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DID

Counselling4you has been working with people with DID (Dissociative Identity Disorder - formally MPD) for over 8 years and understands the complexities that exist with this trauma based disorder.

Not all counsellors work with Alters/Parts but I do, I have always done so and believe that this is the only way forward for a client with DID. I believe that the Alters/Parts are as important to work with and heal as the person who was born because their feelings, pain, individuality and experiences are just as valid.

What is DID?

DID is not a mental disease, it is a trauma based condition and survival mechanism, firstly experienced by a child under the age of 5 or 6. 

It is caused by the splitting of a personality when the person is confronted by a perceived or real, continuous potential life threatening situation/s.  Should the abuse continue the child/youth/adult may continue creating "parts".  DID can be a result of severe ill health as a child and the fear related to operations and injections, but it generally connected with RA and SRA.

The existence of multiple personalities within an individual is diagnosed as Dissociative Identity Disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Prior to the publication of the DSM-IV, it was termed Multiple Personality Disorder (MPD). Neither term (Dissociative Identity or Multiple Personality) should be confused with schizophrenia, although the media often incorrectly use the term split personality to describing the latter, as well as interchangeably with DID.

As a diagnosis, DID remains controversial, with many professional psychiatrists and commentators arguing that there is no empirical evidence to support the disorder, or its diagnosis. On the other hand, some psychiatrists contend that they have encountered cases that appear to confirm the existence of this condition and some mental health institutions, such as McLean Hospital, have wards specifically designated for Dissociative Identity Disorder.

Counselling4you's view on this subject is that DID does most definitely exist.

This view is based on our research, training, our own counselling experiences and experiences based on meetings with other counsellors and the teachings of highly experienced professionals such as Valerie Sinason. 

The Diagnostic & Statistical Manual of Mental Disorders defines DID as:

  • 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.
  • At least two of these identities or personality states recurrently take control of the person’s behaviour and thoughts.
  • Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

 

 

The disturbance is not due to the direct physiological effects of a substance or general medical condition. In children the symptoms are not attributed to imaginary playmates or fantasy play.

Symptoms May Include:

Depersonalisation: which refers to feeling unreal, removed from one's self, and detached from one's physical and mental processes. The person feels like an observer of his/her life and may actually see him/herself as if he/she were watching a movie. Derealisation refers to experiencing familiar persons and surroundings as if they were unfamiliar and strange or unreal.

Amnesia is common initial coping mechanism is to escape the body. It is the beginning of clinical (amnesic) dissociation, which allows a shutting out of an unbearable reality. It is held unassimilated.,i n effect, frozen in time. A dissociated experience can be split up to store the emotions separate from bodily sensations, and the sensations separate from the knowledge of an event. In essence it is the inability to recall blocks of time, (large or small) important information and other noticeable blank areas in one's life.

Derealisation is a change in the person’s experience of the environment when the world around them feels unreal and /or unfamiliar. This would include friends, family, home, work, possessions, places etc. Being spaced out, dream-like, in a sensory fog, being a spectator at some event, these are some of the feelings and experiences one may have.

Identity Alteration: People with DID are often told of things they have done and of notable changes in their behaviour, which they do not remember. They may discover objects, possessions, productions, or handwriting that they cannot account for or recognize; they may refer to themselves in the first person plural (we) or in the third person (he, she, they).

Identity Confusion: "Who am I?" A question we all ask ourselves in periods of our lives, but for people with DID this is a far more frequent question. It is far more than the "normal" monkey chatter that goes on in our heads every day. It can be a serious problem because the decision making process maybe overpowering and cause a fierce battle for the consciousness, inner survival and power. The resulting turmoil due to conflicting or opposing attitudes and views about every subject helps lead to a unwelcome and confusing state of no real self or identity.

DID is a vast and extremely complex subject, one that I cannot possibly explain in my pages here.  There are many web sites should you wish to find out more about it. Below are just some of the basic points of DID and the ground that will be covered on dedicated sites.

A dissociated identity, like a dissociated experience, can hold the entire event or parts of it. "Parts" (inner personalities) may hold only a bodily feeling, only an emotion, or only the knowledge. It is possible for one hundred abusive/traumatic incidents may be held by one identity or conversely one hundred identities may hold the same, similar or parts of one incident; or each identity is holding an abusive experience. In this context, taken together, the identities hold a person's overwhelming traumas and express a survivor's entire life story.

Our instinctive reactions to a traumatic incident or assault are fight, flight or freeze. Fight and flight do not work when sadistic adults abuse children. The only option left is to freeze and take flight through the mind. In dissociating an experience, children split off a part of their self to hold the trauma. In some cases the dissociated aspects of self, immediately or over time, form their own and separate sense of self. When the abuse is over, the original self "returns" and resumes "normal" life, having no/little awareness of what has just transpired. If severely abused children were forced to experience the trauma they had just lived through, they would probably NOT survive.

Dissociation is defined as a complex mental process that provides a coping/surviving mechanism for individuals confronting painful and/or traumatic situations. It is characterised by a shattering of the ego. As abused children grow, their problems typically begin to mount. The load on their unconscious becomes increasingly great, and they feel overwhelmed. As some identities stay out more and more, they may begin to take over and operate in the child's day-to-day world. If the abuse continues or increases, the original self may stay out less and less and in time stop coming out at all. The survivor is then functioning through identities that "switch" to cope with day-to-day life. Because the person suffering dissociation does not completely disengage from reality, he/she may appear to have multiple personalities to deal with different situations. When an alter ego cannot cope with stress, the consciousness of the person is given over to another personality to eliminate the trigger or pressure causing the stress. 

Pushed beyond normal limits, initially for survival and then managing day-to-day life, survivors have discovered extraordinary abilities and coping skills. These abilities are in evidence by survivors who used their powers of the mind to survive. Although these abilities may be wonderful in some respects, they have come at an exorbitant price. Multiple personalities are slowly introducing the world to new realms of possibilities that have yet to be fully understood. With knowing and understanding comes appreciation. Regardless of an identity's name, description, or personality, its main and common purpose is always to protect the child. "Parts can manage extraordinary feats in their determination to keep the child safe. Sometimes these feats are beyond the range of normal human experience or comprehension".

While no two survivors are alike, there are some common themes, such as having both male and female alters, different colours and races within, other more commonly observed abilities in multiples are perfect memory, ability to heal unusually fast, ability to tolerate extreme levels of pain, and ability to self-anaesthetise. By "switching," some survivors are also able to work almost continually with minimal rest. Each identity within the same person may have unique neurological and physiological responses. For example, some identities may require glasses, while others have perfect vision: some identities are allergic to smoke, while others may be chain smokers: some identities are almost deaf, while others have exceptionally good hearing: different alter egos within one person will register unique electrocardiograph, blood pressure, and pulse readings. "Parts" may have different allergies and different ailments and unique responses to medications. One identity may be diagnosed with an ailment, but then be "out" when the medication is taken. In this case, the original alter ego isn't helped, and the receiving alter ego may have unfavourable side effects. Prescribing medication to survivors who are multiple personality sufferers should be done with special care and extra monitoring.

Counselling for people with DID can take many years depending on the severity of abuse/trauma experienced. We can work with every tool possible, (depending on our clients wants and needs) including many creative interventions, dolls, drawing, painting, sand play, story telling, picture cards and so on. Just talking is not enough because we are dealing with both sexes within one body, ages that vary from 3 months up to the present age of the host and each "part" may respond to very different interventions because as you read above they each have their own character, which makes them unique. If a DID client has for example 50 "parts" (this will dependent on the level of abuse and for how long) the Counsellor will in reality possibly have 50 different clients each with their unique personality.

I hope you have found this helpful and please do not hesitate to contact us if you have any questions, we will try our best to answer them.