I received a request from a reader about a major issue encountered by many with DID, self-victimization. In my experience treating DID patients, self-victimization and self-harm seemed to be the rule rather than the exception.
Survivors of early childhood abuse often get attached to successive abusive partners, one after another. It is one of the most unfortunate aspects of the abuse cycle that one goes out to search for an abuser to complete the abuser-victim transaction sketched out in the Karpman Triangle (also known as the Drama Triangle) of the abuser-victim-rescuer socio-gram. Survivors also have similar dynamics within their systems, with different alters playing out similar roles on the inside.
This happens for a variety of reasons, with many different excuses and rationalizations. But rather than respond to the internal logic (or lack of understandable external logic) in the self-harming conduct with arguments, the key point to understand is that healing arises from connecting directly with the alters who are willing to engage, and warmly/gently/kindly inviting others to try to engage.
What does that actually mean? Whether you are seeing a therapist or your have an alter within the system helping out, patiently connecting with a punitive alter (or alters) who wants to inflict pain is critical. Honestly generating empathy for that angry punishing later is key – faking empathy will make things worse. You can generate real empathy by remembering that such alters arose for the same reasons that every other one did – dealing with the direct impact and aftereffects of horrific trauma.
Begin by telling him/her that you understand the feelings of anger, desperation and pain. Be honest if you don’t understand the self-victimization. In that case, you can ask for guidance on how you can better understand his/her view. Gently suggest that the trauma is in the past, but do so by encouraging the alter’s connections with the present. It can be done by identifying the current date. If you are not in the area where the abuse occurred, remind them of where they are right now. My office window overlooked a bridge so I often suggested to my patients that they look at the window and identify that bridge so they could note that the abuse did not occur in this particular city, in this present time.
Physical cues are also helpful. By asking him/her to take a deep breath with you, he/she may then experience even a moment of distance from that traumatic experience. Again, it is encouraging the realization that the trauma can be viewed from a distance in time and space. In other words, it is inviting the experience of safety in the present. It is putting the flashback where it belongs – in the past. It is a memory, not a current experience even though it seems like it is happening now because your body is having the same response of fear, panic, hyper-vigilance and a pounding heart. This is the therapeutic process of disengaging from a flash back.
It is just as important to connect with the alters that are being harmed inside – not just the ones doing the harm. Remember that while some alters seek to do harm, others feel the need to be harmed. It may be phrased by those alters that they deserve to be harmed or that there is no other option. Both need empathy, compassion and understanding as well. Within an environment of understanding, empathy and compassion, the suffering alters will be able to make a shift.
Help those alters in conflict find a safe place to process and heal the wounds. Encourage others in the system to help modulate the conduct of the angry harmful alters, to become their friends. Encourage those that are being victimized inside to connect with other parts of the system that can act as their protectors – not from the point of view of fighting with the other angry alters but rather as a bridge to understanding each alters particular suffering, generating empathy for each other and a spirit of healing teamwork.
For example, the soft and comforting voice of the therapist, or your self-appointed internal therapist, can shift the alter who is still stuck to the past traumatic experience back into the present moment of safety. The pathology is that the particular alter will remain tenaciously stuck to the past trauma. The therapist, no matter from inside or outside, has to persevere to achieve a small, step-by-step separation from the past trauma into the present. It is difficult but this is often the very central central practice in DID therapy.
I want to be quite clear that in this I am directly addressing an alter, treating him/her as my client and giving them my full attention. Some therapists prefer to speak only to the host. In fact, colleagues have criticized my approach as reinforcing the splitting aspect of DID pathology. As I have written elsewhere, fish swim, they are not taught to swim. In that same way, DID individuals dissociate, they are not taught to dissociate. For fish, to swim is instinctual. For DID individuals, to dissociate is similarly instinctual – it is their instinct for self-preservation in the context of massive early childhood trauma.
In my experience, a large part of DID therapy is one-on-one psychotherapy directed to individual alters. If you have an internally appointed self-therapist, working as an adjunct to your therapist or alone because you are unable to find a therapist, one can encourage the same approach of communication between the inner therapist and the self-abuser. Knowing that the self-abuser is acting out unprocessed trauma allows one to communicate always with respect and always with kindness.
[The Karpman Triangle is found on page 126 of Engaging Multiple Personalities Vol 1. It is also displayed by Joan, in Chapter 1, who struggled with this almost every night for months.]
