Without in any way trivializing the trauma that is the core of early childhood abuse, there is a fascinating aspect of MPD that is deserving of further exploration. The fact is that dissociation allowed the abused child to survive. That, in itself, is cause for appreciation of the power of the dissociative response. It is the habituation to dissociation as a response to triggers and unprocessed trauma arising that causes such tremendous difficulties for the patient including amnestic barriers and internal conflict. For some, dissociation can produce unexpected hosts of achievements as part and parcel of the impact of the disorder. In therapy, there is often an over-emphasis on the damage that has been done without a concurrent expression of how genuine healing is possible – that there is hope.
Among those with DID that I have treated as well as those I have encountered after my retirement, some have accomplished extraordinary things both in recovery and in the world. While I discussed this aspect briefly in Engaging Multiple Personalities Volume 2, I believe it is worthwhile to go deeper into this aspect of DID.
It is clear to me that I failed to diagnose certain patients as DID in a timely fashion because of their external accomplishments. I was misdirected by my own admiration for them. I will not identify those patients for obvious privacy reasons but they included people in the top tier of their various professions, in both business and academia.
The first point to make is that for anyone to survive the intensity of trauma that gives rise to DID, they must of necessity be extraordinarily brave, strong and resilient. Anyone coping with and surviving ongoing abuse as a child crafts strategies on a survival level that successfully deal with vicious adult abusers. Some abusers are hiding in plain sight as valued members of the family and/or community. Some abusers are individuals that frighten law enforcement, other adult family members and other adults in the community. Consider the pressure a child is under dealing with abusers which the outside world either cheers as a valued individual or fears as a dangerous individual. For the child, there is no hope of escape, nowhere to run, no refuge.
Dissociation is a most brilliant survival strategy for such a small child. Fundamentally, that is the point I have tried to make in both volumes of Engaging Multiple Personalities as well as on my blog. To both therapists and those with DID, I say please do not turn away from the alters. However angry, mean, sad, or panicked they may be, it is the alters that were the means of surviving the abuse. The difficulties that DID individuals have is dealing with the aftereffects of habituating the use of such a radical means; the only means available to them as children.
Alters arise holding pieces of trauma as well as their own habitual modes of interacting with the world. The ability to dissociate provides a tremendous opportunity for an alter to completely focus when they are in control of the body. The single mindedness allowed survival as a child by focusing away from the trauma as it happened. As an adult, the dissociation via triggers can be an ongoing trap of retraumatization. Alternatively, it can be used to successfully accomplish things in the outside world. On a very basic level, dissociation allows DID individuals to go to work, take care of themselves and others such as their children, while holding the unprocessed trauma temporarily at bay until the system is overwhelmed.
There are those with MPD who may excel in multiple disciplines. For these individuals, each dissociative part, each alter, can develop their focused interest in a topic without distraction. Any scientist, scholar or artist, has this ability of total concentration when working to the exclusion of other distractions. With the ability to dissociate somewhat completely at will, the result of such total concentration can be excelling in a field. If one part is an academic, another an artist, and still another an athlete, how interesting that might be.
Individuals who have publicly disclosed their DID have often been ignored or had their DID denied. However, there are a few individuals whose standing in their respective communities allowed them to disclose their DID without quite the same level of disparagement as others have experienced or rightly may fear. This is not to say that such individuals experienced no negativity following their disclosure. However, because of their stature, they gave pause to the deniers of DID. Indeed, they created the opportunity for non-DID individuals to begin to see DID in a less pejorative light.
Robert Oxnam is an academic who revealed his MPD in his autobiographical A Fractured Mind (2004). Robert is a scholar of Asian studies, having taught in US universities as well as having lectured in Beijing University – in Chinese. His most famous role was to lead a cultural tour of China for the likes of Bill Gate, Warren Buffet and president HW Bush. He also was a China expert advising the former US presidents. He has authored several books and served as the head of the Asia Society in New York. However, apart from the focus on Asia, he plays the cello, and is now a prominent sculptural artist. Beyond that, at different stages of his life, he was a competitive archer, an accomplished cyclist and a prominent, in some circles, rollerblader.
Another MPD autobiographer is Herschel Walker (author of Breaking Free [2008]). He was his high school valedictorian and a Heisman trophy winning athlete. He was an NFL player, and then excelled as a world class bobsledder, sprinter and mixed martial artist. He is a successful businessman in the food industry. In his autobiography, he mentions that his ability to dissociate allowed him to be apparently untouched by pain in the midst of crushing blows from opponents – to their utter consternation.
Going back to the earliest days of psychiatry, Anna O. is believed to be the first MPD patient whose case history was described in detail. Her case is found in Freud’s book—- Studies on Hysteria (1895). Freud missed the diagnosis, or, to be more accurate, there was not an applicable diagnostic category at the time other than the general one of hysteria. Even in missing the diagnosis, he did note her concern about “time-loss” and having “two selves.” Both of these are primary and often the first indicators of a potential DID diagnosis. At different times, Anna O would speak different languages and refuse to believe, for example, that she actually knew others. There are several other points that would lead one to consider a DID diagnosis that are clearly laid out in the case history.
Anna O (real name Bertha Pappenheim) was at one time a patient of Breuer (a colleague of Freud and co-author of Studies on Hysteria). He stopped treating her as she was becoming progressively worse and had to be institutionalized for a period of time. Breuer told Freud that she was deranged; he hoped she would die to end her suffering. One can imagine the depth of her depression through Breuer’s comment. However, she later achieved renown for her social work, such that the West German government issued a postage stamp in honour of her contributions to that field. She was an author of several novellas, poems and plays. In addition, she was a translator and a writer of several important pieces attacking the trafficking of women in eastern Europe and the Orient. Her focus on helping others who were sexually traumatized is not uncommon in the DID world. In my own practice, I saw clear examples of this practical application of empathy by DID patients in dealing with children and other at-risk individuals.
Unfortunately, the term MPD has trivialized the concept of dissociation into parts, offering endless possibilities of theatrical materials for movies and TV series. They tend to emphasize the histrionic parts of the multiple facets of a single patient. This trivializes the pain of the original trauma that caused the dissociation as a defense to protect the fragile ego. It somewhat makes light of the damage done to the growing individual and the possible ill effects impacting the next generations as well as the untold misery affecting many people involved.
Psychiatry struggles to find a better name for the affliction, changing it from MPD to DID in 1989. I wonder if this change has made any difference. Die-hard disbelievers still cling to the pseudo logical argument that if a person can have more than one identity, then two persons hold the same passport or one person can have multiple passports – completely missing the point of the disorder. The book by Schrieber reawakened interest on this issue but some professionals got distracted by a fascination with the multiplicities of the “personalities”.
Because of the word personality or identity in the diagnostic label, many psychiatrists cannot make the paradigm shift to accept the concept of DID, nor accept DID as a genuine psychiatric disorder. Some serious academics still deny DID as a mental disorder, declaring it to be a condition that is produced iatrogenically, or otherwise non-existent. This mistaken view is much to the detriment of the welfare of DID sufferers trying to find a therapist. Even worse, it teaches new psychiatrists something that is simply wrong. Out of their ignorance, they will then perpetuate the same mistaken view and impact an even wider circle of patients.
By studying the successes that individuals with DID have had in healing, in worldly activities and in displaying great empathy helping others, psychiatrists and other therapists can learn quite a bit about trauma, its treatment and the possibility of truly leading those with the disorder into health. The successes can be used to give hope, the critical element in working with those trapped in retraumatization cycles, that healing is possible, that joy is possible and that their very survival as a child is a mark of how creative, strong and successful they were as a child all the way through to this present moment.
