Dissociative Identity Disorder Quotes

Due to previous lack of systematic assessment of dissociative symptoms, many subjects experience the SCID-D as their first opportunity to describe their symptoms in their own words to a receptive listener.

DelusionsDissociative disorders, even those created by mind controllers, are not psychosis, but this program will create the most common symptom used to diagnose schizophrenia. The child is hurt while on a turntable, with people and television sets and cartoons and photographs all around the turntable. New alters created by the torture are instructed that they must obey their instructions and become the people around them, people on television, or other alters when they are told to. When this program is triggered, the survivor will hear “voices” of the people whom the "copy alters” are imitating, or will have many confused alters popping out who think they are actually other people or movie stars. The identities of the copy alters change when the survivor's surrounding change.

~~You are not alone~~ No, really. Literally. Maybe you have always known (or suspected) this. Maybe this news is shocking, baffling, dismaying, even unbelievable to you. Despite what you might believe or may have been told about yourself, you are not just 'moody'. Nor are you crazy or defective or possessed. You have what is commonly called 'multiple personalities'.

The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR.While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false.Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia.

It is necessary to make this point in answer to the `iatrogenic' theory that the unveiling of repressed memories in MPD sufferers, paranoids and schizophrenics can be created in analysis; a fabrication of the doctor—patient relationship. According to Dr Ross, this theory, a sort of psychiatric ping-pong 'has never been stated in print in a complete and clearly argued way'. My case endorses Dr Ross's assertions. My memories were coming back to me in fragments and flashbacks long before I began therapy. Indications of that abuse, ritual or otherwise, can be found in my medical records and in notebooks and poems dating back before Adele Armstrong and Jo Lewin entered my life. There have been a number of cases in recent years where the police have charged groups of people with subjecting children to so-called satanic or ritual abuse in paedophile rings. Few cases result in a conviction. But that is not proof that the abuse didn't take place, and the police must have been very certain of the evidence to have brought the cases to court in the first place. The abuse happens. I know it happens. Girls in psychiatric units don't always talk to the shrinks, but they need to talk and they talk to each other. As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept.(Alice refers to her constant infections as a child, which were never recognised as caused by sexual abuse)

Joe knew that for some, really for most, the derivations of belladonna that blurred their vision and caused their hearts to race would, as well, hasten their forgetting of detail. They would not recall, not readily, any sense of pain or shame or doubt or threat of danger. []There were always children to be used. Members were obliged to offer their children, although not necessarily every child in a family was used. Some were found to be not suited for the rigor. Some were left alone so that if the involved children in a family were to attempt to tell, siblings could not corroborate their experience.

It is so much more threatening to have something out of hand than to believe that at any moment I can stop (I started to say "This foolishness") any time I need to.

When I was cooking I enjoyed a sense of being ‘out’ of myself. The action of dicing vegetables and warming oil made my hands tingle and my thoughts switch to a different hemisphere, right brain rather than left, or left rather than right. In my mind there were many rooms and, just as I still got lost in the labyrinth of corridors at college, I often found myself lost, with a sense of déjà vu, in some obscure part of my cerebral cortex, the part of the brain that plays a key role in perceptual awareness, attention and memory. Everything I had lived through or imagined or dreamed appeared to have been backed up on a video clip and then scattered among those alien rooms. I could stumble into any number of scenes, from the horrifically sexual, horror-movie sequences that were crude and painful, to visualizing Grandpa polishing his shoes.

The DID patient should be seen as a whole adult person with the identities sharing responsibility for daily life. Despite patients’ subjective experience of separateness, clinicians must keep in mind that the patient is a single person and generally must hold the whole person (i.e., system of alternate identities) responsible for the behavior of any or all of the constituent identities, even in the presence of amnesia or the sense of lack of control or agency over behavior.From p8 International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision: Summary version. Journal of Trauma & Dissociation, 12, 188–212.

Denial returned, like a nagging cough you can never quite shake. Actually, it was always close at hand, and even though "satanic ritual abuse" did describe what had happened to me when I was a child. the concept was so foreign and so horrific that some part of me still wanted to stay in denial.Devil worship dominated my childhood. That was undeniable, even if it was still nearly impossible to contemplate. Both of my parents and any number of their friends, as well as "respected" members of our community, had worshipped Satan.I pushed the notion aside with all the power I could muster. I kept thinking to myself that it was ridiculous and impossible.p157

Some alters are what Dr Ross describes in Multiple Personality Disorder as 'fragments'. which are 'relatively limited psychic states that express only one feeling, hold one memory, or carry out a limited task in the person's life. A fragment might be a frightened child who holds the memory of one particular abuse incident.' In complex multiples, Dr Ross continues, the 'personalities are relatively full-bodied, complete states capable of a range of emotions and behaviours.' The alters will have 'executive control some substantial amount of time over the person's life'. He stresses, and I repeat his emphasis, 'Complex MPD with over 15 alter personalities and complicated amnesia barriers are associated with 100 percent frequency of childhood physical, sexual and emotional abuse.' Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.

Escape from reality. In some instances, dissociation induces people to imagine that they have some kind of mastery over intractable environmental difficulties. Dissociation is often implicated in magical thinking or self-induced trance states. This aspect of dissociation is frequently found in abuse survivors. It is not uncommon for abused children to engage in magical thinking to retain an illusion of control over the situation (e.g., believing that they "cause" the perpetrator to act out).

The primary treatment modality for DID is individual outpatient psychotherapy.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact.But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters.Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.

And if we do speak out, we risk rejection and ridicule. I had a best friend once, the kind that you go shopping with and watch films with, the kind you go on holiday with and rescue when her car breaks down on the A1. Shortly after my diagnosis, I told her I had DID. I haven't seen her since. The stench and rankness of a socially unacceptable mental health disorder seems to have driven her away.

Cheryl was aided in her search by the Internet. Each time she remembered a name that seemed to be important in her life, she tried to look up that person on the World Wide Web. The names and pictures Cheryl found were at once familiar and yet not part of her conscious memory: Dr. Sidney Gottlieb, Dr. Louis 'Jolly' West, Dr. Ewen Cameron, Dr. Martin Orne and others had information by and about them on the Web. Soon, she began looking up sites related to childhood incest and found that some of the survivor sites mentioned the same names, though in the context of experiments performed on small children. Again, some names were familiar. Then Cheryl began remembering what turned out to be triggers from old programmes. 'The song, "The Green, Green Grass of home" kept running through my mind. I remembered that my father sang it as well. It all made no sense until I remembered that the last line of the song tells of being buried six feet under that green, green grass. Suddenly, it came to me that this was a suicide programme of the government. 'I went crazy. I felt that my body would explode unless I released some of the pressure I felt within, so I grabbed a [pair ofl scissors and cut myself with the blade so I bled. In my distracted state, I was certain that the bleeding would let the pressure out. I didn't know Lynn had felt the same way years earlier. I just knew I had to do it Cheryl says. She had some barbiturates and other medicine in the house. 'One particularly despondent night, I took several pills. It wasn't exactly a suicide try, though the pills could have killed me. Instead, I kept thinking that I would give myself a fifty-fifty chance of waking up the next morning. Maybe the pills would kill me. Maybe the dose would not be lethal. It was all up to God. I began taking pills each night. Each-morning I kept awakening.

It was soon after that I, overwhelmed with the implications of that memory, overdosed - well, somebody did but as it was my mouth and my stomach that was involved I had to take the consequences. Somehow or other (did an alter ring him?) Bruce (from my support group) got to know, drove over and took us to the hospital.

Parts of you are phobic of anger and generally terrified and ashamed of angry dissociative parts. There is often tremendous conflict between anger-avoidant and anger-fixated parts of an individual. Thus, an internal and perpetual cycle of rage-shame-fear creates inner chaos and pain.

Treating Abuse Today 3(4) pp. 26-33Freyd: The term "multiple personality" itself assumes that there is "single personality" and there is evidence that no one ever displays a single personality.TAT: The issue here is the extent of dissociation and amnesia and the extent to which these fragmentary aspects of personality can take executive control and control function. Sure, you and I have different parts to our mind, there's no doubt about that, but I don't lose time to mine they can't come out in the middle of a lecture and start acting 7 years old. I'm very much in the camp that says that we all are multi-minds, but the difference between you and me and a multiple is pretty tangible.Freyd: Those are clearly interesting questions, but that area and the clinical aspects of dissociation and multiple personalities is beyond anything the Foundation is actively...TAT: That's a real problem. Let me tell you why that's a problem. Many of the people that have been alleged to have "false memory syndrome" have diagnosed dissociative disorders. It seems to me the fact that you don't talk about dissociative disorders is a little dishonest, since many people whose lives have been impacted by this movement are MPD or have a dissociative disorder. To say, "Well, we ONLY know about repression but not about dissociation or multiple personalities" seems irresponsible.Freyd: Be that as it may, some of the scientific issues with memory are clear. So if we can just stick with some things for a moment; one is that memories are reconstructed and reinterpreted no matter how long ago or recent.TAT: You weigh the recollected testimony of an alleged perpetrator more than the alleged victim's. You're saying, basically, if the parents deny it, that's another notch for disbelief.Freyd: If it's denied, certainly one would want to check things. It would have to be one of many factors that are weighed -- and that's the problem with these issues -- they are not black and white, they're very complicated issues.

It is not unusual for subjects diagnosed with a Dissociative Disorder on the SCID-D to be surprised at having their symptoms validated by a clinician who understands the nature of their disorder.

Some dissociative parts of the personality, living in trauma time, may experience the same emotion no matter the situation, such as fear, rage, shame, sadness, yearning and even some positive ones just as joy.

My own studies on the natural history of DID indicate only 20% of DID patients have an overt DID adaption on a chronic basis, and 14% of them deliberately disguise their manifestations of DID. Only 6% make their DID obvious on an ongoing basis. Eighty percent have windows of diagnosability when stressed or triggered by some significant event, interaction, situation or date. Therefore, 94% of DID patients show only mild or suggestive evidence of their conditions most of the time. Yet DID patients often will acknowledge that their personality systems are actively switching and/or far more active than it would appear on the surface (Loewenstein et al., 1987).R.P. Kluft (2009) A clinician's understanding of dissociation. pp 599-623.

Dissociation leaves us disconnected from our memories, our identities and our emotions. It breaks the trauma into digestible components, so that different aspects of the trauma get stored in different compartments in our brain. What happens as a result is that the information from the trauma becomes disorganized and we are not able to integrate these pieces into a coherent narrative and process trauma fully until, hopefully, with the help of a validating, trauma-informed counselor who guides us to the appropriate therapies best suited to our needs, we confront the trauma and triggers in a safe place.

When experiences or emotions become too overwhlming, the mind clevely encapsulates the material and stores it for safe-keeping. Many people respond this way in the face of trauma, but the additional step that occurs in this process, in the case of DID, is the formation of distinct ego states that carry the experience.

There, there, best to bring it all up,' she said. My memory was in shreds. Imagine a photograph cut into narrow strips then jumbled up. Everything is there, but you can't see the whole picture and even the strips have no bearing on reality. I did know I had consumed a large amount of alcohol. But I must have done something crazier than just being found drunk to have a nurse sitting by my bed. I thought it would be a good idea to say something and planned it for several seconds. 'She's all right,' I said. 'Who is?' asked the nurse. 'Alice. I'm all right now.' As I spoke I wondered if I had said something wrong. didn't sound like me. There were so many voices muttering in the background it was hard to tell.

After writing the letter Sybil lost almost two days. "Coming to," she stumbled across what she had written just before she had dissociated and wrote to Dr. Wilbur as follows: It's just so hard to have to feel, believe, and admit that I do not have conscious control over my selves. It is so much more threatening to have something out of hand than to believe that at any moment I can stop (I started to say "This foolishness") any time I need to. When I wrote the previous letter, I had made up my mind I would show you how I could be very composed and cool and not need to ask you to listen to me nor to explain anything to me nor need any help. By telling you that all this about the multiple personalities was not really true I could show, or so I thought, that I did not need you. Well, it would be easier if it were put on. But the only ruse of which I'm guilty is to have pretended for so long before coming to you that nothing was wrong. Pretending that the personalities did not exist has now caused me to lose about two days.

Working simultaneously, though seemingly without a conscience, was Dr. Ewen Cameron, whose base was a laboratory in Canada's McGill University, in Montreal. Since his death in 1967, the history of his work for both himself and the CIA has become known. He was interested in 'terminal' experiments and regularly received relatively small stipends (never more than $20,000) from the American CIA order to conduct his work. He explored electroshock in ways that offered such high risk of permanent brain damage that other researchers would not try them. He immersed subjects in sensory deprivation tanks for weeks at a time, though often claiming that they were immersed for only a matter of hours. He seemed to fancy himself a pure scientist, a man who would do anything to learn the outcome. The fact that some people died as a result of his research, while others went insane and still others, including the wife of a member of Canada's Parliament, had psychological problems for many years afterwards, was not a concern to the doctor or those who employed him. What mattered was that by the time Cheryl and Lynn Hersha were placed in the programme, the intelligence community had learned how to use electroshock techniques to control the mind. And so, like her sister, Lynn was strapped to a chair and wired for electric shock. The experience was different for Lynn, though the sexual component remained present to lesser degree...

It’s hard to feel supported when you can’t tell people everything. People haven’t really got a clue what it’s like. It’s hard to trust anyone. It’s hard to believe people won’t let you down. I’m feeling like I want to cry. My body feels hollow. Empty. I don’t feel like I’m 17. I feel young. I’m not sure how old, maybe about 10 yrs. It’s hard to accept that I can’t get all the support I need from one person. From any person. It’s hard that no one can fully understand. It’s hard for me to admit that inside I feel a really lonely person. What do I need to do to take care of myself right now? Well I need to cuddle my teddies — it sounds silly, but I need some comfort... I was still cuddling teddies when I should have been cuddling boys. The sick imagery in my mind, rather than making me sexually active, had closed that door completely.

I am truly crazy, I told myself. It's over. I am not fixable. I cannot tell Tom. I cannot even tell Francisco. So I won't tell anyone. My brain seemed out of control. Tom does not deserve a crazy wife and my children do not deserve a crazy mother. I finally get it. This is not just repressed memory. This is dissociative identity disorder.

The DID patient is a single person who experiences himself or herself as having separate alternate identities that have relative psychological autonomy from one another. At various times, these subjective identities may take executive control of the person’s body and behavior and/or influence his or her experience and behavior from “within.” Taken together, all of the alternate identities make up the identity or personality of the human being with DID.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p7

My body was a Pandora’s box of aches and pains. When Grandpa died all the ailments came jumping out. I was forever twitching and shaking. I had a persistent sore throat and had difficulty swallowing except when I was taking nips from my illicit cocktail. I was constantly constipated, holding everything in — a disorder that had started when I was two years old. It burned when I passed urine, and my migraines were so severe it felt on occasions as if I were going blind.

Some people with DID present their narratives of sadistic abuse in a quite matter-of-fact way, without perceptible affect. This may sometimes be done as a way of protecting themselves, and the listener, from the emotional impact of their experience. We have found that people describing trauma in a flat way, without feeling, are usually those who have been more chronically abused, while those with affect still have a sense of self that can observe the tragedy of betrayal and have feelings about it. In some cases, this deadpan presentation can also be the result of cult training and brainwashing. Unfortunately, when a patient describes a traumatic experience without showing any apparent emotion, it can make the listener doubt whether the patient is telling the truth. (page 119, Chapter 9, Some clinical implications of believing or not believing the patient)

Many ritually abusive cults deliberately divide the personality system down the middle of the head, making sure that there is no communication between the two sides. “Left side" parts might be instructed to speak to no one other than the perpetrators.

Just as sometimes I wondered if Grandpa had ever existed, sometimes I wondered if I truly existed myself. As I was running, I could see myself from outside myself: a skinny girl with the flapping shorts and too- big a T-shirt, always watching the other girls at school, a girl in a pink bedroom sitting with a book propped on her knees, the words she was reading entering her mind, some sticking like gluey never to be forgotten, others disappearing instantly, I could remember everything and remember nothing. I would watch a movie and recall every scene as if I had written the script, then watch another movie another day and be unable to recall it at all.

Dissociative Identity Disorder...is initially a useful coping response to an environment which is very difficult to endure. The problem is that dissociative responses-such as switching, blanking out, or going into a trance-become automatic, and, once the original abusive environment has been left behind, are of little use in life and may be detrimental.

I want everyone that has been abused by someone in their childhood to know that you can get past it. Having DID is not the end of the world; it's the beginning of your new life. DID allows the victim of exceptional abuse the ability to “forget” the abuse and continue living. Without it, I may have gone crazy as a teen and spent my life in a as a teen and spent my life in a psychiatric hospital.

How was it that we were all so blind?

In the same way that the women's movement of the seventies and eighties brought rape and incest into public consciousness, we can do the same with the causes and reality of dissociation and multiplicity.

The physical shape of Mollies paralyses and contortions fit the pattern of late-nineteenth-century hysteria as well — in particular the phases of "grand hysteria" described by Jean-Martin Charcot, a French physician who became world-famous in the 1870s and 1880s for his studies of hysterics...""The hooplike spasm Mollie experienced sounds uncannily like what Charcot considered the ultimate grand movement, the arc de de cercle (also called arc-en-ciel), in which the patient arched her back, balancing on her heels and the top of her head...""One of his star patients, known to her audiences only as Louise, was a specialist in the arc de cercle — and had a background and hysterical manifestations quite similar to Mollie's. A small-town girl who made her way to Paris in her teens, Louise had had a disrupted childhood, replete with abandonment and sexual abuse.She entered Salpetriere in 1875, where while under Charcot's care she experienced partial paralysis and complete loss of sensation over the right side of her body, as well as a decrease in hearing, smell, taste, and vision. She had frequent violent, dramatic hysterical fits, alternating with hallucinations and trancelike phases during which she would "see" her mother and other people she knew standing before her (this symptom would manifest itself in Mollie). Although critics, at the time and since, have decried the sometime circus atmosphere of Charcot's lectures, and claimed that he, inadvertently or not, trained his patients how to be hysterical, he remains a key figure in understanding nineteenth-century hysteria.

Patients with complex trauma may at times develop extreme reactions to something the therapist has said or not said, done or not done. It is wise to anticipate this in advance, and perhaps to note this anticipation in initial communications with the patient. For example, one may say something like, "It is likely in our work together, there will be a time or times when you will feel angry with me, disappointed with me, or that I have failed you. We should except this and not be surprised if and when it happens, which it probably will." It is also vital to emphasize to the patient that despite the diagnosis and experience of dividedness, the whole person is responsible and will be held responsible for the acts of any part. p174

Denial is commonly found among persons with dissociative disorders. My favorite quotation from such a client is, "We are not multiple, we made it all up." I have heard this from several different clients. When I hear it, I politely inquire, "And who is we?

I cut myself up really badly with the lid of a tin can. They took me to the emergency room, but I couldn’t tell the doctor what I had done to cut myself—I didn’t have any memory of it. The ER doctor was convinced that dissociative identity disorder didn’t exist. . . . A lot of people involved in mental health tell you it doesn’t exist. Not that you don’t have it, but that it doesn’t exist.

Dissociative identity disorder is conceptualized as a childhood onset, posttraumatic developmental disorder in which the child is unable to consolidate a unified sense of self. Detachment from emotional and physical pain during trauma can result in alterations in memory encoding and storage. In turn, this leads to fragmentation and compartmentalization of memory and impairments in retrieving memory.2,4,19 Exposure to early, usually repeated trauma results in the creation of discrete behavioral states that can persist and, over later development, become elaborated, ultimately developing into the alternate identities of dissociative identity disorder.

Another of the difficulties of having DID is the denial. DID is a disorder of denial. It has to be because if the original person knew about the alters and felt their pain, they would either go crazy and be hospitalized permanently, or would die.

The "apparently normal personality" - the alter you view as "the client"You should not assume that the adult who function in the world, or who presents to you, week after week, is the "real" person, and the other personalities are less real. The client who comes to therapy is not "the" person; there are other personalities to meet and work

...when different identity states convey contradictory information and then have amnesia for what the other identity states said, the patient may be thought to be lying. This can appear to be characterological mendacity when it is not.

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them—in other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world.If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered?Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

Although Dissociative Disorders have been observed from the beginnings of psychiatry, the Structured Clinical Interview for DSM-III-R Dissociative Disorders (Steinberg 1985) was the first diagnostic instrument for the comprehensive evaluation of dissociative symptoms and to diagnose the presence of Dissociative Disorders.

A child who is being abused on an ongoing basis needs to be able to function despite the trauma that dominates his or her daily life. That becomes the job of at least one ANP [apparently normal part of the personality], whom the child creates to be unaware of the abuse and also of the multiplicity, and to “pass as normal” in the real world. The ANP is just an alter specialized for handling the adult world—in other words, the “front person” for the system.

It’s hard to imagine a more squarely on-the-nose example of demonizing mental illness than portraying a mentally ill man as a literal demon.

Lies that cause survivors to deny or recent abuse memories and experiences ⸱ The alters who are designated to live in the "real world,” going to school or college and holding jobs while interacting with others in adulthood, are trained, usually at home by parents, to disbelieve any memories that might come up.⸱͏ Children are taught to believe that they got the idea that they were abused from something they read or saw on television or from someone else’s experience or from a therapist. (This is a basic argument of those who attempt to discredit these experiences in the public eye and among professionals.)⸱ Children are also taught that if they experience flashbacks of awful abuses, those must be dreams or imagination or signs that they are crazy. Nothing bad really happened to them

It was early in my career, and I had been seeing Mary, a shy, lonely, and physically collapsed young woman, for about three months in weekly psychotherapy, dealing with the ravages of her terrible history of early abuse. One day I opened the door to my waiting room and saw her standing there provocatively, dressed in a miniskirt, her hair dyed flaming red, with a cup of coffee in one hand and a snarl on her face. “You must be Dr. van der Kolk,” she said. “My name is Jane, and I came to warn you not to believe any the lies that Mary has been telling you. Can I come in and tell you about her?” I was stunned but fortunately kept myself from confronting “Jane” and instead heard her out. Over the course of our session I met not only Jane but also a hurt little girl and an angry male adolescent. That was the beginning of a long and productive treatment.

The case of a patient with dissociative identity disorder follows:Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.

Why did I allow the abuse to continue? Even as a teenager?I didn’t. Something that had been plaguing me for years now made sense. It was like the answer to a terrible secret. The thing is, it wasn’t me in my bed, it was Shirley who lay the wondering if that man was going to come to her room, pull back the cover and push his penis into her waiting mouth it was Shirley. I remembered watching her, a skinny little thing with no breasts and a dark resentful expression. She was angry. She didn’t want this man in her room doing the things he did, but she didn’t know how to stop it. He didn’t beat her, he didn’t threaten her. He just looked at her with black hypnotic eyes and she lay back with her legs apart thinking about nothing at all. And where was I? I stood to one side, or hovered overhead just below the ceiling, or rode on a magic carpet. I held my breath and watched my father pushing up and down inside Shirley’s skinny body.

Perfectionism is the unparalleled defense for emotionally abandoned children. The existential unattainability of perfection saves the child from giving up, unless or until, scant success forces him to retreat into the depression of a dissociative disorder, or launches him hyperactively into an incipient conduct disorder. Perfectionism also provides a sense of meaning and direction for the powerless and unsupported child. In the guise of self-control, striving to be perfect offers a simulacrum of a sense of control. Self-control is also safer to pursue because abandoning parents typically reserve their severest punishment for children who are vocal about their negligence.

Amnesia, which is a loss of memory, is a symptom of many different trauma and/or dissociative disorders, including PTSD, Dissociative Fugue, Dissociative Disorder Not Otherwise Specified and Dissociative Identity Disorder. Amnesia can affect both implicit and explicit memory.

That is the problem with repressed memory and dissociative identity disorder. Your mind represses certain traumas for reasons of pure survival. And then you learn that to survive as an adult, you must uncover the memories, find the parts, and relieve the traumas. The contradiction is almost too much for the mind to comprehend and for the heart and soul to endure.

Early identification of patients who suffer from dissociative symptoms and disorders is essential for successful treatment, because these disorders do not resolve spontaneously.

Once I had found the courage to tell Rebecca about the children in my head, it wasn't so hard in the coming months to tell Roberta. On the train from Huddersfield one day in May I made a roll call of the usual suspects: Baby Alice; Alice 2, who was two years old and liked to suck sticky lollipops; Billy; Samuel; Shirley; Kato; and the enigmatic Eliza. There was boy I would grow particularly fond of named limbo, who was ten, but like Eliza he was still forming. There were others without names or specific behaviour traits. I didn't want to confuse the issue with this crowd of 'others' and just counted off the major players with their names, ages and personalities, which Roberta scribbled down on a pad. Then she looked slightly embarrassed. 'You know, I've met Billy on a few occasions, and Samuel once too,' she said. 'You're joking.' I felt betrayed. 'Why didn't you tell me?' 'I wanted it to come from you, Alice, when you were ready.' For some reason I pulled up my sleeves and showed he my arms. 'That's Kato,' I said, 'or Shirley.' She looked a bit pale as she studied the scars. I had feeling she didn't know what to say. The problem with counsellors is that they are trained to listen, not to give advice or diagnosis. We sat there with my arms extended over the void between us like evidence in court, then I pushed down my sleeves again. 'I'm so sorry, Alice,' she said finally and I shrugged. 'It's not your fault, is it?' Now she shrugged, and we were quiet once more.