Photo: mine
There are few good examples of disassociation in TV or movies, and most of those involve people who are sociopathic and homicidal. Those are the very much exceptions to those who have the more extreme form of disassociation, DID, or dissociative identity disorder (formerly known as multiple personality disorder) which will be the focus of this post. The statistics show that between %0.5 – 3 of the population is impacted by DID- which means you probably know someone with DID. Not all presentations of the disorder are the same, just like the reasons behind DID vary somewhat, mostly by degree. It’s widely accepted that severe and ongoing trauma cause DID.
https://www.mind-diagnostics.org/blog/dissociative-identity-disorder/6-must-know-dissociative-identity-disorder-statistics
To break it down, I’m going to use the example of a bank. The vault is the mind. In a ‘normal’ person (who frequently disassociates on a mundane drive home from work), memory is stored in the main body of the vault. There is nothing to keep the person from remembering things as they occur, as well as being able to recall things at will. For someone with dissociative identity disorder, the mind is more like the safety deposit boxes. They are secure and separated from the rest of the vault by a locked gate of some type, though still part of the entire vault and bank. When abuse or neglect is so severe that a young child can’t process what is happening, the mind breaks into pieces- as many as are needed- to cope with the abuse that has no sign of ending. There is generally no external support system, as most people with DID were traumatized by caregivers. There’s nowhere to go but inside. For a young child, the caretakers and people most often in their life are supposed to provide safety and security. When that is broken down by repeated and severe abuse/neglect, the child goes ‘inside’ to feel safe, creating an ‘alternate’ (or alter) who holds that pain and trauma so the ‘outside’ (or host) personality doesn’t have to remember or deal with the impact of the trauma.
The number of alters isn’t necessarily relative to the severity of the trauma. Each person is a bit different with how their system of alters works, and the biggest thing to remember is that it was a survival mechanism to help the child cope with something it didn’t really understand, and to spread out the trauma so that the mind doesn’t break. Most of the time, the host isn’t aware of the others, and there are varying degrees of awareness of others inside and how they work in the ‘system’ as a whole. The alters are consistent in their behavior, speech, preferences, etc- just like a ‘normal’ person, but with many contained in one body, and the host is clueless about the ones inside until something breaks down the barriers keeping the host unaware of the alters. Memory can be an issue for the host and the alters, depending on the communication between them and the specific purpose for the alter. Over time with therapy, there is a better understanding of both the trauma, and how each alter works, as well as the cooperation between them. The core function is self-preservation and protection- not to strike out at external people.
Most people with DID aren’t obvious. That’s also a survival mechanism. In a world that dislikes things it doesn’t relate to or understand, being ‘outed’ can be a death sentence for various relationships. It’s an invitation to be discredited or have assumptions made that simply aren’t true. The alters can also be exploited (especially younger ones). They can behave in ways that are abhorrent to the host (the one most people know publicly). They can behave in ways that aren’t developmentally in sync with the chronological age of the ‘body’, but not necessarily overtly so. Most have jobs that they are good at (and the employer gets multiple ‘minds’ for the price of one !!). Many have raised healthy kids. On the surface, and with superficial relationships, they are undetectable by design. Some may seem a bit quirky, but nothing that indicates the trauma that they had to survive by any means necessary and available to a young child who has no other ‘out’.
This is very basic information. Do you have any questions about DID ?
Tag: disassociation
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Fundamentals of Disassociation: DID
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Uneventful Few Days, Thank God.
Photo: mine
This roller coaster of emotions as I work through the therapy trauma as well as trying not to lose too much ground on the recovery front is exhausting, so having a few days without anything chaotic going on has been a welcome relief. I had a few routine semi-annual MD visits, which I never look forward to, but they went OK and the weather was cooler which minimizes driving anxiety with the dysautonomia/heat intolerance. Kidney function is a tiny bit worse but still in the same ballpark as it’s been. Parathyroid levels were still elevated, so bones are at risk (already have osteopenia), but meds were adjusted for that. It’s imperative that I don’t let my carbohydrate intake go too low in order to prevent another round of acute renal failure (already 2x in 5 years from carbs being too low). The NG tube is still responsible for roughly half of my fluid intake, so that is relieving some anxiety about fluid intake, and helps to minimize how much I have to do with one thing that is already hard. Whatever makes this easier is on the ‘approved’ list if it means keeping my kidneys functioning. The rest of the chronic stuff may or may not improve, but my kidneys will decline if I don’t keep carbs and fluids adequate.
Emotionally, it’s been a bit less mellow, but with that I am fine with letting some disassociation kick in periodically if it means keeping my brain from spinning out. I will go into the disassociation more one day, when I’m feeling less conflicted about the last 4 years… it’s been that long since beginning active discussion with ex-therapist about being one of her patients. I’m not sure how long it’s going to take to work through the betrayal and exploitation, but I do hope that day comes. I try to remember good parts, and there were some, especially early on. If I can’t remember more of those times, then I don’t want to remember any of this. I don’t like not feeling like I’m ‘here’ enough to be mindful of what is going on, and at the same time being able to ‘check out’ helps with the days when I yearn for not being here at all. I’m not suicidal… I’m exhausted, traumatized, and overwhelmed. Disassociation can be a gift, even when it also feels weird and awkward to discuss. In some ways, it’s like very deep ‘daydreaming’ that gives my mind a break from current stressors. That’s a bit simplistic, but will do for now.
It’s been 8 months since the ‘no call’ to discuss the 2nd colonoscopy prep, and since it never happened and the first prep was very noticeably way more than my stomach could hold, even though I didn’t get all of it in, I didn’t have that polyp removal scope. I was in acute severe pain for hours. It felt too physically risky. I have done preps before and was a laxative purger in the early years, as well as the 1995 relapse, so am familiar with how laxatives work. I should never have been THAT bloated or in THAT much pain with the first scope. For the GI doctors I saw, delayed gastric emptying (VERY common with eating disorders) seemed to be a foreign concept. That 2nd colonoscopy was to remove the large polyp and look for the others that were suspected based on the size of the 1.5cm one they got a photo of.
Her refusal to speak to me as she said she would and degree of apathy spoke volumes. She also tried to tell me about some apparently horrible health issues of her own (vague, cryptic, and “won’t say more because I’m concerned about your health issues”… Uh, SERIOUSLY??) which was on brand whenever she either didn’t want to talk, or had someone else more important to cater to. But, nobody close to her seems to have any clue about any medical issues, so…. ??? It all felt like a way to avoid accountability for her erratic “therapy” and undependable phone call completion rate. Even though she said she was healthy during our first call, I heard about a broken front tooth, multiple issues with a chronic leg problem, asthma, migraines, “a flu” several times (likely food poisoning- IF anything with those since she didn’t report respiratory issues, and influenza IS a respiratory virus), some respiratory infections with no contact for a month, some mystery serious thing that she didn’t have treated- discovered by a pet (which I have heard of, but that she bailed on getting it properly diagnosed was weird- and was flying all over Europe a week after this ‘thing’, so ??), COVID and long-COVID at the same time (not a thing without having COVID before the long-COVID prior to reinfection- in a town with 300 cases among 140K people- and she was one of them? Possible? Yes. Probable? Like desert property in a swamp). Each time she told me of one of her medical issues, a little more detail was added. I was a nurse for 35 years, keeping my continuing education hours up, and some stories simply do not make sense.
I doubt everything she ever said, especially looking back at patterns. New patient moving in (to her home, or another WhatsApp patient) meant radio silence and not even seeing messages for up to a week or so… she ‘shelved’ current patients who weren’t well yet for new ones who took more time, leaving those of us who were already ‘in’ “therapy” before she took on new ones she didn’t have time for . From online comments and the McClintock book, it always revolved around finding the patients who would likely pay more than those of us who were ‘shelved’ with a bit of ‘breadcrumbing’, though she’d agreed to the rates we all paid prior to starting, OR said she’d keep patients with no additional charges. And then ask for monthly money in varying amounts for her personal or adult child’s expenses (sadly, the older daughter was VERY rarely mentioned).
People with eating disorders are already pretty good at feeling worthless, and her actions reinforced that I didn’t mean anything to her, especially after going through the money I’d set aside for therapy- and she continued to ask for more with decreasing contact. The “I love you like a daughter” gives me the creeps now. In a few seconds, I went from hoping for an idea that would help get through the colonoscopy prep to feeling absolutely kicked to the curb. Reminded me of one side of the family’s narcissistic callousness. If I would have listened to anyone about the prep, it would have been her. Since then, I’ve refused to speak to her when it was convenient for her. Worthlessness confirmed. “Therapy” done, and failed. All of the bullshit terms of endearment , compliments, agreeing with a LOT- it all feels fake, and I don’t know how long that takes to work through. Writing does help, however, and I thank you who read my yammering on about this. I hope it starts to fade soon.
I’m not forcing food, but am trying to get in the minimums- though with protein I don’t see a big problem with giving my kidneys a bit of a break. I also have a lot more leg muscle and bicep muscle than 4 years ago. I don’t mind the bicep muscle but the leg muscle just looks like very pale tree trunks, so if that shrinks again, I won’t be at all upset. I’ve removed as many things as possible from the ‘forbidden list’ (as much as I can… works out fine until I try to actually eat ‘fear foods’ and think about the ‘numbers’). If I want soup for breakfast, so be it. If I want cereal for lunch, OK. If I need to get some protein in , but I’m not wanting anything edible, I toss some IsoPure Clear protein into the NG bag. I guess I’m in “whatever works” mode. Kinda like I have been since I was in my teens. It’s kept me alive this long, so I hope I still have time to get back to my baseline eating. It’s still considered restrictive, but I was stable. If I a get back to where I was prior to gaining weight on less than maintenance calories, I’ll evaluate to see if I can tolerate that weight. I don’t have to be an x-ray with skin, but enough lighter to improve mobility, pain, blood sugars, and kidney functioning (not sure about the last one being reversible). My independence depends on it. So, I’m very tired, but hanging on.
Thank you for putting up with me. And a particular thank you to whoever is reposting these posts.