Category Archives: Dissociation

Dissociative Identity Disorder

I thought it might be wise to go back to a topic I covered almost 2 years ago. The basics of Dissociative Identity Disorder (DID). I have a lot more readers now (YAY!) and new friends whom don’t really understand DID. No criticism here at all. Before I was diagnosed with it, I knew as close to nothing as one could get.

Dissociative Identity Disorder (DID) is portrayed in the media as some sort of wacky, wild, really cool to watch phenomenon. If that isn’t their angle? They are usually discussing the controversy of the diagnoses. I hope that if I share what it means to me, it will take some of the confusion out of it and hopefully inspire some understanding.

Everyone has multiple personalities/identities. Even you.
If you stop to think about it, you are not really the same person when you are out with your friends as you would be if you were out with your children. You are different with your spouse than you would be with your parents. You can become the professional at work then transform to a carefree spirit when you go out for an evening with your best buddy. Even your pets get a different side of you.

If you think of your own life thus far, I am sure that who you were as a child is quite different from who you became as a teenager and then that teen became a young adult. Eventually you grew past the age of being a young adult and perhaps started making some more adult decisions like getting married or having children. You continue even now to mature and change with each passing year. Ask someone who’s in their 60’s and they will tell you that they are very different from who they were at 30 and few 50 somethings that I know are still acting as though they are 20.

The difference between you and all your sides/personalities are that they know each other. Each part knows what the other was up to and went through. Who you are right now knows what you have done good or bad over the course of your lifetime. Not perfect memories of every little thing but you have the big picture. At 40, you can recall being a teenager especially as your own teenagers are now giving you the same hassles you once gave to your parents. There is an easy flow of communication between these parts of you.

When you have Dissociative Identity Disorder, this ability to easily communicate is severed or severely affected. It is like growing up and the 4-year-old you doesn’t know the 5-year-old you. Each one is compartmentalized in a separate box and each box is locked. Usually this is caused when there is trauma so severe and so constant that the host could not have survived psychologically without creating a very handy coping tool. Rather than being totally overwhelmed by what is going on and absorbing all that trauma by oneself, some children unknowingly begin to dissociate. This is a very clever secret door that a traumatized mind is able to create to help survive the fear and pain.

Sadly, if dissociations happen regularly and a total “split” occurs, the child will have very few memories of this age. Good or bad. If the trauma continues for many years, these splits can happen over and over. The biggest difference between a dissociative mind and one that has not needed to develop this skill to survive is the ability to recall life in an orderly fashion.

This issue of segregated memories is used to help diagnose cases of DID. When I am asked to give a family history or a history of even my past week, it can be very confusing for me. I don’t always recall who came in to our lives or who went and and when. I have years of missing time scattered throughout my life so I can occasionally recall moving to a new home but not recall leaving it or I could suddenly be in a new home and not recall leaving the last one. People with DID need to constantly juggle what they know with what they can’t recall.

People with DID, myself included often have very large chunks of their life missing. One dissociative part of me from when I was 4 might not even know about me or any other parts. For 43 years I did not consciously know about any of my other parts but most of them knew me. They did not all know about each other though. Some did, some didn’t, some parts formed groups, some stayed isolated, some even thought that they were the only one. They seemed to not even realize that there was me.

These parts and pieces of my life have a very chaotic order to them and they almost all are still the ages that they were when they came to being. This is where it gets really hard for me. That silent 3-year-old that needs to be held and hugged is always 3 and always needs to be held and hugged long after it is “appropriate” to want this from those around her. I can and I do try to take time to fill those needs if I can but I have a LOT of Helpers and taking care of each one would be 3 full-time jobs at this point.

I really like this graphic as a way to explain what I am trying to share here.Excellent

For me this happened 34 times. For a long time I only heard 3 but that was when I was still assuming I was psychotic or just truly bat shit crazy. In time, with a great deal of support and compassion, I allowed myself to begin to hear others and there are 34 in total that have made their presence known. I don’t know them all yet and I don’t have all of their memories.

I work daily on hearing them, finding out what their needs are and trying my best to fulfill those needs. I feel as though when parts of me feel heard and hopefully healed as much as possible, they can get a well deserved break from needing to protect me from what they deem as dangers. This will reduce the “need” for dissociations.

I am not a professional with all this nor do I have all the answers. I am learning day by day and sometimes I get it all very wrong. I’ve been able to help my Helpers at times while hurting them at others. I am working at it though. Every day.
One day I hope that my 4-year-old will know my 6-year-old. My teenagers will know the adults and the adults can allow me to take care of my daily needs without whisking me away. I will not integrate them, I just want us all to communicate more easily with each other rather than living in all these separate locked boxes. My goal is to find peace.DID0

My story.

Girl

It was suggested to me by a long time reader that allowing my story to be told might help reach others. I have hesitated doing this is the past because I just felt the details were not really important. That said? I do agree with this reader and have decided to share some of my story (minus the nitty-gritty) with you today. I do hope it helps you understand me better and I hope it reaches some of you so that you know that you are not alone in this fight for your survival.
I am going to leave my siblings out of this story because I do not feel it is fair to assume how they felt or what they went through personally. If there is a day that the ones still living wish to share with you? I’d happily post it.

Once upon a time, in a land far, far away, there was a princess.
Scratch that. This is no fairy tale. 😉

I was born at the beginning of 1970 in a winter storm. A fitting beginning for the life that would follow. A winter storm of sorts that lasted decades.
I was born to a family that was quite wealthy and had every available support to raise a child as easily as possible. From other family members, I have been told about how my father was thrilled by my birth but my mother hated me from day one. Probably long before day one in reality. I am sure she viewed her pregnancy as a real inconvenience.

My beginning could have been a good one but right from the very start of my life here on this earth, my mother would begin making choices that would seal my fate and my father would not do anything to stop her.
Their first decision? My name.
Heather was the name of a girl whom my father and mother hated. She’d chased my father around and my mother hated her for it. This is the person whom I was named after. Someone they hated.

I have a few memories of my early childhood but none are good. From 0-4, all I recall is being afraid. Many years ago my grandmothers both told me stories of how I was left in filth and ignored while my father was at work. I was also told that I would scream and beg others to take me with them as they left our house or begged babysitters to keep me. That is just not normal behaviour for a young child. Wanting to leave with anyone rather than staying home with their mother.

Starting at age 4, I was given a gift of new underwear for my birthday. Not the best gift for a 4-year-old but they were a tiny hint as to what that birthday would mean. I would be sold to men who liked little girls and my hair was cut so short that I also looked like a boy and could satisfy men who liked boys as well. This was not a rare occurrence. It was done as often as there was demand and there was ALWAYS a demand.

It was also around this time that I learned to mistrust what people said vs. what they actually did. My mother could be the sweetest, kindest, most gregarious person to anyone on the outside but then a monster behind closed doors. It was her perfect “outside face” that allowed others to believe that she was trying her best but that I was a child with some real issues. She convinced therapists, social workers, a child psychiatrist, doctors, teachers and strangers that the problem was set squarely on my own shoulders. I was the one who hurt myself and then lied with crazy stories to cover it all up. This lasted for my entire life with her. It still goes on to this day! She is perfect while I have mental illnesses.

There was a lot of sexual and physical abuse but even worse than that was the sadistic nature of the emotional abuse. I was made to believe that I was only sold to men (and some women) because I liked it and caused it to happen. If there were bruises or broken bones? I had obviously done something to deserve that. If I got ill. that was my fault too. That woman (my mother) made sure that my self-esteem was now only low but non-existent. I felt less than human and not truly worthy of any kindness. This is the part of her abuse that is the hardest to get over or heal from. I feel like I am worthy and then someone talks about me or doesn’t like me and I am plunged deeply right back in to feeling absolutely worthless. My brain knows that I am a good person, that I give a lot of myself to helping others, that I am smart, and have a lot going for me but my heart still says “You don’t deserve any of it and you are just as worthless as you always were”.

I did try to speak out and I tried to reach for help but these efforts were always met with my mothers wrath. I recall being made to eat a “poop” hot-dog in a bun. If I was going to spread “filthy lies”, I was going to eat filth as well. After a certain number of times where I reached out to ask for help and having that come back at me with a vengeance, I gave up. I still find it hard today to speak up about it because my automatic feeling that accompanies this openness is fear.

There are so many details and situations that I could discuss but I am sure you get the idea by now? It wasn’t just a hard life. It was a life filled with monsters that never hid under my bed. They just stayed out in the open and did as they wished with me as often as they wished it. I many ways this abuse started before I was born and still continues today. 46 years of situations and stories that would make your blood curdle.
If you read my list of Helpers from last week, there are a few more details of which Helpers came in to being and when/why.

I wish I could say that I grew up, moved away and never had to deal with my mother again but I moved 3,500kms to get away from her and 2 months later, she was living 1km down the street from me in her newly purchased home.
I have not spoken to her in over 11 years yet she still speaks about me in public to anyone who will lend her an ear. She tells them lies and makes me look horrible. We live in a very small community and there are many people who have never even met me whom hate me with passion. I’ve been called a liar, a bitch, a whore, a selfish daughter and worse by these people who just believe the words my mother shares. Supposed grownups and mostly “church friends” of my mothers. I really try hard not to let it bother me but she has even gotten to my own children and 2 of my husbands extended family members. The words said under hushed breaths make me want to just run away again and never look back… or just give up and leave this world altogether. It is hard not to taint the good that I have created in my life with that poison. I am only human. It is hard to be hated and even harder to be hated for something you never were.

Sadly it is not only my monster/mother that drags me down like this. My father takes part as well. He is quieter about it but when discussions of how my brother abused me surfaced, it was his voice on the other end of the phone calling me a sociopath. In my heart I know that he believes every word and knows the truth but he is unwilling to face it and it seems that hurting me instead is acceptable to him. I recently cut off all contact with him and I know it was necessary for my future mental health but I feel like a 46 years old orphan who never knew what it was like to have a mom or dad.

I’ve felt very lonely lately. I miss those whom have loved and seen die by suicide due to their PTSD. I ache for my murdered son. My heart has cement poured all over it while my living children find their way home. I really miss the nurse I felt close to while in hospital and the doctor whom I got to know before his sabbatical. Now my current therapist is retiring in a couple of months and I must say goodbye to her as well. I know these supports are not meant to be lifelong friendships and I am good with that but it doesn’t make missing them any easier. These people got me, they understood me, They believed me and truly heard me. They made me a better person. I am just tired and I am trying to find and keep my spark. I will find it again. I have faith in that.

I’ve had some comments about how I do not share negative stories on my blog but I feel that my intentions are perhaps a bit misunderstood. I do not keep things positive because I want people to think life is just all great and I am flying high. I keep it positive because I have dealt with and still deal with more negative in the run of a day that some people experience in a lifetime. By remaining positive myself, I feel like I am adding to the good in the world and that somehow negates some of the bad. It takes a lot of effort on a daily basis to live a good and positive life but I almost always feel that it is worth the effort.

This blog is very important to me. YOU are important to me. When someone says that they heard what they needed to hear or got what they needed to get because of a blog I wrote, it helps me add to the balance of positive in my life. Thank you for that.

If there is more you wish to know, just ask. If it is too personal to be on the blog, I will respond with a private email.
All the best to each of you. ❤

Kind Words CopyHand drawn by Heather. For sale. $20
Buy an 8×10 “Be Gentle”

Helpers

What a week I’ve had here! How has yours been?
I have been very busy each day so I am grateful for a chance to sit down to write a blog and relax a bit. I hope you’ll enjoy sitting down for a bit while you read it.

I haven’t discussed the Helpers in quite some time because I’ve been going through a very uncertain time with them and felt it was time for that side of my life to be private for a while. I think we all needed it.

On Wednesday I was in to see my therapist and what a wacky session it was from my point of view. I’ll have to ask her how it was for her when I see her next week. I try very, very hard not to dissociate while there but at times it is impossible. Wednesday was just such a day. I arrived for my appointment feeling the anxiety of at least a dozen parts of myself. A man answered his phone in the waiting room and I nearly jumped out f my skin. Doesn’t everyone know that silence and complete stillness is a good thing? 😉

It wasn’t even just Wednesday. It’s been at least a week now of odd feelings and confusion that has not existed in a very long time. An urge to self harm, drink, drive off the road, say a hearty “F*** YOU” to anyone who was even looking at me. I guarantee you that these are not traits of mine alone. I know the Helpers that feel these ways and want these things. I do my best to give them what they need so that the destructive side of them will be calmed down and we can live life the way we have all chosen to live it. The trouble is that I am sometimes not in a good place to be giving much to them if I am having a hard time myself.
We have made it through the week without any “maladaptive” behaviours but I am quite frankly exhausted from holding it all back. Only 2 more really busy days and then a day off. A much-needed day off.

I have been working for the past few months to create some co-consciousness with my Helpers. If you are unfamiliar with that term (as I was until rather recently), co-consciousness is having awareness of another part and if all goes really well, working with that part/Helper to deal with issues together. It is not integration or becoming one. It is more like both being in the room at the same time. Some people seem to have this ability or skill right off the bat but for me? When my Helpers are out, I am not. I had no clue what they were up to. I am hoping that developing some co-consciousness will help us work together in a smoother fashion.

While at my appointment, my therapist seemed to know that it was not “Heather” who arrived at the appointment and she was partially right. I felt like I was there with a half-dozen others and all their feelings were all over the place. A little closer to the end of the appointment, she asked me how the little ones felt about her retirement in June. The adult Heather (me) has been taking it really well. Almost too well. When she asked how the little ones felt about it, I felt this overwhelming presence of the little ones. They did not take over but their obvious distress was felt full force by me. They/I began to cry and feel heartbroken. We were suddenly very little again. I felt them. Small, scared, heartbroken, wanting to be held and hugged, wanting a real mother, and such a huge amount of loss.

I take my therapy very seriously and I have promised myself to always be willing to go wherever I need to go for healing to take place. It does not matter how painful it is. I truly feel that things hurt more when left to fester inside and are worth the discomfort of allowing them to come out.
That said? On Wednesday? I wanted to beg my therapist to stop. It just hurt SO MUCH. I felt like I couldn’t possibly take it for even one more moment. I held on though and still feel like I was kicked in the gut.

I am sorry if todays blog is a bit disjointed but I am dealing with a lot of Helpers still today. Co-consciousness is my goal but getting there is going to be a very bumpy road. I’d actually love to hear from others who have either tried to develop this skill, already have it and how you control it, or those whom support others through it. Do you have any advice for me? Tips and tricks that could help me or others whom read my blog?

I really hope that you have a great weekend and I think that next week I am going to try to let a few of the Helpers lead the blog for that day. Who knows? It might even happen. *laugh*

As a parting note. For those of you whom are newer to my blog, I wanted to post the quote that gave me the inspiration to call my other parts “Helpers”. A positive quote and a positive connotation for my Helpers. Helpers

 

Dirty word of the day: Integration

I know this will be a controversial post for some people. Many medical professionals do not agree with my views… which is fine because I do not agree with  theirs. 😉 Joking aside, many doctors, therapists, and even some people within the dissociative identity disorder (DID) community feel that integration is the holy grail of healing persons from DID.
To me? Integration is a dirty word.

If you have not read this blog before, I call my “alters”, my Helpers. Hence the name of the blog. 😉

Even now while writing this, I can feel my inner world starting to freak out. Anxiety, worry, a wish to run away, feeling overwhelmed, getting angry… that is what my Helpers deal with every time this word is said. I feel it too. Big time. I feel totally in control today and I am always out front when writing but I can still feel the weight of inner feelings especially when they are shaken up.

I can not speak for everyone else out there but I can speak for myself and I will express how I personally feel about the issue of integration. If you disagree, I’d love for you to write a blog on it and forward it on to me. I’d love to read other opinions. 🙂

Having DID is not easy. Every situation that happens garners my own emotions but then the Helpers step in with theirs as well. Have you ever been at a big get-together and try to get everyone to stop and listen to you? Can you imagine trying to come to agreements about certain important issues? There will be as many opinions as their are people. DID is a lot like that every day.
That said? Some of the same people who may drive you batty would also rush to your aid if you suddenly collapsed or started having real troubles coping. DID is a lot like that too.

I believe that my Helpers started coming in to existence between the ages of 2 and 4. I know for sure there were several there when I was 4 and 5 but I have a feeling they were there earlier. For me? I’ve never had a life without my Helpers in it. For the purpose of this blog, I will set aside all the confusion and thinking I saw dead people and just discuss my view since being properly diagnosed.

As much as life with DID can get hectic, I am never bored and never lonely. I have company at all times and honestly? I am not sure I’d enjoy life so much without it. I was once on medication that made them almost silent (and made me a zombie) and that was a very sad and lonely time for me. I am also ALWAYS full of ideas for new things and ways to use things that I myself may have never thought of.

I also have a huge issue with integrating these people whom I have come to view as such a big part of my life. Who do I get rid of first? Little “Hannah Banana”? My ever faithful sidekick Rielyn? Old man Oscar? Tilly who helped me birth a baby when I was too young to mentally handle it on my own? I am sorry but full integration is never going to happen because each of these Helpers are important to me as individuals.

I am also very aware that each of them is a part of me. A very compartmentalized part of me but still essentially “me”. While it would be all neat and tidy to roll the Helpers and I in to one person, I honestly feel I would end up completely overwhelmed. At least right now there is separation between all these opinions and emotions.

So what do I want? What do I feel is healthy?
Teamwork.
Rather than working on getting each Helper to integrate, I spend that time trying to work out the kinks in our relationships and certain actions. I will use Jenna as an example. She was always having issues with self harm and quite often these “events” were incredibly scary. I still have many scars. Trying to integrate her causes panic, more dissociation and more self harm. Working out a deal between us was FAR more productive. Jenna admitted in writing and through art that she often used self harm not only as a release but also in trying to fix old scars. A deal was made that if there was no self harm for 6 months, we would get a tattoo to cover one set of scars. 6 months later was another tattoo to cover more. Jenna LOVES her tattoo’s and I love them too. She found a new strength during a year of no self harming that she still possesses today. Integration made her run away and refuse help but making a deal with her stopped the harmful behavior and allowed me to take care of her.

One by one, we work out deals. We make rules that certain age groups MUST follow. No one under 18 drives. No one under 18 signs important documents. Only I (Heather) goes to therapy. If anyone has a concern, they can write it down and I will take care of it or help them with it. There are a few other rules that are for safety, friendship, being creative and so forth. These rules are enough for me to feel good about my team of Helpers.

There will always be mess ups, uncomfortable situations, missing time, forgotten occasions and other issues that persons with DID have but would full integration solve all of these issues? And what about all the PTSD triggers they help me through? How often I would have fled out of a movie theater, ran my car off the road at a fright, been unable to function at social events before I was able to stay more present? My life would have been far worse. I am sure of it. My Helpers came in to being for excellent reasons and I do not wish to thank them by making them null and void.  Also, I am aware of 34 Helpers… integration could or would take FOREVER. I’d rather live my life with my team. They help me and I help them. For me personally? That is enough.

Helpers

Rules

Following the leader. ~Rielyn~

Helpers

Some of you will recall me speaking about “Julie” in past blogs. “Julie” is my main Helper. The leader of the pack. “Julie” has decided that she no longer wishes to be called Julie. That was never her name but due to my emotional attachment to the name we bartered for a bit of time so I could get accustomed to the idea. I am very grateful for that time. It helped me a lot. That said? I must introduce you all to Rielyn. This is Helper “Julie’s” real name. Her choice.

Rielyn means “Dominant Leader” which amuses me greatly. Rielyn is most certainly the dominant leader of all my Helpers. She holds a very special place in our lives and she carries a huge amount of responsibility with the precision of a military strategist.

Rielyn is the only Helper that ages along with me. Everyone else stays the same age no matter how many years pass. I am not totally sure when she really came in to being but I don’t ever recall a time when she wasn’t there. Her position of power really took hold after my sister Julie died. In assuming that Rielyn was my sister Julie speaking to me from beyond the grave, I gave Rielyn A LOT of power. She has never misused that power though. She doesn’t always make the right decisions but she always makes them with the best of intentions. That is all we can ask of anyone isn’t it?

A little more about our main gal. 🙂
Rielyn decides who comes out, when they come out and when they retreat again. If you are ever in my presence and I am hopelessly lost in a dissociation, it is Rielyn you need to speak to. I am completely unaware of anything that is going on while she watches and controls every moment.
Rielyn deals with issues swiftly and powerfully. When she decides something, you are following that path. Period. You know how you could goof off in many of your school classes but there was always that one teacher who you just never messed with? Rielyn is just that sort of person. I respect that in her even if she could do a lesson or two in tactfulness just to smooth the edges a bit.

For anyone unfamiliar with Dissociative Identity Disorder, most systems have a leader of some sort. Not all but most. I will try to explain what I understand about how and why DID exists in some of us.
Identities are most often created during times of unbearable abuse. The Level of trauma is so high that survival is almost always uncertain. Different sorts of Helpers are created depending on what is needed. This explains why women can have male alters and vice-versa. Even though I am a woman, there are certain times where a male personality is better suited to deal with a situation. A male may be created to handle a situation where a man may have more control or be able to act in a way that is unacceptable for a woman. (I am 45, not 25 so the rules and gender identity are very different these days although I am sure most systems have men and women.)

Rielyn was very likely created during a time that was just too unbearable to recall. I do think that I had several Helpers before Rielyn came along but perhaps those Helpers needed someone to run the show. Maybe they were disorganized or finding it hard to know what to do? I have no memory of this tie so I am really just guessing here but I have learned that almost every Helpers has a reason for being. Rielyn is a born leader so I believe she was created to do just that.
Her place in my system is to keep everyone on track. Me included.
If she sees a trigger coming or happening, she will often whisk me away before it even begins.
If I am having too many nightmares, she will eventually bring in a Helpers to sleep the rest of the night for me.
If I need to be alone in a place that makes me nervous, she will send out an older male.
I know that Rielyn stays out of my therapy for the most part but if the therapist gets too close to something that Rielyn doesn’t feel I can handle, she will take over and steer the conversation away from that topic before sending me back in.
Rielyn just knows what is needed and when so she makes it all happen.

I think my biggest challenge amongst my Helpers is to get Rielyn to loosen the reins a bit and let me handle more situations on my own. It has to be hard for her after I leaned so heavily on her for so long. I guess it is a bit of a dance between us. We just need to learn the steps.

I hope you’ve enjoyed learning a bit more about my main gal. 🙂

Shame

Shame

I’m feeling a little off today. I had a great day at a fun craft fair (this was written on Sunday because I will be too busy to write this on Wednesday), I had good sales despite a very low turnout, I had some great conversations with other vendors and my work was complimented repeatedly. I feel like I SHOULD feel very happy about my day. The recipe for a good day was completed but somehow the directions were wrong. There is something missing.
I felt it all day.

Before going away for professional help in 2013, NO ONE knew my secrets. I mean no one. Not even one person in this world knew what happened except for me. Even the abusers only knew what they did. I never told one about another. I did try to get help but I would always fail/give up before hardly getting started. If someone doubts the first thing you tell them, you are very unlikely to tell them anything else. Without even realizing it, most adults unintentionally buy the silence of abused children by showing the smallest smidgen of doubt.
“Are you really sure this is what happened?”
“We don’t want to say anything untrue do we?”
“It’s very important that you tell me the truth here.”
If anything even remotely like this is said? We fear not being believed and if we are not believed then we put ourselves at risk for further harm. We feel unsafe.
Silence is now bought and paid for.

After 2013, a very small group of people knew what happened to me. A VERY small group. My nurses in the hospital, a few trusted friends from within the Complex PTSD circles, a good friend and really no one else. Not even my own husband. It was enough though. At that time it felt so freeing just to have a few people know and still be silent with all others. In all truthfulness? That was the extent of my circle.

I still do not feel the need to expose all the “dirty little details” but I am starting to make friends with people outside my Complex PTSD friends and I feel like I am beginning to hide again. I admit to having PTSD but I never say why. I actually feel like I am starting to present myself as 2 very distinct people (and not in a dissociative way). I feel that I am not being truly authentic.

When I began this blog, I chose to not show my full name anywhere. Heather is my real first name and Helpers are my DID pals but my identity was otherwise rather well hidden.

Now there are people who know me personally who read this blog. They can go back and read  over my other posts and piece together little bits if they choose but in the spirit of being and staying positive, I never list details of anything that I’ve been through. I have no interest in changing that because I am VERY proud of this blogs reputation of being positive, informative and honest. Compliments that I hold near and dear to my heart and thank you to all who’ve said it. 🙂

So here is where I feel a bit weird. I am feeling a bit like I am keeping secrets from people. I am meeting all of these new people and I am presenting only one side of myself. The artistic, capable, social Heather. I like those parts of myself but I will admit that I’ve been too afraid to discuss my real diagnoses with anyone. I admit to the PTSD but never to the DID. I am so afraid that I will be viewed as a crackpot. I am afraid to lose these new friendships. I am afraid of losing their respect. Suddenly I am feeling as though I am only showing half of me because of my willingness to offer secrecy and silence due to the fear of being judged.

You see… DID (Dissociative Identity Disorder) is a huge part of who I am. It affects my life on a daily basis. By not divulging it to those I am getting to know rather well, it can lead to misunderstandings, mistrust and even hurt feelings. If I do not allow people to know that I quite often just disappear then have no memory at all of that time, they can take my behavior or things said in the wrong way. Quite often people feel like I just don’t pay attention to them and that is so incredibly untrue. They feel ignored rather than understanding how deeply I dissociate.
If I was just choosing not to tell people and I felt good about it? That would be wonderful but I am choosing not to say anything due to fear.
Oh, let me just be honest. I feel ashamed.
The silence and secrecy that got me in to a terrible place in my past is sneaking back in insidiously because I am fighting shame.

There has to be a way to be authentic without scaring people away?
How do you keep the respect of others who really may not understand?
What do you do to avoid the feelings of shame if the answer is NOT breaking your silence?
Where on earth is that fine line? The balance?

I know for certain that I am not alone. I read these comments in my support group, in emails from others with DID, and discussions with doctors. Will there ever be a day when we will not feel the need to hide, be silent or feel so ashamed?

We are not broken people. We were broken by others. Why do we feel the shame and they do not?

I am sorry to leave this post off like this. I really like to end on a positive and helpful note but today I just do not feel that way at all. I promised to always offer you my honesty and for right now, this is where I am. Perhaps I needed to bare my soul so that others can as well? Who knows but there is always a reason for what I do even if I am not aware of what it is at the time. 😉

Thanks for listening.

432 years old vs. 4 years old.

There is this battle within me.
The first half of it became obvious one morning when I was sitting in a greenhouse with a group of people and we were each asked how old we felt. The actual ages of the people in the room that day was 21 to 48 but the answers were very often in the 60’s, 70’s and 80’s except for the 21 year old who felt that 40 was ancient. I was the last person in the room and I really didn’t want to answer the question. I felt my answer was honest yet weird and I was afraid of what the others would think. Go ahead and tell me how I shouldn’t care what others think. I do care and in my eyes it is not a negative. I care what they think but I do not allow them to affect my final decisions. Am I off the hook? :).
So… what do I do? Well, I do what I always do and be honest.
I clang the chiming bowl and build my bravery up a bit. I admit that I feel 432. Yes. Four hundred and thirty-two. There were a few giggles but then everyone sensed that I was not making light of the question and the person running the group looked at me and said “I see that in you.”
I guess a nice way to look at it is to say that I am an old soul? A really old soul? 😉

I feel 434 (two years have passed) because I feel like I have lived several lifetimes. I’ve experienced so much, done so much, lived so many places, been in so many odd situations, pushed myself to be successful in any area that I wish to be… Friends and the occasional professional who knows me well, understands this feeling I have and they tend to agree. I have lived many lifetimes already.

The other half of the battle is newer for me. The first time it was mentioned to me was by a special doctor whom I saw last year. In his words, I am intellectually very advanced but that emotionally, I am still very, very young. I could not really see what he meant but I am beginning to see more and more clearly that he is right in many ways.

Over the past few months I have been feeling things that I have never really felt as strongly. There are many times where I feel very young and very small. I feel unsure of how to act or what to do more from the eyes of a child than an adult. Situations that an adult would be totally comfortable doing are not as easy all of a sudden.  I believe that some of my child Helpers are feeling more comfortable and being willing to show themselves a bit more. I need to honour that.

While I can and will be an adult when it is socially acceptable or needed for any reason, I also feel the need to make some space for the children within me to experience a childhood. I experienced some aspects of childhood I am sure but I was being traumatized daily and therefore spent most of my childhood in a dissociated state. I also needed to stay smart, stay ahead of other people’s thoughts, needs and wishes in order to stay even the tiniest bit safe. That is not what childhood is about.

Some of this may repeat a bit with another post but that post was called a Dissociative Day. I just reread it (after writing this blog) and realized it must have still been a Dissociative Day when I wrote it. Oops. LOL Please forgive my accident repeats.

I’ve decided to start reaching out to my child Helpers more. I want to give them time to explore being a child. A hippo for Hannah was a good start. She chose the blue one rather than the pink. 🙂 She is soooooo happy with that hippo. It just feels like one part of my inner self is totally happy and relaxed at least for now. Perhaps this Christmas will bring Santa to our home even though my other children are all grown and gone. My Helper children never got to have a Christmas before and I want that for them. My husband won’t feel comfortable with that so we will do it on our own time and that is fine. My husband is AMAZING but even the most amazing person can have areas where they just do not feel okay about things. He’s had a few run ins with the children Helpers and they have been very traumatizing for them. He’s afraid to deal with them because of that. 

I’d love to hear what sorts of things you did as a child that you recall as good memories. A good list of things to experience would be a great start. 🙂 You’re always so helpful so I am sure I can count on you to help me out a bit here too right? 🙂

Have a great weekend and as I said in a blog not long ago, let your inner child out to play a bit. We ALL need that.

Hippos

.

Shattered

acid_picdump_157
I highly doubt that I will ever forget the day that I sat in a small counselling room with my nurse Mike and his nurse in training Nadia. Mike was a very straightforward man but he knew how to place his words gently when needed. He had been watching and meeting with me for weeks by the day of this day and I assumed this meeting would be like the others. Helpful with some answers and confusing with some new questions.

On this day he had brought me there to tell me that he felt that I had DID. A “real” case. I’d had another meeting a day or two beforehand where the idea was presented to me but all I recall from that meeting was lots of people telling me this is how they felt and they all agreed on my having DID… and I dissociated almost immediately within that meeting because it was too much to handle. Bits and pieces of that day have come back but it was this day with Mike and Nadia is the one I remember a clear as day. Mike had gotten VERY Good at knowing when I was dissociating and getting me grounded again before proceeding so I actually recall most of my meetings with him.

“I believe that you have Dissociative Identity Disorder Heather. I’ve been here 30 years and never seen a case such as yours but everything fits. It all makes sense. You definitely have DID.” He then asked me how I felt about him saying that and I recall being of two minds. One side said “Oh thank goodness for an answer! I am so relieved!” The other side said “No fu***ng way! NOT ME!” I spent the next weeks learning a little more about it. I found out that the 3 dead people who I spoke to all the time were actually alters. It wasn’t long before more alters came forward as I started being open to actually speaking to and acknowledging them. It was a very strange process and I was so incredibly afraid of telling my loved ones. I actually did not tell them for quite some time after I knew for fear of them all leaving me as my birth family had for far crappier reasons. I went away to the hospital with depression and was coming back with that and very Complex PTSD, Generalized Anxiety and DID. I felt that all this was just “too crazy”. They all knew I was crazy but that was just “too crazy”.

Other than fear I felt something that I’d never experienced before. The beginnings of inner peace.
For my whole life I felt like I was desperately trying to keep it all together and find creative ways to explain things I did not recall doing, being places I did not recall being, knowing things that didn’t match up with what someone else knew. I felt eternally confused and in constant fear of people finding out how crazy I really was.  When you have DID and don’t know it? The world is an especially confusing place. I thought at different times that I just wasn’t paying attention and that is why I could not recall things. When I missed days or even weeks, I wondered if I had a brain tumour. When someone would say “I told you that” or “You were invited”, I had NO memory of those things and wondered if my tumour was Alzheimers.

When I finally accepted my new diagnoses (it took a while), I felt a new feeling. I felt shattered. I felt angry that my mother had been so horrible that my brain actually needed to split itself in to pieces just to survive. Any word that you can use to explain the feeling of not being whole? I felt it.
On one hand it was such a relief because this finally explained so much but on the other hand? It was terrifying. It would be almost a year before I was able to truly accept the diagnoses and rename my “alters”. They became my “Helpers” and I began seeing them as parts and pieces of a system that kept me alive. Not some group of hooligans that existed to make my life even more hellish.

There are still many days where I feel shattered. Like someone took my mind and tossed it in to the air like a glass vase. Crash! Pieces everywhere. Impossible to fix even with the best glue. You can stick it all back together and it can even be beautiful in a new way but it will never be what it once was. I needed to grieve that loss and honestly? I still really haven’t.

I feel especially fragmented these days. There are many of my Helpers that need some serious attention but I do not honestly have time each day to do that. Perhaps I should say that I don’t MAKE time.
Why don’t I?
Fear.
The fear of not being able to fill their needs. Some are easy and I can use my own self to take care of certain needs but I struggle BIG TIME with the little ones who want their mommy. They do not need my actual mother. They want a mommy. Someone who can hug them and tell them it is okay. Someone who thinks they are special just for being themselves. I can love them. I can care for them. I can take care of most of their needs but they need a mommy and I still need one too. Sorry if that makes me sound pathetic but I am really grieving that a lot right now. Not only did my mother never offer that love to me decades ago but she is still out actively trying to find now and clever ways of making my life a living hell. It is VERY difficult to reconcile this in your brain.

That shattered woman whom I found 2 years ago is still here but I am less shattered than I was. There are pieces that I’ve fit together and the vase has an actual shape now. It still leaks like crazy when the rain is heavy and pieces keep falling off but slowly it is getting stronger and more sturdy as time passes. My recipe for the glue keeps getting better through trial and error.

I wish that no one could relate to this post because if you do? You have been through hell too and I am sorry about that. Truly sorry.
That said? I believe the glue becomes far stronger, far faster when we band together and help to make each other strong.

Shatter

A Dissociative Day

I am thankful for many things in my life and one of the things I appreciate the most is the realization that I have a lot of control over my dissociations and my dissociative parts. It takes months at times to hammer out a deal with a Helper but once an agreement is reached, it never seems to pop back up. I’ve also enjoyed being far more present more often than not these days. Almost to the point that I think my DID is probably 75% less obvious to others than it was 3 years ago. This progress thrills me.

Then I have days that I call my “D-Days”. Dissociation reins! Dissociative parts are running rampant, I have very few chances to feel truly present before another dissociation whisks me away and any deal ever made? All bets are off!!!

I believe it was last Friday that was my last D-Day and it is so confuzzled in my mind that I am not even positive if that was the day. It may have been Thursday. I am sure someone recalls what day it was but that person isn’t me.

What do I recall? I recall dropping in and out of my life at an extremely rapid pace. Each time that I dropped back in, I was reminded of something else that needed to be done. I’d start doing it then suddenly be in a new place at a new time with things yet to be done. It is VERY frustrating. I am quite a busy person and I really do not have a lot of time in my days to “waste” on flickering in and out like some light in a horror movie.

I have come to realize though that these days usually follow times where I feel stressed for some reason or times when I have not been doing a good job at keeping my Helpers involved in my days and my decisions. They can be so well-behaved at times that I forget to include them in on decisions that I am making and that does not bode well…

My trigger this time? Hannah’s pink hippopotamus.
I mentioned it a few weeks ago and since then, I see the box of big toys every time I enter Walmart. Last week I dropped in and to my inner world horror? The box of big toys was gone! Hannah FREAKED. Tracey them became vocal and angry because I had upset Hannah. The other little ones were of course ready to stand up to defend Hannah and her needs as well. Hannah is the youngest Helper that I know of within my Helper circle so the girls only slightly older feel they must protect her.

Don’t think I didn’t feel like a heal and realized very quickly that my hesitance to buy this $15 huge hippo just backfired BIG TIME! I even began to scour other stores and finally found a cute but smaller hippo somewhere else. Anyone who has or knows children well already knows how well this went over. Hannah does not want THAT hippo. She wants HER hippo.

I found it impossible not to take on her petulant, completely peeved, cranky beyond cranky attitude. I didn’t put the two together until yesterday but now I see that it was not me feeling “cranky for no reason”, it was my inner world in absolute turmoil over a (forgive me for saying this) stupid pink hippo. And yes, I know I will pay dearly for how I feel about the hippo but I can not deny I think it is a silly thing to have.

I have been putting a lot of thought in to this and a friend of mine who also has DID discussed buying small Christmas gifts to play with for her little ones. I think she is on to something.

In all truthfulness? I never got to be a child. The first time that I ever really played with toys was while away at Homewood in 2013. Another wonderful friend sent me boxes of toys. Bouncy balls, crayons and colouring books, stuffed toys and all sorts of other little things but I left them there. I could not fit them in my suitcase to bring home. 😦

So why haven’t I bought new ones? Why can’t I buy Hannah her hippo and be happy to give it to her? Don’t worry, if we ever see it again, she’s getting it! Silly in my opinion or not. She will get it and she can do whatever she wants with it.

I also feel the need to fulfil the needs of the other little ones. I’ve unintentionally limited their creative spirits and denied them the chance to be children by my being too busy being an adult to pay attention to their needs.

While on one hand I see this as obviously a huge issue for anyone with DID, I think it can really apply to anyone. When you have DID, your inner parts are separated by walls and quite often, the host is unaware of their existence. this is still true for MANY of my Helpers. I know they are there by other Helpers using their names but I have no contact with them. In other “normal” people, your inner parts have a better flow and you do not need interventions to recall your important memories for the most part.
That does not mean that you don’t still have a child inside of you. One that loved to dance or sing or play with Barbie or G.I. Joe. Maybe you loved to draw as a child and never make time for it now? Who cares if you suck at it? The point is to just have fun and allow that young part of you out to play a bit.
What about your inner teenager? The one that loved loud music and ignoring adults because of how daft we all thought they were? Do you ever just crank that music back up and not worry about the state of your hearing? 😉 Crank it up, lay on your bed and just think about how much better your life with be when…..

We all have all sorts of inner parts. I encourage you to not be so busy being an adult that you ignore the needs of your inner child. It is a HUGE mistake for someone with DID as we start losing control of our inner Helpers but I think it is a shame for anyone to lose those parts of themselves.

Go buy some bubble gum and have a competition with your friends or your family on who can blow the biggest one. Tie your hair back first. I take no liability on what mess you create. 😉
Buy a stuffed animal if you want one. If not that? A model car to put together, a fun game that you loved when you were young, Lego or Star Wars toys (they will be out again soon!). Play! Play with your own children or grandchildren, play on your own, take some time to colour, paint or do something creative. How about finger-painting?
Why not?

Be sweet to your inner child. Yours might not hold your brain hostage for ignoring them but it is still important to be little again now and then.

Have a great week everyone and don’t forget to make some time to play.

hippo

More about Dissociative Disorders

Last week I got very deep and personal. That is hard for me to do but I want to thank you all for your amazing comments and kind thoughts. As a group, you helped me see certain situations from a less personal view and that helped me a lot so thank you.

I thought today I would take a break from the really personal stuff and share some information that I was given by a therapist regarding dissociative disorders. Some of you may see yourself or someone else more clearly by learning about them and then many people will hopefully be a lot like me and just a curious George. 😉

I write all of my own blogs but today I am taking a lot of information out of medical journals as well. The references are all listed at the bottom.

Dissociation is a common defense/reaction to stressful or traumatic situations. Severe isolated traumas or repeated traumas may result in a person developing a dissociative disorder. A dissociative disorder impairs the normal state of awareness and limits or alters one’s sense of identity, memory or consciousness. Once considered rare, recent research indicates that dissociative symptoms are as common as anxiety and depression, and that individuals with dissociative disorders (particularly Dissociative Identity Disorder and Depersonalization Disorder) are frequently misdiagnosed for many years, delaying effective treatmentIn fact, persons suffering from Dissociative Identity Disorder often seek treatment for a variety of other problems including depression, mood swings, difficulty concentrating, memory lapses, alcohol or drug abuse, temper outbursts, and even hearing voices, or psychotic symptoms.  People with dissociation often also seek treatment for a variety of medical problems including headaches, unexplained pains, and memory problems. Many people have symptoms that have gone undetected or untreated simply because they were unable to identify their problem, or were not asked the right questions about their symptoms.  Because dissociative symptoms are typically hidden, it is important to see a mental health professional who is familiar with recent advances in the ability to diagnose dissociative disorders through the use of scientifically tested diagnostic tests. (Someone who believes they even exist is a great place to start.)

What kind of events or experiences are likely to cause symptoms of dissociation? There are various types of traumas. There are traumas within one’s home, either emotional, physical or sexual abuse. Other types of traumas include natural disasters, such as earthquakes, political traumas such as holocausts, hostage situations, wars, random acts of violence, or the grief we feel after the death of a family member or loved one. Dissociation is a universal reaction to overwhelming trauma and recent research with indicates that the manifestations of dissociation are very similar world wide.

Misdiagnosis of People with Dissociative Identity Disorder
Most people with undetected Dissociative Identity Disorder experience depression and often are treated with antidepressant medications. While antidepressant medications may help some of the feelings of depression, it does not alleviate symptoms of dissociation. Some people suffering from undetected dissociative symptoms are misdiagnosed as having psychotic disorders including schizophrenia and are treated with antipsychotic medication resulting in long term side effects. Some other common diagnosis that people with Dissociative Identity Disorder receive include: 

a) bipolar disorder. Mood swings is a very common experience in people who have a dissociative disorder. If you seek help with a professional who is not familiar with dissociative disorders they may only consider bipolar disorder as the reason for your mood swings, when symptoms of dissociation may be the underlying cause.

b) attention deficit disorder. People with Dissociative Identity Disorder commonly experience problems with attention and their memory. Treatment with medication for ADHD may help some of the symptoms associated with poor attention, but again will not help all the symptoms associated with underlying dissociation.

c) eating disorders. People with eating disorders including anorexia, and binging often experience inner feelings of dissociation and may have a coexisting dissociative disorder.

d) alcohol or drug abuse. People with undetected dissociative disorders frequently self medicate with alcohol or drugs.

e) anxiety disorders. People with undetected dissociative disorders often experience generalized anxiety, panic attacks, obsessive compulsive symptoms. Treating only their anxiety will not help their dissociative symptoms.

Other common clues to a dissociative disorder include the fact that a person seems to experience a lot of different symptoms that come and go, and that they have been in treatment for many years and they still seem to have many of their symptoms.

Some people with undetected dissociative symptoms can function well at work or school. Only close friends or family are aware of the person’s inner struggles or suffering. Some times, a person with undetected dissociation may need to be hospitalized  because of feelings of low self esteem, self hatred, self destructive feelings and/or suicidal ideation. The delay in accurate diagnosis results in difficulty maintaining close relationships, working below one’s potential as well as years of unnecessary suffering. This can result in worsening depression and continued mood swings and self destructive behaviors.

People suffering from dissociative disorders can now be identified with the same degree of accuracy as people suffering from other psychiatric or medical disorders. Just like an electrocardiogram can diagnose heart rhythm abnormalities worldwide, individuals who are suffering from a dissociative disorder can now be accurately identified with a test called the SCID-D (Structured Clinical Interview for Dissociative Disorders).  Since dissociation is a universal response to overwhelming trauma, it should not be surprising that dissociative symptoms are the same in cultures that may be very different.

A trained therapist can administer the Structured Clinical Interview for Dissociative Disorders (or SCID-D) in order to detect whether a person is experiencing dissociative symptoms and/or a dissociative disorder. Evaluation with the SCID-D can take three to five hours. Since accurate identification of dissociative symptoms can prevent many years of missed diagnosis and ineffective treatments with medications that can cause potentially serious side effects, it is recommended that one seek out a specialized evaluation with a trained mental health professional as soon as possible.

Five Specific Symptoms of Dissociation

The SCID-D can evaluate whether a person is experiencing specific dissociative symptoms and whether these symptoms are interfering with one’s relationships or work and whether the symptoms are causing distress. The five symptoms of dissociation include:

1) Amnesia or memory problems involving difficulty recalling personal information

2) Depersonalization or a sense of detachment of disconnection from one’s self. A common feeling associated with depersonalization is feeling like a stranger to one’s self.

3) Derealization or a sense of disconnection from familiar people or one’s surroundings

4) Identity confusion or inner struggle about one’s sense of self/identity

5) Identity alteration or a sense of acting like a different person

These five symptoms of dissociation are often hidden and cause much inner turmoil and suffering. Often the person experiences a lot of other symptoms such as anxiety, depression and mood swings. The figure titled “Obvious and Hidden Signs of DID” depicts the inner symptoms of dissociation and the more external symptoms a person might describe to a therapist.

The Five Dissociative Disorders
The SCID-D can identify whether a person is experiencing one of the five types of dissociative disorders. The first four are dissociative amnesia, dissociative fugue, depersonalization disorder and dissociative identity disorder (previously called multiple personality disorder). The fifth type of dissociative disorder, called dissociative disorder, not otherwise specified, occurs when a dissociative disorder is clearly present, but the symptoms do not meet the criteria for the previous four.

The five disorders can be distinguished from one another by the nature and duration of their stressors, as well as the type and severity of the symptoms. A brief review of each dissociative disorder is presented below.

Dissociative Amnesia
A defining characteristic of dissociative, amnesia is the inability to recall important personal information. This common dissociative disorder is regularly encountered in hospital emergency rooms and is usually caused by a single stressful event. Dissociative amnesia is often seen in the victims of single severe traumas such as an automobile accident (forgotten details might include one’s actions immediately before an auto accident in which the person with the disorder was involved). The condition is often seen in wartime; witnessing a violent crime or encountering a natural disaster may also trigger dissociative amnesia.

Dissociative Fugue
Like dissociative amnesia, dissociative, fugue also is characterized by sudden onset resulting from a single severe traumatic event. Unlike dissociative amnesia, however, dissociative fugue may involve the creation of a new, either partial or complete, identity to replace the personal details that are lost in response to the trauma. A person with this disorder will remain alert and oriented, yet be unconnected to the former identity. Dissociative fugue may also be characterized by sudden, unplanned wandering from home or work. Typically, the condition consists of a single episode without recurrence, and recovery is often spontaneous and rapid.

Depersonalization Disorder
The distinguishing characteristic of depersonalization disorder is the feeling that one is going through the motions of life, or that one’s body or self is disconnected or unreal. Mind or body may be perceived as unattached, seen from a distance, existing in a dream, or mechanical. Such experiences are persistent and recurrent, and lead to distress and dysfunction. Chronic depersonalization is commonly accompanied by “derealization,” the feeling that features of the environment are illusory. It should be noted that characteristics attributed to depersonalization disorder must be independent of any kind of substance abuse. It should also be noted that depersonalization as an isolated symptom may appear within the context of a wide variety of major psychiatric disorders. For example, mild episodes of depersonalization in otherwise normally functioning individuals have been reported following alcohol use, sensory deprivation, mild social or emotional stress or sleep deprivation, and as a side effect to medications. However, severe depersonalization is considered to be present only if the sense of detachment associated with the disorder is recurrent and predominant.

Dissociative Identity Disorder (previously called Multiple Personality Disorder)

Dissociative Identity Disorder (DID) occurs in people with varied backgrounds, educational levels, and from all walks of life. DID is believed to follow severe trauma including persistent psychological, physical, or sexual abuse during one’s childhood. In this condition, distinct, coherent identities exist within one individual and are able to assume control of the person’s behavior and thought (American Psychiatric Association, 1987). Unlike depictions in sensationalistic movies, most people with DID do not have dramatic shifts in personality and only persons very close to them are aware of mood swings. In DID, the patient experiences amnesia for personal information, including some of the identities and activities of alternate personalities. Some people with DID experience subtle memory problems, and may only appear to have memory problems associated with attention deficit disorder.

 DID is often difficult to detect without the use of specialized interviews and/or tests, due to: 1) the hidden nature of the dissociative symptoms, and 2) the coexistence of depression, anxiety, or substance abuse which may mask the dissociative symptoms, and 3) feelings of disconnection that are often difficult to verbalize.

Because people with DID may experience depression, mood swings, anxiety, inattention, transient psychotic like states, and may self-medicate with drugs or alcohol, they are frequently diagnosed as having solely bipolar disorder, major depression, attention deficit disorder, anxiety disorders, psychotic or substance abuse disorders. Studies indicate that previous diagnoses in these areas are common to people with DID. It is not uncommon for a decade or more to pass before a correct assessment of DID is made. Research with the Structured Clinical Interview for Dissociative Disorders has identified five distinct dissociative symptoms experienced in individuals who have DID (see section above, Five Dissociative Symptoms.)

Though DID is the most severe of the dissociative disorders, this disorder  can respond well to specialized psychotherapy which focuses on understanding the dissociative symptoms and developing new constructive ways of coping with stress.  Medication can be used as an adjunct to psychotherapy, but is not the primary form of treatment.

References

Steinberg M:   Handbook for the Assessment of  Dissociation:  A Clinical Guide.  Washington, D.C., American Psychiatric Press, 1995

Steinberg M:  The Structured Clinical  Interview for DSM-IV Dissociative Disorders-Revised (SCID-D).   Washington, D.C., American Psychiatric Press, 1994.

Steinberg M:  The Interviewer’s Guide to the Structured Clinical Interview for DSM-IV Dissociative Disorders- Revised.   Washington, D.C., American Psychiatric Press, 1994

Steinberg M:  Advances in Diagnosing and Treating Dissociative Disorders: The SCID-D-R.  Bulletin of the Menninger Clinic. 146-163,  Spring 2000