(*glossary provided below)
by Joanne H. Twombly, LICSW
There are lessons in Kluft’s lines and jokes and remembering them has helped me appreciate some of the more recondite aspects of working with dissociative disordered people, along with appreciating the fungibles of theory no matter how perfect it appears. Years ago the first time I heard Kluft, he said that 20 years from then (otherwise known as 5 years from now) many things would be different about the treatment. This was in my more Procrustean days when I couldn’t imagine that what he’d presented wasn’t going to be the ultimate treatment forever and forever. Now I know that “paradigms are the foundation garments for the mind” so I would never be that rigid again. Imagine choosing to wear a brain girdle! Actually the concept makes me more patient with those who haven’t managed to get that dissociative disorders truly exist. I have compassion for anyone stuck with a girdle on the brain.
Some of the lines I picked up serve as a reminder to me of treatment dynamics and what it’s like to have a dissociative disorder and be in treatment. It was nice to hear Kluft say, “The first 500 times you tell a DID patient something is the hardest.” I say things over and over, and now I know it’s not just because I haven’t figured out the right way to say it! It also helps to hear that “Treatment is an exercise in titrated toleration of humiliation.” It is so clear to me that children are blameless when parents are abusive, that I can minimize the impact of their humiliation that it happened, and the humiliation they suffer needing to sit in treatment telling me about it.
Kluft teaches how to be a better therapist. There’s his prescription for avoiding vicarious traumatization: “You want to be like a wine taster, not a drunk.” When listening to clients, therapists need to taste affect, not drown in it, a very useful metaphor! Lest anyone begin on the slippery slope, there’s the concept of the Heroic Paradigm (the belief that everyone can be cured) which Kluft says guarantees lots of boundary crossings. I think some grad schools teach the Heroic Paradigm, so it’s a good reminder that this isn’t the kind of hero that’s truly heroic. I also liked his quote from his chain-smoking teacher Elizabeth Zetsel. She said to an analysand smoker who wanted to smoke in session: “What makes you anxious is good for the analysis. What makes me anxious is bad for the analysis.” It says something to me about taking care of myself well enough, to be able to be as completely present as possible in session. The last concept I picked up from Kluft years ago when he said he and Catherine Fine would get together everyday and discuss their “Errors de jour.” This neatly decriminalizes and normalizes errors! It teaches something about humility, which is also illustrated by the line: “Guillotine was the only man who solved the mind body problem.”
Simple concepts that clarify difficulties in getting a common world view with dissociative clients include, “Many equate strong with bad, and weak with good.” And “Hope springs infernal…” Clients need to hear, “You’re all in this together. Everyone wins or everyone loses.” Another line I got from Kluft previously is, “How many years do you want to be in therapy?” This may sound harsh, but can clarify a lack of forward moving motivation, or the unconscious (conscious!) belief that therapy is forever. These are lines I will remember in my continual process of untangling and unearthing ways of thinking that I’d otherwise not pick up on.
Last but not least, there are the initial words: MAD or Mental Alchemy Disorder which labels the magical thinking that underlies some of the illogic logic of our clients, and of course, Multiples Unable to Deal with Daily Life Experiences or MUDDLEs. As negative as these may appear, they neatly solidify dynamics that can paralyze a person. As Janet did when he used the description of “mental laziness” in reference to alters who perceive the present as if it were the past, there’s a straight forwardness about these communications. And that is always a good thing when dealing with the intricacies, convolutions, and permutations of dissociative defenses.
Glossary: Kluft’s Vocabulary de Jour
Imbrication: Overlapping as in fish scales.
Fungible: Capable of being replaced in kind.
Recondite: Hidden, not readily accessible.
Procrustean: Forced to conform. Taken from Greek mythology where Procrusteas was an inn keeper with a one size fits all philosophy with regard to his beds. He stretched or trimmed his visitors so they all fit perfectly.
Errors de Jour: Errors of the day (an English/French hybrid).