May 14, 2024

Episode 64:

Understanding and De-mystifying Disassociation When Working with Clients with Aarti Dhanda

In this episode, Aarti guides us through understanding and demystifying dissociative responses when working with clients in our practices.

Episode 64: Understanding and De-mystifying Disassociation When Working with Clients with Aarti Dhanda

Show Notes

Kayla: Welcome back to the Designer Practice Podcast. I’m your host, Kayla Das.

In today’s episode, Aarti Dhanda, psychotherapist and registered social worker will guide us through understanding and demystifying dissociative responses when working with clients inside of our practices.

Hi, Aarti. Welcome to the show. I’m glad to have you here today.

Aarti: Thank you. I’m so glad to be here. Thanks for having me.


Kayla: Before we dive into today’s episode, though, please introduce yourself, where you’re from, and tell us a little bit about your own private practice journey.

Aarti: Yes, thank you. I could actually talk about that for a long time, so I’ll try to keep it brief. But yeah, so I’m Aarti. I live in the Toronto area, and I’ve been a psychotherapist for 13 years and worked in the profession a little bit before that. A little bit about me. To me, it’s a fun fact, I actually didn’t know I was going to be a psychotherapist until I was in my last year of undergrad. And previous to that, I was gung-ho about becoming a speech therapist

And then realized that for whatever reason, that wasn’t feeling like the best fit for me. But I was always volunteering in social work like things. So then listening to my heart, I said, okay, I’m going to do my master’s in social work. One of those things that many therapists might come across was that fear that maybe I was. too sensitive to do this work and learned over time how much of a strength that’s really been. So that’s a little bit about why I ended up in this work. And I guess what’s drawn me to this work has always been this feeling that I want to help children. But I’ve worked with young people and adults, and so it’s been interesting now in my journey with working with dissociative disorders. I really do a lot of parts work, so it does feel like I’m working with people’s inner children. Right. So I really love that part of my work.

And a little bit about my journey. I feel like I started off, like many helpers and many therapists, I did my own personal work, which also inspired me into this profession. And I really started off learning a lot of different modalities: CBT, motivational interviewing, DBT, narrative therapy, all of which I still see are really impactful and understanding when they’re helpful. And I did my master’s in social work and a certificate in addiction studies. And then I was a concurrent disorders therapist for homeless youth who also had trauma and mental health. And that was one of my most meaningful roles that I played in that work. But also, that was one of the first times I saw certain limitations to the approaches given there are more complexities. And, which I noticed over time as they worked with young people in the justice system prior to that as well. And I think what it was just always trying to lean in to see, well, okay, if this is the issue and this approach isn’t working, what else can I learn?

And so, I got trained a lot through a really great workplace that I worked at where we learned a lot about attachment. We learned a lot about trauma. And that really resonated with me a lot. And emotion focused therapy and DBT. And then as I was learning all those things, what I didn’t realize is I was actually learning a lot, based on the really great trainers that I had, about how to work with things at a nervous system level.

So, when I then, a few years ago, took my EMDR training, which was one of the best trainings I’ve taken, it all kind of started to come together. And so since then, I’ve learned that especially through the pandemic, just seeing many of my clients who have complex trauma, approaches we were using before weren’t necessarily working as well. So, I was feeling stumped. So, I was thinking, okay, is it the virtual aspect of the work or am I missing something or what’s going on? And then I learned that there’s a strong possibility that a lot of other therapists have this experience too, is noticing a worsening in the mental health symptoms, even with the same clients maybe I worked with before the pandemic than during and post-pandemic. So then as I did that training, I started to see that many of my clients who were referred to me because I have expertise in complex trauma actually would potentially have a dissociative disorder or even DID. And so that was shocking for me because that was hard for me to wrap my head around at first. But then leaning into that and saying, “Okay, since I already worked with these clients, what training do I need, what do we need to do to help them?” And it’s just been really amazing to see the progress.

Aarti’s Path

Kayla: That’s fabulous. And you talked a little bit about how you got into working with people with dissociative responses. But how did you decide that this is an area you really, enjoy and want to work with?

Aarti: Yeah. How did I decide that I wanted to work with dissociative disorders? I really feel like dissociative disorders chose me more than I chose it. That’s just how it feels. It’s like one of those things where, for me when there’s a gap in my learning. I want to fill that gap. I’m a forever nerd. And so, I always want to learn and see if I can show up. My goal is to show up for my clients the best therapist I can be. So, I’m always learning, always learning. And the more you learn, the more you see things, you can’t unsee them. So, I think once I understood the complexities of complex trauma and attachment. And that piece of going back to early childhood experiences. That’s where my heart is and helping people who’ve gone through that because otherwise what happens is they may feel that there’s something wrong with them, and they can’t show up in the world as like their whole authentic self. And even being inspired by my own personal journey, that’s what keeps me coming back to the work is when I really narrow it down to exactly what I want to do in my work is to really help people actually heal their brain so they can show up as their authentic self in the world and their relationships. Not feel empty or lonely on the inside or broken, these things that they feel inside, but then they have a poker face and how they show up in the world. So, I think that my heart has a tender spot for that. So it makes me want to keep leaning into it. Into that work. I hope that answers the question.

Kayla: Yeah, I mean, I love that. And I think when we think of dissociation, you know, many therapists, especially going into private practice, might be a little hesitant or worried about working with clients who experienced dissociation. So, I think that this topic is really important and timely when we think about that and providing some support for listeners who may work with clients who experienced dissociation and not necessarily even know it right away. So that’s what today is about understanding and demystifying what dissociation is and how it shows up and then also how to work through that or navigate through that.

Defining Dissociation

So, first of all, what is dissociation and what are some common dissociative responses or symptoms that you see when you work with your clients?

Aarti: Yes, that’s a really good question. What I’ve learned is that it’s like a spectrum, just like many other things. Now there’s some experts in the field who do use the word dissociation with their clients and others who don’t, they have their own theories on it. I do talk about it with my clients, but I talk about it the same way I’m going to talk about it today, is it’s a spectrum and it’s normal, right? Now it’s a normal response to what’s happening. So, the intensity of the response actually matches the intensity of the experience or how somebody coped with what was happening at the time, right?

So, an example I’ll give is, so I’m in Toronto. So do you ever get on the TTC and you get on your stop before you know it, you’re at work, but you don’t remember every stop and everything that happened in between. Or you’re driving the same thing. That’s natural dissociation. That’s normal. We wouldn’t stigmatize that, right? Your brain just needs to turn off and get some rest. And you’re doing the same thing over and over again. So, you’re partly here. And partly in your mind or somewhere else. But you’re not necessarily fully present experiencing and taking in everything that’s happening. That’s a very natural dissociative response. So, there’s so many other ways that dissociation shows up in our lives, even when we’re mentally healthy and present and not having the trauma reaction, that’s just natural because the brain needs to just take a rest.

And then so if we’re understanding, well, how does that relate with trauma? And why does that happen more if you have more trauma? The example I give is first thing is understanding trauma then you can understand dissociation. So very briefly, a trauma to be resolved has to have a beginning, a middle and an end. So, the example I tend to talk about because it’s very concrete is how many people break an arm when they’re children? But how many people are traumatized because they broke an arm? I’m assuming that’s happening under normal circumstances, like riding a bike or something, not anything traumatic, right? So, if the circumstances surrounding a broken arm are normal, what happens? The first thing that happens is we see that something is wrong. That’s the beginning. We can see our arm doesn’t look or feel the same. The middle. Would be, we’ve gotten help, we’ve gotten some support, we’ve gotten a cast put on. What happens when a kid, at least in my community, goes to school with a cast? A lot of attention is given, a lot of support is given. People write on the cast. There’s this experience of honoring and acknowledging what has happened. And then we know there’s an ending to that trauma, because the cast is taken off and everything is more or less back to normal. Right?

So that beginning portion when we break our arm, do we see and remember every detail? Do we feel everything or does our body naturally numb it out because it’s trying to protect us? Would it really be helpful if we have a broken arm and feel absolutely everything and blackout? probably not very helpful. So this is the same response, whether the body does this physically or the body does this emotionally. It’s the exact same response to trauma, right? The body’s job is to protect us and make a decision before we can snap our fingers. Looking quicker than that to make a decision about what it needs to do to survive, right? So that’s how we know whether we fawn or we flee or we fight or we freeze. All of that is the same process. But it doesn’t know the difference between something concretely being a danger, or more abstractly, being a danger to our survival as an abuse or neglect, because by concrete I mean a broken arm, a danger from a bear or an animal, that kind of thing. Does that make sense so far?

Kayla: It does, and it actually makes me think about, and I don’t know if any listeners have ever worked shift work before. But when I worked shift work when I first graduated from my bachelors of social work, I did a lot of 24-hour, 36-hour shifts and obviously not very healthy. But even you mentioning about going on the TTC and not necessarily remembering stop to stop. I remember driving home after a 36-hour shift and I actually don’t remember driving home from the 36-hour shift, but I drove home by myself after not sleeping for 36 hours.

And I think going back to normalizing dissociation, as it’s a spectrum, whether it’s physical or emotional. I think we can all relate to it and connecting that to some of the experiences that we’ve had also normalizes it when we’re working with clients who are experiencing it regardless of the reason again, physical, emotional, or maybe even both in some cases.

Aarti: Yeah, exactly. We all have those experiences. And it’s not just that, like, there’s other experiences too, like brain fog. Feeling like you’re present, but there’s almost like a filter between you and what you’re seeing, colors not as bright tunnel vision. We use this language all the time actually, right. Or coming to something that you were there but you weren’t there and now you’re back right. And going into a trance these are just some of the possible symptoms people can have.

But it’s funny because after doing my training in dissociation and then just watching TV at home when I’m relaxing, I’m very aware, okay, this could be dissociating too, right? If I’m watching TV. And then on TV, seeing people referencing dissociation without knowing they’re referencing it. So I just really started to see that it is actually really much more common, even in our language then we realize. Even when we say a part of me feels this way, but a part of me feels that way. Now we’re talking about this internal conflict that’s happening. At some level, we’re aware of these things, but in certain ways that these experiences can happen for us.

Recognizing and Identifying Dissociation

Kayla: Yeah, no, I think those are really great points. And when it comes to dissociation, you sort of referenced this a little bit, but are there specific types of clients who are more susceptible of having dissociative responses? And if so, how do we as therapists recognize or identify if dissociation is present for our clients?

Aarti: Yeah. I’m definitely going to answer that question. But to answer that question, coming back to that analogy of the broken arm, it’s like what’s happening for the clients when there isn’t an ending to the trauma that’s so it’s not actually completed, right? So that’s when people remain in the middle. And I think when they remain in the middle, they remain in that dissociative response. This is how I understand it. And maybe my trainers may explain it differently. So, what I mean by that is like, think of it as once that trauma is over, it’s like a well-organized file cabinet. I like organization. So, I use that example. Everything has a folder, a label, you know it’s there, you know you had that experience, but you can kind of go and make sense of it. It’s all together.

But when it’s an experience that actually isn’t resolved, and I’ll talk about that in a second. Then I think of it as a file cabinet where there’s papers everywhere on the floor, half open, half closed, something is stored in one spot. Another thing that’s related to the exact same thing is stored in another spot. That’s the fragmentation in the brain. So that’s actually what happens when there’s trauma, different parts of the memory gets stored in different places and we dissociate from things because it’s too painful to take it all in.

So, if we’re talking about which people are more susceptible to it, we need to understand, first and foremost, starting with what were their childhood experiences? They may not remember all of them. That’s okay. That’s normal because that’s the purpose of dissociation. Sometimes dissociation looks like memory problems or amnesia. It could be partial amnesia; it could be fully like not remembering and blanking out and losing time. So that’s part of that spectrum and recognizing. Okay.

So, what person would be more susceptible? I would imagine if I put myself in the shoes of a child, a child who cannot escape the difficult things that are happening around them. So, they have to use the resources that are available to them, right? So, if they couldn’t escape, like children can’t just get a job and move out. They don’t have that kind of control. So, finding a way to cope. Now, each child is different. Some children may have some protective factors and they’re actually able to cope with school or sports or other things to actually get them present, right? Like dancing or etc. And others may not have those resources and then they may discover, “Oh, I can cope by going away in my mind. I can cope by going into daydreaming or fantasy or staying in my bed or reading a lot and all these different things” in different ways in which they are not taking in every single stimulation and negative thing in their face every single day. That would be like staring at your arm and feeling all that pain all the time, right? The brain can’t handle that level of intensity of danger, danger, danger coming at them all the time. So, they have to dissociate to survive.

But what happens is once they dissociate to survive, that it’s stored in different places so it’s all over the place in the brain, it’s fragmented. So that’s what we do in our work, we integrate it back together. But once it’s integrated, then they know, “Oh, okay, I’m not in the middle of this anymore. This is actually over.” And so that’s the challenge is we could be walking around in our adult bodies. But still parts of us are stuck in trauma time and aren’t very aware that these experiences are over. So, things in our present day could trigger that experience because it sounds like, smells like the same thing. There’s an emotion, there’s a thought, there’s a sensation in the body that feels the same. Maybe it could be from an experience of pain in a certain part of the body, et cetera. Because we don’t really know where they’ve stored this trauma. So that’s a long-winded answer, but coming back to who’s more susceptible while I would look at anyone who’s experienced childhood abuse, physical abuse, neglect, sexual abuse, it’s a very big one that comes up with dissociative disorders, has multiple experiences like that. Anyone who has or you might think has a disorganized attachment style. Or other things that you might want to think about, right? Like if you’re seeing a client who’s been in therapy for years and years and years or has been in and out of hospital or has a mood disorder that just doesn’t seem to get better and they’ve been in therapy for four, five, eight years, not improving. That would be a flag to kind of think about well is there dissociation there? Anything around chronic suicidality, self-harm, eating disorders, addictions. Addictions mimic dissociation.

As well as there’s another side of dissociation, which is hypervigilance. So panic attacks. What I saw in my journey is when, even when I worked with complex PTSD, prior to learning that that can be the diagnosis we get before we get a diagnosis of dissociative disorder, is even getting that PTSD diagnosis can take a long time for people, if we can’t tangibly say that they went to war, for example, or they’re a police officer. So, then it can be something like, depression and anxiety coming together. But it takes a while sometimes to recognize it’s not just depression, anxiety. It’s PTSD. Oh, wait, it’s not just PTSD. It’s complex PTSD. Then the question is, if you see that pattern, there’s a strong possibility that anyone who has complex PTSD, is it with or without dissociative symptoms? Because there can be dissociative symptoms that the PCL-5, I think it’s called, doesn’t fully capture. So, another red flag might be if you do the screener for PTSD. Do they check off almost all the boxes? So, then my question would be what’s missing, right? So those would be some of the things I would think about in terms of which clients or which presentation just might be ones you want to pay attention to because at the end of the day, we could all have dissociation and we all do. It’s to which degree?

Working with Clients with DID

Kayla: Those are really great points. And I know you’ve talked about working with people with dissociative identity disorder, DID. How does that show up when it comes to working with people who have DID and do, they typically have a diagnosis?

Aarti: Yeah, when I think about my experience in my journey and how I discovered that this was happening with my clients is most of my clients came in with either a mood disorder, like maybe they’re feeling depressed and they’re really struggling with their depression, right? They’ve tried to treat it and sometimes it gets better, but then they’re struggling again and they’re not really sure why. They may not actually be aware that they’ve experienced any trauma. So same thing can happen, it can be like chronic anxiety. And that kind of presentation. And sometimes they do come in with “I think I have PTSD.” or maybe they have a diagnosis of PTSD. Or they really wonder why they can’t focus and they’re really wondering, do I have ADHD, right? So those are some of the kind of common presentations I would see.

But pre pandemic, before I got this training, I still was effective in the work I did with those clients. But what I found is we can use a lot of different techniques to stabilize. But then sometimes it’s not sustaining itself, right? That’s not a sustainable change that’s happening. So, then I was paying attention to, okay, well, what am I seeing in their nervous system and their body? Are they very flat? So, then I’m paying attention to if it’s not substances, what are some other ways they’re numbing out? Is it a lot of doom scrolling? Is it a lot of TV? Is it a lot of gaming? Maybe it’s not internet, maybe it’s other ways, right? Perfectionism, for example, is actually a type of addiction as well. I’m a recovering perfectionist, so I can talk about that experience.

And I think what I would just say is just looking at all of that helped me to see that, okay, they’re not really going to present or come in with any particular presentation or diagnosis. But these are just some things to pay attention to, especially because we know that in Canada, we don’t really have as much– And it’s actually not just in Canada, but I do find in my experience, there isn’t as much assessment or knowledge around dissociative disorders, whether it’s through diagnosis, or just through assessment through other therapists. And that’s why I’m so passionate about talking about it, right? Because it’s still viewed as like, “oh, that’s rare, that’s rarely going to happen.” But actually, saw an article recently on LinkedIn talking about that it’s believed now about 10 percent of the population, which actually makes it just as common as a mood disorder. Which makes sense to me based on what I’m seeing and what my like consultants and trainers also tell me that they’re also seeing more dissociative disorders presentations and referrals coming through the door. And I wonder if that has to do with the pandemic as well.

Kayla: Yeah, thank you for sharing your experience and bringing us through kind of the process. And I know as you’re a social worker, we, as social workers can’t diagnose. But I think it’s really important that, you know, shedding some light on just dissociation and how prevalent it is. I don’t work in an area of dissociation, but I do recall an article years ago, it’s probably at least five, maybe even seven years ago, where dissociative disorders was like less than 1 percent of the population, but obviously, that has changed or if it hasn’t changed, people are recognizing it more and normalizing it more. And I think that that’s the other side of it, right? It’s being more normalized.

Aarti: Yes, exactly. And I’m remembering from a training that I did, they said DID was diagnosed I think two to 6 percent of the population, making it just as common as psychosis. So, I think that’s a myth that we have to start to overcome and thinking about DID as like multiple personality disorder. That old stereotype is not actually how it looks. People aren’t switching different personalities in front of you. That’s going to be a rare because people can be very high functioning and have DID or have a dissociative disorder, right? It’s remembering this is how people survived their difficult experiences. So, they may actually have a really strong poker faith and know how to show up in the world and appear like they are regulated, right? But internally, what’s happening for them might be different. And not being fooled just by their presentation, but also recognizing like does that match with the challenges they have? Does that match with their nervous system response? Like, do they get a lot of panic attacks? Do they numb out?

And I think what I really, really appreciated in this process of learning this, which really blew my mind and opened up my mind. I think it was just realizing there are so many symptoms of dissociation and there’s like 23 different symptoms and many different ways it could show up. And when I was learning that and just going through those questions and I was like, Oh my God, I’ve never asked some of these questions to my clients. And my therapist never asked me this question. But yes, I could say yes, check, check, check. I experienced some of those things now or in my own childhood experiences.

And even just like coming to terms with an accepting that we may have experienced dissociation can bring up dissociation. So, it’s just recognizing the antidote to the dissociation, if I’m going to put it in a very simple way, is getting more present. So, there’s a lot of the training and stuff that I learned is really knowing how to help someone based on where they are. What they need in that moment, what’s happening for them, and how to get them back to being present.

Supporting Clients

Kayla: I love that. So, if a listener recognizes and identifies dissociation is present for a client, how can they navigate supporting their client? In other words, are there specific steps, strategies, or even modalities that could better support the listener with supporting their client who may be experiencing dissociation specifically.

Aarti: Yes. Yeah. So, I think I said, my approach to modalities is I really, like I said, I’m a nerd. I love to learn. So, I’ve learned a little bit at least about a lot of different approaches and now I’m at a place where I really think about it in terms of my knowledge of the nervous system. So, if I’m going to do Wise Mind from DBT, why am I doing it? When am I doing it? When is it appropriate? It’s not necessarily for me about throwing out all the therapy training we’ve done already, but instead of thinking about it as giving your client a menu of options of self-care skills or regulation skills to just give them, here’s a bunch of things and pick the one that works for you. It’s more about matching, like matching this regulation skill. To this response in the body. So that’s how I think of it. I think of it as first and foremost, our foundation shifting from just about the modality to understanding the neurobiology and the nervous system. And when you do that and understanding attachment together, then all the other training you did we’ll start to make sense of her to fall into place as to why do we do the change in temperature, the intense exercise, progressive muscle relaxation. What does it actually do for the body? Versus just saying, Okay, this is the presentation. This is the skill. So, I think there’s still value in those approaches. And I still pull from it as needed for my client.

But the foundational change that came from me is actually doing really good EMDR training, but an attachment-oriented EMDR training. So, I will happily share, I did my training with Jennifer Jones. She’s in Wisconsin and she runs an organization called Lead the Change. I thought her EMDR training was phenomenal and I’ve continued to do consultation with her and it’s been mind blowing for me. And there are some other EMDR trainings as well that I think would be on par, slightly different, but from individuals in the world of dissociative disorders. That are really well known and well respected.

And I think that’s the foundation. But understanding EMDR isn’t just the eye movements. That’s actually like phase four of eight phases. So, it’s really about, first of all, understanding how to assess someone and their nervous system, helping them be in their window. And then, through that process, figuring out how much dissociation do they have? So, this is where this particular assessment, the MID assessment comes in. And the MID assessment training– doing both of those trainings. is really helpful. Understanding the MID and knowing how to administer the MID is really what’s going to tell you how much dissociation someone has and even distinguish it from other, diagnoses they may have had before. So, I think those two things are game changers for me.

And then if you do start to see what I saw, like my first thing was, “oh my God, did I administer the MID incorrectly?” Like how come 70 percent or more of my caseload is showing up with a dissociative disorder. This was a moment for me where I was really questioning at first, am I doing this right? How is that possible? And then when I realized, “No, I’ve administered it correctly,” I’ve done it correctly, I’ve did the follow up. I’m seeing what my clients are telling me is matching. It’s me working through my own shock of accepting that this is what I’m seeing is real and trusting my clinical judgment there.

But then the beautiful thing is that it’s actually really treatable, whereas people think it’s not, but it actually is because it’s a response to trauma. So, if let’s say you do see more of a dissociative response, then getting those trainings. So, one of those trainings I would talk about that I did is a parts work training with Kathleen Martin. She’s also in the States, a lot of the experts are there. But they do virtual trainings. And that was really life changing for me as well. And there are many other trainings I’m going to pursue to continue growing. So, I’m going to be pursuing training in hypnosis, a clinical hypnosis, as well as training in deep brain reorienting. So those are things I don’t know much about yet, but I’m going to learn more about. So, this is just a synopsis of the types of trainings you may want to pursue and learn about if you’re a therapist who wants to work or build your capacity to work with dissociation.

Kayla: I really love that you share these resources to listeners as well because I know more and more therapists are choosing to work with trauma specifically, and may or may not be prepared to work with disassociation that’s associated with complex trauma. I’ll be transparent, neither of us are getting any type of affiliate funding or anything for referencing these trainings today. But they’re just really great trainings for listeners to be able to access if they do want to gain additional expertise in that area.

Aarti: Yes, I’m just sharing with the hope to help inspire other therapists to also lean into this work. There’s so many of us that are drawn to trauma work for various different reasons. And I think that once we understand the trauma and dissociation kind of go hand in hand, it can feel a bit scary at first. It did for me, right? And that’s like when you asked me, what made me choose this? I said, I didn’t choose this. It chose me. That’s literally what happened, right? And I had to make a decision and decide do I do my own personal work and learn what I need to learn, work through my own emotional blocks about leaning into this. And there’s nothing wrong with this choice, or do I want to stay with doing stabilization work with my client but not processing the trauma, like the phase one work of trauma work? That’s okay, and I realize that’s what I did most of my career, and that’s in itself challenging when you have more complexity. But then now that I’m actually doing processing with my clients, I have heard things I’ve never heard before, but I’ve also been surprised by my ability to hold it and contain it and keep showing up as a safe person for my client so that they could actually voice and say all these things that they couldn’t say before. And that’s the beautiful thing is when you’re doing this parts work or whatever modality you’ve determined is correct for dissociative work for your client, as their brain is healing, the need to dissociate goes down. So now all of a sudden, they can remember things they didn’t remember before. And of course, there’s no prompting from me. But then they might remember that they had these experiences when they were younger, or they had different experiences, and they may not be your capital T trauma. It could be a lot of lowercase t trauma that built up over time. So that’s that, you know, death by 1000 paper cuts. There’s a lot of little things that add up, but still make someone feel unsafe about the world.

Additional Insights

Kayla: That’s really great points. Do you have any additional advice, insights, or tips to help listeners recognize, identify, or even navigate supporting their clients who may be experiencing dissociation?

Aarti: Yes. When I think about that I just think about intention. What’s our intention for our work? Just always coming back to that, as we talked about our intention for the podcast before we started. And knowing what our limits are and being honest about that and what our biases are. That’s okay, too, because it’s a process, right? I always tell people, whatever I say right now is based on everything I know right now. If you ask me the same questions a year from now, I might have a slightly different answer if I learn something new. It’s the same thing. It’s a process. It’s a journey. Whether you’re showing up as a therapist or you’re showing up in a different capacity. Just recognizing if our intention is to show up for the person and be helpful, can we be present, listen, hold that space for them? Because when their safety is there, then they may be able to share more about what their experience is. Or even just their body language might tell us more. And if we’re really present and paying attention to that, then just noticing, okay, how can I within my capacity show up for this person? Obviously within the limits of your role and your own boundaries, et cetera.

But then I also always say another important thing is we can’t take people where we’re not willing to go. So, I think that really is something that I always think about. And if I ever do work with students in the future, this is what I would tell them is if I have a blind spot and I’m not willing to go there in my own journey in my own story in my own like mind and my own body. Then I’m going to have that blind spot for my client. That’s okay if we’re not ready or willing to go somewhere, then just being aware of that and making sure that we’re not taking clients on. They want to go somewhere we’re not able or willing to go ourselves because then it’s going to be harder to attune to their body language, their nervous system and hold what they’re feeling. So, we don’t want to be in the room experiencing our own stuff while they tell us they need us to show up and hold it. So I think that’s part of what I would say.

And another thing, I think I would just add. Regardless of what role you play, it’s an important role, whether you’re a friend, a family member, a doctor, whatever role that is, right? I do believe that people need support in many different ways and therapy isn’t going to be the only way to help someone find safety and healing.

So, whatever our role is, like wherever we are, it’s just thinking about, “Okay. How can I be aware of this? Educate myself on trauma and dissociation. Hold that safe space. And maybe in that safe space, there’s an opportunity to help someone if they are having any sort of stigma around mental health and getting that support. And educating yourself on who you can refer them to if you are in a role to refer them to a therapist who has that training. Reducing that stigma for clients with the dissociation is so so important in everyone because dissociation is really about avoiding pain.

Kayla: I love that, and I think, my word of the day is normalizing it, right? It’s going back to stigma; we all experience dissociation. People experience dissociation as a symptom to something else, right? It’s not abnormal.

Aarti: Yes, and that’s another way I explain it to my clients is in a very concrete way. When you get the flu or the cold, you’re told you have the flu or the cold. What is that describing? That’s describing your symptoms, not the cause. So, what’s the cause? A virus or a bacteria? Same thing, right? The way I’m trained and the way that I view it is regardless of the actual diagnoses my client has, and usually they have more than one. That’s describing a cluster of symptoms. And if I want to help my clients, I want to go all the way down to the root under the surface and see, okay, what’s the cause and the causes that trauma and the dissociation is just a symptom.

Connecting with Aarti

Kayla: No, that makes sense. So, Aarti, if there are any listeners who would like to learn more about you and your practice, where can they find you?

Aarti: Yeah, thanks for sharing. So, well, they can definitely go to my website, And I love that image of the whole tree, as we talked about today, healing everything at the root and even at the surface of the symptoms. And my LinkedIn is a great place to connect with me. I’m hoping to offer consultation and training around trauma and dissociation. And following me on LinkedIn, following my newsletter is a good place to know what I’m up to and what I’m offering people.

Kayla: Fabulous. So, to check out Aarti, head to

Or you can simply scroll down to the show notes and click on the link.

I’ll also have her LinkedIn in the show notes too. So please scroll down and check those out.

Kayla: Aarti, thank you so much for joining us today on the podcast and guiding us through how to recognize and identify dissociation when working with clients. As well as providing us with some tips and strategies for navigating dissociation so we can best support our clients.

Aarti: Thank you so much for this opportunity. It’s something I can talk about and go on and on, but I hope that at least today we are able to make it not seem as something that is so huge or unapproachable.

Kayla: And I think you did that for sure.

Thank you everyone for tuning into today’s episode and I hope you join me again soon on the Designer Practice Podcast.

Until next time. Bye for now.

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