Inviting Alters to Therapy

A reader asked about working with alters that were afraid to present themselves authentically in therapy, even though at least some of them viewed their therapist as amazing. It seems that because they were fearful and wanted to remain safe, they were prevented from presenting by what was likely a protector. At least part of the system was afraid of “losing control.” It seems that there was at least one part that “filled with rage and seems to need to come out but can’t.”

Internal conflicts like this a common phenomenon. With any such internal conflict, it is important to respect all the participants and, with that respect, to engage their different perspectives. Using the 5% rule as an approach may give some level of comfort to the protector that things will not get out of hand (https://www.engagingmultiples.com/the-5-rule/). That same approach may allow for an alter that is enraged to express a small piece of anger at a time and feel safer doing it that way.

The healing journey is actually quicker and deeper when one goes small step by small step. Anything more runs the risk of retraumatization. The protector is likely aware of and concerned about the risk of potential betrayal and/or abandonment. The risk of retraumatization is something perhaps the protector is also aware of and concerned about. Both are important functions of protectors. For healing, creating a path that protects from the retraumatization while allowing for engagement is best.

The second part of the question flowed from the first. It concerned the experience of alters in despair specifically because they would leave therapy sessions feeling that they had not presented truly or as they needed to. The result is that they leave feeling worse than when they came to therapy, feeling once again that they had failed. I think that this is also not an uncommon experience.

Making sure that everyone – all of the alters whether they are presenting externally or not – is invited to listen is an important first step. This can be done at the beginning of each session. Then, at the end of each session, everyone should definitely be thanked for listening, whether they actively participated out loud or not.

It is important to acknowledge the bravery of alters that are willing to show up even if they are as yet unable to express what they need to say. By inviting them at the beginning and always thanking them at the end, you demonstrate your willingness to let them decide if and when they feel safe enough to participate directly. By doing so, you demonstrate your appreciation for their desire to heal.

The act of acknowledging alters is a powerful method of validating them because they have never been acknowledged before. Often, therapists are mistaken in thinking that alters should disappear, because they are seen as something pathological to be eliminated. This is a mistaken view.

This acknowledgment is critical. When a very hostile alter feels acknowledged and understood, something is going to shift. Sometimes it can be like defusing a bomb, and the DID system knows this. Remember, behind anger there is always deep hurt.

When one alter is able to engage in therapy, using the 5% Rule or otherwise, other alters will begin to feel the benefit. As one heals, the others will begin to feel safer and eventually participate in the healing process. It is a rippling effect, which often happens in DID therapy. When an alter presents and wishes to participate directly in therapy, they will do so if they are invited with genuine warmth and empathy.

Many alters will heal by witnessing the therapeutic process of other alters as they go through it. As one alter is healed, others may feel the therapeutic effect. Because of this, each alter does not need separate therapeutic intervention.

So be kind to everyone inside, be patient with them as you engage. With that kindness, with that patience, healing can take place.

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