IFS for Complex Trauma and Dissociation, with Joanne Twombly

[Music] Today we are excited to welcome Joanne Twombly back to our podcast. Joanne is a psychotherapist in private practice in Arlington, Massachusetts. She has over 30 years of experience working with complex PTSD and dissociative disorders and provides training and consultation. She has written on EMDR and dissociative disorders, EMDR and internal family systems, and on working with perpetrator interjects. She is an EMDR consultant and a trauma and recovery humanitarian assistance program facilitator, internal family systems certified, and an American Society for Clinical Hypnosis Consultant. She is the past president of the New England Society for the Study of Trauma and Dissociation. In recognition of her achievements and her service on committees and the board of the International Society for the Study of Trauma and Dissociation, she was honored with ISSTD's Distinguished Achievement Award and is an ISSTD Fellow. Today we will be speaking with Joanne about the second edition of her book, Trauma and Dissociation and Formed Internal Family Systems, how to successfully treat complex PTSD and dissociative disorders. And we will be asking her some follow-up questions to the interview we did with her two years ago. Joanne, thank you for being here with us. Thanks for having me. Welcome back, Joanne. About two years ago in November 2022, we met for our first conversation on trauma and dissociation in form of internal family systems. That interview caught our audience's attention, perhaps because of the widespread interest in approaches to trauma treatment that can inform our IFS work. We know you published a second edition of your book, Trauma and Dissociation Informer Internal Family System, how to successfully treat complex PTSD and dissociative disorder. Many congratulations, Joanne. Aren't there any significant differences between the 2022 first edition and the 2024 edition that you would like to mention? There are few, not a whole lot. It's essentially the same book, but I extended the gender section because that's the one section I got a bunch of criticism on. I think it was misunderstandings. I think some people felt like I was the kind of therapist who tries to suppress people's true gender identities, which I was kind of surprised about since that's the last thing I try to do. I really work hard to try to help people become the people that they would have become if they grew up in a healthier family. So I gave more context and expanded it, consulted with a few more people. So I hope it reads better to some people. I think the primary problem is that some people think that if you say you need to change your gender, what I wanted to communicate is that if somebody has a complex dissociative disorder and they say, "I want to change my gender and I want to do surgery," before you support it, you want to explore that with parts. You want to find out if there are parts for it, if there are parts against it. Sometimes kids come up with easy solutions to horrible problems, for instance, a girl's being sexually abused and she decides if she was a boy it wouldn't be happening. Now that may or may not be a time when somebody should have transition. It could be that that's really what's right for them, but that wouldn't have to do with the abuse that would have to do with the person. So that's what needs to be sorted out. So I tried to communicate that a little more comprehensively. The other difference is that it has an index. I was quite surprised that the first book was accidentally published without the index. And then anybody who reads with a calibrated eyeball, which is not me, would notice that there were huge amounts of, there were some missing words, there were misspelled words, there was a whole bunch of editorial problems with the first edition. So the second edition is way better, essentially the same. So in your book and in our last discussion, you suggest that IFS is a very good therapy model for clients with complex trauma, including those with dissociative disorders, but that there are essential elements of trauma treatment that should be integrated with IFS in order for therapists to work in a maximally safe and effective way with these clients. So what are some of the elements that you feel are essential to incorporate in an IFS approach to treating clients with complex trauma and dissociative disorders? One thing I'd say is that the research and the wisdom of years and years of non-IFS treatment of complex trauma disorders is that phase oriented treatment is really important. And the first phase is symptom management and coping skills. And I think that's also important for anybody who has a trauma history. And it saves a lot of grief in the long run. People don't get as dependent sometimes on therapists. They don't have as many emergency calls. They don't lose as much sleep as they as they might. They do better at work. You know, I think stability is a really great place to be doing trauma work from. So helping our clients be as stable as they can while they're doing trauma work, I think is really important. And I know IFS says, well, talk to the exile, ask the exile if they can hold all the burdens and not overwhelm the person. And I think, you know, that works really well. I do that with all my clients. But sometimes exiles don't know what the burdens are. You know, if it's a, if it's more of a complex trauma and they dissociate, they may be dissociated from the enormity of the burden. And they may say, yeah, sure, no problem. But then they can't. And it's not because they don't want to. But there's no, you know, magic going on there. So I mean, I do stabilizations exercises with all of my clients who have any kind of trauma history. Because I think it helps them. It helps them, you know, get their body normalized, their reactivity level more settled. And that helps the trauma work go smoother. But it's essential for people with complex trauma disorders because they can really fall apart if you don't do that. And I've treated IFS people who've been in great IFS treatment and they've gotten worse and worse. And it's because they haven't had stabilization skills or the dissociation wasn't worked with. So I mean, I should not have to do that if IFS works perfectly. And I do love IFS. I think it's a great, it's a real power treatment. I use it all the time. I just add some things. I also think, I don't think diagnosis is evil. I think people pathologize not the DSM. I mean, the DSM, okay, it's political, there's pathologizing. But, you know, we don't have to pathologize to diagnose. And I do think it's really helpful to know if you're working with somebody with a big dissociative disorder. Jovan, in your books, in true, you say that IFS therapy is reading the book. We'll get the ability to integrate the powerful treatment modality of IFS with the wealth of knowledge from the dissociative disorder and complex PTSD field. And in your books, praise page, cat is still, says your book offers pragmatic modifications of IFS to feed more dissociative clients. So how can these book help IFS practitioners? What are those pragmatic modifications and what do they bring to IFS? Okay. One thing is that I have a big, a long chapter on hypnotic language, which includes how you use that to do safe space imagery. How you do it to do containers. People who have big trauma histories go in and out of trance quite a bit. And if you're trained in hypnosis, you can see people, one of the things I learned early on was if people, if you want to help people connect with ego states, you put them in trance. Well, IFS actually does put people into trance. Standard inductions go inside, focus. You know, it's focused attention. And that's exactly what you tell people. Focus on that feeling. Notice the part that's holding that feeling. So, I know IFS says there's no hypnosis in it. But I think hypnosis training is informed all the therapy I do. For instance, I mean, I know EMDR. So EMDR says, "What's a place you felt safe in?" And a lot of clients say they have more of a trauma in history. I've never felt safe in my life. So I start out with, "What's a place or a space you felt safe in or a place you'd like to feel safe in?" So there's the acknowledgement that maybe you've never felt safe, but you wouldn't mind being able to feel safe in a bomb crater with a steel reinforcement or something like that. So the hypnotic language also is really helpful just to have at your disposal, both for these exercises, but also just to say things like I'll say to a client, yeah, we haven't finished working on that yet. The word "yet" means it will happen. So just throwing things like that into our work helps. Or I had did a consult the other day and the woman said, "Yeah, I started doing safe space imagery. It didn't work." I said, "Do you think you could find a safe space?" I said, "No, you can't say it like that because anybody who grows up will say, "No." So you want to say, "What's a place or a space?" "No, do you think you can?" Because that's so iffy and that gives them a way out. You use positive suggestion, you get much better results. And I'm looking where my clients are in trance already, you know, parts that are back in time, they're living during their childhood, they're in some kind of trance. So it's easy to use hypnotic language and have it make an impact. So when can we come back to a definition of dissociation as opposed to the associative identity disorder or the ID, maybe both from an IFS perspective or any other perspective, if you will? I don't know if I'm the best person to answer that. I'll tell you what I think. I think there's dissociation in terms of symptoms or daily life. You know, we all dissociate like for instance, just tying shoelaces. I don't think about how I tie my shoelaces unless I'm trying to teach one of the kids in the neighborhood. I just tie him. The information is dissociated because I don't need it. So it's on hold, but I could retrieve it. Or if I'm driving in my car, the highway hypnosis is a kind of dissociation. You know, I basically think our brains are so amazing. So there's lots of positive, you know, just plain old ordinary dissociation that we all do. And then there's dissociation like an eating disorder case is where somebody says, I'm going to have a little bit of ice cream and then half a gallon later it's like half a, you know, dissociative symptom. And eating disorder populations is one place where people misd dissociative disorders a lot because they're just focused on the eating disorder. And it's also sort of depends on who you're working with. I say people who ambulance people, doctors, they all dissociate. You can't work on a bloody kid if you're not dissociating. So it could be a job requirement. So there's that kind of dissociating. And then there's dissociating when there's an enormous problem like with kids who are being raped at night. And they have to go to kindergarten the next day. I mean, they'd never be able to manage that if they didn't dissociate some way. And the thought is is that if people are born with not a good ability to dissociate, they may not make it through their childhoods. Or they make it through their childhoods, but they end up in prison or hopelessly drug addicted or homeless or whatever. Dissociation, you know, people get upset when they find out they have a dissociative disorder. And I'm like, that's not what you want to be upset about. That's how you survive. You want to be, you want to put the responsibility in the right place. It's not with the dissociative disorder. It's with the parents or whoever were the abusers and neglecters and, you know, set the stage for this kind of disorder. And it's really, you know, people play around with, should it be called a disorder? Well, it's a disorder. It's not a disorder when a kid's developing it. It's a disorder after they become an adult. And then the symptoms start messing with their life, complicating it. [MUSIC PLAYING] For those of our listeners who might be newer to working with clients with dissociative tendencies, dissociative disorders, what are some indications that therapists can learn to notice that their clients might be dissociating during sessions? I keep a laundry list in my head. And I'm always noticing when people say something that could be dissociative. So, for instance, if someone comes in and they say they had a fantastic childhood, but they have all these symptoms, that's one. If I'm meeting with someone and I start losing track of the conversation or start daydreaming or feeling kind of fuzzy headed, that's another one. And that would be that I'm picking up nonverbal communication from the person. It's also something that doesn't usually happen when I'm meeting with somebody. Certainly, there's obvious things, like just thinking a friend of mine is taking a level one and somebody, somebody in her group started talking like a child. Now, that would be an obvious sign that this is a person who's switched into a child part. So, you've got somebody who's normally a competent, grounded adult who suddenly talking like a little kid. It's amazing how often that gets missed, but that would be another one. People certainly, if they talk about not remembering some of their childhood, if we talk about things one session and they come back the next session, they don't remember anything we talked about. I mean, okay, maybe they had a busy week and they forgot that, you know, what you're looking for is a cluster of symptoms. So, if it's one thing, I'm mostly not going to be too concerned, unless it's something like, I don't remember anything before I was 10, you know, then I'm going to be, okay, that's a big one. Or I was heading for your office and I ended up in a different state. You know, I don't know how I got here. That's another one. So, you can notice the big ones, but then they're more subtle ones. But I'm always looking for people with perfect childhoods, twisted childhoods. They just think they're bad, born bad, patterns too. Like, if somebody comes in and they've been diagnosed with three previous mental health conditions, that's a traditional one. Medication doesn't work for them. They've blown through some other therapist. They've had good therapy that hasn't worked. I'm like, what's going on that regular therapy hasn't worked. The coping skills, you know, like DBTs, another one, DBTs, kind of a left brain coping skill program. And I love DBT. DBT does not work with people with dissociative disorders. They want one person there, one part there, and that's it. So, I prepped the clients I've had to go to DBT. I prepped them. So, they have to ask the whole system. What questions do you want me to ask? The expectation is that they're going to go home and work on the skills with the whole system. But that's really a left brain kind of thing. They also need right brain coping skills like containers and safe space symmetry. Stuff that uses their ability to block thing to dissociate. So, if a client is dissociating in some way during a session where maybe they're getting kind of foggy or floaty or less present or shut down, do you tend to use maybe non-ISF or IFS techniques to help them regulate, become more present and grounded, or do you use or IFS techniques to help them be friend the parts that are associated with the dissociation or that may be using the dissociation strategically? Yeah, it depends. I mean, I think that a lot of, if somebody's got a complex dissociative disorder, one thing that's important to know is that what I was taught in my IFS training was say, oh, you client, we've got this great way of working. We're going to work with parts. You know, it's very exciting and blah blah blah. And they're cell blah blah blah. And that often freaks people out because if having parts was a way that you, having Happy. parts that were secret to everybody else and maybe even disconnected from whatever the you is inside you, it's going to be really disconcerting to have a therapist say, "Oh, we're going to find out about all your parts. All your parts who were kept secret, we're going to know about them." So I've treated a couple people who just left their first IFS session and never went back. And that was why. So a lot of the initial work is direct access. And the other thing is, is that over focus in those initial stages on finding self can be profoundly depressing. Because if inside you is a complete mess, it's going to be hard to find self. And either somebody is going to come up with something that passes for self, which, you know, some couple therapists were trying to tell me that their clients had lots of connection with self imagery and I listened to the whole case and I'm like, "Yeah, right, I don't think so." Well, it makes sense what you were saying when you, that it could be very depressing in the beginning to have this, if there's a heavy emphasis on trying to find and connect with self because the number one, lots of parts very active, but lots of protectors, very, you know, cautious, very entrenched in their roles, not trusting for good reason. And so asking them, "If IFS is this constraint release model where we would need the parts to soften and relax in order to open access to self, that's a big ask for these protectors who have had to be." A huge ask. So, what I often do is if somebody is like really fuzzy, as I might, if we've already discussed parts, I might say, "Okay, we're going to work, I'm glad you're here, we're going to work with you and we're not going to work with any of the other parts." So, and although I don't talk self, I use that information. I mean, for one thing, I'm setting in self, and if I'm in self, it's pulling for self, I think all the parts have self-energy. So I'm always trying to increase their self-energy, which is consistent with working with dissociative disorders because we've always wanted parts to have some internal communication, compassion, and compassion among each other and cooperation. So I might say to the person like if I was working with you, Lexi, I'd say, "Lexi, when you look at this part that's making you all fuzzy, what are you feeling towards this part?" And you feel some curiosity towards this part. I think we need to get to know this, this is a protective part, it's keeping you blocked from everything. And so, you know, that would be one way of doing it. And blocking parts are great, and I don't think the training focuses on it enough. Especially, you know, you're working with an exile and you say, "Well, what do you feel about that exile?" And they say, "I feel nothing." I'm like, "Great." So we're not, tell the exile, we're not going to work with her right now, we're going to work with this blocking part, and what I want is to find out why the blocking part needs to block. And then, once we address the concerns, I'll ask the blocking part, if the blocking part would be okay with opening a 5% window and letting 5% of the feelings through. And standing by, I say, ask the blocking part to stand by and be ready to close the access if you get overwhelmed. So, it can open it up a little bit and close it right down. It could be 2%, it could be 3%, and we start there and then, you know, we see how it goes. It's really what you're saying is so important for many reasons, but interestingly, one of the ways is working with these blocking parts can be a pathway to the client accessing some self-energy because, like you're saying, "How do you feel toward this part?" At first, they might be frustrated with it, they might want it out of the way, but when they can appreciate what you were saying before, that this is a part that's trying to protect you, and they really realize that these blocking parts might have been instrumental in saving their life, in helping them survive, then sometimes they can actually feel appreciation toward these blocking parts, and that's their self. Absolutely. And I say, just tell the blocking part, you're super frustrated with it, but I'm telling you, you need to get to know it, and maybe I'm a pain in the ass, but you're going to, you're stuck working with me, so do it anyway. So yeah, I'm frustrated with you, you blocking part, and I'm trying to get to know you, and I'm trying not to be too fruct, I'm trying to make space for you. So I'm like, "You can't lie inside." You have to say something that's honest. So we just work that in. It's really, especially in these systems, right? Because they have such powerful BS detectors, basically. So, yeah. I mean, the people who are like, "Oh, I love all my parts." I'm like, "Yeah, right. It's going to, I'm adding several years on to your therapy." But anyway. What about if you're working with a client and they're blended with an exile who itself is in kind of a shutdown state or just associated state? How would you interact with a client in those moments? You know, it's not always easy. I mean, I think it sort of depends. I mean, it's so much easier if it's someone who's never been in therapy. You know, if they've been in therapy and it's not adequate therapy, then they're going to have to be seeing someone like me or somebody else. So they've already gotten overwhelmed or they're super shut down from previous experience with therapy that just, you know, I have clients who've spent fortunes. They've tried so hard and they either haven't gotten anywhere or they've come out way worse. So you can have a part who's blocked down where you can't really reach them. And then you can have a part who's blocked down and I can say something like I said before. Listen, we're going to work together until, you know, I'm really glad you're here and I'm sitting here. I'm interested in learning more about you. And I'd like to ask one of the adult parts to come join us here. So again, if I'm talking to you, Lexi and you're in a really shut down part, I want the grown-up Lexi to follow my voice, use it like a sidewalk and just come closer and closer so the three of us can work on this together. Now do I know that's happening? I know if I use that language, it's going to happen. It's going to be happening because using that language helps build communication paths. So ideally we've got the blocked down part, blocked out part, adult and me and we're talking together. And you know, sometimes it's just not easy. I remember Cassie steal somebody asked her about a really difficult client. She said sometimes I think what I'm doing is I'm sitting with someone waiting for their brain to develop enough to use therapy. And I thought that was a lovely comment. I have had clients like that. And then there are these other things that you can try. It's also what I do when a kid part pops out. It says, "Who are you and how did I get here and they're completely freaked out?" I'm going to say, "Yeah, glad you're here. I tend to say I'm Joanne. I'll say the adult you brought you here because she knows that I work with people who had confusing and difficult childhoods and we help them feel better." And then get the adult hopefully present and then the three of us talk. I'm just saying, sometimes there's no good answer. I mean, I've worked with a bunch of people who've had some really bad treatment and sometimes things just don't go that well. I had one client spend about two hours sitting under my desk and in a panic child part. And luckily there was another office I could use to meet with some other clients. So you know, sometimes they're things that don't go so well. This is the treatment that leads to healing in the most efficient way. Bethany Brand just did this terrific top DID research project. She's gotten great research that you do phase one treatment well with this population and they all get better. Like, maybe not all, but well over 80% get better. And you know, what's needed is orienting parts to the present, which IFS calls retrieval, which is not as easy as they said it would be in level one. Where they said, of course, all parts want to get out of their childhood. I'm like, not if they're terrified of taking a step. You know, so orienting to the present stabilization skills, communication, working together. These are things that really form the foundation of healing. And there's great research on it. Now, that's why I slug through this book. I'm not a fluid writer. I like writing, but you know, I have lots of other things. But I felt like it was really important for the IFS community to have at least something that integrates the known knowledge of how to treat people with dissociative disorders. I mean, rotten luck to grow up in that kind of family. It's hugely painful and complicating and it's very sad. But it's fairly treatable if you know what you're doing. I really appreciate the contributions that your book made for those of us that do work with these clients who've had, as you say, these really difficult and confusing, really traumatizing childhood. So I think it brings a lot to this. Joanne, you say that the parts of clients with the ID are separated as though by cement. Can you say more about these? Sure. Analogy is just that, you know, say like the professional me is different from the couch potato me or the I was making a cake this morning, you know, the cake making me. So the play with the kids across the street me, but if you have parts that are dissociated, you can get stuck in one and have a hard time getting to another. So if I'm in the couch potato me and I get an emergency phone call from a client or something I have to handle. I had a dissociative disorder. I might be stuck in that kind of lazy child part of me and not be able to function or not be able to make that transition fluidly. It's also a brain thing where the adult me may have a lot of information and a child part me if I'm on the dissociative spectrum isn't going to have all that information. And it one of my clients told me when he was a kid, he was his parents were driving him somewhere. He said, where are we going? They're saying, you know where you're going? You're going to baseball camp. And he freaked out completely because he had no clue how to play baseball. And so that he took, they're like yelling at him because he had spent weeks talking them into taking them to baseball camp. And then when he got home at some point, he realized there was another party and you had to play baseball. It's like that information wasn't present. And now he's connected with those parts is access to it. So it's things like that. Or you know, this, I love the question that IFS has. I mean, one of the things I love about IFS is the language. So what are the concerns the parts have? Well, you know, like I've had clients who are heading to see me and then suddenly they're somewhere else. Well, what was the concern the part had about coming to therapy? Or it could be, you know, just a part of wanted to do something else. And had been suppressed for a long time and suddenly got a pathway in and took off. But that's, I mean, I think some people have really thick layer cement walls between the parts and some people, you know, depending on what's been going on, the layers between the parts aren't so strong. Yeah, like sense. Thank you. So when you have mentioned that sometimes your consultees will tell you that their clients are dissociating less. And you say that this is not necessarily a good thing. You want clients to be able to dissociate better, you say, can you help us understand what you mean by dissociating better and do you recommend it? Well, this is a glaring example. Okay. Someone doesn't have memories before the age of 10. If they're dissociating less, maybe they're starting to get memories. Well, that's risky because, you know, these memories could be filled with enormous amounts of trauma and toxic material, rage, terror, things like that. And they didn't all happen in one day. I want them to be able to dissociate better. So I want them to have all the memories say before or all the bad stuff from when before they were 10 in a container. And then we take out 2% of it or 5% or break it down in some different way so that they can get stronger. And so instead of trying to deal with 100% of the terror all at once, they're dealing with 5%. And, you know, I think they're, I mean, the people I've worked with have gone through horrible things. I mean, horrible abusive encounters. And then there's the horrible emotional attachment stuff that they've lived through and the threats and the neglect. And that can be even more powerful. So I want them to be able to dissociate better or a lot of my clients drive, they are dissociative disorder clients. They drive, they've never been in car accidents. And I'll say to them, yeah, automatically the kid parts are in the back seat. They are not the drivers. And we want you to do more of that. So when you go to work, you know, the parts who can work go to work. The other parts stay in their safe space or they stay home or parts who are freaked out at the doctor's office. They can stay in my office. They don't have to go to the doctor's appointment. So I want them to be able to use their ability to dissociate in ways that help with the treatment. Or this, you know, putting a chunk of memories in a container, taking one abuse of episode out and putting it in a smaller container and then putting percent of that in an even smaller container. Those are all dissociative abilities. I want people to be able to use their ability better. So we also know that you appreciate Reflanius's work with DID. So do you believe it can be integrated with IFS? And if so, how or when might it be helpful? I'll explain anything I think is going to be useful. I have to say the whole neurological explanations. I'm not very good at. I mean, I wrote a primitive one that I wrote in my book. I just have a very concrete way of explaining it. So I'll do that. I mean, I think it's important because a lot of people have been in some version of talk therapy. And it hasn't worked. And I'm like, yeah, of course not because talk therapy, talking is left brain and trauma gets stored in the right brain. So that therapy you did, you know, you got some good things out of it and it didn't connect with where the trauma stuck. So we're going to do that. And IFS does that hypnosis does that DBR EMDR, you know, some other treatment modalities. So in the trauma field, there's some people who say everybody should integrate and there's some people who say, you know, it's a choice and there's some people who say people don't completely integrate. I mean, I mostly say that I think the goal is for people to integrate into a healthy self-led system. Because I think that's a healthy concept and we all have parts. So one of the disagreements with IFS is IFS tends to. say parts or parts or parts and they never get integrated, they never get lost. And I disagree with that because in some of these dissociative symptoms, they have a zillion parts and it is just unwieldy. Like my client who had, I think I wrote about her, she had 50 baby parts. It's inefficient, was way better. She integrated into one stronger baby part who knew about all the other ones and that was way more helpful. So sometimes I think some integration is really helpful. - In many clients with trauma histories experience the state of chronic hypervigilance. So possibly a result of their nervous system is getting kind of retuned toward patterns of protection. So in your experience, what can we do therapeutically to help with this hypervigilance help shift them toward having a more flexible and resilient nervous system? - Well, I mean, I do safe space imagery with people. And you know, safe space imagery, there was some research that a consultant told me about, but he forgot where it was from. That said, if you do safe space imagery from six to 12 weeks, it resets your biological reactivity level. And what I tell clients is that if you grow up with a lot of trauma and depression and anxiety, your body gets used to those states, it becomes a habit. So even when you feel good, your body's still much, you know, carrying the habit of trauma and anxiety. And we need to help you, you know, get your reactivity level back to normal or more normal because that will help with the trauma treatment. And it helps with, it's good for all of us, you know, 'cause it helps with our immune systems and makes us healthier and stronger. And you know, if your reactivity level is high and something makes you upset, you're gonna be way more upset than if your reactivity level is at a normal place. So, and if you've got really dissociated parts, that means all the parts need to be working on it or as many as possible. So, you know, I think that's consistent with IFS 'cause we're working with parts. Yeah, if somebody's been raped, you know, nice for their parts to have a safe space. And if somebody's got really hyper-vigilant parts, I might have them trade off. So one part stands guard while others are in their safe space or some do it for 10 minutes, then another batch, does it for 10 minutes, then another batch? Or when I'm teaching people safe space imagery, I'll ask for one part to volunteer to try it while all the other parts are watching. And really what I want them watching and learning how to do it. So I'm giving their hyper-vigilance a function. The other function is they can watch me and make sure I'm not pulling any fast ones or abusing them while they're soft and safe space imagery, which can feel scary. So, and actually that's one of the advantages of having a dissociative disorder is you can have some parts doing this relaxation thing while others are being hyper-vigilant. I do appreciate how you do that. It's like there is this talent really that the system has, this life-saving talent, and you're helping them use that in ways that actually enhance their quality of life, enhance the treatment, you know. So. Yeah, it's very different. One of my clients, quite a while back, she came to me, she was referred from a locked unit. She, if you added up all her inpatient stays in the previous three years to starting with me, she had been inpatient for two. She was lived in inpatient units much more. She had parts who assaulted policemen and her girlfriend and carved herself up. And, you know, it was so different coming and finding out that she could learn coping skills. Her life changed dramatically. And I have to say she was a fast study, although it was a difficult treatment because of both her childhood and her. the treatment she had had before she started with me. But the coping skills helped a lot. Joanne, you have said that one of the things that inspired you to write your book was, and I'm quoting you, that some IFS trainers teach that phase of the end treatment is bad or not necessary. And some people have suggested that phase of the end treatment therapists kick out parts they don't like. I did hear that in the IFS training. I was quite shocked. You consider these statements to be misleading and not true. Why do you think phase of the end treatment is so important? And why do we need it if we have IFS to keep our client system safe? One thing I'd say is IFS doesn't keep these clients' systems safe. If IFS kept these clients' systems safe, nobody would read this book because we wouldn't bother with it. And I wouldn't either. Hey, if you've got a system where I can work faster and don't have to do all this other crap, I'm doing it. But it doesn't work. I mean, I wouldn't get people calling me desperate for therapy because their IFS therapy isn't working or is making them worse. So, and I think that trainer who said that, I don't understand where that came from because that is not accurate and it's not in the literature and it's not taught anywhere else in the trauma field. And it's incompetent. Hicking a part out of therapy because you don't like the part is incompetent. Yeah, I mean, I was concerned with that being taught, you know, fairly widely across the world because it's not true. [Music] Joanne, can you give us an example of a complex trauma case? Where do you start and how do you proceed? Where would IFS intervention fit into your process? So, someone comes into therapy or we're meeting on the telephone and just an initial contact, you know. And I'm going to ask them about their, you know, what do they need to work on? What have they been, how they tried to work on it? What kind of struggles are they having? And, you know, because I like to sort that out on the phone before someone comes in. And, you know, I'm going to be listening and I might say, oh, so it sounds like a lot of times you're really competent and then sometimes you can't get out of bed. Does that, is that right? I might say, so there's a part of you sometimes that hops out of bed. If they turn green when I use the word part or say, I don't have any parts, then I'm going to shift and start talking about things in a different way. And I might say, there's a side of you who is really hops out of bed. There's another side of you that wants to say in bed or another way of being you. Or I might back way up and say, not say anything about parts or I will probably start using my hands more and saying, okay, so there's the you that gets out of bed. There's you that stays in bed. And I might come in the next session and say something about my parts randomly. Yeah, there was a part of me that was so happy. It was really warm out today. And there was another part of me that was upset because God, it being that warm now and November, that means climate change. And that's a worry. But the southern part of me is just out picking flowers. She's really happy. So I'm just giving in, I'm normalizing parts. And you know, that's going to help them see that it, you know, lightning isn't striking. Nothing bad is happening. So I'm going to work my way into helping them be able to work with parts. And I'm also probably going to do some just some straight psycho head on it. But depending on the person, I'm going to be really careful. I have had people, I had this one person waited for two years before I had an opening and then came in and said, nope, I don't have DID and I don't need to work with parts because I don't have DID took another two years before that person was willing to work with parts because it was very scary. But I think at all, I mean, IFS is fundamentally it's an ecosystem model. It works with parts. But one of the great things is it's taught so many people who Are you still? There used to be a lot of therapists who said, "Oh, I'm a trauma therapist, but I don't work with parts. I don't work with dissociation as if it was on another planet." Or didn't, you know, too complicated not go in there. Then IFS comes along and suddenly everybody's working with ego states. Of course, sometimes they think it's the only, there's no other pools of information about it, which I think is too bad. I think IFS talks about being curious. Curious to me means, you know, there's IFS and there's other ways of working that sometimes are extraordinarily helpful. (soft music) So in our last discussion, you had talked about this concept that you called a crisis of progress where new layers of parts emerge as the therapy progresses. So I was wondering if you could elaborate on how therapists can best support clients during those kind of challenging points in the treatment. Well, I think it's also how therapists can support themselves because I know when I had a client who had been doing really well. In fact, she had given me a happy integration shirt. And then came in and was suddenly cutting and burning and none of the parts knew any coping skills. And I was like, what the heck happened? And really what it was was it was like her unconscious said, you're much stronger now. You can deal with this deeper dissociated material that's much more painful. And so one, the first thing is that it's good for us to know that that can happen. The second thing is that I tell my clients that, you know, because they get depressed. It's like I was doing so well. And now what happened? I'm a mess. And I'm like, no, no, no, no, this is because you're doing better. However, they usually dissociate that information. So I end up repeating it quite a few times. And I think what's really important for us to know is that although healing seems like a really good thing and a lot of difficult childhoods, a kid feeling good about themselves being happy, achieving something, feeling confident, hopeful, that can get punished. And then there can be a lot of blowback from that. So a lot of times people need to understand just how uncomfortable being happy can be and that it's just not a smooth path you have to get used to is being happy, safe. If it wasn't safe when you were a kid, it's gonna feel dangerous. So I think that's something we don't get enough of in grad school or training in general. What are the concerns about being confident? And sometimes I'll say to my clients, I'll say, my father was quite depressed. He said, I was stupid all the time. I have a part that thinks I'm stupid. And if I go to give a workshop, it's hard because I have to work with that part. She's gotten way better, but that'll still come up. I'll get anxious because I know everybody's sitting there thinking I'm stupid. Now if I feel really good about myself, that my part may kick in and say, watch out, somebody's thinking you're stupid. And so I might give an example like that. I think this is not, again, we all live on roughly the same planet. And so I'm trying to normalize and say, this happens to everybody. It's just more extreme when you come from a more difficult childhood. When therapists are working with clients with complicated trauma histories, the second part of phasorancer treatment would involve the paste uncovering of the traumatic material. So what are some suggestions for pacing the uncovering using IFS? - That's the same thing. So you get to a place where you've identified some part. And I also think managers have burdens. Firefighters have burdens. These are not just exiles. You know, a manager who needs to be helpful 100% of the time is managing, but the message that they have to be helpful 100% of the time and can't say no, that's a burden. So okay, we've identified a part that's got a burden. We're gonna work with a burden. So we're gonna do the witnessing. All right, so I'll have the part. Put the burden in a container, or we've already done that. And then take out a percent of it. You know, this is a complicated burden. Usually what I'm gonna do is try to start out with something that's only happened once, like say a date rape in high school, not the rapes that happened almost every night during their childhood. So we put that in and then I might have them take 5% of it out and we'll witness the 5% or 2% or we'll use time. I'll say take out two seconds worth and then the witnessing, you know, again, and it's not always like some big self. It's just a part. The part is doing the witnessing is a part that didn't take part in the trauma and it's a part who has enough self energy to be able to handle the witnessing. So I did a huge amount of witnessing with some 10-year-old part, that part had enough self energy. So, you know, but what was witnessed was a little bit at a time. So in a force starting with something and I'm concerned about stability, I'm gonna say, okay, take out 2% worth and I'm gonna count. Let me know when it's out of the container. Is it out? Okay, it's out. 1,000 and 1, 1,000 and 2. Okay, put it back in. So what'd you get that time? You know, and you know, that may sound elegant, but in the early stages, what I'm wanting is to set up a system. And I've had people who said, 'cause if I'm doing this with someone with a dissociative disorder, I want all the other parts in safe spaces with sound and feeling proofing up. So they're not getting disturbed by the content of what we're working on. I want my clients to be able to keep their day jobs, be able to parent, be able to function. So I don't want them all getting disturbed at once because it's too disruptive. So that might be how I do it. It's just taking the witness, having more granted. We're not witnessing 100%, we're witnessing 5%, or we're witnessing 2%, we're witnessing what works. And then, you know, those parts will be getting stronger and maybe we witness a bigger chuck. (gentle music) (gentle music) - Joann, you are a big advocate of resourcing and coping skills when working with complex cases, right? Why and when should an IFS practitioner acknowledge that a client needs more than just the pure IFS protocol? - Well, you know, I've done pure IFS protocol and it's worked beautifully, but they do tend to be people who don't have big trauma histories or big abuse and neglect histories. You know, somebody's gone through a big trauma. I think it's real helpful to have do safe space imagery. And the reason why you safe space imagery is safe space imagery and the protocol that I wrote about is one, I started learning in working with people with trauma histories through hipnosis and it's a little different than the EMDR one, as I said before. But the reason to use safe space imagery is it teaches people to block out and truths of thoughts and feelings. If you're just doing something like guided meditation or diaphragmatic breathing, those things can be really relaxing. However, with somebody with a big trauma history is when they start relaxing, it decreases their surface defenses and then all help breaks loose. You need to be able to block out and truths of thoughts. and feelings. So I rely on safe space imagery or you know some kind of version of something that's going to help them learn to block out in truce of thoughts and feelings because that's what comes up. I used to treat follow up from a stress management meditation program. You know and people would start meditating and their surface defenses would go down and they'd have flashbacks and then get depressed that they've lumped out of stress management group and I'm like yeah right well that's biology that's not not your problem they should have taught you that. So I think where is I know you can get away without using safe space imagery and just do IFS, straight IFS I think if somebody has a trauma history it can be really helpful. Whether they have a big dissociative disorder or not. It doesn't take a whole lot to teach people how to do it you know. I think one of the things IFS says is that it disses the managers because the managers are used to keeping you know keeping everything organized and I have never found a manager who didn't agree to have their management skills upgraded you know. I mean that's what I say to people I'm like I grew up with a dial phone okay so you grew up with the flip phone. Did you grow up with a flip phone Lexi? Yes okay so and I'm like I don't use it anymore I use a smartphone because it does so much more you know we have these defenses when we're kids we get upgraded ones now and managers the managers I work with like to have upgraded skills they don't seem to mind so I don't know what that business about I you know it has a lot to do how things are presented. Exactly if we're honoring and respecting how hard they work how much they have on their plate how much they've tried to manage with what they had and then we're offering them this option that maybe there's a more effective or efficient way they're usually relieved and grateful. Yeah and I like better better skills I was thinking that this morning making this cake you know I when I was a kid you know I beat the beat the butter by hand you know it's way easier to throw it in and mix it. A mixer yeah. So I have this therapy gives clients experience with the powerful technique of unblending where they're able to differentiate from their parts and be with them rather than being overwhelmed by the emotions and perspectives of their parts but some clients have a very difficult time unblending between sessions without the help of the therapist there especially in the beginning stages of treatment some cannot at all as we kind of alluded to earlier for a very long time. So are there some practical skills or techniques that we can teach our clients to use on their own between sessions to maintain emotional stability maintain their functioning. Well so one thing is if you're relying on clients getting into self that's going to be harder for people with more complicated trauma histories and so you can set up failure if you start talking parts parts parts self self and you're stoking people's fears. I can't tell you how many people have said it panics me that you know about parts you know I'm going to take this away from somehow or I'm going to you know their perpetrators who use their the parts to abuse kids or adults you know they may call on a child part and then abuse the child part when the adult part is getting more you know their feet under them so it can be dangerous. I don't know if it's difficult or if it's that there's so much fear sometimes in in letting people know that they're parts or they're parts that are afraid that you're going to take their control away from them. I always tell people and parts that I want them to have more control and more choices and this includes the perpetrator identified parts who are saying you fucking asshole when I get home I'm carving her up you know because there's something protective about that we just don't don't understand it. It might be simply that if I carve myself up then I have control over when it happens versus waiting you know and again if that part is living in the past and thinks I'm going to be abused every day every second or whatever then they're carrying that information to the present and acting as if they would have to protect themselves when they were a kid. But you know I think sometimes I've had to just kind of sit with people and just kind of work with things and there are people rick cluff who did a lot of the early work. Dissociative disorders were worked within the late 1800s a lot a lot of information from june and then it went underground with Freud repudiating the seduction theory which I think makes sense because you know who was talking about sex back then you know the the environment wasn't very enlightened and he was treating friends of neighbors and neighbors and you know makes sense to me that he would have just said no this isn't happening it's all fantasy but whatever it is it kind of went underground until I think the 40s or 50s or I'm always a little fuzzy on this but and it's kind of come up again so rick cluff was one of the first people who was doing a lot of the work. One of the things that rick said was that their treatment trajectories there's some people who work there's the fast track the medium track and the slow track so if I'm starting with someone who slow track they're going to be phobic of pain they're going to want me to heal them they're not going to want to do homework they're probably have a worse response to medication they probably have more pain conditions like fibro and arthritis and all of this stuff they're probably also more connected to their family of origin and they also sometimes want the world to change so they feel better and I know you knew that feel better if the world converted to being vegan and I'm like seriously you are totally avoiding healing with this so if it's one of a person like that you may have to sit with them for a while and sometimes it's just refusal to work with parts I had one woman who refused to work with parts for five years and I finally said to her I said okay there's a part of me a little part of me that wants to say something and I want you to be able to hear her out can you do that the rest of me thinks we should can keep working the way we're working and we'll get there and she said okay and I said the little part thinks she should quit therapy and come back when you're willing to work with parts and the rest of me thinks we should just keep working the way we're working and we'll figure it out and it was like a subtle kick in the ass and it was both were true and you know it kind of helped her hear things in a different way but you know I talk about my parts I talk about why we need to work with parts I talk about how we all have parts the IFS thing we all have parts enormously helpful I parrot that to clients sometimes more carefully than other times but so we were saying a couple minutes ago that you know you've never had a manager feel insulted because you helped them learn some some coping skills which you know I found the same to be true and we have talked about safe space imagery some skills around that either types of skills that you help managers learn in terms of upgraded coping that you've found to be particularly helpful well there's some you know helping parts get oriented to the present or retrieving parts so in these complicated systems of parts they'll be parts who are living in their childhoods and feeling like they're being abused every day so or they're just be terrified all the time so one thing that I might do is have more oriented parts make a list of what they know about today how they know it's safe in 2024 where they live how they know their their house isn't being [BLANK_AUDIO] broken into. Now I would differentiate if somebody is living in a dangerous area, I'm going to feed that in. But you know, and then when we have a good list, I'll ask them to send the list to all the parts, the ones they know, the ones they don't know, and have them tell the parts they don't need to believe. Anything we're telling them, we just want them to take in the information and check it out between now and the next week. And let us know if they have any concerns, anything to add, any, you know, they disagree with anything. So we do stuff like that. And I mean EMDR trained, I started doing this with, I mean, I started doing it with hypnosis when I became EMDR trained, I'd do it with tapping. I'd make a list with the adults, we'd tap it in. And then the next work time, they'd go through the list and tap and communicate it to all the parts. And then the next week we go over it again and see what they found out. And homework would be driving down the street. So noticing that the license plates in my state, Massachusetts are different from the license plates where they came from. So they came from Georgia. You know, we don't see that many Georgia license plates. We see a few, but not that many. So notice the license plates as you're driving home. Notice the postmark on envelopes, what the date is on it. Notice, I'll have the person, if I'm, again, I'm going to use you Lexi. Lexi is your driving home. Just talk to the parts and show them where you're going. One of my clients lived a couple blocks from where she grew up. So notice that you're going by that street. You're not pulling into it. And just let the parts know we're driving by that street. Now we're taking a left and we're going to our house, which is a white wooden house. And it's not the brick one we grew up in. So differentiating. And it's that differentiating that's important. And sometimes parts need information that adults don't need. I had worked with somebody and what the kid parts needed was anytime they wanted cocoa, they could have it. And I think that was something about respecting their needs, hearing their needs and respecting it. Or what pets does the person have now that are different? They can go home and they can have the pets. When sometimes I'll have people walk around their house or walk around their apartment and introduce it to we have control over who comes inside. One woman I worked with had a lot of childhood surgeries and a difficult family. And so she was walking around her apartment and smelled ether. What was child part smelling ether? So she said no, we're not in the hospital anymore. Look through my eyes and see where we are. Walking is also bilateral. And you know, bilateral can help information sink in. It's sort of EMDR-esque. So things like that, that's another thing. Sometimes, sometimes I'll do that with me. How do you know you're meeting with me? What's my voice sound like? I've had people be triggered by me because I'm tall. I've had them be triggered by me because my hair is now white. Or I change it. I have purple streaks in it now. So if I'm going to have them tune into who I am, I'm going to say, how do you know you're meeting with me? You know, so many people will see someone and they're afraid, automatically afraid. So what do you know about me? We've been working together for ten years. How did you find me? Why did you decide to work with me? What happened when I went on vacation? What happened that time you screamed at me and slammed the door and went out and said you were never coming back? Or what happened that time? I forgot to call you back. And you know, we weave that in. So and then I might have them visualize a fast forward video of the ten years we worked together. And see if there's anything else they want to add. I like Bethany Brand. They now have a new workbook out and I'm starting to use that. That's got a lot of grounding things and it's got all the things they used in their treatment and their research project. So they're they're starting to film videos which I think will be a huge help to treating people. So when is this resourcing approach you are sharing unique to managers or would you also help firefighters and exiles learn new copy skills? No, all of the parts need them. And there are there are exiles that function like managers. I mean I know IFS says that exiles don't have jobs. I disagree. I think anyone who's carrying a huge burden that's a job. And I think that, you know, there's managers can have lots of exile type burdens, so can firefighters. So I mean, I want all of the parts to learn management skills. You know, this is not unique. I wasn't writing about too much that was unique. I mean, I came up with a couple of things but they're all built on the standard knowledge and the trauma and dissociation field and hypnosis field. It's not new. Bethany Brandt said that too. She said there's nothing really astoundingly new in the field. We need to keep doing more of what we've been doing. So I promote the parts helping each other and working together and maybe having some teams that help each other out like a daily life team that handles managing life. I went up for a woman who had a really high power job and she came back and she said everybody thinks I'm a snob. And so we asked who inside is good at socializing and got a five-year-old part out who liked to socialize. So the five-year-old part ended up going to work in this high-power job. Now the five-year-old didn't come out but the five-year-olds energy in the team meant she could go on coffee breaks and chat with people. So, you know, I do some team building like that or problem-solving like who can go to the colonoscopy and who can't. You know, who's who's too afraid to go? Well, and everyone needs to let the medication work who's got concerns about taking the medication. What can we do about that? So I guess, you know, I think about those two coping skills but there's a lot of other stuff like the orienting parts to the present teamwork. Sorting through cognitive distortions, you know, those people always have lots of cognitive distortions. Joanne, you say you start your work with clients teaching skills including safe space imagery, other effect regulation skills and container imagery. So is there or is not a risk of these techniques exiling more of their exiles and stories? That's a great question and sometimes people will say that and I want parts to have safe spaces so they start being able to decrease their reactivity level. I'm not jailing them in the safe space. They have control over being there and coming out and going back in and using it in ways that's helpful. And I think it's sort of a perversion of what's certainly the trauma treatment I learned in grad school. Somebody has a sex abuse history. You need to let them take, they need to get to their rage and their terror. I mean, basically, it was fast-tracking people to the hospital. So I'm like, no, these are not coping skills to hide parts away or suppress the information. It's so that we can work on it in a way that works. And so I'll negotiate that. Now, I did, I have had people come in and say, I have coping skills. One woman is like, I have coping skills. I can get myself into the hospital. I want to work relationally. I love you. like I work relationally, but if you're gonna work with me, we're doing coping skills and she never came back. She'd have a lethal suicide attempt four months before that. I'm not working with someone who thinks she's got good coping skills who makes lethal suicide attempts. (soft music) IFS trainings, they generally involve a lot of guidance around helping clients develop self-to-part relationships with protectors and exiles and not as much focus on helping hearts to develop collaborative relationships with each other. And you just started to talk to us a bit about how you might do that. Your book actually also offers information on how to help foster cooperation and really integrated functioning among the parts in the internal family. So would you talk a little bit about the importance of helping parts develop good relationships with each other, how we might help clients accomplish that? - I mean, I think again, if somebody has a relatively easy, I'm not saying trauma histories are easy, but a more simple trauma history, no problem. But if somebody's got a lot of parts or a lot of dissociated parts, you know, if it's all self-to-part A, you're not gonna get to self-quickly. So if you're doing that, that's gonna take too long and it's gonna be probably depressing for the client because they're gonna be failing. And, you know, there are all these, if there are lots and lots of parts, it's better to help them get some skills and to be able to help each other. You know, that's gonna make the therapy work much more efficient. So I might have a teenage part who kind of looks out for the younger parts like as in sort of like a babysitter part or a part who manages things while other parts are at work or drivers or, you know, I'm always looking for ways that the therapy is efficient. And I think for some people, it's not so efficient to always do self-to-part. I think having parts with self-energy, developing self-energy among the parts means parts can help each other during the week. (soft music) - Joanne, do you see yourself as mainly an IFS therapist and EMDR therapist or another trauma modality therapist? Do you feel IFS also needs EMDR? - I see myself as an alphabet soup therapist. Since I have IFS, EMDR, DBR, TFT training, you know, maybe some without initials. And I think that having these trainings makes, I mean, I don't think everybody needs every training. There are people in this area who are EMDR therapists who dropped it and just do IFS. I think that's kind of like throwing the baby out with the bath water. I mean, I think if somebody comes in with a recent event trauma or a single incident trauma, oh my God, UCMDR get rid of the pain. Then you can do IFS. I treated someone with a really traumatic bike experiment accident. And we did EMDR for, I don't know, 16 sessions. And then a few months later, she came back and worked on her DID. But those 16 sessions meant she went from non-functioning to getting a different job that was better and feeling better and riding her bike again. You know, and there was no need to work with the parts. We worked with the parts later. So I mean, and I also think, else it depends like if somebody comes in and they say they want EMDR, well, I'm always working from some kind of IFS frame. I'm always using some kind of IFS because there's so much about it like the C's, you know, parts developing curiosity, compassion. I mean, curiosity helps enormously informing connections with parts. You can be curious while you load someone. So someone might say, I hate that part. And I'm like, yeah, tell the part, you hate the part, but you're working with me so you're stuck learning to work with her. Not today, but we'll get there. And I say to the part, we're not going to forget about you. And you let me know if you feel forgotten about. - So trauma therapy and most modalities involve some psychoeducation. So could you offer just some guidance around what type of psychoeducation you provide to your clients with complex trauma, dissociative disorders? - What depends? I mean, I have had clients who freak out. I mean, it's like, I don't have DID. I can't have DID and I'm like, no problem. Fine, you don't have DID or I don't say that. I'm not going to lie to people. But I don't talk about DID. I talk about dissociative symptoms or I don't talk about that. I talk about everybody having parts in normal multiplicity. And then at some point when they can handle it, I might throw it in and say, you know, it gets a bad rap. I mean, it's the healthiest way to get through a childhood like yours. You know, people who can't dissociate don't get through those childhoods with the ability to heal and care about people. I might do that. So I think when people ask me what kind of training I think they should get, I say, I think a basic hypnosis course is really useful 'cause it teaches you language and it teaches you how to use language to get more bang for your buck in any therapy you're doing. And so many therapies, so much as hypnosis stuff, EMDR spent a lot of time saying they do nothing. They have no connection to hypnosis. IFS says that too. And then when you look at it, it's like, yeah, but there's hypnotic stuff in it. So I think hypnosis training is super useful. Even though, and I have lots of it, even though I don't use it formally very much at all, I mostly use it to help people learn how to use the transes they're already in. I think EMDR training is great too because sometimes you can get really jammed up with a part and some EMDR helps. I also think for EMDR therapists, IFS training helps a lot. It just makes what you can do with people so much more. And there's other therapies coming up that I think are really useful. I just did DBR, the DBR deep brain reprocessing level one. Super helpful, I'm gonna do the level two after Thanksgiving. So I think it's a exciting time to be a therapist and you know, sometimes it's good to learn some different things and be able to use them together. That line about if you only have a hammer then all your problems become nails. I like to have a lot of different things. - So precisely Joanne in your book intro, you quote 1966 Abraham Maslow comment, Maslow says, I suppose it is tempting if the only tool you have is a hammer to treat everything as if it were a nail. And then you, Joanne, you say, IFS is a wonderful hammer. Do you feel like IFS is an overrated model or is it one of the best models in our field? - I think it's probably one of the best models and it has this glaring limitation that they think you need no coping skills and they teach that. So I think it's unfortunate 'cause it takes a model that I think could be a really amazing model and makes it limited. So I mean, no coping skills, no identifying when people are in the dissociative spectrum, you need nothing from any other fields. All you need is IFS, it'll treat every diagnosis. I think that's limiting and dangerous. And it makes me sad because I think it's too bad. And it's not curious, it's not self-led if you're saying you need nothing from anyone else. In my opinion. (soft music) - Joanne, as for the future, what's coming from you, We just learned that. you are enrolling another training in Thanksgiving? Have you been teaching and case consulting? - Well, I'm not a very good marketer, but this book has done pretty well and I get emails and things from people actually all over the world, which has been a little bit surprising. But I think says something about how, you know, IFS training leaves people needing something more about complex trauma. So I was in Australia in September. I was in Poland in last June. My book's just about to come out in Polish, negotiating with a Spanish publisher. I'll be in Portugal, honey, ball, and-- - Beautiful. - May I think giving like a resort course that will have to chance to do a lot of practicing and understanding more complex trauma and dissociative disorders in IFS? Yeah, I've got a bunch of training things coming up. I'm doing some stuff online. It's going to California. You know, people ask me when I'm gonna write another book and I say I am totally committed to writing a book every 68 years. - It's a big commitment. - I just turned 70 so it's coming up soon. There's a couple books coming out on integrating IFS with EMDR. And I just wrote a chapter on the fire drill for one of them. And I think I might write an intro for another one. And I think it's great. - You look easy. - Yeah. I'm starting to make Christmas cookies. (soft music) - Joanne, thank you so much for having such a joy to be here with you and Lexi. Let's hope we can keep meeting and sharing this model our work and our lives. Thank you so much, Joanne. - Thank you. - Thank you for having me.