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“The development of an incipient careseeking/caregiving system involves moving from avoidance to intra-subjectivity. This can be very anxiety-provoking. One person described it as a 'crisis of attachment '. Any past internal relating is likely to have been highly ambivalent at best. This is my face and which internal beliefs, such as being unworthy of care, which were formed in identification with the perpetrator, are challenged. The little creature [a hidden dissociated part of the self] may perceive both caregiving and careseeking as dangerous. He or she may fear being vulnerable to further abuse or exploitation and 'flinches, expecting pain again '.”

“Dissociation, in a general sense, refers to a rigid separation of parts of experiences, including somatic experiences, consciousness, affects, perception, identity, and memory. When there is a structural dissociation, each of the dissociated self-states has at least a rudimentary sense of "I" (Van der Hart et al., 2004). In my view, all of the environmentally based "psychopathology" or problems in living can be seen through this lens.”

“In this chapter I restrict myself to exploring the nature of the amnesia which is reported between personality states in most people who are diagnosed with DID. Note that this is not an explicit diagnostic criterion, although such amnesia features strongly in the public view of DID, particularly in the form of the fugue-like conditions depicted in films of the condition, such as The Three Faces of Eve (1957). Typically, when one personality state, or ‘alter’, takes over from another, they have no idea what happened just before. They report having lost time, and often will have no idea where they are or how they got there. However, this is not a universal feature of DID. It happens that with certain individuals with DID, one personality state can retrieve what happened when another was in control. In other cases we have what is described as ‘co-consciousness’ where one personality state can apparently monitor what is happening when another personality state is in control and, in certain circumstances, can take over the conversation.”

“Dissociative identity disorder is conceptualized as a childhood onset, posttraumatic developmental disorder in which the child is unable to consolidate a unified sense of self. Detachment from emotional and physical pain during trauma can result in alterations in memory encoding and storage. In turn, this leads to fragmentation and compartmentalization of memory and impairments in retrieving memory.2,4,19 Exposure to early, usually repeated trauma results in the creation of discrete behavioral states that can persist and, over later development, become elaborated, ultimately developing into the alternate identities of dissociative identity disorder.”

“Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters. Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal. Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.”

“Because DID requires the presence of amnesia, DID patients are, by DSM-5 definition (American Psychiatric Association, 2013), unaware of some of their behavior in different states. Progress in treatment includes helping patients become more aware of, and in better control of, their behavior across all states. To those who have not had training in treating DID, this increased awareness may make it seem as if patients are creating new self-states, and “getting worse,” when in fact they are becoming aware of aspects of themselves for which they previously had limited or no awareness or control. Although some DID patients create new self-states in adulthood, clinicians strongly advise patients against so doing (Fine, 1989; ISSTD, 2011; Kluft, 1989).”

“Can the splitting of representations explain multiplicity? Not at all, for two reasons.20 First, a split is into two, not many. The splitting of self and object representations manifest polarity: self-object, good-bad, male-female, friend-foe, and so on, whereas alters generally don't (though they may). Second, hosts and alters are intentional subjects or agents, entities capable of uttering "I." Indeed, one may profitably regard alter as short for alter ego, literally "other I." A given "I" has intentional objects that are its respective self and object representations. In other words, a split representation, even of the self, is an object of thought, not a thinker, not a subject or agent or "I.”

“Why do I take a blade and slash my arms? Why do I drink myself into a stupor? Why do I swallow bottles of pills and end up in A&E having my stomach pumped? Am I seeking attention? Showing off? The pain of the cuts releases the mental pain of the memories, but the pain of healing lasts weeks. After every self-harming or overdosing incident I run the risk of being sectioned and returned to a psychiatric institution, a harrowing prospect I would not recommend to anyone. So, why do I do it? I don't. If I had power over the alters, I'd stop them. I don't have that power. When they are out, they're out. I experience blank spells and lose time, consciousness, dignity. If I, Alice Jamieson, wanted attention, I would have completed my PhD and started to climb the academic career ladder. Flaunting the label 'doctor' is more attention-grabbing that lying drained of hope in hospital with steri-strips up your arms and the vile taste of liquid charcoal absorbing the chemicals in your stomach. In most things we do, we anticipate some reward or payment. We study for status and to get better jobs; we work for money; our children are little mirrors of our social standing; the charity donation and trip to Oxfam make us feel good. Every kindness carries the potential gift of a responding kindness: you reap what you sow. There is no advantage in my harming myself; no reason for me to invent delusional memories of incest and ritual abuse. There is nothing to be gained in an A&E department.”

“The return of the voices would end in a migraine that made my whole body throb. I could do nothing except lie in a blacked-out room waiting for the voices to get infected by the pains in my head and clear off. Knowing I was different with my OCD, anorexia and the voices that no one else seemed to hear made me feel isolated, disconnected. I took everything too seriously. I analysed things to death. I turned every word, and the intonation of every word over in my mind trying to decide exactly what it meant, whether there was a subtext or an implied criticism. I tried to recall the expressions on people’s faces, how those expressions changed, what they meant, whether what they said and the look on their faces matched and were therefore genuine or whether it was a sham, the kind word touched by irony or sarcasm, the smile that means pity. When people looked at me closely could they see the little girl in my head, being abused in those pornographic clips projected behind my eyes? That is what I would often be thinking and such thoughts ate away at the façade of self-confidence I was constantly raising and repairing. (describing dissociative identity disorder/mpd symptoms)”

“Of course, I should have known the kids would pop out in the atmosphere of Roberta's office. That's what they do when Alice is under stress. They see a gap in the space-time continuum and slip through like beams of light through a prism changing form and direction. We had got into the habit in recent weeks of starting our sessions with that marble and stick game called Ker-Plunk, which Billy liked. There were times when I caught myself entering the office with a teddy that Samuel had taken from the toy cupboard outside. Roberta told me that on a couple of occasions I had shot her with the plastic gun and once, as Samuel, I had climbed down from the high-tech chairs, rolled into a ball in the corner and just cried. 'This is embarrassing,' I admitted. 'It doesn't have to be.' 'It doesn't have to be, but it is,' I said. The thing is. I never knew when the 'others' were going to come out. I only discovered that one had been out when I lost time or found myself in the midst of some wacky occupation — finger-painting like a five-year-old, cutting my arms, wandering from shops with unwanted, unpaid-for clutter. In her reserved way, Roberta described the kids as an elaborate defence mechanism. As a child, I had blocked out my memories in order not to dwell on anything painful or uncertain. Even as a teenager, I had allowed the bizarre and terrifying to seem normal because the alternative would have upset the fiction of my loving little nuclear family. I made a mental note to look up defence mechanisms, something we had touched on in psychology.”

“KIuft (1985a, b) describes eight year old Tom, who could "space out," but remain aware of partially dissociated alter personalities. One, Marvin, was based on the character Captain Kirk of the TV series "Star Trek," and on the TV series character "Hulk." Marvin also represented Tom's father. Another alter personality was derived from Mr. Spock, who was also identified with his mother. Two female alter personalities had names taken from 'The Flintstones." The use of fantasy is clearly apparent despite the fantasized characters being identifications with real characters in the child's life. Tom gives us a glimpse of the transition of his fantasies becoming dissociated mental structures.”

“Whatever the theory, it is important to note that clinicians such as Kluft draw attention to the clinical error of insisting that all alters talk as one or that only the alter with the legal name should be validated. 'Such stances are commonly associated with therapeutic failure'.”

“In the world of alters, anything is possible. This is because alters are partly based upon make-believe, and the underiying reasoning is not derived from normal linear logic but consists of 'trance logic', the toleration of completely unrealistic and contradictory ideals which might be found in a state of hypnosis.”

“Children in our culture are familiar with transformation of identity from comics, movies, television, and books. Who has not watched a child zooming around on the sidewalk or in the backyard, pretending to be a superhero or some other figure? Who can doubt the child's intensity of imaginative involvement in this transformation? I think it is reasonable to say that the normal child partly believes in this transformation on a transient basis. It is not necessary to wonder where the MPD child gets the idea of creating someone else inside to cope with the abuse. The strategy of transformation of identity to gain strength, coping power, even and vulnerability is readily available in the child's environment.”

“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 unclear. We know that the diagnosis is DID and that DID is what people say we have. We’d just like to point out that words sometimes do not describe what we live with. For people like us, DID is just a step on the way to where we live—a place with many of us inside! We just want people who have little ones and bigger ones living inside to know that the title Dissociative Identity Disorder sounds like something other than how we see ourselves—we think it is about us having different personalities. Regardless of the term, it is clear that, in general, the different personalities develop as a reaction to severe trauma. When the person dissociates, they leave their body to get away from the pain or trauma. When this defense is not strong enough to protect the person, different personalities emerge to handle the experience. These personalities allow the child to survive: when the child is being harmed or experiencing traumatic episodes, the other personalities take the pain and/ or watch the bad things. This allows these children to return to their body after the bad things have happened without any awareness of what has occurred. They do this to create different ways to make sense of the harm inflicted upon them; it is their survival mechanism.”

“Delusions Dissociative disorders, even those created by mind controllers, are not psychosis, but this program will create the most common symptom used to diagnose schizophrenia. The child is hurt while on a turntable, with people and television sets and cartoons and photographs all around the turntable. New alters created by the torture are instructed that they must obey their instructions and become the people around them, people on television, or other alters when they are told to. When this program is triggered, the survivor will hear “voices” of the people whom the "copy alters” are imitating, or will have many confused alters popping out who think they are actually other people or movie stars. The identities of the copy alters change when the survivor's surrounding change.”

“Several recent studies (Bliss, 1980; Boon & Draijer, 1993a; Coons & Milstein, 1986; Coons, Bowman, & Milstein, 1988; Putnam et al., 1986; Ross et al., 1989b) are largely consistent in terms of the general trends that they demonstrate. At the time of diagnosis (prior to exploration) approximately two to four personalities are in evidence. In the course of treatment an average of 13 to 15 are encountered, but this figure is deceptive. The mode in virtually all series is three, and median number of alters is eight to ten. Complex cases, with 26 or more alters (described in Kluft, 1988), constitute 15-25% of such series and unduly inflate the mean. Series currently being studied in tertiary referral centers appear to be more complex still (Kluft, Fink, Brenner, & Fine, unpublished data). This is subject to a number of interpretations. It is likely that the complexity of the more difficult and demanding cases treated in such settings may be one aspect of what makes them require such specialized care. It is also possible that the staff of such centers is differentially sensitive to the need to probe for previously undiscovered complexity in their efforts to treat patients who have failed to improve elsewhere. However, it is also possible that patients unduly interested in their disorders and who generate factitious complexity enter such series differently, or that some factor in these units or in those who refer to them encourages such complexity or at least the subjective report thereof.”

“Weird? Absurd? That’s how it seemed to me. I had these forces, these compunctions, these alternative personalities inside me, driving me. It was like being a jack-in-the-box and I was unsure which personality was going to jump out next: Billy, who thought of himself as a cowboy or a terrorist; Kato the cutter; anorexic Shirley, whose only self-indulgence was binge drinking and the occasional salad sandwich. I didn’t dislike Shirley. I was afraid of her. Shirley knew things I didn’t.”

“One of the most frightening aspects of this alleged technology is the possibility of mind control by “remote control,” that is, through such technology as microwaves and radio waves. There are many stories about this, coming primarily from survivors, although we do know from a variety of reliable websites and mainstream news that such technology is being developed, or at least the technological groundwork laid. Once again, however, we do not know whether this was in place when today's survivors were programmed. It is difficult at this point to determine how much of this is genuine, and how much comes from false beliefs deliberately induced to make survivors feel powerless, much like the “one huge and invincible cult” of whose existence survivors convinced therapists twenty years ago. I know that one of my mind control survivor clients was convinced of technological monitoring during a psychotic period several years ago, but as he healed he discarded such beliefs, along with many other bizarre ones in favor of recognizing that he had been abused by real human beings whose identity he knew. If some of this remote control it is genuine, we may need to develop technological means to combat it. However, we should not be intimidated. Even if “voices” are induced in the head by remote control rather than through alters doing jobs, survivors can learn to disobey such voices just as they do those of alters. Competent and compassionate therapy for the dissociation can help survivors to heal. Meanwhile, there are numerous survivors whose mind control is of the kind that can be treated through psychotherapy. p205-206”

“Some alters are what Dr Ross describes in Multiple Personality Disorder as 'fragments', which are 'relatively limited psychic states that express only one feeling, hold one memory or carry out a limited task in the person's life. A fragment might be a frightened child who holds the memory of one particular abuse incident.' In complex multiples, Dr Ross continues, the `personalities are relatively full-bodied, complete states capable of a rang of emotions and behaviours.' The alters will have `executive control some substantial amount of time over the person life'. He stresses, and I repeat his emphasis, 'Complex MPD with over 15 alter personalities and complicated amnesic barriers are associated with 100 percent frequency of childhood physical, sexual and emotional abuse.”

“Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.”

“Shortly after I began work with Teresa, I acquired another MPD client, a supposedly schizophrenic young man I will call Tony. He called in to the clinic on a day I was on telephone duty, saying he was having flashbacks of "ritual abuse.” I did not yet know what that was. Tony became my client. He could be quite entertaining. I have a vivid memory of him as a three-year-old, "Tiny Tony,” standing on his head on my office couch, and running down the hall to try unsuccessfully to make it to the bathroom. He had in his head the entire rock band of Guns’n’Roses, and I got to know Axl, the band leader, quite well. I remember the time Tony was in hospital and I went to visit him; Axl popped out and said, "Remember, we’re schizophrenic in here!”

“Some alters are what Dr Ross describes in Multiple Personality Disorder as 'fragments'. which are 'relatively limited psychic states that express only one feeling, hold one memory, or carry out a limited task in the person's life. A fragment might be a frightened child who holds the memory of one particular abuse incident.' In complex multiples, Dr Ross continues, the 'personalities are relatively full-bodied, complete states capable of a range of emotions and behaviours.' The alters will have 'executive control some substantial amount of time over the person's life'. He stresses, and I repeat his emphasis, 'Complex MPD with over 15 alter personalities and complicated amnesia barriers are associated with 100 percent frequency of childhood physical, sexual and emotional abuse.' Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.”

“Also, look for “floating alters.” These are not deliberately created parts of the system, but alters that were accidentally split off at the same time as others.”

“I resolved to come right to the point. "Hello," I said as coldly as possible, "we've got to talk." "Yes, Bob," he said quietly, "what's on your mind?" I shut my eyes for a moment, letting the raging frustration well up inside, then stared angrily at the psychiatrist. "Look, I've been religious about this recovery business. I go to AA meetings daily and to your sessions twice a week. I know it's good that I've stopped drinking. But every other aspect of my life feels the same as it did before. No, it's worse. I hate my life. I hate myself." Suddenly I felt a slight warmth in my face, blinked my eyes a bit, and then stared at him. "Bob, I'm afraid our time's up," Smith said in a matter-of-fact style. "Time's up?" I exclaimed. "I just got here." "No." He shook his head, glancing at his clock. "It's been fifty minutes. You don't remember anything?" "I remember everything. I was just telling you that these sessions don't seem to be working for me." Smith paused to choose his words very carefully. "Do you know a very angry boy named 'Tommy'?" "No," I said in bewilderment, "except for my cousin Tommy whom I haven't seen in twenty years..." "No." He stopped me short. "This Tommy's not your cousin. I spent this last fifty minutes talking with another Tommy. He's full of anger. And he's inside of you." "You're kidding?" "No, I'm not. Look. I want to take a little time to think over what happened today. And don't worry about this. I'll set up an emergency session with you tomorrow. We'll deal with it then." Robert This is Robert speaking. Today I'm the only personality who is strongly visible inside and outside. My own term for such an MPD role is dominant personality. Fifteen years ago, I rarely appeared on the outside, though I had considerable influence on the inside; back then, I was what one might call a "recessive personality." My passage from "recessive" to "dominant" is a key part of our story; be patient, you'll learn lots more about me later on. Indeed, since you will meet all eleven personalities who once roamed about, it gets a bit complex in the first half of this book; but don't worry, you don't have to remember them all, and it gets sorted out in the last half of the book. You may be wondering -- if not "Robert," who, then, was the dominant MPD personality back in the 1980s and earlier? His name was "Bob," and his dominance amounted to a long reign, from the early 1960s to the early 1990s. Since "Robert B. Oxnam" was born in 1942, you can see that "Bob" was in command from early to middle adulthood. Although he was the dominant MPD personality for thirty years, Bob did not have a clue that he was afflicted by multiple personality disorder until 1990, the very last year of his dominance. That was the fateful moment when Bob first heard that he had an "angry boy named Tommy" inside of him. How, you might ask, can someone have MPD for half a lifetime without knowing it? And even if he didn't know it, didn't others around him spot it? To outsiders, this is one of the most perplexing aspects of MPD. Multiple personality is an extreme disorder, and yet it can go undetected for decades, by the patient, by family and close friends, even by trained therapists. Part of the explanation is the very nature of the disorder itself: MPD thrives on secrecy because the dissociative individual is repressing a terrible inner secret. The MPD individual becomes so skilled in hiding from himself that he becomes a specialist, often unknowingly, in hiding from others. Part of the explanation is rooted in outside observers: MPD often manifests itself in other behaviors, frequently addiction and emotional outbursts, which are wrongly seen as the "real problem." The fact of the matter is that Bob did not see himself as the dominant personality inside Robert B. Oxnam. Instead, he saw himself as a whole person. In his mind, Bob was merely a nickname for Bob Oxnam, Robert Oxnam, Dr. Robert B. Oxnam, PhD.”

“I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices. First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different. The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.”

“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”

“Two entirely distinct state of consciousness were present which alternated very frequently and without warning and which became more and more differentiated in the course of the illness. In one of these states she recognized her normal surroundings; she was melancholy and anxious, but relatively normal. In the other state she hallucinated and was "naughty" —that is to say, she was abusive, used to throw the cushions at people, so far as the contractures at various times allowed, tore buttons off her bedclothes and linen with those of her fingers which she could move, and so on. At this stage of her illness if something had been moved in the room or someone had entered or left it (during her other state of consciousness) she would complain of having "lost" some time and would remark upon the gap in her train of conscious thoughts.”