Can you imagine...

You are at work in a meeting giving a presentation to your company. Let your mind absorb how you speak, your mannerisms, your responses to others, what it feels like to be in that situation.

Suddenly a secretary rushes in saying your child or other loved one has just been in a serious accident and the hospital is on the phone. How do you respond? Can you feel your pace change? Your voice? Your emotions? Allow yourself to feel that transition from in-control worker to frantic parent, sibling, or friend.

You are in the hospital with your loved one and she is okay but badly hurt. You are speaking to her at her bedside. Feel that transition...in your voice, in your pace, in your emotions.

Internal parts all represent an aspect of yourself, which is why I like the term self states. For someone with DID, all of the above happens, except there is no memory from worker, to frightened adult, to caring mother.

Maybe as you were running out of the conference room at work your boss said "Take as much time as you need. But at least take the rest of the week off." That would have been heard by frantic you rather than work you. You might call later that day or the next morning asking for time off. Your boss will write that off as you were too emotional to hear at the time.

The next time you visit the hospital, worker you is "in charge" because you just spoke to a co-worker on the phone. A hospital employee that you know by name in the "mom state" greets you by your name but you have no knowledge of that person's identity.

People with DID have constant inconsistencies but pretend. They have an internal sense of "somehow I just got here and have to figure out what's going on". That's been their life experience--missing gaps. "Oh right! How could I have forgotten? My mind was focused on something else. Sorry."

Most can't imagine what it's like constantly having memory gaps but for some with DID, it's invisible. The time gaps are dissociated too. Gee, that last four hours sure went by fast. The person may have begun reading a book and ended four hours later reading the book, but another part could have cooked dinner, done the laundry, and vacuumed. That person will not recall having done the chores but will figure she must have done it yesterday and forgot...or something along those lines. And the lack of movement forward in reading will be "I must have fallen asleep."

Life is an unknown puzzle. Each self state is unknown to the others.

Lets talk parts

Any woman might have the roles of mother, daughter, sister, manager or employee, soccer mom, and wife. A man might be policeman, baseball coach, father, son, brother, husband. Don't each of us adapt our personalities in some way depending on who we are at the moment? A man is going to act very differently at work than he is with friends in a bar. And different when he goes home to his wife. These are generally subtle shifts with some crossover for each role we have in life. And of course we remember ourselves in each role. Most of us also can relate to releasing our inner child when we are having fun. In this respect, all of us have parts. We are multiples without amnesia.

When there is a dissociative split to compartmentalize the trauma of a child being hurt by someone who loves them--and the abuse continues--so does the dissociative split. For children with DID (remember this is decided usually by age 6), the personality develops as fragmented. Many roles in the child's life become compartmentalized by amnesia, meaning the child (and later the adult) does not know of this splitting, nor the teenager, nor the adult. Some children may begin to heal when an abuser moves out of the home or is arrested. Safety is a factor for healing.

People with DID spend three to four decades of their lives (on average) before realizing they are dissociative. I can attest to this statistic since most of my clients with DID were between 35 and 45 with some younger and a few older. The survivor art shown at left is what it feels like when someone becomes aware she has DID. For me personally, as a therapist, and in witnessing survivor art and hearing other survivors' stories, this depiction "hits home". Anything leaking through the amnesia is terrifying to feel. It's not uncommon for the person to feel crazy. It doesn't help that society reinforces that message!

Two Worlds - One Face

One split might be dissociative or repressed. The definition of DID is reserved for two or more distinct identities. A child (especially an older child who no longer has access to the gift of dissociation) may repress memories of abuse. While there are varying definitions, I honor the definition that repression is the mind "storing" memories subconsciously as opposed to having an element of amnesia. It is not unknown memory, it is forgotten memory (stored in the subconscious). In my experience, when a repressed memory is uncovered, the client spontaneously remembers the event. Both repression and dissociation involve memories being drawn into the subconscious realm. And both usually result in strong feelings crossing over into consciousness to which the child has no connection.

For both repressed and dissociated childhood memories, that initial split may appear something like this: The child is aware only of the conscious world in which she is not being hurt. She exists in a state of oblivion to the abuse. The switch to "hurt self" is triggered possibly by an incestuous father's knock at the door at night or hearing footsteps near the bed. The trigger would be anything that has come to mean she is about to be hurt. Wherever abuse occurs, triggers will become connected in a child's heightened awareness. These triggers are their saving grace.

During the molestation (or beating or verbal assault), the child must do as told--submits to the caregiver's will. The survivor art shown in the previous post is a collage conceptualizing having one's will bend to another's demands. Once the child is not being harmed, she becomes everyday girl and has no memory of abuse that may have happened only seconds previously. However, she likely will have crossover fear at bedtime, if the abuse occurs at night, which might manifest as fear of the dark, not liking her bed, wanting the safe parent to sleep with her, etc.

I think we have all heard stories of daycare centers where a caregiver was molesting the children. Observant parents reported their child becoming extremely agitated or upset at being taken to the daycare. Even preverbal children have the aversion response to being left with someone who is hurting them. The child's aversion response has thankfully led to some alert parents pulling their children from such centers.

For all children, this division is survival. It might be referred to as a betrayal bond or double bind. A child does not know how to love and hate a parent at the same time.

The ultimate childhood survival mechanism

Dissociation is not a child's choice. The creation of an amnestic self is a survival mechanism of the brain. It allows a child to function in everyday life while at the same time being traumatized repeatedly. Although the child has no memory of the abuse, she may carry over into her "normal" life a strong sense of guilt, shame, secrecy, and fear which will impact her, at the very least, into her adult life.

Dissociation is often discussed as being on a continuum. All of us experience dissociation to some degree. Highway hypnosis is the most common. We drive. We zone out. We snap to and don't remember the last 10 minutes or the last few exits. Going through the spectrum is post-traumatic stress disorder (PTSD) which all victims of long-term childhood abuse are likely to develop. The extreme of the spectrum is Dissociative Identity Disorder (DID). It used to be called multiple personality disorder. Please don't let that stop you from reading further. This is where much of society has been misled and tends to be frightened.

Typically, if a child is going to develop DID, it has been decided subconsciously by age 6 and rarely after age 9. This is cited in the leading authoritative texts on dissociation by the country's experts on dissociation. Some of the books are listed as therapist resources on this blog.

For clarification, DID does not require sexual abuse specifically. It can be the coping mechanism for overwhelming physical, emotional, and/or sexual abuse. Given the inherent double bind of incest, children from incestuous families have a greater likelihood for abuse beginning at a very early age and continuing for a number of years. E. Sue Blume's "Secret Survivors" is an excellent book to learn the dynamics of incest to include victims who are dissociative.

Divided we stand

If you had been a child being molested at will by a parent or other primary caregiver, would you want to know it was happening or not? Children don't get to make that decision. Their mind does it for them.

In the previous post, the great double bind of having to live with a parent who "loves" you and whom you count on for survival and the reality that the parent is hurting you and terrifying you, is usually the first "split" for a child's sanity. The child compartmentalizes what is happening when being hurt from when she is not being hurt. (While both sexes of children are victims, the feminine will be used for references.)

This compartmentalization could be repressed, as in tucking it away for now and being able to retrieve it at a later time. There is no element of amnesia inherent in repressing a memory. It's buried. Another way a child copes with abuse (not by her conscious choice) is to compartmentalize with a wall of amnesia between hurt self and not hurt self. This is called dissociation.

The basics

I want to present this difficult topic in short concepts. What most of us already know may need to be adjusted to accommodate for modifying some assumptions or allowing for new thinking.

Father-daughter and stepfather-daughter incest is most commonly reported, with most of the remaining reports consisting of mother/stepmother-daughter/son incest. Prevalence of parental child sexual abuse is difficult to assess due to secrecy and privacy; some estimates show 20 million Americans have been victimized by parent incest as children. (Jeffrey Turner, 1996). As cited at the website for The National Center for Victims of Crime.

Educating young children about good touches and bad touches, how to stay away from strangers, how to get help from an adult, how to say "NO!" is definitely important. Unfortunately, in cases of incest, the child is not being hurt by strangers and must obey parents and other primary caregivers. Saying "No!" is usually not an option and often results in punishment to the child. A child of incest is not allowed to say no. Typically, any child being abused will be threatened with harm--or harm to a loving caregiver, sibling, or pet. Most have had their lives threatened to the point there is no doubt that grave harm will come to them and/or another loved one if they dare to tell. Children of incest are conditioned to feel unempowered, helpless, and damaged. (No one will love you if you tell.)

The most damning for children of incest is their reliance on the very person/persons who are abusing them for their survival. It sets the child up for total confusion about authority: "I love you", "I hate you". "If I don't love you, I will die." They are dependent on their parent or other primary care giver (who may be another family member) for food, shelter, warmth...all security needs...while at the same time being terrified, horrified, and repulsed by what is happening to them.

As if it weren't bad enough...

This blog is an important project for me--to share in hopes others will hear, contemplate, consider, research, reconsider. If anything you gain from this blog causes you to think differently, to make changes, to help educate others, and, most importantly, positively impact the lives of children trapped in a world of abuse and the unhealed adults of childhood sexual abuse, then I have accomplished my objective.

I will be sharing personal knowledge from my own healing as well as knowledge gained from my experience as a psychotherapist working with highly traumatized individuals. Mainly, I just want to speak from my heart and soul and reach out to others. I can't change this part of our society alone. It takes more than a village to help these children and adult survivors of insidious child abuse. I invite you to take this journey with me. It's a rough road that's been avoided for far too long.

Photo courtesy of Monica Palermo.