The importance of understanding parts

[Music] Hello and welcome to the Prachidemic's podcast where we aim to keep you informed, connected and inspired in the work that you do with children, young people and families that have been impacted by trauma. This podcast has been recorded on the traditional lands owned by the Jagara and the Turbale people and I'd like to pay my respects to their elders past, present and the emerging community leaders as well as the traditional owners of the land on which you may be listening to this podcast. [Music] In this episode today I'll be interviewing Dr Catherine Hines, who is a clinical psychologist, also with a PhD in neuroscience and EMDR consultant supervisor and I'll be mining her brain over the next couple of episodes. In this episode I ask Catherine to tell me about parts more generally, why they're important and of course how do we work with them. Catherine actually made the great point that the language of parts or the concept of parts is not necessarily new and in fact it features in other therapies but therapies can differ in their perspective on what we need to do when we find conflict within parts and Catherine makes the argument on what she thinks we should be doing in those situations. [Music] Okay so tell me about parts, about parts, yeah, where to start, it's a big one. When I trained in psychology you know there was an assumption in all the therapies that I learned at uni that the mind is unitary, right, that you're one person and you are somewhat consistent in your approach to life and my first job was in a drug and alcohol service and in drug and alcohol service we work a lot with ambivalence, right, the person who like loves to drink but knows that drinking is destroying their life and you know motivational interviewing for example really works with that ambivalence and that was seen at a time as quite revolutionary, right, that this idea that ambivalence is normal, right, and that really appealed to me. When you start to look at the consequences of poor emotional attunement in childhood so parents who don't know how to respond or are unable to respond in a really resonant way with their children, ambivalence really grows like people don't get the experiences that join themselves up, right, and so a lot of the different neurological modes in the brain become really fragmented and just don't get an opportunity to be yoked nicely together into the sense of self and that's what parts are, right, so examples of parts might be action systems from the limbic system that just don't join up so we all have those action systems from the limbic system if we're in danger or we'll be in fight or we'll be in flight or we'll be in freeze, right, but for some people they're so frequently in those limbic modes that a whole lot of experiences get packed in with let's say flight and so there's a huge pocket of anxiety but it's difficult to to engage with that anxiety because there's no opportunity to settle it down, no one's helping you with that so you just pack it away, yeah, for the person who ends up in that situation with lots of overwhelming limbic states that are not getting resolved for them calm down soothed then they often will develop other strategies parts to suppress those so that might be denial, right, oh no, I'm fine, I'm not anxious, right, or it might be shame, right, no, I'm never getting, I'm not allowed to get angry, I don't get angry, yeah, and that shame sort of shuts it down so we can have layers of ourselves that are not very well integrated and that's really what parts are, I can think of multiple occasions where I've been working with someone that said that well tears are running down their face, yeah, it's just that it's like an example of yeah, possible parts, I would say so, yeah, so the incongruence of the verbal statement and the affect is often something where to be curious about why, right, and what it's showing is a fragmentation isn't it, there's a bodily experience that isn't joining up with the verbal statement and that suggests some internal disharmony and that's where I would start to look from a person's perspective at trying to understand what's going on for that person, yeah, so I guess if someone comes in you're doing some stabilisation stuff it doesn't seem to be working in quite the same way as it does perhaps with other access one PTSD single incident trauma people and you're starting to think maybe there's parts, what do you do? yeah, so in the in the beginning a lot of I had this experience and a lot of therapists that have consulted with me on their work you know report this experience that when you start learning about parts work models there's this moment of anxiety in bringing the parts work to the clients because it can feel crazy making, right, like you're suggesting perhaps that this person is less stable than they realise, but actually what you do is just talk to them about what's going on, right, and if we use really normal language for parts work I think people can really relate to it, so going back to the drug and alcohol example you know it's a really normal thing to say to someone, gee it sounds like there's a part of you that's really enjoying the drinking and it's doing a lot for you in your life and there's a part of you that's concerned about the consequences of drinking for you, I wonder if we could look at both sides of this, right, with the person who's struggling to stabilise you want to start to be curious about what the limits of stabilisation are, right, and so one of my early experiences with dissociative identity disorder was with a young woman when she had flashbacks she would drink a lot of alcohol and then be quite angry and aggressive in her placement in a mental health setting and so they called me in to help her manage this and what was remarkable was that in sessions she was absolutely compliant, signed up to these you know plans and safety plans and all that and really willing and able to articulate it and left each session with what seems like a really genuine intention to do that and then it didn't happen and over time it occurred to me that the part who was using the alcohol was not coming to session and that our goal really had to be to reach out to that part and bring that part into the therapy room, right, how do you do that? It's some not as hard as we think you say seems to me that there's a part of you who's reaching for the alcohol that isn't coming here, right, I wonder if we can talk to that part. What do you know about that part? Tell me about experiences when you reach for the alcohol, what do you remember? Yeah, with that part, be willing to share its perspective because I'm sure it's got reasons to be doing that. Yeah, you just talk about it, that's what you do. So you make it, I think overall, go to understand the model really well in your mind so that you can make use of it, but just make it really normal, right, just talk to the person about their experiences internally externally, what are they noticing? And one of the things to be really aware of are those memory gaps and internal conflicts because that's often where the dissociative structures are manifesting. So I guess in this it makes me think about Schemotherapy. Yep, and is that just Schemotherapy? What are you describing? No, it's not just Schemotherapy, but Schemotherapy definitely draws a lot on some parts work models, particularly if you're looking at the mode work side of Schemotherapy. I mean, two degrees, Schemers are parts, but two degree they're not as well. It gets a little bit complicated. But the way I would distinguish the parts work that I do from Schemotherapy, I draw on Schemotherapy and the parts work that I do, but because my background is in brain science and trauma is really a problem of encoding material in the brain, isn't it? So when a traumatic memory is stored, it's stored quite differently to a non-traumatic memory. And the main difference is that the hippocampus hasn't touched it, and so it isn't stored in order in time. The way it ought to be, right? The hippocampus is really important and spatial and temporal memory. It's sort of an index sort of memory. That hasn't happened for traumatic memories, so they're stored in the present tense, right? So given that's what trauma is, I think we really need to look at the brain and have our psychological models really informed by brain science. And so Schemotherapy has these lovely and very helpful modes of being that they've described, you know, healthy adults and abandoned child and so on. And these are useful, as ways of understanding a client, but more useful is getting into the nitty-gritty of the limbic system and looking for fight responses, flight responses, freeze responses, submit responses, and then the parts that try to suppress those from interfering with daily function, those look more like schemas. So to clarify, the parts that are suppressing limbic systems, those parts look like schemas. They can, yeah. So denialism to schema, right? But let's say subjugation and self-sacrifice is a form of denial of needs, isn't it? It's a suppression of needs. So I draw heavily on schema therapy. when trying to formulate someone's particular structures, and I will often give a Schemotherapy questionnaire. Where the work that I do, there's one significant, well, one very significant divergence from Schemotherapy, which is how you hormonalise parts. And I guess I'm looking to understand things from a bit more of a nitty-gritty neurobiological perspective which doesn't come up in the Schemotherapy, right? The action systems that really is in structural dissociation. But the major divergence from the way that the structural dissociation people work in Schemotherapy, people work, is that in structural dissociation, what we're trying to do is resolve the dissociation and hormonalise all brain systems so that your brain can function as an integrated hole, where specialized parts of brain function can kind of come out and do what they need. So if you do need to fight, you can let that limbic system come through, but you're also conscious of that. You're not hijacked by your limbic system, you're collaborating with your limbic system. I'm kind of angry, I need to do something about this. And if you need to run, you're running, right? That dog's chasing you, you're running, and you're conscious that it's you running. This is the goal. In Schemotherapy, there is advice about internally critical parts and banishing them. And a lot of therapies do that, right? Act does that as well, I just ignore that voice in your head and get on with your valued life. I don't think that ignoring parts of your functioning neurology is wise. I think that what we need to do is learn what they're saying and why they're saying it, and help those parts of our minds to adapt in a more harmonious way to communicate in a more functional way. So I would never encourage increasing internal disharmony or self-ignoring, and we would work more on formulating that part and involving that part to collaborate and involve to serve that same purpose but in a more friendly way. So thank you for listening to part of the very wide-ranging conversation that I had with Catherine. I'll be sharing more of Catherine's insights in the following podcasts as we dive deeper into this idea of treating complex trauma and dissociation. So subscribe to our episodes to make sure that you find out when they drop and keep in touch by following us on Instagram, Facebook or LinkedIn. Also, if you're interested in knowing the strategies that both Catherine and I teach in practice to improve safety and stabilization skills when we're working with someone with complex trauma, you can download our free guide in the show notes. So that outlines three easy ways that you can improve safety and stabilization skills in the work you do with people that have experienced complex trauma. Thanks for listening and I hope to catch you in the next episode.