Lack of sufficient time in therapy is a frequent complaint. For dissociative clients, the 50-minute hour is an unproductive limit – it’s just too short a time within which to arrive, get acclimated, get into something serious, do some work on it, and then to get reoriented enough to go on with the day.
Many therapists have also recognized the inefficacy of the 50-minute hour, and they have responded by providing 90-minute or 2-hour sessions. There are even some therapists who will go beyond that. And many dissociative clients who are in therapy attend sessions two or three times a week.
Considering the amount of psychic energy required, that’s a lot of time spent in therapy – so then – why is it still not enough?
And clearly it isn’t – dissociative patients remain locked in uncommunicative darkness within their systems, they continue to go in and out of hospital programs, they continue to struggle with suicidal or self-injurious urges, eating disorders remain trenchant, flashbacks and phobias maintain a dominant interference, memories plague them without being processed – and this is often just as true for survivors after five or ten or twenty years of therapy as it was when they began. Despite the vaunted treatability of dissociative disorders, they somehow appear at the same time to be singularly resistant to treatment. Why is this?
I believe the the problem lies in the unspoken expectation that therapy can do all the work for us. Please note, I did not say the therapist was doing all the work – I said therapy. It’s not that everyone expects to just show up and have that be enough, or that they aren’t willing to do the work required – there are plenty of people who work very hard at their healing when they are actually in a therapy session.
But what about all the hours and hours of time that we are not in session? Are we using those hours to continue what work we can do on our own, or are we wasting them in “just getting through” until our next therapy appointment? Do we talk to other members of our systems and work on building relationships with them ourselves, or would we prefer that they just do all their talking to the therapist? Do we work to find ways to reach all the members of our systems, or do we prefer to stay with the “nice” ones – the helpful adults, the least broken of the children, the least aggravating of the teenagers?
The 50-minute hour of therapy is not enough – in fact, no amount of therapy is enough – to make up the lack if we are not working with our systems on our own time. And, it is not enough for the members of our systems to talk to only to the therapist – in fact, it’s not even practical to assume that this should be enough for them, or to imagine that healing can be achieved this way.
Take your system as you know it – if you don’t know your system very well, multiply the number of members you do know by five (that’s a very conservative estimate), and if you think you know your system pretty well, multiply the number you know by two – then multiply that number by 500. That’s a rough (and again, very conservative) estimate of how many therapy hours it would take for each person to introduce themselves, get to feel comfortable, share even a few of the secrets and the traumas they have experienced, and barely begin to heal from them. How many years of therapy does that end up being for you?
And those hours do not account for the challenges that might still lie ahead and which might, when they happen, need to occupy the therapy time for a while.
Those hours are also not taking into account all the little day-to-day issues that will be presented to your therapist for resolution if your group proves unwilling to handle them internally.
How many people have had a sad or sulky child part or an irritated teenager firing off embarrassing emails to the therapist or occupying actual therapy time getting answers on simple issues like “I want time to do this and so-and-so won’t let me” or “why can’t I have that thing I want” or “she won’t listen to me” or “she hurt my feelings” or any one of a hundred other similar things?
How much of your therapy time has been wasted resolving issues that could have been resolved just as easily – more easily, in fact, and with a lot less embarrassment too – if your group just settled it themselves? I mean, do you really need your therapist to explain why your child parts can’t eat cookies if the adults need to stay on a healthy diet, or helping to establish rules to keep the tweens from driving, or soothing someone’s hurt feelings, or mediating every dispute that comes up? Is that really the best use of that time and that resource?
There are a lot of things that the system members can mediate, explain, teach, or resolve themselves. They can soothe and comfort the children, they can establish and maintain their own rules for how to function safely and responsibly in the outside world, they can devise a fair schedule around the constraints of the outside world for members who want time of their own, and they can take care of the supervision of children or teenagers during their outside time, among other things. Some memories can be processed even without therapeutic assistance, and the group can brainstorm for new ideas or new solutions where needed and then experiment with implementation themselves. Therapy work doesn’t have to end when the session ends. But all of this is only true if the group is working together.
If being “in session” is the only time we interact with our systems, if the system members don’t talk to each other in between sessions (or talk to each other at all), if we’re waiting for all the work to get done in therapy… then therapy will go on forever – literally.
And no matter how long we go or how often we go to therapy… if we cling to the belief that anything can compensate for our own lack of internal communication and cohesion, then we will still be presenting an insuperable block to our own healing.
