Dear Ms. Rowland and Dr. Paulsen,

Ms. Rowland: You have asked about how to use Imaginal Nurturing with DID clients. You “assume that” when they switch you just “go with whatever comes up”. You say that "they can't feel the receiving and the giving at the same time." In fact, no one can, and as I stated earlier, this is directly addressed in the very first principle of I-N. But in any case, with respect, I think that wondering about how to use I-N with a specific population without having mastered the principles of I-N is to put the cart before the horse. Furthermore, while you may or may not have had training in working with DID, I am not prepared to offer consultation on this forum, nor to discuss how to address problems that may arise in using Imaginal Nurturing with a specialized population with a clinician who has not done the training or read my book.

You also ask if in my book I have protocols for working with DID. Like the other components of the Developing a Secure Self approach, Imaginal Nurturing does not consist of protocols but rather principles. So to answer your second question, the book does not contain protocols for using I-N with DID clients (or with any other population). The work is not about plugging in a protocol.

Dr. Paulsen wrote:
“IN should not be touted as appropriate treatment for DID clients if administered by therapists not trained in treating dissociative disorders.”

I am puzzled as to why you persist in this vein. (Maybe you are confusing me with Shirley Jean Schmidt who has put forth her DNMS approach as a possible treatment for DID?) I have never even suggested that anyone work outside their area of expertise such as you are implying. (Nor am I suggesting that Shirley Jean does.) Of course that would be unethical, unreasonable, and irresponsible. For someone who has the training and experience in working with DID, I-N may be found to be useful, however, I have never “touted” it as an appropriate treatment for DID clients... or not. It may be useful at some stages and not at others. As with every client, the therapist needs to use her or his clinical judgement as to clinical appropriateness. I do have colleagues who specialize in the area of dissociative disorders who have incorporated my approach into their work. They are highly trained and skilled, members of the ISSD, and in one case receives consultation from one of the foremost experts on dissociative disorders. And of course, in each case, they use their judgement. This morning, I received a post from a consultee about what good use a DID client has made of I-N, especially in the area of self-care. With another client, it may not be appropriate.

I present my work as an approach to be integrated into one’s practice. One of the keystones of this approach is its responsiveness to the individual client and her or his needs/problems/issues and affect in the moment. One of the reasons I think in terms of principles rather than protocols is that one needs to have the flexibility to be able to respond to a dissociative client (disorganized attachment), differently from a dismissing client, from a secure client, from a preoccupied client. Moreover, the approach addresses the attachment aspects of the therapy. It does not purport to address all of the therapeutic needs of the client.

I find it frustrating to be criticized for statements I have not made, and my approach criticized for concepts that are not part of the approach. I am also perplexed by the hostile tone of your posts and thus am choosing to withdraw from this thread and this forum.

Sincerely,
April Steele, MSc BCATR
EMDRIA-Approved Consultant and Credit Provider
Nanaimo BC, Canada

See Page 2 for continuation of discussion.