I suggest that patients who are able to speak to therapists about their own treatment needs, do so as early in the relationship as possible – including at any initial intake interview. For some, it may be too frightening so please don’t worry, don’t argue inside about it. It is fine to take your time so long as you internally assess the therapist. For all patients, I recommend checking in with your protector parts, as always encouraging vigilance rather than hyper-vigilance to the extent possible, to help with the assessment of a new potential therapist.

I am speaking primarily to patients for two reasons. First, because I do not see a willingness within the profession to change from the current pharmaceutical dominated mechanistic orientation of mental health planning controlled by that industry, accountants and the Insurance health care planners. Second, through my limited participation in social media, I have seen the benefit and power of the DID community members supporting each other in ways that should guide therapists in their treatment plans for DID.

Within the profession, there remains the erroneous view that treating depression with SSRI medications and anxiety with benzodiazepines is the most economic way of dealing with mental health issues within the population. To those in control of how the money is spent, I like to point out that shifting to a trauma based model of psychopathology will ultimately save far more money, more effectively treat trauma survivors, and appropriately apply existing manpower. While medication prescriptions may be essential for dealing with symptoms, we must not allow symptom treatment to blind us to the importance of a more humanistic approach, of applying psychotherapy to the underlying causes of the symptoms. Why? If the underlying cause is treated, the need for medication diminishes, the need for hospitalization diminishes, the need for social services diminishes, and the need for police intervention diminishes. Without treating the underlying cause, prescriptions will remain endless, the cost of monitoring the medications will remain endless, the disproportionate use of all government services will remain endless and the patients will not heal.

Based on experience with my own patients, admittedly a very small sample size, when the DID diagnosis is missed, those with DID become super-consumers of the medical insurance funds. Why? Because they generally have repeated suicide attempts, repeated hospitalizations, repeated self-mutilations and an ongoing inability to safely navigate society. Cases of depression and other extreme difficulties, often identified as “Treatment Resistant” that are the result of diagnostic error. Given that the time lag between initial intake in the mental health system to accurate diagnosis of DID is an average of 6 years (per Putnam in 1979 – I am unaware of current data), if this kind of misdiagnosis is liminated, the suffering that could have been eased, and the money that can be saved societally, would be enormous.

While a single isolated case does not prove anything, I still remember my patient who had spent 5 solid months in a psychiatric ward simply for suicide prevention. When she was discharged, the notation in her file about her then condition was simply that she was still alive. She came to me for therapy after the discharge and we worked together for 2 and1/2 years. With proper diagnosis and treatment, this resulted in her reclaiming a fully functioning life as a mother of two toddlers, without needing psychotropic drugs or any mental health professionals for at least the next 20 years.

Ask your therapist for the empathy, compassion and patience that you need for treatment to be effective. It is one way to take back and restate your own power to heal. Confirm for yourself the possibility that they will take that to heart. They can learn about treating trauma through study and practice. It is much harder to learn genuine empathy, compassion and patience. Best wishes.