Chapter 43: Learning About Trauma and Dissociation

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In the last chapter, I described Post Traumatic Stress Disorder (PTSD). Previous chapters highlighted a few other disorders that I was treating as well as problems and conditions for which clients sought my aid.

These chapters are not sequential in nature. I didn't have just one focus in my practice. I was constantly involved in providing services to clients based on a wide range of issues that they brought to me seeking my aid, treatment, or support.

I didn't describe treating Major Depression but that is a common disorder for which people seek treatment and I had clients with that problem. I was still treating eating disorders other than providing individual therapy to persons with anorexia.

People were coming to me for couples counseling, group therapy, and family therapy in addition to individual therapy. For example, I had a therapy group for persons with eating disorders.

Continuing Education into Trauma

As I was saying at the end of the last chapter, I was the president of the local chapter of the Society of Clinical Social Workers. It is in this role that we both network with other professionals, share our struggles or challenges as professionals, and learn about continuing education opportunities.

As president, I was looking to organize some training workshops that would provide continuing education credits. I had speculated about what happens when extreme trauma occurs early in life because I had heard of some relatively rare disorders, the most extreme of these is called Dissociative Identity Disorder (DID). This is in the DSM-IV – the diagnostic manual used by mental health professionals to diagnose disorders.

As an intern at the Oaks, I met someone that my mentor and supervisor Chris Hauge, DSW, LCSW, stated had DID. When I was working at Sampson County Mental Health Center, I had suspected that Nancy might have a dissociative disorder and possibly DID.

My understanding based on all these experiences and others that I had not specifically described that dissociative disorders are trauma disorders and that the phenomena seen in a hypnotic trance are similar to the symptoms of dissociation.

The amount of other material to which I was exposed about stress, trauma, hypnosis/trance, and dissociation, is so extensive that I could write an entire book about that. DID seems to be the furthest end of a continuum of dissociative disorders in terms of severity and symptoms.

Some of these phenomena of trance and/or dissociation are commonly experienced by all people. Forgetfulness happens to us all and it seems that it can be associated with something stressful, though at other times are memory is much clearer during times of stress or fear. Another common trance-like symptom is zoning out even while driving and not remembering any part of the trip.


The important point I want to make here is that at this point, nothing at all about dissociation or DID, to me, seemed any more unusual than several other disorders that everyone believes are real, including almost every psychiatrist and psychologist. 


I once heard a psychologist say she doesn't believe in the unconscious, but I didn't get a chance to get her to expand upon what she meant. Interestingly awareness of these conditions and the ideas about the unconscious seemed to develop around the same time around the turn of the twentieth century. Freud had started using hypnosis and then turned to other techniques. Many of his theories are hard to prove.

So, we have DID as an extreme example among dissociative disorders and it is something that is rare. I wanted to learn more and see what other professionals in the field know. It made sense to kill two birds with one stone and set up a workshop so that other Clinical Social Workers could gain continuing education credits.

A Sinister Foreshadowing...

My own experiences in the future will be explained in part by what I was learning at this time in 1998. I would find out that extreme stress even if it doesn't seem like trauma can cause some trance-like or dissociative symptoms – obviously not anything as extreme as DID. Note, I am saying that part of my future experiences could be explained by extreme stress!

A Continuing Education Workshop

I had been a member of the International Society for the Study of Trauma and Dissociation (ISSTD) and through that, I met Louise Coggins, who was a Licensed Clinical Social Worker as I was. I asked if she would provide training for Clinical Social Workers at a location in Wilmington.

It was late 1998 and into early 1999 when this was coming together. I don't remember the details about how this came about because over two decades have passed since then. I recall traveling to Chapel Hill and the University of North Carolina campus for meetings that were part of a local chapter of ISSTD if I am not mistaken. Louise was someone I met up there.

DID was being discussed in ways that I was not aware of at the time – on the web and elsewhere. I'll get to that later.

Naturally, I would want to announce this workshop in the newspaper so that other professionals would know about this chance to get additional continuing education credits. I could have just put it in a calendar section of the paper that would only be read by people looking for such things, but I thought I would see if I could get some exposure as a mental health professional. I definitely wasn't looking to hold myself out as an expert on dissociative disorders or DID.

With that in mind, I approached the Wilmington Star-News, the major newspaper in Wilmington asking if they would do a story on this. Indeed, they were curious to write a story about a condition that is hard for people to understand but which simultaneously makes them curious. Schizophrenia is hard to understand for many people, but few are curious to learn more about it like they do with DID.

Louise told me that she was going to bring a client of hers named Grace. I assumed that Grace had DID. Indeed, Grace had multiple different personalities or alters with different names.

It seemed very brave of Grace to come forward and offer to do this - to share her own experiences with others who might be skeptical. DID has been met with skepticism, as I just noted.

Louise and Grace would discuss many different aspects of treatment and many different topics that are important to understand when seeking to understand a mysterious disorder.

What was a bit unclear to me was the term that Louise used in describing the abuse that Grace had experienced growing up. She said she had experienced ritual abuse. From a psychological perspective, the word 'ritual' can be used to mean routine or habit. It need not imply something religious or sacred.


I knew that my mainstream Catholic/Christian religious experiences had created stress, distress, shame, and other problems for me and Lynn. I suppose that is abuse. No little boy should feel shame for the pleasure he feels stimulating his penis!


I don't remember the details about the interview with the journalist with the Star-News or the details of the article. It's been so long that I don't even remember the details of the workshop.

It was good to see my name in a newspaper. I felt like I had gained recognition. As a shy person, I had not expected to appear in the paper one day as president of a local chapter of Clinical Social Workers.

In the next chapter, I will expand upon the topic of DID and therapy.

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