M is for Misophonia

I learned a new word today. I have no idea how prevalent it is with trauma survivors but am sharing it here because some of my triggers cross over from trauma. Am hoping writing of this doesn't trigger anyone, so just in case you are a survivor in early stages of healing, please use caution if you do proceed.

Since my teens, long before I knew I was a multiple or had experienced/was experiencing trauma, I was hypersensitive to gum cracking, eating noises, and things like clinking of silverware on a plate. I recall one time counting the number of times my mother said "um" while talking to me instead of hearing what she said. Flash forward from age 16 to 60 and take into account I just recently changed trauma therapists after being with one for 15 years. The new therapist told me of misophonia and suggested I google it because of the triggers I realized I still had after just having a tremendous emotional healing experience. Here is part of the definition I found from Wikipedia:

"People who have misophonia are most commonly annoyed, or even enraged, by such ordinary sounds as other people clipping their nails, brushing teeth, eating, breathing, sniffing, talking, sneezing, yawning, walking, chewing gum, laughing, snoring, whistling or coughing; certain consonants; or repetitive sounds.^[7] Some are also affected by visual stimuli, such as repetitive foot or body movements, fidgeting or any movement they might observe out of the corner of their eyes. Intense anxiety and avoidant behavior may develop, which can lead to decreased socialization."

You can also google and find a complete list. It's classified as a neurological disorder and apparently neurofeedback can help although I don't know to what extent at this point. I did read of one person where the sounds did not cause such an intense feeling after neurofeedback. Some think it's genetic. However, having been a multiple, I know my brain had to take circuitous routes for information to get from one place to another. Perhaps it routed right through where misophonia originates in the brain. Plus some trauma triggers might be mixed in with misophonia triggers but I'd have no way of knowing at this point.


Before knowing of this word just hours ago, I did/do have coping skills for it. The iPod was my gift from heaven since it was acceptable in many public places and could drown out most offensive sounds. Restaurants were places I was prone to run out of due to my fight or flight response. Others have a rage response to the sounds. When trapped with nowhere to hide from a triggering sound, such as a doctor's waiting room or airplane, I almost always have a pair of foam earplugs with me. They are inexpensive and work, but you may have to play around with the different sizes to find the ones that work for you.

There is a misophonia support group online which I just joined. What a relief not to feel alone. I had tried EMDR and another therapeutic technique called brain spotting which eliminated my one trigger for awhile but it gradually returned. I did that twice so now believe it is "hard wired" and only neurofeedback would work if anything is going to work.

If this is all that's left of my trauma, I'm a happy camper. But life would be so much more fulfilling if I found a way to reduce or eliminate the impact of misophonia. For some it can be socially debilitating. I'm hoping this post will help shed some light for others.

44° North - Explaining the Unexplicable

Apparently I've never written of this part of my healing. At least searching my blog yields no results for key words. Early in healing I had a protector who went with 44N. I had no idea what it meant at the time except that it was a brand of clothing. In 2005, my now husband and I took a trip to Italy. One of the locations I happened to find online: a gorgeous view from a bed & breakfast atop a hill in Cinque Terre. We did our own itinerary. We were able to get reservations at THE B&B whose website I'd found. The trip was booked. Before the vacation, I began to get internal messages as I always do. But I was getting 44N so loudly. Eventually I started looking up the cities we were to stay in to see what longitude and latitude they were. Milan was too far north and Tuscany too far south. Cinque Terre was 44.1° N. At first I was frightened I was going to relive some trauma when I visited. My inner wisdom assured me I'd be fine and see the answers in my photos when I returned.

Indeed, I did see things in my photos and also began to feel healing. It was Gracie who surfaced and who recently integrated into my heart in early June this year. This is the photo that most impacted me.

I hadn't noticed at the time I took the photo that the branches of the vine or olive tree formed the shape of a heart.

I'd had a previous experience with 44°N and this new experience solidified that it meant great healing. Soon my husband and I are off to Paris and Avignon for vacation. Brian had chosen Avignon which sounded perfect to me. My last post in this blog had me processing trauma constantly connected to Iran when I again got hit repeatedly with the 44N message. I immediately checked Paris which was too high. Avignon, however, is 44.0° N. I nearly fainted. Brian said it was impossible because he thought it was so much further south than Italy. Not the case.

My internal processing shifted from Iran (my early teen years) to a huge trauma that shattered my three-year-old being in Germany in 1955. I got the memory in a very detailed manner as well as how part of me split off during the trauma and escaped to 44N in France. New pictures of her showed her healed and an adult. This brings the term "parallel universe" into play. How did that happen? Is it just a story given to me that is coincidental to my travels? How did I manage to go to 44°N twice without conscious realization? And why couldn't they return to me instead of my going to them?

When this message surfaced I was driven (obsessed) to make sure I had saved all of my Polyvore sets...a project that had been more done than not. I dove in and saved every relevant set since the beginning. I also found two DVDs with Polyvore sets from four years ago, the beginning of Polyvore for me and the end of handmade collages. Within those long forgotten sets I could see that most of my programmed system began with that trauma in 1955. Rose represented something programmers wanted eliminated from my being. Her destruction was targeted and resulted in half of her remaining in the trauma as what they wanted her to be and her other half escaped as Rose. I also found a frightening set that clearly showed programming for me to self-destruct should Gracie and Rose ever reunite within me.

I then understood why there were two separate 44N locations. It was dangerous for them to have escaped together. The programming was undone early in 2011 when I had such a difficult time and had overdosed because of a perp part hidden inside despite several previous integrations. It hadn't been safe for Rose to return until that perp and his associated alters were healed. Since then Gracie integrated. It is now safe.

Sets of Rose show her closely connected to Mother Mary. In Avignon is a beautiful gold statue of Mother Mary where logic tells me I might encounter this part of me; but logic has never really worked in the past. I had no idea going to Italy what 44°N meant but, now that I do, I am so excited as are several inside who had been strongly connected to Rose before she left. Most thought she had died but some showed me in my art that they knew of the secret of her hiding and healing.

Call it what you want. The story comes from within but this is only my second European vacation and the only two I've had with Brian. So many questions to be asked of the universe. A sort of invisible miracle? Regardless, healing is healing. I'll take it however it comes to me.

This set was done in February 2009 and named Rose - Safe in a Parallel Universe. She goes with the nautilus, pink roses, and hearts. The following set shows she has emerged from the shell and is awaiting "rescue".

 

I'm looking forward to writing of the reunion when I return...if it happens while I'm there. It did take Gracie several months to make her internal presence known and seven years to integrate.

Insights about integration

So little is documented about this final phase of healing. Am sharing in hopes it might help others now or in the future. I've been stuck in collage land at Polyvore.com. I think all that knowledge that is supposed to become known following fusion (final phase of integration where the memories feel like *mine*), is coming out through images. My once system was very expressive with images the first few years. Now I'm being shown the different systems I had.

There isn't a balance of brain time yet. The reality is that the person who was me integrated into the healed adult core...as healed as one can get, I guess. Still have some issues. I know Jane came out to blog. I think the collages are coming from who was Raven because she knows most of the abuse and the system. Or maybe it's my inner wisdom taking over. Since I discovered the collage site, I zone out for 6 to 8 hours at a time. Anything that needs to be done for the house or me gets blocked out. I need time share.

Yesterday I used the following example to explain what happened. It used to be like living in a dormitory. I knew some of the people across the hall, sometimes talked to them, sometimes overheard them. Now we all live together in one room trying to get along and figure out how to agree on a schedule of whose priorities are most important so I can do my blogs and do healing energy work and still do a collage. Eventually the separateness will "gel" (I hope). Actually feels more multiple during the settling in period after integration...at least to me. After three times, guess I can say I'm experienced on the topic. *snork*

Have been sleeping 7 to 8 hours a night but am staying up later rather than going to bed earlier. Has been more like 4 to 5 a.m. rather than 2 to 3 a.m. Have to figure that one out. Then there's just how to live as only a little bit multiple. Brain processes are greatly slowed right now. Realize I'm being more open with family. Possibly the one who has felt free to speak of being DID and multiple online now has a literal voice. Not sure if that's a good thing. I do know healing is good and am grateful for the healing milestone. It's just not an instant good thing.

Am relieved to be beyond Christmas and have only slight anxiety about New Years. I do wish for a very different 2009. One that has health, fitness, more focus and a new practice with a lovely office to return to psychotherapy. Oh yes, and more moments of joy than sadness. A reasonable goal.

An extraordinary thing

An anonymous commenter on this blog inspired me to write this truth about survivors. You would expect that people having such horrific memories, nightmares, flashbacks, etc. would be traumatized (or re-traumatized) by such explicit and terrifying material. That is not the case though. When survivors remember their trauma and have the opportunity to process the emotions, they heal. They grow stronger as each new horror surfaces and the dissociated selves who held the trauma move into a place of healing and safety. To me, this is validation of the existence of DID.

I'd also like to take a moment to address the belief that people would choose to fake DID. The only people who might gain from such a charade are criminals wanting an excuse for a crime. ("Joe" killed that person, not ME.) DID is not insanity, although defense attorneys have tried to claim so. You will always get a defense attorney claiming insanity with psychiatrists supporting the claim while the prosecuting attorney proclaims the opposite with his or her own expert testimony.

Aside from that, people with DID in treatment learn that having DID is not an excuse. One body encompasses all the dissociated selves and that body is responsible for all of its actions. I taught this to children with whom I worked. They understood. An adult understands too.

If someone wanted to fake a diagnosis (for whatever reason there could possibly be beyond protection from prosecution for a crime), they would certainly choose something easier than DID. I'll use an example (a composite of several survivors). Alter Janie is 5 years old and appears as terrified with a soft spoken voice. She twirls her hair constantly and never maintains eye contact. Everytime without fail.

Lola is the promiscuous adult who recalls being "sexy" for the father beginning at age 5. She sits in a provacative position, has a husky voice, laughs in a flirting way, and cries as soon as she is asked about her feelings about the father. Corky is an 8 year old boy who loves to play. He bounds out and wants to jump up and down on the sofa (which he is not allowed to do) or play pirates. He talks endlessly about his favorite cartoon shows with barely a breath. Corky's job was to be happy no matter what was happening to the body.

Whenever any alter presents, s/he can recall exactly what we were talking about the last time they were "out". A person without DID would be hardpressed to remember who is what age and exactly what unique identifying characteristics go with each consistently over the course of regular treatment.

Lily is an adult who holds hopelessness and is extremely depressed. She also holds constant thoughts of self harm and suicide. She appears at the beginning of a session and begins to work with me when she is suddenly interrupted by another alter. (I work with whomever is there unless I know it's intentionally disruptive to certain work. Then I will set up an appointment time for that part to be heard.) The client is subject to switch frequently. At the end of the session when it's time to ask for a "safe driver", Lily appears completing the sentence where she was abruptly interrupted an hour earlier. She has no awareness there has been a blip in time and is frustrated to learn, once again, that she didn't get enough time with me.

Anyone want to volunteer to do that three times a week for several years? Actors playing someone with DID get retakes to get it right and consistent. DID would be nearly impossible to fake over a period of time. I would imagine that those on trial for crimes have plenty of time to rehearse how they will spend their very limited time with a psychiatrist and attorney to play one or two other roles.

I'm not sure how The Netherlands manages to gain funds for their wonderful research for DID, but I'm glad they do. Several researchers have done groundbreaking work which has been published in the literature recently. One study shows that at least two separate areas of brain activity in someone with DID can exist at the same time. This translates to findings that each dissociated self may have it's own blood pressure, heart rate, vision, and various other characteristics. More research is being done in this area. This is a component that someone trying to "fake" DID would not be able to imitate.

Admittedly both having and/or witnessing someone with DID noticeably switch can be disarming, bizarre, and fascinating. What we need to remember is the survivor is first and foremost a human being who dealt with tremendous trauma at the very least for several years prior to age six. The person deserves our utmost respect and understanding. For those who have some misinformed fear, unless you are threatening the survivor, no part of him or her is going to hurt you or anyone else! If you are known to the host--the survivor who has been your friend or co-worker or spouse and you have been safe in the person's life, it is highly unlikely any part will come out in fighting mode. If anything, there is likely to be a "Who are you?", in which case you can explain you are (name of survivor)'s friend.

In fact, a support person is critical to help the survivor heal. She is not going to know when some other part comes out to talk to you until co-consciousness kicks in. A helpful hint on this topic: If an alter speaks to you and you feel uncomfortable, simply say, "I need to speak to (name of survivor)." Or call the survivor's name and say you need to speak to her. That is okay. It works. Maybe not immediately but it is usally all that is needed in a non-triggering environment.

Remember that having DID is as disarming to the survivor as it is to you in the early stages of awareness and healing.

Roadblocks to healing

Let me count the ways society prevents survivors from seeking and/or getting qualified help.

The well-fed propaganda machine that tells the world that delayed memories can't be trusted and those who claim to have such absurd memories are liars or crazy. Rather than focus more on the group promoting the propaganda, I'm providing a website that can guide you through the ways the False Memory Syndrome Foundation misleads.

Wikopedia provides this as part of their definition: The FMSF coined the term false memory syndrome to describe their theory that some adults who belatedly remember instances of sexual abuse from their childhood may be mistaken about the accuracy of their memory. The term does not have wide scientific use. From this, the Foundation hypothesized that the so-called false memories may have been the result of recovered memory therapy, another term coined by the FSMF in the early 1990s.

When memories first begin to surface, survivors are inclined to jump on the internet and see what's going on. Don't we all do that for symptoms of diseases? When I did this for myself, I kept running into false memory information and how some therapists did not believe memories surfacing at a later age. Add to that information that some people trained to be therapists have another allegiance--to report people who are healing to organized pedophilia so actions can be taken to attempt to bring the healing individual "back into the fold". I was terrified to seek help, which I have mentioned before. Thankfully my fear subsided within two years to seek a qualified therapist.

Many resources that were available to those with DID ten years ago are no longer available. The FMSF has taken it's toll. Highly respected experts have been successfully sued and many facilities to help those with DID (beyond what an outpatient therapist could provide) have been closed. I'm sure there is a statistic somewhere, but the number of survivors who actually sue their abusers is quite low. Ethical therapists working with survivors have the goal of healing--not preparing a client for legal action. Yet that is the focus of the propaganda machine.

Another roadblock to healing is the diagnosis. Why weren't there more with DID prior to the "surge" in the 70s and 80s? Mainly because of lack of training to diagnose as well as misdiagnosis of schizophrenia. Hearing voices was schizophrenia and the poor survivor was placed on very high doses of medication that impeded healing. Research is available on this misdiagnosis if you care to research. The latest new diagnosis for DID is Bipolar Disorder. It definitely can appear that a survivor is bipolar because they embody the extreme of every possible emotion. What appears as bipolar may be switching. In addition, there is a higher reimbursement from insurance companies for a diagnosis of bipolar versus DID. An easy to administer screening for level of dissociation is available but not widely used among the greater medical/psychological community.

In the same light, a diagnosis of DID warrants fewer sessions per year typically by insurance over a diagnosis of major depression. Healing from DID initially may require outpatient visits 2-3 times a week and possible hospitalization for survivors who require more than outpatient care. Nationally, there is a lack of education for hospital staff, including psychologists and psychiatrists, who acknowledge or are aware of DID. Because of the reduction of facilities nationally to less than five, that is rarely an option. Medications have limited impact on DID. Other than anxiety and depression, medication doesn't help. Some very small dosages of some potent antipsychotic medications can help stabilize someone with frequent switching, but too few psychiatrists are knowledgeable in such information.

Another Catch 22 to having been abused as a young child to the point of DID, is survivors are as likely as not to have a past history of hospitalizations, emotional turmoil, erratic behavior, and long-term therapy, all of which create a "witness lacking credibility". The pedophiles win no matter what. By virtue of the abuse, they create a human being whose testimony is likely to be dismissed by the U.S. judicial system.

While a war wages on memories of survivors (which only serves to invalidate a survivor's healing), a war has already successfully been waged in the insurance realm. Trying to gain approval for a survivor to gain appropriate care for DID is a nightmare, to say the least.

This is how society treats those children who were horrifically and sadistically abused by sophisticated pedophiles and who managed to survive through DID. How can this be? What is that saying about when good people do nothing? If you didn't know before, and you are a good person, please spread the word. Speaking out--taking this out of the realm of secrecy--is a good first goal.

From internal chaos to cooperation

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.

High school project earns "A" on DID

This video was a high school project nicely done by teenager. She earned an "A".





A wonderful video reflecting hope and healing from DID.

Child promiscuity...or a cry for help?

Children are not born promiscuous. They learn from someone. A young child asking if she can touch grandpa's penis would be a clue--not necessarily that grandpa was a perp, but children often "tell" by acting out. This becomes extremely complex if the child has begun to dissociate or, worse, is already dissociated into defined parts cloaked in amnesia.

There is a crossover of emotions, triggers, and behaviors from the unconscious to which the child has no conscious knowledge. A child, when asked about where a behavior was learned, may truly not know--have no conscious connection. Aside from repeated threats (covert and overt) to maintain silence regarding abuse, a child may innocently repeat a behavior that crosses over. Sometimes, these may be our only clues.

When a child is a preteen or teenager, their unspoken actions can be easily misinterpreted. This is basically what happens for a developing child of long-term abuse. Although not all child abusers are male, the majority are. When the main perp or perps in a child's life are male, and the child is dissociative, the child becomes conditioned to "switching" to an identity who handles the abuse. The male is in close proximity to the child, the child knows he expects her to respond sexually or she expects to be hurt sexually. Compliance becomes the only alternative. The normal fight or flight response is squelched in alters with the job of enduring repeated assaults.

One of my first clients with DID was a 12 year old girl whose father had been convicted of molesting her admittedly for "several years." This lovely girl was so sweet, wanting only to please. Before her first appointment her mother was frantic because she had sex with a boy. My client had conscious memory up to the point where the boy had touched her and said something of a sexual nature. No pressure was needed. She simply blanked out. She recalls "waking up" after it was over feeling ashamed and confused. The adult response is typically to pile more shame on the child.

A teen may consciously act out as well. "Acting out" can be a dissociative child's way of saying "Look what someone did to me." The child does not realize that is what she is "saying" with her actions. The result is she receives attention from the boys which serves as filling her need for lack of "love" at home (or believes she is receiving "love"). She is drawn to it. Any further shame placed on her by parental response, teacher response, community response, further reinforces the perpetrator's messages that she is a good girl for engaging in sexual activities and simultaneously a "bad girl" for participating in sexual activities (a no win situation for the victim).

The 12 year old was in therapy less than two years and was able to heal from the majority of her dissociation. She will very likely require further therapy to have any healthy relationship later in her life. An excellent source to learn more on this topic is the book, The Dissociative Child.

Falling apart is beginning to heal

Often the individual realizing they are not alone internally says it feels as if she is being sucked into a black hole or falling into an endless pit. The good news is that DID is highly treatable.

Regardless of age, when someone with DID begins to become aware of their dissociation, the typical response is fear and confusion. Noticing the gaps in time; having friends tell you that you behaved "totally out of character" in a recent situation; people claiming they know you from a party or business function and having no memory of the event. The most frightening, in my opinion, are fugue states. I had clients who routinely found themselves in their car miles from home in an unidentified parking lot. Or "someone" went shopping and the person has no memory of the drive or any part of the shopping spree. It's crazy making stuff.

Then what happens? Hopefully the person will seek a therapist experienced in treating DID. That is not so easy. Far too few doctors and mental health professionals acknowledge DID, possibly because it's too complicated and time-consuming to understand, let alone treat. Add to that the propaganda that multiples are fakers and therapists worldwide implant similar memories of childhood abuse into their clients. I would ask, "to what end?" WHY would an ethical therapist even want to implant a memory? If the client is there, she already has issues. I wish someone would answer that question.

If you are a survivor seeking a therapist, a good resource is the ISST-D website where you can look up a therapist by state. Another strategy is to call a number of therapists in your area and ask if they can refer you to someone who treats dissociation. The therapist with the most recommendations is a good start.

To the outside world...

To the outside world, someone who has DID and is not in any stage of healing, may only appear as possibly having mood swings. No one in my life, including a therapist I saw on and off for many years for relationship issues, knew I had DID. My life until the fourth decade was only my conscious memories...a sporadic history of being in school and workplaces and a spattering of childhood memories with no abuse worse than unwarranted physical abuse by my scary father. I was the little girl with gold stars in kindergarten, an honor student in high school and college. I was the good girl, the good employee. Always did as told.

Someone who has never noticeably switched (changed from one self state to another) may begin to do so in the work environment or to family causing fear among loved ones and co-workers. It is disarming to say the least. Especially when another self state is a young child. I would venture to say that most multiples surround themselves with stuffed animals or dolls or coloring books without realizing they are filling the needs of the desire for such toys from within. Often the dissociated self state will have it's own age, personality, and name. Understand this is simply one aspect of the same person which became isolated in trauma.

Admittedly, it is very difficult to be a support person in the life of someone who has DID. Yet it is the one element they most need. Although it looks crazy, it is not. It is a complex survival skill adapted during childhood trauma that made perfect sense at the time. Coming undone at an adult age brings challenges for the survivor, the medical, and mental health community.

The photo of the Nautilus shell is a perfect image of multiplicity to me. It is a beautiful shell (an amazing entity) with many hidden chambers inside supporting the whole.

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.

Highway hypnosis

Nearly everyone who drives experiences some highway hypnosis as mentioned in an earlier post. This might include blanking out for a few exits or "waking up" long past your exit or after a lengthy (more than 10 minutes) period of time.

So when you are "zoned out", who is driving the car? What happens that you are still driving safely, haven't run off the road, been in an accident. You aren't consciously there.

What scenery can you identify from the time you blank out until you "wake up"? You won't remember because it is not your memory. The aspect of you who drove holds that memory. We all have a safe driver somewhere inside who takes over at those times, thank goodness. Do you believe you must also have a homicidal part because you experienced a dissociated state of a driving part? Are you afraid to share your experience with friends or family? Generally highway hypnosis is an open topic. We all do it so it's acceptable even though it is experiencing a dissociative state.

So why is it that someone who dissociates because of long-term childhood abuse is feared and dismissed and devalued as a human being by society? Just something to think about.

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.