Posts Tagged ‘alters’

Interview with Brian Moss: Qualities and Information Useful for a Therapist and a Client Working with Dissociative Identity Disorder (DID)

Interview with Brian Moss: Qualities and Information Useful for a Therapist and a Client Working with Dissociative Identity Disorder (DID)

permission to post

Modified from version originally posted in the Survivorship Journal Vol. 18, Issue 2 December, 2012 at survivorship.org

PERSONHOOD

TOLERANCE FOR AMBIGUITY
Integrating a trauma narrative, especially if it is the result of sophisticated mind control procedures, is a complex and lengthy process where subjective states (hypnosis, drugs) and manipulated states (electric shock, psychic-driving, sensory deprivation, sleep deprivation) are mixed with objective states (veridical memory of ritual/sexual abuse or any other experiences meant to terrorize.)

CAPACITY TO DISSOCIATE

There is a difference between “forgetting” and “forgetting that you forget”; one insulates us temporarily as we metabolize our experience while the other prevents us from fundamentally accessing our experience. The capacity to dissociate in a healthy sense allows us to live our lives in spite of what we know—to balance the terror of being alive with the wonder of being alive. There are so many ways to get derailed: cynicism and anger, despair and hopelessness, or the false relief of numbness.

TOLERANCE FOR ISOLATION
All of us, survivors and therapists alike, got to where we are in stages. Painful truths that do not correspond to what we have been told about the world require new understandings that only gradually come into focus. In sharing what we have learned and/or remembered, there is deep frustration that in telling our most urgent truths we are not believed.

AT LEAST ONE TRUE “INTIMATE”
Whether spouse, partner, mentor, friend, find someone that can handle the material and understand the larger and hidden truths of what you are learning. The reality behind DID is a “through the looking glass” experience and is a journey best not taken alone. Therapy is difficult when the client is lacking outside support or dealing with an unsympathetic spouse/partner. Clients that are still embedded in the deviant social networks responsible for their original abuse have an enormous challenge facing them.

A SUBSTANTIAL DEGREE OF DIFFERENTIATION
A significant moment in my early childhood occurred while I was watching the television adaptation of Orson Welles’ War of the Worlds. There is a scene in which the creatures have landed and are zapping everyone. A priest comes forth, holds up a bible and is incinerated on the spot. I remember thinking, “Are they allowed to do that?” Differentiation from family, religion, dominant paradigms of any kind including television, mainstream media, and society in general—gives us the ability to think independently and to tolerate the withdrawal of approval or ridicule that is often the reaction to doing so.

INTEREST IN CONTROVERSIAL/FORBIDDEN AREAS OF KNOWLEDGE
Many DIDs have teams of parts that are used to research psychic phenomena. These psychic skills are exploited in a variety of contexts including military and intelligence work. It was eye-opening for me to see the seriousness with which this research is pursued covertly while being overtly ridiculed in conventional academic settings.

ABILITY TO DISCERN DISINFORMATION
Quality disinformation must contain a high degree of truth or it will be rejected outright. The goal of disinformation is to present pieces of the truth in a way that leads to the wrong conclusions. The other purpose is obfuscation in general. There is an overwhelming amount of disinformation on the internet and in our media. Who would have guessed that when Orwell’s “Ministry of Truth” finally arrived we would embrace it as “Wikipedia”.

COURAGE TO FOLLOW THE CLIENT’S LEAD
Abandoning their clients’ experience in order to preserve their (the therapist’s) comfortable view of the world is the same dynamic survivors experience at a societal level. Survivors want—and need—to be believed. No-one is afraid of the dark itself, they are afraid of what might be in the dark. Survivors know what is in the dark. They want to tell their therapists; they want to leave the scenes behind; they want to end the dissociation. They want—and need—to know it is over. It is essential that therapists do not let them down. This takes courage as well as expertise.

APPRECIATION OF LIFE’S ABSURD MOMENTS IN ORDER TO DEFEND AGAINST CYNICISM AND THE NEED TO UNDERSTAND EVERYTHING
One of my teachers had a story that I heard him tell often. It was a true story he read in the newspaper about a man who had given up and climbed a bridge preparing to jump. A crowd formed in anticipation of the spectacle and the police were called who, in their best manner tried to negotiate with and talk the man down. Getting nowhere, running out of ideas and becoming increasingly frustrated, one of the officers pulled his gun and threatened to shoot the man unless he came down. The man climbed down. It is important to understand that not everything can be understood.

ABILITY TO PERSEVERE IN THE FACE OF SOCIETAL DENIAL
Judith Herman named it in Trauma and Recovery: “The study of psychological trauma has repeatedly led into realms of the unthinkable and foundered on fundamental questions of belief.” There will be polarization occurring in society as more and more information comes out and more survivors come forward. There will be attempts to discredit survivors and to misinform and censor content for those seeking information but to no avail. There are too many survivors and they will continue to speak their truth in an ever increasing chorus.

A BELIEF SYSTEM THAT ALLOWS FOR EXISTENCE OF THE SPIRITUAL
Most DID systems contain spiritual guides or transcendents capable of guiding the work of healing. DID survivors benefit from therapists who are comfortable with these realities. The transcendents, by their very nature, are beyond the reach of programming/conditioning and remain untouched by mind control techniques much as the Sun does not cease to exist simply because a cloud moves in front or the earth revolves.

BELIEF THAT LIFE HAS MEANING

In enduring or bearing witness to the desecration of every value the belief that life has meaning frames the ability to go forward rather than fall into despair. What I have noticed both for myself and the therapists I work with is that when we are willing to know, and not turn away from darkness, a corresponding light enters our life to help balance and navigate it.

KNOWLEDGE

UNDERSTANDING OF SYSTEMS THINKING
Systems theory addresses the whole, including the relationships of the parts of the whole to each other. It does not simply focus on the individual parts in isolation. The concept of wholeness, the integrative process, is the essence of all psychological growth—not just Dissociative Identity Disorder alone. The word “therapy” derives from the Greek word therapeia meaning “to heal”; the word “heal” from the Old English word hælan meaning “whole”. “Integrate” derives from Latin, integrare, to make whole, from integer, complete.

UNDERSTANDING OF UNCONSCIOUS PROCESS
In terms of unconscious process there is an important distinction to make between repression and dissociation. Traditionally, therapists received training in which experience not consciously available was seen to be a kind of primitive unconscious regulated largely by primary process thinking and regression. (Repressive model) Contrast this with concealed experience and memory systems (DID) that are coconscious, where parallel states are existing with a variety of levels of development, some more healthy or competent than the presenting personality! Knowing the subtleties of unconscious perception, and how they are named, informs the therapist and empowers the client.

UNDERSTANDING OF SYMBOLIC LANGUAGE
Consciously unacceptable material is camouflaged in symbolism. As it is metabolized, dissociated information will become more representational and less symbolic. When information is transmitted symbolically the degree of symbolism used will depend on the tolerance of the system for the material being depicted. When the information needs to be defended against, the defending alter will either not be present or will filter the 4 information symbolically. As integration takes place there is less need for symbolism and both dreams and artwork become more representational.

UNDERSTANDING OF THE TRUE ETIOLOGY OF DID

Complex DID systems are not simply a response to trauma and stress—even horrific trauma such as ritual abuse, though it does have a role to play. Nor is it caused iatrogenically by well-meaning therapists attempting to treat trauma survivors as Wikipedia would have us believe. DID is mind control, intentionally practiced and requiring a great deal of effort and conditioning over a period of many years. To develop an elaborate DID system is to endure an ongoing medical procedure throughout childhood, one that requires clinical settings with access to extensive equipment and pharmaceuticals.

At the turn of the century there were indeed cases of “split personality.” These cases were observed by Pierre Janet in Paris; Breuer and Freud in Vienna; F.W.H. Myers in London; and Morton Prince in Boston. These initial cases were found to be the result of trauma in childhood but rarely produced more than a few alter states and often just one. Childhood incest does not lead to elaborate DID systems.

Modern DID bears no resemblance to these early, primitive cases but is instead the outcome of a century of covert research on these dissociative states and their successful creation and exploitation.

This statement has caused the most discussion yet is critical in understanding the true causes of present-day Dissociative Identity Disorder. So what is Mind Control Programming? I use the concepts programming and mind control interchangeably. All DID systems are the result of mind control and programming techniques. I want to clarify this statement; it is very important and has serious implications. The mind does indeed dissociate naturally both in normative contexts (selective attention) and in response to trauma—but dissociative states do not self-organize into elaborate systems with the levels of complexity that we are seeing today—that is something that requires interference from without. Modern cases of DID demonstrate hierarchy and are structured to meet a variety of demands. This is never random, or entirely a response to trauma, though trauma is used to create and maintain the compartmentalization in DID. These parallel conscious states, each exhibiting their own conditioning, are what we call alters.

That DID is manufactured in its present form needs to be acknowledged in order to understand features of DID that would not otherwise make sense and also to account for the politics of this diagnosis with its troublesome implications regarding our world. Multiple Personality Disorder (MPD), now known as Dissociative Identity Disorder (DID), is the result of a century of covert research on these naturally occurring capacities of the mind. This is where our field truly “leads into realms of the unthinkable and founders on fundamental questions of disbelief.”

Throughout history, exploitation and control of some members of society by others is a continual theme. This control can be subtle, as with the manipulation of peoples’ belief systems through propaganda and religious dogma, or more direct and heavy-handed as with threats of persecution or violence. One of the simplest means of control is to maintain the powerlessness that comes with basic poverty/indebtedness or the lack of access to quality education. A key dynamic with the more overt forms of control is that when people are oppressed—they resist. Advanced forms of control address this fundamental dynamic by developing forms of exploitation that remain largely outside of conscious awareness both for selected individuals (DID) and the larger society (control of the public is achieved through propaganda and the manufacture of consent, an increasingly serious threat with the concentration of media).

Mind control evolved from two main foundations:

1)  The Soviet discovery of conditioned reflexes (Pavlov 1903) and continued research within the field of behavioral psychology.

2)  Advances in understanding the creation of parallel dissociative states with independent memory systems and control mechanisms utilizing research in hypnosis and trauma-based splitting of conscious processes.

UNDERSTANDING THAT EFFORTS TO CREATE DID IN CHILDREN WERE NOT SIMPLY EXCESSES OF THE COLD WAR IN THE NAME OF NATIONAL SECURITY
Disturbing as it is, we must acknowledge the ongoing nature of these activities. Clients are sensitive to any backing away by the therapist and are reluctant to fully disclose when they fear they won’t be believed. Clearly, people who would torture children, for any perceived agenda, are sociopathic. What they are after is a type of power that is outside legal or ethical constraints and better described as organized crime, no matter the context in which it is framed.

UNDERSTANDING ISSUES RELATING TO ALTERS
Over-identifying with the innocent child alters and avoiding the mean and destructive ones maintains division and conflict within the system. Developing a fascination with certain alters, or with the process of switching itself, is another way to become triangulated into the system; there is no reason to encourage switching— most alter systems can be accessed while keeping a sense of co-consciousness with the normative section. DIDs can parallel process to an extraordinary degree and this ability can be utilized to integrate without losing stability.

AWARENESS OF BLENDING VS. SWITCHING

Many clients and therapists expect a more dramatic presentation (switching with lost time) and miss important system shifts because the client remains co-conscious. When an alter, or programming is behind, alongside or blended with the front system, the changing quality of consciousness may present more subtly. Most alter movement taking place in a therapist’s office (unless the client is severely destabilized) involves blending with no loss of time.

DISCERNMENT REGARDING THE DIFFERENCE BETWEEN STABILITY AND INTEGRATION
The front/normative section is designed to be free from interference and highly functioning as long as the covert aspects of the system remain unknown and there is compliance with the demands of the programmers/handlers. Programming is designed to maintain stability through compartmentalization. Paradoxically, it is the more effective therapists, who begin to make inroads into the deeper structures, who find themselves inadvertently destabilizing their clients. This “success” can trigger programming. (Dissociated trauma scenes and conditioned self-destructive behavior.) Overt stability is not the same as integration.

UNDERSTANDING OF DEEPER STRUCTURES OF DID
While allowing for some variation, most programming follows standard protocols. The front/normative section is designed to be free from interference and highly functioning as long as the covert aspects of the system remain unknown and there is compliance with the demands of the programmers/handlers. Many therapists deal with leaking or triggered trauma scenes related to sexual abuse and ritual abuse without ever getting to the deeper structures and teams involved in covert activities or the programming responsible for it. The trauma scenes act like a mine field keeping these deeper structures and parts hidden and compartmentalized.

RECOGNITION OF THE DOUBLE-BIND IN MIND CONTROL
As with all double-binds the only way out is to acknowledge the bind and transcend it. There is no way to resolve the situation if it is accepted as presented. The basic feature of false choice programs is: “I stay safe and comply with programming/training or I resist and trigger trauma scenes.” It is not either/or; alters should be made aware that both sides of the dilemma are manipulated and all parts of self can come to the present and be free of the demands.

UNDERSTANDING THE NEED TO WORK “FROM THE OUTSIDE IN”
Trauma programming is layered. A good visual image to illustrate this concept is the children’s game of Mikado or “pick-up-sticks”—the outermost sticks must be removed before attempting to move underlying ones. When working to dismantle programming any interference encountered must be dealt with before proceeding. Not to do so is like pulling a stick from the middle of the pile and activating multiple layers of conditioned responses at once—something guaranteed to stop any further progress and destabilize the client.

UNDERSTANDING THAT EMOTIONAL CATHARSIS IS NOT NECESSARY FOR INITIAL MEMORY WORK
There are two basic forms of memory: explicit memory and implicit memory. Explicit memory is what most people are referring to when they talk about memory; it records consciously available information about past experiences. Implicit memory is information that is not consciously available and was encoded outside of conscious awareness. Abreaction and triggering can be understood in terms of implicit memory. The sense of self and self-control that accompanies explicit memory is lost when a trauma memory is an implicit recollection. The difference between these two forms of memory must be acknowledged to understand the basis of trauma programming.

AWARENESS OF POSSIBLE SURVIVOR CONTACT AND SABOTAGE BY HANDLERS
All survivors are monitored internally via programming that is designed to force compliance or initiate reporting to programmers/handlers in the event of non-compliance. Of greater concern and missed by many therapists is that survivors are also often contacted and sabotaged by the people in their present life—even survivors well along in their recovery; this includes people (often family in generational cults) known to the survivor as well as unknown handlers able to access alters outside the awareness of the normative personalities.

A CLOSING STATEMENT FROM BRIAN:
The chance to share this information with you is my pebble in the pond—maybe reaching you on the far shore. Don’t doubt that there are many survivors whose voices have been heard, and many therapists who know the truth about what is going on in the world; all of us working quietly (or out-loud) to make healing possible for each other and to create the world we know is possible.

Brian Moss, MA, MFT is a Clinical Fellow and Approved Supervisor of the American Association of Marriage & Family Therapy. He lives in the Seattle area and consults widely, specializing in working in partnership with DID clients and their therapists.
http://ritualabuse.us/research/did/interview-with-brian-moss-qualities-and-information-useful-for-a-therapist-and-a-client-working-with-dissociative-identity-disorder-did/

Open Letter to Dr. Phil From Jenny Hill

Open Letter to Dr. Phil From Jenny Hill

Judy Byington and I have been close friends for 20 years. She has been my confidant and dearest friend. She and her husband have adopted me as part of their family and I feel they are my family. I trust Judy completely. She listens to me when I hurt and need consolation. Judy has given me her time, love, acceptance, money, food, bought me glasses, clothing and on occasions even provided me a place to live.

At no time has she ever tried to take advantage of me. Without Judy’s love and concern over the years I might not be alive today.

Judy has not been my therapist as they said on the Dr. Phil show. I have a therapist at Wasatch Mental Health. My other therapist was Dr. Weston Whatcott at the Utah State Psychiatric Hospital who was one of a team of mental health professionals who diagnosed me with Multiple Personality Disorder now known as Dissociate Identity Disorder. That was ten years before I met Judy.

Early in my life I decided I wanted to have my biography written to help other victims of the horrible abuse I suffered as a child. I asked Judy to write my biography. It was my decision to deliberately bring some of my parts forward so Judy could meet them. Last August at the request of producers at the Dr. Phil show, Judy and I taped my alters taking over.

I understand that after the Dr. Phil show aired some people may have the impression that I would not receive a profit from the sale of my biography,”Twenty-Two Faces.” That is not true.

I am fully capable of making my own decisions and if I wanted to set up a bank account for monies received from the sales of my book I could and would do so. It has been my decision not to set up an account at this time. Judy and I haven’t talked much about profits from the book because it has yet to make a profit. I have told Judy I don’t want to make money off “Twenty-Two Faces” but wish my share of profits to go toward helping victims of ritual abuse. That has been the goal of both Judy and myself since we started writing the book 20 years ago. It’s not about the money. It’s about being able to help ritual abuse survivors.

Another concern has been the contract I signed with Judy giving her copyright to my story. I agreed to sign the contract knowing this was because our literary agent required my and Judy’s literary, electronic and film rights to the story in order to present the book to publishers. I made this decision myself, knowing exactly what I was doing. I took my time to think and pray about this and when I signed the agreement I did so of my own volition and was not manipulated into doing it.

I also want to make it clear that I have multiple personalities or DID. Most of the time I am in complete control of myself but occasionally one of my alters will take over and do something which I am not aware of. I can’t remember doing it and I can’t help that. I am moving forward with my life one day at a time and making progress.

I understand the following is a statement about me written by my sister Susan. It is taken from my son Robert’s blog on the internet..

“She has confided in me on numerous occasions that Judy Byington has manipulated and used her. I have a recently-recorded phone message from Jenny stating that she does not condone what Judy has done with her life story. She has been repeatedly lied to and has been harassed so much by Judy that her case worker at Wasatch Mental put a restraining order against her (Judy). Jenny complained that she wants some help to get away from Judy so that she might tell her own version, but Judy holds the copyright to her life story, and she (Jenny) legally can’t speak out. ….”

I cannot remember calling Susan and saying these things, nor would I even think of saying something like this.

It is common for me to get depressed. In December I checked myself into inpatient care and told my caseworker that no one was to know where I was including the only two people who I have regular contact with, my son Robert and Judy.

I do not believe Judy has manipulated and used me. I do not believe Judy has ever lied to me. Judy has never harassed me. I did not ask my caseworker to file a restraining order against Judy. I do not want any help to get away from Judy. I certainly do not want to write another version of my story. It took Judy and I 20 years to write “Twenty-Two Faces.” I don’t want to do that again. Judy has never said I can’t speak out about my life story. In fact, Judy encourages me to speak about it and has given me opportunities to do so.

I asked Judy to write my biography. We wrote it together. We outlined what was to be in each chapter and then I wrote out the chapters. Sometimes my alters would take over and write their feelings in the chapters. The book was taken from those writings, those in my diaries and my writings at the Utah State Hospital.

I completely agree with my life history as it is written by Judy in “Twenty-Two Faces.”

I stated on the Dr. Phil show that it was hard for me to read the book. And it is. I read a little bit and then have to put it down because my childhood is very traumatic and reading about it brings back bad memories. That doesn’t mean that I don’t know what’s in my biography because I do. I lived it. I helped write it.

Because of the time restraints of a TV show like Dr. Phil I didn’t have the opportunity to say everything I wanted to say.

This is my statement and no one else’s.

See my notarized letter of 14 January, 2013 on http://www.22faces.com.

http://22faces.com/jenny-hills-open-letter-dr-phil/

Dr. Phil “My Husband, My Kids and My Multiple Personalities” May 10, 2012, Ultra-Orthodox Shun Their Own for Reporting Child Sexual Abuse

Ultra-Orthodox Shun Their Own for Reporting Child Sexual Abuse
By SHARON OTTERMAN and RAY RIVERA May 9, 2012

The first shock came when Mordechai Jungreis learned that his mentally disabled teenage son was being molested in a Jewish ritual bathhouse in Brooklyn. The second came after Mr. Jungreis complained, and the man accused of the abuse was arrested.

Old friends started walking stonily past him and his family on the streets of Williamsburg. Their landlord kicked them out of their apartment. Anonymous messages filled their answering machine, cursing Mr. Jungreis for turning in a fellow Jew….

Abuse victims and their families have been expelled from religious schools and synagogues, shunned by fellow ultra-Orthodox Jews and targeted for harassment intended to destroy their businesses. Some victims’ families have been offered money, ostensibly to help pay for therapy for the victims, but also to stop pursuing charges, victims and victims’ advocates said….

Some ultra-Orthodox Jews want to keep abuse allegations quiet to protect the reputation of the community, and the family of the accused. And rabbinical authorities, eager to maintain control, worry that inviting outside scrutiny could erode their power, said Samuel Heilman, a professor of Jewish studies at Queens College….

In Brooklyn, of the 51 molesting cases involving the ultra-Orthodox community that the district attorney’s office says it has closed since 2009, nine were dismissed because the victims backed out. Others ended with plea deals because the victims’ families were fearful.

“People aren’t recanting, but they don’t want to go forward,” said Rhonnie Jaus, a sex crimes prosecutor in Brooklyn. “We’ve heard some of our victims have been thrown out of schools, that the person is shunned from the synagogue. There’s a lot of pressure.” http://www.nytimes.com/2012/05/10/nyregion/ultra-orthodox-jews-shun-their-own-for-reporting-child-sexual-abuse.html

Dr. Phil “My Husband, My Kids and My Multiple Personalities” May 10, 2012

Tracy is a married mother of four who says her life was forever changed the day she was diagnosed with dissociative identity disorder, more commonly known as multiple personality disorder. She says she has five personalities, or “alters:” Emily, a frightened 5-year-old child; Becky, who cuts, bruises, chokes and has threatened to kill Tracy; Susie, an innocent 10-year-old child; Samantha, “the CEO” and Miss Anne, “the caretaker.” Tracy says that she’ll oftentimes black out when an alter takes over and that the transition back to being Tracy can make her physically ill. Joined by her husband, Tyler, the couple says Tracy’s alter egos and unpredictable moods are causing strain on their marriage, and they’re struggling to explain her erratic behavior to their children. Is Tracy’s diagnosis real?

Then, in a Dr. Phil first, Tracy transitions between her alters onstage. Speaking as Becky and Susie, can Dr. Phil gather insight into Tracy’s disorder? Tracy’s therapist, Dr. Peggy Avent, joins the show and explains her diagnosis. Could a secret from Tracy’s childhood hold the key to understanding her illness? Tracy’s mom, Sandy, weighs in and shares why she blames herself. http://drphil.com/shows/show/1846/

Information on Dissociative Identity Disorder 

http://childabusewiki.org/index.php?title=Dissociative_Identity_Disorder

Dissociative identity disorder (formerly called Multiple Personality Disorder or MPD)

copied with permission

Dissociative identity disorder (formerly called Multiple Personality Disorder or MPD) is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one’s behavior. The patient has an inability to recall personal information. The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance.[1]

DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. The reports of patients with DID are often validated by objective evidence.[1]

Physical evidence may include variations in physiological functions in different identity states, including differences in vision, levels of pain tolerance, symptoms of asthma, the response of blood glucose to insulin and sensitivity to allergens. Other physical findings may include scars from physical abuse or self-inflicted injuries, headaches or migraines, asthma and irritable bowel syndrome.[1]

DID is found in a variety of cultures around the world. It is diagnosed three to nine times more often in adult females than males. Females average 15 or more identities, males eight identities. The sharp rise in the reported cases of DID in the U.S. may be due the greater awareness of DID’s diagnosis, which has caused an increased identification of those that were previously undiagnosed.[1]

The average time period from DID’s first presentation of symptoms to its diagnosis is six to seven years. DID may become less manifest as patients reach past their late 40’s, but it can reemerge during stress, trauma or substance abuse. It is suggested in several studies that DID is more likely to occur with first-degree biological relatives of people that already have DID, than in the regular population.[1]

Symptomatology

Individuals diagnosed with DID demonstrate a variety of symptoms with wide fluctuations across time; functioning can vary from severe impairment in daily functioning to normal or high abilities.[2]

Patients may experience an extremely broad array of other symptoms that resemble epilepsy, schizophrenia, anxiety disorders, mood disorders, post traumatic stress disorder, personality disorders, and eating disorders.[2]

Causes

The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents,[3] insufficient childhood nurturing, and an innate ability to dissociate memories or experiences from consciousness.[2] Prolonged child abuse is frequently a factor, with a very high percentage of patients reporting documented abuse[4] often confirmed by objective evidence.[1] The Diagnostic and Statistical Manual of Mental Disorders states that patients with DID often report having a history of severe physical and sexual abuse. The reports of patients suffering from DID are “often confirmed by objective evidence,” and the DSM notes that the abusers in those situations may be inclined to “deny or distort” these acts.[1] Research has consistently shown that DID is characterized by reports of extensive childhood trauma, usually child abuse.[5][6][7] Dissociation is recognized as a symptomatic presentation in response to psychological trauma, extreme emotional stress, and in association with emotional dysregulation and borderline personality disorder.[8] A study of 12 murderers established the connection between early severe abuse and DID[9].

DSM inclusion

DID meets all of the guidelines for inclusion in the DSM and is supported by taxometric research.[10] Research has established DID as a valid diagnosis.[10] In one study, DID was found to be a genuine disorder with a constant set of core features.[11]
History

The 19th century saw a number of reported cases of multiple personalities which Rieber estimated would be close to 100.[12]

By the late 19th century there was a general realization that emotionally traumatic experiences could cause long-term disorders which may manifest with a variety of symptoms.[13] Between 1880 and 1920, many great international medical conferences devoted a lot of time to sessions on dissociation.[14]

Starting in about 1927, there was a large increase in the number of reported cases of schizophrenia, which was matched by an equally large decrease in the number of multiple personality reports.[14] Bleuler also included multiple personality in his category of schizophrenia. It was found in the 1980s that MPD patients are often misdiagnosed as suffering from schizophrenia.[14] Multiple personality disorder began to emerge as a separate disorder in the 1970s when an initially small number of clinicians worked to re-establish MPD as a legitimate diagnosis.[14]
Physiological Evidence

Physiological evidence has provided additional evidence to back the existence of DID. One review of the literature found “physiologic and ocular differences across alter personalities.” [15]. Additional studies have been found showing optical differences in DID cases.[16][17] One study found that “eight of the nine MPD subjects consistently manifested physiologically distinct alter personality states.”[18]. Other reviews have found additional physiological differences[19]. Brain mapping has also found physiological differences in alternate personalities[20]. A variety of psychiatric rating scales found that multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction[21].

DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. The reports of patients with DID are often validated by objective evidence.[1]

Physical evidence may include variations in physiological functions in different identity states, including differences in vision, levels of pain tolerance, symptoms of asthma, the response of blood glucose to insulin and sensitivity to allergens. Other physical findings may include scars from physical abuse or self-inflicted injuries, headaches or migraines, asthma and irritable bowel syndrome.[1]

DID is found in a variety of cultures around the world. It is diagnosed three to nine times more often in adult females than males. Females average 15 or more identities, males eight identities. The sharp rise in the reported cases of DID in the U.S. may be due the greater awareness of DID’s diagnosis, which has caused an increased identification of those that were previously undiagnosed.[1]

The average time period from DID’s first presentation of symptoms to its diagnosis is six to seven years. DID may become less manifest as patients reach past their late 40’s, but it can reemerge during stress, trauma or substance abuse. It is suggested in several studies that DID is more likely to occur with first-degree biological relatives of people that already have DID, than in the regular population.[1]

Symptomatology

Individuals diagnosed with DID demonstrate a variety of symptoms with wide fluctuations across time; functioning can vary from severe impairment in daily functioning to normal or high abilities.[2]

Patients may experience an extremely broad array of other symptoms that resemble epilepsy, schizophrenia, anxiety disorders, mood disorders, post traumatic stress disorder, personality disorders, and eating disorders.[2]
Causes

The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents,[3] insufficient childhood nurturing, and an innate ability to dissociate memories or experiences from consciousness.[2] Prolonged child abuse is frequently a factor, with a very high percentage of patients reporting documented abuse[4] often confirmed by objective evidence.[1] The Diagnostic and Statistical Manual of Mental Disorders states that patients with DID often report having a history of severe physical and sexual abuse. The reports of patients suffering from DID are “often confirmed by objective evidence,” and the DSM notes that the abusers in those situations may be inclined to “deny or distort” these acts.[1] Research has consistently shown that DID is characterized by reports of extensive childhood trauma, usually child abuse.[5][6][7] Dissociation is recognized as a symptomatic presentation in response to psychological trauma, extreme emotional stress, and in association with emotional dysregulation and borderline personality disorder.[8] A study of 12 murderers established the connection between early severe abuse and DID[9].
DSM inclusion

DID meets all of the guidelines for inclusion in the DSM and is supported by taxometric research.[10] Research has established DID as a valid diagnosis.[10] In one study, DID was found to be a genuine disorder with a constant set of core features.[11]
History

The 19th century saw a number of reported cases of multiple personalities which Rieber estimated would be close to 100.[12]

By the late 19th century there was a general realization that emotionally traumatic experiences could cause long-term disorders which may manifest with a variety of symptoms.[13] Between 1880 and 1920, many great international medical conferences devoted a lot of time to sessions on dissociation.[14]

Starting in about 1927, there was a large increase in the number of reported cases of schizophrenia, which was matched by an equally large decrease in the number of multiple personality reports.[14] Bleuler also included multiple personality in his category of schizophrenia. It was found in the 1980s that MPD patients are often misdiagnosed as suffering from schizophrenia.[14] Multiple personality disorder began to emerge as a separate disorder in the 1970s when an initially small number of clinicians worked to re-establish MPD as a legitimate diagnosis.[14]
Physiological Evidence

Physiological evidence has provided additional evidence to back the existence of DID. One review of the literature found “physiologic and ocular differences across alter personalities.” [15]. Additional studies have been found showing optical differences in DID cases.[16][17] One study found that “eight of the nine MPD subjects consistently manifested physiologically distinct alter personality states.”[18]. Other reviews have found additional physiological differences[19]. Brain mapping has also found physiological differences in alternate personalities[20]. A variety of psychiatric rating scales found that multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction[21].

References

1. American Psychiatric Association (2000-06).Diagnostic and Statistical Manual of Mental Disorders DSM-IV TR (Text Revision). Arlington, VA, USA: American Psychiatric Publishing, Inc..  http://books.google.com/books?id=3SQrtpnHb9MC&pg=PA527&lpg=PA535&sig=25ML_7zbvvLZl6ySYCF4DomqeRU DOI:10.1176/appi.books.9780890423349. ISBN 978-0890420249.

2. Dissociative Identity Disorder, doctor’s reference. Merck.com (2005-11-01).  http://www.merck.com/mmpe/sec15/ch197/ch197e.html

3. Pearson, M.L. (1997). Childhood trauma, adult trauma, and dissociation (PDF). Dissociation 10 (1): 58–62
https://scholarsbank.uoregon.edu/xmlui/handle/1794/1837

4.  Kluft, RP (2003). Current Issues in Dissociative Identity Disorder (PDF). Bridging Eastern and Western Psychiatry 1 (1): 71–87.

5.  Putnam FW, Guroff JJ, Silberman EK, Barban L, Post RM (June 1986). “The clinical phenomenology of multiple personality disorder: review of 100 recent cases”. J Clin Psychiatry 47 (6): 285–93. PMID 3711025. http://www.ncbi.nlm.nih.gov/pubmed/3711025?dopt=Abstract

6.  Ross CA, Miller SD, Bjornson L, Reagor P, Fraser GA, Anderson G (March 1991). “Abuse histories in 102 cases of multiple personality disorder”. Can J Psychiatry 36 (2): 97–101. PMID 2044042.”The patients reported high rates of childhood trauma: 90.2% had been sexually abused, 82.4% physically abused, and 95.1% subjected to one or both forms of child abuse….Multiple personality disorder appears to be a response to chronic trauma originating during a vulnerable period in childhood.” http://www.ncbi.nlm.nih.gov/pubmed/2044042?dopt=Abstract

7.  Boon S, Draijer N (March 1993). Multiple personality disorder in The Netherlands: a clinical investigation of 71 patients. Am J Psychiatry 150 (3): 489–94. PMID 8434668.”A history of childhood physical and/or sexual abuse was reported by 94.4% of the subjects, and 80.6% met criteria for posttraumatic stress disorder….Patients with multiple personality disorder have a stable set of core symptoms throughout North America as well as in Europe.” http://www.ncbi.nlm.nih.gov/pubmed/8434668?dopt=Abstract

8. Marmer S, Fink D (1994). “Rethinking the comparison of Borderline Personality Disorder and multiple personality disorder”. Psychiatr Clin North Am 17 (4): 743–71. PMID 7877901. http://www.ncbi.nlm.nih.gov/pubmed/7877901?dopt=Abstract

9.  Lewis, D., Yeager, C., Swica, Y., Pincus, J. and Lewis, M. (1997). Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder. Am J Psychiatry, 154(12):1703-10. “Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases. CONCLUSIONS: This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder.”

10. Gleaves, D.H.; May MC, Cardeña E (2001) An examination of the diagnostic validity of dissociative identity disorder. 21(4) 577-608 http://leadershipcouncil.org/docs/gleaves2001.pdf

11.  Ross, C.; Norton, G. & Fraser, G. (1989). Evidence against the iatrogenesis of multiple personality disorder (PDF). Dissociation 2 (2): 61–65.
https://scholarsbank.uoregon.edu/xmlui/handle/1794/1424

12.  Rieber RW (2002). “The duality of the brain and the multiplicity of minds: can you have it both ways?”. History of psychiatry 13 (49 Pt 1): 3–17. DOI:10.1177/0957154X0201304901. PMID 12094818.  http://www.ncbi.nlm.nih.gov/pubmed/12094818?dopt=Abstract

13.  Borch-Jacobsen M, Brick D (2000). “How to predict the past: from trauma to repression”. History of Psychiatry 11: 15–35. DOI:10.1177/0957154X0001104102.

14. Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press, 351. ISBN 0-89862-177-1.

15 Birnbaum MH, Thomann K. Visual function in multiple personality disorder. J Am Optom Assoc. 1996 Jun;67(6):327-34 “BACKGROUND: Multiple personality disorder (MPD) is characterized by the existence of two or more personality states that recurrently exchange control over the behavior of the individual. Numerous reports indicate physiological differences, including significant differences in ocular and visual function, across alter personality states in MPD. METHODS: The existing literature was reviewed to provide an overview of the nature and characteristics of MPD, with emphasis on reported physiologic and ocular differences across alter personalities. In addition, a case is reported of an MPD patient seen over a 3-year period. RESULTS: Physiologic differences across alter personality states in MPD include differences in dominant handedness, response to the same medication, allergic sensitivities, autonomic and endocrine function, EEG, VEP, and regional cerebral blood flow. Differences in visual function include variability in visual acuity, refraction, oculomotor status, visual field, color vision, corneal curvature, pupil size, and intraocular pressure in the various personality states of MPD subjects as compared to single personality controls. CONCLUSIONS: The possibility of MPDs should be considered in patients who demonstrate unusual variability in ocular and visual findings, particularly with a positive psychiatric history. The existence of visual and other physiologic differences across alter personalities in MPD offers a unique potential for the study of mind-body relationships.” http://www.ncbi.nlm.nih.gov/pubmed/8888853

16 Miller SD. Optical differences in cases of multiple personality disorder. J Nerv Ment Dis. 1989 Aug;177(8):480-6 “MPD subjects had significantly more variability in visual functioning across alter personalities than did control subjects.” http://www.ncbi.nlm.nih.gov/pubmed/2760599

17 Miller SD, Blackburn T, Scholes G, White GL, Mamalis N. Optical differences in multiple personality disorder. A second look. J Nerv Ment Dis. 1991 Mar;179(3):132-5. “In the present study, data from 20 patients diagnosed with MPD and 20 control subjects role playing MPD were analyzed for statistical and clinical significance. The findings from the present study appear to confirm results from the earlier study that individuals with MPD experience differences in some aspects of visual functioning between alter personalities. The results further confirm that MPD subjects experience more differences across visual measures than control subjects simulating the disorder.” http://www.ncbi.nlm.nih.gov/pubmed/1997659

18 Putnam FW, Zahn TP, Post RM. Psychiatry Res. 1990 Mar;31(3):251-60.Differential autonomic nervous system activity in multiple personality disorder. “Numerous clinical reports suggest that these alter personality states exhibit distinct physiological differences. We investigated differential autonomic nervous system (ANS) activity across nine subjects with MPD and five controls, who produced “alter” personality states by simulation and by hypnosis or deep relaxation. Eight of the nine MPD subjects consistently manifested physiologically distinct alter personality states.” http://www.ncbi.nlm.nih.gov/pubmed/2333357

19 Miller SD, Triggiano PJ. The psychophysiological investigation of multiple personality disorder: review and update. Am J Clin Hypn. 1992 Jul;35(1):47-61. “psychophysiologic differences reported in the literature include changes in cerebral electrical activity, cerebral blood flow, galvanic skin response, skin temperature, event-related potentials, neuroendocrine profiles, thyroid function, response to medication, perception, visual functioning, visual evoked potentials, and in voice, posture, and motor behavior.” http://www.ncbi.nlm.nih.gov/pubmed/1442640

20 Hughes JR, Kuhlman DT, Fichtner CG, Gruenfeld MJ. Brain mapping in a case of multiple personality. Clin Electroencephalogr. 1990 Oct;21(4):200-9. “Brain maps were recorded on a patient with a multiple personality disorder (10 alternate personalities). Maps were recorded with eyes open and eyes closed during 2 different sessions, 2 months apart. Maps from each alternate personality were compared to those of the basic personality “S”, some maps were similar and some were different, especially with eyes open. Findings that were replicated in the second session showed differences from 4 personalities, especially in theta and beta 2 frequencies on the left temporal and right posterior regions.” http://www.ncbi.nlm.nih.gov/pubmed/2225470

21 Coons PM, Bowman ES, Milstein V. Multiple personality disorder. A clinical investigation of 50 cases. J Nerv Ment Dis. 1988 Sep;176(9):519-27. “50 consecutive patients with DSM-III multiple personality disorder were assessed using clinical history, psychiatric interview, neurological examination, electroencephalogram, MMPI, intelligence testing, and a variety of psychiatric rating scales. Results revealed that patients with multiple personality are usually women who present with depression, suicide attempts, repeated amnesic episodes, and a history of childhood trauma, particularly sexual abuse….These data suggest that the etiology of multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction.” http://www.ncbi.nlm.nih.gov/pubmed/3418321

Bibliography

* Baer, Richard A. (2007). Switching Time: A Doctor’s Harrowing Story of Treating a Woman with 17 Personalities. [New York]: Crown. ISBN 0307382664.
* Braun, B.G. (1989). Dissociation: Vol. 2, No. 2, p. 066-069: Iatrophilia and Iatrophobia in the diagnosis and treatment of MPD (PDF). http://hdl.handle.net/1794/1425
* Brown, D; Frischholz E, Scheflin A. (1999). “Iatrogenic dissociative identity disorder – an evaluation of the scientific evidence”. The Journal of Psychiatry and Law XXVII No. 3-4 (Fall-Winter 1999): 549–637.
* Gleaves, D. (July 1996). The sociocognitive model of dissociative identity disorder: a reexamination of the evidence. Psychological Bulletin 120 (1): 42–59. DOI:10.1037/0033-2909.120.1.42. PMID 8711016. “Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted. No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.” http://psycnet.apa.org/index.cfm?fa=search.displayRecord&uid=1996-01403-003
* Goettmann, B. A.; Greaves, B. G., Coons M. P. (1994).Multiple personality and dissociation, 1791-1992: a complete bibliography. Lutherville, MD: The Sidran Press, 85. ISBN 0-9629164-5-5. http://boundless.uoregon.edu/cdm4/item_viewer.php?CISOROOT=/diss&CISOPTR=38
* Kluft, R.P. (1989). Iatrogenic creation of new alter personalities (PDF). Dissociation 2 (2): 83–91. http://hdl.handle.net/1794/1428
* Underwood, Anne. Identity Crisis – What is it like to live with 17 alternate selves? A survivor of multiple personality disorder discusses the disease and the painful integration process that made her whole. Newsweek, October 22, 2007. http://www.newsweek.com/id/57861

External links

* United States of Tara – Learn More About D.I.D. – Showtime supports the awareness for Dissociative Identity Disorder  http://www.sho.com/site/video/brightcove/series/title.do?bcpid=1847322218&bclid=5253538001&bctid=6803420001

Sex abuse victims reject Church payout offer, MPD movie

Sex abuse victims reject Church payout offer 27 Jan 11

Victims of sexual abuse at Jesuit schools in Germany said Thursday that the Catholic Church’s offer of €5,000 in compensation is too low. “This sum is not at all sufficient to compensate for the damages suffered or to signal a recognition of guilt,” leader of the Eckiger Tisch victim’s group Thomas Weiner told daily Frankfurter Rundshau.
Weiner also said he found it incomprehensible that victims already known to the Church would have to file an application to receive the payment.

On Monday Klaus Mertes, rector of Canisius College, the elite Jesuit school in Berlin at which the first allegations surfaced, told daily Berliner Zeitungthat the 205 known victims would share about €1 million in damages payments from the Jesuit order, meaning each would receive roughly €5,000….

The onslaught of sexual and physical abuse revelations within the Catholic Church began in January 2010 when it emerged that priests at Canisius committed dozens of assaults on pupils in the 1970s and 1980s. Since then more than 200 cases of such abuse at Church institutions throughout the country have emerged.
http://www.thelocal.de/society/20110127-32695.html

When the Devil Knocks  January 26, 2011 CBC News Network

Until her mid-40s, Hilary Stanton lived with big gaps in her memory that she thought were normal. Then Hilary had a breakdown, started therapy, and gradually discovered that – during those gaps in memory that she thought were so normal – other personalities (“alters”) were taking over from her….Many of the therapy sessions were videotaped to train therapists in the treatment of Dissociative Identity Disorder (formerly known as Multiple Personality Disorder). Remarkably, Hilary has given Bountiful Films permission to use these videotaped therapy sessions in a documentary – When the Devil Knocks.  (website has online film)
http://www.cbc.ca/documentaries/passionateeyeshowcase/2011/whenthedevilknocks/

movie of a woman suffering from Dissociative Identity Disorder – MPD

When the Devil Knocks is – the intimate story of a woman suffering from Dissociative Identity Disorder, formerly known as Multiple Personality. The film premieres at the 2010 Vancouver International Film Festival. http://whenthedevilknocks.com/

When the Devil Knocks is the intimate story of a woman suffering from Dissociative Identity Disorder, formerly known as Multiple Personality. Hilary Stanton gave the filmmakers unlimited access to more than 40 hours of videotapes of her psychotherapy, filmed over 10 years. The therapy tapes reveal a cast of supporting characters, “alters”, who kept Hilary alive by taking over from her during times of crisis. As Hilary says, “For years, my alters went to therapy and I wasn’t there for more than five minutes.”

Until her mid-40s, Hilary Stanton lived with big gaps in her memory that she thought were normal. Then Hilary had a breakdown, started therapy, and gradually discovered that – during those gaps in memory that she thought were so normal – other personalities (“alters”) were taking over from her. http://whenthedevilknocks.com/when-the-devil-knocks-documentary/

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