And there is nothing wrong nor shameful about requiring assistance or needing hospitalization. For many, after a life of such severe, chronic, and painful trauma; followed by a litany of symptoms, stigma, treatment, disbelief, and endless barriers to accessing the same life everyone else was awarded — a boring life is the goal. That is the success. No adventure, no high-stakes, no demands, no chaos. Just peace. Just average. A mundane, quiet, unremarkable life, in harmony with their communities and mind, can be the richest reward for so many. But, what each individual person wants for their life, or has fought tirelessly hard for, says nothing about what the broader collective of DID survivors are, or should be, capable of. Having DID is not what will influence a survivor’s success, lack of safety, support and resources is.

 

Part Two:  Supporters, Therapists/Clinicians and Survivors Themselves

 

✘ Myth:  The term alter stands for "alter ego".

Alter [most likely] stands for "alternate states of consciousness" or "alternate personality", though there has been confusion about the original phrasing, including the rare-but-existing use of "altered state of consciousness". In the professionals we’ve worked with, the first term was used in their literature, education and in patient charts of their trauma disorders units. The second is seen most often in journals, sources online and by the majority of second wave dissociative researchers. The third attempts to compare it with trauma-related dissociation, but not label the actual trauma-related dissociation itself. The absolute origin of the term alter is hard to pinpoint, particularly when some publications are no longer in print (which may explain why the former made its way into psychiatric trauma hospitals and research papers of many pioneers without having an identifiable date to timeline it). But, the most currently accepted term we see cited is 'alternate personality'. However, "states of consciousness" is a term used interchangeably for alter/personality in various therapeutic circles. So, the first two are none too dissimilar.

"Alter ego", however, has zero relevance in DID whatsoever. That one can stay with Beyonce and Fight Club.

 

✘ Myth:  People with DID only have a few alters.

Some can only have a couple or a few, but it's more common to be around the teens. It's also extremely common to only be aware of a few for some time, and then discover many many more as therapy progresses and it is safe for them to be known by the others. Systems in the 30s and 40s are not uncommon either. For those with backgrounds of human trafficking, organized violence, ritual abuse, or mind control, it's well-observed for systems to be well into the hundreds, or even impossible to count. System size does not validate or invalidate a survivor. There is also no direct correlation to system size and severity of trauma.

 

✘ Myth:  All systems have specific types of alters  (i.e. “The Rebel Teen”, “The Promiscuous Alter”, “The Loving Mother”, “The Adorable Child”, “The Evil Introject”, etc.)

Sure, some do have these alters, and it’s often for good reason and due to themes that exist in abuse, not necessarily themes within the disorder. Many will have none of these alters, others have completely reversed takes on them, and so forth. While it makes for easy book and film-writing - and some survivors absolutely do find themes within their system and another's - there is no universal recipe for a DID system. Additionally, getting too specific or trying to categorize alters into specific role subtypes can be quite damaging and lead to a whole host of new issues (none too dissimilar to the complications that arise from trying to fit regular humans into boxes or “types”).

 

✘ Myth:  All alters will be (or should be) the same gender/race/sexuality as the survivor.

As mentioned before, different genders, sexualities, and even races may exist within one system. Sometimes this happens at complete random, others develop from positive childhood influences, and then other times these changes were bred out of traumatic necessity. (Unfortunately, this also means some alters become who they are because of stigmatizing belief systems fed to the child about folks that are different from them. In these instances, these potentially toxic or discriminatory identities can be worked on in therapy and eventually transformed into healthier, more authentic self-concepts - free of harmful stereotypes, caricatures, or even bigoted projections.)

 

✘ Myth:  Inhuman alters are impossible (robots, wolves, ghosts, cats, etc).

Not impossible at all and instead very common. For many children, being a human is scary. It gets them hurt. Being invisible or incapable of feeling, becoming a terrifying entity, a loving creature, or even a shapeshifter can feel infinitely safer and more protective of the whole than fragile humanity. Note: Alters do not come about by conscious choice or planning. They happen within a child’s mind, through their understanding of the universe at the time, unconsciously, and by way of a heavily dissociated surreality. Anything that seems even moderately safer than their current state is fair game inside their survival escapism. Just as human alters can be deaf, blind or have no voice to speak, even within an able-bodied system, inhuman alters who are unable to do similar tasks are just as real, valid and important as the humans. They are protective and significant, not weird or unbelievable.

 

✘ Myth:  All “littles” are broken and damaged.  Or, Inversely, all littles are happy, bubbly kids that hold the survivor's “innocence”.

*re-accessing our theme here* All humans, systems, and alters are different. Some child parts are deeply traumatized and hardly able to function. While, others' kid parts are the most innocent, endearing, and happy little angels. But there is also every shade in between, and some systems have TONS of kids - up to hundreds even - each vastly different from the other. Happy, sad, energetic, daring, lonely, scared, adventurous, genius, precocious, disabled, shy, athletic, mean, messy, giggly, pristine, posturing, infantile, newborn, brave, hidden, exuberant…the possibilities are endless in child parts, including their capacity to grow, change and transform.

 

✘ Myth:  “Introjects” are inherently evil and are just like the abuser(s) in that person’s life. 

The word introject refers to any alter who is modeled off an outside individual - mirroring their personality, behavior and sometimes even taking on the same name and visual presentation. These individuals may be positive or negative influences in the survivor's life; some are even fictional characters. (Remember: Alter development is not a conscious process and takes place within a young, traumatized child's mind. Pulling from fiction makes complete sense to little minds.) Most notably, though, are abuser introjects -- alters who are so prevalent in DID systems that the term introject itself has nearly become synonymous with “the bad guys”. That said, it is extremely important to remember that these introjects serve a very important, valuable purpose, and(!) they are NOT the actual abuser. They are a victim, a single part within a large beautiful mind, bred from the survivor's essence. They are just copying behaviors shown to them by bad people, not harboring the intent, sadism or immorality of the actual perpetrators. Most are even trying to protect the system at large. Antithetical as it sounds, these introjects can truly believe that hurting the body or internal system members, can still be ultimately protective, misguided as that is.

Let's learn why.

Introjects are only able to model outside individuals so well because they’ve spent copious amounts of time with them. So, in the case of abuser introjects, it typically means that those alters were the most abused by them. By “becoming them”, they not only get to deliver themselves from that powerless dejection, they get to decide what is allowed and what is not. They write the rules. Their intimidation, bullying and posturing as the voice you fear most in this world can make you far less likely to talk in therapy, to tell a family member or friend, seek justice, file a report, go back to school/work, and more.  …anything your real abuser threatened great harm against you for even considering. Introjects' verbal insults may leave you timid and embarrassed, afraid to “put yourself out there”. They may feel this is the only way to protect you from the 'inevitable' pain, rejection, betrayal or loss that comes from making connections. Even healing from your trauma can feel too threatening or unsafe. By being a relentless, menacing part who terrorizes your mind and body, you stay sick, which keeps you safe from whatever those "threats" are. ...but, unfortunately, only by adding new threats to your safety.  Helping them see this paradox can be the first step in getting them to take pause, and eventually become an alter you can work with instead of fearing implicitly.  Some of these introjects are even extremely young child parts who just posture as these ‘big bad adults’ for some semblance of control and power. It's helpful to keep all of this in mind when you're under siege.

It is especially important to remember that they are not evil. They’re usually extremely traumatized and were given a highly manipulated understanding of safety and love. But also, YOU as a whole are not evil just because these parts live inside of you. They are not the actual abuser and they are just reenacting behaviors/thought patterns that were taught to them by bad people for years and years. It's all they know. But, the difference is that deep down they believe they are keeping you safe from something they believe to be absolutely unbearable. You just need to figure out what that is.

 

✘ Myth:  Alters who persecute (via bodily self-harm or harm to other parts inside) are bad and should be tamed/gotten rid of/ignored/killed/etc.

In a similar vein, most of these parts are doing these things for a reason - a reason they feel is extremely important or keeps everyone safer (even if that just means safe from having to feel any PAIN if they're profoundly suicidal).It’s important to keep in mind that just because these things may not make sense to YOU (since you can clearly see all the destruction and harm it's causing elsewhere in life), they aren’t working with the same information, life experiences, or emotional connections to the world as you.  If you were locked in a dissociative barrier for years, only able to pull from a select number of life experiences (most that were utterly horrifying), you might not be the most empathic or understanding person either. Moreover, many system members adopted their concepts of “safety” when the body was a child. ..a traumatized child. What they consider safe isn't always going to make sense.

Ignoring them, trying to shut them up or restrain them, punishing them, or any of the various attempts at “getting rid of them” will not only never work (their needs will only become greater and louder), they’ll become more and more traumatized as you confirm to them their every belief about the world. You can’t actually “get rid of them” anyway, so it’s far better to try and understand them. 

 

✘ Myth:  You can kill alters.

Even if mock deaths or temporary experiences of alters “dying” from old age (or other means) have been acted out in some systems, they aren’t actually dying. You cannot kill off a collective part of the conscious mind like you can a person. Their thoughts, memories, emotions will all still be there, so they must be as well. The part may have gone into extreme hiding, been momentarily immobilized, or merged with another part of the mind, but they most assuredly did not and can not disappear entirely or “be killed”.

Above all: THIS IS EXTREMELY DANGEROUS AND TRAUMATIC TO EVEN ATTEMPT.  Do not do it.

 

✘ Myth:  Alters can’t have their own mental health issues if the main survivor doesn’t have them.

They actually can, and many do. It’s extremely common for individual alters to battle depression, anxiety, OCD, bipolar, eating disorders, self harm, etc., while other members of the system experience no such thing. Some extremely differentiated systems may even need that system member to come forward and take medications that the rest of the system does not need and will not get.  ..and their brain’s neurology responds accordingly.

One note about some disorders, however. Non-verbal, poor eye contact, savant-like, or sensory-processing-disorder alters can be extremely common traits in DID systems. However, it’s important not to just jump to calling these parts “autistic” if the system as a whole is not autistic. It’s possible for alters to behave in ways that mimic their understanding of SYMPTOMS in other disorders they know about, while not actually possessing the neurology for them. This is a complicated subject we could try to elaborate more on at some point, but it’s just an encouragement to pause and not automatically label some parts as having certain conditions just because they show a few traits of them. It can cause a great deal of conflation and misrepresentation of those illnesses. It may also be purely based on discriminatory or uneducated stereotypes of those conditions that were adopted into a young child’s mind. So, it’s just helpful to check for that possibility first!

But, make no mistake, most expressions of mental illness amongst alters are incredibly real and valid and should be treated as such.

 

✘ Myth:  It’s impossible for alters to have different vision, health conditions, talents, and so on. "Those are physical. Even if the mind is different, the body stays the same."

Not impossible at all, and instead, extremely normal. We must remember that the mind and body are not only extremely connected, but that DID also isn’t just “in the mind”. There are all kinds of changes that take place neurologically to encourage these harsh separations. Some alters can operate on entirely different neural pathways of the brain, and that determines a lot of what the rest of the body will experience, feel and tells the other organs to do. This may mean allergies to different foods, different glasses/contacts prescriptions, over- or under-production of various hormones, and so forth. The brain is incredibly powerful; it not only tells the rest of the body how and when to operate, but it can completely change how the body interprets and responds to cues, sensations and feedback based on which areas of the brain are most active at the time. Much of this is still being studied because it's so fascinating, but there's no shortage of anecdotal examples and several others already within published research.

 

✘ Myth:  Anyone can treat a DID patient.  All trauma-informed therapists are capable of seeing a DID client through to healing.

DID is extreeeeemely complex. Even specialists can struggle with the sheer volume of curveballs and knowing they must remain vigilant to any and all unforeseen complications. Most psychology curriculums that lead to a degree in clinical practice only spend about a week or two on DID and other dissociative disorders. To add insult to injury, the majority of the information is out-of-date. Trauma-informed classes rare enough and are something most passionate MH professionals must go out of their way to find. Then, they invest extra time, coursework and continued education just to be able to competently and confidently treat a trauma survivor. Depending on the program, many of these folks are still unfamiliar with the nuances of dissociation, personality differentiation, system dynamics, common pitfalls of therapy, memory-processing, and alter fusion (if that’s what a patient desires). While a clinician who's missing these skills may still be able to bring a PTSD patient through to wellness, these are an absolute must when it comes to rehabilitating a patient with DID.

When patient safety is often in jeopardy (either due to self-harm, eating disorders, drug/alcohol use, or ongoing abuse), and suicide attempts occur as frequently as they do in this population, there is limited room for error. And, just sitting with that knowledge can be extremely (and justifiably) upsetting for many therapists. This may leave them feeling anxious, desperate, or even becoming quite protective over their client - which only increases the opportunity for unintended mistakes.  Specific training in DID, or at the very least a sincere dedication to learning it (and quickly) while working with a patient, is highly advised. Not just anyone can treat this condition, and trying to do so ill-equipped can be catastrophic.

 

Part Three:  The Bizarre and the Out-There

 

✘ Myth:  People use DID as an excuse to get away with crimes -or- people with DID can commit all the crimes they want and just blame it on an alter.

Very rarely is this ever used as a criminal defense, and when it is, it’s almost always publicized because it’s preposterous. Despite what Primal Fear may have taught you, no, people don’t really lie about DID just to get away with crimes (if for no other reason than it’s very easy to prove they don’t truly have the condition, nor do they demonstrate any of the behavior consistently). But, wait! There's an even bigger reason: this is not a viable defense in a court of law. DID is NOT insanity.  Regardless of what any alter does outside of one’s awareness, the whole person is still responsible for their crimes and will be prosecuted accordingly. If someone uses that as their defense, it will fail them.

 

✘ Myth:  People with DID are possessed by demons.

This sounds like something to laugh at, but one short gander in DID communities online and you will find all KINDS of people who firmly believe this and will offer unsolicited advice and/or demands for survivors to be exorcised. Regardless of your faith, this is NOT what is happening in DID, and research has provided a complete explanation of what is happening inside the mind and why. Demonic possession, even if you believe, would not present in such a highly organized, specific, and intelligent way, while also happening to meet all the criteria for a well-documented mental health condition. And attempts at exorcisms, “praying it away”, or even the mere suggestion of something more sinister existing within them can be extraordinarily damaging and traumatic to the already-suffering survivor. This was a somewhat understandable explanation in like, the 1600 or 1700s — but in 2017, this projection onto survivors who simply switched? Is absolutely inexcusable.

 

✘ Myth:  This is just something the Americans made up. 

Patently false. It’s been found worldwide, and some of the leading research in the field has come from countries that are not the United States.

 

✘ Myth:  DID and schizophrenia are the same thing.

Not even a little bit. There aren’t really even any universally overlapping symptoms from person to person. Schizophrenia is a biologic, neurocognitive, and in some cases, neurodegenerative, disorder (frequently labeled a psychotic disorder - which carries its own unfair stigma to overcome). Dissociative Identity Disorder is a trauma disorder. Without trauma, it could not organically develop. It is PREVENTABLE. No medication can “treat it” in isolation. This mix-up causes harm to both communities.

 

✘ Myth:  Films like Split, Sybil, Three Faces of Eve, and Frankie and Alice taught me everything I need to know about DID! The United States of Tara is amazing representation!

Hardly shocking that media can be extremely inaccurate, but when it comes to Split, Sybil, Three Faces of EveFrankie and Alice, etc, you'd think that most would intuitively know they're pretty awful. ...but, just one look around and you'll find that disproven rather swiftly. These films are not only abysmal in terms of representation, they severely damage and inhibit the public's understanding of DID. And, sadly, it’s not just the general public who seem unsure of their accuracy. I recently heard a mental health professional, who treats both C-PTSD and DID, refer to some of these as “good” and “informative” — a reference point for those who are new to the condition. Disappointingly, knowing just how harmful they are is not a given, even in the MH community.

When it comes to The United States of Tara, while it is absolutely better than the others, it is not “good representation” by any stretch. Yes, it did touch on some important topics, but most of those are moot when it also displayed the most commonly stigmatizing and damaging tropes in excess, and got so dark by the end that many with trauma histories couldn’t even finish it. A simple scroll back through these myths and you’ll find MOST of them in the show. (She was violent to strangers, abusive to her family, cheated on her husband, and was deemed unsafe to even be around children. Her switches were SUPER dramatic, alter differentiation was the most extreme, and they used very predictable tropes for her alter characterization. She introjected a therapist without any trauma or major life event to necessitate the addition, sought extremely toxic "therapy" without the show ever defining it as such, and safety was dealt with so irresponsibly that it was disturbing. There is much more to add.)

We could write an entire article on this alone (and we may even do so one day), but for now, let’s just squash the myth that USoT is “positive representation”.  I know that as survivors we tend to think of anything that isn’t actively hurting or abusing us as being GREAT! But, just because something isn’t a total disaster or has some redeeming qualities does not mean that it’s positive. At all. And we shouldn’t accept it as such. USoT is great for some laughs and entertainment, but it is not good DID representation. We save our choice words more for films like Split, but hey, we even managed to exercise some restraint there while discussing it in this article here! :)
 

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    No doubt there are far more myths than this. We encourage you to add some of the most wild things you've heard in the comments. What are some misconceptions you held onto or believed when you first heard of the condition? What are some things you still hear from those around you or online? ...possibly even from clinicians?  While none of these are a laughing matter, and we hope that we've educated significantly, it's still okay to get a laugh from things now and then, especially when they're so absurd. If we didn't, we'd all go a little bonkers

     We sincerely hope this was very useful to you, and we hope to see you sharing it with anyone who needs some clarity!

 

 

MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101101 Techniques for Self-Care
  ✧  Flashbacks 101: 4 Tools to Cope with Flashbacks
  ✧  Nighttime 101 and Nighttime 201Sleep Strategies for Complex PTSD
Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101Healing Pool and Healing Light
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
  ❖  
Article Index  ❖


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Did You Know?: C-PTSD and DID Edition

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    No matter the topic, misinformation and lack of understanding is everywhere.  When errors are made or false ideas get perpetuated, they tend to go unchecked and unchallenged usually because most of us just plainly don't know enough to even realize it needed to be corrected or looked into.  And, this is completely understandable, right?  We can't be expected to be informed on nearly every subject and struggle of humanity.  We can try our best, but there will always be things we are still woefully ignorant on.  Access to education, reliable resources, and just knowing where to even look for more information on any given topic is so hard.  We're left to take our cues from those claiming to be knowledgable, go along with the basic understanding held by the general public and our loved ones, and/or just let it be and invest our attention elsewhere.  When it comes to mental health, no doubt, all of these issues collide head on - multiple times over.  We unconsciously acquire so much misinformation about psychological disorders by the time we're only kids - and just by casually picking things up in conversations, media, and comedy, we also tend to adopt some heftily stigmatizing ideas as well.  And, if this is true even for those expressing no real interest in mental health, imagine the damage when people who do try to learn from the professionals are met with uninformed practitioners or those grossly misleading the public, their colleagues, and even their patients.  This is how Complex PTSD, and most especially Dissociative Identity Disorder, have been treated for decades.  We would like to start changing that.

   Little by little, bit by bit, we want to undo some of that damage and raise more accurate awareness for both C-PTSD and DID.  You can read more about the conditions themselves here (individual DID page coming soon!), but we also think it important to touch on what survivors with these disorders are currently going through just to obtain treatment.  After all, they wouldn't be struggling to get care so badly if those in the field had more of a vested interest in them - becoming at the very least trauma-informed, or better-equipped themselves to treat a client with complex trauma.  This will be an ongoing series no doubt - with many myths to debunk and important notes to impress!  So, to start chipping away at that iceberg, here are 8 things we should all know about Complex PTSD and Dissociative Disorders, and the survivors who have them.  

 

  With as vast as the United States is, this is supremely disappointing.  You can find the current list of those facilities here on our website.  Even within those 9, many keep relocating or downsizing, some have a very small number of beds or are restricted to only certain age groups, others have had all their additional programs (like PHP/IOP) cut entirely or are so underfunded they don't run smoothly.  Overall, the standard of care for trauma patients nationwide is very low.
   Finding a trauma-informed unit at all is pretty scarce, but the greater drawback is that many who claim to be able to take Complex PTSD or DID patients offer them no therapeutic tools or classes designed to address their unique needs and have them intermingled with the rest of the mental health population. This might not sound like an issue, but due to the nature of a trauma patient in crisis and their high susceptibility for flashbacks, panic attacks, switching, and self-harm, being surrounded by unpredictable and sometimes volatile patients is unreasonable and unsafe.  Staff also need to be heavily trained in what is an acceptable and safe way to engage with a severely traumatized patient - particularly if they are in flashback, a dissociated self-state, or critically unsafe.  Units remain safest (from perpetrators and potential flight-risks) when they are locked, but an understanding that this can be also be extremely distressing for other patients is something staff need to be able to empathize with and negotiate.  In short, the nuance of care required for complex trauma patients is unlike that of any other mental health condition.  And yet we have less than 10 places we can safely send individuals, and many of those 10 even have their shortcomings.  A couple even continue to produce more negative reviews than positive, and some of the leading facilities have proven time and again they are fantastic with some patients but are not equipped to handle ritual abuse patients.  Greater education, as well as funding to produce more units in existing psychiatric hospitals is a MUST.

  As a side note, there are a handful of residential facilities cropping up in various places throughout the U.S.  Residential treatment centers, while valuable and a potentially great resource (especially when there's nowhere else to turn), are typically not equipped to handle clients who need stabilization or are struggling with safety.  They are also more unregulated, therapy modalities can be harder to discern, units are not locked, insurance rarely participates, and they tend to be extremely small in bed-availability.  While they are often very beautiful and relaxed, and nothing like an inpatient setting - they can be extremely expensive, with limited staffing, and tough to guarantee quality of treatment.  And again, while they may be able to facilitate a chronically traumatized patient through a rough patch in their healing, they are often not trained or equipped to aid in crisis stabilization, and are usually far from a hospital should the need arise.

   As it turns out, averages can be tough.  Research in this field is still limited, and even where it exists, trauma patients aren't typically the most eager to participate in a study.  However, despite research on treatment length being slightly dated, and the fact we are getting more practitioners better-able to facilitate a patient through their recovery, as well as those who can at least make an informed diagnosis more quickly -- we are still grossly behind.  So, while some may want to argue this estimate is too high based only on what they see in their well-trained offices, others who have patients working well into their 15-20th year of therapy would argue it's still much too low. Regardless of the exact specificity, this is a very reasonable estimate at the moment, and is witnessed to be valid by many, many clinicians, patients, and communities of survivors fighting this battle. Now, this does not always mean 10 years of consecutive therapy - though it absolutely can and does for many.  It's quite common for patients to have to stop and re-start therapy multiple times - for myriad reasons.  Finances, inadequate treatment, personal unreadiness, a geographic move, unavailability of clinicians, and/or feeling stable at one point but needing to return as more things surface later - these are all very common factors for a more drawn out therapeutic journey.

   Ultimately, treatment of complex trauma takes a very, very long time in even the best of circumstances.  It can be extremely daunting and feel outrageously unfair to the survivor.  The average of several misdiagnoses before arriving at a proper one alone, then coupled with misguided therapy, not only adds more years to the recovery but also risks turning clients away from therapy altogether.  It's even been a traumatic experience for far too many.  We need compassion and understanding for these survivors.  To support them through this long process, no matter how many years it may take or how many times they need to stop and try again. Recovery from trauma is scary.  They need our love and support, not added obstacles.

   As mentioned earlier, inpatient care for complex trauma is extremely scarce.  It requires a specialized unit and, for many, that will be out-of-state.  Insurances rarely cover beyond their state's borders and non-participating provider agreements can be very tough to come by - let alone something we should ever expect a survivor to have to fight for themselves while in a terrible, terrible place.  Because of this, many of them have to pay tens- to even hundreds-of-thousands of dollars out of pocket for care.  Many facilities will not let you pay once you get in and settled and can think clearly.  They often require a sizable sum up-front, before you even enter the unit.  And, again, coming up with thousands and thousands of dollars that most don't have to begin with, particularly while in crisis, is a feat many just cannot accomplish.  Needless to say, most go without.

    How many people in the world do you know with red hair?  There are at least that many people with DID in the world - though, more than likely a lot more than that.  Due to fear, stigma, high rates of suicide, misdiagnoses, lack of public education, and countless other reasons, most who have DID aren't even accounted for yet.  But, the bottom line is that this is NOT a rare disorder.  It's only rarely talked about.  And, when it is, it's very rarely talked about in a positive, empathic light.  Most refuse to confront the reality of its prevalence rate, because to do that would mean having to confront causality.  And, what causes DID?  It's most always man's inhumanity to one another and the cruel callousness of the world.  No one wants to acknowledge that or accept how rampant it is, so they sweep the survivors of such under the rug (while others go so far as to actively paint them as dangerous or truly insane, especially in media).  DID is not rare.  It's not a one-in-a-million case you'll never see.  It is everywhere.  And those suffering with it just want someone to help them after years and years of abuse, pain and neglect.

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   This is another fact that is just so very sad.  Complex trauma and dissociative disorders are hard enough on their own, but so are depression, anxiety, OCD, addiction, eating disorders, self-harm.  To have a collection of many of these at once just seems grossly unfair - yet that's the insidious nature of trauma.  The ever sadder part is how many of these aching, traumatized souls find themselves in eating disorder facilities or drug/alcohol rehabs (or even jail) for the more overt or destructive symptoms, but never receive trauma-informed care of any kind. Care that is specific to complex trauma or the uniqueness that DID can play in some of these more addictive or self-sabotaging behaviors is even more rare in places like these.  Additionally, when you try to "fix" an addiction or eating disorder through traditional means, without addressing the way its delicately woven and spun around the trauma, you can make them dramatically worse.  This, like all bad treatment, can turn them away from therapy (or help in general) forever - or more devastatingly, push them to lose their battle before they ever had a real fighting chance.

   It may be a broken record, but there is no place that the abundance of misinformation, redirection of resources, or ignorance of childhood trauma doesn't touch.  PTSD in any form is brutal and terrible and all-consuming.  But it's sad that in 2017, the first group of people that comes to mind for most whenever you mention trauma or PTSD, is still veterans.  If our "war flashbacks" and "triggered" memes online are any indication, people really do not understand the severity of the condition at all, nor do they even attribute it to the population struggling with it the most.  There is absolutely a way to keep the very real and VERY valid suffering of war veterans and those who've served in the military very present in our minds, hearts, and resource initiatives, while ALSO lifting up childhood trauma survivors and victims of sex crimes considerably higher than they currently are.  They need our attention and visibility.  And fast. 

    I bet if you call to mind any trauma survivor you know, they've also got at least one chronic (or "mystery") illness - maybe even several.  In fact, it's probably several if they've survived prolonged trauma.  Migraines, fibromyalgia, asthma, autoimmune disorders, rheumatoid arthritis, severe allergies, eczema, dysautonomia, POTS, EDS, neurologic disorders, chronic fatigue, or possibly even the highly insulting [and inaccurate] label of "conversion disorder".  These are all seen to coexist alongside trauma in abundance.  This list is by no means exhaustive, and - just like diagnoses for C-PTSD and dissociative disorders - many are still trying to just figure OUT what is wrong. They know they have a chronic illness, they just don't know which one, and every avenue they explore seems to point toward a dead end.
    We may have a helpful answer to you.  In reality, trauma affects absolutely every part of the body - especially the autonomic nervous system (which then affects everything else).  This can cause all sorts of havoc and in ways we are only just beginning to more fully understand.  It's been well-observed for awhile that trauma and physical illness go hand-in-hand, but it's only more recent that we've been able to see how, why, and where more specifically.  Because of this, and the fact it's a very lengthy topic, we cannot recommend the book The Body Keeps the Score by Bessel van der Kolk enough.  Or, at the very least, if you aren't interested in reading, maybe peruse some of his work online.  It'll be something you definitely won't regret, and supplies a well-studied introduction to all the ails, aches and pains, and mysterious illnesses you or a loved one have been suffering with for what seems like forever.

    Finally, in the same vein as so many of these facts but on a slightly different wavelength - traumatized children are seeing some of the most ludicrous misdiagnoses we've seen in quite some time.  The lack of understanding of what children who are being actively hurt (or just recently were) are "supposed to look like" in terms of their symptoms, is staggering.  Instead of traditional PTSD symptoms that we observe in adults, most kids are demonstrating all of the behavior one might expect from a child presently terrified, scared, shut down to numb, avoidant or afraid to attach, feeling under threat, trying to seek control and a voice, and who doesn't know what to do with all that adrenaline and nervous energy coursing through their tiny, terrorized little bodies. Sure, traumatized children can present in a variety of extremes, and that can be tough to distinguish at face value - but it's not too difficult to learn. And it's not acceptable to take the response of "No, no one's hurt me." as gospel in a child who's still in danger and never pursue it further - especially when all their symptoms are telling you otherwise.
   Jumping to the opposition-defiant, mood-dysregulated, ADHD, autistic, etc labels/misdiagnoses can be so harmful and even lead to more abuse at home.  Not to mention, they can follow them around forever, reshaping who they think they are or believe to be "wrong" with them.  It can make them feel broken or defective - particularly when the treatment for these suggested conditions can make them so much worse.  In reality, they are just traumatized children who did nothing wrong, but are being wronged by all the caregiving adults in their lives.  They're trying to communicate their suffering to you in any way they know how, but most of those "listening" are all too eager to villainize, label, or neglect them instead.  That is not helping them.  We need to do better.


  There are so many, many more things we all need to know and recognize about Complex PTSD, dissociative disorders, and the survivors who have them.  We will absolutely be continuing this list and adding more to the conversation.  What are some of YOUR greatest misconceptions about trauma disorders, or details you really wish people knew about the process of healing from them?  Please share them below!

 

MORE RESOURCE POSTS YOU MAY FIND HELPFUL:

  -  Grounding 101: 101 Grounding Techniques
  -  Nighttime 101 and Nighttime 201Sleep Strategies for Complex PTSD
  -  Imagery 101: Healing Pool and Healing Light
  -  Coping with Toxic/Abusive Families During the Holidays

 

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Imagery 101: Healing Pool and Healing Light

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Whether you are struggling with physical pain, body memories, illness, headaches, or any of the other distressing symptoms that can come with being a trauma survivor (or someone with a chronic illness) - there are imagery techniques out there that can help alleviate your suffering!  As I'm sure you're well aware, medications do little to nothing to relieve your body of pain it’s reliving from the past.  Conditions like fibromyalgia and other autonomic/nervous system disorders are also highly prevalent amongst trauma survivors, and they, too, show some of the greatest resistance to medications and other external approaches to treatment.  While there are several therapies that can help release your mind and nervous system of these specific types of pain, one solid tool you can use anywhere and anytime, no matter what shape your body is in, is imagery.  More specifically, Healing Pool or Healing Light imagery.

We'll walk you through both of these techniques, but to make sure you have the greatest chance at success, we want to be sure you understand the concept of imagery and how it's used first. (If you're already familiar, you can skip this part and head straight to the exercise!)

Imagery is a coping skill that allows you to picture things in your mind's eye - very vividly and in exquisite detail - to bring yourself and your body to a calmer state. It may be used to relieve pain, put away upsetting memories or intrusive thoughts, contain distressing emotions, retreat to a safer or quieter place, get some desperately needed rest, or just about anything your mind can create.  This is a skill that, like all tools for combatting trauma symptoms, does take practice and is one to experiment with when you don't "need" it. This way, when you're flustered, overwhelmed and unable to think clearly, it's second-nature instead of "some dumb thing that's probably useless anyway".  (Yes, we're very familiar with that rhetoric and guilty of it ourselves when distressed.)  Imagery is a technique constructed around being as detailed, descriptive, multi-sensory, and personalized as possible. Imagining yourself in a place or scenario that holds absolutely zero interest to you, that you have a hard time visualizing, or is even upsetting to you, is NOT going to be helpful.  Commanding the full use of your mind and its senses will engage so many more neurons and ask them to get off the upsetting or painful feedback loops they’re currently on - which is good not only mentally but for your physical health.  So, more detail, more customization toward my preferences and interest, got it!  What else?

Have patience with yourself.  Sometimes your mind is going to wander, that's okay. Sometimes the environment just isn’t going to work well, and you might feel frustrated, but that's also okay.  It's not your fault, or an inability to "do it right", or "never going to work".  Your body may be under a lot more distress than can be managed at that moment or it’s a visualization that just isn’t tailor-made for these symptoms. If for any reason it's making things worse, perhaps there's something triggering about the scene you chose that you hadn't even considered.  Or, particularly for those with DID, maybe there's a part of your mind who has misgivings about allowing you to feel comfort or make the pain "go away".  (Even if you don't have DID, some aspect of your mind may still feel this way.)  This happens sometimes.  It doesn't mean all is lost, that you'll never be able to use this skill, or that your mind is sabotaging you.  You just need to work with that stumbling block and either talk through it or at least find a compromise.

And, finally?  The more you truly believe these skills are working for you - drawing out the pain from your physical body, sealing up those memories nice and tight, slowing not only the intense emotions but your heart rate and tense body too - the better it will work.  If you just go through the pictures in your mind and don't try to connect them to what your body and mind are truly experiencing (whether that’s because you were sure it couldn't possibly touch the level of pain you’re in, were just doing it to tell your therapist you did, think coping skills are worthless, yadda yadda), welp, then, you're right, it's not going to work.  The mind is sooo powerful, and highly susceptible to the input YOU give it.  If you tell your mind you're now feeling differently or that parts of your body are starting to feel numbed or relaxed, it's likely going to believe it at least a little (if not much more) and start to follow suit. (And not just in a hocus-pocus, frou frou kind of way, but instead a well-researched, biological way - based on the new neural connections you helped your body make.)  Trust in it; the more you do, the more success you'll have.  And truly, if you're in distress and just need the madness to pause, or the pain to stop, what do have to lose by committing your whole self to the exercise?  You've probably tried everything else, possibly even things with serious side effects.  This has zero, so why not give it your all?

Now for the fun part!

 

 

HEALING POOL

Healing pool is just what it sounds like.  It's imagery that relies on a body of water with personalized healing properties to target and alleviate your pain from head to tippy toe.

To start, choose a location that feels the most calming and soothing to you based on the type of pain you’re experiencing and the environment that appeals to your senses.  Nothing is off limits!  It can be a real place you’d like to visit or one you’ve already been and love. Or, you can create a magical, mystical wonderland that’s the perfect fantasy destination for healing. Try to paint the scene as vividly as you possibly can. Is it a tropical oasis?  ..on a beach with crystal clear waters, sand, and an ocean breeze?  Is it in a mythical forest?  ..with a hidden spring, ancient stone fountains, and tall woodland trees all around you?  Is it in a rainforest or Hawaiian escape?  ..with tall, cascading waterfalls emptying into a warm, quaint natural pool?  (Hey, it can be magic, remember? That pool doesn't need to empty out somewhere else just because there's a waterfall leading in!)  Or, do you prefer something in a colder climate? A northern, mountainous retreat with perhaps a hot spring bubbling up, or a cooler lake to calm the aching? If none of these known environments are pleasing to you, you can even leave this world behind and be on your own planet, in a futuristic world, or high atop the clouds in a land with its own prodigious body of water. Creativity in imagery knows no earthly bounds!

Once you've chosen a general landscape and water source that is perfect for you, go deeper still into that world.  What do you hear?  Are there birds or other animal/nature sounds? What kind? Are they quiet and sporadic or filling your ears like music? Does the water itself make a trickling sound, have crashing waves hitting the shore, or does it bubble as it waits for you to enter? What do you feel? Is the air warm? The hot and muggy kind? Sunny but breezy? That still and "just right" feeling? Or, is it instead cold, clear, crisp and refreshing? Now, what about the time of day? This may change each time you return, but is your healing hideaway in the invigorating daylight, amidst the beautiful colors of a sunset, or is this a moonlit dip in the water?  (You can try all the above in future visits!) Now, return your focus to the water.  This is your healing water - not just any old water. Does it have a special color? Does is glisten or sparkle? Does it have any billowing mist coming off of it? Perhaps it's not even earthly water, and instead a mystical, dry ice-like fog?  Or, maybe it's more like a warm liquid gold? Maybe crystal blue ocean water with iridescent ribbons of light eager to heal your pain speaks to you? The possibilities are endless!

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Now it's time to get in.  We know when you’re in terrible pain and agony, the urge to just jump right in and submerge yourself immediately can be so intense - anything to stop the pain immediately. But, this technique actually works much better, and for longer, if you can gradually go through each part of your body, one at a time - really feeling it take effect not only in your mind, but in your skin, muscles and bones. Some may even witness the coloring in their skin shift through different techniques as their body responds as though this were entirely real. So, go slow and commit yourself to experiencing the variety of sensations; relief will find you much more completely.

Go ahead and stick your toes in. What happens? Does the water change color? Make a sound? Begin to draw the pain out of your body, dissolving it as it hits the water? Is it cold on your toes - almost making you shiver or giving you goosebumps? Or is it so warm and inviting - everything you ever hoped to be - stirring an audible sigh of relief at first touch?
Now, go ahead and let it cover your ankles.  Wiggle your toes around and paddle your feet, remembering that this is YOUR healing water, no one else's. It knows just what you need.
Move further still, putting your calves in. Notice them relax, surprising you at just how much tension they were holding while you were totally unawares. Give your legs another kick, pushing and pulling against the weight of the water, feeling it whisk between your legs as they pass each other. 
Scoot further in now and let it cover your knees.  Spend some extra time here and let it fully soothe your tired legs and aching joints. Notice how incredibly weightless they feel. It's quite possibly the best feeling you've ever had.
Slide in now and feel the water come up over your thighs and up to your hips. It's not too hot or too cool, it's exactly what your body craves, almost as if it was pulling you in. Notice your legs just completely melt, almost wishing to release a sigh of their own. It's as if not only the healing properties but the water itself goes straight through your skin into every tissue, cell and fiber of your body, drawing out every ounce of hurt or exhaustion in your poor, tired legs. They feel almost euphoric in the release.
Go in up over your tummy and up to your ribs now.  As a wave of relief washes over you, even the coloring in your face changes and the tension held in your pained expression relaxes. All the nausea and cramping and pain - any body memories or low back pain - it's all just drawn out of you and replenished with a level of comfort you didn't even know was possible. Cooling, numbing, calming every inch, while warming and softening other aching muscles.
Go ahead and let your arms start to fall in now.  After your fingers dip in, it's only natural to want to play with the water. You've never been in anything like it! What does it feel like? Does it swirl? Can you pick it up, does it change when you hold it in your hands?
Now sway your wrists and hands through the water, pushing and spreading it out. See how cramped and pained your hands were? You maybe didn't even notice in all the rest of your body's aching. Or, maybe they were swollen and rigid and tense and this was exactly what you wanted. Spend extra time on them. Now you can open and close a fist without pain, wiggle your fingers loosely, and dance in the water without pressure or restriction. They feel FREE!
Drop your arms until the water covers your elbows - now able to stand completely comfortably, your shoulders more relaxed. Take a nice deep breath. Do you want to keep walking around in it now - free to twirl in a circle - or, would you rather sit on an underwater stone or rocky ledge and just take it easy?
Either way, dip yourself slowly lower until the water is up to your collarbone.  Feel your chest cavity expand and the fresh oxygen rush into your lungs.  You'd been holding your breath for so long in the pain and you're now invigorated with such clean, healing air. You didn't know your lungs could open so far! Notice your heart rate slow and steady. And the PAIN held in your heart and chest, the spaces between your ribs - all of that weight from such emotional anguish and hurt - it just dissolves.  ...almost as if the healing water swirled around inside of you and gave your heart a warm, loving hug. Stay here as long as you need. This is so important.
When you're ready, cover your shoulders - possibly relaxing back against a cozy ledge.  Goodness, it's like your whole body has become jello now. Some of those last bits of tension are melting away and releasing the hold on you they'd had for so long. Take another deep, deep breath. Close your eyes if you want to.  And, now it's up to you if you want to take your head under or just splash some on your face instead. If you have a headache or migraine, I'm sure you almost can't wait. If you don't want to go under, that's okay, too. Just being close, or rinsing your face can be more than helpful.
If you decided to dip yourself under, go ahead.  Good news is that in this healing pool, you don't have to worry about holding your breath. Just let the water relax your jaw, smooth away the creases from your brows and forehead once contorted from pain. Feel it draw out all of the throbbing, aching, pounding, or sharp pains in any and every part of your head. Your thoughts calm and slow, and the worries, memories or awareness of pain just disappear. Everything goes quiet, and feels still. You could almost sleep in the absolute serenity. You're only right here, right now, and it's all you could ever hope to feel. Breathe deep. Spend all the time on you and your body that you need before lifting your head out of the water.

You can decide if you want to stay here and swim, take a nap in this place, or just relax for a few more moments - making sure you truly experience deep, deep healing in even the most stubborn parts of your body. When you're ready to leave you can slowly bring your awareness back into the present, but don't worry, the healing doesn't just disappear. You take at LEAST a piece of it with you for the most sore parts of you, and even more elsewhere. It wants to gift it to you and you’ve already changed a great deal of how your neurology while you were here. It won’t just undo. Over time, if it wears off or symptoms return, you can return. You can come back to this at any time and change any part of it that you need - customizing it for any future aches and pains, headaches, overstress or body memories.  

 

You may need to take a couple extra moments for grounding after coming out of such a calming oasis. If you're heading to bed or doing this before sleep, you're a-okay.  But if you need to return to the regular world, you may need to shake the fog from your eyes and fully connect with your surroundings before re-engaging with life again. So, be sure to orient yourself fully. (If you aren't sure what to do for grounding, good thing we've got 101 Techniques for that!)  But, even though reconnecting with the real world can be undesirable, that doesn't mean the calm, peace, and pain relief found there just goes away! You're more refreshed than you've been in...maybe ever.  Just be sure to fully re-orient, even if that haze seems more inviting.  ;)

 

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Healing Light

Healing Light works in a very similar way to Healing Pool, but it's especially great for anyone who has any kind of uneasiness around water, needs more of a localized "spot treatment", or has a harder time creating more scenic imagery in their mind.  

Just like Healing Pool, this skill is much more effective when you make it as descriptive and detailed as possible - only this time you will mostly need to focus on detailing the light and less so your surroundings. The light can even reach you right where you are sitting or laying right now if you'd like. But, if you want to visit a more soothing environment as you practice this, you are more than welcome to include one and detail it just as we did earlier! It’s all about your comfort and what will maximize the benefits you’ll receive.

So! When it comes to light, the possibilities here are endless. Is it a sun ray that bursts through the clouds and finds you? Is it more like a secret weapon, a thin, pain-zapping laser? Is it more like a glowing orb of light, personalized just for you? Or, perhaps it’s more conical like a flashlight, being emitted from some other precious source that you can turn on and off? Maybe it's no beam of light at all, but more like a dancing, ribbon-y, spritely kind of light flitting through the air. Is there a trail of shimmer or glistening particles that follow it in its magical nature? Is it warming and softening, or cold and tightening? Possibly something more gaseous, or like pressurized ice that can flash-freeze and numb ANY type of pain, seems more satisfying for your needs?
Does it make a twinkling sound, the whirring of a pulsating orb of light, or is it more of a buzzing or zap of a machine as it obliterates the pain? Does the light come in one color or many? Maybe you have different colors for different areas of the body, or a variety of colors and styles dependent on the type of remedy you need for it to give.  Perhaps you have one light that heats and relaxes the skin, another that freezes your pain dead in its tracks, a third that envelopes and "holds" the pain until the throbbing stops, a more aggressive light that shatters the pain into a million pieces and then individually dissolves each one, another that injects coolness through the area like a gel and feels like an internal ice pack, a highly unique one that simply erases the aching entirely as if it were never there, and a super satisfying light that draws the pain out from your body like a magnet or vacuum. You can even have one that incorporates more of a spiritual element, or the energy and care of someone you love, who can offer a special kind of comfort that no one else can. So many options!

Like the slow entry into the water in Healing Pool, it is oftentimes more effective to start with an area of the body that's unaffected - gradually approaching your "target" area so that your mind and body have an opportunity to fully connect this imagery exercise with your actual pain. If you're a fan of those that obliterate and destroy the pain with like dry ice blocks, etc, you miiiight want to give the light a "seeking" function that just cools and nurtures the healthy areas as you begin the process, then let it 'scan for' the most painful section you want it to destroy.  We don't need you feeling like your forearm just got pulverized or flash frozen when it was your shoulder that was waiting for the relief, ya dig? ;)

Okay, so, first!

Visualize in your mind's eye where the light source is coming from. You might even start to feel building anticipation of the relief you’re about to receive. Picture this light source, notice its glow, feel the warmth or coolness it’s emitting, listen to its unique sound.
If it's your head that is throbbing, perhaps allow the light to first hit your spine - releasing and soothing each individual vertebrae as it climbs your back to your neck and head. Allow the healing particles to weave throughout your jaw and mouth, completely relaxing them along with your brows, forehead, and eyes. Then send it to your pounding skull. Let it do there what you’ve desperately been needing it to. Let your mind subconsciously direct it. If your abdomen or low back are aching, maybe show some love to your toes, feet and legs before reaching the pain of your midsection. If it's your shoulders or neck, let the light graze your fingertips and creep up your forearms, triceps and deltoids before tackling your upper body pain and releasing that suffering.

This light is so detailed and meticulous, so specified to you and your needs. It reaches through every capillary, tissue, cell wall, vein and nerve fibre. It knows what you need without your instruction.

Visualize what's happening beneath the surface as it finds your pain. The way it coats, cools, and soothes your pulsating nerves. See the light pierce through all parts of you to find your toughest tissues and muscles, melting them into the greatest relaxation you've ever felt. Imagine how your light sprinkles your skull with tingling, healing properties - how they then trickle through all the wrinkles and spaces and curves of your brain, quieting and soothing not only the aching but all your frenetic thoughts, too. Picture its warming, swirling path to all the cramping and twitching muscles that are remembering something from the past. See it drawing out the inflammation and "darkness" that can feel so heavy when it gathers in your joints, or even in your lungs or heart. It's gone now. You can breathe. You can feel that relief. It may have even felt so good that now you need that light to go everywhere else. That's perfectly okay! Practice that self-care and bathe in that light if that feels right to you. This is your light. No one else's. It's made just for you, for your pain. No one can change it, tamper with it, or even know about it if you don't want them to! This is YOUR healing light.

When you've decided that you are finished, you can watch the light slowly leave your body - taking any last stubborn remnants of pain with it. Take a deep breath knowing that as it leaves, the pain will not just immediately return; it's been healed. Your mind and nervous system have chosen a different path and sent wellness to that area. You aren't just "imagining" relief, you've neurologically and chemically given your body some different instructions. And when life is being a jerk again, you can call on your healing light any time to give your body that relief once more. It is so precious.
 

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These techniques are but a few in a sea of treating ailments and managing distressing trauma symptoms through imagery. There are countless others, like those involving the use of colored “pain water” that fills up the body but is slowly drained out from the heels. Another semi-silly one that is taught in some trauma units is called "flick the pea". In this one, you imagine your pain as a very large sphere (like a basketball or even larger if it feels more massive). You then move that ball away from that area causing you so much distress, toward your arms, shrinking it down in size as it travels, until it's so small (the size of a pea) that once it reaches your fingertips, you can flick it away with a very, very satisfying flick. There's another that is specific for numbing that just involves sticking your finger in an ice cold water and mentally carrying that frozen feeling up your arm and through your body until it meets the pain you’re suffering with. This is one you can often see the color change occur in the skin as your mind registers the chill taking over you.

We have also made a post on Color Breathing, which not only helps with emotions and panic, but pain as well. There is also an introduction to imagery techniques that use dials to help modulate pain, intense feelings, and memories which you can find here.  If you would like us to share any of these in more detail, we can certainly do that. We are planning to make many more articles on imagery - particularly containment skills (for memories, emotions, intrusive thoughts, self-harm urges, etc), but we wanted to be certain to tackle those that help with physical pain first!

We truly hope these skills help! Feel free to expound upon any of them, make them your own, or - if you're just learning - even let your phone or computer read them out to you so that you can just close your eyes and follow along, visualizing as it guides you through! These can also work for anyone, not just trauma survivors! So don't hesitate to share them with friends and loved ones, particularly if they have chronic pain or any chronic illness!  Good luck, and if you have any questions, please ask below or message us!

 

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More Resource Posts You May Find Helpful:

✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Flashbacks 101: 4 Tools to Cope with Flashbacks
  ✧  Nighttime 101 and Nighttime 201Sleep Strategies for Complex PTSD
   Coping with Toxic/Abusive Families During the Holidays

  ❖  Article Index  ❖

 

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Nighttime 201: Small Sleep Strategies that Make a Big Difference

Welcome to Part Two! If you're coming from our Nighttime 101 Guide - and if you're not, why don't ya start there first - it may seem the techniques offered there are a bit more on the advanced side as they'll compare to what's about to be presented. So, why would we have picked that as the starting point if these are more simplistic, quicker fixes? While those ‘foundational four’ skills - a nighttime routine, journaling, internal communication and medication - do require more in-depth understanding and greater effort overall, we really feel that for survivors with Complex PTSD, that approach to sleep is truly your first line of defense. It is your ground level to build on. If you cannot successfully apply some of those tools, your sleep could remain interrupted and fitful even if you completed every single item on this list. The tips and tricks here are more like icing on the cake; things to add to your already-reliable baseline that will improve the quality of the rest you may finally be getting. It's possible some of these may become a part of your own foundation, particularly if they tackle a critical issue that's been keeping you up, but for the most part, none of these alone will be the key that unlocks decades of restlessness for you. We hope they instead improve what you've already been working on, tie up loose ends, and settle any of the hiccups that continue to cause you grief. With trauma, sometimes the simplest of steps can make the largest differences, particularly in this complicated fight for good rest.

So, let's go some sleep! Here is a list of several additional things you can do that may create a safer, more comfortable, restorative, and peaceful rest.

  • Make your room, and your bed, an inviting place to be.  If your room is full of clutter, food, your school or work items; is comprised of drab colors, lifeless pillows, or contains only the bare bones necessary to call it a bedroom? How is your poor mind ever supposed to want to be there for several hours? How is it supposed to feel calm and secure and nurtured? Warm it up. Make it a place that welcomes you, pulls you in, is a place you want to be. Even if you possess very little or have minimal means to change things, there are small ways to make it your own and tell your mind ‘at least I care about me'. Keep it decluttered, refreshing, and not too busy. Try not to bring things into it that wind you up or stress you out - like work, school or projects. Create a sea of fluffy pillows, cozy blankets, soft colors. Maybe add a few nice pictures or go real wild and buy some new drapery that makes it look like you really know what you're doing in there. ;) Try out a simple DIY project that makes you proud of yourself and what you've done with the space. (And hey, not crafty at all? All the more reason to create something just for you! Because not only will you be even more proud of what you were able to make, you'll always be reminded of the fact you believed you were worth that effort! Because you are!) Even with the smallest of budgets, it's possible to take a space you've sorely neglected and transform it into your perfect, personalized little oasis. And, this seemingly insignificant change to where you rest your head can actually do wonders for your mind and body - which leads to more Zzz's.

  • Use signs or pictures near your bed to help with grounding.  Put notes and personalized reminders right where you can see them from your space on the bed. Create a pretty sign for the wall, put a notecard or photo in a frame that stays on your nightstand, decorate the ceiling if you have to! Make something that has the current year in bold lettering, along with with other grounding or reassuring statements. Perhaps you need to elaborate further on where you are, how old you are, that you are safe now, or a mantra that settles or re-centers you — anything that you know you'll need to see the moment you open your eyes struggling. Whether you wake from a nightmare, re-open your eyes as you're drifting, or are wrestling with flashbacks during the night, having those reminders right where you can see them and without having to work too hard to find them when you're disoriented can really be the thing that helps you until you're in a better place to help yourself.

  • Make a music playlist just for sleep.  The options here are limitless. Some folks like calming versions of songs they enjoy during the daytime, while others go for ambient music made just for sleep, classical sonatas, or even kids' lullaby music. If you have child parts inside, sometimes an album full of kids' music (or just sprinkling a song or six into your otherwise adult playlist) can be great for all of you as a unit. Whether you like a Fisher Price or Baby Mozart album made with newborns and young children in mind, pretty Helen Jane Long albums, any of (ironically named) Sleeping At Last's instrumental tracks, or songs from your favorite film score, there is such a wide range of music that can help you strike a balance between adult and childlike music.  ..no matter which end of that spectrum you'd like to fall on. Even if you don't have parts inside, you'd be amazed how much lullaby-esque songs can soothe even the toughest of adults, sending them peacefully into dreamland.
    Some individuals prefer there be lyrics, so as to keep their mind engaged and less likely to drift into dark places, while others need zero lyrics because they keep them awake or cause them sing along ;) Whatever you need is just right and is definitely out there with a little bit of effort! Change it up weekly if you need, or keep it exactly the same so that your body always knows it's time to rest when you hear it. And? If you sleep with a partner who's anti-tunes, the lightest little bit of quiet music from beneath your pillow can still be more than enough to reach you. Headphones/earbuds are also an option, but we'll hit on those later!

  • Discover podcasts, Spotify playlists, or white noise apps that really appeal to you.  The internet and smartphones/iPods (yes, some people still love their iPods and refuse to give them up) have changed the game in helping people get some sleep - particularly if they cannot staaaaand silence, yet outside noise keeps them up. Entire Spotify playlists exist just for sleep. There are apps upon apps upon apps that contain soothing sounds or "white noise" options specifically designed to help you rest easier. And if music isn't your thing but a flashing TV is too much, podcasts may be your solution. Find one you love, one that bores you to tears, or is a happy medium between fascinating and something you aren't too invested in - that way you can stop listening and fall asleep without being sad you missed something important. Podcasts without massive highs and lows in volume or content that could be stressful are most recommended. Some of us find that the podcast A Way With Words fits that bill nicely for most survivors :) But there are tons out there for you to discover.

  • Consider buying some darkening curtains/blinds. If you are super light-sensitive or find you're only able to sleep during the day, a set of darkening curtains/blinds can be a lifesaver. And the good news is, inexpensive stores like Walmart and Target even have some great options now. We're sure other outlets or discount fabric stores would have even more impressive prices, but you don't have to completely break the bank for darkening curtains anymore.

  • Conversely, buy lighter blinds if you have a hard time waking up or like to sleep all day as an escape.  We all want our blinds closed at night so no one can see in, but if you're prone to sleeping in all day or struggle with depression to the point it keeps you returning to that bed in the daytime - some lighter blinds may be what you need. A bright, sunny room is harder for many to sleep in, but it also helps keep your internal clock more aware of the time of day - willing you to stay awake even if you want to come back. Staying on a proper sleep|wake schedule during the day can make resting at night a much better experience.

  • Consider going to bed with a full tummy.  We know traditional sleep guides (and whack diet advise columns) insist on not eating an hour or more before bed. Whether they claim it gives you bad dreams or makes you gain weight, little to no science agrees. And when it comes to Complex PTSD specifically, for many survivors, an empty stomach can be upsetting for a number of reasons. Some grew up rather poor and had to go to bed hungry each night. Others were plainly denied food as punishment or as part of their abuse. Many survivors have struggled severely with eating disorders, and may still be struggling today. Some simply just could not eat after trauma when they were young, or wouldn't do so before bed if they thought trauma was imminent because it made them sick. Alllllll of these reasons and countless others can be terrible reminders of trauma, pain and sickness - and the simple growl of your stomach as you try to go to sleep can signal to your mind and body that you aren't okay. Something as simple as heading to bed with a moderately satisfied, or even full, tummy can lead many to feel more secure, and thusly safe enough to disengage for rest. And, eating a bit before bed can even lead some to just naturally get sleepier, solely because their body is no longer trying to get their attention to tell them they're hungry. Imagine that!

  • Try not to drink too much right before bed.  Conversely to above, drinking too much before you head to bed can not only make you feel a little sloshy when you lay down, but it frequently leads to that midnight bathroom run. Sometimes just KNOWING you'll need to go to the bathroom in the middle of the night can keep you restless and unable to fall asleep as easily just because you're on alert - anticipating when it's time to "go".  And, above all, once you've had to get up to make that pit stop, it can sometimes be nearly impossible for sooooo many of you to get back to sleep. We don't want that for you.

  • Make sure to listen to what YOU need, not just what someone else tells you is good or bad to do before bed - including us!  There are countless guides out there telling you what to do and not to do at night. Whether it's the ones that say don't eat before bed, to never sleep with a TV on, not to drink ANY caffeine 12 hours (or whatever arbitrary number) before bed, don't exercise or be active at night, or any other seemingly sound rule -- no rule is gospel. And that includes ours! Some can drink coffee RIGHT up until the second they lay down without the slightest disturbance. Others require a TV on. And someone else may not even be able to tolerate laying down without having a huge mug of their favorite beverage first. Listen to your needs and know that your body may be more or less sensitive to certain things than others'. No matter what someone else insists is the root of your sleep problems, they might not be right. And only you can know that. We provide suggestions based on what we've seen in so very many survivors, but wholly recognize that it won't apply to each and every one of you. Feel free to pass on those that don't! You know you better than we (or anyone else out there) ever could. Try out new things, as you may be surprised by their effectiveness, or your ability to adjust to something you thought you'd hate but turn it to real help, but ultimately do what your body needs.

  • Invest in nicer pillows, throw blankets, or comfort items.  Not only do some of these items make your room LOOK nicer and more inviting, they are actually comforting to your physical body and mind together. They make you eager to lay down in your now very gorgeous, soothing bed. The sense of being able to flop down on pure comfort, or cozy up in the softest, snuggliest of blankets, just automatically makes your body want to relax and let its guard down for the night. Don't have much money? Sometimes something as simple as buying some extra stuffing for 3 bucks on Amazon (especially if you have, or want to buy, pillows that zip close) that you can use to fluff up your pillows to your own desired squishiness can make a dramatic difference in the coziness of your bed. Sure beats a flat and sad pillow. ;) Or, just choosing to go in on one velvety soft blanket that all but swallows you up, and is only yours, can bring so much gentle peace.

  • Pajamas. In the same spirit, get yourself some nice pajamas or underclothes for sleep -- something you can't wait to get into and that immediately makes you feel ready for bed. Ragged T-shirts and basic cotton bottoms can get the job done, but if you're really struggling to sleep, sometimes just taking a little more interest in you and what you wear can be a game-changer. It's also about self-care. Not only do you just feel snuggly in your nice, new PJs, you also feel taken care of.  ...reminded that you are worth the rest you are about to get. You are worth more than just that disheveled tee and holey pants you've been wearing for years. If you have an impossible time feeling motivated to lay down, a new set of nice PJs can make you a bit more eager to get started so you can be in those comfy clothes sooner. (As an aside, they don't even have to be FANCY pajamas by any stretch. Sometimes just getting something new is enough. It feels fresh. It feels different. It feels special. Too many of us have been in the same haggard jammies for yeeeears. A simple item or two can spruce things up a lot and remind you that you deserve to be comfortable. You're worthy of good sleep.)

  • Linen sprays or fragrance/oils. If you aren't a fancy schmancy homemaker, you might not have even known there's such a thing as linen sprays. But, boy, are they a thing! There are so many fragrances you can put on your linens that just call to you - inviting you to breathe them in deeply and just melt into them deeper as you exhale. Isn't that what we all WANT to feel when we hit the bed for the first time after a long day? Find a fragrance that does that for you. The same is true with essential oils or other items that produce fragrance. Whether you believe in the calming properties of various essential oils or not, some of the scents alone can just take you to a nice and relaxed state that speaks directly to you and your needs - while also being a grounding presence that keeps you in the here and now.

  • Light a candle a bit before bed that will leave your room with a pleasant aroma.  We don't want you to leave candles lit while you sleep, but sometimes lighting a candle for an hour or so before bed and blowing it out still leaves the room billowing with a fragrance you love. This is not only calming, pleasant, and/or inviting, just like above, it can be really grounding as a strong scent that lingers should you re-wake.

  • Consider purchasing a tiny child's stuffed animal or baby blanket - even as an adult.  It may seem silly, but sometimes that younger you who feels so afraid of sleep can feel at ease by these little gestures. You're never too old, too cool, too tough, or too anything for a stuffed animal or small blanket. And, if you have internal parts, this simple "gift" can bring such wonderful comfort to you all.

  • Try color breathing before bed or once you lay down.  This is a wonderful way to calm down. Additional breathing techniques, especially those combined with visual imagery, may be equally as helpful if you have one you really like. You can also create your own technique! Yes, you are completely allowed to just make something up. Not every breathing technique has to come from a manual, guide, doctor, or study. Sometimes you know just what settles you best.

  • Progressive muscle relaxation.  Here is one example, but there are many - some even come with audio recordings to lead you through.

  • Healing light/healing pool imagery for pain.  Healing light and healing pool, along with some other similar imagery-based techniques, can be critical skills in relieving physical pain that could be the root of what's keeping you up. You can read about those here. They can also just be so satisfyingly relaxing for mental distress, upsetting emotions, or to just relieve natural tension we all carry.  

  • Consider asking your therapist to make you a voice recording. They aren't hard to do anymore, as just about every smartphone has a record feature that can then be easily sent through email (or even text if it's short enough). The recording could be a guided imagery, various grounding statements, or just generalized comforting thoughts to lead you to sleep. Hearing them from your therapist (or loved one even) can offer an added layer of security and calm that we can all use as we try to rest our eyes.

  • Positive reinforcements and gratitudes.  We mentioned something similar in our Nighttime 101 Guide, but that was a bit more specific to journaling practices before bed. This is something you can just do in your mind. If you are particularly restless, in an anxious or upset place, or just can't stop the recursive self-shaming that your mind wants to do as you rethink the day - consider trying to redirect your thoughts to naming 5 positive things about the day. They don't have to be groundbreaking, but they're there. You'll find them even on the worst of days. Similarly, you can think of 5 or 10 things you're thankful for - in general or even just that day. For others, you may want to pick 3-5 things you like about yourself or that you did right/well that day. Challenging other cognitive distortions may be an area someone else needs to focus on. Whatever you need most, just be sure to flip the script to this tone of thought and you'll be grateful for how much calmer and sleepier you feel. It may even improve your dream quality.

  • Do some light stretching before bed.  Tension is a jerk. It causes pain, increases anxiety, steepens depressive feelings, and just plainly makes us miserable. Some slow stretching can get out the excess energy still zinging through your nervous system from the day, while also soothing and calming your body down for the night. It can loosen stiff muscles, un-pinch painful spots, and send fresh blood throughout your whole system so that your body can more effectively heal and repair itself during your period of rest.

  • Temperature, pets, and outside influences.  There are so many things outside of us we can't control that keep us up, so anything we can do to tend to them before laying down we should definitely do. Double-check that the temperature will still be comfortable as night falls, your pets are where they need to be (with you or closed away in their sleeping area), family members are aware you're trying to turn down, your phone's notifications are silenced, any TV timers are set, you have any extra blankets or socks you may need already in reach, contacts are out, mouthguard is washed, makeup is off, meds are taken, etc etc. Literally double-check all the things that could make you have to get up after you've already snuggled in (or worse, already fallen asleep). Nooo one likes having to get up after they've already experienced that first wonderful sigh climbing into bed. The second time around is never nearly as satisfying, and if you were already asleep, getting back to sleep can be a nightmare on its own.

  • Wash your sheets frequently.  Simple, simple. Little is more inviting than fresh sheets to make your body feel peaceful and happy when you lay down. Crumbs, dirt or "stale" sheets aren't exactly the most welcoming invitation for your dreams and sleep. Wash 'em. You'll be glad you did.

  • Consider buying a therapeutic pillow or (if you have the finances for it), a new mattress. This is certainly not in the realm of possibilities for everyone - and it's something most of us have all heard plenty of times.  ...but sometimes the solution to poor sleep really does lie within your mattress and pillow. Given so many survivors with C-PTSD are also sufferers of chronic pain, a proper mattress and pillow that supports your head and neck sufficiently may be what you truly need.

  • Invest in some soft and pliable earbuds. For many, any outside noise at all will wake them up, startle them into symptoms or keep them from sleeping. But earplugs can be unsettling (all you hear is yourself breathing in your ears, or your pulse, which isn't helpful if you're anxious), and many headphones aren't comfortable to sleep with. There are a few companies that make super soft and flimsy earbuds that have little to no hard plastic or metal at least inside your ear - and some even have fairly soft connecting pieces, so even if you laid on your side it wouldn't hurt your ears. We know that Samsung makes a few, but there are most assuredly other companies out there, too. This would not only allow you to listen to music/podcasts/recordings/white noise without bothering anyone else (particularly if you have a partner or have to sleep in a more public area for a trip or something) - but for those really sensitive to outside noise, earbuds ensure that you hear nothing else.  The sounds you want to hear just get injected into your ears and fill your whole head with goodness and block out the outside - effectively shutting out the world and leaving you free to get the sleep you need. Now, some don't mind sleeping on even the hard earbuds (and we recommend giving it a go if really you don't mind it) - but if you can't take the discomfort, spending a little extra money for the softer ones might let you sleep through the night bot pain- and distraction-free.

  • Look into information regarding blue light or the effect electronics can have on your sleep cycle.  There is now a ton of literature on the way the 'blue light' from our electronics can affect brain activity, but more importantly, how it can alter the cadence of our sleep cycle. There are various ways to turn this off in our devices. If this is something that concerns you, something you want to learn more about, or if you just want to learn how to turn it off in your personal gadgets, you shouldn't have to google too far before you find just what you need. It could make a difference - particularly if you're someone who is more sensitive to it than you ever knew.

  • Get browser extensions, or use the installed features on your personal devices, that won't allow you on certain apps/websites at certain times.  Ha, yes, they exist out there! Some even come on the device itself now. And there are plenty of them - for both computer and mobile - that are designed to meet your specific needs. These can be extremely helpful in getting you off youtube/social media/gaming websites if you just can't resist or are using them as a distraction to keep you from sleeping. Many allow you to set the time you need it run as an "every day at this time" function, or require you turn it on when you need/ want it in use and then you set a timer of how long. Some are even created to ensure that even IF you uninstall it, the timer will still be in effect until it runs out.  ...so you can't cheat by just getting rid of it! If you find yourself glued to your phone or computer when you should be sleeping (or working!), you may need to look into these extensions and apps that exist to help you out here.

  • Better waking up.  If you can wake up easier and more smoothly, you're much more likely to be ready to sleep when bedtime rolls around. If you have trouble sleeping TOO long, ignore your alarms, or return to bed during the day, it of course disrupts sleep rhythm and leaves you wide awake come nighttime. So, when it comes to waking...  Set alarms that have music that MAKE you want to get up - invigorating fun music. Something that makes you happy. We don't like the idea of obnoxious, annoying alarms because that just puts you in a bad mood the second you open your eyes.  ...or rather, before you've even had a chance to open them!  And that doesn't make aaanyone want to be awake. Start your day off right with something that makes you happy. And change it often so that happy-fun-new-alarm-that-you-love doesn't turn IN to something you hate! No one likes when a good song gets ruined! ;) Put your phone across the room so you have to get up to turn it off. Or, incentivize. If you get up and stay up, you get to have x treat. Remind yourself that if you're truly that exhausted by late afternoon, you are allowed take a short nap then.  ...but not until you've given the day your best shot for a good while. You'll be surprised how ready to get up you actually were.

  • Just. Get. Started.  The hardest part of any task - absolutely any task whatsoever, including something as seemingly simple as heading to bed - is just getting started. Once you get up, begin your nighttime routine and start aiming for bed, you'll be baffled by just how ready for sleep you really were. ...no matter how sure you were that you were totally wired and sleep was nowhere in the near future.  Just. get. started.  Once you mentally "turn off" and start heading for the pillow, you'll be consistently impressed almost every time at just how much your body was craving the collapse. ..even though it was only mere seconds ago you were convinced otherwise.

  • Give it a shot anyway.  Sufferers of chronic sleep disturbances are no stranger to the losing game of just not being able to sleep, no matter how hard they try. You can do everything right, but still be awake for ages after you lay down. But, after experiencing this so much over time, we can convince ourselves so confidently each night that "it's just not gonna happen tonight", because for so much of our lives it really hasn't. But this kneejerk response to how we THINK sleep will go can lead to that becoming reality as we stay up far longer than necessary and refuse to even entertain the idea of settling down yet. ...because "we just know". But our confirmation bias - looking for only the signs that prove we were right - can actually influence what our body believes, and lead it to respond accordingly. WE can be the reason behind why we're still up because we just decided how our body was likely feeling, and it followed suit. But, sad to say, we're often wrong.  Had we just given it a shot anyway, we would've actually been fast asleep by now. So, what's the worst that happens if you do give it a shot? You get nice and ready for bed and it's a no-go. Oh well. So you get up or do something in bed and try again later. But at least you're now cozier in your PJs and physically ready for bed. So the moment you are sleepy, you can just turn down right away instead of having to "wake yourself up" just to go get ready for bed. ..additionally running the risk of missing that window of opportunity we all know exists. But hey, the other possibility is that you might actually crash. You've been trained your whole life to ignore your body. You'd be amazed (and impressed) by how exhausted and ready for sleep it can actually be without you realizing it. You're very rarely going to regret trying, but you almost always regret waiting too long to try. ..especially the when you wake up the next morning!

  • Finally, we can't forget about things like journaling, internal communication, grounding, medication, and more (each discussed in our first post)!  The suggestions here may be a bit easier to apply, but the skills there will be relevant and useful throughout your entire life - no matter the home you live in or the path life has taken you. Give those a look-see and don't forget their importance either :)

  Now it's your turn! Because so many of these are much simpler, we are certain many of you have countless ideas just like 'em! Tell us, and all the other survivors reading, what you do to get some sleep!  What's the one thing you can't get to sleep without, or has made the biggest difference for you in your journey for better rest?

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MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101: 101 Self-Care Techniques
  ✧  Nighttime 101 and Nighttime 201Sleep Strategies for Complex PTSD
Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101Healing Pool and Healing Light
  ✧  DID MythsDispelling Common Misconceptions about Dissociative Identity Disorder
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
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Article Index  ❖

 


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Nighttime 101: Sleep, Nightmares, Insomnia and More

 

Getting Some Rest as a Complex Trauma Survivor

It’s no secret survivors of trauma often have an incredibly difficult time with sleep. Whether that's due to terrible nightmares, night terrors, or sleep paralysis, having a racing mind that won’t turn off, only feeling safe to sleep during the daytime, or wrestling with any of the other complications that can surround bedtime, we know the time of day most really look forward to can be the one to fill many survivors with dread. We have accumulated, utilized, and witnessed the success of a wide variety of sleep strategies over the years - tools specifically designed to help trauma survivors not only get to sleep, but do so safely and stay asleep more peacefully. In sharing some of them with you, we hope it may even shift your overall approach to sleep and, ultimately, lead to a much more secure, restorative rest. As an added bonus, you can fund reassurance knowing you are not alone, crazy, nor making too big a fuss out of “something so easy” or “basic". It is not easy; there are incredibly valid reasons this is so difficult. Be kind to yourself. And, hopefully, we can help get you some long overdue rest!

We'll be tackling four main areas: Nighttime Routine, Journaling (both before bed and as a tool for nightmares), Internal Parts (for those with DID/OSDD, but also still applicable to most), and Medication. Feel free to take what you need and just leave the rest. Also, be sure to add your own experiences, struggles, and suggestions below! You may find that someone else has the perfect solution for your biggest challenge, or - by sharing your own experiences - you spark a light bulb for someone else and bring clarity to their lifelong sleep battle. So, don’t be shy! Your voice is valuable.

 

Nighttime Routine

One staple skill for just about anyone to have in their toolbox when they're warring with sleep is: creating a nighttime routine. When you take a series of deliberate, personalized steps about 30-60 minutes before bed - and do so night after night - you send an early signal to your mind and body that you plan to disengage soon. It learns that once you've begun step one, it’s time to start slowing down, settling your heart rate, and preparing to turn off and recharge. As you likely know all too well, most (C/)PTSD minds are extremely hyperaware and vigilant for any sign of distress throughout the day, and some turn on their Expert Level mode once they suspect sleep is on the horizon. So, any early indicators you can give your mind that you plan to disconnect - while also offering reassurance that you’re both taking intentional steps to ensure it's safe to do so and that this is all in your control - can make a dramatic difference in it following suit. ..and doing so in a timely manner.

For many, this routine may start with taking nightly medications - which is a great place to start if you have any that are for sleep. Doing so 30-45 minutes before you aim to rest allows them time to take effect before your eyes are closing. Perhaps there are sitcoms or online videos you like to watch to help you unwind and shift into a lighter place. If this kind of entertainment is an important part of your evening, it’s good to add it to the routine early so that you’ve had a solid 15-30 minutes without electronics before shuteye (longer is even better, but let's start realistic!). This isn’t only a good idea because of the way digital devices keep our minds active and can affect sleep rhythms, but they are notoooorious for sucking us in and getting us to watch one more episode, scroll a little longer, or play just one more game. …or, okay, one more. ;) If you're also dissociative or just really, really avoiding sleep? I don’t think you need us to tell you that it can lead down a tech-hole that's not easy to get out of, robbing the entirety of your designated sleep hours from you. So, enjoy these treats early on, with focused intention and built-in boundaries, then continue on with the rest of your bedtime routine. Get a snack, drink some tea, or enjoy another calming treat. Feed your pets if you have them. Wash your face. Brush your teeth. Take out your contacts. Put on your PJs. Set your clothes out or gather other items that you need for the next day.  Do all the things that you need to be ready for bed while adding in any self-care items you aren’t currently doing that could be helpful to you and your sleep.

Once you’ve climbed into bed, we know this can be the hardest part. Ease into it. Go ahead and plug in your phone, set your alarms for the next day, and turn on any light music or white noise apps that you enjoy. Then, instead of just closing your eyes, you’ll want to take some extra steps that are just for your mind. This is part of the Nighttime Routine, not just what brings you to the physical bed. Whether this is done through journaling (discussed more below!) or mental imagery, do what you can to consciously put the day and alllll its stressors and triggers away. Take some time to acknowledge to yourself where you are, the year, that you are an adult, and that you are safe. Look around and do some self-talk, reminding yourself of all the ways you are secure in your home and in your room, that no one can interrupt your rest in an unsafe way now (even if you easily startle by pets, kids, or partners). If you have parts/alters inside (DID/OSDD), go ahead and take time for them; make sure their needs are met and they are ready for bed as well. (More on this below!) Then, spend a bit more time on pleasing imagery for yourself, whatever that may mean for you: safe place imagery, progressive muscle relaxation, color breathing, or just envisioning a special place you’d like to visit. Hopefully, it shouldn’t be too long before you drift.

While we know there can be other pitfalls to sleep that we’ll discuss in a moment, establishing a routine like this that you try really hard to follow in the same order each night can do wonders for your rest. Setting that rhythm and getting your mind, neurology, and whole body in sync can be the key to achieving - at the very least - a more still and restful state of being. The more you can stick with it, the better the efficacy. And hey, we know life happens. It’s okay if your routine gets interrupted or you forget a step or two. It’s less about absolute perfection and more about the intentionality of taking gradual steps away from high-alert and toward a more settled and calm you. 

Journaling

 

Journaling to Help with Sleep

One of the best ways to ensure a good night’s sleep is to practice a coping skill called containment - and, one of the most universal mediums for that is journaling. Containment allows you to temporarily “put away” difficult thoughts, feelings, memories, urges, and more by mindfully and consciously giving them a place to go. This way, you can continue on with your day - or in this case, your rest,l - without those things intrusively revisiting you.

Everyone has experienced sleep that was made more difficult by mild stress throughout the day. But, trauma triggers you've encountered, worries and fears you have about the upcoming day, memories you’ve been wrestling with, and all sorts of similarly challenging material can make it a million times harder. Taking a moment to briefly write some of these things down gives your mind a chance to acknowledge and validate how much these things are affecting you.

This is important because it keeps you from “stuffing” (pushing things down or pretending they don’t exist, don't faze you, or are so invalid they shouldn't be there at all). Stuffing nearly always results in those unpleasantries thrusting themselves back into your awareness when you least expect it or are most vulnerable (including in dreams). “Hey! I'm still here! Don’t forget me! Okay, you're ignoring me! No! Meet this need or I won't stop 'til you do!” Validating these things by jotting them down (and just a headline or bulletpoint will do - see below!) tells your mind “I see you, I can't forget you now, and I will come back this.” But, even more importantly, journaling gives it a place to go. The journal gets to hold on to it, and when you shut the book, the hard stuff is contained within its pages - allowing your mind the freedom to concentrate on more pleasant, calming thoughts. No more ruminating, bouncing from one trigger to the next, or ancient anxieties sprung from the grave. Thinking of it in this way and making the conscious effort to believe the difficult items are contained tight within your journal pages - until you want to revisit them (be it the next day, in therapy, or weeks from now) - means you're far less likely to be kept awake or have your dreams disturbed by their content in any form. This skill is especially important if you’ve been having an excess of nightmares/terrors, body memories, or unsettling dreams.

  “How long should I journal?”  “What should I write about?”  “Won’t thinking about all the hard stuff right before I lay down just make me feel WORSE?”  “I’m so tired before bed, I don’t have time for that, I just wanna sleep!”  “I have never journaled before and I’m not a writer.”

Fear not, we’ve got some answers! You don’t need to have ever journaled before to be able to benefit from or be “good” at this skill.  Because the cool thing is, you don’t even need to write full sentences. In fact, many avid journalers can get swept away in their storytelling and get themselves worked up and fully “in it” again. We don’t want that before bed! So, some useful tips include not only setting a time limit for yourself, but consider keeping it a short one. If you want to do longer journaling (which we highly support and recommend!), you can do so any other time of the day! Keeping it simple is as effective and doesn’t get your neurological system all revved up and firing again when we just settled it down via your routine. Try briefly writing a bit about your day, some of what recycles in your mind or is upsetting you, and at least a word or two on how it made you feel. For some, this may literally be just a bulleted list, no sentences at all. If the material is particularly triggering, writing a full sentence about it may take you right back there. An effective tool to prevent that, or if you just don't know how to explain a huge event with brevity, is to give it a headline. What would a newspaper title the full story? You'll know what it means because you were there; you know they story. For other material, it's possible to list what you did or what happened that day through timestamps or a web of emotional experiences. There are countless journaling techniques out there (we will likely even make a post about them one day!), so try to personalize it based on what you know about your mind and heart. Don’t give up if it the first few attempts didn't feel right! Listen to your brain and go where it needs you!

(Note: another common, justifiable, objection to journaling a lot of survivors have is the fear someone will read it. While we love the thought of you getting a journal that feels like a really personal, inviting place to hold all of your experiences for you — there is nothing wrong with or ‘lesser' in just writing via the Notes section of your phone. Then it is always on your person, you can lock entries so no one can find them, and you still help your mind displace some of its recursive thoughts by putting them somewhere outside of your sweet little head. There are also now good “hidden apps" for this on phones and computers you may want to explore, too. We are happy to help you brainstorm if your living situation isn't conducive to safe journaling.)

Final thoughts on this! Ultimately, the purpose of journaling right before bed is to put away the day’s worries and stressors, but some use it for a ‘next step’, too. While we highly recommend following your journaling up with pleasant imagery as you lay down, many incorporate that into their journaling.  They use their 'good thoughts' as a bookend to their writing so it doesn’t feel as if all the “yuck” was just left open-ended on the page. If this appeals to you, you can do so in various ways:
- Further describe a container you'd like to place these specific things in, like a locked chest deep in the sea, flown away on a private jet, a flood of emotions filling up an entire canyon in a remote desert, images projected on to a movie screen that you can leave in the theater, a filing cabinet or bank vault system with an elaborate system of locks, so many possibilities!
- End your entry with 5 to 10 statements that challenge current upsetting beliefs or distorted thoughts. Statements like, “I have worth.” “I am safe and can protect myself.” “Their beliefs about me do not MAKE me those things. I know who I am.” “I am not to blame; they made that decision.” “My needs are important.” “I am not too much.” “I am not responsible for other people's feelings.” .
- Close with: 3 positive things you like about yourself, several grounding statements, 5 good things in the day (no matter how small), and/or 10 things you are grateful for.  There are many positive, uplifting, affirmative, or calming things you can use. 

Choose whatever feels right to you and meets your greatest need in bringing things to a more peaceful, light place. Then, that satisfying thunk shut, locking away all the bad memories and heavy thoughts, can feel that much more successful - nothing bursting at the seams or already clawing to get out - because you pacified all its energy before even picking it up. It's such an excellent closer technique. ..literally!

 

Journaling to Help with Nightmares

  Journaling isn’t only a great tool to use before you go to sleep, it can also be incredibly useful after you’ve had a nightmare. Some nightmares are just too stubborn and intrusive that all the coping skills in the world beforehand can’t keep them from finding you. But, returning to sleep after one can be positively dreadful, if even possible at all.  Keeping your journal nearby may be all that lends a hand when little else does.

  Similarly to above, this can work as a kind of containment your mind really needs after all that distressing content was pulled to the forefront of your mind. Though you may be exhausted, unintelligible and handwriting illegible, scribbling down a bit of your nightmare can help you ‘get it out’ so you’re less likely to keep replaying it as you try to fall back to sleep. It also allows your journal to “hold it” for you, protect you, by keeping it far away from your mind or sleep. You don’t have to write much detail or elaborate heavily, just hitting the key components that were most distressing to you is what matters most. Just list them, give them a headline, name a few feelings, objects or people, draw something if the words are too hard—any means to get the bulk of the nightmare out of your poor head and onto something inanimate. For good measure, a lot of people like to fold that page of their journal over so they can’t even see it anymore. It gets extra-contained in its layers and thickness; unseeable. Then, you can close the book up tight, set something heavy on top of it if you please, shut it tight in a drawer, and even move to the other side of the bed if you can or feel you need to. …nothing is too silly if it helps you feel it can no longer reach you. Now you're free to think about pleasing scenery or a place you wish to be instead, knowing it is tight and secure where it belongs, and you’re in your safe place heading towards relief via rest.

  As a bonus, jotting these nightmares down can be incredibly useful to later bring to therapy. If you have a particularly recurring dream, there are strong themes in your nightmares that may be trauma-related, or you’re having actual flashbacks in your nightmares, these notes can be extremely valuable when you’re in sessions. Having them written down the moment you woke from them, as authentically and raw as they came, can help you tackle things in a much more nuanced way. This can get you through them more quickly and more accurately, which inevitably leads to better solutions for them all-around. And better sleep far sooner. Nothing could be more relieving than that!

 

 

Internal Parts (DID)

  Not all survivors with Complex PTSD have internal parts, as this is more DID-specific, but that doesn’t mean some of these ideas won’t still be helpful for all to at least consider. There are many different aspects of the whole self that can struggle with sleep, aspects of yourself that you may be unaware of or had never considered before.  For those who have DID, we know it can seem so simple or obvious that alters may be the reason your sleep is so disrupted.  But it’s also completely understandable that you might be inclined to look just about everywhere else for what may be to blame before you ever think to look inside.  "Did I have too much caffeine?" "Is this work project getting to be too much?" "Did I stay online too long?" "Maybe I shouldn’t eat that before bed anymore..?"  When there are sooo many things that can keep a person from sleeping, it never hurts to be reminded to stop and consider…hm, maybe someone inside is keeping me up.  While individual alters may be physically responsible for keeping you awake, for trauma survivors without DID, the younger aspects of yourself and traumatized parts of your mind may still need just as much attention and care.  They could very much be the source of your restlessness, too.

  For DID/OSDD systems…. Parts inside might not be intentionally trying to keep your body awake, but that is actually also a possibility, too.  Checking inside to see if someone is afraid to go to bed, has a belief that you need to be more productive or don’t deserve to sleep, or actively wants to punish you for something they feel you did wrong, are all things that could be going on beneath the surface.  Looking to see if any of these types of feelings are what’s at play may lead you to some very surprising answers.  Other possibilities may be much more innocent. Like parts making a bit of a ruckus inside, but not because they wanted to keep the body awake; it was just an accidental byproduct of their distress.  Maybe a small kiddo part really wanted a you to sleep with their favorite stuffed animal or wear your fuzzy socks. Or they needed someone inside to come tuck them in or read them a story before they could rest, which left you wide awake up front.  Other parts may be having an incredibly difficult with nightmares or triggers around bedtime that you weren’t even aware of - and their nervous energy or insomnia even on the inside may be keeping you up. Some insiders may just be ungrounded or unaware that it’s 2017, and extra grounding help before bed may be all they needed to quell their terror and lead them to sleep.  Other struggles may be more challenging to overcome, though, like a part not liking that you have to share the bed with your partner if you have one.  Issues like this may require a lot of talking and compromise before you can all get some shut-eye.  A simple nighttime snack may have been the answer for someone one night, while making sure to double-check the locks on the doors may be a absolute non-negotiable every single night for someone else.  There are countless things different parts could be having a hard time with - some that may relate to sleep and others that might not at all.  But until their needs are heard and met, you will likely be left awake. 

  The good news is that there are often solutions to many of these issues.  Some are quick fixes while others take a lot of work, time, therapy, and/or compromise. But there are usually answers somewhere, if given the proper time and attention.  If you don’t yet have good internal communication, learning what the issue even is may be the harder part for you.  But if you remain open to hearing from your mind, and let everyone know it's safe for them to express their needs or worries, you’ll likely hear (or at least pick up on) something you can work with.  Perhaps making sure all parts have gone to independent safe places before bed is what you will need to do nightly.  If they each have their own room, maybe child parts will need bedtime stories and snugs from maternal, comforting parts inside.  And, sometimes things on the outside are your answer to making parts happy - like special PJs, blankets, a fan being turned on, a favorite movie, or even something more serious like not sleeping in just undies.  The solutions may not always be comfortable to you, and this is where compromise and explaining your needs alongside theirs will be necessary.  But it’s a start.  And a start is often better than nothing if it’s been months since you’ve slept and you’ve tried EVERYTHING. If this is the first time you’ve gotten any insight to what’s keeping you up, it’s worth giving it your best effort. 

  It’s just too easy as we go about our lives to forget about parts inside or even those younger, traumatized parts of ourselves if we don’t have individual alters.  Tending to their needs, fears and worries - or just taking extra time on self-care and grounding for all of you before bed - can do wonders for your mind.  You’ve been through so very very much and your mind is going to wrestle with the idea of turning off for awhile, especially when it's the most vulnerable position you can be in all day.  It’s only natural that you may need to take some extra time, thought and attention toward your health, safety and comfort.  Yes, when you’re absolutely exhausted and just want to rest, this can feel like such a pain.  But I can promise you that it’s well worth it if it actually results in good, restorative sleep in contrast to the restless, angst-ridden wrestling and warring you’re currently doing.  Be kind to yourself, to your body, to young you and teenage you and adult you.  You each have your unique challenges, but you are all one, and that whole person in this singular body needs and deserves a great night’s rest each day of the year.  So, whenever you find yourself just having zero luck catching even a moment of decent sleep, or you're routinely waking up at the same time each night, we urge you to check inside.  See what might be going on for the rest of you that you’re often less aware of during the day.  Whether that is to each individual alter, or the traumatized and still-healing aspects of the singular you, give some thought to what you may need and ways you could tend to those worries or fears.  The worst that happens if you try and it’s not where the problem was?  Well, you just get a little extra self-care and comfort.  Shucks!   ;)

 

 

Medication

  Oh, medication — it seems it’s either the most vital necessity or the greatest enemy to complex trauma survivors.  And heck, both can even be true within the same person at different points in their life, orrr even at the same exact time!  When it comes to sleep, there are no ifs, ands, or buts about it — you absolutely must get it and you just cannot keep going if you aren’t getting a good amount.  For many of you, this will require medication at some point in your life, and that is one-hundred percent okay.  Whether the decision to try medication comes after you’ve tried everything else, or is something you jumped for at the first sign of trouble, there is never any shame in asking for, or needing, medication to help you sleep.  We fully support and recommend its assistance to you under the direction of a mental health professional (most preferably one who is familiar with complex trauma, but we know those are hard to find.  We’re working on that!).  That said, we know just as well as many of you know, that sometimes medication can just stop working one day, never really did in the first place, gave you awful side effects, left you with terrible nightmares, or is something parts inside (or even you alone) have intense misgivings about and can’t reliably take each night.  We want you to know that no matter where you fall on this spectrum of the medication journey, we empathize with you completely and are sorry that it has to be so difficult.  Sleep is so important and absolutely vital; we ache for anyone who, even after all their best efforts on their own terms, can't even rely on medication to be a sustainable resource.

  We don’t have any hard and fast answers or guidelines here, but we did want to mention its role in this battle against insomnia and nightmares.  Because, while it may not be a long-term solution, and may include some unpleasant side effects, it may still be the most welcome rescue to your desperate need for sleep. Now, just going to your personal care physician and telling them you’re having an impossible time with sleep maaay lead to them prescribing some pretty heavy duty sleeping pills.  But, we want you to know that not only are these NOT the only options out there, they aren’t always the best option for someone with your specific needs anyway. Talking with a psychiatrist tends to lead to a much more nuanced understanding of what about sleep is so difficult for you.  And this can make all the difference in getting either a medication that just physically sedates you, one that takes down your excessive anxiety so you can fall asleep organically, or even antidepressants that can regulate your body’s natural sleep cycle so that you can turn down when you want and wake when you need.

Another lesser-known but available option is a group of medications that target nightmares more specifically.  These are usually only prescribed by very knowledgable psychiatrists since they tend to affect blood pressure, and nightmares are not the medication’s primary focus.  However, in recent years, they have found that certain medications (such as MiniPress/Prazosin and Catapres/Clonidine), which typically lower blood pressure, have been affective in treating PTSD nightmares.  They do not always work and require very close monitoring of the person’s blood pressure since most who are taking it for PTSD reasons do not need their BP lowered. ...but that will still happen anyway.  However, it’s always helpful to know that some of these options exist out there and could potentially be viable for you.  You will need to talk thoroughly with your physicians to find what is right and safe for you, but just knowing there are various possibilities out there may lead you to the help you deserve.  “Sleeping pills” or the hardcore medications you’ve heard tons of awful things about are not your only option. In fact, they’re pretty rarely used for trauma patients (with exceptions of course).  Whether it’s through benzodiazepines, antidepressants, other psychiatric drugs with sedating side effects, blood pressure medications, or any other class of meds — there are so many ways to tailor your sleep regimen to your specific needs.  There is no one-size-fits-all when it comes to sleep, and that even includes within the same person.  What you needed, or did terribly with, as a teen may be the most unhelpful or perfect solution to you now.

  Of course, we know there will still be a subsection of you who have tried literally every concoction under the sun and there’s just no way to get relief through medicine.  We extend our sincerest sympathies and encourage you to look deep for internal reasons that insist you fight and override every combination of medicines thrown at you.  The mind is an incredibly powerful force and if it doesn’t want to sleep, it can beat even the most powerful of substances.  This could very much be the case for you, and really taking the time to explore why sleep is so forbidden, frightening, or “bad” could eventually unlock the mystery that’s been - quite literally - keeping you up at night.  And, if that doesn’t seem to be a fruitful exploration and you’re still desperate for some Zzz’s, it's never a bad idea to at least consider retrying medications you’ve tried once before.  The body, its chemistry, and your personal needs can change dramatically over time.  What you need now may be completely different than what you’ve been trying at this stage or in the past.  We know just how frustrating this can be and completely understand why you may've thrown your hands in the air already not wanting to try anymore.  But you deserve sleep. You NEED sleep.  We want to see your body and mind get that wonderfully restorative break.

  If you needed a nudge or for someone to tell you that it’s okay to try medication again - or for the first time - this is it.  We’re telling you it’s okay.  It doesn’t have to be forever, you don’t have to rely on them, and you can stop at any time.  But you deserve a chance at peace, comfort and rest.


  We truly hope that this has helped some of you in your fight against nightmares or insomnia.  If nothing else, we hope that it’s helped you think about this battle you face every night in a different way, and perhaps it will lead to some looooong, peaceful nights.  Please don’t forget to share your experiences or own personal tips an tricks with us and others below.  We have far too many possibilities to include them all here, so we know that you guys have even more!  And, nothing could be more helpful than a collection of survivors’ stories on how they beat what kept them up for so long and finally got some solid sleep!


 

MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101: 101 Self-Care Techniques
  ✧  Nighttime 101 and Nighttime 201Sleep Strategies for Complex PTSD
Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101Healing Pool and Healing Light
  ✧  DID MythsDispelling Common Misconceptions about Dissociative Identity Disorder
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
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Article Index  ❖

 


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