Thread by @TheCrisses

Analyzing Brand et al 2012 more deeply, and we're so frustrated with this study. I hope they re-do a similar study for current practices and use it to help inform the ISST-D guidelines because this is *headdesk*.

The DID experts surveyed weren't recommending doing trauma work, for the most part. Barely used EMDR. Used CBT during the middle phases of therapy. There's good info in this document, but it's so out of date it's painful.

It looks like the majority of the experts surveyed recommend spending significant time repairing the therapeutic relationship. What EXACTLY is going on during therapy sessions that this becomes one of the major focuses of therapy?

We're not going to let up on our recommendation that client empowerment is 100% necessary and should be prioritized after the most rudimentary stabilization. A more empowered client, and less pushiness of the therapist might help avoid whatever those issues are.

Another glaring issue is "Teaching/practicing grounding" — this could be a mistake of the survey design team, same with some of the other categories on this survey (101 reasons to ask peers to be on these teams!). "Grounding" (in your body) during stage 1 is

likely to destabilize the client, which is not why they're trying to do it. Presence, not grounding. Hello, experts, don't direct us back into our body until you're sure we don't have chronic pain or physical/somatic memories to process.

Your colleagues send clients home and they spend days flooding (uncontrolled flashbacks), or end up in crisis units due to this. Presence skills are good, grounding in our body is contraindicated.

This is the survey in question if anyone wants to look it up. doi.apa.org/doiLanding?doi…

"the data are consistent on the importance of talking directly about & with dissociated self states in order to facilitate patients’ understanding of & willingness to work collaboratively with their self states. All of the therapists recommended this intervention…"