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She's a Killer

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Kirsten McDougall

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“A refusal on the part of psychiatrists and therapists to validate the horrors of their patients' tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable. Such a denial is, however, no longer ethical, for it is in the human capacity to dissociate that lies part of the secret of both childhood abuse and the horrors of the Nazi genocide, both forms of human violence so often carried out by 'respectable' men and women.”

“DID may be underdiagnosed. The image derived from classic textbooks of a florid, dramatic disorder with overt switching characterizes about 5% of the DID clinical population. The more typical presentation is of a covert disorder with dissociative symptoms embedded among affective, anxiety, pseudo-psychotic, dyscontrol, and self-destructive symptoms, and others (Loewenstein, 1991). The typical DID patient averages 6 to 12 years in the mental health system, receiving an average of 3 to 4 prior diagnoses. DID is often found in cases that were labeled as "treatment failures" because the patient did not respond to typical treatments for mood, anxiety, psychotic, somatoform, substance abuse, and eating disorders, among others. Rapid mood shifts (within minutes or hours), impulsivity, self-destructiveness, and/or apparent hallucinations lead to misdiagnosis of cyclic mood disorders (e.g., bipolar disorder) or psychotic disorders (e.g., schizophrenia).”

“My own studies on the natural history of DID indicate only 20% of DID patients have an overt DID adaption on a chronic basis, and 14% of them deliberately disguise their manifestations of DID. Only 6% make their DID obvious on an ongoing basis. Eighty percent have windows of diagnosability when stressed or triggered by some significant event, interaction, situation or date. Therefore, 94% of DID patients show only mild or suggestive evidence of their conditions most of the time. Yet DID patients often will acknowledge that their personality systems are actively switching and/or far more active than it would appear on the surface (Loewenstein et al., 1987). R.P. Kluft (2009) A clinician's understanding of dissociation. pp 599-623.”

“In 1973, Jan Erik Olsson walked into a small bank in Stockholm, Sweden, brandishing a gun, wounding a police officer, and taking three women and one man hostage. During negotiations, Olsson demanded money, a getaway vehicle, and that his friend Clark Olofsson, a man with a long criminal history, be brought to the bank. The police allowed Olofsson to join his friend and together they held the four hostages captive in a bank vault for six days. During their captivity, the hostages at times were attached to snare traps around their necks, likely to kill them in the event that the police attempted to storm the bank. The hostages grew increasingly afraid and hostile toward the authorities trying to win their release and even actively resisted various rescue attempts. Afterward they refused to testify against their captors, and several continued to stay in contact with the hostage takers, who were sent to prison. Their resistance to outside help and their loyalty toward their captors was puzzling, and psychologists began to study the phenomenon in this and other hostage situations. The expression of positive feelings toward the captor and negative feelings toward those on the outside trying to win their release became known as Stockholm syndrome.”

“Their experiences led them to create assumptions about others and related beliefs about themselves such as "this is my lot in life" and "this is what I deserve". Some also learned that personal safety and happiness are of lower priority than survival and that it may be safer to give in than to actively fight off additional abuse and victimization. When abuse is perpetrated by intimates, it is additionally confounding in terms of attachment, betrayal, and trust. Victims may be unable to leave or to fight back due to strong, albeit insecure and disorganized, attachment and misplaced loyalty to abusers. They may have also experienced trauma bonding over the course of their victimization, that is, a bond of specialness with or dependence on the abuser.”