Therapists aiming to deal with patient’s adverse experiences in childhood sometimes attempt to offer corrective experiences to reverse the damage. In trying to describe that approach, the term “re-parenting” is often used to describe what therapists are trying to do. The methods used are quite diverse. The language used in doing this work is often metaphorical, but there are also therapists whose methods may include physical contact of some sort.

I will say from the outset, as I have written in my blog and books, that my view is that “…If a parent has abused their child, they no longer qualify to be defined or treated as a parent.” https://www.engagingmultiples.com/christianity-forgiveness-part-2/

Nevertheless, it is easy to see a therapist taking on the role of a pseudo-parent in the sense of paying warm non-judgmental attention to their patient. It can be akin to the way a kind parent would listen to the difficulties of their child, and reassure them of their basic safety. In DID therapy, this can certainly happen while engaging with a young alter. It does not extend to the physical comforting one might expect from a loving parent.

An actual kind parent would likely hold their child physically close as part of the comforting dynamic. As the child ages, the physical comforting generally happens less and less, as the child/teen/adult grows capable of processing difficulties and being comforted without the need for the close physical contact an infant/toddler may need. I refer to a therapist taking this approach as a pseudo-parent because they are simply not a parent. They need to be kind, compassionate and insightful, but they do not have the rights, status or definition of a parent. They need to maintain therapeutic boundaries so as to maintain clarity in the relationship between therapist and patient.

One can use the sense of touch in therapy by encouraging the patient to use their own hands on their belly to feel the weight and movement as they breathe. I am aware of some therapists who encourage their patients to put rubber bands on their wrists and snap them a bit to help ground them. I prefer the weight of one’s own hands on the belly as a safer approach that is as far away from self-harm as possible.

I believe there is a severe risk of boundary issues arising in the context of physical contact between therapist and patient, even, potentially, by shaking hands with the patient. Any such contact must be extremely limited and geared to avoid the boundary issues. As I have said elsewhere, on very rare occasions when a patient’s young alter needed physical contact to ground themselves when a difficult memory arose during therapy, I used a large couch bolster as the intermediary. I pushed against it from one side while the other side was touching my patient.

In this way, the patient experienced the grounding aspect of the sense of touch without any direct contact. I used a bolster rather than a pillow due to its larger size and stiffer quality. This limited the patient’s perception to a grounding sensation of touch without experiencing the sensation as if it came from a hand.

The through-line of this is that by remaining fully present with warm deep listening, a therapist can open the possibility for the patient to be guided in reclaiming their own sense of agency. This agency is critical. It is also the goal of proper parenting – to enable one’s child to become a full complete human being with agency as well as proper boundaries when engaging the world. With time and healing, this can enable the patient, on their own, to access the safety of the present moment rather than remaining trapped in a re-traumatizing flashback – just as a proper parent would wish. Such guidance requires kindness, compassion and empathy, coupled and capped with psycho-therapeutic insight.

There are other therapists who take a different approach. While they do seek to provide care and nurturing, rather than listening in a non-judgmental way to enable the patient to re-learn the experience of safety, without proper boundaries they insert themselves but as if they are an actual parent who will provide the missed nurturing. In lieu of applying psycho-therapeutic insight to guide the patient to distinguish the flashback cycle of re-traumatization from the safety of the present moment, they take on that parental role, blurring the boundaries of the therapist-patient relationship.

This ignores the fact that one cannot change the past. One can therapeutically intervene to interrupt the complex PTSD flashback cycle, but one cannot erase the past. The goal is healing, it is to step beyond triggering flashbacks so as to enable the patient to live safely in the present circumstance. Creating a false parental relationship with goal of an alternative parent/child dynamic is, in my opinion, a dangerous path.

This blurring of roles may show up in a patient’s desire for continual accessibility of the therapist, just as a child desires continual accessibility of a parent. It sets up a dynamic that will eventually, sometimes sooner and sometimes later, fail. The therapist will at some point demand space for their own life, which the patient will, understandably in light of their past trauma, experience as abandonment by the therapist that has allowed the blurring of therapeutic and parental roles. Without the appropriate boundaries, therapy itself can set up this kind of re-traumatizing experience.

I have seen comments in DID social media where patients feel abandoned if a therapist fails to return a text or email in what the patient deems an appropriate time frame. From the patient’s point of view, per the re-parenting therapist, a “good” parent, would be there to speak to their child. This boundary issue is not the fault of the patient. It is the failure of the therapist to establish clear boundaries from the outset. Further, if the therapist has established with the patient that emails, texts and phone calls are not a problem, then the therapist has truly invited that that risk of the re-traumatizing experience of abandonment for the patient.

In treating some of my DID patients, I have seen infant/young toddler alters seeking parental style comforting. Therapists need to understand that one can give the needed comforting without undermining therapeutic relationship boundaries, but not if the therapist gets their own psychological reward from responding as if they were the actual parent.

Re-parenting is ill-defined in the therapeutic context. While it can be seen as one way of engaging with this need, it is a broad term covering many possible approaches. While any individual therapist’s definition of it may indeed be helpful in a given specific situation, concretized re-parenting should not be seen as a generally applicable approach. I would discourage any therapist from concretizing a re-parenting relationship in therapy – particularly when treating a patient with DID. The risk of re-traumatizing one or more alters is too great.

In addition to the risk of re-traumatizing the patient, there is the risk of the therapist’s own potentially confused parental dynamic, with their own parent or child, being pushed onto the patient. There is the risk that the therapist will use the re-parenting dynamic with their patient to work out their own parenting issues. This is inappropriate ethically, and dangerous to all involved.