Virtual Group Work and DID – Raising Awareness For Psychotherapists
The pain and sadness was evident on the face of 72 year old Ruth. After years and years of struggling, she had finally been seen by a professional who recognized her symptoms as DID and healing had progressed in an astounding way every since. “So much of my life was wasted. What do you need to know so that others do not have to wait to get the help they need?” she asked our therapists’ group. Like Ruth many suffer in silence, their condition exacerbated by inappropriate medications, professionals that don’t understand or believe them, and a constant fear that they are really ‘crazy’.
As a reaction to repeated abuse some children begin to create imaginary characters to hold the brunt of the trauma. Thus begins a lifetime of assigning pain and memories to ‘others’ so the ‘host’ no longer has to feel. An entire system of alters is created and the ‘craziness’ begins as the adult switches or dissociates. This compartmentalization helps the person survive the brutality of their experience.
Virtual group work is no surprise to those of us who have worked with DID clients. They bring with them a whole group, in their heads, made up of different ages and genders and even different mental health issues! At some point these ‘individual’ participants begin to interact with each other and then group dynamics takes on a whole new meaning!
But let me back up a bit for those of you who may be skeptical. We have all had clients who have experienced childhood abuse or trauma. As adults their symptoms are very much like PTSD and we comfortably begin to help them with their memories, hyper vigilance and anxiety. After awhile we may notice that our usual tools are not working as well and relief is temporary for the client. Medications are not helpful. Suicidal thoughts or self-injury behaviors seem to come out of nowhere and then suddenly disappear.
Strangely these clients are honest about substance abuse describing it as a means to “shut myself up” or “explain my quirky behavior”. Some clients can seem completely functional and professional in certain areas like work. Their ability to focus is often exceptional. Still, at other times there will be an outburst of radically different behavior that is out of character. Some of these behaviors might involve cruising for sexual partners, child like behavior such as climbing a tree or suddenly exhibiting an expertise or talent they are unable to demonstrate at other times.
Another clue that DID is present is a very high tolerance of pain. A client was in a car accident but only went to the doctor days later because the lawyer requested the consultation. The doctor was astonished to find my client’s chest severely bruised and she refused painkillers. She didn’t understand what the fuss was about. This is tied to the client’s excellent ability to compartmentalize thoughts and feelings. You might also notice headaches or a sense of dizziness proceeds behavior changes or panic attacks. Your client may be switching to another alter.
Here are some clues that you are dealing with a ‘group’. Clients will talk about constant chatter, running commentary or arguments in their heads. Journal entries may have noticeable changes in handwriting. E-mails or phone messages may have different vocabulary or tone. Stories of abuse will be shared one week and completely denied the next even apologizing for wasting your time.
It is true you cannot safely diagnose DID until you have witnessed an alternate personality. It helps to use the DES questionnaire for more indicators. Unofficially, when my client politely leans towards me and with a sweep of her hand circles her face and asks me “Are you telling me there is really nothing going on in your head?” and they are astonished that I live with such ‘emptiness’, I have a good clue that this client has been dealing with a life long, complicated and busy system of alters. Then I can begin the ‘group’ work that will lead to the empty contentment I so enjoy myself!
Jane Parker is a licensed mental health therapist in Bradenton, Florida who has a special interest in Dissociative Identity Disorder. Together with Sue Mackey she is co-owner of New View Counseling providing opportunities for a fresh perspective for clients ready to make a change in their lives and relationships.
http://www.newviewcounseling.com