Controlling the appearance of alters, how they seem to be switched on or off in a system, is a complex matter. I do not claim to know all the ways this plays out, but I suspect there are many different considerations that govern the appearance of any particular alter. It is likely that specific triggers govern certain appearances, but the overall control is based on an internal system of vigilance that is constantly evaluating the total environment.
The appearance of any particular alter likely depends on the system’s assessment as to whether an alter should come out to fulfill a function or, alternatively, is triggered to jump out in reaction to a situation. In the absence of specific triggers, there is sometimes an alter, often called the gate keeper or having that specific function, with almost complete power to decide who may come out and when.
During the course of therapy, the therapist may eventually learn specific ways to invite out the appearance of particular alters. But, we should not take lightly the ability to “press the button” as it were, to call out an alter for therapy. This should not be done in the absence of extreme circumstances, such as the immediate risk of serious self-injury. Instead, let the system present the alters needing therapy in its own time based on its own assessment. Sometimes the presenting will be direct, as in an alter coming out and speaking to you about their issue in a session. Sometimes it will be indirect, when one alter starts talking about the difficulties of another alter or bringing in notes another alter has written down for the therapist to read.
I give an example of a mistaken approach I once took with the hope that other therapists will not repeat this mistake. I had a patient with one severely depressed alter. At the suggestion of the patient’s very supportive husband, I wanted to bring out this alter for therapy. He said that the specific alter was triggered to come out by the touching of her hair. Because the suggestion and encouragement came from her genuinely caring husband, I thought there was an implicit consent to this by the patient. That was not a correct assumption. Looking back, the touching of her hair was likely experienced by the patient, specifically that alter, as a kind of violation. I learned from that mistake, but it was a bitter lesson.
It is far more preferable to allow the system to choose, at any particular moment during therapy, to self-initiate therapy with a specific alter. In other words, it is for the system to control the appearance of an alter in need, not the therapist. Giving that power back to the patient is consistent with good psycho-therapeutic practice for patients suffering from early trauma and dissociation. I learned later in my practice that empowering the patient is essential. It is a foundational approach in therapy for survivors of early childhood abuse.
