Excerpt
Agreeing to write the foreword for this book caused me to review both Christine's and my own journey with Dissociative Identity Disorder (D.I.D.). My training did not focus on helping people with what was then called Multiple Personality Disorder (MPD). Indeed, it was more common to debate whether the disorder existed at all than to discuss treatment methods. What I was taught and was able to find in my own review of the literature suggested that the therapist should determine which one of the personalities was the 'core' or primary personality and direct most efforts to assisting this personality. It was thought that the other personalities were less important and 'complete' than the core personality and, indeed, were termed 'alters' in much of what I was taught and read. Somehow the alters would eventually agree to 'die' or to stop taking executive control of the person's mind and body. I could not see how they would agree to do so. There was a significant lack of research into the topic. Therefore, there was no evidence-based manner in which I could see to proceed. The prevailing theories about how to treat patients with D.I.D. did not strike me as sensible. I was not clear on how I should proceed to assist these people. This did not sit well with me.
I first became aware of Christine Ducommun when her therapist at the time contacted me for a consultation. She described an adult woman who was manifesting a child personality and wondered whether it would be potentially harmful to engage in play therapy with the patient in the child persona. While not certain in my response, it seemed sensible to me that if a child personality would be more comfortable receiving therapy in a play setting that it would likely not harm her. What my training did very well was encourage me to focus on the person in therapy and to provide the safest and most comfortable environment that I could in order to facilitate personal exploration. It was with this in mind that I recommended play therapy for the child personality. Christine's initial therapist consulted with me regarding her care a few more times before she ultimately retired, leaving Christine without a treatment provider. It was also around that time that Christine was charged with criminal offenses that were committed by another of her personalities. It was in this context that I agreed to become her primary therapist.
Early visits were focused on the establishment of trust and the creation of a safe and comfortable treatment setting. It was difficult for Christine to trust anyone at that time, much less a large and imposing man in a position of authority. Rather than use prevailing theories on treating DID, I determined to treat each of her personalities as complete people unto themselves. That is, while I recognized that none of Christine's personalities could be considered complete, functional people as each had a specific set of skills and abilities while almost completely lacking others, each still needed to be valued as individuals. For me it was a matter of respect. In fact, I determined to call each of her personalities 'selves,' rather than 'alters,' and to treat each as if they were separate patients. This approach seemed sensible to me and was well-received by Christine.
Once I became familiar with most of the selves that made up Christine's dissociative system, the task became to increase cooperation amongst them. D.I.D. is associated with powerful amnestic barriers between many of the selves. Some individuals within the system feel unable to manage certain kinds of situations, for example, an angry confrontation. When faced with an angry confrontation, people with DID switch to a self who is more comfortable and able to manage such situations. In this way, individuals in the system are able to avoid situations that cause them to feel fear or discomfort. I encouraged Christine's selves to share experiences. That is, I encouraged selves to 'look through the eyes' of the self who was in control at the time so that they would be exposed to a wider range of experiences and so that they would learn that they could tolerate and manage emotions and could share skills amongst themselves. In this way, selves could gain mastery and confidence.
Finally, it was important for misunderstandings and conflicts amongst the selves to be mediated. With strong amnestic barriers there is the potential for powerful mistrust. The actions of some selves are difficult for other selves to accept, for example aggressive, criminal or sexual behavior to a highly moral and virtuous self. This can contribute to selves opposing and demonizing other selves. In Christine's care it was important to help her selves to recognize that each self has an equal right to exist and an equal right to determine their own course in life. As the selves shared experiences by looking through each other's eyes, the need for amnestic barriers decreased and differences between the selves gradually diminished until we were left with a single individual Christine.
It is with great pleasure that I offer this foreword to a book that describes Christine's long and successful journey. It has been my great pleasure to know and work with her. I hope that her book provides encouragement and strength to others in similar circumstances. Recovery is possible. Dr. Doug Jurgens