What Therapists Should Know About Dissociation and Dissociative Disorders: An Interview with Dr. Jamie Marich
Curt and Katie interview Dr. Jamie Marich, author of Dissociation Made Simple, about dissociation and dissociative identities. We talk with Jamie about what therapists often get wrong as well as some basics on what dissociation is and how best to understand and treat it (when it actually needs treating).
Click here to scroll to the podcast transcript.Transcript
An Interview with Dr. Jamie Marich, Author of Dissociation Made Simple
Dr. Jamie Marich (she/they) describes herself as a facilitator of transformative experiences. A clinical trauma specialist, expressive artist, writer, yogini, performer, short filmmaker, Reiki master, TEDx speaker, and recovery advocate, she unites all of these elements in her mission to inspire healing in others. She began her career as a humanitarian aid worker in Bosnia-Hercegovina from 2000-2003, primarily teaching English and music while freelancing with other projects. Jamie travels internationally teaching on topics related to trauma, EMDR therapy, expressive arts, mindfulness, and yoga, while maintaining a private practice and online education operations in her home base of Northeast Ohio. Jamie is the author of numerous books on trauma recovery and healing, with many more projects in the works. Marich is the founder of The Institute for Creative Mindfulness.
In this podcast episode, we talk about how therapists can support clients navigating dissociation
A friend of the show, Dr. Jamie Marich, wrote a book Dissociation Made Simple, and we wanted to talk about it!
What are therapists getting wrong when learning about and treating dissociation?
- Not believing in dissociative identities or dissociative systems
- Fear of and misunderstanding of dissociation
- Thinking of dissociation as a dirt word and something to avoid
- Believing that dissociation must always be healed (when in fact it could be useful at times)
What is dissociation? What is dissociative identity disorder or dissociative experience?
- Exploring different definitions and conceptualizations
- It is a lot of different things
- Severing/separating from the present moment or from aspects of ourselves
- Disaggregation or dividing your self into parts
- Purposeful, meeting a need or protection
- The shift to thinking about elements of dissociation as adaptive or maladaptive situationally
How can therapists support clients in understanding and managing their own dissociation?
- Helping clients to identify what purpose their dissociation is serving
- Assessing dissociative profile through an inventory in the book (triggers, how we dissociate, adaptive/maladaptive)
- All dissociative behaviors can be assessed as adaptive or maladaptive
What clinical models are available to work with dissociative parts?
“So many of us who are in the dissociative disorders community, or dissociative people who identify as having dissociative identities, really think IFS [Internal Family Systems] is lacking, because it is such a model… To really understand us, you need to get to know our system. And we may or may not like words like exiles, defenders, protectors, firefighters. Like I kind of find all of those words a little icky.” – Dr. Jamie Marich, Author, Dissociation Made Simple
- Old School Jungian archetypes (Dr. Jamie Marich is most aligned with this model)
- Ego State Therapy (psychodynamic)
- Fraser’s Table (gestalt)
- Theory of Structural Dissociation
- Internal Family Systems (discussed the caution with this model)
How can a therapist assess for dissociative identities or systems?
- Language may vary (parts, defenders, team, selves, side, aspect, etc.)
- Previous diagnosis or self-diagnosis
- Listen for the experience (a “part of me” wants this, a “side of me” wants this)
- Speaking in a parts-informed way
- Exploring for thinking from different parts of self, potentially even already with names
- Dissociative Identities inventories
What are clinical goals with clients who have dissociative experiences and/or identities?
- When working with someone with a system, will need to get buy in from all elements of the team for treatment goals
- Goals may not align across different parts
- The theory that you’re working with a family
- Many clients have Chronic PTSD and the focus of treatment may be trauma
- The importance of being trauma informed
- Grounding, anchoring, or settling into the present moment
- The goal is usually NOT integration
- Cohesion, communication, or cooperation
How can therapists overcome their fear about dissociation?
“If you don’t think you dissociate, you do.” – Dr. Jamie Marich, Author, Dissociation Made Simple
- Identifying your own dissociation
- Overcoming the “us versus them” related to dissociation
- Moving away from bias and stereotypes of folks who dissociate
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Dissociation Made Simple (the book)
Jamie’s website: redefinetherapy.com
Jamie’s social media:
Trauma Therapist Rants on Twitter
Trauma Therapist Rants on TikTok
Relevant Episodes of MTSG Podcast:
Jamie’s episodes
Dissociation in Therapy: An interview with Dr. Jamie Marich
The Balance Between Boundaries and Therapy: An interview with Dr. Jamie Marich
Exploring Trauma and the 12 Steps: An interview with Dr. Jamie Marich
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 0:15
Welcome back modern therapists, this is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists where we talk about the things happening in our offices and our profession. And as Katie was just pointing out, I will give her credit for this is, as we continue to go on, and through our number of episodes, we find ourselves moving into the things that happen with our clients and how to work clinically a little bit more often, and what better resource to have than Dr. Jamie Marich joining us again today to help us navigate the world of dissociation. And she is returning now for I don’t know like to bajillionth time, has been at the Therapy Reimagined conferences, is just like an overall phenomenal, wonderful human beings. So thank you so much for joining us again.
Dr. Jamie Marich 1:04
My pleasure. I think this is number four on the podcast.
Katie Vernoy 1:07
Wow. Well, we’re super glad to have you here. It’s always fun to talk with you. And we’d love having friends of the show come join us so we can have some amazing conversations. But for folks who are first meeting you or for the rest of our audience, you can remind them who are you and what are you putting out into the world?
Dr. Jamie Marich 1:10
Who am I? That’s a big question, Katie.
Katie Vernoy 1:12
Huge.
Dr. Jamie Marich 1:13
…question. So, as it relates to this topic today, I’ll give you a little more finessed answer: professionally I’m Dr. Jamie Marich, I’m an EMDR trainer, I’ve written 10 books on trauma recovery. I also do an expressive arts therapy training program, and I’m considered accomplished and learned in my field. But on the personal end, I’m just Jamie, many of you know, Will and Grace and just Jack like I’m just Jamie. What I often like to say. And I think that’s important as we’re talking about dissociation because there is this very professional part that I put out there to the world. And she’s an important part of my system, and that she helps me get shit done when the world is crumbling down around me. And as a pretty vulnerable person. I will say that Jamie, who I really am underneath does feed a lot of Dr. Jamie’s knowledge and wisdom and what I put out there. Yet so much of what I’ve been trying to do in this recent season of my work with dissociation is to speak more as Jamie. And if people are going to listen to me because I have the credentials and I’m quote unquote Dr. Jamie Marich, cool. Yet I think in this season in my life, what I’m really working towards putting out there is honoring the lived experience of not just Jamie but other people who have dissociative identities, what the field might call dissociative disorders, and inviting us to speak more candidly about it and not so technically.
Curt Widhalm 2:53
There has been historically a lot that our field has gotten wrong about dissociation. And I think we’re our field at its current iteration of being wrong is different than where it was when we first joined the fields. You know, I think at that point, it was, you know, merge all personalities together, get rid of this, this is bad. What’s our current iteration getting wrong?
Dr. Jamie Marich 3:18
There’s still a lot we’re getting wrong. It’s something I was told in 2003, 2004, when I was in graduate school, is that dissociative identity disorder, formerly multiple personality disorder is very rare. There’s very few cases of it. And we just shouldn’t indulge our clients too much who have it. And one of my students who’s also an ICM team member was told the same thing in graduate school in 2017.
Katie Vernoy 3:40
Wow.
Dr. Jamie Marich 3:41
So I still think there’s a lot of that mythology that’s around there. There’s still a lot of professionals who don’t believe that dissociative identity disorder is a real thing. I think we’ve made some big steps in the right direction to be sure. Yet, like a lot of things we talk about in the field, there is still so much work that needs to be done. I will say obviously, what I just mentioned is still a problem. This idea that people either think dissociative identity disorder specifically is not a real thing. Or clinicians do believe it’s a real thing. And they feel so overwhelmed to do anything with it. I don’t want to destabilize you, I don’t want to do further harm. I’ve had so many people with DID and dissociative systems who were turned away by clinicians under the guise of I don’t really have the expertise to work with you. Yet what a lot of folks hear when that is said is you’re too much for me to handle. So I recently did a TikTok where I said which is it? Do we not exist? Or do we exist and we’re too much to handle. But I think probably the biggest problem that is underlying the field is this fundamental fear of misunderstanding of dissociation. I have a chapter in my new book that’s coming out called dissociation is not a dirty word. Because I still hear people in the EMDR community, EMDR which is a trauma modality, say things like, don’t let your people dissociate. Like, it’s the worst thing somebody can do. And any person with a dissociative experience will tell you it has been our lifeline. It still serves us in a lot of ways, even in a state of recovery. And I really believe so many clinicians are afraid of it, because they are still operating from a lot of myths and misconceptions about it being something that’s so destructive, so damaging, so violent. And that’s a stereotype that a lot of media fuels, but I think clinicians have bought into it. And what I fundamentally teach at the heart of all of this, is, we all dissociate. And I think clinicians really must understand where dissociation shows up in their own life, so that they don’t have the fear of addressing it in a clinical space.
Katie Vernoy 5:49
When you’re talking about this, I find myself kind of going through the full range of what you discussed, because I I’ve been a clinician for quite some time, and I’ve had the, like, dissociation is evil and wrong and horrible and scary. And you know, all the things.
Dr. Jamie Marich 6:03
Yes.
Katie Vernoy 6:03
But I’ve also felt like I’ve gone to the other extreme, sometimes where, you know, kind of spacing off is dissociation. And so are we over labeling dissociation as a society because it’s a trauma response? And are people misunderstanding it just from all all angles? So maybe it helps to take a big step back which we have students, but we also have probably very established clinicians who need this lesson as well. But…
Dr. Jamie Marich 6:30
Right.
Katie Vernoy 6:31
What is dissociation DID dissociative system? What are the basic foundation that we need to be able to really continue forward with this conversation intelligently?
Dr. Jamie Marich 6:40
Certainly, and I will say with dissociation, like with trauma, I see virtually no risk and over labeling it.
Katie Vernoy 6:45
Okay, good.
Dr. Jamie Marich 6:46
It’s recognizing that it shows up in different degrees. And in different forms. I would rather people over label it, so they’re able to recognize it in themselves. Let’s start there.
Katie Vernoy 6:57
Okay.
Dr. Jamie Marich 6:57
So dissociation, it’s easy to get it confused, because as a psychological construct, it is a lot of things. And even Pierre Janay, who first coined it as a psychological construct, you know, he is who many of us consider the father of trauma therapy, has come under criticism, because it’s like, what is it? Is it this general splitting off we do from reality? Because reality is unpleasant? Or is it that we’re disaggregating ourselves into various parts and aspects and dissociation as a word was used before Janay. Like Herman Melville used it in the novel Moby Dick as just a general word in the English language. But recognizing it is a lot of different things. I like to come back to, Curt knows this from studying with me, the word basics. Where do we even get the English word dissociation? So it comes from a Latin root ‘dissociatio,’ which means to sever or to separate. And so I think if we’re really keeping it basic, let’s start there. Dissociation means we’re severing or separating from something, either the present moment, because the present moment is unpleasant, overwhelming, painful, or there’s a severing, or separation from aspects of ourselves. The word Janay used in French was désagrégation, which better translates as disaggregation. And I think that’s a more useful construct for this idea of parts or aspects of self splitting off. But for better or worse, William James translated it into dissociation in English. And that’s what we’ve had as a psychological construct. So it’s to sever or separate either from the present moment from aspects of ourselves. And we generally do it consciously or subconsciously, for two reasons: to meet a need, or to protect oneself. And that can also mean a system of selves with it. So if we’re operating from those fundamentals, we often know now that dissociation shows up in a lot more ways too than just how we think of it as mental health professionals. Something we go into in the book is how a lot of the kind of dark evil capitalistic forces at play in society want us to be dissociated, to keep us separated from each other. And a lot of folks, especially marginalized folks will use dissociation to cope with living in this world, let’s say as a black man or as a black woman, we have two contributors in the new book who share their experiences with that. So dissociation is a lot of different things. So I would rather people over label it. A construct that I put out there is something that comes directly from EMDR therapy, which is where Dr. Shapiro, Francine Shapiro, who developed EMDR used the terms adaptive and maladaptive to define responses.
Katie Vernoy 9:47
Sure.
Dr. Jamie Marich 9:48
She leaned into those words adaptive and maladaptive instead of healthy and unhealthy, instead of good or bad, because she felt adaptive and maladaptive were less of a value judgment So for instance, what is adaptive to me, Jamie may be maladaptive to Katie. And vice versa. What was adaptive to me at one point in my life, daydreaming my days away, because that’s how I survived as a kid in a dysfunctional home, eventually became maladaptive, especially when I was trying to get sober. And now as a person who’s in a state of recovery, I still daydream. But I’ve had to develop more discernment over where is it adaptive for me? Where is it maladaptive? Where does it get in the way of me living the life I want to live? So I think when we’re discussing dissociation, I encourage people now to use Dr. Shapiro’s construct of adaptive or maladaptive because sometimes it’s one, sometimes it’s the other, sometimes it’s both depending on the person and how it shows up in their life.
Curt Widhalm 9:55
But Jamie that doesn’t fall into nice, neat little boxes. That we have to adapt everybody to fit into one or another. And that makes it hard for therapists. How dare you?
Dr. Jamie Marich 11:04
Well, hashtag Sorry, not sorry. And I say that when I do trainings on dissociation, sorry, not sorry, I can’t give you a neat model for this. It can’t be done. And that’s what I’ve presented to you is as neat as I’m able to make it as a definitional basis. But yes, when it comes to treatment, I get that question all the time. Well, how do you quote unquote, treat dissociation. And one of my smartass responses to that right away is it doesn’t necessarily need treating in all circumstances. And that’s where we have to make these judgment calls.
Curt Widhalm 11:36
And I think that it was, at least in my trainings, and Jamie and Institute for Creative Mindfulness is where I did a lot of my EMDR trainings, and really being able to hear it in that way. For those who may still be kind of trying to piece that last step together, it’s what function does it serve? And that may change from day to day, even within the same client that really helps to bring awareness and helps in kind of the client health, I guess, is maybe a way of conceptualizing it of here’s what you do with it. It’s not always something that has to be fixed. It’s something that awareness does a really good job of bringing you into the next stages of treatment.
Dr. Jamie Marich 12:21
Correct. And even in the ICM curriculum, I’ve shifted the language away from healing dissociation, to navigating dissociation, because it doesn’t necessarily need to be healed. Yes, some of it does. And it’s not the dissociation but the traumatic roots of it, where we’re really trying to target the healing. And so many folks in the dissociative disorders community particularly will identify dissociative responses as a superpower. Somebody I work closely with, who also contributed to my new work has said, it’s both a superpower and a disability. And for this individual, it’s been learning how to navigate the interplay between the two. And that’s a lot of what I’ve had to do in my life as well.
Katie Vernoy 13:04
As a society, it seems like that we’re, you know, and I think this is speaking to the kind of capitalist kind of busy society that you were talking about before. I think a lot of dissociation happens, scrolling. And then being on social media and those types of things, I think there’s a lot of awfulness that are just accepted as reality is that many of us dissociate with. But my experience more recently, and I think I mentioned this to you, when I was starting to read an early version of your book is dissociation during grief. And I recognized that I was aware of what was going on, but there was a big portion of myself that was dissociated for at least a couple of months. And so to me, it feels like this picture of dissociation becomes very complex. And kind of maybe I’m pushing in a little bit further into when we’re talking to clients around whether it’s a superpower and adaptive or a disability and maladaptive, like, how do we recommend that clinicians talk to lay people around: What is it and how does it serve? Because I felt like for myself in experiencing it in different ways, and in, you know, kind of both the maladaptive and adaptive ways, I felt like there was a lot that I was still trying to uncover to kind of get a grasp on it. And so what do you recommend?
Dr. Jamie Marich 14:18
It’s a great question. And I think it has to start with a conversation similar to the one we’re all having right now. Which is, what is it really? And starting with this idea of we’re severing or separating. Sometimes it’s maladaptive or not serving us. Sometimes it’s adaptive or serving us. Sometimes it’s one in the same. More specifically answer your question, but I want to point out the scrolling example…
Katie Vernoy 14:41
Okay.
Dr. Jamie Marich 14:41
Because a couple of our contributors, including Jamie Pollack, who wrote the foreword for the book, identified as people with complex trauma who are triggered as hell by society around them. Scrolling can actually be very adaptive. If you’re waiting in line at a very overstimulated store.
Katie Vernoy 14:56
Sure.
Dr. Jamie Marich 14:57
If you’re at a family event, just having that little bit of time to scroll can give you the lifeline that you need, can scrolling become maladaptive? Absolutely. And that’s something that I would say, capitalism leverages.That we’re going to keep scrolling and getting into oh, we need more, we need this. And if scrolling is going to keep you disconnected from your clients and your children or people you have to attend to clearly it can cross a maladaptive line. And so that’s where I recommend an exercise, and it’s in the book. But I’ll give folks a general summary of it here on the podcast, which is called a dissociative profile. Which is essentially you doing an inventory to borrow the language of the 12 steps on where dissociation shows up in your life? What tends to trigger it? And it could be a major life event like a death or a loss that’s brought about a grief response? What did the pandemic teach you about your responses to dissociation? So I think some of this inventory has to look at what can trigger our dissociative responses? How do we dissociate? And then doing some inventory or discussion with your therapist on: Is it adaptive? Is it maladaptive? Or is it serving me? Or does it not serve me? And another example I use for myself is, so the other thing that gets a bad rap with dissociation is Netflix or Hulu, or constantly binging, you know binge watching television. Can it become maladaptive? Of course, especially if you’re binging through the night and you’re not getting sleep, and you’re not getting to work, and you’re not attending to what you have to. But I would, like in my evenings, that is my favorite thing to do is to lay down on the couch with one of the pets and watch a couple episodes of a show. Or if I give myself like a real down day, I really like to go into a binge. To me that is completely adaptive. Because it allows me to rest my body, to enter into an emotional world where I don’t have to be anything for anybody. I can just be. And I would argue if I were to spend my evenings doing more work, or diving into like all the success of spiritual practice that would be maladaptive. Because I’m pushing myself, because I think a lot of us use work to dissociate. Let’s be frank, we’re overachieving therapists. I would say most of us who are engaged with these kinds of podcasts. So I think that’s something we have to look at too. Is work for us something that’s adaptive, maladaptive, or both? So these are the fundamentals of a dissociative profile, to get a sense of how it shows up in your life. And I think from that insight and awareness, we can know how to take positive action, if that’s necessary.
… 17:23
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Curt Widhalm 17:37
You’ve talked about dissociative systems a few times here. And I hear a lot of therapists and myself at times are drawn to various modalities that have parts work involved with them. You’ve got your concerns with some of these approaches.
Dr. Jamie Marich 17:55
Yes, I do. People ask me all the time, well, which goes into your: but Jamie, Which model do I use? How do I check the box for doing what I do? And I the probably the most asked question I get is Which model do you use for working with parts? Or do you use IFS, which is kind of the most popular one out there today? And my short answer is, I have no one model I use. They all have good things about them. They all have their problems. Honestly, the one I probably most align with is old school youngin archetypes, because I think he was one of the original people in modern psychology who was really doing parts work. And I think the archetypes still give us a lot of insight. So the ones on the modern buffet would include those folks who are still Jungian ego state therapy, which came out of psychodynamic therapy, a lot of people gravitate towards Fraser’s table, which is fundamentally a gestalt model. And gestalt has a lot of insight for parts. There’s a theory of structural dissociation, which is also a popular option. And then of course, IFS, internal family systems. And I tend to say and I’m backed by others on this, this is not just me, trauma therapist ranting or with a chip on my shoulder, that IFS, I think, helps people, therapists who do not necessarily have dissociative systems themselves have some kind of solid groundwork to start thinking in the language of parts. Yet so many of us who are in the dissociative disorders community or dissociative people who identify as having dissociative identities, really think IFS is lacking, because it is such a model. Similar to what we were saying earlier like to really understand us, you need to get to know our system. And we may or may not like words like exiles, defenders, protectors, firefighters. Like I kind of find all of those words a little icky. Honestly, when I reflect on my own system. I’ve also had some concerns about the way some IFS senior trainers have talked about people with dissociative disorders and dissociative identities. And that has kind of just made the head on my back of my neck curl about Have you really gotten to know, people with systems and doing this work? And I mean, a criticism I’ve heard in response is well IFS is for everybody. It acknowledges this idea that we all have parts. And while I think that’s good, that our field has some models that do that, I think a lot of these parts systems have really come at the erasure of actually talking to people, and especially talking to clinicians, who also identify as having dissociative identities.
Katie Vernoy 20:42
For me, the clarification that I’d love to talk about right now is really how someone who’s working with a client who is really engaged in these idea of parts, you know, when is it this kind of more IFS kind of parts work, or even the, you know, the id, ego and super ego or whatever it is where people come into therapy, or come into kind of an understanding of, we have these different parts versus what’s a dissociative system? I mean, how does it show up differently? And how can we honor the differences there?
Dr. Jamie Marich 21:12
That’s an excellent question. And I think before I fully answer, I want to clarify, because this was a big learning that came out of folks I talked to for the book. Parts is the word du jour in the field. And it’s not a bad word. I use it for myself. But many contributors don’t like the word parts. One said, it makes me sound like a car, I just call them selves.
Katie Vernoy 21:33
Okay.
Dr. Jamie Marich 21:33
So you will hear selves, you will hear, one individual I talked to just uses the word defenders. Instead of system, some people will say my team. I sometimes say my team instead of systems. So I think part of it is recognizing that people’s language may differ around this. And I think, though, for all clinicians a good place to start, many clients will come to you knowing that they have a DID diagnosis, or that they have been discussed within this language of parts before. And I think if they’re coming leading with that, you want to listen. And that’s a really good indicator that you likely are dealing with a dissociative system or team. Yet, the majority of us will either be diagnosing it from the ground floor, will be in the position of needing to explore it with clients. And I think a fine place to start with any client who comes through the door is: Have you ever thought of your struggles in terms of Well, there’s a part of me that wants to get sober and a part of me that doesn’t? Yeah, most anybody could kind of acknowledge that. That there’s a part of me or a side of me might be another word that you hear. There’s an aspect of me that wants to get out there and engage with life. And there’s another aspect of me that wants to just stay in bed all day. So I think this very plain language is a good way to introduce it or listen for it, because most clients will go there without you having to. They’ll use language like that. I remember one of the very first clients I worked with in county level drug and alcohol treatment at the beginning of my career. She plopped down in the office for her first assessment. She was sent there by the court. And she said Jamie the whole way here, I was debating in my head, do I tell you the truth? Or do I tell you what I know you want to hear so I can get out of this. And I applauded her honesty and candidness. But obviously there we started a dialogue that was very parts and form. So listen for your clients, and you’ll probably get a jumping off place. I will say for a lot of people with dissociative identities, which is a term we’re leaning into more now. Instead of dissociative identity disorder, because a lot of us don’t like the disorder part of it. And even like me who’s technically diagnosed with OSDD, or otherwise specified dissociative disorder, I’m one step criteria and away from having DID. But I definitely have a distinguished system. I have a team. So it’s very relevant for me to say I have dissociative identities. Most of us, once we start having this dialogue that I just referenced with you, will likely say things like I’ve just always been this way. Or I’ve always kind of felt like there’s many me’s on board with me. And they might be more easily inclined to already have names established for them. Like I remember one client once who said, Oh, yeah, there’s little me and there’s me. And she had used this terminology years before she even came into therapy. But she was grateful that I was not looking at her like she had 10 heads for thinking in those terms. So I mean, that’s a very just general piece of guidance I can give folks. And for people who really want to see it in writing, of course you can give a DES or a MID which I’m not the biggest fan of, or there’s other structural dissociation inventories that you can give. The SSCID I think is another one. And I discussed these in the book or they can be looked up online. So if you really want to have it more in black and white, those inventories are there. But what I presented with you is more of the generalities. And the cat is obviously weighing in on her opinion here, I don’t know if she’s coming.
Katie Vernoy 25:18
So we’ve talked about kind of what therapists can do wrong. And so if we’ve got someone that has dissociative systems, dissociative identities, a team, however, they kind of frame it and understand it. What are the clinical goals? Obviously, it’s this is a very broad question. And I know a lot of it depends. But what are some best practices to consider when someone’s coming in? And this is something that is of concern to them or something that they’ve not been able to navigate as successfully as they would like to?
Dr. Jamie Marich 25:50
Well, I think like any good therapy, we really have to make that a client centered question: What do you want to get out of coming here? And if you know you’re working with a system, you have to acknowledge that the different parts of that system may have different goals for therapy. So knowing what all of those are, can become very important. And to know that, for many people with dissociative systems, there is like a more driving presenting core or host. You do have cases of dissociative systems where there’s not one, where it’s just kind of a pure constellation of parts. And so there, you really have to be more finessed to the idea that different parts may have different goals. And to quote Debbie Korn, who’s one of my EMDR mentors who’s interviewed in the book, you really are doing family therapy with everybody. And I like that, once you know you’re working with a system. And I think the goals for working with dissociative identities or complex trauma where dissociation is heavily a feature, because a lot of folks I talked to for the book identified more that way CPTSD with just a lot of dissociation. You’re obviously going into what are my goals for more stabilization and grounding? And then do I have goals for actually kind of getting to the root of this and healing a lot of what has caused this? And a fun fact about grounding, because if you look at a lot of the literature that’s out there on dissociative identities and dissociative disorders, like there’s a new book by Bethany Brand and her team called ‘Finding Solid Ground,’ and we always talk about grounding, grounding, grounding. And a few of the contributors I talked to for the book said “I just hate that word.” And I’m like, please tell me more. Because as therapists we talk about grounding ad nauseam. And one contributor especially said, it makes me feel punished. And so I like the word anchoring. Cool. Another contributor likes the word settling. So I think I’ve said this, even on this podcast before that part of being trauma informed is realizing language is always variable. So I think that’s the first place we have to start is getting a working definition of what it might mean to ground or anchor or to reasonably stay in the present, so that you can meet what your goals are for interacting with life. And then the bigger part of this question, I shouldn’t say the bigger but it’s the one that’s certainly more controversial is What does treatment quote unquote, for dissociative disorders look like? Because part of the old school thinking was it had to be a pure integration, bring the parts into one cohesive alloy. And for most people in the dissociative identities community, integration is a dirty word. So even when I talk about like Dan Siegel’s, integrating the three brains type of idea, I have to say he doesn’t mean integration, like in that sense. Because there’s just been so much forced integration, or therapists operating with this idea that to truly function in life, you have to be more integrated. And that’s just not true. Many of us have leaned more into a construct like cohesion, communication, cooperation, some of us will say, Yeah, I have a system. It’s not as differentiated as it used to be. Meaning we have more communication with each other. And I would say that is the gold standard for most people I know. And most people I’ve treated and most people I’ve talked to, for this book, in the dissociative disorders community, there were two folks I talked to who do believe they had pure integration in the old school sense. And I’m like, I don’t want to erase your experiences, either. Like, tell me what that was like for you and how that works for you. And so I think all of this goes back to just good clinical basics, which is any goals that are developed in the therapy room have to be a collaboration between client and clinician where the client leads. As opposed to well, here’s my treatment plan for you because I learned it at a workshop.
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Katie Vernoy 29:42
I think that the other thing I’m assuming, and I want to test this assumption is that much of dissociation, if not most of dissociation, or all of dissociation is a trauma response. Is that too simple?
Dr. Jamie Marich 29:57
I don’t think so. If we understand the broader definition of trauma.
Katie Vernoy 30:01
Okay.
Dr. Jamie Marich 30:02
Which is that trauma’s wound, and it may or may not qualify you for a PTSD diagnosis. I mean, I think one of the antiquated ideas I got in graduate school was to truly develop dissociative identity disorder, the level of trauma you had to experience would have had to be at the level of like ritual satanic abuse.
Katie Vernoy 30:22
That’s what I learned as well.
Dr. Jamie Marich 30:23
And I want to be clear, and I say this in the book, I’m not negating those experiences, either. Because a lot of people, including one contributor, have said that that’s part of their story. And yet, the other side of that is most of us who have developed dissociative identities, yes, there’s some kind of trauma in our upbringing, for sure, usually of a complex variety, but I’ve seen people with all different types of traumatic responses in childhood develop dissociative disorders, or dissociative identities, experiences. And to talk about the correlation or the interplay is a better word between trauma and dissociation, Amy Wagner, who’s one of my contributors, and she runs our dissociative certificate program with ICM. She says if traumas walking in your door dissociations parking the car. That she rarely sees one without the other, like you don’t see one without the other. And that’s something I tried to get people I trained to see as well. If you’re treating trauma in any way, there’s some level of dissociation that’s going along with it.
Curt Widhalm 31:28
And can you tell us a little bit more about your new book?
Dr. Jamie Marich 31:33
Yes. So the new book is called ‘Dissociation Made Simple: a stigma free guide to embracing your dissociative mind and navigating life.’ So I have two other made simple books that are on the market, there is ‘EMDR Made Simple’ and ‘Trauma Made Simple’ from 2011 and 2014. And so this felt like the next natural progression to write a Dissociation Made Simple. But in credit to my publisher, North Atlantic books, they really allowed me and encouraged me to do this as more of a book for the general public, that clinicians could also read and learn from. Whereas my other two made simple books were more for clinicians. So I’m delighted by this book, it’s my favorite thing I’ve ever written. Largely, because even though I did give Jamie more permission to speak, which is why this book is so meaningful to me, Jamie and the members of my team, I also elicited the voices of 61 contributors who came forward through a public call and some people I did invite to participate. And I asked them all the same 10 questions. And those experiences are woven in through the book as well. So 19 People of the contributors have DID, or dissociative identities. another handful additionally have another dissociative disorder. But most people who came forward, identify more in that realm of having PTSD or CPTSD, with intense dissociative experiences connected. So I hope this book shows that talking about dissociation is not just talking about clinical dissociative disorders, that dissociation shows up in any mental health diagnosis. And it shows up in so many different areas of life of society.
Katie Vernoy 33:13
Any other things that we want to make sure that our listeners take away before we sign off?
Dr. Jamie Marich 33:20
If you don’t think you dissociate, you do.
Katie Vernoy 33:25
Well, I know I do. So I’m not one of…
Dr. Jamie Marich 33:29
The one I have to convince. But I say that jokingly yet seriously, because so many clinicians who I’ve interfaced with have very much of an us versus them attitude towards it. That this is something quote unquote, intense trauma survivors experience or it’s something that really has to be treated. And I’ve long taught and Curt knows this from following my work for a long time that the key for us really taking away our fear on dissociation is recognizing where it shows up in us and how it’s developed in us and what we do it in response to. So that’s my parting word.
Katie Vernoy 34:04
I just want to reflect on that. Because I feel like that’s really important. And my takeaway from this conversation is that there are adaptive reasons and functions of dissociation. And I certainly experienced that in an acute state of grief. But you know, like, for me, it’s been something where I now have lived experience, I guess that feels more relevant to this. And I think it’s something where, if folks can recognize that dissociation is a tool in our tool belt that sometimes is adaptive, sometimes isn’t and accept it and embrace it a little bit. I think not only is it us versus them, but I’m also I’ve also seen it, almost a laziness or a or a failure or something when you dissociate. It’s like: Well, no no no, this is your body, your system, whatever protecting itself or giving itself some space. And so to me, I feel like just the way in which you’ve talked about it. It’s been very helpful for me personally, but also I think it helps to think about it is just one of the tools that overused might become maladaptive or used in the wrong situation may be maladaptive. But is it valid tool that I think we all use and need to have more understanding about.
Dr. Jamie Marich 35:13
I’m really glad you put that out there, that people who dissociate are lazy or that it is inherently this flaw.
Katie Vernoy 35:20
Yeah.
Dr. Jamie Marich 35:20
And that’s just not the case.
Katie Vernoy 35:23
No.
Dr. Jamie Marich 35:23
I would argue that people who don’t leverage dissociation may have more problems than those of us who do. You could read more, if that interests you.
Katie Vernoy 35:32
I love it. I love it.
Curt Widhalm 35:34
Where can people find out more about you and all of the various projects that you put together?
Dr. Jamie Marich 35:40
Sure. Well, as it relates to what we’ve been talking about today, we have a new website set up www.redefinetherapy.com.
Katie Vernoy 35:49
Nice.
Dr. Jamie Marich 35:50
It’s a hashtag I’ve used for a lot of years since 2014. Redefine therapy. It’s very similar with your mission. I don’t know what it’s going to become yet fully as a website, but we have it set up now is like the book tour website, the virtual book tour and book resources. So yeah, I’ll direct folks there most prominently www.redefinetherapy.com. You can look up myname.com or InstituteforCreativeMindfulness.com as well, which is our training company. And you’ll find me on social media. If you search the name, I will show up.
Katie Vernoy 36:21
And I just want to say that I’m loving your trauma therapist rants. That’s something…
Dr. Jamie Marich 36:25
Oh, thank you.
Katie Vernoy 36:26
…I look forward to whenever you put them out because they are just so so resonant. And…
Dr. Jamie Marich 36:33
Thank you for reminding me about that. Yes, on Instagram and Tiktok, both at TraumaTherapistRants. That was also a hashtag I started using a while ago and I decided to turn it into its own handle. So I will say trauma therapist rants is definitely more Jamie’s voice, uncensored. This field is full of a bunch of… and I want to start calling it out. And I don’t care what people think anymore. So thank you for mentioning trauma therapist rants, I appreciate that.
Curt Widhalm 36:38
And we will include links to all of the stuff that Jamie is mentioning here in our show notes. You can find those over at mtsgpodcast.com. And if you want to support our show, please consider becoming a patron or supporting us on Buy Me a Coffee. You can also find those links in our show notes. And until next time, I’m Curt Widhalm with Katie Vernoy and Dr. Jamie Marich.
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