A Guide for How to Support a Loved One with Structural Dissociation

~~~NOTE! This is a Work in Progress!~~~

You understand that your loved one lives with structural dissociation & is in trauma recovery to decrease the intensity & severity of its effects on daily life.

But what does that mean for you? How can you support their healing journey within day to day interactions?

Firstly, how can you {learn to} identify a dysregulated autonomic nervous system?

A dysregulated sympathetic nervous system will cause things to seem overactive while a dysregulated parasympathetic nervous system can cause things to appear underactive.

Signs of a dysregulated sympathetic nervous system:

  • psychomotor agitation, such as restless legs

  • rapid or pressured speech

  • mania or hypomania, mistaken for bipolar disorder

  • insomnia: sleeping less than usual, not wanting to sleep, sleeping less soundly than usual, awake at odd hours of morning or night, etc.

  • anxiety: {HOW TO RECOGNIZE????? Will come back to this!}

  • feeling of increased body temperature: wearing clothes too warm for the present weather, comments about it being hotter in the room than it actually is/feels, etc.

  • increased heart rate: compassionately say, "Take a deep breath for me," & feel their pulse

  • aggression: more critical than usual, more harsh than usual, more defensive than usual, more irritable than usual, may comment about feeling impulsive

  • on edge: physically prepare to “go” (run/fight)

  • anger

  • narrowed eyes: eyes not as wide & open as usual; more narrowed

  • furrowed brow: crease in brow, between eyebrows; may be mistaken for being upset with you

  • sleeping less or feeling less need to sleep {*See: Insomnia}

  • listening to music louder than usual or is healthy

  • speaks with uncontrollably loud volume {overextended "outdoor voice"}

  • higher tolerance to sour, salty, & spicy foods/flavours

Signs of a dysregulated parasympathetic nervous system:

  • psychomotor retardation: moving much slower than usual

  • selective mutism: being unable to effectively utilize verbal communication

  • depression {LIST SYMPTOMS}

  • exhaustion/fatigue

  • catatonia, which is characterized by an inability to move normally {psychomotor disorder}: the most common symptom is stupor, which means being unable move, speak, or respond to stimuli

  • feelings of decreased body temperature: wear several layers for moderate {not freezing} weather, comments about always feeling cold, poor circulation especially noticeable in hands & feet, etc.

  • decreased heart rate {causing minor movements to trigger “out of breath” or feeling like heart pounding out of chest: easily fatigued}

  • regression, such as age regression: responding from a child's perspective, etc. {HOW CAN THIS BE EXTERNALLY IDENTIFIED/ RECOGNIZED?}

  • physically curled up or pulled back

  • shame

  • large/widened eyes

  • raised eyebrows

  • sleeping more, or feeling the need to sleep more

  • prefers listening to music quietly

  • speaks extremely quietly

  • higher tolerance for very sweet flavors

This is important to identify because of what is happening within your loved one's body & brain beyond their conscious awareness or control.

~insert insight about how EVERYone's being, including brain, is all regulated/ managed/ controlled by the nervous system: make it valid & relevant.~

When triggered, trauma-related implicit memories are drawn from the subconscious & begin leaking into the consciousness, causing alarm.

This subconscious occurrence then triggers the sympathetic nervous system, which is the body's emergency response system.

When the sympathetic nervous system is triggered, the prefrontal cortex literally shuts down: goes offline, becomes inactive, becomes inaccessible, no longer contributes to the conversation within the brain & body.

This is significant because the prefrontal cortex is solely responsible for one's ability to ~

  • be mindful & curious

  • retrieve & manipulate already learned information

  • learn new concepts or skills

  • integrate new information

  • regulate impulsivity

  • test reality

  • manage dysregulated autonomic responses

When the prefrontal cortex shuts down, the trauma-related parts of consciousness are abandoned to respond with pure survival instincts, attempting to seek relief any way they know how.

Trauma-related parts of consciousness are associated with the right hemisphere of the brain, while the going on with normal life part is associated with the brain's left hemisphere.

Left Brain Hemisphere:

  • Going on with Normal Life Self

  • able to gather information & categorize it {Fisher, p225}

  • more positive outlook

  • prioritizes order, sequence, organization, & good judgment {Fisher, p224}

  • access to facts

  • "verbal linguistic self" {Cozolino, 2002} who "keeps on keeping on," earning it the title of the "going on with normal life part" {NLP} {Fisher, p67}

Right Brain Hemisphere:

  • Trauma-Related Parts {TRPs}

  • driven by emotional & survival imperatives

  • deeply emotional

  • more focused on the negative & on the threat

  • mobilizes the "corporeal & emotional self" {Cozolino, 2002}

Once you've been able to recognize that your loved one's autonomic nervous system is dysregulated, you can compassionately respond with a brand new approach that incorporates Janina Fisher's multi-conscious parts approach {published 2017: this is all NEW information!}.

Using the "language of parts" can offer your loved one the tools to help regulate their dysregulated nervous system.

With this approach, it is assumed that any & all symptoms represent communication from other parts of consciousness within their structural dissociation, which has developed within subconscious neuropathways {which control & affect all parts of the body} in response to some form of early childhood trauma.

What kind of symptoms might be considered communication from parts?

Psychomotor agitation. Impulsivity. Struggles with substance abuse or addiction. Defensiveness. Anger. Irritability. Struggles with self-harm. Depression. Catatonia. Struggles with suicidal ideations. Selective mutism. Psychomotor retardation. Insomnia. Dissociation. Headaches. Body aches. Body pains. Pressure pains. Can all be communication from subconscious parts.

The objective is to help your loved one separate self from symptom in order to re-active their prefrontal cortex, allowing them to regulate their dysregulated autonomic nervous system.

Reframing the triggering topic as "theirs" helps separate self from symptom, providing the opportunity to re-engage the frontal lobes of their beautiful brain.

The emphasis is curiosity & compassion.

What part of your loved one might be experiencing this trigger?

Could this response---these emotions, reactions, somatic sensations---belong to a child part worried about making a mistake or that things will fall apart, or afraid of being hurt or judged or neglected or rejected?

Using the language of parts, gently(!) guide your loved one towards reframing their triggered experience as "theirs" rather than "mine."

After the intensity of the symptoms have been somewhat diffused, then it's time to bring back the "going on with normal life self" & re-activate the prefrontal cortex.

{Goal~~~Create Guide to Help Identify Positive Triggers for Going on with Normal Life Parts}

{I am very dissociated writing this. If it doesn't make sense, I will try to come back & fill in the gaps later!}