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Case Study - Page 2

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Once I'd begun to form a coherent picture of the turmoil Marcia was experiencing, I gave her both the "good news and the bad news." The good news was that she didn't have to give up her children to save them, and the bad news was that the trauma she thought she'd left behind was still very much with her, manifesting in a furious inner battle being waged by her various "parts." I began to explore with her how unresolved internal attachment issues can surface as otherwise normal life stresses evoke the fears and feelings of our disowned, abandoned inner parts.

Using Sensorimotor Psychotherapy, the bedrock of my therapeutic work, I began to help Marcia differentiate between the impulses, thoughts, and feelings of her traumatized inner parts and the actions and reactions of her "wise adult self." The felt sense of "who I am" as a compassionate, thoughtful adult is palpably different from the experience of a hard, scathingly judgmental part or a young child yearning for care or an angry part fighting for justice. I began by focusing Marcia on sensing those differences and mindfully noticing the parts within her rather than reacting to them. From there, I began to guide her in "befriending" the parts she'd unconsciously disowned so many years ago, even as they were causing havoc in her current life.

But how do we actually "befriend" parts of ourselves? The answer is: the same way we befriend anyone else. We show interest and curiosity. I invited Marcia to learn what made her parts tick as if they were people she was getting to know for the first time. What were their likes and dislikes, fears and fantasies, habits and growing edges? That meant teaching her to listen, to really hear what these parts were trying to tell her, even though that meant making a radical leap of faith, believing that all these distressing feelings, thoughts, behavior, impulses, images, and dreams represented communications from parts of her own self. In doing this kind of work, I find myself repeating certain phrases and instructions again and again: "Notice that feeling of shame as the ashamed part is trying to talk to you. Notice what she's trying to tell you. Is she feeling responsible for the angry part? Or is the judgmental part making her feel bad about herself? What is she saying? If that dream were a communication from some part of you, what would that part be trying to say?"

Despite my best efforts to translate her inner experience into "parts language," it was almost impossible at first for Marcia to accept that her mood and behavioral swings represented communications from parts of her. "I have to be responsible for my behavior," she protested. Then, in the midst of her therapy, she experienced a crisis so intense that it moved our work together into another level of intensity and clarified issues she'd been struggling with all along.

Losing Control

One Sunday afternoon, as her husband was once again engrossed in watching a football game, completely unresponsive to her, she felt a sudden surge of rage and, in a moment of depersonalizing horror, watched herself lift up their television set and hurl it across the room while her children screamed in fear.

"That's unforgiveable: that's not me," she said at her next appointment. "I'd never do something like that!" Aided now by her willingness to do anything to avoid repeating that scene, I asked her to go back to the moment when her husband had failed to respond to her and notice what had come up inside her: "I'm looking at him, and I can feel the rage roiling inside."

"OK, now assume that this rage belongs to some part of you. Separate from it a little bit, so you can notice it instead of 'being' it. See what happens if you say, 'She's furious.'"

"It's easier to manage the intensity if I say 'she' instead of 'I'. But I just want her to stop it! She's ruining my life and my marriage."

I challenged her: "So you're telling me that you want to tell this badly abused child to just stop being angry? Is that right?"

Marcia paused and had to think: "Well, I guess that's not very realistic, is it?"

"If this child were your foster child living in your home, would you tell her to get over it? Or would you try to help her? Would you understand why she got so angry at your husband?"

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