We can treat trauma processing like any other difficult situation and prepare for it by making a BDA Plan. It is a structured way to make sure that we have everything we need so that the therapy session can go smoothly. Being informed and organized takes at least some of the stress out of a demanding situation.

We don’t process memory alone. It needs a therapist to guide us through the rough parts, to help with co-regulation and to be a witness. You would never work on a BDA plan like this alone. Your therapist should guide you through it to make sure it fits the techniques and the setting they have to offer. You both take responsibility for the work you do together by planning it together.

This guide is for therapy that uses regular trauma processing techniques that are adapted for DID. There are other ways to approach trauma in DID, like working with hypnosis, progressively processing small units or highly focusing on integrative actions with parts while keeping the confrontation at a minimum. Depending on how your therapist works, a plan like this might be a lot more than you need. Please talk to your therapist about it and don’t just do what the internet says.

 

Before we even start

Before we even start to make a plan we have to ask ourselves if we meet the basic requirements for regular trauma processing. Are we safe? Are we able to manage our symptoms? Can we regulate ourselves? Do we have inner cooperation? Etc.

If not, there are more urgent things to work on than memories.

 

Before

First, we choose a scene for trauma processing. We discuss our ideas with our therapist and listen to their advice. It makes sense to pick a scene that is relevant for our current life because it comes up a lot or it hinders our plans for the future. Usually your therapist will ask you for informed consent to work on this memory with their technique. Nothing should be worked on without mutual consent.

Next, we make sure that we have all the abilities that we need to process this scene.

• Which parts know about this scene or carry fragments of memory from that scene?
• Do we have a stable line of communication with these parts?
• Are they willing to work on the scene and do we have at least some experience cooperating with them?
• Are they able to step out of the memory when it floods them (flashback experience), with help or alone?
• Can they get oriented in time and space in the outside world, with help or alone?
• Do we have any experience co-regulating them? Have they worked with our therapist before and can our therapist co-regulate them?
• Can we keep up dual awareness of the outside world and the inside experience or the inner team?

This is important information. There is a way to work with parts without having any co-consciousness but it is slightly out of fashion and most therapists work with co-conscious parts who support each other in the process. Parts who are utterly stuck in memory without an ability to orient themselves need a different approach and it matters if they know about the outside world in our current time already or if they are just oriented in the inner world. When we know all the parts involved, we will not get surprised by someone showing up out of nowhere. Every ability we can bring to the session will make it easier. A therapist can compensate for a lot, there are ways to work around problems, but if we pile up the difficulties, it will just get more difficult for everyone. Good preparation can make trauma processing unpleasant but relatively smooth.

 

Resources

Once we have a good idea what we are dealing with, we can pick resources that will help the parts involved. We can go through the sensory things they like, topics that catch their attention, toys and whatever we already know about them. You might have documented that in a resource book. These are things we can prepare to take with us for regulation.

Then we can examine our inner relationships and figure out who would be the best support for them, which inner helpers to keep in mind and which parts of the inner team should be in a safe space to hide from the whole process.

Ideally, we work with a therapist who already knows us. But sometimes it is necessary to process trauma in a clinic and there is very little time to get to know each other. We need some basic faith in their ability to do their job and to be able to work with the techniques they have learned. Working out the necessary resources together can give us both a better idea of where we are standing with each other and they can suggest options for us that are unique to this setting.

 

Questions regarding therapy

In our conversations to prepare for trauma processing our therapist should introduce us to the technique(s) they are using. It should be one that is fairly established and where we can understand how it works to resolve trauma. They should talk us through the steps, what to expect and also the risks and success rate of the technique. There is no trauma technique without risks. Someone who has uncritical faith in their technique is not experienced enough for treating DID. Some therapists will offer to demonstrate how something like bilateral stimulation works and they let us pick between options.

If you have DID, they have to explain how their technique gets adapted for DID and these adaptations need to make sense to your system and feel like something that works. If they have no idea how to use a technique for DID it is safer not to process memory with them. ‘Knowing about’ something is no guarantee that someone can actually do it but ‘not even knowing it at all’ is a sure sign they can’t do it. Ask as many questions as needed to feel safe with the procedure.

Ask specifically what they will do in case you switch. A DID therapist should be able to work with trauma parts in person and not just through the host. It should not be a problem. But because this is a situation where we obviously lost control and something did not go according to plan, it can be important to hear how they will continue and protect our dignity in the process.

 

Setting

Next, you can check out the room where the session will take place. Is this ok for you? Do you want to bring something extra? Should something be moved out of sight for the session? Is the chair situation one that works for you? Your therapist cannot change the color of their carpet but they can move a chair around.

It is your therapist’s job to make sure they have enough time for processing. When they plan the appointment, it really helps when the next client is not waiting on the doorstep already. We can try to get an appointment at a time of day when we are awake and focused and when circumstances in our life make it easier, like still having daylight outside.

 

Just before the session:

Make sure that you have a safe way to get to therapy that day and that you know how you will get home safely, even when you are too stressed to drive yourself.

Put on helpful clothes that make you feel good or that support your sense of touch for grounding. It can sometimes help to wear business casual to remind ourselves that we are an adult with competences now. It is up to you to decide what suits you best.

Pack all the resources you will need for the parts who are involved in this session. Add self-care items as needed.

 

 

During

 

Anchors

On the day of processing, take some extra time to arrive in the therapy room. It can help to choose 3 anchors that you can check when you need more orientation. These things should remind you that you are in this therapy room right now and not somewhere else.

You can also choose one thing about your therapist that reminds you of who they are. When we are halfway inside a memory, faces can sometimes distort and we might get insecure with them. I tend to go for the shoes because I already like checking what shoes therapists wear. A necklace, watch or hairstyle can also help to remember who they are when we struggle to recognize them.

 

Signals

Agree on some kind of signal to tell when you need to take a break or when the therapist needs to slow down or be more shallow. Some therapists work with finger signals to enable other parts to show when they are not ok with something. To do that, the therapist would ask inside parts to pick a signal to show them when something is up. It feels strange for the front person but it can be important when co-consciousness is not as solid as we would hope for.

Sometimes it also helps to give the therapist a signal when we feel that we will switch or dissociate any moment. With some parts it is obvious but a heads-up can make it easier for the therapist to adapt. Looking ‘inside’ can sometimes lead to the same empty expression in our eyes that we would have when we dissociate. Having a signal to show when we are truly starting to dissociate is helpful. Only choose necessary signals that actually help in the process. A ‘stop’ signal might be all you need.

 

The Process

Eventually, we will have to follow the lead of our therapist. They walk us through the steps of their technique. It is our job to speak up when something needs to be adapted for our personal situation or needs, or when something new comes up. While we follow their guidance this is still a collaborative process. We can remember the basic movement of pendulation, keep an eye on our own orientation & grounding and check in with other parts who are involved. It is not strictly necessary but it can give us a sense of agency and that is an important element in trauma processing.

Some find that it is best to rely on co-regulation from the therapist when things become difficult. Others need a moment for themselves. The presence of another person is not calming for every individual. I have recently taken bathroom breaks to give inner parts the chance to calm down in private. Some therapists will turn around and not look at us when we need a moment. Choose options for possible breaks.

In the past, I have taken the offer of hot tea when my body was shutting down more than I could easily handle. This is a time when we listen to our needs (breaks, slowing down, inner comfort, more safety etc). We don’t have to push through a technique and ignore how we are doing. In the best session possible, we create a little dance with our therapist where we take on the memory as best we can and we also make sure we are ok during this process. Good therapists will keep an eye on us but with DID, inner experiences are not always visible and it is easier when we take care of our side of the process as well.

 

Stabilizing

A session should always end with some re-orientation and stabilization. That can include small talk about the plans after the session. I like to tap into a topic where I am especially competent to remind me that I am an adult now who has special skills. It tends to activate the brain in a way that is different from trauma time. By telling our therapist about competences beforehand, they can guide the conversation into that direction.

We can use the resources we brought to regulate us. Dissociative people tend to slip into trance states that aren’t obvious but then we try to unlock the elevator door with our apartment keys or we don’t find the way home because we don’t recognize the streets. Thorough grounding can minimize this and we should include it in our plan.

If we switched to a younger part, now is the time an adult has to show up again. It can help to practice intentional switching beforehand or to have a code word with the therapist that tells everyone it is time for a specific adult part to take over. It is usually ok to allow us to sit in a waiting area until we feel ready to leave. More attention from the therapist does not usually lead to a faster switch back.

Sometimes therapists will offer us an item to take home and bring back the next session. It is wise to take it even if we think we don’t need it. Other parts might. A processing session usually only starts a process, which will continue for a couple of days, as our brain renegotiates what to do with the memory. The next few days might need a little extra emotional support. Therapists should keep suitable items ready.

 

 

After

It is wise to have a solid plan for the first few hours after processing. Depending on the technique that was used, the memory might come up in waves a couple of times before it settles. Make sure that you have a safe way to get home or to a safe room where you can stay for a while. Driving yourself with a car is not forbidden but also not wise. Sometimes taking a train or crossing bridges on foot can worsen suicidal thoughts. I believe that it is best to have someone to pick you up if you are not in a clinic anyway.

 

Self-care

Next, you plan how to take care of basic needs for a couple of days. Food is an important source of energy and processing takes energy. I like to eat a meal with the person who picked me up whenever that is possible to make sure that I remember to eat. Prepping a couple of meals in advance can be tremendously helpful when energy levels are low.

For the next few days, our job is to be kind to ourselves. We get to choose something extra we don’t usually do, we get favorite drinks or meals or activities. Gentle care is better than strict discipline but if discipline is the only thing that gets us to self-care then that is fine as well. Whenever we feel like we have to force ourselves we can check if it might also work with a tiny little bit more ease.

 

Recovery

Recovery needs time and is an active process. Some people like to journal, some go for walks. Sleep is an important factor. If we feel like it, friends can support us. It is better to do things that are grounding than to go for numbing. Our therapists will usually ask us to check in with them to make sure we are ok. If everything goes well, we can use different kinds of activities for recovery.

 

When difficulties arise

Things don’t always go well. Make sure that you have emergency medication at hand in case the distress is getting too hard to cope with. All the resources you brought to therapy should still be around to help you to calm yourself. Call your therapist or other emergency contacts if you experience a crisis and keep an updated emergency plan close. These are things you prepare and plan for so that you don’t have to think about it when you are too stressed to make plans.

Sometimes, only individual parts are experiencing a crisis but the inner team is able to stay safe. Then we return to the classics. Do they have a safe space? Can we somehow contain the memory together? Is an Inner Helper the support they need? How about holding their hand to show them that we are here? Most of these things should not be new to you. They are the basics of symptom management and you can find them in our Index. It makes sense to brush up on them beforehand.

Hurting parts might need a House of Healing for their next step in recovery. When connecting to the world today is too strange and different from the life they know, a Halfway House might be the best option. These are more specialized exercises to help parts after trauma processing. Maybe your therapist knows something else that you can try and keep in mind.

 

Integration

Integrating the memory is a longer process than people think it is. When it worked well, we will see changes in the parts who processed memory, in the way the system responds to that, in our responses to the outside world and other people and in the way we see ourselves in this world. When it worked really well, it can feel like our whole world was shifted slightly. It takes time to get used to changes. Sometimes it takes work to hold on to them and it is also possible to partially lose progress because we did not have enough capacity for so much change all at once. The next sessions with our therapists should help us to adapt to the change and integrate it as much as possible. There should be plenty of time before the next trauma session. Recovery looks like something. It looks like a bunch of smaller or bigger changes within the system, the way we experience things, the way we act. It needs time to see all that and get used to it. The ‘After’ part of our BDA Plan takes a lot longer than we think. Doing this right helps us to hold on to change and not lose it again. Integrating change is its own big step in trauma processing that reaches into phase 3 in a small way. We get a taste of what could be. That will help us to go back and process more.

 

 

This is just a rough guide on how regular trauma processing can be approached in a structured way. It cannot possibly list everything that is helpful for everyone and it certainly lists more than some people need. You have to make it your own and develop a plan for yourself that meets your needs. If you don’t, it can make your process unnecessarily complicated. Think of it as a buffet of collected experience where you and your therapist are also asked to bring something to add to the choices. You only put on your plan what you fancy to use or what looks useful for you. BDA plans like this can be re-used but they always have to be checked and adapted to the parts who are involved in the process. After a while, you get a better idea of what you need and making a plan for yourself becomes easier and more personalized. Once you think you can do it without a plan, make one anyway. You never know what will happen and plans can be a routine that gives the system some security when facing difficulties.

 

 

Leave me a comment with your most useful resource or tricks that can help with preparing for trauma processing!