Thank you so much for once again joining me for our next episode from the Lessons from the Playroom podcast. And today, everyone, we’re talking about a topic that we’ve never discussed ever in this entire podcast series. Wow.
I know. Which is on Dissociation. It’s such an important topic.
And I have with me another amazing guest to help unpack this topic for us. So let me go ahead and introduce our guests. So I have with us the amazing Annie Monaco.
And for those of you that are not familiar with Annie, let me share a little bit about this fabulous person. She is a licensed clinical social worker. She’s a registered play therapist.
She’s a faculty member of the Child Trauma Institute. Truly a global trainer. You have been a global trainer for many years.
You have a specialty in EMDR with children. Although, listeners, if you’re not EMDR trained, this podcast is still going to be completely relevant for you. Your advanced trainings include how to work effectively with attachment and dissociation in children, especially with aggressive and hostile parts.
So you are the person that I’m having this conversation with because it’s a topic that we don’t talk about, I think, enough in our work with children. Your private practice, you’ve been at this for a really long time. Almost 30 years.
Those that can see me, I know I don’t look that young. Thank you. But really I’ve built up to this place what I really want to do for the rest of my career, forever long that is.
Just help therapists not be afraid of Dissociation, that you actually welcome it. You go, oh, my gosh, dissociation is in my playroom. This is great because Dissociation really gives us a lot to work with.
It’s really a child giving you their inside personal struggles and they’re sharing it with you. But it is the stage for this conversation in such a beautiful way. I’m so excited, listeners.
I hope you’re excited too. Just hearing. So first of all, I can just say that the passion for this topic just oozed right out of you.
Absolutely. Well, I just want to continue with where you were headed. Let’s assume that no one’s ever heard this word before.
Yeah, let’s just start there. So what is association? How would you even describe it? Yeah, so I talk about it in a very interesting way, and I talk about it in a way that it’s how the therapist feels when they’re with a child who’s dissociative. So it’s really how I started to teach therapists, because I could give you all the symptoms and all that, and it might connect with you, might not.
But it’s when I’m with a child or a teen in my office and all of a sudden I start to feel different. And what that means is I start to look at this child and I go, wow, they’re acting unusual, they’re acting odd. I might even hear the word bizarre in my head, like, that’s a bizarre behavior.
Or wow, they look different, they’re talking different. And so suddenly I’m feeling it all in my body. I’m saying something is off about this child.
And it happens repeatedly. It’s not just one moment, one session, but it’s a repeated feeling inside of me that then I really start to say, I wonder what’s going on with this kid? Now, me 20 something years ago would have went to a supervisor and said, this child, I think they have schizophrenia, I think they’re bipolar, think they’re having a psychotic break, right? So now when I hear therapists say this to me, I say, well, I’m going to guess 99% of the time it’s dissociation. And so because we’re just really beginning as a field to welcome dissociation, accept it and not be afraid of it.
And we don’t often have psychiatrists who are on board with that theory. So psychiatrists are often naming dissociative symptoms with some other type of disorders, right? And that’s another key piece to understanding symptoms, is I just got a referral and the kid had twelve diagnosis, right? And I had already seen this kid three times. I go, oh, he’s highly dissociative.
He has twelve parts inside of him. He’s twelve years old, he’s shared it with me, right? But a doctor diagnoses so differently. So symptoms can be lots of things.
It could be the glazed look, it could be a child is encaphetic. The most famous words that caregivers will use is they switched. We were in the kitchen and we were eating dinner and all of a sudden my kid switched into somebody I don’t know.
And that is typically a very significant sign that you’re dealing with dissociation. Define it when someone is dissociative. And my understanding and my experience is that it’s also on a continuum and there’s a whole continuum of it.
But what does it mean? What’s happening when there’s a dissociative response? Yeah. And so I won’t do textbook, I will say it. How I think of it is that I’m working with a foster care girl right now and recently removed within the last six months.
And it’s the little girl inside of her that went through things. And so children and teens have little people inside of them. It’s the best way I can say it.
It’s that these parts, these young parts got stuck at the time of the trauma, and for her, it was witnessing violence and it was witnessing her sister being hurt. And so she has a little girl inside of her. So these young parts have witnessed a traumatic event.
They didn’t get healed, and they kind of stay inside the child, and they often really want to be healed. And dissociation comes about because of traumatic events. So therapists often say to me, well, how will I know? And I say, well, if you look at their trauma history, and it’s a significant trauma history, you’re really looking at dissociation.
It’s when you can’t handle the present moment anymore. Let’s say we’ve had horrific things happen in our world, like earthquakes and floods. If there’s an earthquake, I’m just going to dissociate at some point during the earthquake.
It’s too much, it’s too big. And I might forget parts of what happened during that horrific episode. So it’s kind of a stepping out of the present and just going someplace else in your mind because this is too overwhelming without being too graphic.
I think about kids who are sleeping at night and a parent comes in to harm them, to perpetrate against them, and they don’t remember it. It’s like they just go into a subconscious part of their brain and they really don’t want to remember what happened because then they’d have to accept the fact what their parent did to them. What I’m hearing, which is lovely because you use the word like invitation, right, and almost setting the stage of we don’t need to be afraid of this process occurring, because what I’m hearing you say is, we’re working with a protective part.
We’re working with the child’s protective system. Is that a way? Yeah. So there’s victim parts, which makes sense to everybody.
The little kids inside of all of us, right, are victim parts. We went through things that were awful, and then there’s protective parts, and then there could be or most likely is imitator parts. And the imitator parts are what scare most therapists.
So the victim parts we can understand. A victim part says, yeah, I was a little girl, I went through this awful stuff, and a therapist feels okay to help that part. Then there’s these protective parts where it might look like the kid being angry or not listening to their parent or switching into a different voice and getting defiant or oppositional or they forget things.
It’s the imitator parts about why people feel so fearful about Dissociation. So the imitator parts are when a child imitates, they sexually abuse another child, they harm another child. It’s the imitator parts that very much scare us.
So it’s usually grouped into those three victim protective and imitator perpetrator parts. So let’s keep flushing this out. I know that I mentioned that there was a spectrum here.
And will you give us different examples, like just a couple of different examples of what it can look like across the spectrum? Sure. So a mild case, and this might sound dramatic, but it was a very securely attached child, had very good parents, and his dad unfortunately suddenly died. Right.
Even though that sounds so significant, which it was, but he had incredible extended family and he was securely attached. This child had dissociative moments of remembering when he was told about his father had passed. So he had some forgetfulness.
When I did some processing around the memory, he would glaze away. He would get stuck in his emotion, but he was able to process through it. He didn’t really end up having a lot of behavioral problems.
He didn’t really have a lot of significant parts of self. He was just truly dissociative at the time of the event of remembering that moderate is what most of us have. That could be a child with one securely attached parent, and then they might maybe don’t have another securely attached parent.
So I have a little girl that I work with. She was in today. She’s destined to be a social worker.
She’s already said it to me, I’m going to be a counselor. And I actually was ready to terminate with her. And the week before, I brought up the divorce of her parents, which we have worked through numerous times.
And she just shut down. So I know not everyone could see me, but she looked down, she looked away, and she walked away from me, and she’s never done that. And I said, what’s wrong? What did I say? And she wrote on my whiteboard behind me, she wrote, I don’t want to talk about this, which was great on her part, but she suddenly, I could tell, just became a little girl.
She started sucking her thumb, which she’s never done in my office. She’s never done. She started stomping her feet.
So that’s dissociation like she just went into when she was a little girl and her parents had a pretty difficult divorce. And so she went right into this little girl mode, and I witnessed it. But she’s not a child with parts of self.
She has a little girl inside of her that’s upset about that time, but it’s one part, and she’s not what we call fragmented. Before you go on to some other examples, you just raised a really interesting question for me. So would you say that when we are with our clients and our client goes into because what you just described was also regression.
Right. If a client goes into an embodied regression, are you saying that there’s a dissociative aspect with that because there’s an embodied regression? Absolutely. Really interesting, I think learning point.
Yeah. Just to let folks know what I did, right. I just got very quiet and I said, there’s a little girl inside of you that remembers this and you don’t want to talk about it, and that’s okay.
And we ended, and the mother told me today, she said she didn’t talk for 3 hours. And so my guess is she regressed back to that time where she would probably hide in her room when her parents were fighting. And so then I brought mom in for this session, and we processed that time period while playing drums, while playing instruments.
We went out in the parking lot, and in between the drumming and all that, we talked about some of those difficult, challenging memories. And she was able to stay engaged. Yeah.
And so then your most severe did children, which is really who I love to work with and who I want to work with, is these kids that really have many parts of self, and they’re often foster care kids that are being adopted. They’re out of country adoptions, severely neglected, but they have really distinct different ways of acting. And I struggle to say personalities because that could take us down a road, but it’s really like they’re different kids, and so it’s really just getting them to feel comfortable and safe with their parts of self and getting parents to be comfortable with their child’s parts of self.
I have a story that I would love to share. Sure. So my mom was a therapist, and my mom’s specialization was did.
And when I was in graduate school, we had all kinds of interesting conversations about what I was learning and whatnot and she said, I want to show you something. So she showed this image to me of what looked like a genogram. Right.
Because I’m studying genograms. I’m like, oh, is that a genogram? And she said, no, these are all the parts right. She referred to as altars.
Right. But these are all the parts within one client. And I remember feeling so incredibly fascinated.
Yes. And in awe. In awe of the mind and in awe of the brilliance.
I didn’t know who this individual was. Right. Meant nothing to me right.
In terms of identifying information and whatnot, but just the recognition that there were all these parts of self that were created due to the trauma. It was one of those moments of profound gratitude for being able to be in this field and to witness such brilliance even though it wasn’t even my client. Does that make sense? Absolutely.
Because it is. And I’ll give a story. It’s a boy that I work with, and he’s eight.
And so I’m trying to help the adoptive mom understand why he gets in trouble in school. He just like many kids, everyone on this podcast will have that client where he just loses it in school and hits a kid and then gets in trouble. And I said to him in the playroom one, I said, yeah, it’s like there’s two different I’ll call him John.
Two different go, you know, you come into my office we do sand work, you love my dog, we have a good time, you’re happy. I said, but then mom talks about that there’s this other John in school, and that side of you or that part of you or that John hits kids. I said yeah.
I said, It’s like two different parts of you. And he yeah. And so here’s a famous question I ask kids, and I go, how long has that John part of you been around? And this is what so many kids say.
He goes, oh, since I’ve been two, I know why he says Two? And I go, what happened at two? He goes, oh, that’s when the lady came in, and the police came in, and the police handcuffed my parents, made them get on their knees, and that lady took me away from my parents, and I never saw them again. And he said, that’s the day I said no one will ever hurt me again. I said, oh, that’s when this other John part of you got formed.
And he I said and he goes, well, he’s bad, though. I said, oh. I said, no, he was protecting you back then, right? He was protecting you.
He took care of you. He wanted to make sure no one would ever hurt you like that again. I go, So we actually call this a protective part, and he’s eight or nine, so he got it.
So mom comes in and I go, can you explain to mom? He goes, you know, I have a bad John part, but it’s protective, and I know he doesn’t need to protect me that way anymore. But that’s what’s happening in school, right? But mom finally got it right, because then we explained the two years old and things like that. Annie, do you believe that we all have some level of dissociative parts in all of us? Yeah.
And I think that’s where this needs to be demystified. Like, this isn’t just a certain group of people. First of all, our world has changed, and it is really hard to say that none of us haven’t been through stuff, right? We’ve all experienced stuff.
And if you understand that on some level you have a little girl, a little boy inside of you, that’s okay. Does it mean you’re so fragmented and you’re forgetting time and you don’t know who you are and you don’t remember where you were last night? No, but we all have that part. What I say to therapists is we all go back to our family of origin, right.
We go for holidays. Easter was just here. I come from a very Italian family.
My mother, who’s 88, still runs the show, and my mother will come to my house and go, your kitchen is not too clean, right, in a typical Italian, right? And I feel the 13 year old come right up, right? I’m 13, and I’m ready to argue with her. And then my adult self takes over. And I go, you’re right, mom.
The kitchen is not clean. Right? But the 13 year old would be happy to tell my mother what I think, right? So we all have those parts, especially when we’re around family of origin. And it’s not being afraid of that.
It’s really accepting that you have parts of self. And if you need therapy, then you have to get therapy. But it’s really how we manage life.
I’m hearing an invitation here for therapists to become really curious about parts rather than almost the way that I have historically heard about dissociation actually almost fragments. It further like the language that has historically been used to describe is actually a fragmented language. And I’m hearing like, no, how about we unify or appreciate or hold curiosity for? This is a necessary part of who this is.
So when therapists present in consultation, I get a little funny and dramatic, and I go, that is fantastic. He just showed you his dissociative part of self. Because, Lisa, it really is.
When a kid shows me their different parts, that means those parts think I’m okay to witness just that’s. That’s really great. That means I’m doing an okay job, right? And I’ll often say to kids who have very deviant sides, I’ll say, I have this boy who’s from another country, and he had a part that would try to spill water on me.
And I was like, what’s going on? What am I doing that I’m agitating that part? And the next session, I just kept apologizing. I kept saying, I’m so sorry. I think I upset a part of you.
I did something wrong. So sorry. I’m so sorry.
And the next session after that, he walks in and I go, you know what? I’ll call him John too. I go, you know what, John? All parts of you are welcome. And he’s got language issues.
And he goes, all parts of me? I go, all parts of you? The ones that want to look at people’s private parts, the ones that want to put water on me, I go, Whatever. All these the ones that take dad’s credit cards, all those parts, they’re welcome here. And, Lisa, for 1 hour, he sat down and told me all about those parts.
And it was the game changer for him because I said, oh, my gosh. Oh, this part curiosity, okay, right? And I’m writing everything down because I have to do talk to the parents about some concerns. And then his most mature part came forward and said, but we don’t want to do this anymore.
We don’t want to look at people’s private parts, right? But I’m curious. I’m just curious and neutral. Well, and it’s so interesting that oftentimes the protective parts end up doing things that then they get shamed for in their attempt to protect.
And then what a confusing internal experience, because it’s a part that’s trying to do its job because needed to at a time, and now it’s getting shamed. And so what a beautiful thing to welcome the part is a different message to the part that you’re worthy of love, too. Yeah.
And that’s a great statement, because some trainers said to me, these parts have no idea what it feels like to be loved, accepted, heard, witnessed, or wanted in a therapy office. Right. These are the kind of kids we send to the hospital.
Right. And I’m just like, I welcome all parts of you. I’ve had kids threaten me.
I have kids attempted to hurt me. Right. And I just turn around and I go, yeah.
And that part’s really upset with me. I wonder why. And it diffuses the part.
Right. And I teach parents this. It’s very hard for a parent to go, honey, you brought some scissors on the bus today.
I wonder why. But if I can get a parent to buy into it, wow. The kid’s like, well, yeah, there’s a part of me that felt like that boy was going to hurt me.
Okay. And it’s working through that. That’s hard.
It’s hard working with parents, but I have a lot of success getting parents on board because I’m like, this is great. Their dissociative parts came out at Know, and an adoptive parent is like, what are you talking about, Annie? I’m like, this is great, because now we can heal those young parts. Right.
And so this is how I get parents to buy into it, because I’m not scared of the dissociation. I say, let’s welcome this. This gives us the opportunity for you to heal your child.
Here’s a practical question for you. Do you, in your work with some of the children, ever invite the child to name the we? And that little boy who had the part, that was John who was attacking other kids, I said, what do you call this part? I said, Will you draw that part? I actually have them draw it because for me, a visual is really good. So I remember the parts, and he drew a volcano and wrote volcano.
And he said, this is the part that blows up and gets in trouble. And I always reframe to say, oh, volcano is your protective part. So I just have kids draw the parts so then we can go back and refer to them in the drawings.
What are some of your other I’m hearing you say naming the part, right. Welcoming the part, drawing the part, identifying the part. What are some other things that you could help play therapists kind of begin to get curious about? So what I did with that boy and actually, it was not the fighting part of him, but he had a part that didn’t do schoolwork.
And so I said, could you draw the part that doesn’t do schoolwork? He draw the part. He drew the part and he wrote board. I said, hey, is there a part of you who wants to pass school? And he says, yes.
I said, Will you draw that part? And then he called that part no fail, meaning he didn’t want to fail school. And so I said, could board tell no fail why they don’t want to do schoolwork? So he said a few things. I said, what about no fail? Can no fail talk to board? Right? So what I’m doing is creating dialogue between two parts, right? And then this is a very interesting thing that I’m teaching therapists is that it’s up to the child to negotiate how this is going to work out.
And therapists are like, but they’re young. I say, I do this with as young as four years old. I wonder what those two parts are going to work out.
So I’m encouraging a dialogue, I’m encouraging negotiation, I’m encouraging a solution, right? And I’m like, I wonder what that part? Can they come up with any solution? And this little boy looked at me and he goes, well, if we do our homework on Sunday, if we just do it, mom said we could watch the football game. I said, oh, no, Phil wants to watch the football game. I wonder what Bored thinks.
And back and forth and back and forth. And he did it on his own without the mother prompting, right? It was the negotiation. And that’s a big part of this, because people are like, okay, Annie, I’ve identified the parts.
I got their names, I got the drawings. Now what? I said, they’re a family inside. They have to work this out.
They have to talk to each other. They have to negotiate, they have to share their feelings. They have to be accepted, right? A little boy today well, he’s not a little boy, he’s a teenager.
And he did some awful things to his biological sister, and he put in the sand today what his disgusting part. So I’m bringing this up, Lisa, because when a child has a part of themselves they hate, what’s happening is this continuous internal dialogue of I hate that part of me. So just like if I said to you over and over, lisa, I hate you, I hate you, I hate you, you’re suddenly going to react to me and get aggressive with me, right? So a part does not want to hear that they’re hated or not loved or not wanted.
And so teaching a child to have compassion towards those parts is so key in the treatment, including the parent doing that. And I say to the parent, you can grow the monster, which means if you keep telling that part of the child they’re bad, they’re just going to keep acting out more and more. I said, if you don’t want to grow the monster, then you have to learn to love this part and help this part understand that it’s loved and accepted and doesn’t need to keep acting this way.
So it’s a critical piece of the treatment. That is so not easy. I have another question for you, Annie, that might also fall of not easy, right? What if the therapist has a belief that what this part is doing is not okay? Yeah, and I’m faced with that every day.
How I started in this field was working with kids who committed crimes and adults who were sexual offenders, and it’s very hard to understand those parts. And so what I say to therapists is finding the origin of how that part got formed will help you deal with compassion. What I said to this teenager today, I mean, he did a horrific sexual act towards his sister.
And I said to him, I said, I wonder where you learned that from? And he stiffened. And he goes, well, what do you mean? And I said, well, from what I understand about your biological parents, something similar happened. You witnessed it.
He goes, I don’t know about that. And I said, well, I think it’s a part of your history that your parents do need, your adoptive parents, they live out of state. Unfortunately, the and but the relief, Lisa, right.
Like, the relief to understand that what he did was an imitate or potentially an imitation, he got it right. And that helps me to have I mean, I know what he did was harm, really harm. And this is all our shooters, too, our young people who shoot and are aggressive.
It’s really understanding where they’ve imitated, where they’ve learned that, who were the perpetrators in their life. It’s not easy. Consultation is really the answer.
One of the beliefs that I have held is that all behaviors make sense when you have enough data points. And that if I’m judging someone’s behavior, it simply means I don’t have enough data points, because that’s what I found in my own life and in my own work and even towards myself. If I’m not understanding something that I’m right, if I’m not understanding what someone else is doing, or if I critical of someone else’s behavior, for me, it’s been a really useful reminder personally and clinically to go, wait a second, I’m missing information.
So what are the data points I need? Because I inevitably find the moment that I see the picture and I get it, my heart softens. It’s almost like instantaneous, right? To my client, to myself, to my own kid, like, whatever. And I think that I’m hearing that too.
There’s an invitation here as clinicians almost like, how wide can we go? How curious can we become? And I say we’re not only therapists, we are detectives. And really what I mean by that is that you have to look at a symptom, and if it’s hair pulling, I’m always thinking, I wonder why they hair pull. I wonder where they learned that from.
I wonder how that behavior got formed. Right. And in any kind of disturbing or really difficult things.
I’ve had kids who’ve. Killed. And I have to really say, wonder how you got to that place, right.
And being open to that. Absolutely. Yeah.
And what I’m also hearing in this conversation is and recognizing that the part that killed was likely a dissociative part, there’s something going on and sometimes they have no memory of this. And that’s another hard piece to understand that is that what do you mean they don’t have memory? Yeah, definitely. Wow, this is so it’s a great topic.
Curious here for listeners that are super curious and want to continue to learn, you do have a training coming up right around the corner. Can we go ahead and just make that? And so and I can give you a link, too. Lisa so it’s called managing know through different exercises, through different interventions.
And so it’s a one day, it is in person in Buffalo, New York, but we’re doing it live and online and it’s very experiential. So I spend the morning just teaching about dissociation in a very interactive kind of way. You have scripts, you’ll learn how to explain it to a parent, you’ll learn how to identify symptoms.
And then we spend the rest of the day doing different, more embodied kind of movements or activities to really get kids grounded. So while they’re talking about parts of self or while they’re dissociating, we’re finding ways to get them grounded in the present moment. And our belief as trainers is that you’re teaching kids, but you’re also teaching parents.
And because me teaching a kid for 1 hour is not the total answer, the total answer is getting these parents to learn how to get their children in the present when they’re at home. So that’s the one day and I’ll give you the link what day it is. It’s July 26.
July 26. There’s an in person, but an online option. Yeah, that’s a great introduction into hearing me talk about this.
And then obviously there’s other, further, more extensive trainings. If you’ve never taken a training from me, then you can go from there, but be prepared to move and do some fun stuff with us. Great.
Give the website Annie well, they can look at my website, WW dot anniemonico.com. Anniemonaco.com so that one will be on my website.
And then I do other trainings on the playfulemdr.com website. Folks are absolutely more than welcome to email me.
And you’ll have links if I give them to you? Lisa yeah, they can email me and just ask me questions about what training and different things to take. Well, before we wrap up, because there’s a final question I want to ask you. You also do have a book.
So for those of our listeners that do want more information about EMDR and Play therapy, I know we didn’t talk specifically about EMDR today, but I imagine EMDR is very helpful. That book has 19 authors, including Lisa Dion, and that book is obviously for EMDR. But the topics part of it is for every child therapist.
Right. So it’s EMDR in the playroom. And again, we can give you the link to that, but anybody could really read that book to just understand attachment.
Dissociation, there’s a whole host of topics that we do, and it’s really great child therapists, and all of them are play therapists who use the EMDR component to reprocess memories. Yeah. And I do EMDR trainings.
My final question for you, Annie what do you want listeners to take away from this conversation? What do you want? Be excited about Dissociation, even if you don’t know what to do with it. If all you said to a kid is, wow, it seems like there’s two different John’s. There’s this john and there’s this john.
And I will tell you that 99% of kids will go, yeah, that’s true. Right. And because they’re waiting for us to ask.
So if they walk away with just reflecting back the different sides of children, it opens the conversation. Yeah. Awesome.
Thank you for taking this topic and just doing what you’re doing with it for our field and for wrapping your arms around this. As you probably know, my mom passed away a couple of years ago, and I’m having a moment of, oh, I want to I know, be like, mom, I just had this amazing conversation. I know.
I had a moment that I was like, can I meet her? And then I was like, yes, we can. With a deep breath, yes. So thank you.
Right? Thank you for bringing me full circle to conversations that I have had over the years with my own mom. Listeners, thank you so much for tuning in. Thank you so much for continuing to be a part of this Lessons from the Playroom podcast series.
Thank you for asking for what you want, for sending in your feedback. If you have topic ideas, please send them to me. I love reading about how these conversations are impacting you and wherever you are in the world, take care of yourself.
You are the most important toy in the playroom. Until next time, everyone. Great.
Thank you, everybody. Bye bye. Thanks, Annie.
