HOW DO WE FIX THIS?

You don't. She does.

It's really that simple. Your SO is not going to get well at all until she decides she wants to, then acts upon that impulse.

Your SO needs a lot of things to help along the road, one being a good therapist. Good luck there, folks. DID is almost an afterthought when educating medical students. It s a curiosity, and not much time is spent on it .

Here are some suggestions for finding a therapist:

• Check with your insurance company (doesn't guarantee quality).
• Call local rape and abuse crisis centers.
• Call local mental health associations.
• Ask for recommendations from other multiples in your area, if you can find any.
• Look in community newspapers for meeting notices and support groups.
• Call your large local hospital and check with the psychiatric department.
• Ask friends on the internet.
• The MPD/DID Forum on AOL has a physician locator - check it out

  When you locate a therapist:

  • Has he/she ever treated multiples before?
  • What method does he use, and what's his success rate?
  • Does he accept your insurance?
  • MOST IMPORTANT: does your SO like him and feel safe there?

   

  Some survivors prefer one gender for their therapist over another. It's all about feeling safe. Remember, you provided a safe and secure enough environment for her to start sorting things out: now she needs someone who can help her the rest of the way. Someone she can trust and feel safe with.

  The therapist might mention integration. This is where all of the personalities are fused into one. If so, do not make a big deal out of this. Alters are generally terrified of this concept, and it's not going to happen until all parties agree, if it's going to happen at all. One cannot force this.

  Another method of treatment is to simply get the parts cooperating. Some survivors don't integrate. If all of the parts can learn to work together, function can be returned to the system.

  Her therapist will want to make her feel safe to begin with. Once a relationship is established, they start mapping, wherein they try to find out who's in there, as well as their placement relative to one another (who is more powerful, who does what - see ALTERS). The therapist's role is part support, part parent, part communications facilitator, and part teacher, teaching her patient to parent herself or `grow herself up.'

  She will try to talk to the various alters and determine where they came from and what their function and place is within the system. The alters are encouraged to communicate with each other (some do naturally) and with your SO. This is a great awakening for all involved. Once your SO hears some of the others, it becomes that much more real.

  Things will go a lot better when the parts start communicating and getting along better.

  Rules are made and hopefully observed, for the good of the system.

  Don't expect this to happen this week, next month, or even next year. DID therapy can take years, and typically does. There's no Magic Pill or wand waving here, folks. In fact, it's all talking and doing. And again, you're there for support.

  EMDR

  This is a new therapy traditionally used on Post Traumatic Stress patients, but is found to help dissociators too. For more information, see Online Resources.

  PAY ATTENTION, DOCTORS!!!

  Does your patient have persistent migraines, with every organic cause ruled out? Does she fail to fit into any `normal' category? Is there significant, unexplained episodic amnesia? Check the DSM-IV under Dissociative Disorders.

  I'm somewhat hesitant to give tips here, because if you're not comfortable with dissociatives, you don't belong treating them in the first place.

  When treating a multiple, it is *extremely* important that they feel safe. Safety can take many forms. I will list some of the things I have heard that might help. This applies to therapists, psychiatrists, dentists, and any other professional (survivors can print this out and take it with them if they're uncomfortable asking for things).

  • Ask her where she's most comfortable sitting. Some survivors like to be close to an exit or in view of the door.
  • Maintain a safe distance at all times. This varies with the patient.
  • No sudden moves. Even if you're just going to open the window, announce it calmly beforehand, to let her know what's going on, and that you're not coming to hurt her.
  • Have a box of tissues handy. Crying is common.
  • Remember that multiples have many child parts. Have some teddy bears, crayons, art supplies, and games handy, in case that might help to make a child more comfortable.
  • DO NOT TOUCH THE PATIENT without getting her permission in advance. Therapy is about empowerment.

     

    Rainbow Colors (of the internet newsgroup alt.support.dissociation) said:

    The ISSD [International Society for the Study of Dissociation - do a web search or check my links page] seems to cover this pretty well. Check with Peter Barach in the group [a.s.d.] for the guidelines. The main thing about therapists is that disbelief is ignorant and useless. If you don't believe you have _no_ right/business treating a multiple and you should probably get some further training as multiplicity is an official, acceptable disorder as valid as depression. If you are going to pick and choose what you accept you should ethically be limiting your practice to just these problems.

    MEDICINE

    Medicine is not a treatment for did. It can help with some of the symptoms, such as depression, or concurrent disorders, like bipolar disorder, but it won't fix things.

    Depression is a very common problem. Many dissociatives take an antidepressant. These are fun little pills, in that there are so many different kinds, each with its own method and side effects. Some antidepressants are stimulants, some are sleep- inducing.

    The current breed, called Selective Serotonin Reuptake Inhibitors (SSRI's, such as Prozac and Zoloft), is the cleanest, safest pill yet. Good news for all of us - it's damn near impossible to overdose on them, so if you live with someone who has a pill problem, this won't kill her.

    The bad news is that SSRI's have pretty common side effects. Drowsiness, sleeplessness, decreased need for sleep (this is actually helpful), headaches, stomach aches (take with food unless your doctor specifies otherwise) and the most fun of all - sexual problems. Most common is decreased drive, followed by delay or inability to climax. This goes for men AND women. I suspect this class of drug was invented by a woman, as revenge for lousy male lovers. How many times have you ever heard a man grumbling that he did not climax? You just might, if he takes an SSRI.