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1 " Frosh (2002) has suggested that therapeutic spaces provide children and adults with the rare opportunity to articulate experiences that are otherwise excluded from the dominant symbolic order. However, since the 1990s, post-modern and post-structural theory has often been deployed in ways that attempt to ‘manage’ from; afar the perturbing disclosures of abuse and trauma that arise in therapeutic spaces (Frosh 2002). Nowhere is this clearer than in relation to organised abuse, where the testimony of girls and women has been deconstructed as symptoms of cultural hysteria (Showalter 1997) and the colonisation of women’s minds by therapeutic discourse (Hacking 1995). However, behind words and discourse, ‘a real world and real lives do exist, howsoever we interpret, construct and recycle accounts of these by a variety of symbolic means’ (Stanley 1993: 214). Summit (1994: 5) once described organised abuse as a ‘subject of smoke and mirrors’, observing the ways in which it has persistently defied conceptualisation or explanation. Explanations for serious or sadistic child sex offending have typically rested on psychiatric concepts of ‘paedophilia’ or particular psychological categories that have limited utility for the study of the cultures of sexual abuse that emerge in the families or institutions in which organised abuse takes pace. For those clinicians and researchers who take organised abuse seriously, their reliance upon individualistic rather than sociological explanations for child sexual abuse has left them unable to explain the emergence of coordinated, and often sadistic, multi—perpetrator sexual abuse in a range of contexts around the world. "
― , Organised Sexual Abuse
2 " Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact.But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self. "
― Cameron West , First Person Plural: My Life as a Multiple
3 " Some clinicians and researchers believe that andropause is primarily the result of our loss of testosterone. It is clear to me that it is much more than that. Andropause is a multidimensional change of life with hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. "
4 " Underlying the attack on psychotherapy, I believe, is a recognition of the potential power of any relationship of witnessing. The consulting room is a privileged space dedicated to memory. Within that space, survivors gain the freedom to know and tell their stories. Even the most private and confidential disclosure of past abuses increases the likelihood of eventual public disclosure. And public disclosure is something that perpetrators are determined to prevent. As in the case of more overtly political crimes, perpetrators will fight tenaciously to ensure that their abuses remain unseen, unacknowledged, and consigned to oblivion.The dialectic of trauma is playing itself out once again. It is worth remembering that this is not the first time in history that those who have listened closely to trauma survivors have been subject to challenge. Nor will it be the last. In the past few years, many clinicians have had to learn to deal with the same tactics of harassment and intimidation that grassroots advocates for women, children and other oppressed groups have long endured. We, the bystanders, have had to look within ourselves to find some small portion of the courage that victims of violence must muster every day.Some attacks have been downright silly; many have been quite ugly. Though frightening, these attacks are an implicit tribute to the power of the healing relationship. They remind us that creating a protected space where survivors can speak their truth is an act of liberation. They remind us that bearing witness, even within the confines of that sanctuary, is an act of solidarity. They remind us also that moral neutrality in the conflict between victim and perpetrator is not an option. Like all other bystanders, therapists are sometimes forced to take sides. Those who stand with the victim will inevitably have to face the perpetrator's unmasked fury. For many of us, there can be no greater honor. p.246 - 247Judith Lewis Herman, M.D. February, 1997 "
5 " The DID patient should be seen as a whole adult person with the identities sharing responsibility for daily life. Despite patients’ subjective experience of separateness, clinicians must keep in mind that the patient is a single person and generally must hold the whole person (i.e., system of alternate identities) responsible for the behavior of any or all of the constituent identities, even in the presence of amnesia or the sense of lack of control or agency over behavior.From p8 International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision: Summary version. Journal of Trauma & Dissociation, 12, 188–212. "
― James A. Chu
6 " As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept.Child abuse will always re-emerge, no matter how many years go by. We read of cases of people who have come forward after thirty or forty years to say they were abused as children in care homes by wardens, schoolteachers, neighbours, fathers, priests. The Catholic Church in the United States in the last decade has paid out hundreds of millions of dollars in compensation for 'acts of sodomy and depravity towards children', to quote one information-exchange web-site. Why do these ageing people make the abuse public so late in their lives? To seek attention? No, it's because deep down there is a wound they need to bring out into the clean air before it can heal. Many clinicians miss signs of abuse in children because they, as decent people, do not want to find evidence of what Dr Ross suggests is 'a sick society that has grown sicker, and the abuse of children more bizarre'. (Note: this was written in the UK many years before the revelations of Jimmy Savile's widespread abuse, which included some ritual abuse) "
― , Today I'm Alice: Nine Personalities, One Tortured Mind
7 " The main reason why clinicians may not diagnose personality disorders is that they think that doing so supports therapeutic pessimism. Recent research has shown this is not true; most patients get better, either with time or with treatment, that the prognosis is actually better than in many patients with severe mood and anxiety disorders. "
― Joel Paris
8 " The thesis that DID is merely a North American phenomenon has been refuted in the past decade by research reports based on standardized assessment from diverse countries, such as from The Netherlands, Turkey, and Germany (Boon & Draijer, 1993; Gast, Rodewald, Nickel, & Emrich, 2001; S ̧ar et al, 1996). Clinicians and researchers should be careful to avoid categorizing a universal human condition as culture-bound. "
― , Dissociation and the Dissociative Disorders: Dsm-V and Beyond
9 " Richard J. McNally, a Harvard clinical research psychologist, considered the " politics of trauma" in Remembering Trauma (2003).[139] He argued that the definition of PTSD had been too broadly applied, and suggested narrowing it to include " only those stressors associated with serious injury or threat to life" —a suggestion that would drastically alter the public discussion of rape, incest, abuse by clergy, and the traumatic affect of racism and homophobia, to name just a few potentially trauma-inducing contexts and actions.[140] McNally presents his conclusion that most traumatic experience is remembered soon after the event, as if his view represents objective scientific research, when much evidence suggests that memories of traumatic events reoccur over time unpredictably. McNally’s bias is apparent in his strong support of Ian Hacking’s curiously fervent effort to discredit the diagnosis of multiple personality (dissociative identity disorder) and Hacking’s effort to blame clinicians attached to recovered memory therapy of the spurious " rewriting" of patients’ " souls." [141] While McNally accounts for those who do recall their traumas, he does not equally offer an explanation for those who do not remember them, and his extensive bibliography and research do not cite key publications that would challenge his results.[142] - Page 19 "
10 " Do You Have DID?Determining if you have DID isn’t as easy as it sounds. In fact, many clinicians and psychotherapists have such difficulty figuring out whether or not people have DID that it typically takes them several years to provide an accurate diagnosis. Because many of the symptoms of DID overlap with other psychological diagnoses, as well as normal occurrences such as forgetfulness or talking to yourself, there is a great deal of confusion in making the diagnosis of DID. Although this section will provide you with information which may help you determine if you have DID, it is a good idea to consult with a professional in the mental health field so that you can have further confirmation of your findings. "
― , Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder
11 " The categories used in psychiatric diagnosis are based on observation of signs and symptoms, rather than on pathological processes. One can make use of a few signs, such as facial expressions associated with depression or the flight of ideas associated with mania. But what clinicians mainly use for diagnosis are symptoms, the subject experiences reported by patients. Psychiatrists have little knowledge of the processes that lie behind these phenomena. Thus psychiatric diagnoses, with very few exceptions, are syndromes, not diseases. "
― Joel Paris , The Intelligent Clinician's Guide to the DSM-5
12 " Psychoanalysis has suffered the accusation of being “unscientific” from its very beginnings (Schwartz, 1999). In recent years, the Berkeley literary critic Frederick Crews has renewed the assault on the talking cure in verbose, unreadable articles in the New York Review of Books (Crews, 1990), inevitably concluding, because nothing else really persuades, that psychoanalysis fails because it is unscientific. The chorus was joined by philosopher of science, Adolf Grunbaum (1985), who played both ends against the middle: to the philosophers he professed specialist knowledge of psychoanalysis; to the psychoanalysts he professed specialist knowledge of science, particularly physics. Neither was true (Schwartz, 1995a,b, 1996a,b, 2000). The problem that mental health clinicians always face is that we deal with human subjectivity in a culture that is deeply invested in denying the importance of human subjectivity. Freud’s great invention of the analytic hour allows us to explore, with our clients, their inner worlds. Can such a subjective instrument be trusted? Not by very many. It is so dangerously close to women’s intuition. Socalled objectivity is the name of the game in our culture. Nevertheless, 100 years of clinical practice have shown psychoanalysis and psychotherapy not only to be effective, but to yield real understandings of the dynamics of human relationships, particularly the reality of transference–countertransference re-enactments now reformulated by our neuroscientists as right brain to right brain communication (Schore, 1999). "
― , Ritual Abuse and Mind Control: The Manipulation of Attachment Needs
13 " Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5 "
14 " The writings and the recommendations of the earliest medical scientists and the new breed of clinicians between the mid-fifteenth and early seventeenth centuries were based on the supposition that sufficient study and experimentation would elucidate not only the origins of disease, but its treatment as well. "
15 " People who might normally have to travel hours to a distant city to see a cardiologist can now do so virtually, through Cisco technology, at their local hospital or health clinic. Clinicians use technology to share patient reports and diagnostic images and collaborate on cases. "
