In addition to wanting to make smart business decisions, I really wanted healing and better relationships with my brother and sisters. It takes all one's skill and knowledge to avoid error. The work of the doctor is a struggle to apply the ideas of our practice to experiences that are always different. This, too, is the dialectic of medicine. Medicine for us is more than a profession. It is a way of living; It takes an entire lifetime to understand how to treat patients. When the treatment is right, you can feel it is so. You know it from experience. There is a natural method to treatment. You heal the patient. Sometimes the questions might actually be coming from another part, although you are not aware of it, so it is usually best to simply answer them or explore their meanings in as calm and reassuring a manner as possible. People with DID can also be easily startled. Even if you move to do something as benign as turning on a fan, calmly state what you are going to do beforehand. It is important for partners also to understand these issues. You might do playful things with the host, but then a child ego state appears and what was playful has now become frightening. You certainly cannot predict every circumstance, but if your partner reacts to something with a startled or fearful response, simply respect it and tone down your own behavior without making it personal. It is important to try consciously to predict situations in which the person with DID is likely to be triggered so that a joint decision about how to handle things can be made. Prediction is true for therapy situations as well. Of course, this information comes to light through experience, so the process is ongoing.

Other topics to discuss include when touch is and is not okay. My younger brother had died, and I didn't want to lose my connections with my other siblings. During reflection about one decision, I felt very clear and excited about what I thought was the best way to proceed. It made perfect business sense to me and seemed ideal. But when I took that vision of a solution into my quiet time, affirming my desire for healing in my sibling relationships along with wise business action, I received a no from my inner guidance. Instead of my original vision, an image came to my mind that was a different solution. From my limited viewpoint, I couldn't quite see how the new vision was going to work, so I asked my inner guide a yes/no question. I asked if I should pursue this new vision, and I received a yes answer. Over the years of learning to hear my personal GPS, I knew my inner guide would not steer me wrong. So I thanked my inner wisdom and pursued the different solution. It turned out to work wonderfully, I am now seeing things move forward in a good business way, and I am having better relationships in my family. But where the treatment is right, you feel it yourself, in your body, in your emotions, in your relation with the patient. When the treatment goes badly, it is not just the patient who feels blocked but the doctor, too. Her illness, her failure to improve affects me. Is this not your experience? I will tell you, in old China, Chinese doctors claimed to have secret knowledge of herbs and ancient family remedies. For me the secret knowledge is knowledge of the patient and his relationship with you and others. Interpretation For Paul Samuels, Hiram Bender, Helen McNaughton, and Gu Fangwen medical practice is more than the professional job it is for Andy Spier. Healing is the center of gravity of Dr Samuels's life.

He tells us that becoming a healer resolved a key tension in his adolescent development and adult personality. Some survivors are frightened by touch when they are experiencing strong emotion because it reminds them of abusive experiences in the past. Anger and anxiety are two emotions important to address. Self-soothing techniques are generally helpful in the case of anxiety. Anger can be less predictable because it can turn so quickly to rage. Rage is often related to survival instincts. Even though current conflicts are not likely to be life and death situations, they can feel that way to the person with DID. It is best to let the anger ride its course as long as neither you nor the other person is in any danger. In therapy, rage can occur when the therapist says something he considers to be neutral or matter of fact and it triggers something internally for the client (typically shame. Doing so together is helpful in increasing awareness on the part of the dissociator. It also helps increase intimacy in the relationship, be it with a therapist, partner, or friend. I feel very grateful. Feeling confident in the guidance you are receiving is one of the most powerful skills you can develop for yourself. It takes time and practice. Just as you practice to get faster and better at calming yourself with meditation, and just as you get stronger and more confident in purposefully activating the energy you want working for you in the shared energy field, you also need to practice and gain confidence in feeling the intuitive guidance you receive. Try these strategies, or some ideas of your own, to grow confident in the GPS guidance available to you. Keep a guidance journal. Whenever you have a nudge or inspiration or intuitive knowing, write it down. Record not only the idea but also the feeling you had inside. Was it a warm, happy sensation in your heart?

Did it feel like peaceful knowing? Anthropologists studying healers in non-Western societies often elicit similar accounts (Kleinman 1980). Not infrequently a powerful illness experience leads a patient into the healer's role. He also feels a need to be effective. There is a deeply personal basis to this need. His personality is part of his therapeutic work. Thousands of miles away, in a radically different culture and society, Gu Fangwen reports a therapeutic sensibility that is also anchored in personal experience, though its sources and conception are rather different. Hiram Bender's words suggest that this experiential core of doctoring is a moral domain that is not reducible to the now-dominant technical and economic metaphors used to model therapeutic relationships. For Dr Bender each patient is a life story, and treatment means entering that peculiar life world. Helen McNaughton is deeply troubled by the constraints placed on her therapeutic skills by the institution in which she practices psychiatry. She laments the transformation of the healer's art into mere technique, the crude seduction of care into a money-making commodity. Setting clear boundaries and knowing useful soothing techniques are essential parts of navigating the rough waters of DID, but they are not enough. As a significant person in the life of someone with DID, you cannot be present in her life without first showing up for your own in a meaningful and fulfilling way. Therapists can help themselves, and ultimately their clients, by modeling good boundaries and by continually assessing their own stress levels and responding accordingly. A backup therapist can help. A backup therapist can function in various ways. He might see the client from time to time to work on specific issues with which you do not feel competent. He might serve more as a consultant who meets with you and your client when you feel stuck in therapy or find yourselves caught in a power struggle that simply will not resolve itself. Or, he may simply provide coverage for you when you are away from the office. On the positive side, having a backup therapist means you are getting another opinion about the direction of treatment, and you know your client will be safe when you are away because she will have access to someone she knows and with whom she has already worked.

The danger of having a backup therapist is the possibility of triangulation or splitting if the client becomes angry with one therapist and goes to the other. Was it like an eager voice prompting you, Yes, pay attention, that's it? Write down specifically what it felt like. Later, as things come to pass and you've acted on some of your nudges, look back at your journal. Notice which feelings gave you clear guidance and which did not. Did acting on an inspirational idea or a nudge connect you with your desires? If so, what feelings did you write down that went with that idea? Get to clearly know which feelings are your guidance signals and which are not. Gather information. Recall from earlier that the more information you collect about an idea or an opportunity, the stronger and more accurate your intuitive guidance will be. So when you have an inspiration, a hunch, an idea, check it out. Dr Gu Fangwen, expressing himself in the cultural idioms and tropes of an entirely different civilization, says something similar to Hiram Bender. Both practitioners see themselves as students of human nature, teachers of moral wisdom. But they see their craft's moral aspects as equally central. This is not Andy Spier's vision. For him, private practice is an almost intolerable burden. He wants to get out. He fears that if he continues in practice he will not merely burn out but become a danger to his patients and himself. His chief interests are concerned with the biology of disease; One suspects that Andy Spier's patients (like Dr Richards's patient Mrs.