A special note for therapists
Everything I write is based on my 25+ years of 24/7 knowing that I'm a multiple (and being all-too-self-aware), knowing other multiples equally as long (more than just a few), and on my studies of psychology, philosophy, self-help techniques, counseling, coaching, and sociology.
Just about 10 years ago, I came to the startling theoretical conclusion that multiples operate strongly by the principle "As outside, so inside." This principle works in so many applications in the world, but none so startling as multiples. How can multiples get along in the external consensual reality, if they cannot get along amongst themselves in the internal, subjective reality? The amount of transference, sublimation, mirroring, etc. is so prevalent, it's uncanny. And I expanded my little principle to say As outside, so inside (and vice versa) because effecting change in one arena of life can effect change in the other. Another way of putting this: for a multiple to get along with ease and love in the world, they must get along with ease and love in their head, and vice versa. This principle and my self-observations and intimate knowledge of many multiple systems inform my suggestions, primarily encouraging a healthier internal community, in the United Front Boot Camp. I have no doubt that clients will have healthier and happier external relationships if their internal relationships improve, and once relationships improve everything else follows.
In the paradigms I outline, we turn away from digging-in-the-past Freudian talk-therapy techniques and turn to forward-facing and value-affirming self-help and life coaching techniques (some of which are based on cognitive-behavioral, gestalt, and humanistic psychology, social intelligence, family systems theory, and choice theory) as the basic methodology. We take the social skills commonly accepted in the external or “consensual” world outside our bodies, and use them as a paradigm to influence our internal relationships, our subjective reality, in which we are not only a multi-faceted entity, we are a group of separate entities confined in the single body with all the constraints, legal and logistical, that that imposes upon us.
If you are familiar with internal family systems theory, with Jungian paradigms of anima/animus and internalization of archetypes, or even with Freudian’s model of the Id, Ego & Superego, then you are familiar with the rich history of psychology acknowledging that nearly everyone consists of separate internal-reality “parts.” Since your clients experience these so-called “parts” as entire people, often with a very rich fabric of belief, talents, religious ideologies, memories, emotional ranges, speech patterns, habits, etc. that closely mirror those of unique and autonomous people, it is prudent to meet them on their turf rather than argue them out of their paradigm (one that presumably works for them even if psychology does not agree).
And most modern thoughts of early development suggest that infants are not a single mental entity yet. When development proceeds without untoward interference, a young child begins to fuse their disparate sensory information, their reactions, their ideas, their preferences into one whole personality. In the early life of someone who is traumatized and afraid, there may be so many conflicting needs — most notably the need for comfort, protection, nourishment, shelter, etc. from the same caregivers who scare the crap out of you — that you need to be able to play a shell game within your own mind before you have even brought all these confusing perceptions and modes of being into one stable entity. To presume that this results in a single "better than everyone else" Host personality is presumptuous, and using this language or giving preferential treatment to one internal entity over all others creates and reinforces uneven power dynamics in the system, creates a competitive environment. Most especially, competition over limited resources, such as Front time.
How does it help the client's internal relationships if you create tension and adversity by telling them they are "not real people" or frequently or exclusively asking to speak to one entity over another? Does that serve a helpful therapeutic purpose? This attempt to belittle and distance the internal entities from one another creates a "Holier than thou" relationship between the therapist and client (once "patient"), and also between the internal citizens of your client's mind. You de-humanize them. You undermine their nearly non-existent self-esteem, you create immense potholes in what needs to be a more level playing field. To what end? The end is a power struggle and an attempt for one alter to force their will on the other alters, or to create a group of "good" alters versus the group of "bad" alters. Here's where choice theory (Glasser) comes into play: coercion will not get you anywhere fast. You create an atmosphere where the internals can do nothing more than rebel, act-out, become demoralized and depressed, resist treatment and moreover resist change. Add to this relationship the constant regurgitation of past trauma, over which these internals may have a great deal of guilt, and you've created a therapeutic paradigm full of pain and years(!) of treatment. It's simply INHUMANE.
Society resists acknowledging these internal entities as people, and you happily reinforce this dehumanizing paradigm. Please stop. Whatever your personal or professional beliefs, you should not force the dogma of society and psychology on the client unless it will actually assist the therapeutic relationship. No amount of coercion is likely to reduce the subjective experience of these entities as actual people, and given the complexity of working with a multiple, I think we all have better things to do than argue what is technically a philosophical standpoint to the point of engendering very deep client resistance and abolishing client rapport (both inside and outside the system).
In my work — podcasting, writing, or client-facing work — I insist on treating all residents as humanely and equably as possible. It works for me, I've seen it work for other multiples, and I won’t change my language of respect to humor current thought in psychology which as an organized entity is not much more than 100 years old and could change on a dime.
If you can deal with this point-of-view that may conflict with your learning on the subject, your clients can work through the United Front Boot Camp or listen to the Many Minds on the Issue podcast and get assistance on an as-needed basis from you while using the program tools. They can progress as quickly or slowly as they like or are capable of. It does not replace therapy, and you can spend more time in sessions working on PTSD and trauma issues while the client works through their internal relationships and paradigms so they can come to an understanding and a consensus on what their system would like to do with their life going forward.
Please cut to the chase by considering alternative therapies for treatment of PTSD. As one example, Emotional Freedom Technique (EFT) is very effective for your client to work through their own triggers, or you can use EMDR or ART. These allow your client to get over invasive symptoms quickly and thoroughly. I'm all about using alternative techniques with the exception of guided visualization, guided meditation and hypnosis. It's my personal and professional (as a life coach & multiple) opinion that multiples in general are much too susceptible to the dissociative states to rely on hypnogogic states for therapeutic benefit, and I personally steer very clear of having others hypnotize me, to the point of "sitting out" of all guided exercises (past life regression, relaxation exercises, etc.) at conferences and workshops.
When a client has no current PTSD symptoms, please don't encourage PTSD by digging through the past. At least wait to work in that paradigm until after going through the United Front system and getting the internal community to a better place. These materials will help you help your client build a firm foundation of internal organization, ability to track time, a consensus-building environment, firm rules and ways to enforce them. After the foundation is built, discuss with your client whether digging up past traumas is necessary and desirable for other reasons. With the better coping strategies, self-awareness, and spirit of internal teamwork that will be achieved through this program, perhaps the chance of becoming dysfunctionally retraumatized will be mitigated.
The primary need of a multiple in crisis is to return to a level of normalcy that allows functioning in family and society. That is not the appropriate time to spend years poking around for hidden residents or for digging up traumas. Neither of these techniques return the multiple to functionality directly, more it does so by accident over the course of years via the long route. I request that you not consider "being normal" more important than "being functional." I would rather be a contented functioning and even productive member of society and able to follow my passions as a multiple entity rather quickly, over spending more years being dysfunctional, traumatized, trigger-happy, depressed, and anxious in order to come out so-called "normal" on the other side.
Let's prioritize this correctly: your client needs to achieve a certain level of co-awareness, co-consciousness, collaboration and communication regardless of whether they choose to merge or fuse, AND in order to function in spite of being multiple. I'm offering tools to start on a pathway to get there quickly that leads to less chaos along the way.