Dissociative Identity Disorder: Treatment Perspective – Part 3

​How do personality parts or alters express themselves? Prior to 1994, Dissociative Identity Disorder (DID) was known as Multiple Personality Disorder. The psychiatric establishment then concluded that each person can only possess one personality and it cannot be split. What is separated or dissociated is the memory system of the individual, and not his personality. 

Given the fact that the average age for the onset of sexual abuse is between 6.5 and 7.5 years old, it would not be unusual to discover that the first personality parts created are child alters. However, they may not be the earliest ones to surface during treatment. In most cases, these fearful child parts are hidden deep within the subconscious of the individual and may be the last few to appear. The most aggressive or emotionally unstable alters are commonly the first to come forward. On occasions, a principal alter, who appears to know a great deal about the presence of all or most of the parts, may appear. Then it would be prudent to establish a trustful relationship with it, in order to verify the names of the various alters, and their relationship with each other, and the parts’ genesis. 

While the client was in a trance state, with her eyes closed, the first part to appear was the principal alter. She was confident and calm, and spoke  with an authoritative air. She seemed to be aware of the client’s present predicament and talked about several personality parts in her. However, she was unable to name the other alters , but she hears them talking among themselves, in the client’s head. One of the distinctives of DID is that the actual person do hear, at times, different parts holding a conference together. Once a decision had been reached among them, a particular alter would be responsible for executing the agreed decision. 

In another client, a suicidal part popped out in the first counselling session. He had been sodomised as a young teenager by an older guy, and was so traumatised by it that whenever he was crossing a road, the suicidal part would try to talk him into stepping out in front of the criss-crossing traffic. 

A young pre-teen alter was the first to come out. She was sexually abused by her older brother. She would rough out her hair as though they were too long for her age, and spoke with a child-like squeaky voice, even though she was a 40 year-old married lady.

In my initial case, the married woman had personality parts named after her husband, her two sons, adoptive family members, ​several of her aunties and uncles, her husband’s friends, father-in-law and mother-in-law, and her father-in-law’s employees and maids, and neighbours. These alters were created during traumatic incidents throughout her life, involving both perpetrators and innocent bystanders, who were present, from 4 years of age into her late 60s. They held traumatic memories that included witnessing a suicide, others’ adulterous relationships, rapes, physical and mental tortures, physical abandonment and emotional deprivations. 

​As dissociative parts are fragmented memories, disagreements among themselves are common. So, one part will not talk to another even though they are aware of each other. Particularly when it involves some of the disturbing memories mentioned above. It is as though the parts see one another as different ‘persons.’ Irreconcilable differences may initially be as difficult as in real life, but there are ways to bring them around to accept each other’s opposing views on various issues, in line with how our mind normally functions with multifarious opinions.