Children who have DID grow up as the most wounded of the wounded. Yet, because of their unchosen coping mechanism in childhood, their coming out of that state of amnesia can appear as anything from sudden mood changes to not even visible to anyone except one trusted support person. It is rare that a person becomes an ever switching person, going from alter to alter. Most can relate multiple personalities to the movie Sybil. While Sybil's story was an accurate depiction, it condensed years of treatment into a two hour movie. A few things I'd like to clarify about people with DID.
Switching (changing from one dissociated state to another and/or from consciousness to a dissociated state)
Prior to a survivor entering treatment with a therapist, it is possible others may have never noticed. It is generally with a safe person that a person with DID may begin to have dissociated parts come forward. Generally, when a survivor "switches" (think of changing the channel on a television), something has just been said, heard, or seen that triggers the dissociated self out. People who switch frequently are the exception. Someone who is triggered, however, may begin to switch suddenly and rapidly until the PTSD level of adrenaline calms down.
How many do you have?
Dissociated self states (a/k/a alters, parts, ego states) develop differently in each individual with that coping mechanism. Numbers are irrelevant. If a child has one self state who takes over when the host child is angry, that one self state may have that job for the entire life until healed. In another person, their mind might create a new dissociated self state for each trauma memory. Often several self states recall a single trauma but healing would still be the same. Yet another child may create anger self states at various ages. It is not uncommon to find the name of one self state at various ages. In addition to being irrelevant, someone with DID really doesn't know how many are inside. They only know what they know. In other words, DID has the component of amnesia. A person may be substantially healed but find themselves still occasionally working with a self state that surfaces.
I've been using the terms self states, dissociated states, dissociated selves, alters, and parts interchangeably. The literature is not consistent and some argue that there are distinctions among terms. As a therapist, I always asked my client his or her preference for a term. And that's what I used. Sometimes a little humor added to a very serious topic can help give the reader time to catch his or her breath. In that vein, to quote a certain fast food commercial from about 20 years ago, "Parts is parts." At least for purposes of this very broad explanation of a very complex process, the terms are interchangeable. Someone who has DID as the result of a main caretaker (and possibly one or two other family or relationship perps) is going to have less internal turmoil than someone abused from a very early age by many to intentionally induce dissociation. The process of healing alters is the same with some added complexity. But it can be done with a dedicated therapist and a survivor committed to healing.
As for the survivor, coming to terms with having DID can be daunting. While some find it easy to embrace that all parts of themselves did their best to help her survive, others fight it with denial which tends to cause more disruption. For people who have successfully healed, there has been a slow and steady journey of creating an internal world of cooperation and safety. Once that is established, identifying and working with new self states becomes mostly a pattern of allowing the part to speak and to be acknowledged—and especially to see that there is no punishment for telling or crying. Since most parts are dissociated from each other inside, each needs to hear the same messages of current safety. Sometimes, there are families of alters or pairs or groups. In my experience they also heal as a group.
It is important to know that most with DID have the capacity to heal and develop strong coping skills over time to stay present (not switch) and work with assistance from inside rather than alters having to take over externally. There are various phases to healing. I prefer not to label them because I’ve learned even those are different for everyone. The goal is to be functioning to where the survivor is back in control of his or her life rather than having dissociated selves disrupt existence.
Whether at the hands of one or many, the emotional impact is very damaging. Some of the damage is healed as internal parts heal. What remains after functioning returns is learning to work as a unit in a healthy way for interacting with society and in relationships. Realize, those with DID have had different thinking processes and only have known one way to process information. It has been proven through the work of Ellert Nijenhuis and others in The Netherlands that brain connections that disconnected through the dissociative process reconnect in healing. The transformation of a healing survivor is incredibly beautiful.
Unfortunately, while healing survivors have amazing courage and would like to share with their friends and greater outside world, we learn very quickly it is a taboo topic. People would rather not hear or know, some preferring to disbelieve. We hate the people who do this to children and then silence the adults who braved the years of abuse and came through their trauma to heal. It's a very unjust world in this respect.
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