Dissociative Identity Disorder – Dealing with a difficult Alter

I had a very enlightening session with my Psychotherapist today. We didn’t do any EMDR as we decided my suicidality was too high, I would dissociate too much. Not a good mix so we decided to discuss my Mother alter and the amazing influence she had been having on my life in the last few months and different approaches we might take to tackle that issue without alienating her.

In doing this we both knew there was a risk that I would switch to her alter and she would lock horns with the Psychotherapist. When that happened she became truculent, rude, petulant and argumentative. My therapist didn’t engage but spoke politely to her eliciting as much information about the past as she could to help build as complete a picture of my abusive childhood as possible. Amazing what she was told that I in my present self or other alters did not tell her or seem to know. Today thankfully she listened intently to the conversation and spoke through me, warning the therapist when she was unhappy with what was being said but I did not switch to her. Unusual.

My therapist had recently joined a Dissociative Identity Disorders Psychotherapists Association in the United States and was involved in a very interesting chat forum on ways of dealing with Alters and the benefits of merging them into the present day person as opposed to separating them and placing them in a ‘black box’. The consensus seemed to favour separation but gaining as much strength from the alter as possible. In the case of harmful alter separation, was favoured but this is a difficult form of treatment and takes some time but can be achieved through careful planning and painstaking work. Therapeutic alliance is vital. he purpose of a therapeutic relationship is to assist the individual in therapy to change his or her life for the better. Such a relationship is essential, as it is oftentimes the first setting in which the person receiving treatment shares intimate thoughts, beliefs, and emotions regarding the issue(s) in question. As such, it is very important that therapist provides a safe, open, and non-judgmental atmosphere where the affected individual can be at ease.

Trust, respect, and congruence are major components of a good therapeutic relationship. Therapists are encouraged to show empathy and genuineness. As with any other social relationship, the therapeutic relationship has boundaries which help to define acceptable and unacceptable behaviors.

Establishing a therapeutic relationship is a vital step in the recovery process and for the relationship to be productive, trust is key. A person seeking a therapist must trust that his or her therapist has the knowledge, skill set, and desire to provide appropriate care. Since the balance of power in the therapeutic relationship greatly favors the therapist, a person in treatment must also trust that confidential matters will remain confidential, and that he or she is safe from harm or exploitation at the hands of the therapist.

Once the therapeutic relationship is formed, an individual in therapy might be more inclined to open up emotionally and provide further details about his or her concerns. This, in turn, helps the therapist to better comprehend the affected person’s point of view, feelings, and motives. Equipped with a more complete understanding of the situation, the therapist is then able to provide the most appropriate treatment and employ the most effective strategies in order to address the issue. I have been with my psychotherapist five years now and we have a very strong alliance. I have told her my entire story and she is privy to aspects of my life absolutely no one else is or every will be. I trust her implicitly.

In my case, my Mother alter is very destructive and demands suicide and self-harm. I have lost count of the number of times my arms have been stitched all under her instruction. She works in with my present day self who is riddled with guilt for the abuse that happened and feels shame, guilt and plays on that. She uses that vulnerability to push her self-harm agenda. We agreed today that through my alliance with my therapist I need to call on it to slowly start pushing back against my mother’s wishes. This is very difficult given that often the switching happens under dissociation. The trick is to catch the dissociation before it happens. I do have warning signs. I get an aura just a person gets when they’re getting a migraine. That will help. It’s only a small step but one step at least. I am then as soon as possible to call my therapist or tell my husband what has happened and gain support. Reassurance of having done the ‘right thing’ is vital. Each small battle one needs to be acknowledged. The strength then needs to be recognised and celebrated. So that’s my goal for the next week. I hope to stay safe in between.

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