abandonment, fear of 7, 12, 27, 109–11, 142, 179–80, 182, 190–1, 232–3
acting in 67
acting out 67
adaptation of body and mind 2, 67–69
adaptive projective identification 258
addictive behavior 111; associated with trauma 127; neurobiological basis for 13; producing relief 131–2, 136–7; as symptom for internal splitting 29–31
Adult Attachment Inventory 17
aggression and therapist working with 179–80
alienation from self 5, 7, 15, 66–67, 75, 77, 100, 142, 213; avoiding 254–6
amygdala: activated 36–37, 45, 51; and mindfulness 78; in survival response 34–35
animal defense responses 25, 68, 136
anorexia 131
ashamed part 80, 84–88, 91, 142, 189–93
attachment 16–17; building bonds 206; to caregiver becoming frightening 105–9; continuous secure 249, 250, 257; controlling strategies 107, 132–3; cultivating internal 228–31; disorganized 103, 105–8, 115–16, 179–80, 191; manifestations of 113–15; recontextualizing 110–12; drive 65; earned secure 13, 16, 17, 63, 77, 104–5, 241, 242–60; fears of internal 209–13; formation as a child 55–56; internal 209–10, 228–31, 259–60, 269–70; remembering early 104–5; repairing internal attachment relationships 213–16, 259–60, 269–70; secure 15, 198–9, 206, 228–31; developing 239–41; intergenerational legacy of 250–3; mother resonating to baby 237–8; as a somatic and emotional experience 253–5; seeking part 70; and self-destructive behavior 132–3; traumatic 5–6, 12–13, 103–24; Type D, 105
attachment figures: conflicting proximate-seeking drive and fight and flight responses 24, 132–3; creating secure attachment 198–9; as source of danger 105–9
attach part 78, 87–88, 109–11, 132–3, 175, 179–80; relationship with the fight part 115–16; and transferences 112
attunement 10, 216, 227, 231, 238–40, 253–4, 257–9; with child and caregiver 198–9
autobiographical memory 104
autonomic arousal 131; dysregulation 136–7; regulating 228–9
auto-regulation 104
baby: attaching to mother 103, 258; dialoguing with mother 121–2; mother resonating to 237–8; reacting to frightening attachment figure 105–6
befriending one’s parts 74–75, 100–1
Benjamin, Jessica 107
Bessel van der Kolk’s Trauma Center 1, 6, 7
blending with one’s parts 12, 55, 82–83, 158–9, 168, 190–4, 254; automatic 91; and reality-testing 90
body: adapting to trauma 2; helping to form attachment bonds 206; as a shared whole 61–62; use of to gain relief 130, 135–7
borderline personality disorder 8, 26, 67, 106, 146; confused with disorganized attachment 116
brain: holding multiple states of consciousness 44–45; left hemisphere 15, 36–37, 44, 168, 224–6, 250–1, 260; negativity bias 37; response to traumatic memory 36–37; right hemisphere 4, 15, 44, 224–6, 250–1, 260; split of right hemisphere and left hemisphere 4–5, 9, 22–24, 67–68
breathing space 9
caregiver. See also parent: co-regulation with child 198–9; as source of danger 105–9
child: becoming fragmented 19–20; brain development and dominance 23; co-regulation with caregiver 198–9; rupture and repair 227–9, 259–60; survival responses to frightening attachment figures 105–6
child part 8, 12, 28, 38–39, 46, 48–50, 52–54; “bad child” 5, 19–20, 60–61; building impulses to care 235; communicating compassion toward 229–31; communicating with 231–5; creating safe places for in normal adult life 245–8; developing emotional connection with 206–9; and emotions 128; empathy for 60–61, 84–85, 227, 230–1, 243, 269; “good child” 19–20; hearing 259–60; listening to and responding to 195–7; normal life part bonding with 3, 201–3, 221–3; sensing 15–17, 214; taking under one’s wing 203–6; using other parts to take care of 200–1
client: changing role of 42–64; overcompliance 234
coherence 249; narrative 249–50
compartmentalization. See dissociative compartmentalization
compassion, self 2, 12, 77–78, 94
conditioned learning, overcoming 162–3
consciousness: continuous 163; overcoming gaps in 168–70
continuous consciousness 163
continuous secure attachment 249, 250, 257
controlling attachment strategies 107, 132–3
controlling-caretaking behavior 107, 132
controlling-punitive behavior 107, 132
corpus callosum 23
cortisol release 35
curiosity about one’s self 71–72, 78, 80, 159, 203, 219, 259, 266, 270
damage limitation strategy 193
depersonalization 148
depression 5, 20, 27, 31, 35, 42, 142
derealization 148
Dialectical Behavior Therapy (DBT) 136
directed mindfulness 78
disorganized attachment 103, 105–8, 115–16, 179–80, 191; manifestations of 113–15; recontextualizing 110–12; status 24
disowning the other one 21–22, 66, 67, 254
dissociative amnesia 148
dissociative compartmentalization 19–26, 67, 163–4, 166–7. See also dissociative fragmentation; dissociative splitting; healing 244–5, 248–9
dissociative disorder not otherwise specified (DDNOS) 26, 67
dissociative disorders 14–15, 22; assessment tools for 150–1; diagnosing 148–9; disputed 145–6; knowing when to make the diagnosis 149–50; underdiagnosed 69
Dissociative Experiences Log 17, 170, 271
Dissociative Experiences Scale 151
dissociative fragmentation 4–7, 9. See also dissociative compartmentalization; dissociative splitting; by abused children 19–20; biological basis of 22–26; disowning of 21–22, 66, 67, 254; recognizing signs of 26–27; symptoms of 27–32
dissociative fugue 148
dissociative identity disorder (DID) 8, 26, 67, 83; disputed 145–6; recognizing 146–8; underdiagnosed 69
dissociative splitting 2, 3, 9, 24, 67–68. See also dissociative compartmentalization; dissociative fragmentation; denial of 21–22; as a mental ability 244–5; symptoms of 27; trauma related 2, 3
Dorahy, M. J. 148
dorsal vagal system 131
dual awareness 91, 95, 163, 178, 196, 198, 206; as approach to treatment 44–45; maintaining 227–8; and mindfulness 78–81, 85, 260
dyadic dancing of therapist and client 121–4
earned secure attachment 13, 16, 17, 63, 77, 104–5, 241–60; and trauma resolution 256–8
earned security 17
eating disorders 111, 131–2; development during puberty 134; neurobiological basis for 13
emotional resonance 10, 229, 237–8, 250–1, 254
emotions: mastering unbearable 128–30; self-regulating 128; as threatening 128
empathy for one’s parts 60–61, 84–85, 227, 230–1, 243, 269
endorphin 130
erotic transference 110
expectancies developed by babies 105
experience, recreating sense of 206–9
explicit memories 38; acknowledging 47–48
eye contact 104
Eye Movement Desensitization (EMDR) 79
false self 5, 25; challenging 223–6
fight part 8, 13, 25, 29, 47, 65, 70, 78, 81, 122–3, 191; acknowledging 138–41; and aggression 179–80; creating alliance with 113–15; creating new purpose and mission 237–41; development during puberty 134; and internal distrust 235; relationship with the attach part 87–88, 115–16
flight part 12–13, 29, 35, 68–70, 73–74, 111–12, 122–3, 133; acknowledging 138–9; creating new purpose and mission 237–41; development during puberty 134; and internal distrust 235; and transferences 112
flow charting one’s parts 85–88
Four Befriending Questions 18, 202, 209, 215, 231–5, 272
fragmentation. See dissociative fragmentation
free-associate 56
freeze part 35, 71, 73, 98, 121, 124, 133, 143, 258; and transferences 112
fright without solution 105
fugue episodes 148
Gazzaniga, M. S. 168
going on with normal life part 35, 68–69, 81, 88, 110, 111; accepting dysregulated parts 254–6; bonding with child part 221–3; communicating compassion with child parts 229–31; connecting with 98–100; engaging prefrontal cortex 157; increasing its presence 172–4; supporting 248–9; therapist acknowledging 187–90; working with the other parts 123–4, 157–9, 181–2, 201–3, 215
Grigsby, J. 36
healing, objective nature of 2–3
healing story 250
Herman, Judith 6
Hesse, E. 105
hijacking, dissociative 26, 27, 54, 71, 84, 111, 139, 154, 158, 162, 189–90
hippocampus 36
hospitality being provided to self 95
hypervigilance 6, 9, 16, 20, 24, 27, 35, 42, 128, 187, 228
hypothalamus in survival response 35
identity alteration 148
identity confusion 148
implicit memories 21, 38, 73, 104, 110, 136; acknowledging 47–48; evoking in therapy 43; fearing 127–8; linked to triggers 242–3, 269
indecision as symptom for internal splitting 28–29
infant. See baby
inner child. See child
insta-blending 91
integration: definition 242–3; of self 16, 21, 104, 142–3, 187–94
interactive regulation 104
internal attachment. See also attachment: cultivating 228–31; fears and phobias of 209–13; repairing 213–16, 259–60, 269–70
internal dialogue 163, 168, 177, 214, 219, 228–9; communicating compassion with child parts 229–31; establishing 226–7; and Four Befriending Questions 231–5
Internal Dialogue Technique 17, 142, 266–8
internal distrust and fear 235–7
Internal Family Systems (IFS) 8, 22, 73, 79–80, 136–7, 182, 228; blending of parts 81–82; concept of self 97
internal splitting. See dissociative splitting
Kurtz, Ron 220
language of parts 8, 10–11, 22, 71–72, 97–98, 117, 119–20, 177
left hemisphere of brain 36–37, 44; in dissociative disorders 15; establishing retrospective consciousness 168; focusing on daily tasks 4; functions of 224–6; and resolving trauma 260; and secure attachment 250–1; split from right hemisphere 4–5, 9, 22–24, 67–68
Main, M. 105
meaning-making 51, 74, 96; versus differentiating observation 81
medial prefrontal cortex 44–45
Meditation Circle for Parts 231–2, 264–5
Meichenbaum, Donald 81
memory 9; acknowledging explicit and implicit 47–48; autobiographical 104; brain’s response to 36–37; creating neurobiological regulating environment to experience 48; disclosure 154–5; emotional 104; explicit 38; implicit 21, 38, 73, 104, 110, 136, 242–3, 269; issues as symptom for internal splitting 29; pathogenic kernels of 45–47; processing 10, 63–64, 90–91, 219–23; recalling traumatic 20; role of 221–3; spontaneous recall of 20; transforming 40, 63–64
mindfulness 44, 77, 177, 196, 216, 264–5; approach 8–11, 14, 16; directed 78; externalized 85–90; for treating trauma 78–81
mindful witnessing 155
missing time 148, 160–1, 169–70
moment-to-moment experiences 159–60, 252–3
mother. See also caregiver; parent: attachment with infant 258; dialoguing with infant 121–2; resonating to baby 237–8
movement intervention in therapy 61–62
multi-consciousness 10, 22; approach to treatment 44–45
multiple personality disorder 145
multiplicity 22
Myers, Charles 25
narrative expression 155
narrative of past chronological events in therapy 20–21, 43, 46
negativity bias of the brain 37
nervous system 25; autonomic adapting to trauma 9–10; dysregulated 56, 72–73, 105; and mindfulness 78; somatic interventions to regulate 203
neurobiological regulation by therapist 55–59
Nijenhuis, Ellert 4, 24, 45, 107
normal life part. See going on with normal life part
observation versus meaning-making 81
oppositional-defiant disorder 106
organicity 182
over-eating 131
parasympathetic dorsal vagal system 105
parasympathetic nervous system in survival response 35
parent. See also mother: dependence on 65; regulating child’s nervous system by soothing 55–56
parts: acceptance and attunement with 257–8; accepting dysregulated parts 254–6; acknowledging/integrating 16, 21, 104, 142–3, 187–94; acknowledging self-destructive ones 138–41; approach to treatment 44–45; ashamed 189–93; autonomous functioning of 154–6; awareness of by the therapist 116; befriending one’s parts 74–75, 100–1; blending with one’s 12, 55, 82–83, 90–91, 158–9, 168, 190–4, 254; communicating with 231–5, 254–6; conflicting flight and attach part impacting therapy 110–12; creating new purpose and mission for 237–41; decoding their activity 159–60; developing emotional connection with child part 206–9; disidentifying from trauma parts 197–200; empathy for 60–61, 84–85, 227, 230–1, 243, 269; expressing worry 226–7; giving a voice to 269–70; host providing hospitality 95; identify and understanding 31–32, 60–61, 65–75; interest in 78–81; internal struggles between parts 73–74; lack of conscious awareness of 165–6; language of 8, 10–11, 22, 71–72, 97–98, 117, 119–20, 177; normal life part working with other parts 157–9, 181–2; not judging 170–1; observing 78–81; paradigm 11–12, 22; providing information about present to 174–7; recognizing signs of their presence 72–73; and relationship to present life 96–97; restoring order to 156–7; seeing them 85–90; shifting of parts 81–83; soothing to prevent triggering other parts 141–2; switching 83–84, 164, 169; therapist avoiding working with only one part 120–1; therapist coaching 171–2; therapist listening for 116–18; transferences of during therapy 112–13; triggering other parts 141–2; unblending with one’s 12, 14, 17, 74, 87, 91–95, 159, 168, 178, 197–200; five steps to 263
past: acknowledging 39–40, 47–48; connecting with the present 160–2, 227; differentiating past from present 49–50; reorganizing relationship to the past 220–1; talking about and reliving 20–21, 43, 46
pathogenic kernels of memory 45–47
Pat Ogden’s Sensorimotor Psychotherapy Institute 7
personality: fragmentation 19–32; trauma-related parts of 25, 68–69, 98–99; uni-consciousness vs. multi-consciousness of 10
Phase-Oriented Treatment Model 44, 47
phobia of therapy and the therapists 107–9
post-traumatic stress disorder. See PTSD (post-traumatic stress disorder)
prefrontal cortex 49, 50, 51, 54, 72, 73, 84, 203; development by early attachment 104; and the going on with normal life part 157; inhibition of 162; and mindfulness 78
present: being in the present 39–40; connecting with the past 227; linking to the past 160–2
procedurally learned attachment 104
process memory 10, 63–64, 90–91, 219–23
protector part 189, 235–7; creating new purpose and mission 237–41
proximity seeking attachment behavior 24, 65, 179–80; conflicted with safety 105–9, 132–3
psychoeducation 54–55, 94, 119, 177, 235; on self-destructive behavior 129–30
psychopharmacological medications: non-response as symptom for internal splitting 28
psychotic-like symptoms 148
psychotic transference 110
PTSD (post-traumatic stress disorder) 8, 50, 67
readiness for potential danger 35
reality-testing 38; and blending of one’s parts 90
re-enactment behavior 36
regression: experiences 148; as symptom for internal splitting 28; therapist working with 179–80
regulation: auto 104; autonomic dysregulation 136–7; co-regulation with child and caregiver 198–9; interactive 104; neurobiological regulation by therapist 55–59; self-regulating emotions 128
remembering: actions and reactions 38–39; rendering one speechless 51–52; uninvited 37–38
reparative experiences 231
resonance, emotional 10, 229, 237–8, 250–1, 254
retrospective consciousness, establishing 167–8
right hemisphere of brain 44; in dissociative disorders 15; functions of 224–6; and resolving trauma 260; and secure attachment 250–1; split from left hemisphere 4–5, 9, 22–24, 67–68; in survival mode 4
rupture and repair 227–9, 259–60, 269–70
safety: conflicted with proximity 105–9, 132–3; creating sense of 199–200; discussion by therapist 122–3
secure attachment 15, 198–9, 206; cultivating 228–31; developing 239–41; earned 13, 16, 17, 63, 77, 104–5, 249–50; intergenerational legacy of 250–3, 256; mother resonating to baby 237–8; as a somatic and emotional experience 253–5
self: acceptance of multiple parts 74–75; alienation from 5, 7, 15, 66–67, 75, 77, 100, 142, 213; challenging false self 223–6; compassion for 2, 12, 77–78, 94; concept of 8, 97; embracing 187–216; false 5; false and true 25; healing 182–3; as a host providing hospitality 95; managing 136–7
self-compassion 2, 12, 77–78, 94
self-defeating stories 74, 81, 220
self-destructive behavior 20, 114, 126–43; acknowledging 138–9; and the attachment drive 132–3; contributors to 127–8; neurobiological basis for 13; as relief-seeking 129–32, 135–7; as symptom for internal splitting 29–31; treating causes of 136–7
self-disclosement, fear of 108
self-regulation of emotions 128
self-sabotage as symptom for internal splitting 28–29
sense of self, integrated 16, 21, 104, 142–3, 187–94
Sensorimotor Psychotherapy 8, 49, 50–51, 62, 79, 94, 136–7, 182, 220, 228
sexual behavior, unsafe 114
Siegel, Daniel 16, 17, 21, 242
social engagement system 183
Somatic Experiencing 79
somatic intervention 228
somatic symptoms of internal splitting 28
soothing parts 142
speechless when recalling trauma 51–52
splitting. See dissociative splitting
Steinberg, M. 148
step back therapy 228
Stevens, D. 36
structural dissociation 58–59, 133, 219
Structural Dissociation Model 2, 4–5, 8, 9, 11–12, 14, 67–68, 79, 97, 119, 137, 146
Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) 151–3
stuckness in treatment 6–7, 43
submit part 78, 81, 123–4, 132–3; and transferences 112–13
substance abuse: development during puberty 134; producing relief 131–2, 135–6
suicidality 114; associated with trauma 126–7; developing during puberty 134–5; neurobiological basis for 13; as symptom for internal splitting 29–31
survival behavior 42; changing 177–9; internal struggles 73–74
survival responses 2, 4, 9–10, 13–14, 19, 34–37, 66, 73–74, 122, 187; of children to frightening attachment figures 105–6
switching one’s parts 83–84, 164, 169
sympathetic nervous system 35, 127
Teicher, Martin 23
therapist: as auxiliary cortex 51–55; avoiding picking sides of a part 120–1; becoming aware of the multiple parts of client 116; bias of 234; changing role of 42–64; coaching many parts 171–2; cultivating a loving presence 220–1; dialogue with client 121–4; as director and coach 59–61; encouraging self-healing 182–3; getting information from client 153; having client inhibit emotions triggered by the past 194–7; having client speak the language of parts 119–20; listening for the various parts 116–18; as a neurobiological regulator 55–59; patience and persistence of 181; phobia of 107–9; pressure to accomplish therapeutic goals 219–20; as witness to client’s narrative 48–49; working with regression and aggression 179–80
therapy: conflicting flight and attach parts impacting 110–12; creating alliance with fight part 113–15; phobia of 107–9
time, loss of orientation 148, 160–1, 169–70
transference of parts to therapist during therapy 112–13
trauma: adapting to 47–48; associated with independent brain development 23; associated with self-destructive behavior 126–7; and attachment being frightening 105–9; and controlling attachment strategies 107, 132–3; differentiated from a trigger 49–50; distancing from 66, 132, 218; feelings activated during therapy 20–21; processing 10, 63–64, 90–91, 219–23; resolving and earned secure attachment 256–8; responses 9–10; trauma-informed stabilization treatment (TIST) 137–42
trauma-informed stabilization treatment (TIST) 137–42
trauma-related fragmentation. See dissociative fragmentation
trauma-related procedural learning 24–25
trauma-related triggers 49–50, 134–5, 141–2, 194–7, 219, 242–3
Trauma Symptom Inventory 151
traumatic attachment 5–6, 12–13, 103–24
traumatic memory. See memory
treatment: history as symptom for internal splitting 28; multi-consciousness approach to 44–45; resistance to 43; stuckness in 6–7, 43; trauma-informed 43–64
triggers 134–5, 141–2, 194–7, 219; activating 117; differentiated from the trauma 49–50; linked to implicit memories 242–3
true self 25
trust: cultivating 214; increasing 15–16, 164–7, 198–9
Type D attachment 105
unblending with one’s parts 12, 14, 17, 74, 87, 91–95, 159, 168, 178, 197–200; five steps to 263
uni-consciousness models of personality 10
van der Hart, Onno 4, 24, 25, 45, 107
van der Kolk, Bessel 1, 6, 7, 36, 40
ventral vagal system 199
verbal narrative of past experiences 20–21, 43, 46
visual focusing of one’s parts 85
vulnerability 61, 66, 77–78, 113–16, 128, 134–7, 141–2, 191, 235–6
window of tolerance 35–36, 55–56, 104, 106, 110, 116–17, 227–8
wise self 136
witnessing being witnessed 50–51