In his 2010 book, Reconciliation: Healing The Inner Child, Thich Nhat Hanh suggests using mindfulness to listen with compassion to our inner child. This can be very helpful for those patients without DID. In such situations, mindful listening with compassion is something the therapist must model for the patient as they encourage the patient to mindfully listen to their inner child within.

For those without DID, the inner child remains part of our subconscious – an accessible metaphor the patient can themselves use in explaining their difficulties to themselves or to others. For the patient, this approach offers a ray of light that there is a healing possibility based primarily on acknowledging the unmet need.

For Those With DID

For those with DID, there are commonly young child alters. These alters are seen within the DID system internally as children. They can and do express themselves as such when interacting internally within the DID system as well as externally when triggered. Child alters should not be dealt with as if they are metaphorical. Alters are not metaphors. They are an inseparable part of the whole personality system of those with DID.

I agree absolutely in Thich Nhat Hanh’s recommendation for using mindfulness to listen with compassion, but it is mindfulness on the part of the therapist that is key. It is the therapist’s exercise of mindfulness, not the patient’s, that is critical to establish the foundation of a proper therapeutic alliance and to guide progress in therapy. Beware therapists who place the burden of mindfulness on their patients rather than on themselves.

Meaning no disrespect to Thich Nhat Hanh, meditation is not therapy. Thich Nhat Hanh’s meditation experience was extraordinary, mine is definitely not. But, while meditation can be helpful in supporting therapeutic work in non-DID patients, there are risks to encouraging meditation in DID patients. As a result of having seen major difficulties for individuals with DID who had been strongly encouraged to do mindfulness meditation, I posted on my blog some of these risks, along with some recommendations: https://www.engagingmultiples.com/mindfulness-meditation-and-did/

In those with DID, why would introducing mindfulness meditation be a problem? Why is there such a grave risk? It is because one needs to understand the potential re-traumatization risks for someone with DID.

For those with DID who have yet to resolve their internal negative dynamics, beginning a mindfulness practice creates an open space, a flash of quiet. However brief that flash may be, it can open the floodgates to many if not all the alters simultaneously. These alters, with different traumatic memories, can clash violently with each other as they, all at once, clamor for attention – demanding to occupy and express themselves in that open space.

DID patients do not experience alters as metaphors. Alters are not something to be analogized or otherwise manipulated. They are not a conceptual tool to clarify unmet needs. They are the potent and therapeutically accessible result of incredibly horrific trauma. This kind of inner child, when triggered, has little to no choice in whether or not they erupt out. If the therapist tells the alter erupting out that they are merely a metaphor, that they don’t exist this will destroy any therapeutic alliance that may or might have been established. The direct result is that the therapist will be unable to help such alters interrupt the re-traumatization cycle the therapist has just triggered.

In urging mindfulness practice on a patient, the therapist may be creating the opportunity for triggering that patient to re-experiencing old traumas that are not ready to be processed. Why? Because alters re-experience their trauma of abuse, of those “unmet needs”, directly when they are re-traumatized, not at a distance of any kind. Re-experiencing trauma is not conceptual. It cuts the patient off from any sense of the safety of the present moment and isolates them into the past triggered trauma.

Again, for those with DID, an alter is not a metaphorical. An atler inner child is crystallized, concretized and anchored in their trauma. At the same time, he/she is an inseparable part of the whole personality system of your DID client. For the patient, the inner child alter exists, and is experienced as just as real as the child living in the house next door. Alters perceive themselves and behave as if they are real individuals, and should be treated as such during therapy. The therapists who question their authenticity, or are afraid to speak to them as individuals, are doing more harm than good in a therapeutic relationship.