TW: a brief reference to sexual assault.
Note: Please note that throughout this article, I may switch between personal pronouns. This is on purpose, which will hopefully be explained by the article’s topic (Dissociative Identity Disorder). Typically, ‘I’ describes a specific alter, whereas ‘we’ is used for our collective system in this shared body. A glossary of terms used is at the end of this article.
At the ripe old age of 23, we have had at least ten therapists. Living with DID is a challenge. But, living in a society that doesn’t understand DID or even believe in systems is near impossible. DID, as I constantly reiterate, is a complex childhood trauma disorder and isn’t something treated with medication alone, as that only helps the comorbid conditions. Therapy is the crux of managing DID, processing trauma, and starting to live again.
Our first therapy experience was with a therapist called Joy. It was long before we had our DID diagnosis or before we even knew what DID was. Indeed, at the time, we didn’t even really recognise we had trauma, thanks both to dissociative amnesia and the internal normalisation of our experiences. Everyone was treated the same in our world: being afraid to go home at the end of the school day or fearing you wouldn’t be alone in bed that night was standard. Deep down, we recognised this as denial, but when the perpetrator of abuse sat next to us in every session, how could we think that they were anything other than ‘good’?
We spent most of that therapy time discussing what we know now as our inner world. This was because it was 2015, so our obsession with Inside Out had just begun! At the time, this was curious, as a teenager who lived and breathed Inside Out (ultimately a younger kid’s film, despite its wide reception) and had no other way of relating to the world was unusual. And now we wonder what the early signs of our DID were… Far from artists, we spent time drawing the places in our brain (I remember ‘the library’ and ‘the big house’, both of which have become significant with our discovered traumas and DID), trying to pin down our ‘core memories’, and talking about the ‘personified emotions’ (read: alters!) Yet, ultimately, we were discharged due to ‘not making progress’. As we often say, you’ll never live up to expectations when you have a therapist called Joy!
That discharge marked the first of many therapists and other health professionals who dismissed, disbelieved, or discharged us. Whether the slightly suspicious hypnotherapist, the school counsellor who didn’t utter a word (not even a ‘how are you?’ to open the session), or my penultimate therapist who left me needing therapy, the therapeutic hasn’t always been a pleasant one.
That is until I met my current therapist, Britney (a pseudonym for obvious reasons, although chosen for her impeccable taste in music and because saying ‘my therapist, Cher’ would confuse and cause some worry for our mental state!) After years of ineffectual and often harmful therapeutic interventions, we finally decided to interview therapists. A word of advice from us: please interview the therapists you are considering because you cannot get the full sense of a person until you have a conversation with them. I will freely admit that what swung the connection was her wearing a Guns N’ Roses t-shirt to our initial session, which feels apt when therapy certainly feels like it should be accompanied by the opening to ‘Welcome to the Jungle’ at times…
Then, the tough work began. From a fearful, newly discovered system of eight members who would only allow the then-host to go to therapy, to the slightly chaotic band of 85 who cannot predict who will turn up, our confidence in the therapy (Zoom) room has grown. We have learnt that therapy isn’t just the structured interventions or ‘coping skills’ or even ‘trauma processing’. Therapy is safety. We do Gestalt psychotherapy, a fancy word for turning up to therapy with what is going on for us in the present moment. Some days, that’s a traumatic memory; other days, the latest stresses of an Oxford degree; and most days littles showing off our multitude of stuffed animals. The therapy happens in the relationship: everyone says it, but we now know it’s true and more than just a cliche. It’s the safety that no matter what is happening that week we can press ‘join meeting’ and be met with Britney’s comforting smile; it’s the routine of knowing that twice a week we will have somewhere to offload; it’s her dogs barking in the background; it’s the occasional meme shared between us; it’s the ability to swear like a trooper for 50 minutes and not be judged; it’s the messages of pride when we share an achievement, reminding us therapy isn’t just about the losses; it’s the 3-year long relationship that isn’t ending anytime soon (sorry, Britney!) and never feeling like I am going to be got rid of again.
It is this last aspect of safety I wish to stress: therapy for someone with DID doesn’t necessarily ‘end’. It is a chronic condition, and no matter which end goal you choose- final fusion, functional multiplicity, or something else- the road is long and exhausting. We think we can never recover from the trauma that caused our DID, but we can heal. However, you certainly cannot heal in your 12 sessions of NHS-prescribed CBT to deal with your ‘anxiety’ or your year of NHS-prescribed DBT (if you’re lucky), where you risk being turfed away again if you break their arbitrary rules about what makes progress.
And so, I shall leave you with the lines from a poem I once played on repeat as a teenager, the one from which this article takes its name. ‘Did the therapy work?’ is a question far too often asked of me, especially by my psychiatrist, who cannot fathom that my therapist is doing her job amazingly if she needs more than 3 years to ‘cure me’!
My response? ‘The therapy worked for me in the sense that it did its job. But its job was never to cure me. This is going to be a bit of a journey. One that requires me to land tricks unexpectedly and sometimes I’m gonna land them and sometimes I’m gonna land on my knees. And I need you to know that this struggle is not one that ends so easily because it doesn’t end, it doesn’t end, it doesn’t-’
Glossary:
DID: Dissociative Identity Disorder, previously known as Multiple Personality Disorder. A condition where a child’s brain, due to extreme and ongoing trauma throughout childhood, does not form the same way as most people, leaving a person with distinct identity parts and a level of amnesia between them.
System: the term people with DID typically use to describe themselves as a collection of alters.
Alter: a distinct identity part within the system. Others may call these parts, identity states, headmates, or simply people. Some still use the term personalities, though this is less common and can cause controversy. Alters can be different ages and genders, look different internally, use different names, and have different interests and personalities.
Host: the alter in the system who fronts most often. For some, this is the alter who identifies most with the body; some systems do not have a single host or any at all.
Dissociative amnesia: the loss of memories, skills, or knowledge triggered as a response to trauma. This goes beyond typical forgetfulness and is incredibly distressing. The person may forget basic information about themselves or end up in places or situations they do not know how they got into.
Littles: child alters, who usually are stuck at the age of trauma. When a child alter is fronting, the body has the mental capacity of that age and acts and often talks like a kid.
Final fusion: the term used by systems who aim to integrate their alters and become ‘one person’. Some fusions happen naturally, as alters resolve their individual traumas. This was previously viewed as the only treatment by psychiatric professionals.
Functional multiplicity: an alternative treatment goal, which focuses on communication between alters and allowing the system to flourish as many alters working together, without the ‘disordered’ aspects of DID.
Resources on DID:
FPP charity (legacy site) https://www.firstpersonplural.org.uk/dissociation/complex-dissociative-disorders/
@dissociation.info (Instagram)