Living with Multiple Personalities (and some Disorder!)

Extra Sensory Perception?

2011-09-28T23:34:00.000-05:00

Q: I, myself have multiple personalities and I was curious if you experience some type of extra sensory perception or paranormal events with yourself. I would like to know if there could be a link between these two, as I experience unique abilities as randomly as "the others" come out. - Anessa

A: It depends on how you want to define extra sensory perception.

Many survivors of abuse have learned to be hypervigilant, and have learned how to read other people very well. They usually had to learn now to read the behaviors, body language, minute facial expressions, tone of voice, and other signals from their abusers in order to try to stay a step ahead of their perp. They may have also developed very strong sensory skills as part of how Post Traumatic Syndrome Disorder affects the brain, making them have very good hearing, smell, taste, visions, of tactile perception.

Many people with Dissociative Identity Disorder may have parts who specialize in these perceptive skills. These parts may also have these skills be very important to their overall function and identity. For example, I have a part who has exceptional hearing, and that appears to be her main function and a large part of her identity. She listens for signals of danger, and can hear things most people miss, and then sets off an alarm for the rest of us so we can hop into action. I have another part who is skilled at reading the minuscule changes in people's body language and facial expressions to help figure out their intentions and truthfulness, and to notice when words don't march with the non-verbal cues (like the people on the tv show Lie to Me). Unfortunately she requires so much resources to do her skill that we rarely let her out anymore. Which is a shame because I really wish I had her skills!

As far as the fringes of extra sensory perception, I have met quite a few people with Dissociative Identity Disorder who believe they have parts with this skills. Some people will argue that it really all books down to just really good sensory processing, memory skills, and luck. But many believe they have parts who can discern when ghosts or evil spirits are around, or can tell ahead of time that something bad is going to happen in a place different than where they are.

I have had some experiences with knowing things, like that someone is about to be in a car wreck or about to die, when they weren't even in the same state as I was. My grandmother also had that ability, but she would often not be able to tell who was going to have the disaster so she would call way too many people to warn them. That ability scares me and I try to avoid it.

I'm not sure how the brain develops differently with children who develop Dissociative Identity Disorder. I don't know how the brain develops differently in people who has psychic abilities, who are empaths, or who have other types of extra sensory perception. But I do think people with DID might have a better chance of maintaining a skill, because of the dissociation process, that otherwise they might have disowned or "grown out of" if they had not become DID. I think many children are innately more perceptive and skilled in sensory processing and awareness (like reading emotions and truthfulness in adults). But they are trained to give up this skills because "it's not nice" to call out an adult for lying, or to keep bugging Mommy to find out why she's in a bad mood when she's trying to tell you everything is fine.

I also think people with DID may understand and accept that there is a lot more in this world than just what we can see and put into words. Our minds are so full of things that feel so real, that we can't put into words, that others can't see... but we hold them to be true. I think that's why a lot of people with Dissociative Identity Disorder can be highly creative, can be strong believers in a spiritual world, and can be willing and able to experience the intangible and unexpected (like paranormal or spiritual gifts).

Do people hide DID/MPD?

2011-09-02T23:40:00.002-05:00

Q: Do people with multiple personality try to hide it? - Anon

A: For a large percentage of the time, for a very large majority of the people who have Dissociative Identity Disorder, the answer is YES! There are several reasons.

1. Early on, they may not realize they have anything unique or different about themselves. They may assume all people have the same experiences. So they may not tell anyone.

2. In childhood, adults expect (naturally so) that kids will create imaginary playmates, wild stories, and my act out different role playing or identities. This is all a normal part of development. So the early signs of Dissociative Identity Disorder may be mistaken as normal play.

3. Many survivors of abuse and trauma learn to cope with their trauma by learning to ignore it. They avoid memories, avoid triggers that might bring up those memories, and distance themselves from the emotions too. If they are aware that the Dissociative Identity Disorder exists, they may ignore it because they know it's a symptom of the trauma. To avoid the DID is another way of "acting normal" after something very abnormal happened.

4. Some survivors were threatened that if they told people of the abuse that very bad things would happen to them or to loved ones. Hiding the alters becomes important then because if people see them they will ask questions, and those questions may lead to very dangerous truth.

5. Shame is a powerful motivator. People who carry the shame of their abuse may also feel shame towards their Dissociative Identity Disorder, too. They may be afraid of the judgements people might make if they knew. They may be afraid of losing friends, family, spouses, jobs, even the custody of their children.

6. They may not think their DID is important or a vital part of who they are. Many Multiples go through a period in recovery where they want people to know about the Dissociative Identity Disorder. But they also go through a later period of recovery where they want to be known for their other aspects, talents, interests, quirks, etc. DID becomes just one small part of the whole picture of who they see themselves to be.

7. They may not know they have Dissociative Identity Disorder. Some of the alters know, but they may be protecting themselves and others inside by keeping the knowledge a secret. They may also not know how to reach the other alters yet to communicate.

What's it like to switch?

2011-08-29T00:20:00.001-05:00

Q: What's it like to switch? - David

A: I have never seen a tv show, movie, or book that has resonated with how it feels for me to live with Dissociative Identity Disorder as much as Quantum Leap. I had to be like Sam Beckett trying to figure out the missing pieces, while preventing people from realizing I was someone else, and trying to figure out what tasks had to be done before I leapt out of there.

An alter is inside, minding their own business, maybe even sleeping. Then, usually without warning, unless they were intentionally trying to take over control of the body, they find themselves out. Being out means you are in control of the body, and you may or may not have access to the other people inside the body. But as a survivor of abuse you know that your life depends upon maintaining the secret of the abuse. That also means hiding the secret that your body holds more than one...

So you find yourself out, surrounded by people and places you may have never seen before. Maybe doing activities you've never done before. Minutes, hours, days, or even weeks may have passed since the last time you were out. All you really know is your own personal past, and your own personal skills. Sure, the previous alter may have known how to drive, but do you? Do you even know where you are driving to? Do you pull over and wait, or are you going to be stuck out for so long that waiting is pointless?

Usually alters can hear at least one other alter who is still inside, and sometimes they can communicate to each other. This may be an alter who can offer help and guidance, like Al does in Quantum Leap. Or maybe they can can go ask others that theynhave access to that your don't, like Ziggy the Computer in Quantum Leap or the staff back in the lab that Sam can't talk to.

Since we honestly believed hiding our existence was the only way to survive, we did not develop very obvious external differences, like you often see in movies or tv shows. My access to clothes, jewelry, makeup, etc was the same regardless of who was out. We viewed the body as a car: no matter who gets in to drive, the car is still the same; how they choose to drive may be very different though. I have graceful alters, and I have klutzes. I have alters who feel fat and slow, and alters who feel skinny and fast in the same body.

The biggest change some people notice is my mood and language shifts, and that my beliefs or point of view may change depending on who is out. For example, I don't curse often. A frequently out part of me, however, curses like a sailor, and with much comfort! But my skills also change. My boys know how to build things and are mechanically inclined than me. Some of my people are very socially comfortable whereas I am quiet and introverted. Some have religious or spiritual knowledge while others do not. One knows Spanish, one knows American Sign Language, one doesn't know how to speak.

There are times when you want to leave being in control up to someone else. When I have a lot of physical pain, I want someone better equipped to deal with it to be out. Sometimes you don't want to give up control, but are forced to. Either one of administrators of my system shuts the whole body down, or they can force a replacement out. This is good for dealing with alters who are self-destructive and putting the body at risk, or who are having a panic attack or otherwise not functioning well. And sometimes someone else just wants the control because they want the control. They have people to talk to, things to do, or just cabin fever from being inside too long. This can be the worst shift.

When I am out, and someone else demands to be out, and I don't want to let them do that, I have to fight. I have to fight to keep focus on where i am and what I am doing. I have to fight to shut their voice or images out of my head that they are distracting me with. They may turn up the volume to drown out my own thoughts. It may give me a headache because were both fighting for the same mental resources. Some of them used to be able to cause physical pain (muscle spasms, migraines, IBS, stabbing pains, dizziness, nausea, feeling cold or hot). Luckily since the body know does that all on it's own, no one uses that tool anymore because now they've been on the receiving end.

I had a grad school profess assume I was ADD/ADHD because in class I would fight to stay out for the lecture. My ways of doing that usually involved a LOT of foot tapping or leg bouncing because the constant physical sensation and exertion helped me keep others away. I was also a prolific doodler and almost frequent gum chewer for the same reasons.

Then there are times when you've had enough and you want to go back inside. Sometimes no one else wants to deal with what you're dealing with either, and you get abandoned and locked out. Sometimes alters would resort to self-injury or cutting to force someone else to come out to protect the body. Other times the system can't seem to make a switch happen (stress, inner turmoil, no one wants to be out, they can't afford to let the person who is out to come back inside yet), in which case we usually escaped to sleep. So, once again, like Sam Beckett, sometimes it's time to leap, and sometimes it isn't.

When did you first know you were Multiple?

2011-08-28T01:10:00.001-05:00

Q. When did you first know you were Multiple? - Marcy

A: I was diagnosed with Dissociative Identity Disorder in the summer of 1996. I was already aware that I was Multiple before the official diagnosis got applied, but there was still something oddly heavy, scary, and final about having a Psychologist and a Psychiatrist confirm it (when I hadn't told them my suspicion).

It's hard to answer the question of "When did you first know you were Multiple?" Who, exactly, are you asking? Because some of us inside knew almost two decades before others inside found out! But there is also the complication that when you are a young kid, you think you are normal because you don't have a lot of reference points yet to compare with. And that's especially true when talking about trying to figure out if your brain works the same as everyone else.

As far as we can tell, I became a We at age two or three. "How do you know your memory is from that age? That's an awfully long time ago!" yes, it is an awfully long time ago for most of us. But some of my parts are frozen in time, and that's not far away from their perspective. The way I'm able to age most of my memories though is because my family moved every year or two, so I can figure out the years based on what house I'm remembering. I've also verified details and memories of houses and ages with my mom, and the records she has of our moves.

Anyway, we continued to make alters to help deal with new challenges (moving, school, church, friends, continued abuse, different abusers, etc.) until the abuse stopped at age 14. I, Selah, didn't meet the others until college. I was created to go to school, and protected from knowing about the others so I wouldn't also have to know about the abuse. When they began to make themselves known to me, I felt like my world was being ripped apart, like I was being shredded apart. I began to question everything, and I trusted nothing, especially not them.

I knew we were different from our peers early in life, before school even started. Mostly because I understood my father's threats that the abuse was a secret that had to be protected at all costs. I withdrew from my peers because it was the easiest way to protect the secret. We knew being Multiple was something we had to hide by the time we were 6 or 7. Which is why Selah got created, because we needed a unified appearance and memory for learning for school.

Things began to unravel in college. That's when it became painfully obvious to me, Selah, that there were others sharing my life and my body. And they started to really show me the holes in my memory and daily life. I remember my mom came to visit me in college and a lady came up to me and asked how I was doing and what I was up to, normal chit chat for someone who knows you. But I didn't know her. She asked who I was with and I had to figure out how to introduce my mother to a stranger who seemed to know me. I was mortified. My mom caught on and helped introduce herself, then later asked me what happened. I told her the truth: I had no idea who that lady was. I speculated that she had me mistaken for someone else.

Later that night I got shown of memory that I had been in a writing class with that woman earlier that year. But I didn't remember the class either! It was a month long semester in January where my college offered unusual classes, and the more I tried to think about it the more I realized I didn't remember January! I asked my best friend about the class casually, and she had taken the class with me. Oh vey.

Another stark slap in the face was when I found myself in second year college Spanish one day and realized I didn't understand a single word! The alter who had learned Spanish had decided that she was no longer going to be in class. I was confused, ashamed, and mostly pissed. How was I suppose to pass a class in a foreign language that I never learned?!

Good times ;-)

So, we began to unravel and start tearing down the internal amnesia in 1993, with Selah really finding out starting in 1994. Recovery really started for us because we were finally away from the father for the first time. It was finally safe to feel and remember again. But it also became necessary to get Selah to know because we knew we had to confront the father before he had the chance to abuse grandkids that were hitting the "right ages" for them to be at risk of sexual abuse. We did confront him in 1995, which really opened the floodgates for even more alters and memories to come out of the closet for all insiders to face. That's when recovery became a real life or death deal, one we weren't always sure we'd survive. But we knew that to avoid recovery was an absolute one-way ticket to suicide.

DID without abuse history?

2011-08-26T23:20:00.004-05:00

Q: Is it possible to have DID if I haven't been abused? - Anon

A: Yes, for two reasons. First of all, since a critical part of Dissociative Identity Disorder is amnesia, it is possible that not all alters know about the abuse. Secondly, a lot of things can be traumatic enough to cause DID without necessarily being something you would call abuse, if you're only using that term to mean physical or sexual abuse. Severe and recurrent trauma can be caused by abuse (physical, sexual, verbal/emotional), extreme neglect (isolation, imprisonment, withholding or inaccessible food/water, etc.), or significant acts of violence that carry a significant risk to health or life (natural disasters, wars, refugee camps, etc.). But while research shows a very strong link, with the expectation of a causual relationship, between early childhood abuse or trauma and DID, the clinical diagnostic criteria for Dissociative Identity Disorder does not require a trauma history.

A few people with Dissociative Identity Disorder do claim that they have no memories of abuse, and feel that they have adequate knowledge of their internal system for them to be able to rule out that the abuse memories are simply blocked by amnesia. Some believe that they simply created their system because they were very bright, creative, or imaginative enough to create the DID.

Clinically this is unexpected. I would encourage someone who has symptoms of severe dissociation, with no reasonable memories of trauma to explain their symptoms, and who has thoroughly explored this issue in counseling, to seek a full evaluation to also rule out medical or neurobiological conditions that may be underlying their condition (ie, tumors, seizures, brain injury, etc). I would also want to rule out other mental illnesses that can have dissociation symptoms such as Bipolar, Borderline, Schizophrenia, and Schizoaffective disorders.

How do I get to know the others inside?

2011-08-21T23:05:00.002-05:00

Q. How do I get to know the others inside? - Cheryl

A: With time, patience, acceptance, and by not forcing them to be known. Think of it like meeting a new person in real life. If you approach them directly, start asking personal questions, demand they explain their presence, seem angry or scared that they are there, etc., they are going to blow you off, leave, or get angry.

Most people with Dissociative Identity Disorder seem to start their internal communication through writing or drawing. I'd recommend a diary or notebook. Write letters to them and invite them to write you back. But keep writing even if they don't respond. Chances are they are listening and seeing if you're safe and to make sure you're really ready to meet them. Sometimes having pens and pencils of different colors and even thickness (for young ones) help others inside be willing to share their writing or drawings back.

Once people start communicating, it can be helpful to start making a family tree or system map of your insiders. Most people want to know if that alter has a name, an age, a gender, and when they were created or what job they have inside. As you fill in the details you'll also start to know more about their likes, dislikes, temperament, etc. And can add that to the family map. A spreadsheet can be a good tool because you can sort by age, genders, etc. And it's easy to add in new people or new information as it becomes available.

Just take your time. This isn't a fast process for most people. Many alters have spent years in hiding from insiders and outsiders, so it's going to take time to build up their trust in you and their trust in their safety.

A new iPhone app we like is UFace which gives us the ability to draw faces of what people look like inside even though we have no real drawing ability!

Reparenting young alters?

2011-08-21T22:51:00.002-05:00

Q. What about young alters who want to go through re-parenting in therapy before they agree to age or integrate? - Angela

A: I am not a fan of outsiders reparenting alters. Too many counseling clients have become overly enmeshed or dependent upon counselors and other professionals who thought reparenting was a great idea. We have seen a few Dissociative Identity Disorder autobiographies that showcase this style, and failure, of treatment.

I believe insiders have the ability, the responsibility, and the skills to reparent younger alters. Most systems even have these older, wiser, calmer alters already created. They are there for a reason! Use them for that! I don't think we create these caretakers and protectors by accident.

I fear that depending on an outsider to reparent leaves alters too open for more hurt, abuse, abandonment, and even a slower recovery. Why? Because an outsider is never with you 24/7. An outsider will always lose patience with your needs sometimes because of their own needs and stressful life. An outsider will either start to resent your needs, or will become attached to the role of caretaker or special friend and may not want you to recover because they want to maintain that role. They may not even realize they are sabotaging your recovery, because they really usually do want to help you by giving you comfort and support. But it's a fine line between support and enabling.

So reparent from within. You have the resources. Plus reparenting inside helps the whole system learn how to take care of themselves, the body, and even how to nurture other relationships in their lives. That way both the reparent and the reparented grow from the process.

Appropriate to share therapy notes?

2011-08-21T22:41:00.002-05:00

Q. My therapist feels its not appropriate to share her notes and findings and theories on me with me, for fear it could inhibit progress. Is that right? - Rowan

A: Usually this is a real risk. Being a counselor, I know it's very hard sometimes to know how much to tell a client, and when. I also have to figure out if it's helpful to share that information, for the client, rather than just sharing clinical tidbits or jargon that makes sense to only me.

When working with someone who might have Dissociative Identity Disorder, this is a very complicated process. If the therapist tells too much, too soon, then people in the system may feel like the therapist "knows too much" (unsafe), "told my secrets" (untrustworthy), or worse "doesn't know what they are talking about!" (disconnected, not listening, not a good counselor, making up illnesses, pushing medications, etc.). The reactions from clients could be firing the therapist, refusing to seek outside help from referral sources (like medications), increased self-harm or suicidal thoughts, or severe loss of progress and trust in the counseling relationship.

Counselors should be able to tell you some basics, like what is my current diagnosis, are we making progress, are we a good fit, do we have an agreed upon set of boundaries or rules that both sides feel comfortable with, is medication an option or even recommended, are there other types of treatment or self-care things I can be doing to help my recovery?

I also don't like to share my notes because they are hard to read (handwriting), hard to understand (usually fragments or phrases that make sense to me), or are required but not therapeutically required (i.e., required by insurance companies for billing). I may also choose to leave out certain things from a chart because they are highly private and I don't think they are specific to the treatment, but I want to protect my client's confidentiality. For example, if I'm working with a client for anxiety that appears to be related mostly to a medical condition, I may opt to leave out the fact that my client discussed their homosexual lifestyle one session because it isn't directly related to our focus and therefore should remain private from anyone else who may read that chart. I want to be a counselor, not an informant.

Is DID a lifelong diagnosis?

2011-03-22T20:49:00.002-06:00

Q: Is the diagnosis of DID a lifelong diagnosis? - Anon

A: It depends on what your goal is in treatment (integration or healthy co-functioning). When many people ask this question what they are really wanting to know is if the trauma ever heals. Do the bad memories ever stop being so close to the surface?

"Time heals all wounds" can seem like a vicious lie when you are a survivor or have Dissociative Identity Disorder. One of the main problems with that saying is that time doesn't move normally when you have trauma in your life. It's hard to " just forget" or " move on" when parts of your brain are actually functioning as if they are still in the middle of the traumatic experiences. And research on PTSD and Trauma that looks at trauma processing and neurological functioning show this to be the case.

Recovery is slow and usually incremental. It may be hard to realize how far you've come in recovery. But those around you may see dramatic differences because they aren't living inside the chaos everyday. Add to that the issues that you face AFTER you get through therapy to process the trauma, learn to not rely on dissociation to cope, and then the time you may spend seeking integration. These can include recovering from addictions, learning coping and life skills, and learning to have health relationships and support network in your life. Recovery may be lifelong.

But yes, I have seen in myself and others that you can move from a place of chaos, abreactions and flashback, PTSD and frequent triggers to a healthy place. You can reach a point where you actually have a hard time retrieving some of the same memories that used to jump into your mind whenever they wanted. It's wonderful when you are able to control your memories instead of them controlling you.

Some people are afraid of losing memories. Don't be. When you move out of the "stuck in trauma overdrive" into a place where memories are stored naturally, then you do lose some of the details. But you don't lose the gist. You don't forget that you were hurt. You just forget the intense details that act as triggers such as specific smells or fabrics. And normal, healthy people do not have access to as many detailed memories as traumatic abuse survivors. Part of that is functional - the brain removes memories that are no longer needed to make room for new learning and new memories. Wouldn't you rather have that room for some newer, better, happier memories? Another part of it is consolidation - memories that are of similar events may be merged into more generic memories. For example, remembering abuse that occurred repeatedly but now no longer able to remember them each individually.

So Dissociative Identity Disorder will stay around as long as it is needed, or it can be improved and possibly ended through the hard work of recovery. Some people claim their alters just "went away" but all the times I've seen that they have actually suppressed their memories and alters and run the risk of it all coming apart again. They aren't done with recovery, they are in denial.

Suicidal? Get help from the professionals!

2011-03-19T21:41:00.001-06:00

Two social networking type sites that I frequent have had serious suicidal gestures from users this past week or two. And these aren't support type sites. I have mixed feelings about this.

On one hand I am grateful they said something that raised eyebrows and got other users to inquire deep enough to get to the root issue - suicidal thoughts with intent. On the other hand it frustrates me that people reach out in these secretive ways in places they know their comments could easily be overlooked as just stress or a bad day. After all, these sites aren't run by or moderated or otherwise staffed with professionals.

Maybe I'm also a bit jaded after having been around so many people who claim or even threaten suicide as a form of emotional distress or sometimes manipulation. Most of the time these folks have no intent, no plan, and are just acting up to reach out. But each false "wolf call" makes us all more jaded and unresponsive. And that makes us ready to lash out, belittle, ignore, or punish the next person who may be much more lethal and serious.

I've been in that suicidal place. I know how hard it is to reach out and also the fear of reaching out. And it's a battle you don't have the energy for when you're suicidal. But please, reach out to people who can help. Or be honest and tell your friends that you're suicidal and need them to help you find the pros. A hotline, 911, a hospital emergency room, anything but a covert remark on a social networking site that can easily be missed, misunderstood or seen too late. Your life is worth more than kinda-sorta asking for maybe-if-it-is-not-a-bother help.

That's not my name!

2011-03-19T10:31:00.002-06:00

On Second Life I heard a song called "That's not my name " by the Ting Tings. It was an instant hit inside. Not only do we have a name that is difficult for many people to pronounce because it's unusual, but then you add in the Dissociative Identity Disorder. How often do you have someone inside who wants to argue that they aren't the body's name? How often do they want to have that argument when it's an outside person you'd never in a million years admit to being MPD to?!

Anyway, if you haven't heard it, or just want to see a really cool and cute video of the song, check out this SL of it:

http://chaffro.blogspot.com/2008/11/fuzznutz-music-video.html

Still alive!

2011-03-18T22:38:00.002-06:00

Sorry we vanished there for awhile. I hate when that happens!

We have been dealing with some chronic illness and major job stress stuff for the past year. I am really shocked at how bad this past year has been. But we have survived. Yay.

I have felt very dissociated at times, and very empty at others. I think this crisis has caused more dissociation, less co-awareness, and few people wanting to be out. Most of us don't like pain, so when the body is stuck in chronic pain it's hard to get any volunteers. I can't blame them, I'd leave too.

But I am trying to keep the house running and the job stuff going. It's taking all the energy I have to keep my head above water. So it's hard to help mom and hubby through their own struggles now too. I feel bad about that. But I keep hoping that it will improve. For all of us.

So I have felt the need to write again so maybe that means people are willing to talk inside and outside again. See you soon!

Treatment guidelines?

2008-05-09T20:40:00.001-05:00

Q: How is Dissociative Identity Disorder treated? What about children who have DID? - Peter

A: The International Society for the Study of Trauma and Dissociation have created treatment guidelines for Adults and Children with Dissociative Identity Disorder. These documents which cover diagnosis, assessment, and treatment information can be attained here.

Additional books that may be useful include:
Dissociative Identity Disorder: Diagnosis, Clinical Features, and Treatment of Multiple Personality by Colin A. Ross
Not Trauma Alone: Therapy for Child Abuse Survivors in Family and Social Context by Steven Gold
Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders by James A. Chu

Diagnosis from MMPI?

2008-05-05T21:02:00.003-05:00

Q: Can you diagnose Dissociative Identity Disorder from an MMPI? - Anna

A: Dissociative Identity Disorder can not be diagnosed from an MMPI.

The MMPI was originally designed to measure the following symptoms/disorders:
1 Hs - Hypochondriasis
2 D - Depression
3 Hy - Hysteria
4 Pd - Psychopathic Deviate
5 Mf - Masculinity–Femininity
6 Pa - Paranoia
7 Pt - Psychasthenia
8 Sc - Schizophrenia
9 Ma - Hypomania
0 Si - Social Introversion

Over the years, people have found that they can measure other symptoms/functioning using the same questions, and have created other scales (measuring protocols). They are too numerous to list here, but you can see them all here. Post-Traumatic Stress Disorder is one of these additional scales, so it may be diagnosed from the MMPI.

Do all memories need to be recovered?

2008-05-03T22:17:00.003-05:00

Q: Do all our memories need to be recovered and processed to heal? - Tom

A: No, not at all. If that was the case, you'd probably spend a VERY long time in counseling and miss out on a lot of the life you could be living NOW! You have to remember enough to know what happened, why you have parts, and what needs to be done to feel safe again. Most Multiples have gone through repeated abuse events, sometimes with more than one abuser. Each abuser has to be addressed in counseling, but many of the types of abuse events were repeated. As you deal with a few memories related to one abuser and one type of abuse event, you'll also be dealing indirectly with the other similar events (and usually the same alters). Some memories stand out as major turning points, major traumas, or other life-changing events which tend to require a lot of processing in therapy so not all memories are created equal!

Are my memories true?

2008-05-03T22:04:00.003-05:00

Q: How do I know if my memories are true? - Jane

A: That is a question survivors ask themselves and their counselors over and over again. Unfortunately, there isn't an easy answer. No one can be totally sure of the accuracy of all of their memories unless they have been followed by video cameras their entire lives! So save yourself the torture and accept that your memories, and the memories that your alters have, are true... but they may not be accurate.

What that means is they are true to the personality that has them, but they may contain inaccuracies such as:
1. Symbolic material that helps convey emotions, memories, fears, and other information,
2. Combination of more than one similar event into an amalgam that appears to be one memory,
3. Deception or misinformation purposely added by the perpetrators of abuse to further scare, manipulate, discredit and silence the victim,
4. Merging of real events with internal imagery used to dissociate (for example, being abused by the child imaging they were really somewhere else taking a hot air balloon could create a memory of being abused while in a hot air balloon,
5. Blocking of information or denial which removes some of the events, emotions, or sensations involved in the original event.

The key is using therapy, internal dialogue, journaling, and other methods to help distill the truth of the memory, the emotional content of the memory, and how the information needs to be handled in order to help heal from the damage. Therapy should not be seen as an arena to gather memory evidence to use in court against your perpetrators, but rather a place to let every part of yourself be heard, validated, and thanked for helping you get through difficult times and confusing emotions.

What medications are used in treating DID?

2008-04-27T00:14:00.004-05:00

Q: What medications are used in treating Dissociative Identity Disorder? - Emily

A: There are no medications specific for treating Dissociative Identity Disorder. Many symptoms related to sleep problems, depression, anxiety, and PTSD hyperarousal can be managed with medications specific for those issues.

Anti-depressants are commonly used, especially those in the selective serotonin reuptake inhibitors (SSRIs) family, to help regulate symptoms of depression and anxiety. Effexor, an anti-depressant that is not in the SSRI family, is often used because it has been shown to be effective in treating PTSD symptoms in addition to depression. Caution should be used with Effexor because of it's withdrawal syndrome.

Anti-anxiety medications such as Klonopin can be used to help with sleep issues, panic attacks, and flashbacks. These are best limited to as low dose as possible and only as needed due to risk of abuse and dependency.

Sleep aids include over-the-counter options such as Benadryl or Tylenol PM (same active sleep-causing ingredient in both), herbal supplements such as Melatonin (which is a substance that naturally occurs in the body and helps regulate our sleep cycle/internal clock), and prescription options. Many prescription options also have a risk of abuse, dependency, and withdrawal and are usually recommended to be taken for a short time (7-14 days) such as Ambien and Lunesta. Newer forms are allowed to be taken longer, such as Ambien CR and Rozerem (which is the only prescription sleep aid to work on the melatonin system). Any medication used for sleep on a regular basis can create psychologically dependence, which is basically the psychological belief that you need the medication to get to sleep and may become frustrated when sleep fails to come as quickly without the medication. Many doctors recommend that you limit your sleep aid use to 3-4 nights per week to avoid dependence issues. Your doctor will best be able to address these issues with you.

Other medications which are sometimes used with Dissociative Identity Disorder include anti-psychotics and mood stabilizers. These are controversial and should probably only be used for emergency situations or if Bipolar Disorder is thought to co-exist with the DID. In lower doses, these may also be used for medication resistant depression.

Is DID a neurological disorder?

2008-04-27T00:06:00.003-05:00

Q: Is Dissociative Identity Disorder a neurological disorder? - Anon

A: At this time Dissociative Identity Disorder does not appear to be caused by neurological damage (such as brain injury), nor does it appear to cause neurological damage/changes (such as lesions or tumors). As new advances in neurological imaging, such as SPECT scans, continue to evolve it may become possible to differentiate alters or to differentiate dissociatives from non-dissociatives. For the most part, the brain has a preferred mapping for where it stores general abilities/task centers, and this is not expected to vary due to DID. Therefore, Dissociative Identity Disorder is a psychological disorder because it appears to be caused by psychological trauma.

Is DID a personality or thought disorder?

2008-04-26T23:22:00.007-05:00

Q: I've seen news articles referring to MPD as either a thought disorder or a personality disorder. What is it? - Anon

A: Multiple Personality Disorder seems like it would fall under the category of a "personality disorder" because of the name, but it is not. Rather, it is grouped with other disorders under a subtype called "dissociative disorders", which fits the newer name Dissociative Identity Disorder. It is also not classified as a "thought disorder".

The handbook used to diagnose mental health issues is called the Diagnostic and Statistical Manual of Mental Disorders (DSM).

There are five axis in a diagnosis:
- Axis I: Clinical Disorders (mental illnesses, substance abuse, etc.) including developmental and learning disorders
- Axis II: Personality Disorder and Mental Retardation
- Axis III: Medical conditions and physical disorders (such as brain injury/post-concussive syndrome, menopause, chronic pain, etc.)
- Axis IV: Psychosocial and environmental/support system stressors contributing to the disorder/symptoms (typically issues that are making things worse psychologically or could be barriers to recovery)
- Axis V: Global Assessment of Functioning (a rating scale on 0 - 100 of how well the person is functioning in interpersonal, vocational, and self-care areas)

Thought disorders are usually symptoms of an Axis I disorder, typically in the Schizophrenia-type disorders and Autism. Read here for more about common thought disorders such as pressured speech, tangential speech, word salad, and echolalia.

Personality disorders are pervasive (they happen in relation to most situations/people) and enduring (life-long) patterns of thinking, reacting, and interacting with others. Common examples include antisocial, borderline, schizoid, narcissistic, and dependent.

Dissociative Identity Disorder is an Axis I diagnosis as part of the subgroup called Dissociative Disorders (which includes DID, fugue, depersonalization, and dissociative amnesia).

It is possible for specific alters to have characteristics of a thought disorder or personality disorder. Some people may be diagnosed with MPD/DID and borderline personality disorder, but this would not be clinically appropriate if only a few of the alters have borderline characteristics because it would fail to meet the full criteria of pervasive and long-term.

DID in the news... again...

2008-04-25T19:28:00.005-05:00

Well, it seems Dissociative Identity Disorder ends up in the news about once a year either because someone admits to being Multiple, someone makes a bad movie about MPD, or someone thinks a pop star's erratic behavior is really Dissociative Identity Disorder. And we've got the trifecta going on right now!

1. Hollywood
- Big Screen: 04/17/08 per Variety: Halle Berry has announced that she's going to produce and star in a movie called "Frankie and Alice" in which she portraits a woman with two alters, one of which is a white racist. Yippee.
- Little Screen: New TV show by Steven Spielberg called "The United States of Tara"
2. Herschel Walker's new book "Breaking Free" hit the shelves and news outlets this month.
3. Who else is being called "Multiple"?
- Not Famous: Rozita Swinton, aka "Sarah" the tipster that set off the events in a cult compound in Texas
- For Publicity: Miley Cyrus, aka Hannah Montana
- As if we didn't suspect already: Tori Amos, aka American Doll Posse
- Yeah, right, sure...: Britney Spears

Every time it pops up I wonder when I'll have to suffer through a "MPD is fake!" conversation. Or hear people confuse it with Bipolar, Schizophrenia, or a personality disorder. At work I have to smile and ignore the comments about the people "stupid enough" to fall for that rubbish, or the counselors who must has "swindled" them and "implanted" these outrageous ideas. My favorite is when people swear that they could easily spot someone who "truly" had Multiple Personality Disorder. Yeah... right...

So, cheers everyone, we survived another round of stupidity, misinformation, and "experts."

Changing levels of internal activity?

2008-04-25T19:20:00.003-05:00

Q: Went years and years without losing time... or without losing a lot of time that I was aware of. Then re-entered counseling and WOW the voices are going wild and losing time has jumped to almost daily. Why the skyrocketing increase since entering counseling? Was in and out of counseling for year and years from 11 yrs old to 24 yrs old then nothing for about 13 years... never diagnosed until this real commitment to healing (2 years ago). So the question is.... why the increase in "parts" activity... almost to the point of not being able to function? - R. Kidd

A: It's kind of like a leaky dam. The leak lets out a steady stream of water, but that stream is nothing compared to the amount of water that comes rushing out when the dam breaks. I think the "volume" changes when there is no other choice (major stress or triggers that finally overwhelm the system), or when it's time (alters feel safe or the decision to commit to therapy is made by several parts).

Early on our main hosts (parts who dealt with the outside world on a regular basis) often had little awareness of the internal chatter/activity because they needed to function. It wasn't until we moved away to go to college and had a sense of safety that people began to break down those barriers inside. When we decided to confront our main abuser, and finally ended all ties, then people inside felt strong and safe to come out. That's when the dam broke and we went from chatter to a bustling train station worth of noise!

At first, it was disabling and overwhelming. Everyone seemed to be scrambling for their time out to do what they wanted to do, to make friends, to talk about their memories and needs... all the while work and school seemed to be slipping away from our grasp. I think the "falling apart" process helped us be able to take stock of what was really going on (Dissociative Identity Disorder, self-injury, depression, nightmares, etc), admit the severity (honest assessment of MPD and abuse severity), and take real action (be honest in therapy about internal workings).

It was by falling apart that we crossed the line from being a victim to being a survivor. It was by making a mess of things that we had to face the truth that our abusers were responsible for the damage they did early in our lives, but from that point forward it was us causing any additional damage. We had to choose recovery which is a lot harder and a lot nastier than it sounds. Recovery doesn't just land in your lap, it's a daily (sometimes hourly or even breath by breath) choice to move forward. And we were going to have to do it together.

Encourage people inside to learn when it's okay to communicate and ways in which they can do that. Can they join an online email/support group, draw/paint, play sports, write in a journal, take a walk, or find other ways to let off steam? Can they agree to have "quiet times" (such as work hours) in exchange for you giving them "loud times" (like a set schedule of 9-10 pm you give them time to do the things that let them communicate, let off steam, and enjoy freedom)? Can you introduce them to your counselor and encourage them to write down things they remember during the week that they want to be sure gets talked about in therapy, so they don't have to keep repeating the same information to you over and over again?

Quiet periods and noisy periods still come and go for us. The loud, overwhelming, cascading roar has quieted and will probably never reach that level again. I know that the more stress we're under (or the more people under stress at the same time), the more people inside are feeling ignored/abandoned, and the worse the body feels (like when it is sick), the more likely the noise level will increase. But I also know that when it's too quiet things may not be okay. I may have shut people out (put my head back in the sand?), or they may have shut me off somewhere so I don't know what's really going on inside (so I can keep functioning in the real world). So, a comfortable medium is where we are most of the time now, and it's quite nice.

Difference between MPD and DID?

2008-04-20T17:43:00.001-05:00

Q: What is the difference between Multiple Personality Disorder (MPD) and Dissociative Identity Disorder (DID)? - Anon

A: Mental disorders are named, classified, and described in a book called the Diagnostic and Statistical Manual of Mental Disorders (called the DSM for short). This book is used by doctors, counselors/therapists, and psychiatrists to diagnose behaviors/symptoms, and the book is updated every decade or so to reflect new research, beliefs, understanding of mental illness.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for Multiple Personality Disorder (MPD) was first established in 1980. The clinical criteria was:

DSM-III Criteria for Multiple Personality Disorder:
A. The existence within the individual of two or most distinct personalities, each of which is dominant at a particular time.
B. The personality that is dominant at any particular time determines the individual's behavior.
C. Each individual personality is complex and integrated with its own unique behavior patterns and social relationships.
D. Two or more alter personalities must exhibit individually distinct and consistent alter personality-specific behavior on at least three occasions.
E. There is evidence of some type of amnesia or combinations of types of amnesia among alter personalities (e.g., one-way amnesia, mutual amnesia, etc.). the amnesia does not have to include all of the alters.

The DSM-IV, which was released in 1994, changed the name of Multiple Personality Disorder to Dissociative Identity Disorder (DID) and changed the criteria to:

DSM-IV Criteria for Dissociative Identity Disorder:
A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
B. At least two of these identities or personality states recurrently take control of the person's behavior.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

So, according to the DSM, the name Multiple Personality Disorder has been replaced or renamed Dissociative Identity Disorder. Therefore, they are the same and the newer name should be used.

But...

Many people with the disorder may prefer one name over the other, based on:
1. What the disorder was called when they were diagnosed,
2. What name they believe best fits their experience or system of alters,
3. Their stance on if the name was changed just for political reasons inside the psychology field in an attempt to make it less "sensational" or more "palatable" for professionals to admit they treat it.
4. Their personal beliefs that MPD and DID should be used to describe different levels of severity, different causes, and different expectations for the number and amount of differentiations between personalities. Many people seem to think that MPD better describes a more severe form of dissociation, would tend to be caused by more severe or long-lasting trauma events, and that the alters involved would be better defined/more distinct. For example, imagine a glass vase as being an integrated/normal/non-dissociative personality. If you dropped the vase 3 feet and it cracked in a few places, but still held it's overall shape, it would be DID. If you dropped the vase repeatedly, or from a more drastic height, and it shattered or pieces broke off, then that would be MPD.

P.S. I still prefer the term Multiple Personality Disorder, but have had to move towards using Dissociative Identity Disorder more on my blogs and websites due to how search engines function.

Don't want to integrate?

2008-04-19T18:20:00.004-05:00

Q: There are so many of us and we all really don't want to merge into One. But our Counselor wants to see us Merge. We are not Merging EVER. Can you tell me what will happened if we don't Merge and my host is still DID for the rest of her life? - Christina

A: Integration is a choice, not a necessity. Being Multiple doesn't become a true "disorder" until it impairs your ability to live your life (hold a job, meet your basic needs, be as social as you want to be, etc.). Many people with Dissociative Identity Disorder choose not to integrate, and they learn how to function in a healthy manner with their parts through communication, cooperation, compromise, and usually a fair amount of co-consciousness. Other choose not to set integration as a goal for therapy (or life in general) but find that over time they have many alters who seem to slowly blend together into a couple or group of like-minded alters. Integration should really only be a goal or requirement of treatment if the system can not function and communicate well due to a high level of animosity or amnesia.

So, you can choose to not merge, and still have a good life. If your therapist demands integration, state your firm belief/desire to not place that as a goal, and continue to work on other issues. If your counselor refuses to honor this because they think integration must be the goal of treatment, it's time to find a new counselor.

Can't afford therapy!

2008-04-19T18:14:00.003-05:00

Q: My SO is a multiple. I have known him for over 10 years. We have no health insurance and need therapy very bad. - BJ

A: There are a lot of places that offer low cost or free counseling. Contact your local rape crisis center, local church counseling centers, and domestic violence hotlines for referrals. Local mental facilities (hospitals, clinics often called MHMR for Mental Health and Mental Retardation) for information about county programs that you may qualify for. Your family may also qualify for Medicaid health benefits (which includes mental health care) based on income. Many states are also opening up hotlines that can be reached by dialing 211 from a regular telephone to access assistance programs for their area.

Animal alters?

2008-04-19T18:01:00.003-05:00

Q: Have you had any experience with animal alters? I have two inside and am having difficulty in communication. - Rell

A: Non-human alters appear to be fairly common. Most Multiples I know have at least one alter who appears to be an animal, ghost/angel/fairy, or some other creature/being. In our system, we have a cat alter who we late discovered was a child (she calls herself Katt!). I think for some alters, being human is just too scary because of what humans do to other humans (abuse, neglect, torture, etc). Admitting your human can be scary because it means admitting you're at risk of being hurt and used in the same ways the physical body is being harmed. I think some alters also pick out beings that they feel a connection with, either because that other being feels safe, powerful, or representative of how they feel or wish they could feel. Approach these type of alters as you would any small child or non-verbal alter. Use body language, eye contact, and written communication to help reach out to these parts.

Where is the research?

2008-04-19T17:50:00.004-05:00

Q: Why isn't there research proving the cause and existence of DID? - Anon

A: I think most experts agree that Dissociative Identity Disorder forms at a very early age (usually agreed to be around 4-6 or younger), and many of these children would have a difficult time verbalizing the abuse, much less the presence of dissociation, following the trauma. If you look at Piaget's Stages of Intellectual Development, it makes sense that DID could form in a child who is abused during the Preoperational Period because of how children try to make sense of their world under normal circumstances - symbolic, magical, creative, parts versus wholes. It's rare that you will ever find a group of 4 - 6 year olds who have lived a life without trauma and then go through a traumatic event together so you can see if DID develops (and it sure wouldn't be ethical to subject healthy children to trauma just to see if DID develops!). Most group-trauma events happen to older people, such as students in a school shooting or bus accident, and by that age Dissociative Identity Disorder isn't expected to develop as a coping technique.

Where is DID now?

2008-04-19T17:47:00.002-05:00

Q: Where is Dissociative Identity Disorder now? There was a good deal written about DID in the 1980s and 1990s, then it seemed to die down, and in the last few years, there seems to have been a resurgence, at least in mainstream venues. - Craig

A: I don't think "DID" faded away, it just got divided into subparts: trauma and dissociation. For example, the main organization and journal concerning MPD has changed names numerous times over the years. In 1984 the first major conference on MPD was held in Chicago by the International Society for the Study of Multiple Personality and
Dissociation (ISSMP&D; Journal="Dissociation"). This society continued, and in 1994 was renamed the International Society for the Study of Dissociation (ISSD; Journal:"Journal of Trauma and Dissociation"). In 2006 it changed to the International Society for the Study of Trauma and Dissociation (ISSTD; Journal unchanged).

Nay-sayers have nothing to lose; but those who support the validity of the diagnosis and even dare to treat those who have the disorder face ridicule from peers, scrutiny from insurance companies, and threats of lawsuits from supporters of the False Memory camp. I have known people who have lost careers and the custody of their children because of the DID diagnosis - not because of their actions but because of fear and misunderstanding from employers and the court system. It may be hard to find supporters willing to go public with their belief or even with their own personal history of DID, but that isn't the same as there being no supporters. There is still a strong curtain of silence, shame, and fear.

Why the controversy?

2008-04-19T17:44:00.004-05:00

Q: Why is there so much controversy over this diagnosis? - Anon

A: I think people get confused and disbelieving about Dissociative Identity Disorder because they only see the extreme cases or Hollywood versions of the disorder. I believe there are three types of people with DID:
1. Those who aren't yet aware they have it. They may be in denial, or may be chasing symptoms (such as depression, anxiety, mood swings, substance abuse, etc.) and not realizing it's root cause.
2. Those who know they have it and function very well, so they "pass as normal." They may have periods of time when they need counseling or medication to help deal with stress and symptoms (such as depression, or when dealing with major life stressors such as the death of a significant other, marriage issues), but have probably never been hospitalized. The main alters or hosts who run the body/life may not have much, if any, awareness of what is going on in the rest of their internal world so they erroneously believe they are Singletons.
3. Those who have spent years being misdiagnosed, mismanaged with medication, or have not had access to appropriate therapy. They do not function well most of the time and have frequent hospitalizations. They may be disabled by their condition, or by their lack of appropriate treatment.

I think most people fall into the second category. This is what makes tracking the diagnosis prevalence difficult. Many studies only use hospitalized patients, but if many or even most of the people with the disorder are never entering the hospital then we can not accurately determine how many people have the disorder. The other commonly used method is looking at how therapists bill services and what diagnostic code they utilize. Many therapists will use the code that is related to the chief complaint (such as depression, PTSD, eating disorder, etc.) rather than all the possible codes that fit a client (such as DID, Axis II codes for personality disorder, and other diagnostic codes that may seem overly stigmatizing or difficult to be approved for treatment). This doesn't even begin to measure the number of clinicians who could miss the diagnosis due to lack of training/experience, or due to lack of belief in the Dissociative Identity Disorder diagnosis.

Switching as a married couple of Multiples?

2008-04-19T17:40:00.004-05:00

Q: Have there ever been times, or are there still times now, when you and your husband "split" into one of your alters simultaneously, so it's actually one alter talking to another? I would imagine that if you have two child-alters dealing with each other, that could pose a problem. For example, what if you guys are taking a road trip somewhere, or maybe trying to handle business at a bank or at a store, and these alters come out? If both alters are really young, how would you be able to drive or deposit money or pay for items at a grocery store? - Craig

A: First of all, let's clarify some terminology. Splitting is the creation of new alters, which for the most part takes place in childhood and teenage/young adulthood years. The older you get, typically the harder it is to create new alters. Most Multiples tend to stop being able to create new alters (not fragments) in their teens (unless traumatic events/abuse continue to happen). Switching is the chancing of who is present or in control of the physical body.

Switching alters isn't really that difficult to understand as a singleton. You have an internal mechanism, or conscious, that lets you know when different behaviors are allowed or appropriate. When you can hug certain people, use curse words in front of other people, when you have to be "all business" and when you can "let your hair down." Most people with Dissociative Identity Disorder also have an internal mechanism or group of alters that help control when switching can be allowed or forced. This allows safety and function, so that young alters don't suddenly appear while the body is driving a car but they are more than welcome to come out when watching a kid's movie at home. It also helps ensure that someone is available to deal with crisis situations, such as strong or assertive alters being able to be called into action when other alters feel unsafe or fear that the body is in danger. This system usually works very well, which allows many people with DID to be highly functional and appear normal. But there can be times when internal stress is very high, or when a system of alters hasn't learned to cooperate, that this can fail to happen.

Being a married couple of Multiples means we usually have a good balance of being able to have similar types of alters interact,and also being able to have a supportive or adult alter available when the other person has a scared or young alter out. With any married couple there is a natural fluctuation of roles and care-taking behaviors that help ensure that both partners have turns being supportive and supported; whether that is physically, emotionally, or financially. There are long periods of neutral functioning, but also times when one or the other of us needs extra TLC.

How to use this blog

2008-04-18T18:30:00.010-05:00

Welcome to the "Living with Multiple Personality (and some Disorder!)" blog.

I have Multiple Personality Disorder (MPD, later renamed Dissociative Identity Disorder, DID). It's an unusual diagnosis, as well as a controversial one. While the experts were arguing over if MPD/DID was real or not, I moved through many phases of recovery, married my soulmate (who is also Multiple), attained a BA in Psychology and completed an MS in Rehabilitation Counseling Psychology. As a counselor, I now help people recover, reclaim parts of their lives, and find the hope that their future is worth surviving and fighting for.

I believe that I have an interesting point of view given that I've "been on both sides of the sofa," so to speak. I have not only been a consumer of mental health services, but now I'm a provider. I have to balance my understanding of my clients from both perspectives: objective/clinical/factual, and emotional/empathetic/been-there-done-that/past experience. Every day is a challenge, a endless list of to-do's, an mountain of paperwork, an obstacle course of bureaucratic red tape... and if I'm lucky... a glimpse of the amazing power, resiliency, hope, and perseverance of the human spirit.

If you have questions, feel free to email me or ask them in a "comment" to *THIS* post.

If you want to leave feedback or your answers to a questions, use the "comment" section.

Use the "search blog" box at the very top of the page to help you find topics/questions that interest you.