Transcript: Episode 2
What Is DID?
[Short piano piece is played, lasting about 20 seconds]
Dr. E. speaks: Hello. I was sitting in my office today, and I got an email that was giving me notice that my podcast had been published. This was done by Sasha, as she shared in the podcast of Episode 1. I knew that it was coming, but I didn’t know she had done it, or that it was, um… [pause] I knew that she had done it…um, we had talked about it, and spoken about it a bit, but I did not know that she was going to take such a storytelling approach. I don’t know if that was helpful or not, but it’s definitely not my style, and I do want this to be informational as well.
I am the part of the system –the “alter”, I guess is the technical term, but that’s not one we use internally—I am the one who does work every day, and has a job, and functions in that way. I have very little contact with the family, and I have, um, as little contact with others inside as I am able to get away with, simply so that I can focus and function. I’m not yet able to do that very well when I am overly involved, clinically or otherwise, with those inside, and I do try to stay out of that, other than being pulled into squabbles and disagreements, and that sort of thing. So at times I do play referee a bit internally, but I would rather that not be my job, and I have to do less of that now that we have a good therapist.
[pause]
At work, they call me “Dr. E.”, and so you can use that as my name. I don’t really want to otherwise be involved here, and I’m not a medical doctor, nor am I giving any kind of advice here, so let me clarify that. But that’s just what I’m called at work.
If we are going to do a podcast, I do want some of it to be informational. That would be my preference, although I know that’s not as fun for Sasha, so I will leave the storytelling up to her, and you can skip hers or mine, or listen to both. I did not plan on participating so much, but I thought she was going to share more of a clinical perspective. I don’t know why I made that assumption. I guess that’s not consistent with who she is, but I didn’t know we—I did not realize she was just going to do so much storytelling.
With that preface aside, let me talk a bit more about what dissociative identity disorder is. This is from my understanding of clinical literature, from therapists that have explained it to me, as well as research we have done ourselves online. Our understanding is that dissociation is a long continuum, from very mild that everyone experiences to more severe and complicated cases like ours. Um, some examples of mild daydreaming would be: a kid looking outside the window at school instead of focusing on schoolwork, or highway hypnosis, when adults are driving and, um, you don’t realize where the last few miles have gone, because you’ve just been listening to music or thinking about something, and all of the sudden you’re five miles down the road. And so you’ve sort of lost that time, but you still know where you are, and you’re safe, and you can put pieces together, and you’re still on the right track. Those are some mild forms of dissociation.
There are many different theories of what causes dissociation, and how that works. Some of them have very strong schools of thought, and a following of people who very firmly believe this, or another. I will just take my approach of my understanding. So I’m not saying that this is best, or right, or applies to everyone, only that this is the part that I understand thus far, and I will share that with you from my own perspective.
My initial question, when I heard even just the word “dissociative,” I wanted to know, dis-associating from what? I know what “associating” means. If you, um, associate with others, you call them your friends, or spend time with them. If you associate with certain activities, maybe you’re a sports fan, or, um, you have a hobby. If you associate with something, it means you are connected to something. So, I assumed that DIS-association meant that you were NOT associated with something. But I wanted to know what it was that we were not associated with. And what I discovered from, um, sort of a summary of my understanding of the literature, was that what I am dissociated from, or what we are dissociated from, has several layers, actually. But at the neurobiological level, it really has to do with being separated, a separation between the right brain and the left brain, um, and that this disconnect happens during development, because of neglect and trauma.
So, backing up a little bit, integration—not meaning as a treatment modality for blending all parts of an internal system into one. I don’t mean that, I mean the integration of a person as they’re developing—that this comes through an interpersonal, like with self, the right brain and the left brain are connected together; um, and intrapersonal, with others, meaning you are able to connect with others outside yourself; and then inter-systemic, meaning yourself with self. So, the part of you that’s sad, and the part of you that’s angry, and the part of you that’s happy, you have access to all of those parts, and that’s what integration is, as a developing child growing up. And I’m not talking about, um… I am not talking—again, I am not, let me emphasize, because it’s such a poorly used words, and I think, um, such a badly used tactic for treatment—but I am NOT talking about integration as in an end stage of therapy where everybody disappears and there’s just one person. I am not talking about that, or any kind of application about that. I am talking about as opposed to the, um… the, the whole self developing as a child, that the antithesis of that is what is dissociation.
And so, those three layers: the connection with yourself, the ability to connect with others outside yourself, and the ability for you to connect with different aspects of yourself, that is what should be associated, if you are healthy, and have good object relations development, and have a safe environment—and not just safe, but responsive. And so, I say “should”, meaning, um, not that you’re bad if you don’t, but “should” as in, um, ideally that’s what would happen for a healthy, happy, well-loved, and well-cared-for child. So when there’s dissociation, it’s because those pieces are not there. And some people may be more genetically predisposed to it, or other causes as well, but primarily it’s these three systems being disrupted in some way, um, or interfered with in some way. And this is really important, I think, because you cannot compare different trauma stories. One person’s trauma story is their story, and another person’s trauma story is their story, and you can’t compare them, because the impact of those are different for each individual, based on those three layers: the interpersonal, intrapersonal, and inter-systemic.
And so, the connections or disconnections that happen there are different based on different people’s development and experiences. And part of that is not just, “Were they neglected?” or “Were they abused?” or “How bad was their trauma?” I think that’s really unfair to do to people, or for survivors to do to each other. Part of it has to do with, um, shame. If you read a lot of the shame research literature, like Patricia DeYoung, for example. Um, if you read her materials, what you learn is, um, how much was what other people thought, or criticized, or responded, or did not respond when you needed them to, how much of that happened, that has to do with as much of the trauma as whatever kind of specific abuse or neglect caused, and is really its own kind of neglect. Um… So… what I’m trying to say, that is abuse is not just “Oh, this happened to me and it hurt me.” But it’s also really a presentation from a caregiver that “My needs are more important than your needs.” That’s the message a caregiver gives when they’re abusing someone. And then neglect is more like, “I don’t care what your needs are, and I’m not going to do anything about them.” So it’s not just my neglect story of, “I was hungry”, or “I didn’t have shoes”, or this or that. Um, but also just that your needs were not recognized. And so that’s one reason that you cannot compare trauma stories, because everyone’s needs are different. Everyone’s needs are unique to them and their situation, and their experience at any different time in their life, and my needs may be different one day than another. And so if those needs are not met, or…or, or paid attention to, or responded to, then that is neglect, even if it doesn’t fit some other state definition of neglect, or something like that.
That’s also how there’s so much trauma that is undocumented, because when the state intervenes with children, or different situations like this happen, then… there are, um… When the state intervenes, or there’s other situations like this, there may be checklists, or assessments, or different things that they go through to measure, “Does this qualify to count as neglect?” or “Does this—how does this measure up against the standards for abuse according to the law?” But those are all statutory issues, those are not inter-psychic issues. That’s not about what’s happening in the internal experience of the child. So what happens is, when there’s ongoing abuse, or ongoing neglect, according to those definitions—not just a police report or some other sort of documentation—then what you get is chronic shame, which is shame without repair, meaning you continue to have shame placed upon you, because you have needs that are being ignored, or needs that are not being met, or other people’s needs are more important than yours. This is often what gets called “personality disorders” when people are adults. I think that’s often misdiagnosed, and it’s unfair, although if it gives someone access to treatment, then that’s great.
But really, underlying everything, what it often is about, is about people—people, or children, especially, but also in domestic violence situations or in other cases…um… Children are taking the brunt of other people’s problems when their needs are not as important as the needs of their caregiver, or the caregiver doesn’t care what their needs are. And that can be really really simple, like maybe you’re hungry, but your parent is busy doing something else. Well if that happens a lot, then it sends the message that your needs are not as important as theirs, and so that’s abuse, even though it’s not the same as being spanked or something else. Um…
Traumatic shame comes in when you deal with all of this, and these layers of shame, but there’s also a social isolation component to it. So not only do my needs not matter, but now I have been rejected without ability to escape, which means my needs won’t ever matter. And that’s when we start feeling hopeless and helpless, which is way too much of a burden for an adult, much less a child. So, the pathology of it—if you’re going to call it that, which again I don’t think is a fair word, but the way it gets looked at from the mental health community or mental health providers—the pathology comes in when there’s this disconnect between me and the world, between me and others, or me with my—within myself. I’m unable to feel sad, or I can’t stop feeling sad, or I cannot regulate my anger, or I don’t know how to grieve, or I don’t know how to resolve this trauma, because it’s never been modeled. No one’s ever been present with you in that process, so how are you supposed to learn?
So that’s what we’re talking about, what dis-integrates, is the personality, and um…whether that’s one personality internally or a lot of them, regardless of your theory of, um, personality development. What dis-integrates is the personality and the internal structure…um, that should be developing through object relations as your needs are met. So, the dissociation is that dis-integration because of what you have been through and what you have experienced. So part of that is what you have been through externally, the abuse or the neglect, from your needs not being met and your needs not mattering to those around you, but also the internal experience, as you continue to develop and become more and more aware that your needs were not being met and your needs didn’t matter, and that often this was painful, whether that was direct abuse in the classic sense, or some other form.
So when there is dis-integration or dis-association, what happens is that all of that is still inside you, all of those experiences, all of those visceral experiences, the emotions that go with them, but they are disconnected from each other. So, in different parts of the brain—which, um, some of the videos online are really great about explaining—but the different parts of the brain are really good at separating different parts. So maybe the smell of that memory is in this part of the brain, but the visual of this memory is in that part of the brain, and the sound of the memory is in this part of the brain. Or maybe the emotion you had in that time is at this part of the brain. It’s all divided up, if you will, and um…stays there. It’s not like it goes away. It doesn’t just move on because the other people who caused these issues have moved on, or don’t care, or haven’t noticed. It still just stays there. It’s registered in the brain, and all of it, every bit of it, is looking for expression. And so when we go into the far end of the continuum, all the way into dissociative identity disorder, then those different parts of those different experiences are very refined, and grow up through other experiences, becoming more and more refined, and more and more developed as distinct individuals, until, um… until what you have is dissociative identity disorder. So then not only are there all these personalities, or parts, or alters that exist internally as part of a system, but each of them have their own smell memories, or their own visual memories, or their own sound memories, or whatever the sensory bases are. And this is part of why grounding skills are so important, which we can talk about another time. But it conflicts with those messages in the brain, the pain signals that the brain is trying to send, and disrupts those signals, and so, can alleviate or bring some comfort to them, rather than the pain gates being open, and the signal just continuing to be shot through those gates, because, um… it’s waiting for relief, or trying to find resonance with what should have been a connection, but where there was neglect or abuse in the past.
So it’s like there are circuits in the brain, and everything that you go through as a child, or even as an adult, everything that you go through gets coded into your brain, but not all of it gets processed all the way in the full circuit. And so that’s part of why we need therapy, or the videos that are on YouTube, or the groups on Facebook, like, it’s all amazing support. And the reason it’s so important, is because those moments of connection help complete that circuit. And that’s where that shame is resolved, even if it’s a tiny, tiny bit at a time. Because finally, someone is hearing you, someone is receiving your message of “I have this need,” someone is reflecting back to you their awareness of that need. And it all goes all the way back to infancy.
So if you want to google on YouTube, those of you who are so good at YouTube, if you want to google on YouTube, look up the still face experiment. I’ll try to put a link in it, in the podcast details, but at least, um… you could look it up later. I know this is a podcast, but you could look it up later. The still face experiment. And it’s, um…uh… a mother and a baby. Um, and the mother and the baby are looking at each other, they’re playing together, the baby is very responsive, the baby is cooing, and the mother is making faces to smile and be in tune with the baby, right? And so, but then they did an experiment of what happens. And the mother puts on a very flat expression, does not respond to the baby’s cooing or needs or anything. And you see all three of those levels play out with the baby. The baby does all three things. One is, the baby first, um, continues initiating those sounds that the baby—the mother was mimicking back, and tries to connect through the mother that way. When the mother still does not respond, then the baby gets upset, and tries to even physically push the baby away, which is exactly what happens with like, borderline personality disorder, right? The “come here, go away, I hate you, don’t leave me.” It’s the same thing. They’re trying to get in tune with someone, but no one will get in tune with them. It’s not that their behavior is bad, or that they are evil, or terrible people, or failing—like, none of that is true. And it’s horrible, misrepresenting stereotypes of those people, because all they’re trying to attune—do, is attune with someone, just like this infant in the video. And then when that still doesn’t work, then the baby matches the mother by turning the baby’s head, the baby turns its head and looks away. Because the mother’s not making eye contact or responding, and so the safest thing the baby has to do is to match that. So imagine that, for those of you who not only suffered abuse or neglect, but maybe also had mentally ill parents, or depressed parents, or something where there was not connection, your needs not being met, dissociation makes complete sense.
So, part of the context of healing comes through… part of the context of healing comes through the presence of another, whether that’s a friend, or a safe person, or a therapist, or the podcast, or videos out there, something. Those moments where you’re like, “Oh, this person gets it! They understand!” That’s what that is, that’s attunement. What abuse and neglect are, are misattunement. And that’s when there’s shame imposed, or cycles of shame, or, um… those circuits are not completed. Because you have to have another person, you have to have that other expression, for you to be able to express too, and that be reflected back to you, for healing to occur.
So with dissociation, the person has literally dissociated themselves from the situation or experience or memory that is too violent, too traumatic, or too painful to assimilate into the conscious self. That’s what it says on WebMD, but you can see how there’s so much more to it than that. There’s so much more playing out. Um… it’s also why, especially with this particular disorder, or any other disorders that have trauma involved, um, why medications alone cannot help, and why case management alone cannot help, or why bad therapists are so dangerous. You’ve got to have a good therapist, and a good connection, to be able to express these things, and come full circle for that circuit to be completed, and for healing to happen, whatever healing looks like to you. Like, it’s--it’s you and your system, and you get to decide what healing looks like to you. But for those things to get processed, and for healing to happen, there has to be that expression to another, where there’s attunement, and that is reflected back to you, and present with you. Like at the end of the still face experiment, where they close off the experiment and repair that damage with the baby, by the mother reconnecting with the baby. So it does not have to be, like, some sort of substitute mother, although there are some cases where that’s very helpful. But there does need to be someone who can, um… for lack of better words, repair that, um… through a connection, and through understanding, and through new insights, and that feeling of “Someone has heard me. My needs matter, and someone can help me meet my needs.” I’m not talking about in an unhealthy way, where there’s co-dependency, or you’re wanting someone else to fix you. But someone else who is present there with that work, and someone else who can reflect that work to you, and even your progress in it, and the struggle when it’s hard, and all of those things, letting the experience be real to you. Because it’s your experience, and no one else gets to say what it is, or describe it for you, or tell you it’s not real, because they don’t know and they can’t know. Because it’s all brain circuitry, and how everything has been coded into the brain.
That said, to get an actual diagnosis of dissociative identity disorder, there needs to be, um… two or more distinct identities. There’s an also an inability to recall key personal information. Um… so, some sort of amnesia. Like for example, as Sasha mentioned, um… Emma does not remember anything from before… she got married. She also doesn’t know that… she knows of me now, because the therapist has told her, but she has no idea that, um, that I am not at all interested in being married to her husband, or having any kind of contact with him. It’s just not who I am, or what I need, and so she’s—there’s no awareness there of that. In other situations, there may be more awareness. Like, I can—I am able to speak with Sasha, and know what’s going on, or see her or meet with her or talk to her, and she is with me as well, but Emma does not have those skills yet, and not that level of awareness yet.
These alters, or parts, or different aspects of, um, the different identities, uh, in a person with dissociative identity disorder, um, could have any kind of identity that is important to them, or there for some reason, and that should be respected. They may have distinct ways of talking, or standing, or walking, or behaving, different preferences, different likes of food, different, um… even different health statistics, um, there may be different heart rates or blood pressures, things like that. Changing between personalities, or parts, or alters is called switching, and it’s just that one is coming out front and another one is going back, or together they may be co-conscious and able to share a little bit of the fronting. That’s not something we have yet, so I don’t really want to talk more about it, because I don’t know more about that, other than what I’ve seen on some of the YouTube videos. So again, those YouTube videos can be pretty helpful, we just wanted to be sure that, um, there is a podcast for those who need that, instead of only the videos.
I can’t really describe what DID is like from Emma’s perspective, maybe she can do that some time when she’s ready. But, um… I did not expect even to participate, honestly, when we did the other one, or when Sasha told me about it. But she just told stories the whole time, and I wanted there to be a little more information as well. So I don’t know if any of that’s been helpful, but that’s all I have to share today, and thank you for listening. I hope that there is something there, and I will continue to share other information as I learn it, or appreciate your feedback for anything that I misunderstood, or did not get correct, or that you have a different perspective on. I appreciate that. Thank you!
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Thanks for listening! Your support really helps us feel less alone while we sort through all this, and learn together. Maybe it will help you in some way, too. Connect with us on Facebook, in some of the survivor groups, or on our website, systemspeak.org . Thank you!
Thank you for joining us with System Speak - a podcast about Dissociative Identity Disorder. You can listen to the Podcast on Spotify, Google Play and iTunes or follow along on our website - www.systemspeak.org. Thanks for listening.