The best indicator of a positive prognosis for those with DID is found in those with defiant angry alters. In effect, it is those parts that say “You have no right to humiliate me. I will not surrender to your will. You have not subjugated me. I will fight you always.” The implication for those treating DID patients is to remind those patients that their angry alters are generally the ones that refused to simply surrender to their abuser. Even though they may only have the initial capacity to express their anger in ways that are frightening to others both internally and externally, a path forward to healing can be found through engaging with them in therapy.
Engaging the angry alters is the opportunity to access that positive defiance, that refusal to accept humiliation as defining them. Appreciating their strength and insight is a genuine method to develop support within the system so that alters can begin to work in concert rather than in conflict. In my practice, the patients with the best prognoses were those that were able to connect with their anger – which often meant engaging with those angry alters again and again. By ongoing engagement in that way, one invites their assessment and potential trust in the therapy.
A common and negative outcome for the victim is submitting to the punishment without harboring some internal rage. In short, succumbing to the abuser’s humiliation of them.
There are several possible changes in the personalities of people who emerge from significant childhood humiliation experiences. They range from inability to relate to others which may appear as awkward socialization to severe psychopathic behaviour.
In the worst scenarios, the victims of humiliation – in the case of DID it may be one or more alters – over-compensate. As noted in the previous post, they may develop a powerful urge to gain personal power to control all social interaction. The drive to control can be so strong that it eliminates any sense of sympathy and compassion for others – including other alters – as well as when interacting with other people. Extreme levels of self-protection take over. It is this manifestation that makes angry alters both powerful and difficult. But, please don’t see those alters as identical or inextricable with their difficulties. To do that will mean that you miss their capacities as keys to healing.
For many with DID who have had their spirit seemingly crushed through humiliation, instead of acting out for revenge externally, that rage against powerlessness is turned inward. Chronic depression may be coupled with generalized fear with the loss of self-confidence as the outcome. Social relationships, including familial and marital, are compromised because of deep inherent mistrust. To heal this, and it is possible to heal this, calls for powerful transformational changes.
Once again, humiliation crushes the child’s spirit. It is intended to undermine any possibility of self-confidence and to infuse the child with fear. It impacts the child by giving them a twisted perspective of human relationships. The result is often to eliminate the capacity for genuine intimacy. It attacks that human capacity for intimacy by convincing them to distrust all relationships that might appear safe.
It does so by convincing them that they will never be safe, certainly never from the abuser. It seeks to convince them that “Anyone trying to convince you that they are safe is only presenting an appearance of safety because safety doesn’t exist.”
This is a critical barrier for therapists to be aware of and to overcome in dealing with anyone with DID. In my practice, the only path to overcoming that barrier was to respectfully engage the alters including the angry ones and to always gently invite them all to participate in therapy even by simply listening in as I engaged others in the system.
