In DID treatment, there is the concept of different ‘phobias’ that need to be overcome for recovery. The phobia of the inner experience is at the core of the first phase of treatment, stabilization, and needs quite a lot of time to master.
What are ‘inner experiences’?
Sometimes these are also called mental actions but that usually doesn’t clarify anything. It describes a number of experiences we can discover inside of us. Some of it are things we experience with our mind like thoughts, beliefs, predictions, memories, hopes and dreams etc. All our emotions belong to the category of inner experiences and so do our body sensations and sensory experiences. Things like our will and impulses to act, our values, our needs and our sense of self over different situations also belong here.
In addition to the normal set of inner experiences, we have some that are a result of trauma. What is called ‘vehement emotion’ in some of the classic textbooks does not mean intense emotion. It means overwhelming emotion with the taste of trauma survival that we would probably classify as emotional flashbacks today. In addition to normal memory we have traumatic memory and flashbacks. Some of our beliefs might be so deeply impacted by trauma that they don’t respond to ordinary cognitive strategies and need a trauma approach. There might be too much or too little body sensation for our life today. And next to the normal experience of a self we might have an inner experience of multiple selves. The phobia of inner parts and the phobia of traumatic memory are traditionally treated separately from other inner experiences even though they technically belong to this category. It just gets confusing when we try to solve too much at once. Taking one logical step after the other will help us with challenges down the line. We need to start with stress states and vehement emotion because we need new coping strategies when we approach inner parts. Without regulation skills we can’t move forward.
Normal and trauma-derived inner experiences
We might be completely unfamiliar with the concept of inner experiences that happen on a normal level because they are buried under trauma responses. But they do exist, even in us, and they are mostly helpful. An awareness of our body sensation supports our self-care. Emotions can be great at showing us where our boundaries are or what is truly important to us. The sum of our inner experiences makes us feel more alive. Not always comfortable, but very much alive and kicking.
Normal inner experiences might not be a topic for therapy for a long time. When they happen, they also trigger traumatic inner experiences and those tend to overwhelm everything that is more quiet and calm. The intensity we experience does not mean that we can’t have normal inner experiences and it is not a reason to feel ashamed. This is normal with trauma. It happens to everyone with trauma in one way or another. Since a normal inner experience can trigger trauma experiences, it is often useful to check how much of our inner experience belongs to the present and how much belongs to the past. A quick way to do that is using percentages but we can also take our time to examine the quality of experiences we are having more closely. Simply just knowing that some of the experience is rooted in trauma can help us to stay in control. It is not all about the present situation. Therefore we don’t have to resolve it all in the present situation. Trying to solve old problems in a current situation can drive a person into despair. We feel the deep need that it has to be resolved but we are using the wrong context for it.
Characteristics of trauma-derived inner experiences
Inner experiences that are connected to trauma in some way have a very particular feel to them. There is a flavor of threat, survival and sometimes even doom. Different kinds of stress responses are mixed into the experience so we might feel a distinct flight or fight or freeze and give-up energy that is driving the experience. And while it shows most obviously in our emotions, it will absolutely touch our thoughts in frantic predictions of what is going to happen next or our needs that get triggered with a quality to them that feels like we are going to die if we don’t get what we need right now. This vehemence is unusual for the people around us while we might only know ourselves within shifting patterns of this trauma activation and numbing. That in itself is not borderline, that is the typical pattern of trauma. We will see it in parts as well. Some will experience an activation while others experience a deactivation. Thoughts might be stuck in doom and needs might have vanished from awareness. It helps to understand which parts tend to feel explosive inner experiences and which ones tend to feel less than what would be normal. It needs different approaches. What most parts have in common is that they can’t reach the level of normal intensity and it will be a challenge over time to find the experience beyond the trauma response.
It is very common to develop a fear of inner experience because they always feel so overwhelming because they have that touch of trauma mixed into them. The real problem here is not the inner experience, it is the overwhelm. It is natural and healthy to be scared of overwhelm. It is what causes traumatic injuries and retraumatization. If we had the ability to experience things safely and in a contained way, it would still be hard but not as utterly scary. So we target the overwhelm as the core of our project of overcoming the phobia of inner experiences. This is my personal experience: Healthy things come to the surface when the traumatic symptoms go down. We are not messed up to our core. Underneath a thick layer of trauma, there is a natural ability for all the healthy inner experiences. We just never got a chance to know them.
Capacity describes our ability to regulate ourselves when we get stressed. It is ok to get stressed. Can we still manage it or are we getting overwhelmed? The experience of overwhelm is our indicator that we don’t have enough capacity for the full experience at this point in time. Then we make things smaller until they do fit our ability for regulation. Titration describes a technique of small steps that only allows a drop of the experience to come through to us so we can cope with that and then try another drop. We can’t go any faster because that would lead to overwhelm. But the tiny drops help us to get used to experiences at our own pace and we can slowly build up our tolerance for them. This is the technique we use when we work with parts who are not triggered yet and who just want to explore a normal inner experience and also with parts who are deactivated. We don’t try to activate everything at once, that would be overwhelming. Tiny steps are enough and the fastest way to go.
Managing overwhelm
There is no way to avoid trauma-derived inner experiences from getting activated. We can try but eventually it will happen. As a reminder: The activation is actually not the biggest problem (even if it feels that way), our overwhelm of our ability to regulate ourselves is. When we face overwhelm, our only goal is to stop it and get to a place that feels stable again. We don’t try to use these situations for any kind of learning moment. Overwhelm is not the mental state that allows us to learn anything from the experience. We learn when we increase capacity in a controlled setting. We stop overwhelm when we face overwhelm. These are distinct processes that we won’t mix.
To stop overwhelm we need to learn new techniques on how to cope with these trauma experiences. Nobody is born with the ability to just manage that. Sometimes I meet people after they had their first real stress response and they always seem kind of shocked how much they lost control and just couldn’t do anything about it. The good news is that there are a LOT of really good exercises and tricks out there that we can try. We can look for trauma resources for symptom management and we might also peek into things people with other reasons for overwhelm do to manage their overwhelm. That can lead to a collection of trauma-specific, body-focused, sensory or really general tools. This blog has a vast collection of articles that help with overwhelming inner experiences. You can find those in the chapters on Symptom Management, Stress Regulation, Emotional Regulation, Resources, Mind Exercises and more. I will link useful places to start below.
Preview: normal inner experiences
There will come a time when we aren’t getting triggered that much anymore and life is more stable and calm and we get to experience normal emotions and other normal inner experiences. They don’t come with the feeling of survival but they can feel very strange and new and suspicious. We might have no memory of ever having felt that way. And we did not learn how to manage healthy inner experiences as a child. That will lead us into a really exciting and puzzling time of figuring out how to function as a normal/healthy human being. That needs capacity too. It will be different but it will still be a learning process before we can regulate ourselves naturally. We realize that we don’t need our trauma tools anymore because that would be overkill. But we still have to develop the quieter tools and normalize them for ourselves. That will be a topic we will look into in more detail once we face the phobia of normal life and the phobia of change in a later phase of treatment.
Where to start:
Mind- Skills
We need our mind to sort through our complex experiences, that is why reflection skills are often taught first.
- reflecting about inner experiences
- reflecting about the outside reality
- separating inside and outside reality
- how to observe with some distance to the experience
It is also valuable to learn that inner experiences are not the same as actions. We can think and feel a lot without it having any effect on the outside world or other people whatsoever.
Observation and reflection skills create a foundation for other tools.
Stress responses
We regulate stress responses before we attempt to regulate an emotion because the stress response is amplifying the emotion and it gets easier once we calm down.
- flashbacks
- Hyperarousal part 1 and part 2
- freeze
- shutdown
- working with the impulse
- orientation & grounding
- reality check
Emotion
Most of the triggered response goes down with the stress response. When emotional flashbacks linger, we can try this:
Body
Because the body experienced all the trauma we need to be very gentle when we approach it to improve body connection.
You can find articles on beliefs, impulses, specific emotions and other specific inner experiences in our Index. It is normal that it takes a long time to learn how to cope with all these different inner experiences. It is not done in a month. Take your time. These are the foundations for all that is to come.
[This article is mainly based on The haunted Self (Steele, Nijenhuis, van der Hart), Coping with trauma-related dissociation (Steele, Boon, van der Hart), general standard treatment for PTSD and personal experience]