Milestones in treatment for trauma: everyone is a fingerprint

My old therapist often used the phrase, “Everyone is a fingerprint, everyone has a different story, everyone’s healing is different.” Then why did my therapy seem so undefined and generic? And by the same token, why couldn’t she identify the “fingerprint” milestones I had accomplished, providing only generic milestones instead?

Even after a few month, I felt something wasn’t right. So why was this fingerprint thing important?

Everyone’s therapy is a different

My therapist told me that I was creating my own therapy and recovery. It was defined by my story and my needs. And to “trust the process.”

On one hand, that gave me some comfort – I was being seen as a unique individual and would be treated according to my unique needs. On the other hand, it made me feel like my course of therapy was undefined, without milestones to strive towards, and without a means to evaluate my progress. Also, not based on professional guidelines for the diagnosis.

As I have said many times to her and everyone else, I am an engineer. I want specs, I want the recipe. I want to see where I am in the process. Some times they laugh at me. Yeah, I know. 🙂

And I’m sure to a therapist who deals in abstractions and this mysterious (to me) “process,” I was probably a pain in the ass.

Well, yeah.

It is who I am, and while I am willing to float free in this “process” for many months, I can’t flap in the breeze forever, just because I am this unique “fingerprint.”

Recognized phases of therapy

Herman describes three phases of therapy – my therapist recommended her book, Trauma and Recovery, although she never referenced it in therapy. These are: establishing safety, uncovering the past and processing the traumatic memories (remembrance and mourning), and finally, reconnection with ordinary life. Gudrun Frerichs describes three common phases in her research, reaching out, coming together, and connecting.

Frerich’s align somewhat well with Herman. The first phase of both is establishing trust and safety. The second for both deals with reconnecting with both emotionally and cognitively to the past. Frerichs adds that the second phase includes reconnecting with the other parts of your self as well, while Herman adds the concept of mourning what happened. In the third phase, both speak of reconnecting with humanity and ordinary life. Frerechs specifically mentions that in each stage, trust needs to be developed all over again. Herman notes that the three phases do not occur sequentially, but that a patient may cycle through them or be in more than one at once. Makes sense. I seem to be in all three to various degrees.

My therapist doesn’t like the concept of milestones, and has pushed back on that several times. But it seems to me that these phases are pretty broad and cover the breadth of about 5-7 years of therapy. So, there’s gotta be intermediate milestones. (Break out the project plan! God, that would’ve floor her! <heh heh>)

Her assessment and my assessment of milestones accomplished

So, in my second-to-last session, we began to discuss some of the questions I brought up in my email to reestablish trust (post – Changing therapists – what to consider). She finally gave me some milestones that I have accomplished – as described in Lessons learned in a therapuetic relationship gone wrong.

She said (and I transcribed as she spoke):

  • ŸYou were able to tell your story (yup, did it in the first few sessions)
  • ŸYou could reveal your sides and find your core personality

She identified the next few milestones:

  • For me to see the overlap of functions of personalities
  • ŸFor me to feel good in the various roles I play
  • ŸGiving me value because abuse brings a sense of being unvalued

Yeah, I wrote these down as she said them, and yeah, they make sense. But they seemed so sterile. I have heard these before in therapy. But I guess they seem like generic goals and I am not sure how I fit in there – feels like these are outside me somehow.

Then this morning I woke up and realized that I have milestones that are specific to ME. Interestingly, she is all about this “fingerprint” thing, but then offered me milestones that are pretty generic, rather than my own “fingerprint” milestones!

So what are MY fingerprint milestones?

  • ŸI told my story. (Therapist identified this)
  • ŸI revealed the parts of myself to my therapist. (Therapist identified this)
  • ŸI revealed the parts of myself to my best friend, who I considered disposable at the time since we had just met, and found out from that meeting that I would not be rejected for telling what happened to me. And that I found someone who would end up being my brother and best friend.
  • ŸI met with my mother, after 25 years, and talked about all the stuff that happened – the cousins, the rape, the dissociation. She knew part of it. I am working now to fix a relationship that has had a certain strain all these years.
  • ŸI learned about triggers – how to recognize them after the fact, and how to learn to respond to them. This is ongoing as I continue to practice it.
  • ŸI found the little child inside me – the pure little girl who was reaching out to those I trusted before I was even aware of it! My coach told me to find that little girl, to love that little girl because she didn’t do anything wrong. And then she reached out to him before revealing herself to me. To my utter shock, she/we asked my coach how he lost his virginity. And sensing what was happening, he shared it honestly and genuinely. Amazing!
  • ŸI revealed my diagnoses to my husband. I got the confidence to share something that could have ended my marriage, and found out that he supports me completely, even if he does not understand. (With fondness he tells me, “I know you’re crazy. But I’m not going anywhere.” I am also “his nutty wife”)
  • ŸAnd as a completely different milestone later, I have improved my relationship with my husband. We are clearing away a few years of misunderstandings and misconceptions. Things I had no idea he was worried about; things he had no idea where in me. He is becoming actively involved in helping me see the triggers and to defuse them before I escalate out of control. Wow. BIG one!
  • ŸI found that I have a support system that I can trust. Even when I have problems trusting, I know intellectually that they will be there. (Still got to work on the emotional belief.)
  • ŸI found out and have acknowledged (owned) that I have a mean and nasty side of me that I was unaware of. That I am now only partially co-conscious with. It hurt to be made aware of it, but I know it is true and I have taken steps to own it.
  • ŸNot only REVEALING parts of me, I am understanding how my parts protected me, and now I can see more when those parts of me are out. And I am learning to accept them, WAY BEYOND just revealing them.
  • ŸI have done a great deal of research and feel that I know a lot about the field, and this gives me more confidence and comfort to believe in the diagnosis and believe that I will get better.
  • ŸI started this blog to reach out to people and share my thoughts and research. As Frerichs says, make connections at each stage of healing – reach out to people. While I am not ready to shout my news from the hilltops, I have bared my soul sort-of anonymously online.
  • ŸMy father found out and now my dad and I are starting to talking.

These are MY fingerprint milestones. These are all major accomplishments that make me feel good and proud when I read them. They just poured out of me and my heart is warm and happy, and there is a smile on my face. Warm. I *have* accomplished a lot.

So, it appears the real list of milestones is a heck of a lot longer than my therapist acknowledged.

I wish that I could have seen it all before now, or that she could have been more concrete with me. She has said for months that I have been making tremendous progress and that I am very motivated to get better. I believed her, but I told her that I was upset because I did not remember the progress. Instead of reminding me what my accomplishments were, she just replied “you will.” ???. So unsatisfying for someone who is intelligent and who has accepted the memory problems. That she would not help me to remember.

But she does not know DID well – that is not terrible, it is just a fact. I recall the keynote by a clinician in the field, “The first five hundred times you a DID patient something are the hardest.” I just love that – makes me not feel so bad about the whole memory thing. But my repeated requests seemed to bother her.

Final thoughts

So what’s the bottom line? My goal is not to use this blog to trash my last therapist. She did a very good job for the stuff she has many years of practice treating. Although it may seem like I trash her, I try to be logical (oh, the engineer) about why the relationship failed, or why it never really worked from the start for some parts of me. That is probably clear from my last post.

But it wasn’t until this morning that part of the uneasiness in me crystallized – that I never saw the fingerprint. I never saw how my experience and my healing was unique. In addition, the common elements I saw with many folks with DID were NOT showing up in my therapy. And that just gave me the final sense that the match was no longer working.

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7 Comments»

  mom wrote @

You are amazing.

  Gudrun Frerichs wrote @

Hi Emily, before I respond to your post a note on the side: I have no idea why your trackbacks don’t show up on my blog. I have ticked all the right boxes – but have to admit that my strength is NOT blogging technology. I am learning it in little baby steps. I’ll be working on it!

I think you are making a very important point in your post. That is: every person’s recovery – no matter what their diagnosis – is a very unique journey. The recovery literature makes a very strong point of that. You will find a lot of info about that when you google mental health recovery. W.A. Anthony is a good person to read up on.

When we talk about stages (you mentioned Herman and me, but most writers use a stage framework) we are really talking more about a general direction. It organises thinking, helps therapists who are not so familiar with the subject to feel more confident; and clients who wonder whether they are going crazy can be reassured that they are certainly not.

The most important part in the therapy is the relationship between client and therapist. The relationship needs to provide safety and containment so that clients can start doing the all important tasks of healing themselves: trusting and liking themselves, trusting and letting in others, respecting and appreciating themselves and others. These are very generic terms and you have given some lovely examples of what they mean specifically for you.

I am thinking of the therapeutic relationship in terms of mutual recognition. That means that between therapist and client needs to be a sense of emotional support, care, respect, equality, and appreciation. I have written about it at length in my PhD thesis that deals with how services shape the recovery from sexual abuse. If you – or your readers – are interested, they can download it from the archives of the University of Technology, Auckland, by following the link: http://hdl.handle.net/10292/344.

Your relationship with your ‘old’ therapist must have been good enough for you to be able to make these amazing steps – although I have also seen that sometimes clients make progress in spite of their therapist. Anyhow, all the best for the continuation of your journey. You sound as if you are well on your way.

Cheers and all the best
Gudrun

  Beth Fehlbaum wrote @

Hooray for you!

Beth Fehlbaum, author
Courage in Patience, a story of hope for those who have endured abuse
http://courageinpatience.blogspot.com
http://www.kunati.com/courage-in-patience
Chapter 1 is online

  emilylonelygirl wrote @

Dear Gudrun,

I am so pleased that you have written and shared some of your thoughts about my posts. Everything you have shared in your comment I have now come to realize (in my core, rather than just intellectually) is really true. And it is calming to have that mirrored by those doing research in the area.

From your work, I can see that you are clearly more interested in the real-life aspects of DID than the pure research ends, but you did a great job integrating (ha ha) the two. I will contact you directly, but would love to have you as a guest writer on this blog.

My best,
Emily

  emilylonelygirl wrote @

Beth

I have read some of your work, and am interested in reading your book when it comes out. I have thought to publish one as well on this topic, and to do it differently than the books that are currently out there. I know how hard it is to write, and it is wonderful that you are sharing something positive.

My best
Emily

  Pure wrote @

Just have to say I love the comment:

“It is who I am, and while I am willing to float
free in this “process” for many months, I
can’t flap in the breeze forever, just because
I am this unique “fingerprint.”’

Glad I’m not the only DID client that needs some structure, some sense of clear direction. Being a medical academic, I was constantly looking for a formula, some way of explaining the unexplainable (still am *grin). I felt like telling my first therapist, come on lady “bring it on” “I’m not your usual client” “Let’s step it up a notch” Not it a mean way. Part of me liked the acceptance, you mentioned that as well, but another part felt like I was being sold short. There was something more, something I wasn’t getting, despite 2 years of “holding out for more.” Thanks for sharing your expriences. I just found this blog and your candidness is amazing.

  emilylonelygirl wrote @

Dear Pure

I read myself in your comment – we are SO alike! My engineer wants the BLUEPRINTS! I got so frustrated, and like you, wanted my therapist to get in there harder – I couldn’t understand how she was evaluating progress and she couldn’t explain it. I can see now that we were many times, but without her ability to communicate that to me, I felt lost.

I hope to see you around more – thank you for your kind words!

Emily


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