It has been about two years since the publication of Volume 1 of Engaging Multiple Personalities. While I have received numerous and important responses from individuals with DID and at least a few therapists, I have solicited responses from other readers from whom I had somewhat surprising feedback. I am putting up this post as it highlights some of the obstacles facing those with DID. Forewarned is forearmed, so I offer this as something to help prepare individuals with DID to deal with mistaken views on the part of therapists who should know better – and others they may encounter.
1. “Trauma happened decades ago, surely patients can forget and move forward.” This was also expressed as “They should stop dwelling on the past and focus on the future.” This is the most common response to my book by both general (non-DID individuals) readers as well as highly learned or qualified people, including two professors in Medicine, one church minister and headmaster. I am flabbergasted! I thought that by now it would be general knowledge that after some trauma, the memory is stuck in the body, and that one cannot wipe it clear based on the strength of one’s will. The saying is “The body keeps the score.” (Van der Kolk.)
General Dallaire of the Canadian Forces peacekeeping soldiers Rwanda wrote a moving account of a flashback he had that was triggered by seeing a person chopping open a coconut shell with a cleaver. Simply seeing that image, he immediately began to re-experience watching people being killed with machetes. His ability to intervene and rescue anyone, to stop the slaughter, was blocked by the UN mandate prohibiting any intervention by him or his men. He re-experienced the trauma of seeing what was going on, as if he was there once again.
That is the way flashbacks work, it is not a question of choice. They come back faster than a rocket, by-passing the conceptual process. They take over your mind and your body through the autonomic nervous and motor system before coming to one’s awareness. They take over your perceptions so that you are no longer grounded in the present, rather the past reaches out its hands to pull you back. People with PTSD all experience that. DID survivors commonly experience that kind of flashback regarding early childhood trauma that might have happened decades ago
2. Another frequent questions was, “Do they really appear like that, as a 4 year old child in the body of a 50 year old woman?” Rather than commenting on the depth of abuse that must have occurred to generate the protective mechanism of dissociation, this is the topic that generated interest. General readers, again referring to those without DID, sometimes get sidetracked by the dramatic aspect of the DID presentation, of an alter suddenly appearing. In doing so, they fail to grasp the impact of the trauma, the fear and suffering the individual experienced in the past or in the present moment of a flashback, and consequent loss of function.
This is worse than unfortunate! In general, people do not want to face the ugly facts of childhood trauma. Because of how terrible the trauma must have been, people cut off their own empathy – perhaps afraid that they themselves will be overwhelmed just contemplating it. Instead, they often refer back to their own experience of a mild loss of details of events from their own childhood. But those references are to what life was like when they were 4 years old rather than imagining the trauma someone else experienced at that age that results in dissociation. It is safer for non-DID individuals to get carried away by the drama, and avoid the trauma.
3. The general reader (and society in general) simply does not grasp the immensity of the problem, the number of individuals affected, and how horrific their experience must have been. It impacts an enormous number of psychiatric patients who are looking for therapists to help treat their trauma and dissociation. It may be that this will change as the impact of foreign conflicts involving large numbers of traumatized children, just as it was not until the tidal wave of PTSD impacting military personnel returning from Vietnam forced society to at least acknowledge that it was there. And just as with the returning servicemen, the impact of the wartime trauma on children in foreign conflicts will take decades to truly unfold.
Certainly toward the end of my psychiatric practice, I repeatedly received confirmation from patients I met suffering from depression that they were prescribed antidepressants without questions even being asked about their possible adverse childhood experience. I am well aware that even when such questions are asked, they may not yield the correct answer in the first place – which may correctly be yes or no. However, when patients are not even given the chance to offer any information on past trauma, the therapist has failed in a fundamental way.
I encourage you to have confidence in your own experience as you proceed on your healing journey rather than be subject to the confusion and ignorance of even professionals. Find therapists who do understand DID, or train decent therapists, who simply don’t have experience, through the honesty of your journey.
