Identifying Dissociative Identity Disorder

(for the helping professional)

Dissociation is a coping mechanism, and a very practical one for all of us at times. Who hasn't spaced out during a boring classroom lecture and found themselves staring out the window, daydreaming in another place and time? That's rather simplified but not that dissimilar. Fortunately, when we space out we generally come back completely and easily with little effort or effect on our life. For someone with a dissociation disorder it's not that simple. That's why it's called a disorder.

When a child is very young and they are severely abused they learn to cope by dissociating. Once one learns to cope that way, they continue to cope that way because that's what they know and it works for them. When someone is abused for the first time at an older age, they cope different. Someone who suffers similar abuse, only at an older age, will likely become diagnosed with post-traumatic stress disorder.

When the abuse is severe and the trauma is more then the child can handle an “alter” (or alternate personality) is created or appears and takes the abuse. This alter appears to others as a separate personality. The term “host” refers to the actual 3D person, the term “alter” refers to the various personalities that may be present or available.

Often the presence of alters is confused with the hallucinations of a schizophrenic. This is very dangerous, as it can not only lead to the D.I.D. not being treated but also can lead to dangerous medications being prescribed for the wrong diagnosis.

Anti-psychotic medications do nothing to eliminate alters. Occasionally a D.I.D. can benefit from medication for a mood disorder or anxiety on a short term basis while they are in therapy. But schizophrenia is a brain disease that can chemically be altered with antipsychotic medication. D.I.D. Is completely different and can only suffer the uncomfortable and potentially damaging side effects. This kind of medication may be used if, and only if, an alter is dangerously out of control and only until the proper therapist can be found. It does not make alters disappear, but will calm anyone. It is dangerous used in this manner and should only be used if lives are in jeopardy.

Schizophrenic hallucinations are generally vague and unconnected within the senses. Meaning, they are visual, or they are auditory, seldom both. Occasionally other senses are involved but they just don't mesh like in real life. The alters of a D.I.D. can be seen, heard, smelled, even touched by the person with the diagnosis. They are as complete to the host as the people you know in your life. They even may be older or younger then the host, they may be male or female, they may have knowledge that is very different to the knowledge of the host. They may have family systems within the alters (i.e. alters may be siblings, spouses, even families with children).

Alters may not be recognized by the professional who tries to help. Alters may speak in their own voice, a voice very different from the host, but only if they trust you. If the alter doesn't trust you, he/she may speak through the host person in the hosts voice. This can fool you into thinking the host is involved and fully knowledgeable of what is happening. They may not be aware at all but may be “dis-associating”.

Trust them if they say they don't remember an event. D.I.D.'s are often known as “chronic liars” because they dissociate and honestly don't remember. If they know they are D.I.D. And they've had some therapy they may be able to investigate and find the alter who is responsible. If they are not yet diagnosed and do not understand what has happened they may become defensive. It's quite possible they'll think you're accusing them of lying, as everyone else has in their past, and they will not handle it well. If they've never been diagnosed this is a key sign that they may be D.I.D. If this is the case you may find it advisable to wait until you find an experienced therapist to talk to about this. This is the time to confer with someone more experienced and make a referral. Even if you're a mental health professional, if you're inexperienced with D.I.D. then work side by side with an experienced professional. Depending where you work and your exact job description, you may only be expected to recognize and refer, and, of course, not make things worse. Always remain the friend or helper, but do not expect to be the primary therapist unless you're sure you know what you are doing.

Always remember that the primary mission of any alter is to protect their host. They were created for this purpose and will continue to do this whenever necessary. This is what can make a D.I.D. a danger. Often the host is someone who, by nature, isn't capable of violence towards others. Pushing them can make them violent towards themselves. Suicide is a constant concern.

Another key sign that a person could have a dissociative disorder is the “loss of time”. The host may have no knowledge at all of entire months or years of their life. Or they may have just lost a few hours now and then. That time is set aside for the memories of an alter. It is not unusual for an alter to take control of their host and go their own way now and then.

Often alters will be children. They need what all children do, nurturing. Children alters may grow up quickly as they make progress in therapy.

There are many psychiatrists in community mental health centers that will never accept the diagnosis of dissociative identity disorder. They may have been trained to believe that dissociative identity disorder was extremely rare and they can't possibly have one in their office. Plus, no one can recognize a D.I.D. in a 15 minute office visit.

If someone is not diagnosed D.I.D. and doesn't know anything about D.I.D. they may very likely not even know that they were ever abused. The alters experienced the abuse, not the host. At the time they were abused, they were far too young to handle it and survive.

Be fully prepared before you suggest the possibility they were abused. Once you've opened Pandora's Box, there is no backing out. And remember that the abuse may still be part of the host's life. If this is the case, you may cause them to be in even more danger. It is important to learn about the person's family and current living situation before upsetting the present.

An adult dissociative identity disorder may be 1) never before diagnosed, 2) diagnosed but never in treatment, 3) misdiagnosed or 4)diagnosed and in treatment. Many undiagnosed dissociative identity disorders function well for years without treatment. I know one D.I.D. who had a career and was happily married until her children were grown and out of the home. She was involved in a serious car accident and most likely that triggered the reappearance of the alters. I knew another D.I.D. who was homeless, alcoholic and struggled to make it from one day to the next. He'd been diagnosed but was told their was no treatment available. I know another who'd been misdiagnosed since the age of 4 when a pediatrician couldn't think of another reason why a 4 year old would still be nonverbal except retardation. He was later diagnosed schizophrenic when he started talking as he talked only to the alters which he could see.

One book I read, believe it or not, claimed that dissociative disorders were as common s all mood and anxiety disorders combined. I think that has to include those daydreaming in boring classrooms around the world. But, at the same time, I doubt it is the rare occurrence that so many psychiatrists seem to believe. Many D.I.D.s may be best left in the dark, not having to deal with the trauma that lay hidden in their alters. But when the hidden trauma still interferes with their quality of life, or when it surfaces after a traumatic event in adult hood, it needs to be dealt with in a humane and compassionate manner.

SEASCAT is linking with another nonprofit, Advocates for Excellence.  It will solve one part of our mission- the provision of housing for homeless adult survivors.  It's not quite ready, yet, but is a work in progress.  SEASCAT has an office now, and our first goal with be to assist Advocates for Excellence in finding funds to help pay for their rooms.  And I have set up assessment and program plans to assist with idenitfying needs of residents.  Those who fit the profile as adult survivors will also receive services from SEASCAT.

It will take time, but we are working hard to set things in place.  I will keep everyone updated and for information you are welcome to write to me at seascat@gmail.com or contact me via our website at www.seascat.org.

Also please note, if you joined the website recently you may need to join again.  An error occurred and some information was lost.  We are still learning and it shouldn't happen a 2nd time.

Thanks,
Connie J. Conklin MEd,   founder

Homelessness and the asca

As the founder of SEASCAT, I'm asking people to advocate- write letters to newspapers, politicians, mental health programs, etc. on the behalf of homeless adult survivors of child abuse.  I repeat, as I so often do, that most abuse occurs in the home and by a parent- leaving children who survive with no support network when they reach adult hood.  They also lack the skills to develop one.

Anyone who has ever moved understands that moving is stressful.  Well, homelessness is like moving- over and over and over and over again.  Sometimes we move in knowing full well it’s only temporary.  We still try to make the place livable, but when it’s someone else’s place it has to be subtle- as you’re trying to keep your host from ever finding you in the way.  They get a cleaner toilet and a roll of papertowels in their kitchen.  They DO NOT get furniture rearranged or pictures hung on the wall.  Those are things you only do if/when you know you’re there permanently.  (a few weeks count sometimes as permanent)

And you don’t acquire things of value that you will just have to put into storage.  Sure there’s a hookup for washer and dryer- but you don’t go buying things like that.  It’s hard work moving in and out of storage units every few months, and can be costly if you have to hire people to do it and a truck.

By now most people know that the mentally ill make up a far greater portion of the homeless population then they should based on their numbers in the general population.  You may think this is more about substance abuse or truly psychotic disorders who lost out when we ‘de-institutionalized’ mental health.  Well, I’m talking about adult survivors of child abuse and trauma.  And most of the ones I know are older women- in their 50s+.  I could actually name 4 I know, one of whom is about to be myself- again.

I don’t know what I’ve done to get this apartment manager to hate me so much.  But, ever since she’s been manager I’ve found myself walking on eggshells trying to avoid her.  She delights in touting me and then writing me up for my reaction.  And yes, I do react.  I don’t yell, I don’t throw things at anyone, I never, ever, ever hurt another human being and pretty much have enough control to not break things of any monetary value that I might have to replace.  But, I do self-injure.  And sometimes I just can’t get to a safe, quiet place before I do it.

I also have PTSD startle reflex.  I jump and scream when a car horn beeps, diving for the nearest ditch.

I get written up every time and threatened with eviction.  I learned long ago to only go out of my apartment at night to go to the laundryroom or check my mailbox.   The one time I went to a potluck activity with the other tenants and the manager was there- she had such delight in joking about my severe insomnia that makes it impossible for me to function much during normal hours.

The complex is 2 years old and I was one of the 1^st to move in.  I know of one schizophrenic and now two with C-PTSD who’ve been evicted from this complex which is supposed to be for elderly and disabled with HUD.  Everyone else is elderly, pretty much.

The apartment was the nicest place I ever lived.  It had central heat/air and a dishwasher.  It was soooooo very quiet and I loved that.  I loved my neighbors, too.  I had pictures on the walls, dark curtains which doubled as solar panels in the winter and were pulled back to make a bold statement against the stark white walls otherwise.  I had my computer set up and even was connected to the Internet for a few months.  I incorporated my non-profit, SEASCAT.  If I was going to still be there, I’m sure we’d have the $ for the IRS soon and get our official non-profit status so we could apply for grants and large donations.  As it is, I hope I can get the extension on our application in a timely manner and don’t lose any of our paperwork.  I have furniture, used, but I made it mine- a bed of my own where I felt safe for awhile…. My own kitchen and pots and pans and healthy food in the fridge.  Now back to peanut butter and jelly or soup kitchen food with lots of starch (filling and cheap, but not good for overweight type 2 diabetics).

I’d been living in my truck 2 years ago.  I don’t have that truck, anymore.  Even with broken windows letting in snow and rain, it was a better alternative to the ancient Toyota I have now.  I’ll barely be able to keep my medications a change of clothes and my blankets with me- and no place to spread out those blankets.

The worst part of being homeless again- each and every time- is that empty feeling of aloneness in the pit of the stomach.  And the thought that why am I bothering to stay alive for this.

The anger for the injustice eats away at me.  But worse, is the desperate feeling that I just will not survive.  Oh, I’ll make it through the summer.  But, not through another winter!  And even the summer will be hard.  I have breathing problems and use a nebulizer twice/day- worse when I’m outdoors and get out of the air on polluted days.  I use oxygen for sleep.  Heck- I don’t sleep even with a safe bed… not much…. And I fight brain fog and disorganization on the best of days.  I won’t be keeping track of my medication right, I already know it.  My blood sugar will be all over the place….. oh and cholesterol!  That’s only under control when I have a kitchen.  And I can’t go to the soup kitchen in this town, I was kicked out of there last summer- all I did was try to get a glass of water when someone in the garden got to close with a weedeater.  Oh- and my garden plot.  That’s my sanity and this year I have two plots.  They are already mostly planted- with the early spring stuff- lettuce, spinach, peas, etc.  But, if I can go to the next town over and stay closer to there- they have a soup kitchen that serves 2 meals/day 5 days/wk. and one on weekends.  Plus, they have a shower.  And no one has had any problem with me being there.  It’s kind of a safe place to be when you’re homeless- which is what every homeless person is soooooo desperately seeking.  The emptiness, the pain return at night when you try to figure out where to go- where can you park and not get picked up by police- do you take a chance and try to sleep somewhere? 

Those sleeping pills aren’t any good if you don’t have a bed to lay down on- why not just take the whole bottle and get it over with!!!  - well, that’s a constant thought and not an easy one to live with, or die with.

I have a problem with the term "personality disorder" - used to lump everyone with a personality disorder together with the same symptoms, like they're all the same- all malignant, dangerous and untreatable.  They are not.   

The key differentiating factor with Narcissists, that make them horrible as parents is the lack of empathy.  And then it's on a spectrum.  Our culture fosters 'narcissism' in the general, still functional, manner found in most Americans.   Most people think of themselves before others, most people want and expect money, fame, and possessions. (They just fall short of actively hurting others to get money, fame, and possessions.)  The far end of the spectrum is the sociopath. Those of us who end up 'here' have parents somewhere in that middle of the spectrum.  (I was motivated to write this after, again, reading posts on ACON 'adult children of narcissists' a yahoo group.)

While still being cluster 2 disorders, BPD and HPD (borderlines and histrionics) are highly dramatic and emotional- but capable of having empathy.  They may be too caught up in their own problems to show this empathy often-  but they're not going to lie and manipulate others out of pure malice or selfish greed like a narcissistic or sociopathic personality disorder. 

I've found that most people who were raised with abuse develop borderline behaviors and tendancies to some degree.... and with help and hard work can deal with these.  They want and are capable of relationships, once they've received the help they're looking for- which is the intent of most borderline behavior.... finding help.... finding someone who will listen and care. 

My Nmother was a narcissist and, as a result, I've been looking for someone all my life who is capable of caring about me, ....someone, anyone who'd notice my very existence.  For years, I fought accepting that I had borderline personality disorder because of it's negative and hopeless connotation.  When I worked in the mental health field, I found myself being sent the worst BPDs in our system to work with- because I was successful with them.   (I set clear boundaries, structure and listened well)  And I learned to recognize my own borderline behaviors- and without ever agreeing with any psychiatrist's suggestion- I knew I could fit the diagnosis.  The last psychiatrist I spent any time with (about 1999 in NM, as they've gotten hard to find these days) suggested that the diagnosis of BPD was no longer negative like it used to be.  And we discussed the possibility that I could be BPD.  He agreed that it was never written in my chart and if I didn't agree, he wouldn't write it in my chart, either.

It takes a lot of self inspection, and I mean continuously, every day- to see those behaviors in yourself and nip them before they effect another relationship another day in a life that gets shorter and shorter with every season.  But, BPDs are capable of that, narcissists generally aren't (malignant narcissists and sociopaths definitely aren't capable of change and plain old narcissists aren't generally ever that motivated).

Clusters A and C- are personality disordered whom, I'm sure, would find offense being lumped together with malignant narcissists and sociopaths. Raised by a narcissist who never cared, I found myself dependent and needy when the 1st man came along and claimed to care (Dependant Personality Disorder). I was so afraid he'd abandon me just like my Nmother did every time I really needed her that I effectively pushed him away.   Dysfunction and failure in my life resulted in avoidance of anything that could cause me pain (Avoidance Personality Disorder).

Neither APDs nor DPDs are malicious, just sad. Their behavior is meant to protect them, not hurt others. And unlike people on the spectrum of Narcissistic-Sociopathic disorders they want and can benefit from the care and concern of others.

How alone do you feel in your work towards recovery?

If you're like most adults whose childhood was fraught with abuse, neglect and/or dysfunction, your answer is- "I'm quite alone!" (again, I repeat- 90% of all abuse comes from within the home! That means that 90% of abuse survivors have no support system. Unless or until you're in AA or NA.... sick, but I do sometimes envy the people I know with substance abuse issues because they have a place to belong.)

My family didn't appear dysfunctional to the outside world. My father earned a decent income and was respected as a community leader. My mother was a housewife. Our parents owned their own home and we were fed and clothed quite sufficiently. Not a soul in our house had problems with alcohol or drugs. In fact, I'd wondered most of my life why I felt so lost and confused by life when, to the best of my knowledge, our upbringing was better then many other kids I'd known. And for that reason I blamed myself.

I've learned that blaming anyone is a waste of energy and time. But, still I needed some kind of explanation for what I was going through.

Well, I finally got that answer when I was in my mid 50s and read about malignant narcissism.

It was a relief to have an answer, an explanation that it wasn't all 'just me'! For a few months, I reveled in the new-found knowledge that I now had someone else to blame. But then, what was I to do with that knowledge. And why couldn't I just "get over it"?

It wasn't like I was a novice at this search for an explanation. Nor was I a novice at a search for the solution. I'd been involved in one way or another in my search for answers for 25 years.

Well, I got over the blame stuff- I think. My Nmother's (N is part of the spelling when your mother is a narcissist) 80th birthday is next week. I no longer run and hide from her, as I once did. But, I also will never completely trust her. She's played with my head one too many times. I now take her for who she is. She will never change, in fact, she will never acknowledge she was anything less then a perfect mother. There are times when you can look at her and see her as the simple self-centered 5 year old she's always been and always will be.... and it would actually be kind of cute, if, I could let go of the hurt her self-centeredness caused the child inside of me.

Will I ever feel loved by anyone, ever? Possibly not. I've learned that the people who claim to care most will likely be the first to manipulate and use me for their gain. It has become a pattern in my life... one I don't know how to change, but will continue to make every effort to-.

Do I give up? No.

It's not because I'm a fighter or survivor. My sister was born with a birth defect that made her the primary target for physical abuse. I hid in the closet. My first thought, will probably always be running for the closet, hiding in it's darkest corners under blankets and clothes. I have to make a conscious effort not to do that when things go wrong, as they invariably do.

I've spent much of my life being a really good secondary target for my sister and others like her. When someone else is in pain- I step right in and make myself a target for their anger and hurt. After all, I was hiding in the closet during the initial battle. There is guilt that comes with hiding in the closet.

If I could hear from someone, anyone, whose pain I accepted as my own- that it helped them- I'd probably continue to do it. But, I've never heard that. And I'm tired of the pain. I'm sorry I hid in the closet. But now that I'm no longer hiding in the closet.... I'm going to stop being the secondary target. The only pain I claim from now on, is my own.

Will I stop caring or helping people who hurt? Good heavens, no! That would mean I had no reason for being.

I will always advocate and work towards improving the lives of adult survivors and that includes myself. But, I will not martyr myself or give up any more of myself while doing it.

Connie

SEASCAT- where do we go from here:

Hopefully, if you're reading this, you've read SEASCAT's mission. (Please see Care 2 SEASCAT groups page or one of seascat's websites at seascat.angelfire.com   or http://www.orgsites.com/nc/seascat/index.html.)

While we may discuss topics related to adult survivors in order to educate and help others understand, we must always keep in mind the mission of SEASCAT.   Education is a part of improving the community environment for ASCAs (adult survivors of child abuse).   People who are educated on the issues should have better empathy then those who don't, and should be better prepared to offer assistance towards helping us reach our goal.   But education alone, is not the mission.

(I've developed an educational workshop on powerpoint that is available for others who wish to educate in their community, and we do plan to use it more in western NC. Plus, we are working on other workshops with more specific topics.)

What do we NEED to fulfill SEASCAT's mission:

1. ONE thing we need is an active and committed board of directors.

SEASCAT is incorporated in the state of North Carolina (USA). Anyone who is interested or knows someone else who may be interested- please contact me, Connie J. Conklin founder at seascat@gmail.com. The only absolute requirement is that they be in NC and able to get to the town of SYLVA (Jackson County) for a meeting.  (And of course, agree with our mission, etc.) We expect to encompass all of western NC with our local board and activities.

The dream began with Andre- he wanted to use his trauma to help others. (If all you know about him is what is happening now, this may not be evident.  But he was quite sincere at the time.   I soon will be giving away copies of the book I wrote at his request.) About a dozen or so years ago, I questioned his diagnosis and the alters started telling their stories.  The search to find help for him, and then for SEASCAT forced me to also deal with my issues related to also being ASCA.  It's a little late for SEASCAT to have a really big impact on either of our lives, but every year there are others that can benefit.  And being useful is necessary for me, I need a reason to go on.

I have a mentor who has helped me with the paperwork so far.  All we are lacking is the 501(C)3 from the IRS, to have all the paperwork done and be able to apply for grants and be recognized many more places.  I had contacts online when I first talked to my mentor.  But, he insisted we needed to focus on actual physical bodies, 3D people that we can sit down and talk to right here where we are..... that's what is needed above all else. That would be the board of directors.  Well, we managed to get 3 people to sit down at once.... no easy feat for sure... and we signed the by-laws.  Most of the people 'here' (physically in the same town) and interested in what we're doing are other ASCA's who are struggling.  They can't wait for us to get to the point of having something to offer them.  They are not what we really need for board members.  We need people, not in need of help, but willing and able to help.

I had one non-ASCA and I made him chairperson for the board. Unfortunately, just today, he resigned because he just didn't have the time to dedicate.

That leaves us, at the moment, with 3 older female ASCAs who still struggle and all without transportation.  I'm in the process of getting a car for SEASCAT (a nightmare of paperwork and hiking all over town, begging rides when possible) but we'll have it eventually.  We'll be able to get around and get more brochures and fliers out.  I'm hoping now we will be able to increase our local contacts by visiting churches and other agencies.  And maybe we can do some very small fundraising to, at least, get the $300 for the 501(C)3 and keep this car running.

2. Money, Money, Money!

We are really struggling financially- and that means me, if I may be so blunt.  Every dime so far, has come from my pocket.  That's why, no matter how hard I thought about what SEASCAT would be, I couldn't do a thing about it until 2 years ago when I moved into HUD housing.  A person can't do a thing when they're struggling to stay warm each day without housing.  I have SSDI with Medicare only, and have struggled with homelessness while searching for the right part-time job.  Well, now that I have housing with HUD and my Medicare premium paid by the state and prescription coverage- I'm able to get a little beyond the struggle of day to day existence.  A little. I still have many health problems, issues and lack of transportation has really held me back.  I have the Internet at the moment (don't know how much longer I'll be able to afford it, though) and that's made a tremendous difference. (Google SEASCAT, we have 20 listings- LOL!) And now, if the perfect paid job came along- I wouldn't have time for SEASCAT and I'd lose everything (housing, prescription coverage, Medicare premium pd by the state) and I wouldn't come out ahead.  So- in esssense, SEASCAT is my part-time job, all volunteer, and I can't earn more $ to add to the pot.... we have to find it elsewhere. 

A. We need the $300 for the 501(C)3, and

B. funds for ink cartridges, computer upgrade and monthly Internet.

C. equipment for educational workshops (laptop, projector, screen)

3. Volunteers

A.   to help with local educational workshops (finding locations around western NC, organizing and distributing handouts, advertise & recruit people to come, and assist with presentations).

B.  to help with fundraising.

PS- that's another thing we can get once we have the 501(C)3- we will then be able to recruit volunteers from the University's Service learning Program. The board chair that we had for awhile is with that program. He needed to work with a nonprofit that he could get credit for working with- one that had the 501(C)3 and one that was focused towards his career of working with disturbed YOUTH. But, he knows he could get us other volunteers from the program if we had the 501(C)3.

I'm in Sylva, NC and I'm the founder of SEASCAT, a Supportive Environment for Adult Survivors of Child Abuse & Trauma.  We're incorporated in NC and working on filing our 501(C)3.  We have a group here on Care2.  We're working on presenting educational workshops on the issues of adult survivors of child abuse in the western NC area.  Please contact us at seascat@gmail.com to learn more.  You can also learn more about us at http://www.orgsites.com/nc/seascat/index.html.

Please also read, sign and share my petition at http://www.thepetitionsite.com/1/survivorsofchildabuse.    It is very important that I get it to the NC house, senate and DOC, with signatures from within the state, soon.

thanks!
Connie Jean