WEBVTT
00:00:19.832 -->
00:00:21.774Hello, welcome back, meaning Seekers.
00:00:21.774 -->
00:00:24.475I am so glad to have you back with me.
00:00:24.475 -->
00:00:26.056Welcome new people.
00:00:26.056 -->
00:00:35.701Hi, I am Dr Dirk Winter, your host board-certified adult and child psychiatrist on the Faculty of Psychiatry at Columbia.
00:00:35.701 -->
00:01:00.344This is a show where I take you along as I travel from traditional mainstream psychiatry world into the wide world of integrative trauma treatments which have really transformed my thinking and created all kinds of opportunities for deeper, more efficient, more permanent healing.
00:01:00.344 -->
00:01:08.376Today I am excited to present to you Joanne Twombly, one of my colleagues.
00:01:08.376 -->
00:01:15.941Supervisors said Joanne Twombly is the bomb and after listening to this interview, I think you'll agree.
00:01:17.063 -->
00:01:24.510She is a social worker with over 30 years experience working with complex trauma and dissociative disorders.
00:01:24.510 -->
00:01:30.066She is the past president of the New England Society for the Study of Trauma and Dissociation.
00:01:30.066 -->
00:01:43.046She has received the Distinguished Achievement Award from the International Society for the Study of Trauma and Dissociation, isstd.
00:01:43.046 -->
00:01:49.423She is extremely skilled at integrating IFS with EMDR and hypnosis.
00:01:49.423 -->
00:02:03.310She is the author of a book that I really like called Trauma and Dissociation Informed Internal Family Systems how to Successfully Treat Complex PTSD and dissociative disorders.
00:02:04.572 -->
00:02:05.173I'm going to stop.
00:02:05.173 -->
00:02:06.314You get the idea.
00:02:06.314 -->
00:02:18.039She has a lot of clinical expertise and wisdom and we're going to get into hypnosis, why it's important to learn hypnosis.
00:02:18.039 -->
00:02:33.371We're going to hear about the history of different kinds of work with dissociative disorders and the story of different kinds of work with dissociative disorders and the story of Sybil and the suppressed memory syndrome controversies that happened.
00:02:33.371 -->
00:02:54.920We're going to hear about why traditional talk therapy sometimes don't get at the brain regions that hold trauma and why it can be very helpful to use other integrative trauma treatment approaches like EMDR, hypnosis, ifs that can access trauma in a way that traditional talk therapies sometimes don't.
00:02:54.920 -->
00:02:56.925I learned a lot in this episode.
00:02:57.125 -->
00:02:58.247I hope you will too.
00:02:58.247 -->
00:03:02.021Please enjoy my conversation with Joanne Twombly.
00:03:02.021 -->
00:03:07.453Welcome, I'm so excited to have you talking with me today.
00:03:07.453 -->
00:03:08.360I've read your book.
00:03:08.360 -->
00:03:10.205I've listened to some of your podcasts.
00:03:10.205 -->
00:03:20.881For people who might not be familiar with who you are, I'm curious what kind of a healer are you and where do you sit in the world of mental health treatments?
00:03:20.881 -->
00:03:27.401And I know you're well known for dissociation and having really a specialty in that.
00:03:27.401 -->
00:03:32.092How would you describe, kind of where you sit in the wide world of mental health treatments?
00:03:32.979 -->
00:03:49.663Well, I think where I sit right now is I'm not getting any younger, so what I've told the clients I still have is that I'm not taking more clients and I'm doing more training and more consultation.
00:03:49.663 -->
00:03:56.522So I'm not quite as available as I used to be, but I'm not planning on retiring at the moment.
00:03:57.504 -->
00:03:59.848How many clinical hours would you say?
00:03:59.848 -->
00:04:04.989I know it varies a lot and you're traveling, but like percentage wise, how would you break it down?
00:04:05.659 -->
00:04:10.210Well, skipping the training because that complicates things.
00:04:10.210 -->
00:04:18.913But I think probably about 30% consultation, 30 to 50% consultation, the rest clinical hours.
00:04:20.161 -->
00:04:22.685And what are the kinds of trainings that you do?
00:04:22.685 -->
00:04:24.769What are some of the recent trainings that you've done Right now?
00:04:24.829 -->
00:04:38.213what I'm doing mostly is trainings on internal family systems and my concept of expanding on IFS to include work with complex trauma disorders and dissociative disorders.
00:04:38.213 -->
00:04:41.149I mean, I like internal family systems.
00:04:41.149 -->
00:04:44.399I think it's a great modality, it's a power therapy.
00:04:44.399 -->
00:04:48.142They fall apart at the more complex trauma.
00:04:48.684 -->
00:05:00.341Yeah, this is, I think, at the heart of a lot of what I think about when we think about your niche and teaching, and maybe everybody has a little bit of a different description.
00:05:00.341 -->
00:05:08.315So I'm always curious do you have a short explanation of what is IFS internal family systems therapy?
00:05:08.399 -->
00:05:09.504My elevator pitch.
00:05:09.886 -->
00:05:10.086Yes.
00:05:10.761 -->
00:05:28.124I think what I say is it's an ego state modality and they teach that everyone has parts, which has been well known in the ego state dissociative disorder, complex trauma community and less well known across therapy in general.
00:05:28.223 -->
00:05:34.581So I think IFS has really helped by making people understand that we all have parts.
00:05:34.983 -->
00:05:42.406I mean, which makes sense you know the part of me that likes chatting, doing podcasts, and the part of me that's shy, you know.
00:05:42.406 -->
00:05:51.968So that's something I'm truly grateful to IFS for is having more people working with parts than there used to be.
00:05:51.968 -->
00:06:06.771So, in any case, ifs is an ego state model and then they have a concept which is not unique to IFS, but again, I think IFS has been a therapy modality that's popularized.
00:06:06.771 -->
00:06:30.788It, a concept that we all have a self which is not a part, and you know you're in self If you can look at someone you don't like and instead of saying they're a total jerk, which would mean you're blended with a critical part, however accurate that might be, but if you can say, well, I'm curious about that person.
00:06:30.788 -->
00:06:50.362And they have a list of C's like curiosity, compassion, and when you sit from curiosity and compassion, then you really can communicate with another person and their model helps people get into self and then work through self with their parts.
00:06:51.584 -->
00:07:00.408So simplistic, but I really like your explanation and I like internal family systems also and I was surprised.
00:07:00.408 -->
00:07:02.992You know, I never really came across it.
00:07:02.992 -->
00:07:03.894I'm at Columbia.
00:07:03.894 -->
00:07:08.946Nobody at Columbia that I run into really has heard of it still.
00:07:08.946 -->
00:07:14.362I mean, they've sort of starting to hear about it, but people, they're so psychodynamic.
00:07:14.362 -->
00:07:37.908But to me in retrospect it's so obvious that our brain is multiple and I have to hold you and me and if you think about AI and building a powerful computer, you need multiple little computing machines running in parallel and that's much more powerful than any one thinking entity.
00:07:37.908 -->
00:07:42.684And anytime we have conflict we have one part wants this, one part wants that.
00:07:42.684 -->
00:08:02.168So I think that really resonates with me and the idea of self, of just having sort of more of a big brain state like a Dan Siegel, optimal, flexible, connected, or a you know a gorgeous Deb Dana polyvagal, you know ventral vagal.
00:08:02.168 -->
00:08:09.310There seems to be a consilience around a lot of these concepts these days, which is really exciting to me.
00:08:10.420 -->
00:08:11.442I think that's true.
00:08:11.442 -->
00:08:27.000I find that with the different therapy models that have been developed, there's sort of a convergence, like I've been learning deep brain reorienting, now Frank Corrigan's model, which is really exciting.
00:08:27.560 -->
00:08:40.775So I signed up for the training in that model, based on your recommendation and listening to a podcast of Ruth Lanius.
00:08:40.775 -->
00:08:49.686Yes, and that was enough for me to sign up, but I still have no idea what deep brain reorienting is.
00:08:49.686 -->
00:08:56.730I'll know in May or whatever, when I do the training, but please tell me what is deep brain?
00:08:57.812 -->
00:08:59.592reorienting.
00:08:59.592 -->
00:09:10.831He's a Scottish psychologist and he was doing a lot of EMDR, which he found quite powerful, which I think has been most of our experiences with these different therapies.
00:09:10.831 -->
00:09:22.272You can do so much more, you can help people heal so much more with these newer therapies than we could when we were just doing talk therapy, which is certainly how I started out.
00:09:22.272 -->
00:09:31.692And then I learned I bumped into hypnosis, sort of by accident, and learned hypnosis and that gave me so much more information.
00:09:31.692 -->
00:09:36.006And then I learned EMDR and then, you know so, dbr.
00:09:36.006 -->
00:09:57.847What Frank felt and it's based on other trainings and other people he works with, it's not like he just discovered this out of nowhere, but what he felt was that EMDR wasn't going deep enough and so he developed this modality that helps get to the midbrain and the brainstem.
00:09:57.847 -->
00:10:08.364It's sort of below the level of parts and there's a lot of neurology to it and I'm not a real neurology person, I just want to know how to make it work.
00:10:09.626 -->
00:10:11.971Nice, so we'll talk more about that.
00:10:11.971 -->
00:10:20.926And just briefly, emdr, very briefly eye movement, desensitization and reprocessing, and Francine Shapiro's model.
00:10:20.946 -->
00:11:10.749Shapiro's model, where you connect with a traumatic memory and then you move eyes back and forth while Well, what you do is you come up with an image or a negative cognition like I'm a piece of shit or an image of being assaulted and it's actually not just a trauma therapy, it's basically for anything that's stuck and then you focus on it, come up with a negative cognition and tune into feelings and sensations like sadness, pain in your chest, whatever Heather, and do back and forth eye movements or tapping, bilateral tapping, and I'm not sure they've quite figured out exactly how it works.
00:11:10.769 -->
00:11:30.711But one thought is that what is true is that trauma and things that get stuck get stuck basically on the right side of our brain, just to use the casual kind of brain references, and thinking and talking is in the left brain and you can see that on brain scans.
00:11:30.711 -->
00:11:33.875So talk therapy isn't going to go deep enough.
00:11:33.875 -->
00:11:46.196You need something that gets to the material that's stuck on the right side and things like hypnosis, EMDR, IFS, ego state therapies, DBR.
00:11:46.196 -->
00:11:51.904They get into the right brain and sort of loosen things up so that there can be some healing.
00:11:53.269 -->
00:11:59.712It's so fascinating and, yes, the emotional memories come on as the verbal come off.
00:11:59.712 -->
00:12:03.071Bessel van der Kolk had kind of a funny line.
00:12:03.071 -->
00:12:04.666I forget where I heard him say it.
00:12:04.666 -->
00:12:05.647Essel van der Kolk had kind of a funny line.
00:12:05.647 -->
00:12:10.549I forget where I heard him say it, but somebody asked him about anger management and skills for anger management.
00:12:10.549 -->
00:12:13.510He said well, they all work great.
00:12:13.510 -->
00:12:18.833These are great skills to learn until I get angry and are all left.
00:12:18.833 -->
00:12:19.434Brain skills, yeah.
00:12:25.340 -->
00:12:39.940But when the right brain gets triggered then the left brain is offline and it's so interesting because I could see that as I was working with people and then, as neurology got more sophisticated, you could see it in brain scans.
00:12:39.940 -->
00:12:48.494You can see pre-post differences in brain scans with people who've done EMDR, dbr, probably IFS.
00:12:48.494 -->
00:12:51.666I haven't seen them for IFS, I've seen them for other things.
00:12:52.480 -->
00:13:05.667There was a Nature paper where they were moving a light back and forth with mice and they could block traumatic memories by moving a light horizontally back and forth, whereas a flashing light wouldn't do it.
00:13:05.667 -->
00:13:12.413So anytime a memory gets brought up, laying it down again requires protein synthesis.
00:13:12.413 -->
00:13:25.820It's an active process, so you can either lay it down more firmly and make it more intense or you can sort of diffuse the intensity of it, and a lot of these therapy approaches sort of are built around that concept.
00:13:25.840 -->
00:13:39.394Well, the only thing I would add is that memories, or traumatic memories, I mean they get stuck in the right brain, and so it's not just that they don't get diffused unless they're accessed.
00:13:39.394 -->
00:13:41.686I think that's really important.
00:13:42.360 -->
00:13:44.686Those stuck places need to be accessed.
00:13:44.686 -->
00:13:50.870I mean, I treat people, oh God, I treat people with 10 to 50 years of treatment.
00:13:50.870 -->
00:13:57.501They've had talk therapy for years and years and years and it has not touched the trauma or people.
00:13:57.501 -->
00:14:22.931I think the other thing that you know, I often, have often had people come in and say, oh, I've been diagnosed with OCD, I've been diagnosed with ADHD, or I have an eating disorder, but nobody's ever taken care of their trauma in their history and I'm like, well, let's heal the trauma and then we'll see what's left of the ADHD, or we'll see what's left of your eating disorder.
00:14:23.659 -->
00:14:34.554One more question, sort of before we get into your history your difference between just the mainstream IFS and bringing in grounding skills.
00:14:34.940 -->
00:14:36.844Well, I think mainstream IFS.
00:14:36.844 -->
00:14:51.229Basically, the premise is that what they teach is all you need is IFS and you don't need coping skills because you help people get into self and then, through self, we have everything that we need.
00:14:51.229 -->
00:14:52.072That's available.
00:14:52.072 -->
00:14:54.488And I'm like into shortcuts.
00:14:54.488 -->
00:15:00.370I'm like, hey, no problem If I don't need to teach people coping skills and this takes care of everything.
00:15:00.370 -->
00:15:02.966I'm so there, but it didn't work that way.
00:15:02.966 -->
00:15:08.403I'm so there, but it didn't work that way.
00:15:08.403 -->
00:15:16.822And as I got, I got a lot of started getting people coming in from having been in therapy with good IFS therapists and they were falling apart or they were feeling stuck.
00:15:16.822 -->
00:15:18.206Nothing was happening.
00:15:18.967 -->
00:15:30.789And can you illustrate with sort of a anonymized example kind of what kind of person might have come from a great IFS therapist and then what you might have added?
00:15:30.789 -->
00:15:31.932That's different.
00:15:32.600 -->
00:15:35.927Well, I mean, I come from a background.
00:15:35.927 -->
00:15:46.072I've worked with people with complex dissociative disorders and complex PTSD for years and so I've gotten a lot of that training.
00:15:46.072 -->
00:15:51.267And it's interesting to hear you say, like people at Columbia, they don't know about IFS.
00:15:51.267 -->
00:16:09.542And you know, I kind of stumbled into working with people with dissociative disorders and started getting training in it, which people don't always do, and I think that I mean I like making links to other therapies.
00:16:09.542 -->
00:16:13.937It's the idea that IFS is the only thing you need doesn't make sense to me.
00:16:13.937 -->
00:16:16.022People are so variable.
00:16:16.022 -->
00:16:21.974Some people one thing they'll respond to and sometimes a different thing.
00:16:21.974 -->
00:16:30.932Or if you're working with somebody with really dissociated parts, something may work for a while and then that's not working and we pull something else out.
00:16:30.932 -->
00:16:34.629You know it's good to have a bunch of different approaches.
00:16:36.523 -->
00:16:37.407I agree so much.
00:16:37.639 -->
00:17:04.171Basically what I learned with starting with hypnosis training is that you know if people have trauma histories or they've grown up with bad attachment and you know they have, maybe parents who have untreated trauma histories or anxiety disorders then they're going to grow up with a fair amount of anxiety and stress in their bodies and our bodies become accustomed to that.
00:17:04.171 -->
00:17:13.607So one thing that's good is to teach them safe space imagery so that they learn to block out intrusive thoughts and feelings and their bodies can start to normalize.
00:17:13.607 -->
00:17:23.067So if their reactivity level is up here because of growing up in a stressful family or dysfunctional family, you want to get it back down here.
00:17:23.067 -->
00:17:25.941That makes doing trauma work a whole lot easier.
00:17:28.224 -->
00:17:34.582And so you're talking about safe space imagery as a way to, which is one of the coping skills.
00:17:34.742 -->
00:17:39.933that I think is terrifically useful and it's also kind of a right brain coping skill.
00:17:40.640 -->
00:17:44.691And it's just this sort of imagining, either a real or a hypothetical.
00:17:44.691 -->
00:17:48.020How do you do a safe space?
00:17:48.080 -->
00:17:51.704EMDR teaches it in a way that I think is kind of inadequate.
00:17:51.704 -->
00:17:58.070So I've done some writing on EMDR and trauma and EMDR and safe space imagery.
00:17:58.070 -->
00:18:12.211But what EMDR tends to do is say think of a time when you felt safe, feel into that memory of being safe and let's install it with eye movements or some tapping or something.
00:18:12.211 -->
00:18:20.894The trouble is is when people say I've never felt safe in my life, and then you know, then that doesn't work.
00:18:20.894 -->
00:18:31.775So what I start out with and this comes from my hypnosis training is what's a place or a space that you felt safe in or you'd like to feel safe in?
00:18:31.775 -->
00:18:39.993Switches things immediately, because there's no expectation that they've already failed on feeling safe.
00:18:41.240 -->
00:18:47.300So the languaging is different and you're using a hypnosis style, languaging right there, right right.
00:18:47.340 -->
00:19:05.625And the other thing is in trance there's increased learning, and so if you use some of the I use a lot of hypnotic language, I don't do a lot of formal trance work, but you know, you basically get more bang for your buck.
00:19:05.625 -->
00:19:19.452And since most of the people I work with are suffering a fair amount and have suffered you know, I want them to be able to say heal as much as possible and as efficiently as possible.
00:19:19.452 -->
00:19:24.611So I'm going to use everything I can to make that something that happens.
00:19:25.974 -->
00:19:39.192Yeah, I really agree with you that having tools from these different modalities and putting them together in synergistic ways is really exciting, and I feel a little self-conscious about dinging Columbia for not knowing IFS.
00:19:39.192 -->
00:19:53.250I train residents and none of the residents really knew much of anything of IFS and I asked maybe if they wanted me to teach and I think there's a big resistance.
00:19:53.250 -->
00:20:07.876I feel like there's a lot of sort of analytic people who sort of see IFS and say, oh, this is just sort of psychoanalysis light which I've heard from analysts and I really couldn't disagree more.
00:20:08.980 -->
00:20:29.074There was an analyst who did a plenary at an MDRE conference and he said that he thought that I don't remember his name, I almost had it but he said he thought EMDR was turbocharged analysis, so that the free associations just come with the eye movements.
00:20:29.074 -->
00:20:31.446And I think there's some truth to that.
00:20:31.446 -->
00:20:41.795And having treated some analysts who spent a lot of time in analysis, they were pretty shocked at how quickly things started resolving.
00:20:41.795 -->
00:21:05.229And obviously these were analysts who didn't have huge trauma histories and I also think that analysis and I don't know that much about analysis, but I think that some of the newer analytic things are much more powerful than the old style which was basically talk, talk, talk, which of course is left brain.
00:21:06.279 -->
00:21:15.907I'm curious how you sort of encounter all these different healing modalities and we can sort of flesh out what each of these adds to your tool set.
00:21:15.907 -->
00:21:28.215But just to sort of back way up, I want to know sort of what, early on, was in the ether for you, that sort of might have sent you in the direction of becoming a healer.
00:21:28.215 -->
00:21:30.200And starting with where you were born.
00:21:30.661 -->
00:21:39.193I mean, you know the joke of 98% of therapists come from dysfunctional families and the 2% who don't are in denial.
00:21:39.815 -->
00:21:39.934No.
00:21:40.599 -->
00:21:49.575I mean, I was a parentified child and I grew up feeling like you know, if I just tried hard enough, you know I can make things work.
00:21:50.642 -->
00:21:52.528And where was this what?
00:21:52.528 -->
00:21:55.246Where were you born, to start with?
00:21:55.666 -->
00:21:56.347In Boston.
00:21:56.829 -->
00:22:00.268Okay, all right, so you're local still.
00:22:00.701 -->
00:22:01.665I am local.
00:22:01.665 -->
00:22:04.308I mean, I've lived in Germany for a couple of years.
00:22:04.308 -->
00:22:10.192I lived in California a bit, so I've been other places, but I grew up here and I still live here.
00:22:11.039 -->
00:22:13.023Boston's really nice these days.
00:22:13.023 -->
00:22:15.650I lived in Boston a long time too.
00:22:16.070 -->
00:22:37.779I like Boston also easy place to live and I think these days I particularly appreciate that we don't tend to have horrible droughts and big fires, so climate-wise it's kind of an okay place to live too.
00:22:37.779 -->
00:23:03.825But in any case, I grew up kind of having this crazy notion that if I tried hard enough I could really help people, and that I think I got a little stuck in a latency age place where I had this like sense of, you know, things should be fair and it's just not fair when people grow up in these really complex childhoods or have bad things happen to them.
00:23:03.825 -->
00:23:12.596And so, you know, it was just such a no-brainer that I slid into being a therapist.
00:23:12.596 -->
00:23:29.384And then, of course, I had to learn things, like I had to learn what I wasn't noticing, so I would notice people's strengths and not notice their weaknesses or their difficulties, because I was so primed to notice everything that was positive about them.
00:23:29.384 -->
00:23:33.394So I went through, you know, a lot of therapy.
00:23:34.421 -->
00:23:47.022So latency, pre-puberty, that sort of elementary school years and a lot of concern about fairness and just thinking about your comment, of sort of being stuck in that a little bit.
00:23:47.022 -->
00:23:58.140But then, in wanting to fix people, you went through high school and then college and you knew you wanted to be a therapist at that point, or how did this all unfold?
00:23:58.921 -->
00:24:29.608Eventually I had a good psychology professor who ended up being someone who molested a lot of male students at the college so eventually got kicked out, which is horrible and it seems ironic, but he was not one of the worst teachers I had, which is one of the really complicated, difficult things about people who are rigged to be perpetrators is they can have these good fronts.
00:24:29.608 -->
00:24:34.681But in any case, yeah, I was just always interested.
00:24:34.681 -->
00:24:49.223I had a grandmother who volunteered at the Bedford VA for years and years like I think 40 years or something and she worked with a bunch of really difficult people.
00:24:49.223 -->
00:24:53.814She was the only woman who was allowed to go up on the violent men's unit.
00:24:54.819 -->
00:25:00.761And she'd take this one guy out because they liked to garden, so they built all these rose gardens there.
00:25:00.761 -->
00:25:03.488But I like listening to her stories.
00:25:03.488 -->
00:25:13.993So there's, you know, the combination of basically being parentified and always sort of being in that role of helping.
00:25:15.759 -->
00:25:16.942No, I can relate to that.
00:25:16.942 -->
00:25:29.002I think that the combination of being able to help people and also getting to listen to stories is really powerfully appealing to me.
00:25:29.002 -->
00:25:30.508And it sounds like you.
00:25:30.508 -->
00:25:38.729So you had a grandmother who liked stories and liked helping people, so you sort of had that in the ether for you, influencing you.
00:25:39.871 -->
00:25:51.592Yeah, definitely and eventually I I mean I worked for the state doing child abuse investigations and so so you, what was your undergraduate degree, and then what?
00:25:51.592 -->
00:25:53.266It was in psychology.
00:25:53.941 -->
00:26:06.214And you're a PhD psychologist, or you're, I'm a social worker, because becoming a social worker was the shortest degree I could get that would allow me to get third-party payments.
00:26:06.214 -->
00:26:12.407So I wanted to get a clinical psych degree.
00:26:12.407 -->
00:26:14.992The status of it appealed to me.
00:26:14.992 -->
00:26:16.654That was one thing.
00:26:16.654 -->
00:26:37.097There was a status thing in my family, but there's no way I could have done a dissertation, so I never would have gotten through it at that time and I also grew up with a huge feeling of not being good enough, which I now totally appreciate, because it's pushed me to do all these trainings and things has been quite formative.
00:26:38.289 -->
00:26:40.692What part do you think you were missing at the time that would have.
00:26:40.692 -->
00:26:54.818I think you can learn and contribute and I really feel blessed now to be surrounded by a lot of really amazing social work and also people who do coaching and all kinds of different backgrounds.
00:26:54.818 -->
00:27:01.161It's much like I felt like I've kind of been in a bubble for a while and then sort of emerging from that.
00:27:01.161 -->
00:27:04.440To me it seems like you could have easily become sort of a nerdy PhD.
00:27:05.410 -->
00:27:08.820Oh, I could have absolutely done that if I grew up in a different family.
00:27:08.820 -->
00:27:12.901I mean, it's not like I didn't have the capacity For sure.
00:27:12.901 -->
00:27:21.817But there's no way that I could have done that at that time and social work I didn't have to write a dissertation, it was a two-year degree.
00:27:21.817 -->
00:27:28.012I could start working in at an agency, which was what was really interesting to me.
00:27:29.276 -->
00:27:34.050And what were the main modalities that you learned in social work school?
00:27:34.391 -->
00:27:36.315Oh, I didn't learn anything.
00:27:36.315 -->
00:27:40.643All the important stuff I learned after my degree.
00:27:40.643 -->
00:27:49.839I mean, I was, you know, bumping along being a talk therapist and I was always interested in learning things.
00:27:49.839 -->
00:28:07.236So I went through a group, the Northeastern Society for Group Psychotherapy, which is the local AGPA branch, for group psychotherapy, which is the local AGPA branch, and that was great.
00:28:07.236 -->
00:28:15.116And then there was a woman in the agency who was treating somebody with MPD and she went out on maternity leave and they decided they'd assign the client to me.
00:28:15.277 -->
00:28:24.232So MPD is multiple personality disorder, which is what dissociative is now called dissociative identity disorder.
00:28:24.512 -->
00:28:27.298Okay, so how old would you have been at this time?
00:28:28.240 -->
00:28:34.375I worked for a bunch of years before I got my MSW, so I got that when I was 30.
00:28:34.375 -->
00:28:42.066Then I worked for the military in Germany for a couple years, so I was probably in my mid-30s.
00:28:44.031 -->
00:28:51.117And that's when you saw this person with MPD and they were assigned to you, and what was that like for you?
00:28:52.570 -->
00:28:54.218Well, you know I was interested.
00:28:54.218 -->
00:28:55.213I had read that book.
00:28:55.213 -->
00:29:07.221Sybil, which was, I mean, Cornelia Wilbur, had treated the client, the woman who was named Sybil in this sort of fictionalized account, and she wasn't.
00:29:07.221 -->
00:29:10.132Nobody would take any of the papers she wrote.
00:29:10.132 -->
00:29:13.020She was a psychiatrist treating this woman.
00:29:13.020 -->
00:29:14.787She wrote papers.
00:29:14.787 -->
00:29:17.133None of the clinical journals would take them.
00:29:17.133 -->
00:29:23.898So she got a reporter to co-write the book Sybil with her, and so I thought that was interesting.
00:29:25.272 -->
00:29:41.621Let me pause you for a second on Sybil, because it sort of keeps popping up for me in different places and I haven't read the whole book, but I have it actually on my bed stand now and I'm sort of going through it a little bit at a time.
00:29:41.621 -->
00:29:46.361But what's your take on it?
00:29:46.361 -->
00:29:48.333So it's you.
00:29:48.333 -->
00:29:56.065I've heard people say so many different things, like it's total fiction or it's I mean.
00:30:07.789 -->
00:30:10.232I think that there's an issue where there are people who will say that dissociative disorders it's not a real diagnosis.
00:30:10.232 -->
00:30:17.582Quite a while ago I was given a workshop someplace in Boston and this guy said well, why do you bother working?
00:30:17.582 -->
00:30:19.605Can't you just treat them like borderlines?
00:30:19.605 -->
00:30:29.490You know, that's all I do.
00:30:29.490 -->
00:30:32.540But I think there are people who really still don't get that dissociation is really important to pay attention to.
00:30:32.540 -->
00:30:39.842I mean PTSD, simple PTSD, is a dissociative disorder because you can't have intrusions and numbing without dissociation.
00:30:41.410 -->
00:30:46.513And just sort of to sort of pause on that statement can't you just treat them like borderline personality disorder?
00:30:46.513 -->
00:30:50.884There's a lot of stigma with borderline personality disorder.
00:30:50.884 -->
00:30:54.961I'm just curious how did that resonate with you?
00:30:55.289 -->
00:31:01.334I'm not good at neurology, remembering neurology, and I'm also not good at remembering names.
00:31:01.334 -->
00:31:21.847But the person who came up with the borderline personality disorder diagnosis basically said this is a personality disorder and disregarded that all the people, that what was seven or eight women who all had really complicated trauma histories and disregarded the trauma history.
00:31:21.847 -->
00:31:41.241So I mean now if you're treating somebody with BPD, it's like this is somebody who's got an attachment disorder, trauma history is coming from a really complicated childhood and you know, on a continuum, it's sort of on the dissociative disorder end.
00:31:43.170 -->
00:31:59.186And the main features of borderline personality disorder are sort of not trusting oneself and extreme sort of Well, and basically, if you grow up with a parent who's got a disorganized attachment, I mean we're hardwired to go to our parents when we're upset.
00:31:59.186 -->
00:32:03.597That's sort of a basic survival of the species kind of thing.
00:32:03.597 -->
00:32:23.291But if something bad happens and you run to your parent and then you look at them and say to yourself, oh my God, that's why the bad thing happened, you have this approach of you know and then crumpling response because you're like oh right, I can't really go to my parent.
00:32:23.291 -->
00:32:28.932I'm biologically driven to go to my parent for help and it's my parent who's causing the problem.
00:32:28.932 -->
00:32:38.459So if you grow up with that pattern, then when you're an adult you're in that pattern with other people around you because we learn how to socialize through.
00:32:38.459 -->
00:32:41.713You know whatever it's like in our childhoods.
00:32:41.713 -->
00:32:50.455If you're victimized as a kid, you go out in the world and get bullied because you know how to be a victim, I mean.
00:32:50.556 -->
00:33:07.902So I understand the borderline diagnosis, or one way that I think of it, is that there's people who have just a more intensely reactive emotional system, that, you know, it's more like a sports car versus a Mercedes.
00:33:07.902 -->
00:33:34.123If there's like a little stimulus, there's a big response, and often those people are sort of in an environment of people who don't get that and who say, oh, you couldn't possibly have such a, you know, like you're overreacting, you're being dramatic, and there's this constant, intense internal sensation and an invalidating external environment which then sort of creates, fuels it up.
00:33:34.123 -->
00:33:39.259You know, then I have to amp it up because like no, no, no, I really am this upset, and so let me show you.
00:33:39.881 -->
00:33:55.624And so then there's, you know, there's the part issue where you know they may not be quite as dissociated as somebody with DID, but you get a part who longs for attachment and a part who says stay away from me.
00:33:55.624 -->
00:33:57.492You know you're dangerous.
00:33:57.492 -->
00:34:11.896And I I say to my clients, because people are always being taught you have to develop trust with your clients and I say to my clients yeah, if I grew up in your family, I wouldn't trust anybody either, don't worry about it.
00:34:12.577 -->
00:34:21.172Which I think probably in some way helps them feel like they can sit with me, because I'm not expecting something that feels so foreign to them.
00:34:21.893 -->
00:34:28.436You just accept them where they're at and say it makes sense, which is so helpful, it's so simple and it's so helpful.
00:34:28.436 -->
00:34:33.530So now you have this person with MPD and they're assigned to you.
00:34:34.333 -->
00:34:57.195Well, the first thing that I did was I started looking for resources, which nobody at the agency had done, and Jim Chu, who was this local psychiatrist, one of the psychologists at the agency, told me he was giving a grand rounds, and so I hot-footed it to the grand rounds and you know, it's just an hour on treating people with MPD.
00:34:57.195 -->
00:35:07.273And then I went up to him afterwards and said, oh, I'm just learning this.
00:35:07.273 -->
00:35:08.257And he said well, there's a local society.
00:35:08.257 -->
00:35:18.472It had a longer name originally, but eventually it was called the Northeastern Society for the Treatment of Trauma and Dissociation, which was an offshoot of the International Society for the Study of Trauma and Dissociation.
00:35:18.472 -->
00:35:32.282It kind of folded after COVID, but for a lot of years it was a really great society, and so I started going to those meetings and started really learning.
00:35:32.282 -->
00:35:49.186There was going to be a session where one guy was going to talk about working with kids with MPD, and then Dan Brown, who is local to Boston, is a psychologist who is a brilliant hypnotherapist.
00:35:49.228 -->
00:35:51.291He was doing something about.
00:35:51.311 -->
00:35:55.135PTSD and hypnosis and I thought, yeah, that's totally bogus.
00:35:55.135 -->
00:35:59.981But since I had paid for the series, I went anyway.
00:35:59.981 -->
00:36:04.592It was quite clear that I needed to learn hypnosis.
00:36:04.592 -->
00:36:07.797So I immediately started getting trained in hypnosis.
00:36:07.797 -->
00:36:14.192And then my boss at the time started perseverating.
00:36:14.192 -->
00:36:17.539When I mentioned learning hypnosis she said we don't do that here.
00:36:17.539 -->
00:36:18.750We don't do that here.
00:36:18.750 -->
00:36:19.853We don't do that here.
00:36:19.853 -->
00:36:25.003I said, don't worry, I won't do that here, which inspired my private practice.
00:36:25.710 -->
00:36:28.956Wow, so I want to hear this story a bit more.
00:36:28.956 -->
00:36:35.440So what was it that Dan Brown talked about in hypnosis that caught your attention?
00:36:35.809 -->
00:36:39.704It was a long time ago, but basically talked about dissociation.
00:36:39.704 -->
00:36:48.246You know, if somebody gets battered as a kid and there's no help, there's nothing they can do.
00:36:48.246 -->
00:36:51.610They basically compartmentalize it.
00:36:52.672 -->
00:36:55.253It's a protective, adaptive response.
00:36:55.914 -->
00:36:57.534Yeah, it's just what we do.
00:36:57.534 -->
00:37:01.077We try to avoid it, we try not to notice it.
00:37:01.077 -->
00:37:15.844And then and it's basically what I was talking about with the right brain is where traumatic things get stuck neurologically, or the more primitive brain, and thinking and talking are more left brain.
00:37:15.844 -->
00:37:18.206So he said you need to get in there.
00:37:18.206 -->
00:37:24.838I know he was talking about state-dependent learning and said when you're being battered, you're in one state.
00:37:24.838 -->
00:37:27.936When you're not being battered, you're in a different state.
00:37:27.936 -->
00:37:30.849If you're just talking, you're in that different state.
00:37:30.849 -->
00:37:38.103If you want to get into the state, hypnosis is close to that state, so it gets you in there.
00:37:38.103 -->
00:37:52.422And I'm like, having been knocking my head against the wall with some of my clients, you know, and in effect trying to convince them that they were okay and not getting anywhere, I was like, okay, this is going to get me in there.
00:37:53.231 -->
00:37:56.500It's like you're treating the wrong part or you're treating the wrong state.
00:37:56.500 -->
00:38:05.476You're working, you're explaining, you're connecting with some part and it's agreeing with you, but then the trauma will take over and a whole.
00:38:05.476 -->
00:38:07.597A lot of training through him, a lot of training through.
00:38:21.550 -->
00:38:28.923NESTTD and then got involved with the International Society for the Study of Trauma and Dissociation.
00:38:29.510 -->
00:38:31.918What was the first acronym that you said?
00:38:31.918 -->
00:38:32.860Nesttd.
00:38:33.670 -->
00:38:38.782NESTTD was the New England Society for the Treatment of Trauma and Dissociation.
00:38:42.329 -->
00:38:43.472And so then, do you have a definition of?
00:38:43.492 -->
00:38:43.652hypnosis.
00:38:43.652 -->
00:38:44.934Well, let's see.
00:38:44.934 -->
00:38:48.380I mean there's the normal trance states.
00:38:48.380 -->
00:39:07.081Hypnosis is the formal use of trance, and normal trance states are things like being in the zone or highway hypnosis You're driving down the highway and all of a sudden you realize you've gone a whole bunch of a whole distance without realizing you had driven so far.
00:39:07.081 -->
00:39:13.963You read a book and you're so absorbed in it that you don't notice when somebody calls you for dinner.
00:39:13.963 -->
00:39:24.362So there are all sorts of normal trance states and hypnosis is just learning how to use them and facilitate their use.
00:39:25.293 -->
00:39:26.949That's probably a pretty primitive definition.
00:39:26.969 -->
00:39:40.219It's a really nice definition and I'm fascinated with hypnosis and I think your episode I'm in the middle of this IFS series and this podcast I'm sort of moving.
00:39:40.219 -->
00:39:59.059So I was born in Germany and I then grew up in Amherst Mass and we went back and forth and I like going into different cultures and immersing myself, and so this is kind of I feel like I'm sort of wandering through different healing communities in order to like figure myself out.
00:39:59.059 -->
00:40:06.326Like I'm sort of wandering through different healing communities in order to like figure myself out and um, and so I'm really loving being uh in this IFS land now.
00:40:06.326 -->
00:40:08.657But where I'm going with this podcast is uh.
00:40:08.657 -->
00:40:14.775The next series is going to be on hypnosis and I have a really nice interview with um Mike Mandel, who is um.
00:40:14.775 -->
00:40:21.784He's a brilliant hypnotist who built this big hypnosis academy in Toronto and I've done training with him.
00:40:21.784 -->
00:40:35.360But the history of hypnosis is so fascinating right, because Charcot and Mesmer were treating trauma and Genet and Freud.
00:40:36.371 -->
00:40:37.757And then Freud was with them, right?
00:40:37.757 -->
00:40:39.293That's where Freud started, Sort of.
00:40:39.293 -->
00:40:45.759He started with hypnosis and then went into talk therapy and everybody thinks Freud, Freud, Freud.
00:40:45.759 -->
00:40:50.762But hypnosis continued to evolve in really interesting ways since then.
00:40:51.572 -->
00:41:02.061And then there was a big you know a door got slammed on it with the false memory syndrome foundation and also got slammed on working with trauma.
00:41:02.061 -->
00:41:09.572I mean, the good thing about it is it made us better therapists because there were people using too much suggestion.
00:41:10.614 -->
00:41:11.856So maybe tell that story.
00:41:11.896 -->
00:41:15.891You have all these symptoms you have to have a sex abuse history.
00:41:15.891 -->
00:41:17.355No, that's not true.
00:41:17.355 -->
00:41:36.152Or the whole memory thing, which is another thing I'm always kind of perturbed with EMDR and IFS about, because they talk about, oh, your memory, your memory, but you know they don't necessarily say you might have a memory, but you know it could have been shifted over time.
00:41:36.152 -->
00:41:38.938Or if you have a dissociative disorder.
00:41:38.938 -->
00:41:45.153You know that joke about the seven blind guys and the elephant.
00:41:45.594 -->
00:41:48.440Sure Parable maybe.
00:41:48.481 -->
00:41:51.067Yeah, I like it.
00:41:51.067 -->
00:41:54.233It's different perspectives but I think same thing.
00:41:54.233 -->
00:42:00.237You can have somebody with a dissociative disorder and different parts describe 10 different rapes.
00:42:00.237 -->
00:42:10.797Well, that could be one rape seen through 10 different sets of eyes and if you validate that the person was raped 10 times, you're vastly complicating the treatment.
00:42:10.797 -->
00:42:20.342So I prefer to use the term traumatic material and I talk about memory dynamics when I'm working with people.
00:42:21.769 -->
00:42:30.117So can you remind me a bit the story of how the false memories oh sure how that society evolved.
00:42:30.277 -->
00:42:53.733Well, the False Memory Syndrome Foundation was founded by a couple whose daughter Jennifer Freed, who's a research psychologist, and this is public knowledge she confronted her father about sexually abusing her and in response to that they formed this huge society to say that people were coming up with false memories.
00:42:53.733 -->
00:42:57.760And it eventually got folded.
00:42:57.760 -->
00:43:01.184I mean, there were some interesting people involved with it.
00:43:01.184 -->
00:43:09.637There was one guy who gave an interview to a Dutch pedophile journal and said pedophilia is an act of God.
00:43:10.409 -->
00:43:28.186So that was one of the people on their board, I think these were the people who were discrediting hypnosis for implanting false memories, people who are discrediting hypnosis for implanting false memories Right and discrediting also discrediting that the fact that if a lot of bad stuff happens, we can compartmentalize and not remember it.
00:43:28.186 -->
00:43:35.320When people ask me about that, there is some solid research which they threatened to.
00:43:35.320 -->
00:43:41.739They had a lot of money for a while but in any case it really slowed things down.
00:43:43.210 -->
00:43:44.672And if you were.
00:43:44.672 -->
00:44:01.143So I have this fantasy and I'm working hard to make it kind of real, hiring people and training them in these new modalities, including hypnosis, and having integrative treatments and sort of a consilient approach to mental health.
00:44:01.143 -->
00:44:11.760Looking where things overlap between sort of ancient trauma practices and modern science and psychedelics has a place there as well.
00:44:11.760 -->
00:44:32.641But hypnosis when I mentioned to people, hey, I think you should learn hypnosis a lot of them there's a big resistance, and so can you maybe make a pitch for young therapists why it would be a good idea to get some training at least in hypnosis.
00:44:33.503 -->
00:44:42.387When people ask me, when people who are in school ask me what trainings they should start getting, I say you know, take a basic hypnosis course.
00:44:42.387 -->
00:44:51.789You don't have to become a hypnotherapist, but it teaches you how to use language.
00:44:51.789 -->
00:45:00.445So one example I give is if you grow up in a family where people tell you you're stupid, or they say no all the time.
00:45:00.445 -->
00:45:14.101If I say to them let's do some safe space imagery or let's try this, or what do you think about trying this, they'll say I can't Much better to use positive suggestion and say we're going to do this.
00:45:14.101 -->
00:45:19.262And you know, this is just something to learn and we can work on it together.
00:45:19.262 -->
00:45:29.840Or what's a place or a space that you felt safe in or you'd like to feel safe, versus try to come up with a place you might want to feel safe in.
00:45:29.840 -->
00:45:38.628And that's just something I learned with hypnosis training is the power of positive suggestion, is the power of positive suggestion.
00:45:40.730 -->
00:45:46.762It's suggestion and what kind of language will stick and create meaning versus just sort of roll past somebody.
00:45:46.762 -->
00:45:51.710And I'm right now thinking of hypnosis really is everywhere.
00:45:51.710 -->
00:46:04.856The formal, like the NLP, neurolinguistic programming training that grew out of Ericksonian hypnosis and Tony Robbins teaches it and Donald Trump is using.
00:46:04.856 -->
00:46:17.922I'm sure Donald Trump is trained in these languaging techniques and people say, oh, how come everybody is so influenced by the way that he talks.
00:46:17.922 -->
00:46:20.324It's, it's hypnosis, it's every.
00:46:20.324 -->
00:46:23.333And language is in advertising, in.
00:46:24.173 -->
00:46:37.900I was looking up stuff for a workshop I gave and so you can look up how to use hypnosis to seduce women, how to use hypnosis to sell cars, how to use hip.
00:46:37.900 -->
00:46:43.036You know there are all these things online and and people talk about it being dangerous.
00:46:43.036 -->
00:46:45.862And I'm like look, you have a rolling pin.
00:46:45.862 -->
00:46:50.541You can use it to make a great pie crust or you can beat the crap out of someone with it.
00:46:50.541 -->
00:46:53.371You know, everything can be used in a bad way.
00:46:54.452 -->
00:46:59.777All of our treatments can have positive and negative treatments can have positive and negative impacts.
00:46:59.817 -->
00:47:07.103And I think you know, like EMDR, I don't know, they probably still there's no hypnosis in it.
00:47:07.103 -->
00:47:10.005They do safe space imagery, they do containers.
00:47:10.005 -->
00:47:12.407You know they do imagery things.
00:47:12.407 -->
00:47:19.746Imagery things have a lot of trance stuff in it.
00:47:19.746 -->
00:47:26.014Ifs says there's no hypnosis in it.
00:47:26.014 -->
00:47:26.775But how do they start?
00:47:26.775 -->
00:47:31.146Go inside, focus on where you feel that sensation and ask the part that's holding the sensation Ego state work is trancy.
00:47:32.070 -->
00:47:42.786Yeah, and I just want you to elaborate a little bit more on that, because yes, dick Schwartz talks about hypnosis, is not IFS or IFS is not hypnosis.
00:47:42.786 -->
00:47:55.911But a lot of the originators, the original IFS crew, are trained in hypnosis and people go into trance.
00:47:56.592 -->
00:47:59.438I like being able to, I mean know.
00:47:59.438 -->
00:48:03.112As I've said, I primarily work with people with dissociative disorders.
00:48:03.112 -->
00:48:06.478Dissociation's a trance dynamic.
00:48:06.478 -->
00:48:17.661So you know, you have a part that thinks they're living in 1972 and they're 10 years old and they're being abused every day.
00:48:17.661 -->
00:48:19.304That's a trance state.
00:48:19.304 -->
00:48:36.983And since I know about helping people learn to use the trance states that they already, or learn to use their capacity to dissociate and evolve their symptoms into coping skills, I mean that's just very helpful.
00:48:36.983 -->
00:48:46.664In the IFS book I wrote, I put a big chapter on hypnotic language because I think learning some of that just is really helpful.
00:48:47.449 -->
00:48:49.873And we'll put this in the show notes.
00:48:49.873 -->
00:48:51.434But can you just say the title of your book?
00:48:51.434 -->
00:48:52.054I read your book.
00:48:52.054 -->
00:48:54.217I really like it.
00:48:55.018 -->
00:49:18.106It's Trauma and Dissociation-Informed Internal Family Systems and there's a subtitle, Since I put out a second edition last year which has a lot of the editing cleaned up, although a Polish edition just came out and they found a bunch of editing problems.
00:49:18.106 -->
00:49:24.083So I'm cleaning that up because there's some Russian publisher that wants to publish it in Russia.
00:49:24.083 -->
00:49:29.121Wouldn't mind getting it published in German, It'll happen.
00:49:29.581 -->
00:49:34.436Yeah, das müssen wir machen.
00:49:34.436 -->
00:49:43.056Ja, so, do you have a model of dissociation, uh?
00:49:44.137 -->
00:50:08.954or I mean, you're sort of already talking about it in a lot of different ways, but but I'm just sort of trying to conceptualize it, or so it's actually the way that people work with dissociative disorders is basically what Janae was doing a long time ago and I think partly what trashed that was.
00:50:08.954 -->
00:50:27.318Charcot got caught falsifying some research material and then Freud went off and you know I have some empathy for him, you know saying that sex abuse didn't really happen, it was sort of a fantasy thing or whatever he was talking about.
00:50:27.318 -->
00:50:37.364I mean, he was treating neighbors and kids of neighbors and living in this suppressed sexuality kind of society.
00:50:37.364 -->
00:50:49.413I mean we're still not that open, but we've come away since Freud was working with people and I think it makes sense that he decided that that wasn't actually something that happened.
00:50:51.235 -->
00:50:54.262I mean, he was a product of his environment.
00:50:55.063 -->
00:50:58.614You know it'll be interesting to see what things are like in another 20 years.
00:50:58.614 -->
00:51:26.503And I remember the first training I did on working with dissociative disorders with Richard Cluft, who was one of the people who did a lot of the work Once people started treating people with dissociative disorders again, he was one of the earlier people and he said the way that we work now will be completely different in 20 years.
00:51:26.503 -->
00:51:31.478And I thought, no, this is perfect, but not really.
00:51:31.478 -->
00:51:47.625But in any case, the things that I think of in terms of a model is there's phase-oriented treatment for treating trauma and it's basically the way to go.
00:51:47.625 -->
00:51:55.704So the first phase is teaching coping skills, stabilization, symptom management, affect management.
00:51:55.704 -->
00:52:13.726The second phase is some kind of paced uncovering of traumatic material and the third phase is whatever else working on living life without being organized around trauma, and most trauma treatments fall into that.
00:52:13.726 -->
00:52:21.202Ifs teaches that it's bad because they have this idea that phase-oriented trauma therapists kick out parts they don't like.
00:52:21.202 -->
00:52:27.141That's actually some kind of false kind of knowledge.
00:52:27.141 -->
00:52:28.744That's not actually true.
00:52:29.931 -->
00:52:31.713How would you reframe that true?
00:52:31.713 -->
00:52:32.195How would you?
00:52:32.255 -->
00:52:32.496reframe that.
00:52:32.496 -->
00:52:33.396It's incompetent.
00:52:33.396 -->
00:52:35.141That's how I reframe it.
00:52:35.141 -->
00:52:44.634I just am like, yeah, that's actually wrong and it's incompetent.
00:52:44.634 -->
00:52:46.197Nobody who's competent kicks out parts they don't like you know.
00:52:46.217 -->
00:52:47.121I don't know where they got that notion.
00:52:47.121 -->
00:52:52.791You teach coping skills while honoring all the different parts at the same time.
00:52:52.851 -->
00:52:56.815Yeah, and if you know, that's the three phases.
00:52:56.815 -->
00:53:05.121But within the first phase, if you're working with someone with a dissociative disorder is you need internal cooperation and compassion.
00:53:05.121 -->
00:53:11.224Among the parts you know and they all need there need to be system-wide coping skills.
00:53:11.224 -->
00:53:17.376If you had a dissociative disorder and I taught you safe space imagery, the parts wouldn't be listening.
00:53:17.376 -->
00:53:20.242So you have to make sure the parts are listening.
00:53:22.291 -->
00:53:32.920So there's one part that's maybe holding the trauma memory because it happened and we need to learn from bad things that happened in order to survive in the world.
00:53:32.920 -->
00:54:17.514And then there's other parts that sort of push push the those away and allow us to go to work and function without, you know, being consumed, and then some little things will reactivate trauma memories and then those will flood in and we'll be in some kind of a fear state, and so there's different sort of modes of operating and they they're not necessarily aware of each other, and so you're kind of slowing this whole process down and sort of introducing these different parts to each other and also also the concept of the parts, are getting to know each other and getting some understanding of each other and how they operate.
00:54:18.356 -->
00:54:25.998But you don't want to get into the trauma, you don't want to pop the lids on the traumatic material until they can cope with it.
00:54:25.998 -->
00:54:33.440When I went to school, I remember a professor teaching us you know, somebody has a sex abuse history.
00:54:33.440 -->
00:54:36.539You have to help them feel their terror, feel their rage.
00:54:36.539 -->
00:54:56.400Basically, they were teaching us to fast track people into the hospital Because if you, you know, helping someone feel their terror, if they can't manage it, you know and it's not just terror from one incident, you know, these are the people who are abused pretty much every day.
00:54:56.400 -->
00:54:58.215That's a lot of abuse.
00:54:58.215 -->
00:55:06.259You need to learn how to compartmentalize it so you're not trying to work with it all at once.
00:55:06.259 -->
00:55:07.996That's what I tell my clients.
00:55:07.996 -->
00:55:16.322I'm like, yeah, you know, there is stuff happening to you every day of your childhood.
00:55:16.322 -->
00:55:19.677We can't work on it all at once, we have to do a chunk at a time.
00:55:21.269 -->
00:55:25.179So really getting the pacing right is important for this work.
00:55:25.179 -->
00:55:32.322So I want to be mindful of time and we've covered hypnosis and EMDR and IFS.
00:55:32.322 -->
00:55:37.695I want to hear a bit more about, I guess maybe DBR, but then shifting towards meaning.
00:55:38.016 -->
00:55:46.461Well, I think DBR and psychedelics are the two reasons why I wish I was like 20 years younger and had more time in the field.
00:55:47.650 -->
00:55:55.172So let me ask you, what are you most excited about sort of that's emerging in the field, and maybe is it DBR and psychedelics.
00:55:55.934 -->
00:56:05.800Yeah, I mean I think DBR is probably what I'm most excited about at the moment because I've had that sense.
00:56:05.800 -->
00:56:14.322It made sense to me when Frank said he thought EMDR doesn't always go far enough, and I think that's probably true for IFS also.
00:56:15.329 -->
00:56:16.452What do you do in DBR?
00:56:16.452 -->
00:56:18.137That's not an EMDR.
00:56:18.137 -->
00:56:22.777So if I'm in your office and you're doing DBR with me now, how does that look different?
00:56:22.777 -->
00:56:25.762Or what specific to DBR would you be doing?
00:56:26.369 -->
00:56:36.985Well, with DBR you get a target, like a today target, like my husband screamed at me and I had this big reaction.
00:56:36.985 -->
00:56:39.634So that might be the target.
00:56:39.634 -->
00:56:47.032So then you do this exercise called the where self, which is, frank says, not hypnotic.
00:56:47.032 -->
00:56:59.057I find Frank's voice a little hypnotic because he's Scottish and he has this very quiet, slight monotone and I find it intriguing.
00:56:59.057 -->
00:57:21.619It's probably because this stuff is so interesting, but in any case it basically locates the person in their body, in the present, and then you go back to the target and you say okay, when your husband screamed at you and you got really upset.
00:57:22.581 -->
00:57:23.664just focus on that.
00:57:23.664 -->
00:57:30.719What do you notice across your forehead, around your mouth, your eyes and where your skull meets your neck?
00:57:30.719 -->
00:57:33.384What sensations do you notice?
00:57:33.384 -->
00:57:36.117So the focus is on sensations.
00:57:36.117 -->
00:57:49.673And so somebody might say I feel tension in my forehead, I feel tightening around my mouth, and then you basically say deepen into that and that becomes an anchor.
00:57:49.673 -->
00:57:53.802Which is interesting, that these negative sensations become an anchor.
00:57:53.802 -->
00:57:55.873What do you mean by an?
00:57:56.034 -->
00:57:56.275anchor.
00:57:56.275 -->
00:58:02.222So you're getting into the body-based components of these experiential memories.
00:58:02.989 -->
00:58:14.150That feeling in the forehead, around the mouth, doesn't want you to focus on jaw tension, because that tends to be anger and that's like apparently a higher level kind of feeling.
00:58:14.150 -->
00:58:20.490So you want the lower feelings because this is getting into the midbrain and the brain stem.
00:58:20.490 -->
00:58:26.403So that opens up the file to what he calls shock.
00:58:26.403 -->
00:58:41.726So then what you want the person to notice is are they feeling any shivering or shaking or temperature changes or jolts in the body or, you know, like their body's moving forward or sideways?
00:58:41.726 -->
00:58:52.204And by focusing on that he said, what EMDR doesn't do is get rid of that shock so that stays in your body.
00:58:52.204 -->
00:59:00.780And this would be again, I think, for people who are maybe more complicated, because I absolutely think things like EMDR can heal a lot of people.
00:59:00.780 -->
00:59:09.996But getting rid of the shock then helps, gets people much closer to healing, and then feelings start coming up.
00:59:09.996 -->
00:59:13.701You know what you need to do is get a hold of Ruth Lanius.
00:59:14.652 -->
00:59:15.335Okay, I will.
00:59:15.769 -->
00:59:18.579She can do a much better job of this than I can.
00:59:19.251 -->
00:59:22.438That was good though, so my interest is piqued for sure.
00:59:22.438 -->
00:59:40.952Turning towards meaning, I feel like I went into psychiatry with a lot of existential questions and this idea that, with a lot of existential questions and this idea that, okay, if I'm talking to people in their deepest moment of dread and hearing their unfiltered truth, I'm going to figure out something that's helpful to me.
00:59:40.952 -->
00:59:47.097So I sort of assume that other therapists kind of went in with this also, which is not necessarily true.
00:59:47.818 -->
00:59:49.643I think that's probably true.
00:59:50.210 -->
00:59:54.735I think it's often true and then sort of went into pretty medical direction.
00:59:54.735 -->
01:00:09.943But I like Viktor Frankl's perspective or lens, that meaning is the central human drive, and so I always have this question of like if there's a symptom, is that just our body telling us that we need to make a shift in our life towards more meaning?
01:00:09.943 -->
01:00:12.987Or is that something that we need to medicate or give our life towards more meaning?
01:00:12.987 -->
01:00:17.239Or is that something that we need to medicate or give some kind of therapy or do some kind of?
01:00:17.539 -->
01:00:18.302Or do a combo.
01:00:19.010 -->
01:00:20.474Combo intervention right.
01:00:20.673 -->
01:00:27.382There's a bunch of people I've worked with who wouldn't be alive or wouldn't be healed if they hadn't been on medication.
01:00:27.563 -->
01:00:28.085Absolutely.
01:00:28.085 -->
01:00:37.599I prescribe medicine myself every day that I'm working, so I believe that it is helpful, but I'm curious about sort of meaning.
01:00:38.471 -->
01:00:43.262I think the deal with meaning is sometimes it can get stuck in a left brain.
01:00:43.262 -->
01:00:53.501It's why the early analysis didn't work completely, because people would get everything but wouldn't have that transformational kind of you know.
01:00:53.501 -->
01:00:55.693They'd still be stuck in their same patterns.
01:00:56.215 -->
01:01:01.072What comes to mind for me is that meaning has a lot to do with connection.
01:01:01.072 -->
01:01:02.996Connection and impact.
01:01:02.996 -->
01:01:14.751And there's a short story writer, george Saunders, talks about short stories and Russian writers, and everything in the story has to be there for a reason and have an impact.
01:01:14.751 -->
01:01:32.114And if the cloud looks a certain way, and so the opposite of meaning is randomness and disconnection and dissociation is sort of disconnection from ourselves, or it can be, or parts being disconnected and so in a way healing dissoci.
01:01:32.114 -->
01:01:39.378Dissociation has to do with sort of reconfiguring the internal sense of connection and meaning.
01:01:39.378 -->
01:01:42.960But how that works, I'm fascinated.
01:01:42.960 -->
01:01:43.521The first European.
01:01:43.541 -->
01:02:08.201Society for Trauma and Dissociation Meeting and this psychologist, ralph Buck from Leipzig, went to the talk I gave and came away from it thinking I was an analyst.
01:02:08.201 -->
01:02:16.579So I was quite surprised when he asked me to speak at his conference and sent me the pre-conference billing.
01:02:16.579 -->
01:02:22.664I was billed as a clinical psychologist, psychoanalyst, and I'm like and he wanted me.
01:02:22.664 -->
01:02:50.572It was very funny with people who have dissociative disorders and so I kind of backed into learning about projective identification, reenactments I mean, and countertransference, because you have to pay attention to all of that, because so much of the communication that's really important has to be nonverbal.
01:02:50.992 -->
01:03:02.092You know if you shut up, if you're taught that, you know if you tell anybody anything, you're going to get horribly abused or someone you care about will be killed or whatever.
01:03:02.092 -->
01:03:04.275You're not going to be able to say things.
01:03:04.275 -->
01:03:11.737So I have to pick it up in the transference or the counter transference and get it into words.
01:03:11.737 -->
01:03:20.661So I think when I think about meaning, sometimes I think about watching people for those subtle shifts.
01:03:20.661 -->
01:03:22.103Or what am I feeling?
01:03:22.103 -->
01:03:30.554You know, if I'm feeling completely hopeless, there may be some of my stuff in that, but it may be something that the client's feeling.
01:03:30.554 -->
01:03:32.760Or if I'm feeling completely jammed up.
01:03:32.760 -->
01:03:41.079That may be a reenactment or a nonverbal communication about how jammed up they were as kids.
01:03:42.731 -->
01:03:50.541So you're using what's projected into you to understand and connect with your client.
01:03:50.750 -->
01:03:54.117Yeah, all the time, and sometimes I'm.
01:03:54.117 -->
01:03:56.391I'll give you an example.
01:03:56.391 -->
01:04:06.336I was sitting with a woman, actually a psychologist, and I was thinking, oh my God, I should never have picked this person up.
01:04:06.336 -->
01:04:09.851I don't know, I'm just not good enough, I don't know what I'm doing.
01:04:09.851 -->
01:04:13.041And I suddenly realized that I was.
01:04:13.041 -->
01:04:20.923I mean, I had my own competent stuff left over from not feeling good enough as a kid, but it was excessive.
01:04:21.349 -->
01:04:38.585So I realized I was picking up her feelings of not being competent and so I wrote the word competent or incompetent on my pad and I circled it and put some arrows pointed towards her and visualized it going back to her.
01:04:38.585 -->
01:04:42.000I figured if I could be picking it up, I can send it back.
01:04:42.000 -->
01:04:43.835And she started crying.
01:04:43.835 -->
01:04:46.916Oh wow, it was totally nonverbal.
01:04:46.916 -->
01:04:51.635I mean, if I'm picking up suicidal despair, I'm sending it out the window.
01:04:51.635 -->
01:04:53.657If I'm picking up suicidal despair, I'm sending it out the window I do.
01:04:53.657 -->
01:04:59.202One of the things I love about IFS is their fire drill, which is an exercise on sorting through.
01:04:59.202 -->
01:05:20.161Like if my buttons are being pushed by a client, it's my using IFS on myself to sort through the parts that are getting triggered by the client, finding out what's going on and what needs to happen so I can be in my adult therapist self when I'm meeting with the person I think this is huge.
01:05:20.262 -->
01:05:21.563Yeah, it's huge.
01:05:22.913 -->
01:05:27.061It's a terrific exercise and process.
01:05:27.362 -->
01:05:41.478The fire drill does that because you're imagining the person that's activating all your upset parts and then you're looking inside and seeing what your parts are and finding out what does the part want me to know about it?
01:05:41.630 -->
01:05:44.800And it may be as simple as I've done it.
01:05:44.800 -->
01:06:10.378I do it in consultation sometimes, or I do it different places, but sometimes it's as simple as the part thinks that the therapist is like a kid and then it's just updating the part, you know, saying ask the part to look you in the eyes and look back and let the part know how old you are and that you have skills and resources that you didn't have when you were 10.
01:06:10.378 -->
01:06:15.193And sometimes the parts are like oh yeah, no problem, you can handle this.
01:06:15.193 -->
01:06:21.478And sometimes it can be a part that's holding a burden of traumatic material that hasn't been resolved.
01:06:22.242 -->
01:06:28.961And so I might help them develop a container until they can work through whatever they need to.
01:06:30.230 -->
01:06:34.501And really having a sense of what's yours and what's theirs.
01:06:34.780 -->
01:06:35.282That's right.
01:06:35.282 -->
01:06:41.914There are a couple of people Steve Frankel's a psychologist in California, psychologist lawyer.
01:06:41.914 -->
01:07:05.989He does a lot of ethics things so both of them talk basically about some similar things and saying that if we're going to ask people to go to their deepest, darkest places, it's only reasonable that we're willing to go to our own deepest, darkest places, and I think that's a totally ethical and responsible way of working.
01:07:06.391 -->
01:07:07.192Yeah, I agree.
01:07:07.192 -->
01:07:17.273So let me ask you a couple rapid-fire questions, a few rapid fire questions about meaning, and then we'll bring this to a close.
01:07:17.273 -->
01:07:23.030So my first question is, according to me, Joanne Twomley, the meaning of life is.
01:07:23.831 -->
01:07:25.012The meaning of life.
01:07:25.012 -->
01:07:35.793I mean, I guess I feel like what I want in terms of my life is to have a purpose, like right now.
01:07:35.793 -->
01:07:47.543My purpose is to enlighten the IFS crowd about dissociation and trauma and the usefulness of simple coping skills.
01:07:47.543 -->
01:07:52.240I mean, they would say nobody needs them because we have everything we need.
01:07:52.240 -->
01:08:05.001And what I would say is, if you grow up with parents who are wildly dysfunctional, who beat the crap out of you and drink if they're having bad feelings and project them onto you, you probably don't have the you know.
01:08:05.001 -->
01:08:11.286It probably would help to get somebody to help you with symptom management and affect management.
01:08:11.286 -->
01:08:14.112It's not just magic.
01:08:14.112 -->
01:08:26.913So I think, in terms of what I think is important in life is having a quota of fun, a quota of balance and a quota of feeling like you're doing something that's purposeful.
01:08:27.997 -->
01:08:28.337I love it.
01:08:28.337 -->
01:08:31.604Yeah, fun, purposeful and balance yeah.
01:08:31.604 -->
01:08:33.307Next question Most and in balance yeah.
01:08:33.890 -->
01:08:34.010Yeah.
01:08:34.970 -->
01:08:35.533Next question.
01:08:35.672 -->
01:08:43.498Most meaningful thing that I did yesterday was the most meaningful thing I did yesterday was oh, probably.
01:08:43.498 -->
01:08:47.265I had dinner with a high school buddy, who I don't see very much.
01:08:47.265 -->
01:08:52.077I had dinner with a high school buddy.
01:08:52.077 -->
01:08:54.643I responded to the Russian publisher.
01:08:54.643 -->
01:08:58.000I wrote a reference for someone Nice.
01:08:58.630 -->
01:09:09.163Most meaningful work of art that I've come across in the last week could be a movie or music or TV or book or anything.
01:09:09.670 -->
01:09:21.519I'm reading a book on Chechnya which I've been really liking, but I don't think I ran into anything that completely blew me away in the past week.
01:09:22.180 -->
01:09:33.118Okay, after I'm gone, the thing that I most want to be remembered for is Well, I guess I probably you know I have a couple of different thoughts about that.
01:09:33.118 -->
01:09:42.599I mean, one thought is eventually I don't think anybody's going to much remember me, but you know, I guess I'd like to be remembered for that.
01:09:42.599 -->
01:09:44.804I was a all right.
01:09:44.804 -->
01:09:48.560So one part of me would say that I've been a psychotherapist.
01:09:48.560 -->
01:09:58.238I've helped a lot of people heal and I've helped a lot of people heal and I've helped a lot of therapists learn about integrating different models and about staying open.
01:09:58.238 -->
01:10:03.135And what's sort of interesting about IFS is, they say, all you need is IFS.
01:10:03.135 -->
01:10:05.340And I'm like, what about being in self?
01:10:05.340 -->
01:10:08.552What about being curious about different models?
01:10:08.552 -->
01:10:18.256So I think that what I teach is be curious, you know, be open to things, don't throw the baby out with the bathwater.
01:10:18.256 -->
01:10:31.479And then probably I would like to be remembered for being kind and maybe like this grandmother who worked for the VA for so many years, Because she was a really wonderful person.
01:10:32.381 -->
01:10:43.430Yeah, it does sound like you have Been guided by her and you've made amazing impact On a lot of people through clinical work and then teaching.
01:10:43.430 -->
01:10:50.914And then this message of curiosity, getting people to use integrated approaches With dissociation.
01:10:50.914 -->
01:10:59.952If I have a crisis Personal crisis and sort of existential I feel like I don't matter, my life doesn't matter, I'm just this speck of dust.
01:10:59.952 -->
01:11:04.881Somebody comes to you with that kind of existential situation.
01:11:04.881 -->
01:11:08.150What's kind of your first approach in that?
01:11:08.430 -->
01:11:12.014My first approach is to wonder what was going on when they were a kid.
01:11:12.014 -->
01:11:16.735You know what were the attachment styles that they grew up with.
01:11:16.735 -->
01:11:19.078What kind of neglect did they have?
01:11:19.078 -->
01:11:30.163I mean, the basis of dissociative disorders is abandonment, neglect and attachment problems, not trauma, not trauma.
01:11:30.163 -->
01:11:32.365So that and trauma?
01:11:32.365 -->
01:11:33.605What is entreated?
01:11:33.605 -->
01:11:36.108What makes them feel so insignificant?
01:11:36.108 -->
01:11:43.234What's the root?
01:11:43.296 -->
01:11:46.270cause of this and how do we deconstruct it and shift things?
01:11:46.270 -->
01:11:51.752Nice and yeah, so I really appreciate our conversation.
01:11:51.752 -->
01:11:52.713There's a lot for me to go and think about.
01:11:52.713 -->
01:11:55.680Anything else that I should have asked you, or final thoughts.
01:11:55.680 -->
01:12:01.981If there is some kind of a big message, I mean, you kind of do have this message of learn all you can.
01:12:01.981 -->
01:12:06.457Dissociation, integrative approaches be curious.
01:12:07.729 -->
01:12:12.713I mean, certainly what's been pivotal for me is learning about the impact of trauma.
01:12:12.713 -->
01:12:22.020Certainly what's been pivotal for me is learning about the impact of trauma, and I mean trauma, traumatic neglect, abandonment, you know, attachment disorders, that whole thing and the impact on therapy.
01:12:22.020 -->
01:12:28.846And I think therapists who don't get it about that often aren't treating what people need to have treated.
01:12:28.846 -->
01:12:35.009You know it's like there's a fulcrum and they're missing it and it's.
01:12:35.009 -->
01:12:39.037You know it's kind of depressing for people to spend.
01:12:39.037 -->
01:12:44.293You know, 30 years of therapy costs a lot and not have.
01:12:44.734 -->
01:12:58.676when I see somebody who's been in therapy for 30 years and it's like they've never been in therapy, I'm like that's a lot of time to get support without a lot of results and now there really are a lot of tools.
01:12:59.591 -->
01:13:08.202And there are really good tools and it makes being a therapist more fun when you can help people heal.
01:13:08.202 -->
01:13:13.417And even the complex dissociative disorder clients I have.
01:13:13.417 -->
01:13:16.744They get better in decent treatment, mm-hmm.
01:13:16.744 -->
01:13:18.949And even the complex dissociative disorder clients I have, you know, they get better in decent treatment, mm-hmm.
01:13:18.949 -->
01:13:23.939Someone else you might want to talk to sometime is Bethany Brand.
01:13:24.822 -->
01:13:25.262Who is she?
01:13:28.833 -->
01:13:50.458She's from Town and she has been doing this research on what helps people with dissociative disorders heal and she got a bunch of therapists, client pairs, and then she's had them watch videos and rate them, she and her team, and now they're publishing stuff.
01:13:50.458 -->
01:14:07.342But she says there's nothing that new, it's just doing what we know teaching coping skills, orienting parts to the present, doing work chunk by chunk, things like that.
01:14:08.609 -->
01:14:46.252So, yeah, there's lots to follow up on and I'm really curious about what more is in store for you and where can people learn about you and your workshops and your teaching giving a two-day workshop at the end of March in California, near San Francisco, but I'm giving a five-day workshop retreat workshop in Portugal on IFS and dissociative disorders, which should be a lot of fun in.
01:14:46.271 -->
01:14:48.595May, that does sound fun, that sounds fun.
01:14:48.855 -->
01:15:00.881I also have a website, but it's not very, it's a little primitive, but it's joannetwombleynet, so I try to put things on the website.
01:15:00.881 -->
01:15:02.814And you know my book.
01:15:02.814 -->
01:15:04.198I like my book.
01:15:05.932 -->
01:15:06.775I like your book too.
01:15:06.997 -->
01:15:08.079yes, oh, thank you.
01:15:08.079 -->
01:15:28.070You know it's not the most sophisticated, it's not research heavy, but it's practical and what I like is being able to read something and you know I like having things handed to me on a platter so I kind of tried to write it in a way that you know, I like that also yeah.
01:15:28.070 -->
01:15:33.994So it's very practical and that's what people have liked about it.
01:15:33.994 -->
01:15:44.921So it's a good place to start learning something about dissociative disorders, and it's mostly for IFS people, but a lot of non-IFS people have read it too.
01:15:46.182 -->
01:15:48.085Thank you so much for talking with me today.
01:15:48.085 -->
01:15:52.587This was really great and I really appreciate our conversation.
01:15:54.710 -->
01:15:55.551Thank you for having me.
01:15:57.256 -->
01:15:58.377Thank you for listening.
01:15:58.377 -->
01:15:59.399I really enjoy that.
01:15:59.399 -->
01:16:00.421I hope you did too.
01:16:00.421 -->
01:16:06.327If you did, please leave us a rating on whatever podcast platform you are listening to now.
01:16:06.327 -->
01:16:15.539Leave us a comment, check out our Developing Meaning website and sign up for our Substack newsletter at developingmeaningsubstackcom.
01:16:15.539 -->
01:16:29.412Next month, we're going to move into the world of hypnosis and I'm going to present to you a conversation with Mike Mandel, who is one of the great hypnotists and teachers of hypnosis of our time.
01:16:29.412 -->
01:16:38.240And, as always, until we meet again, I hope you have a meaningful, meaning-filled month and if you figure out the meaning of life, let me know.
