This post is to encourage the development of self-soothing skills. It is not psychiatric advice, as I am retired, no longer have patients, and cannot give therapeutic counsel. I am posting these thoughts and recommendations based on approaches I took with some of my patients that had positive results. If you do not have a therapist at the moment, please make sure that you remain safe as you consider or try developing self-soothing skills. If these seem like they might be helpful to you, and you do have a therapist, please discuss them with your therapist before trying any of them.
I have posted this because it is common knowledge that there is a dire unmet need for competent DID therapists. This is true all over the world. Even if one gets past the barrier of being able to find a therapist who acknowledges the validity of DID as a diagnosis in accordance with the DSM, one still has to find a therapist within that group who is willing to work with DID patients, and who has the time as well as the training to do so. These obstacles can sometimes appear to be insurmountable, at least in the short term.
The clear problem facing DID individuals then is what to do in terms of self-care if circumstances dictate a long waiting period to find a therapist. However, we can start with the understanding that even in therapy, self-soothing techniques are complementary to basic one-on-one psychotherapy. Just as Olympic athletes in training need to do daily weight-lifting and stretching exercise routines, self-soothing practices should be part of the routine for DID individuals.
The fundamental point of any self-soothing practice is learning to be kind to yourself. In general, DID individuals are in conflict and pain – often both internally and externally. They generally experience being trapped in a haze of confusion, sometimes with and sometimes without an ongoing conscious awareness of their DID circumstances. They are struggling with the consequence of dissociation. This can show up in the conflicts between the host and some alters, between alters, and with others they encounter in society. There is the ongoing suffering from the pain of early childhood trauma, whether it was physical and/or sexual assault or lack of emotional attachment to the primary care taker.
With DID, just as with any other form of PTSD, one is easily triggered into flashbacks. In a flashback, your body is behaving out of the host’s control. On an ongoing basis, there is likely an accompanying self-destructive behaviour such as substance abuse, eating disorders, and/or attacking one’s own body.
Substance abuse is related to taking a short-cut, using chemicals for self-soothing as are eating disorders. Repeating self-destructive behaviors has a similar impact and consequence. Unfortunately, these do not fundamentally do anything for your healing. It simply provides a short term impact that creates an ever increasing need for more of whatever substance or conduct is being abused. Relying on this kind of external and negative source of comfort falls short of processing the basic trauma, because it does not empower you.
Without processing the trauma and gaining the self-empowerment that goes along with that processing, one continues to feel empty, weak and passive. There is a loss of personal power, or dis-empowerment, that began with the original early abuse. DID has that component of PTSD which robs the individual of his or her innate basic confidence because the nature of abuse-based dis-empowerment trains you to believe that you will always to be a victim, no matter what. This fundamental dis-empowerment needs to be exposed for the lie that it is, a lie told by abusers to further subjugate the abused.
The basic therapeutic approach to correct this destructive imprint involves re-empowering the DID individual. Positive conduct that promotes the personal power and confidence of someone with DID would be a most beneficial adjunct to the therapeutic goal of processing the trauma.
Is there some basic principle to follow? The answer is yes; definitely yes. Learn to make friends with yourself. This is not a platitude, it is an actual thing to practice. You must learn to be kind to all the parts. That can only happen when you are open to understanding why the different parts may seem to have competing attitudes, agendas, and demands.
Do practices that strengthen the system as a whole. You are all in that one body together so stay connected and learn to function as a team. Visualize you are like an Olympic team with a distinct common goal in mind. As an Olympic team, you have a target and a purpose, which is to score goals. The target and goal here is to be kind to each other.