December 8, 2008
Do you feel like you can be very different people?
Do you have trouble remembering what happened through your week?
Do you have minimal memories of your childhood?
Do you feel a lot of conflict within yourself, and have unexplainable extremes in your behavior, thoughts, or attitudes?
Do you have conversations in your head, and do the voices in your head talk about you?
Read on…. This article is for you. And no, you are not crazy.
Dissociative Identity Disorder (DID), formerly known as multiple personality disorder (MPD) is an adaptive response to a very maladaptive environment. It develops in response to trauma severe enough that people can only handle the experience by mentally splitting themselves off from it. A common thought becomes, “that’s not happening to me – it’s happening to somebody else.” By forming other selves to handle traumatic situations, the person compartmentalizes the experiences and dissociates themselves from their occurrence. This allows the person to maintain a separated sense of self, safely secluded away from danger. even when their physical body is obviously forced to participate in intolerable activities.
The treatment for DID is based on reversing and repairing this splitting and separating. This amazing coping skill, once highly adaptive in traumatic situations and originally a life- and sanity-saving strategy, eventually causes great disturbances in a person’s life. Over the course of time, the depth of pain, the volume of emotionally laden memories and experiences, the constant conflict between too many opposing needs, the hidden loss of original self, and the chaos of having many separate selves all become too overwhelming to manage. The dissociative walls that once neatly separated these areas begin to crumble — complications, confusion, disarray ensues.
By this time, therapeutic treatment for dissociative disorders can be highly beneficial.
As these survivors gain safety from any ongoing abuse and any ongoing reason to dissociate, they can begin the process of healing and re-associating themselves with their parts. This occurs gradually, as they connect with the painful, emotional, intellectual, physical, and spiritual experiences that forced them to split and separate in the first place. Only as they re-learn about their traumatic history, meet the needs that went unmet at the time, find comfort for their pain, and develop a safe life without trauma, can they heal the emotional wounds that have been left unattended for so many years.
The dissociative treatment process is long and complex because of the depth of the issues involved. Typically for those with DID, the abuse occurred for years, with a wide variety of offenders, and a significant lack of comfort or assurance of safety. Pain, crisis and trauma became an “everyday normal reality” and no area of life was unaffected by such extreme trauma. Healing from this depth of injury takes time because there is so much healing to do.
If you are dissociative and you’ve carried your hidden pain within your hidden selves for too long, healing through the reconnection process is beautiful. It is not easy, but it is very much worth the effort.
Kathy Broady, LCSW
December 7, 2008
Current safety is a building block of therapy for clients who have been sexually abused.
It is a known fact that children are being abused and exploited on a daily basis by sexual predators. Any child trapped in an abusive situation will naturally continue to use trauma-based coping strategies. They need safety in order to develop healthier strategies. If children are not given safety, they often do not learn how to find it on their own, no matter how old they become. Often a childhood filled with abuse continues into a lifetime filled with abuse. Sometimes it even continues right into the next generation of children.
An important part of working with adults who have been severely abused is to check thoroughly about their current safety. People who have been severely abused as children are often still deeply tangled in abusive relationships as an adult. This comes in many different forms.
People who have not resolved their childhood trauma issues are at high risk for adult relationships full of abusive dynamics, many of which parallel their childhood abuse. These include physically or sexually violent partners, sexual compulsivity, using sex as a weapon, promiscuity, and sexual repression. Due to the power of dissociation, some people continue to be victimized by perpetrators well into adulthood.
Some people continue to act out their childhood sexual abuse, with or without their conscious awareness, by repeating the patterns of the original trauma bonds. Survivors may find that their adult relationships mimic the dynamics of the original perpetrator relationship. People might harm themselves in the same manner that they were abused, or a child who was raped by a variety of offenders might become extremely promiscuous as an adult.
Due to this reenactment process, it is not uncommon for adult survivors to be involved with prostitution, sadism, masochism, or pornography. Dissociative survivors may have whole other lives involving these activities of which they are unaware. Such involvement is not universal, but the frequency with which the issue occurs means it must be thoroughly and repeatedly checked out. It is absolutely essential that any repeated patterns of violence be addressed thoroughly in the therapy process.
Self-injury, self-induced abuse, and self-directed violence also undermine safety and stability. “Self-injury” ranges from cutting and burning, to breaking bones, to crashing cars, to refusing appropriate medication. When people are actively hurting themselves, they are undermining their healing process. However, self-harm is a very common issue in the treatment of severe sexual abuse and dissociative disorders.
No child or adult will be able to make significant progress in their emotional growth, stability, and healing if they have frequent contact with a perpetrator. The constant anxiety, extreme stress, emotional paralysis or emotional chaos, and hypervigilence of being perpetually on alert for the next abusive incident interferes with the ability to make treatment gains.
Each violent episode causes medical and emotional crises, detachment, and destabilization, so it is imperative that therapists and support people pay consistent attention to the safety of the abused person.
People of all ages need to feel safe in order to talk about and heal from abuse. Ensuring a person’s safety is the first step in the therapeutic process. It may be a very long step, but it is absolutely essential.
Kathy Broady, LCSW