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1 " At cocktail parties, I played the part of a successful businessman's wife to perfection. I smiled, I made polite chit-chat, and I dressed the part. Denial and rationalization were two of my most effective tools in working my way through our social obligations. I believed that playing the roles of wife and mother were the least I could do to help support Tom's career.During the day, I was a puzzle with innumerable pieces. One piece made my family a nourishing breakfast. Another piece ferried the kids to school and to soccer practice. A third piece managed to trip to the grocery store. There was also a piece that wanted to sleep for eighteen hours a day and the piece that woke up shaking from yet another nightmare. And there was the piece that attended business functions and actually fooled people into thinking I might have something constructive to offer.I was a circus performer traversing the tightwire, and I could fall off into a vortex devoid of reality at any moment. There was, and had been for a very long time, an intense sense of despair. A self-deprecating voice inside told me I had no chance of getting better. I lived in an emotional black hole.p20-21, talking about dissociative identity disorder (formerly multiple personality disorder). "
― , Wholeness: My Healing Journey from Ritual Abuse
2 " Switches among identities occur in response to changes in emotional state or to environmental demands, resulting in another identity emerging to assume control. Because different identities have different roles, experiences, emotions, memories, and beliefs, the therapist is constantly contending with their competing points of view. Helping the identities to be aware of one another as legitimate parts of the self and to negotiate and resolve their conflicts is at the very core of the therapeutic process. It is countertherapeutic for the therapist to treat any alternate identity as if it were more “real” or more important than any other.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision "
― James A. Chu
3 " The primary treatment modality for DID is individual outpatient psychotherapy.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision "
4 " Treatment for DID should adhere to the basic principles of psychotherapy and psychiatric medical management, and therapists should use specialized techniques only as needed to address specific dissociative symptomatology.Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision "
5 " Chronic trauma (according to the meaning I propose) that occurs early in life has profound effects on personality development and can lead to the development of dissociative identity disorder (DID), other dissociative disorders, personality disorders, psychotic thinking, and a host of symptoms such as anxiety, depression, eating disorders, and substance abuse. In my view, DID is simply an extreme version of the dissociative structure of the psyche that characterizes us all. "
― , The Dissociative Mind
6 " What's wrong with me? I lose my footing, in here.' He touched his head. 'When a neuro-typical looses their footing, they yell or escape to the TV, or maybe the doctor throws them on depression meds. But when I slip, I fall all the way through. I feel the ground give way and I'm gone. It's a crack -- a crack in what's real, and beneath there I'm stuck. Then, I guess I become someone else. Mom says I still know my name, but I walk a different world. The shrink calls it DID -- Dissociative Identity Disorder -- with a little added autism to spice up my other personality. I suppose he's right, but only I know how it feels to slip through the cracks. Then the monster shows up. "
― Jonathan Friesen , Both of Me
7 " 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. "
8 " A substantial minority of DID patients report sadistic, exploitive, and coercive abuse at the hands of organized groups. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision "
9 " Interestingly, the patients who presented to me self-diagnosed [with Dissociative Identity Disorder had tried to tell previous therapists of their plight, but had been disbelieved. These therapists had used fallacious " capricious criteria" (KIuft, 1988) to discredit the diagnosis; e.g., that the patient could not possibly have MPD because she was aware of the other alters [sic!]. "
10 " The case of a patient with dissociative identity disorder follows:Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.Cindy had been well until 3 years before admission, when she developed depression, " voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters. "
11 " ...the vast majority of these [dissociative identity disorder] patients have subtle presentations characterized by a mixture of dissociative and PTSD symptoms embedded with other symptoms, such as posttraumatic depression, substance abuse, somatoform symptoms, eating disorders, and self-destructive and impulsive behaviors.2,10A history of multiple treatment providers, hospitalizations, and good medication trials, many of which result in only partial or no benefit, is often an indicator of dissociative identity disorder or another form of complex PTSD. "
― Bethany L. Brand
12 " Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of Dissociative Identity Disorder had been referred to as Multiple Personality Disorder. The renaming of this diagnosis has caused quite a bit of confusion among professionals and those who live with DID. Because dissociation describes the process by which DID begins to develop, rather than the actual outcome of this process (the formation of various personalities), this new term may be a bit un "
13 " The DID patient is a single person who experiences himself or herself as having separate alternate identities that have relative psychological autonomy from one another. At various times, these subjective identities may take executive control of the person’s body and behavior and/or influence his or her experience and behavior from “within.” Taken together, all of the alternate identities make up the identity or personality of the human being with DID.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p7 "
14 " I cut myself up really badly with the lid of a tin can. They took me to the emergency room, but I couldn’t tell the doctor what I had done to cut myself—I didn’t have any memory of it. The ER doctor was convinced that dissociative identity disorder didn’t exist. . . . A lot of people involved in mental health tell you it doesn’t exist. Not that you don’t have it, but that it doesn’t exist. "
― Bessel van der Kolk , The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
15 " Mary was my first encounter with dissociative identity disorder (DID), which at that time was called multiple personality disorder. As dramatic as its symptoms are, the internal splitting and emergence of distinct identities experienced in DID represent only the extreme end of the spectrum of mental life. "
16 " 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 "