This is a lightly edited response to a question posed by a spouse about alters coming out far more at night than during the day:

In Volume 1 of Engaging Multiple Personalities, I discuss one of my patients who was similarly having alters, particularly highly traumatized young alters, come out at night. Her spouse had similar difficulties due to him being unable to go to sleep until the alters expressed what they needed to express – and yes, not going to sleep until 2 or 3 am night after night. For that patient, there seemed to be two reasons for the evening appearances of alters, both equally important: 1) they came out at the time of night when the abuse generally occurred, and 2) the alters were feeling safe enough to come out with the spouse and express what they needed to express as part of their therapeutic journey.

The spouse came up with some quite innovative approaches to helping the alters, giving them space and comfort as well as the recognition that they were with the spouse in a time and place where the abuser never was. These are also discussed in Volume 1. Check in with the therapist working with your spouse on any approach you wish to take. Certainly, the therapist should know about the alters coming out each night and what is happening. I do not encourage spouses to be therapists, but when alters come out, you do need to be kind, empathic and know what to do.

Please take care of your own health while doing this. To provide the support your spouse needs, you MUST maintain your health, your balance and your empathy. Volume 2 includes a section on self care for therapists, and the warnings I give there might be applicable to spouses that are meeting with traumatized alters at home late at night.

Know your own limits, and know when they are being reached. You cannot expect that traumatized alters will see the strain on your health, and they often do not have the capacity to stop once the flashbacks start. Set time limits with the alters so that you can help them the next evening as well, for example, rather than burning yourself out. You might  try some of the grounding exercises with them that I have written about in my books as well as on my blog, but again, check with the therapist.