If you are a therapist who has never treated DID…
Is there a point to deny, discount or argue with different alters in a DID patient? Bluntly speaking, the answer is no. While DID/MPD deniers will deny the existence of alters no matter what evidence or experience you present to them, I have seen and engaged many different alters in DID cases. Further external validation is unnecessary to proceed with treatment.
There are two key points to keep in mind when acknowledging the presence of different alters:
1. Alters feel strongly about their individuality. To insist that they are just one identity or personality is going to push them away from the therapist and destroy any possibility of a therapeutic alliance. I accept their way of thinking of themselves as separate individuals. I will not impose my own “unitary” concept of personality and try to convince them that they are deluded or simply wrong. This multiplicity aspect of personality is prevalent in all of us. It is only a matter of degree. When I play tennis, I am acting and feeling like a teenager, trying to hit the ball to the other side so that my opponent cannot return it. It is the “teenager” in me that is playing the game. It is a conceit to think that the teenage quality of me playing tennis is not part of the continuum of experience that includes alters in DID patients.
A therapist should never argue or try to convince a client that he/she does not have different alters. It would be akin to attempting to convince that a schizophrenic patient’s voices are not “real.” However, common sense and appropriate therapeutic demands dictate that clients’ alters should all work out a way to handle the practical aspect of day to day business. Alters should obviously find a way to live in a cooperative way because there is only one body – one cannot go to a party and simultaneously rest at home.
2. When treating a DID patient, unless a therapist acknowledges the presence of alters, treatment cannot even begin. Therapists cannot get anywhere if they insist on ignoring an alter because that means shutting down therapeutic communication. This is so basic but is one of the major obstacles in DID therapy for psychiatrists who have no experience in treating such patients. There is a strongly held but erroneous belief that if a therapist talks to an alter, it is going to make things worse. In fact, the opposite is true. Ignoring the alter(s) undermines the therapeutic alliance. The patient will close down this most important support and gateway for healing. It is the equivalent of telling a non-DID patient that the therapist does not want to hear what is really bothering him/her.
Once these two points are understood and agreed upon by the therapist, treatment of a DID client is no different from treating patients with most other psychiatric diagnoses. In DID therapy, therapist should focus on processing past trauma, and bringing together the alters so that they learn to live together in harmony and mutual support, like a team of athletes with different strengths and skills all pulling together toward the common goal of healing.
Sometimes a therapist who has never treated DID will be open-minded and even read my books to get started in treating DID. Claiming to have no experience is not a good excuse because DID is not rare. Sooner or later the therapist will see or at least recognize another case of DID. No therapist should deprive themselves of the opportunity to learn to treat DID.
If you cannot find a psychiatrist, any psychotherapist from other disciplines can work with DID patients. Social workers, psychologists and others can equally engage in treating DID. Anyone trained in psychotherapy can treat DID if one follows the simple principle of processing trauma and bringing together the different alters to work as a team.
