How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Selah R, M.S. LPC Your Own Question

Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Type Your Mental Health Question Here...
Selah R, M.S. LPC is online now
A new question is answered every 9 seconds

I am a therapist (LPC)for 19 years... Im working with a woman who has DID. She has

Customer Question

I am a therapist (LPC)for 19 years... I'm working with a woman who has DID. She has been through years of therapy in the past, her alters have integrated quite well. I have been seeing her for weight loss using hypnosis. She has felt very safe with me. One of her three known alters has made herself known to me. She has talked to me twice. Her "little girl" alter told me there are others that no one knows about. Only she knows of them, she gave me one of their names. I asked to speak to one and she said they did not want to and went deep, deep inside. So, my question is can an alter have her own alters which the other alters don't know about? My client said she did not know of any others. I only know about DID by what I have read. I feel I need to continue to work with this client because she feels so safe. However, I need to talk to an expert and or do a lot more reading. Any suggestions on reading material?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Selah R, M.S. LPC replied 3 years ago.

Selah R, M.S. LPC :

Thank you for trusting JustAnswer with your important question.

Selah R, M.S. LPC :

Yes it is possible for there to be alters that the main alters do not know about. They can either be alters that split from the little girl alter, and now seem to live inside her; or they can be cut off from the other two alters you've talk to through dissociative barriers. It could be that the rest of the system decided the body would be safer and more functional if those two alters didn't know about the others and the information/memories/emotions they may be holding.

Selah R, M.S. LPC :

I'm not sure what you've read on the subject, so please feel free to tell me what some of the books are you've already got. I can help point you in the direction of a few more.

Selah R, M.S. LPC :

But I've talked with many systems that had strong divisions. Some systems are set up in levels like a house, there they talk about alters being in different areas of awareness based on how high or low they are. Some systems talk about the division being more of a good versus evil, light versus dark side, or safe versus unsafe type terminology. Many times the alters that hold most of the traumatic abuse, and the most volatile emotions, are the ones lumped into the less desirable place/group.

Selah R, M.S. LPC :

I've also seen systems that appear to integrate online to then find the next layer of alters. In that case it's usually reaching a certain level of stability and mental health that allows the internal self helpers to decide that the alters most commonly out are now ready to deal with more information/trauma history/alters. It's a safety mechanism to try to keep from overwhelming or disintegrating/splitting the newly combined alters. It can also be a safety measure to try to prevent overwhelming the counselor and other supportive people whom they might fear would leave if they "knew everything at once."

Selah R, M.S. LPC :

The biggest thing you can do for her right now is to reassure her that you're going to be part of her treatment team as long as possible, and that you will help her find more treatment team members if needed. Some DID clients have so many issues that they really do benefit from having more than one therapist to work on separate issues. Especially when one therapist may need to work on the DID and trauma, while the other may need to stay focused on one particular issues like an eating disorder or substance abuse issue, or another major life skill focus.

Selah R, M.S. LPC :

The main two need to know that the little girl believes there are more alters, and they need to be reassured that their internal landscape and system was created to keep the body and everyone inside safe. No matter how chaotic it might feel for them to face that there might be "others", they need to remember they can survive the process of meeting, hearing/knowing, and merging with those alters too. The journey to recovery never lets us see the entire road at one time. We take each twist and turn in the road with limited information and an obstructed view... but we keep moving forward through the peaks and valleys.

Selah R, M.S. LPC :

Encourage the little girl to create a system map with you. What does the internal "family tree" look like? What does the internal landscape look like? Are there houses or other buildings inside? Is she aware of internal self helpers, historians, or other care takers inside? These alters often seem to be the older (as in created early on in the DID process), and are invaluable in the recovery process. They also tend to be the ones with the most knowledge about what all is really going on inside.

Selah R, M.S. LPC :

You also can start trying to listen to see if these others appear to be fully developed alters, or are they more one-dimensional and temporary, what would be called fragments. Fragments can seem like alters to other insiders, but they are easier to integrate because they don't have as much experience being autonomous as more developed alters.

Selah R, M.S. LPC :

You may want to contact other professionals in your area who have more experience treating DID for a consult. Sidran.org and ISST-D.org both offer directories of professionals who work with complex trauma, dissociation, and DID. Both sites usually also offer education, books, and treatment guidelines to help professionals learn about treating DID and related issues.

Selah R, M.S. LPC :

When using tools like hypnosis or EMDR, it's always critical to get a signed informed consent form from your client. They need to understand the psychological risks of these tools, and that these risks are higher for DID clients. They also need to understand that what they remember while using these tools is often considered "tainted" if they intend to pursue legal action based upon the memory/trauma work. Not many are worried by these risks, but it's still legally and ethically wise for you to get this type of information in a written form they can sign.

Selah R, M.S. LPC :

Sincerely

Selah R, M.S. LPC :

Selah

Customer :

Selah, Thank you so much, you gave me excellent information. The books I just ordered are "Clinical Perspectives on MPD", Kluft; "Treating DID:Power of Collective Heart", Krakauer; and "DID Sourcebook", Haddock; I also thought about getting "Trauma Model Therapy" by Colin Ross. I live in Dallas so I can also go to the Ross Institute for help. Any other suggestions for reading material or comments on the Ross institute. I see you are offline now so I can wait or have another person answer.

Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Selah R, M.S. LPC and other Mental Health Specialists are ready to help you
Expert:  Selah R, M.S. LPC replied 3 years ago.
Those are great books. Also sign up for a visiting professional day at Timberlawn's Trauma program if you're interested. They also offer free CEU Brownbags that are sometimes trauma and dissociation specific. Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders - Paperback (Apr. 16, 1998) by James A. Chu is another one I recommend, but only if you feel like you need additional information on treatment and containment tips after you've read the others (especially the Trauma Model). Some EMDR CEU classes also focus on grounding techniques to use with trauma or DID clients, and these tools can be useful even if you don't do EMDR.

Best wishes,
Selah
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Selah R, M.S. LPC and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
Thank you again. You have been very helpful.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 

Related Mental Health Questions