Since the publication of Volume 1 of Engaging Multiple Personalities, followed by Volumes 2 and 3, many members of the DID community have written to me expressing appreciation for those books. They have said often, directly and in Facebook groups, that the material has been helpful to them as well as to members of their support network. In fact, many have brought copies of my books and blog posts to their therapists to help communicate their needs as a patient with DID. This feedback from the DID community allows me to continue to push forward to communicate the importance of correct diagnosis and correct therapeutic support.
I have even received some notes directly from therapists about how helpful the volumes have been in their own work with DID patients. That is the good, actually wonderful, news.
Almost 6 years have passed since Volume 1 of Engaging Multiple Personalities was published. Volume 1 reviewed patients identified as having experienced early childhood trauma and dissociation. Some of these had been treated successfully with psychotherapy as their antidepressants were simultaneously tapered off and discontinued. I tried to identify the reasons why some were treated successfully while others were not. From members of the DID community, there were expressions of relief both that their difficulties had a context and that healing was possible. A year later, Volume 2 was released which specifically focused on guidance for therapists.
Unfortunately, it seems that the psychiatric community still remains, for the most part, fundamentally unchanged in its view of DID. Copies I sent to colleagues failed to cause even a ripple in their consideration of DID and early childhood trauma. In my naivete, I expected them to be at least disturbed enough to re-examine their prejudice against DID diagnoses. I hoped to raise their index of suspicion when meeting patients with depression, self-harm and dissociative presentations to at least consider the possibility.
From colleagues, I got the uncomfortable feeling that Volume 1 in particular was treated as a book of curiosities. They were not so interested in the other Volumes either. Because my peers had not identified any such cases in their decades of practice, they ignored my suggestion that perhaps they had simply missed them.
Nevertheless, I was confident in this explanation. Why? Because in the many patient referrals I received, their files included notes identifying them as having dissociative tendencies and presentations without a primary or even secondary diagnosis of a dissociative disorder.
I am confident that psychiatrists see many dissociative patients in their daily practice. They don’t identify them as such because they are not expecting to see them. This is based on their own incorrect training mischaracterizing DID as extremely rare, Therefore, their index of suspicion is very low. Further, therapists are routinely distracted from the dissociative symptoms by their search for symptoms of depression. Why? It is because their index of suspicion is geared towards symptoms that will justify and support the prescribing of medication; i.e. antidepressants.
It is of ongoing concern to me that psychiatrists and other therapists are so stuck in their habitual way of looking at patients that they are not able to raise their index of suspicion to include dissociative disorders, despite overwhelming evidence.
Many years ago, a friend told me that he took a course on how to identify edible wild mushrooms. As soon as he completed the course, he suddenly started to notice just how many wild mushrooms were all along his daily jogging path. If only that kind of change had happened in the psychiatric community after we published the book(s). We can still work toward that.
Is it worthwhile to repeat this ad nauseam? I think yes. Why? Because of the response noted above from the DID community itself.
