By Hal Brown, MSW, Retired clinical social worker, psychotherapist
An article in HUFFPOST by a woman who describes her experiences as someone who has dissociative identity disorder, or DI.D., which was previously called multiple personality disorder, caught my attention because I have had more experiencing treating such clients than most clinicians in general practice.
Below are samples of the comments to the article in HUFFPOST which prompted me to weigh in with my own comments since some of them were either ignorant or hateful. Reading the candid article by Jamie Marich (below) also prompted me to excerpt and re-post portions of the blog I wrote about Herschel Walker not having to do with him since he has claimed he had dissociative identity disorder.
Here's the HUFFPOST essay:
- This is complete nonsense. There’s no such thing as multiple personalities. One can have delusions that one has multiple personalities just like one can have delusions that one is a fire truck.
- Check yourself into the booby hatch.
- Borderline. Personality. Disorder,
- Some people are just plain nuts and can't be helped.
- Undoubtedly taxpayer dollars are being funded to support this useless bum who will never be anything more than a burden.
- Actually… It sounds exactly like they describe it on TV.
- If men can wake up one morning and decide to be a woman, you can certainly whomever you want
- Does she just have a very active imagination coupled with a fiercely independent nature that allowed herself to become more than one identity? I guess we could all do this if we so desired. Serious role playing. It might even be fun in a more accepting society. I have no desire to do this, probably because it’s not socially acceptable, and my mother would have smacked me down if I tried. I also just like the one “me” and don’t like complications. Like invisible friends, some things you simply choose not to do, be or have when you grow up. Most people anyway.
- Uh Ohhh...
- A new letter... P... Plural.
- That goes with the B for bisexual...
- And the D for dissociative and the PTSD which brings us back to...
- This is written backwards.
- If you start with the logical part at the end (Think about the last time that you were bored...)
- Then the workshop stuff... Then all y...
- "Hollywood is obsessed with exploiting the lives of people with dissociative identity disorder". How do you figure that? When was the last time a movie was made on the subject? How many movies about it have actually been made in the last 50 years? What do you do, sit in a chair and watch those 6 movies over and over? Who's obsessed? people aren't concerned nor to they give a moment's thought to such things. Hollywood is obsessed with John Wick, Marvel, Violence, CGI, Star Trek, and action movies. Whose lives were "exploited" exactly? It's called drama and entertainment. "Dramatization". It's not MEANT to be real. No actual people were harmed in making those films. Playing victim isn't going to advance your cause - is that your 4 year old? Do you realistically think everyone should go out and get a degree in psychology? I'd be surprised if even half the country made it through high school.
- Ohhhhhhh, "pronouns", she's "woke"! wait, they're "woke". All four of her! We need laws to prevent her 4 year old and 9 year old from engaging in adult activities! Child self abuse! Calling Ron DeSantis
- How does she know what I've seen on TV? What if I saw HER?
- My first thought at the idea of having a 4-year-old identity inside a 43-year-old body is that it’s not the same as being a 4-year old.
- A 4-year-old is learning all the time and the things that she learns will help her as the 5-year-old she soon will be.
- A 4-year-old identity is a simulation of a child. It would be frustrating to deal with such an identity knowing it could never truly mature.
Scroll down for my comments and the replies to them:
I wrote a long essay about Herschel Walker who has claimed to have DID. In it I describe my own experience as a therapist who treated at least five clients with complex DID (and several more with a questionable diagnosis of DID). There are those who understandably question the validity of the diagnosis but the majority of the MH community believes it exists (and it is in the DSM-5). Here's my essay: https://www.halbrown.org/2022/10/herschel-walker-or-one-part-of-him-may.html
In my 40 year career as a therapist I had eight clients who I was the first torecognize as having alter personalities. Some were simple, for example one with two alters who I ended up hiring as a mental health worker in my day treatment program after the dangerous alter was integrated. I had various others DD clients with between 3-10 alters. The most complex manifestation of DD was with a client who had more than 100 alters including sub-alters (alters of alters) who died of suicide after I moved out of state and she was picked up by other therapists. Her death came when her most malevolent alter decided to kill her body believing he would live on.
I think this is an illuminating article which hopefully can lessen the stigma associated with the disorder.
I believe there are two schools of thought among those working with DID clients. One is that the goal of therapy should be integration of all the personalities, the other is to achieve peaceful coexistence and cooperation between the personalities crucially eliminating periods of amnesia. With either goal the problem is that in many, if not most, of those with DID there is at least one alter that identified with the aggressor, or abuser, in their life who is the person who was responsible for the person developing DID as a coping mechanism, a means for survival, using the amnesic dissociation. Unless that alter is rendered harmless they are always at risk of them taking control and, like with my client, with dire consequences.
- I suspect it should be up to the client. If they want to integrate, the work should be toward integration. If not, help them develop the coping skills they need. It's the client's brain. They should have the first say in how it works.
- What a load of mystic nonsense. I probably have more experience and every bit as many credentials as you have. I have always tried to understand this particular subject from different perspectives, only to be shaken back into reality with actual client experiences. I have come to believe validating multiples/alters is just neglect of authentic client needs. Perhaps even abuse. Boundaries, reality testing, and some form of cognitive behavioral therapy loaded with education and diversion are what Borderlines need. Not magical thinking.
I consider DID to be a condition of where the person accidentally, not by choice, used self-hypnosis and created alters with amnesia which were used to avoid experiencing extreme trauma. The presentations of the client are frequently what you call theatrical. Some alters can be diagnosed as histrionic personality. In fact, various alters can have their own psychopathology while other are psychologically what would be called normal. Unless someone has actually worked with someone with DID and observed how different the alters, seen the extent of the amnesia between alters, are and gotten to know them it, is easy to consider it an ordinary personality disorder or just theatrics. This disorder more than any other demonstrates the power and potential of the mind. I have some concerns about the author of this essay, mainly that she doesn't describe whether she had a malevolent dangerous alter and how this was handled in therapy, but her basic description of her life experience dealing with DID rings true.
- She’s just driving a long-active, attention-seeking fabrication. It is much simpler. She has an ordinary personality disorder, and therapists like you have cultivated this theatrical behavior.
Every once in a while I find myself either reposting an old blog story or going back to update it. Because Herschel Walker is no longer in the news I won't repost all of the article about him and his dissociative identity disorder. You can read it here if you are interested.
What I will do is repost the portions of that article that have to do with dissociative identity disorder below.
During my 40 year career I have treated five patients with dissociative identity disorder of DID. I could write a book about them and my experiences in trying to help them avoid engaging in the self-destructive behavior which was caused by one or more personalities, or alters, trying to hurt or even kill the others. In some cases these alters didn't know that killing the body of another alter or alters would also end their lives. The belief system of such alters sometimes didn't include a recognition that they resided in the same physical body as the other alters. In fact when in control these alters often had far greater physical strength than the others and didn't experience pain.
Having read the comments I want to add that some of those who made them consider DID to be a personality disorder. It is not. It is considered correctly to be a sub-type of post-traumatic stress disorder (PTSD). This is because it develops as a way someone undergoing extreme stress as a child, generally repeated sexual abuse by a family member or someone close to them and their family.
It should be understood that because the personalities, also called alters, are not only different ages and genders, but if evaluated separately would also have their own different psychiatric diagnoses. Not only that their IQ's would be different and there have been documented case where some would need eyeglasses and others would have perfect vision. Some could be extraordinary strong even though their body weight and physique wouldn't suggest this.
The following is based on my own experiences with DID patients, extensive reading, and attending workshops presented by experts. It is adapted from my Herschel Walker essay.
DID develops as a way to cope with extreme childhood abuse. It is usually sexual abuse of a female by an adult male in the family, usually a father, step-father, or other caregiver. DID in males in less common. The most well known case of a male with DID is Billy Milligan.
For reasons not known, some victims are capable of creating alter personalities which experience the abuse and then instead of developing totally amnesia for it create, through a kind of self-hypnosis, another personalty which has no memory for it.
In DID a patient can have only two personalities, one with the abuse memories and one with no memory of them. Other patients may continue to create new alters to deal with other incidents of abuse, and then use this ability to continue to spin off alters to deal with other life stress. In very complex cases an alter can have one or more alters.
Sometimes people with DID never seek treatment because despite periods of amnesia they don't feel much distress. Someone with DID may end up walking along a dark country road in the middle of their night in their pajamas and switch alters and have no memory of how they got there. They may accept this because similar things often happen so they'd just walk back home.
They may be used to finding things around the house they never saw before because another alter bought them.
It must be noted that amnesias like these are hallmark features of DID. It can be incidents of amnesia that prompt them to seek therapy.
It is an unfortunate aspect of the disorder that in the worst cases the patient has an alter that identified with the authority figure who abused the actual patient who is perceived by this alter as a different person. While originally a protector they can develop to be a destructive force in the patient's life.
For the safety of the therapist it is crucial they develop a working relationship with any malevolent alter. They may want to sabotage therapy, or worse. I had a client who had a handgun and insisted on searching her handbag prior to each session.
A hallmark of DID is amnesia. During many of the times when certain alters are in control various other alters have no memory of what was happening. For the therapist in complex cases figuring out the ways the amnesia functions between numerous alters is, to say the least, a challenge.
Here's a clinical example from my own experiences (with all names changed):One of my patients first came to me with the presenting problem being that she was losing things, and when I pressed her to explain she reluctantly told me she was also losing track of time, sometimes entire days. In that first session I said matter-of-factly "is there someone here who'll tell me what happens when Alice doesn't remember what is going on. Alice was very puzzled by this question but I told her to bear with me and I asked again three or four times. She then changed her facial expression, looked me directly in the eyes, and said in a slightly different voice, "she's so stupid she doesn't keep her valuables in a safe place." I asked who I was talking to and my patient said "I'm Denise." Then I went on to talk to Denise and when I realized I was dealing with a full-blown case of DID I also ended up "meeting" the malevolent and dangerous personality who I eventually had to tell with in almost all of our sessions. This was George who eventually was created as a protector when Alice was being sexually abused by her father but when she was an adult also became her most destructive alters.
Successful treatment of someone with DID usually means working with the healthier alters to form alliances among them so they can resist having the dangerous alters take control. All of the therapy involves with these alters must be conducted with the therapist knowing that the dangerous alter is aware of your intervention and observing the session. That personality sometimes takes over so the therapist has to deal with him (with females it is usually a male) and works both an advocate for the vulnerable alters and tries to create a relationship with the dangerous alter. There are times when the therapist "makes deals" with the dangerous alter.
Curing DID is exceedingly difficult and those therapists who claim they have done this may be deceiving themselves. A complete cure means that all the alters have integrated into one, that the memories of being abused have been dealt with in therapy, and there are no incidents of present day amnesia. The reports of amnesia with someone with DID means that another alter or alters were in control during the period of lost time.
A more modest goal, and with some the only realistic goal, is to work on developing a cooperative relationship between the alters. This seems to be what the author of the HUFFPOST article achieved.
Updated comment and my reply:
Comment: Thank you for sharing, The information you gave is very informative.
18 seconds ago
You are welcome. There are so many examples of how extraordinary this manifestions of DID are that I could have doubled the length of my blog describing just what I experienced. I would add for therapists with these clients that it is best to work with a co-therapist, have a good inpatient back-up facility available, and be able to see the client 2-3 times a week. One example from my practice is a client told us her malevolent alter observed what she saw with a third eye and then it appeared as a raised reddish circular welt in the middle of her forehead. After the session we asked each other incredulously "did you see what I saw?" Another example of when a malevolent alter took control in the hospital was when he took control of her 100 body and toppled large heavy tables over. It took rarely used chloro hydrate injections to calm him down.
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