Talking About Myself Behind My Back
Dr. Hutt's Published Article on panic and anxiety disorders in children and adults in the WSCA (Western Suffolk Counselors Association) Publication, Spring 2013
Current Life Symptoms and Past Life TraumaJamie contacted me about a pain in her neck. I told her that I’m not a chiropractor. Now that the ice was broken we proceeded. Psychotherapy, hypnosis, meditation, medication; an array of traditional medical and alternative practitioners were unable to make a dent in her neck pain. MRI and X-rays were negative. She was desperate for a solution. She inquired about past life therapy (PLT).
As a psychotherapist/hypnotist and practitioner of past life regression therapy I was eager to give it a shot. The approach is to simply offer a path to finding the original cause and promise no more than that (Woolger, 1988). If the stars align and this approach can ameliorate a symptom on a permanent basis, that’s gold.
The first two regressions were unremarkable. The third was stunning. Jamie was on the floor of my office wailing in pain. Two Nazi SS troops were kicking her as she cradled her baby in her arms. Screaming in horror and agony I asked her what the soldiers are saying. She responded in German. After the session she tells me it is a language she does not speak. This is a phenomena known as Xenoglossia, defined as a paranormal phenomenon where a person speaks a language that they do not have knowledge of (Matlock, 2017). After the session ends and she is spent, sitting on the floor, we talk. Jamie is an observant Jew with strong ties to the state of Israel. I gave her time to breathe before we processed this past trauma. From that session on she was completely asymptomatic. Her neck pain abated abruptly. But this article is not about Jamie. It’s about the person who she referred to me for help after we terminated.
My Most Unusual Patient
When I met Zara in my waiting room I had no idea that she would become the most unusual patient I have ever treated. Zara suffered from dissociative identity disorder (5th ed; DSM-5, American Psychiatric Association, 2013), formerly known as multiple personality disorder, that included 25 different personalities. Rather than a multiplicity of past lives, this was one life with many selves. Initially though Zara presented as a typical patient, one haunted by vague memories of sexual trauma, a difficult childhood, and strained family relationships in adulthood.
Zara told me that she had a difficult childhood with many holes in her memory and lapses in her recollection of past events. She knew for sure that she had been sexually assaulted in a hospital by a janitor when she was around 9, but that nothing had been done about it and her family just seemed to want the incident to disappear. She also had vague intimations of something similar that had occurred with her father. But mostly there was doubt, confusion, and uncertainty. As a regression therapist I could have initially done memory retrieval but I intuitively knew that was not appropriate. As a former supervisor would say, “Continue doing archeology, dig for the truth, as best as you can”. I did not want to force anything in order to let things unfold organically.
Historical Abuse and Complex Family Dynamics
As therapy progressed, Zara had many dreams of violence, death, and sexual assault. Memories began to emerge of sexual abuse inflicted by her father, and recurring urinary tract infections as a young girl – a potential sign of abuse. Graphic scenes of rape flooded her memory. The sexual abuse was also accompanied by manipulation and emotional abuse.Her father told her that he loved her differently than her sister, and it was a love that could only be expressed sexually. As often happens in such cases, she came to identify with her aggressor (Shaw, 2014). She believed that she was responsible for her predicament, which young victims are particularly prone to believing. Convincing such a person “It’s not your fault” is so much easier said than done. There were deep seated levels of subconscious internalized conflict to reframe and redefine for Zara.
The other members of her family – her mother and her younger sister – also presented a complicated picture. Both as a child and as an adult she experienced her mother as a cruel and vindictive woman who emotionally, verbally and physically abused Zara, and who colluded with her husband, enabling him to exploit her. Ricker (2006), asserts that ignoring the abuse of a child, or actively aiding in the abuse of a child, are enabling behaviours and acts of ultimate betrayal. It was also left to Zara to protect her younger sister from her father. Anytime her father approached her sister’s bedroom, she would divert him by grabbing his attention. Her sister also got her share of her mother’s wrath but nothing compared to Zara. Many sessions were spent bearing witness to Zara’s anger, expressed as a deafening silent scream, and at times a not so silent catharsis.
With the help of therapy, Zara got the courage to tell her mother that her father sexually abused her as a child. She asked her not to discuss it with him until she was ready to let him know. Her mother refused to honor her request, causing a rift between Zara and her mother, with Zara taking the blame. After much thought and collaboration, Zara and I decided that I would invite her father and her mother together, then her and sister, to separately participate in a therapy session with Zara. Zara felt safe with me, and thought my presence when confronting her family would protect her. Most of all she wanted to speak the silent parts of her family life out loud, a sign that she was beginning to make the long journey to healing. She was no longer the little girl cowed by her father (and mother) but ready to openly name what had happened in the family.
The first session was with her mother and father. Immediately her mother was defensive, dismissive and condescending towards Zara. The free for all that ensued was unproductive, and I was forced to ask her mother to leave and set up a separate session. She agreed, and Zara and her father and I met for the remainder of the session. Zara confronted him. Something that many victims never get to do. Her father responded by saying “I believe that she believes that this happened”. That was the best that he could do to validate her. I believe that, in essence, it was his confession because it was not an outright denial. Zara understood this on a deeper level as well and some of her rage towards her father dissipated because she felt affirmed.
When her mother came to her session she was intent on convincing me that her daughter was mentally ill, and that even as a little girl the cause of all the stress in the house. She unequivocally denied the abuse, and any accountability for her failure to act as well. However, she did validate that something had indeed occurred, at least once, between Zara and her father. Conceding that “Yeah, I did have to pull him off of Zara one time”. She then immediately minimized and excused her husbands act of perpetration, adding “He was drunk and thought you were me”. Her willingness to make excuses for her husband, rather than acknowledge the truth, is a classic form of denial that often occurs in such cases (Sinason & Conway, 2021), and Zara’s case was no exception. I later shared my perception of her mother with Zara, interpreting that “evil” emanated from her when it came to Zara. This verbalisation was deeply affirming for her. As she said, “The relief I felt was incredible that someone had witnessed her attempt to destroy me.”
The session with her sister though, was in some ways the most disappointing of all. On the surface her sister listened and responded appropriately. She was seemingly supportive and tried to be there for her. She appeared to listen empathically, and physically get closer in her chair to Zara. But she had difficulty addressing the fact that she grew up in a family beset by incest, and became increasingly flat and removed from the conversation.
As later evidence of her denial or avoidance, when Zara asked her sister what her own therapist thought of the revelation, she simply said, “I did not mention it”.
The Ties That Bind
The above sessions with Zara and her family occurred a few years into the therapy and it was only through a period of unfolding and processing which allowed such meetings to occur. When Zara initially presented for therapy she was in her mid-40s, was married and had two children. She had seemingly established a separate life for herself outside her family of origin . But the ties and wounds ran deep.
Why after a lifetime of abuse did Zara not detach, move on, and create more separation from her parents, if not cut them out completely, as I have experienced with other patients whose parents or other family members made life untenable?
One tie that bound her was financial. For much of her adult life, Zara worked for her father, who had built a successful business over the years. For over 20 years she had helped him build this business, toiling in a work atmosphere that mirrored the toxicity she had experienced as a child growing up. Her father would practice the opposite of nepotism. He would treat and reward other employees over his own daughter, and humiliate her. But Zara felt that walking away from the business, and her family of origin, would in a way reward rather than punish them. Staying would ensure her status as a beneficiary of a very large estate, one that would create a massive amount of financial freedom for her own family and children. Whilst it could not make up for years of abuse, it could provide a form of reparations. Walking away from it would in essence allow her family’s bad acts to go unpunished, and even rewarded. Like a falsely convicted prisoner who seeks restitution from the state, Zara saw her continued involvement with her family as a way to ensure that they paid her back for her years of misery.
My role in this additional dilemma was challenging because it eliminated for me an exit ramp from this long standing family drama – helping her to jettison her family involvement and move on. A part of me felt protective of Zara and listening to fresh wounds being added to old wounds was deflating. Psychotherapy and medication did not make a dent in her pain. Sleep medications gave her a bit of a reprieve. Simply put, she was hell bent on getting that money that was rightfully hers. I could not blame her one bit.
Dissociated Personalities and the Multiples System
Then came the turning point. Zara comes to a session presenting as she ordinarily would. Then, shortly into the session she stood up and started to scream in a man’s voice. The vitriol spilled by Zara, as I believed her to be in that moment, was a raging rant directed at her parents, but by who? Was she role playing? Did I miss a major cue? Usually I’m not the type of therapist to get rattled, thinking, “I’ve seen it all”. But I had not see it all. Not even close.
By the end of this session I knew that this was Dissociative Identity Disorder, a mental health condition usually precipitated by trauma and where a person splits into many personalities or “alters”. My first thought, as an experienced therapist was, “Oh shit!”. Never having worked with a multiple, the term I’ll use, I was at a loss. But I was also trained as a family therapist and knew “systems”. Systems theory recognizes the interplay between members of a family and its effect on the individual. Murray Bowen (1978), the father of this model, laid out a theoretical approach that helps an individual separate within the context of a family system. It is a method of liberating oneself from their family of origin, and achieving a different and healthier definition of self. It allows one to regulate their own anxieties and to learn how to not react to the anxiety in others. In addition to systems theory, my training as a regression therapist was also invaluable and would assist both Zara and I to co-discover the underlying dissociated traumas, parts and patterns (Lucas, 1992). I knew that the manifestation of one’s personality and circumstances is but a layer of the whole self, and that I had the experience to help Zara if I proceeded cautiously.
As I expected, other alters followed “George’s” lead, and outed themselves during our sessions. Or I should say, flooded me with their presence. I had to keep a flow chart to keep track of them. I also had to redefine who the patient actually was. Alters have as much claim to the therapist as the host, in fact maybe even more. They represent the whole personality system, and carry memories and perceptions that comprise the constellation of selves.
Twenty five personalities and sub–personalities emerged; some very young and some adults, some at war with each other, others there to help, and others there to cause pain. I will note the primary ones, first the young ones. Suzi was the terrified one. She was only 4 years old and couldn’t make eye contact with me for fear of being hit and punished. She was afraid that “No one would love me”. Tom was another younger part of Zara; he was angry. He held Zara’s memory and said about her mother, “The female bitch never wanted me around.” He was angry at Zara because she did nothing to protect herself. “We are all Zara’s victims”, he said. Tom insisted that Zara “Tell her parents to F themselves”. Jane was a little girl who held Zara’s pain and wanted to help her with her guilt. She was also “Daddy’s little girl” who was special to him. She felt alone among the alters, believing they all hated her. She was the alter I spent the most time with until she hid for quite a while.
The adult alters possessed a similar range of feelings and memories. There was George, who like Tom, was angry, bitter and hostile. Margaret was the rational one, who was calm and assured. Alex was the “Free spirit”, the artsy photographer who recognized the beauty in the world. Abby was the seriously depressed alter. She wanted to die and wanted to kill her parents, who she saw as her torturers. She was shocked when I told her that I’d like to try to help her as she felt utterly hopeless. She cried at the thought of being cared for. Josephine saw herself as a worthless “Dirty little whore” beyond help. She said “I am a slut and what is there to be loved about me?” Acting out what Zara had been told by her mother – that she almost killed her during the birth process – she claimed to have tried to kill Zara’s mother when she was born. Then there was the nameless male adult, the “evil” one, who wanted to kill the incestuous father. He was feared by the other alters, who also do not let him emerge, hence the lack of a name.
Sarah was the enlightened personality. One of the many remarkable aspects of multiples is the Internal Self Helper (ISH), who attempts to watch over all the other alters. Putnam (1989) notes that the ISH can “Provide information and insights into the inner workings of the system” (p.110) and once identified prove to offer often invaluable guidance to the therapist. Sarah was the ISH in this case. As I sat with her I felt that I was in the presence of a prophetic being. She was the embodiment of a self-reliant, self-assured, confident individual. She explained that “I am the behind the scenes person. I pick up the pieces and put them back.” She acted at times as my supervisor, co-therapist, and occasionally, a mystic. Possessing a great sense of humor, and in reply to my comment that she is a great co-therapist, she said wryly, “So I get part of the fee”.
Altered States and Therapeutic Challenges
I even had an alternate role in the drama. There were times during the “transition”, defined as the switching between alters and host, that Zara slipped into other realms of consciousness. These I believed were past life sojourns that included me in the narrative. It appears that I was an older brother or friend/relative who took good care of her. Those moments, few and far between, were the most peaceful and serene times in the therapy.
The therapeutic challenge, as described by Dr Putnam in his book ‘Diagnosis and Treatment of Multiple Personality Disorder’, “Is the recovery of dissociated traumatic material and the integration of this material into a larger memory and sense of identity” (1989, p.191). Not all that dissimilar to past lives, which requires a similar integration. Those of us who practice past life therapy know that it is dirty work. We see the rawness of human emotions. The brutality that history can dish out. We know that we have to be enormously grounded and secure in ourselves to allow a patient to go through the experience without the need to rescue them; thus potentially depriving them of a cathartic therapeutic experience and missing the possibility to reach even deeper levels of trauma for the sake of healing. My experience with PLT was indeed a helpful grounding for working with Zara.
The therapeutic work was intensive, in both content and time. To integrate all the personalities each alter had to have their turn with psychotherapy. Typically we’d have two double sessions per week. On rare occasions we’d do a third session. Some alters also required more therapy than others. Jane was one such example. Not only was she in a deep state of despair, but she acted it out by physically beating Zara, who would come to a session all bruised, with no memory of the attack. She was reacting to Zara’s continued attempts to reach out to her mother, seeking kernels of acceptance that seldom manifested. Zara’s rare moments of connection with her mother were fleeting and would be quickly followed by another rejection. Jane would then punish Zara for subjecting her “selves” to continuous torment by physically hitting her.
Jane was so primitive that she had to be socialized to express her feelings in words rather than acting out. I had to validate Jane’s desire to hit Zara while at the same time helping her to channel her rightful rage in a more acceptable way. This required forging a strong relationship between myself and Jane. I’d say to Jane that she had every right to want to hit Zara but that was not going to stop Zara from pursuing her mother. Jane would then ask me what she could do to express herself. I’d say, “Try to save your anger for our sessions and express it with me. Tell me how you hate it when Zara demeans herself in pursuit of her mother’s love”. During rare light moments, as she processed my advice, she even giggled a few times like a typical child of her age.
Survival, Integration and Completion
Eventually Zara came to understand the roles the alters played in her survival; they were the repository of all her trauma induced memories and feelings, each crying out in their own way to be heard. As disturbing as the presence of alters can be, it is also an exquisite example of the sub–conscious mind at work to protect the self against obliteration. In the same way that the immune system attacks invaders to the body, the mind employs its own defenses in response to trauma. To say that Zara is a survivor of childhood trauma does not do justice to the miracle of adaptability, and the power of the individual to survive.Once integration was accomplished, Zara and I moved onto more traditional supportive psychotherapy. Zara asked me if I thought she had the right stuff to go back to graduate school and become a therapist. Without hesitation I unequivocally said yes. Like everything else, we looked at all angles of this plan. Sure, she knew there might be triggers but she had the coping skills to adapt and even extricate herself if necessary from situations that might be too challenging for her. It might be curious for some to think that I’d sanction a person to work in the mental health field when years before she was cowering in fear under a table in my office for fear of getting attacked. Well I say, “Who better than Zara? Who has been to the depths of oblivion and slowly emerged intact, strong, capable, resilient and wise”.
Zara was placed in her second year (internship) setting at an organization doing crisis intervention, intakes, and mostly short term therapy treatment. This agency hired her upon completing her degree and she works there to this day doing excellent work, having earned the respect of her peers. No-one at work knows about her past and her recovery. She’d like to eventually fill them in. I hope that she does. It might give them an education – the likes of which grad school could never come close to. They do in fact need more education. The topic of multiples arose a few times in her supervision as well as in ‘rounds’. She was incredulous that some clinicians did not see this as a real problem. They tended to see it as an offshoot of a psychotic condition or a manipulation representing a secondary gain. In my own experience I have come across psychiatrists who did not even think such a diagnosis was real. I can only imagine how many people have been misdiagnosed and mistreated over the years. I’m sure that many anti-psychotic medications were used to quell the inner desire for internal voices to be given a platform to express themselves.
Conclusion
‘Talking About Myself Behind My Back’ was going to be the title of the book that Zara was thinking about writing but never did. One of the primary reasons, not surprisingly, is that it could not be written until both her parents passed. Zara did not want to be disinherited under any circumstances. She earned that money and now it is rightfully hers. I hope that the alters were able to understand this to a degree. Maybe they do get it, because as Zara would quip. “The natives have not been restless for quite some time”.
Postscript by Zara
I look at my arms… They are cut… I don’t know how or why… I told people I played with a cat. A moment in and out of time. I survived because I do not hold the memories of my traumatic past. I can counsel others because I do not hold the memories. The thought that alters saved my sanity is surreal. But it is the truth. Growing up there were so many memory gaps that I did not understand.
I talked to some of my parents’ friends as an adult… They implied that they knew something was happening in my house… They didn’t know what to do… Time halts but continues, freeze arrives for many in moments, but in and out of time life flows. I do not know who “adulted” for me, I think they did a good job.
I was sent away to my grandparents for many summers so I was not a problem for her… At least those moments of summer sojourn showed me what love truly is… I was in the position of my father’s wife… A loveless marriage… Both parents put me there… Perpetrator parent and colluding abuser… I would be woken up early on weekends to make him coffee so that she could sleep… I made dinner reservations for them every weekend… Why was that?… I don’t or can’t know… But somebody knows… What I do know is that at times my husband and kids would look at me strangely wondering why I did not remember things that I had done or said. I had no explanation. That bothered me. Now I know I was not crazy, someone else was doing my work and living my life so my core could survive until integration.
Integration happened over the last few years; I no longer jump in terror by triggers I cannot understand. It is a strange feeling to know I was traumatized and have few memories, but I am grateful that my soul (personality) split in order to handle the traumas. At times, and being an older adult now, I feel that I have lost part of my life (amnesia). But I am so happy to be whole and want to thank all the alters who handled what I could not, got angry for me, and loved me enough to help me become the person I am today.
I am also grateful to Danny for believing me and believing in me. He was a safe and protective friend as well as my therapist. He journeyed with as a guide through the dark, and a companion towards the light. I will never forget him and all the help and support he offered me.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Bowen, M. (1978). Family therapy in clinical practice. NY and London: Aronson.
Lucas, W.B. (1992). Regression therapy a handbook for professionals: Volume II – Special instances of altered state work. USA: Transpersonal Publishing.
Putnam, F. (1989) Diagnosis & treatment of multiple personality disorder. New York: The Guilford Press.
Ricker, A. (2006). The ultimate betrayal: The enabling mother,incest and sexual abuse. Arizona: See Sharp Press.
Shaw, D. (2014). Traumatic narcissism: Relational systems of subjugation. New York: Routledge
Sinason, V. & Conway, A. (2021). Trauma and memory: The science and the silenced. New York: Routledge.
Woolger, R.J. (1988). Other lives, other selves: A jungian psychotherapist discovers past lives. New York: Bantam Books
As a psychotherapist/hypnotist and practitioner of past life regression therapy I was eager to give it a shot. The approach is to simply offer a path to finding the original cause and promise no more than that (Woolger, 1988). If the stars align and this approach can ameliorate a symptom on a permanent basis, that’s gold.
The first two regressions were unremarkable. The third was stunning. Jamie was on the floor of my office wailing in pain. Two Nazi SS troops were kicking her as she cradled her baby in her arms. Screaming in horror and agony I asked her what the soldiers are saying. She responded in German. After the session she tells me it is a language she does not speak. This is a phenomena known as Xenoglossia, defined as a paranormal phenomenon where a person speaks a language that they do not have knowledge of (Matlock, 2017). After the session ends and she is spent, sitting on the floor, we talk. Jamie is an observant Jew with strong ties to the state of Israel. I gave her time to breathe before we processed this past trauma. From that session on she was completely asymptomatic. Her neck pain abated abruptly. But this article is not about Jamie. It’s about the person who she referred to me for help after we terminated.
My Most Unusual Patient
When I met Zara in my waiting room I had no idea that she would become the most unusual patient I have ever treated. Zara suffered from dissociative identity disorder (5th ed; DSM-5, American Psychiatric Association, 2013), formerly known as multiple personality disorder, that included 25 different personalities. Rather than a multiplicity of past lives, this was one life with many selves. Initially though Zara presented as a typical patient, one haunted by vague memories of sexual trauma, a difficult childhood, and strained family relationships in adulthood.
Zara told me that she had a difficult childhood with many holes in her memory and lapses in her recollection of past events. She knew for sure that she had been sexually assaulted in a hospital by a janitor when she was around 9, but that nothing had been done about it and her family just seemed to want the incident to disappear. She also had vague intimations of something similar that had occurred with her father. But mostly there was doubt, confusion, and uncertainty. As a regression therapist I could have initially done memory retrieval but I intuitively knew that was not appropriate. As a former supervisor would say, “Continue doing archeology, dig for the truth, as best as you can”. I did not want to force anything in order to let things unfold organically.
Historical Abuse and Complex Family Dynamics
As therapy progressed, Zara had many dreams of violence, death, and sexual assault. Memories began to emerge of sexual abuse inflicted by her father, and recurring urinary tract infections as a young girl – a potential sign of abuse. Graphic scenes of rape flooded her memory. The sexual abuse was also accompanied by manipulation and emotional abuse.Her father told her that he loved her differently than her sister, and it was a love that could only be expressed sexually. As often happens in such cases, she came to identify with her aggressor (Shaw, 2014). She believed that she was responsible for her predicament, which young victims are particularly prone to believing. Convincing such a person “It’s not your fault” is so much easier said than done. There were deep seated levels of subconscious internalized conflict to reframe and redefine for Zara.
The other members of her family – her mother and her younger sister – also presented a complicated picture. Both as a child and as an adult she experienced her mother as a cruel and vindictive woman who emotionally, verbally and physically abused Zara, and who colluded with her husband, enabling him to exploit her. Ricker (2006), asserts that ignoring the abuse of a child, or actively aiding in the abuse of a child, are enabling behaviours and acts of ultimate betrayal. It was also left to Zara to protect her younger sister from her father. Anytime her father approached her sister’s bedroom, she would divert him by grabbing his attention. Her sister also got her share of her mother’s wrath but nothing compared to Zara. Many sessions were spent bearing witness to Zara’s anger, expressed as a deafening silent scream, and at times a not so silent catharsis.
With the help of therapy, Zara got the courage to tell her mother that her father sexually abused her as a child. She asked her not to discuss it with him until she was ready to let him know. Her mother refused to honor her request, causing a rift between Zara and her mother, with Zara taking the blame. After much thought and collaboration, Zara and I decided that I would invite her father and her mother together, then her and sister, to separately participate in a therapy session with Zara. Zara felt safe with me, and thought my presence when confronting her family would protect her. Most of all she wanted to speak the silent parts of her family life out loud, a sign that she was beginning to make the long journey to healing. She was no longer the little girl cowed by her father (and mother) but ready to openly name what had happened in the family.
The first session was with her mother and father. Immediately her mother was defensive, dismissive and condescending towards Zara. The free for all that ensued was unproductive, and I was forced to ask her mother to leave and set up a separate session. She agreed, and Zara and her father and I met for the remainder of the session. Zara confronted him. Something that many victims never get to do. Her father responded by saying “I believe that she believes that this happened”. That was the best that he could do to validate her. I believe that, in essence, it was his confession because it was not an outright denial. Zara understood this on a deeper level as well and some of her rage towards her father dissipated because she felt affirmed.
When her mother came to her session she was intent on convincing me that her daughter was mentally ill, and that even as a little girl the cause of all the stress in the house. She unequivocally denied the abuse, and any accountability for her failure to act as well. However, she did validate that something had indeed occurred, at least once, between Zara and her father. Conceding that “Yeah, I did have to pull him off of Zara one time”. She then immediately minimized and excused her husbands act of perpetration, adding “He was drunk and thought you were me”. Her willingness to make excuses for her husband, rather than acknowledge the truth, is a classic form of denial that often occurs in such cases (Sinason & Conway, 2021), and Zara’s case was no exception. I later shared my perception of her mother with Zara, interpreting that “evil” emanated from her when it came to Zara. This verbalisation was deeply affirming for her. As she said, “The relief I felt was incredible that someone had witnessed her attempt to destroy me.”
The session with her sister though, was in some ways the most disappointing of all. On the surface her sister listened and responded appropriately. She was seemingly supportive and tried to be there for her. She appeared to listen empathically, and physically get closer in her chair to Zara. But she had difficulty addressing the fact that she grew up in a family beset by incest, and became increasingly flat and removed from the conversation.
As later evidence of her denial or avoidance, when Zara asked her sister what her own therapist thought of the revelation, she simply said, “I did not mention it”.
The Ties That Bind
The above sessions with Zara and her family occurred a few years into the therapy and it was only through a period of unfolding and processing which allowed such meetings to occur. When Zara initially presented for therapy she was in her mid-40s, was married and had two children. She had seemingly established a separate life for herself outside her family of origin . But the ties and wounds ran deep.
Why after a lifetime of abuse did Zara not detach, move on, and create more separation from her parents, if not cut them out completely, as I have experienced with other patients whose parents or other family members made life untenable?
One tie that bound her was financial. For much of her adult life, Zara worked for her father, who had built a successful business over the years. For over 20 years she had helped him build this business, toiling in a work atmosphere that mirrored the toxicity she had experienced as a child growing up. Her father would practice the opposite of nepotism. He would treat and reward other employees over his own daughter, and humiliate her. But Zara felt that walking away from the business, and her family of origin, would in a way reward rather than punish them. Staying would ensure her status as a beneficiary of a very large estate, one that would create a massive amount of financial freedom for her own family and children. Whilst it could not make up for years of abuse, it could provide a form of reparations. Walking away from it would in essence allow her family’s bad acts to go unpunished, and even rewarded. Like a falsely convicted prisoner who seeks restitution from the state, Zara saw her continued involvement with her family as a way to ensure that they paid her back for her years of misery.
My role in this additional dilemma was challenging because it eliminated for me an exit ramp from this long standing family drama – helping her to jettison her family involvement and move on. A part of me felt protective of Zara and listening to fresh wounds being added to old wounds was deflating. Psychotherapy and medication did not make a dent in her pain. Sleep medications gave her a bit of a reprieve. Simply put, she was hell bent on getting that money that was rightfully hers. I could not blame her one bit.
Dissociated Personalities and the Multiples System
Then came the turning point. Zara comes to a session presenting as she ordinarily would. Then, shortly into the session she stood up and started to scream in a man’s voice. The vitriol spilled by Zara, as I believed her to be in that moment, was a raging rant directed at her parents, but by who? Was she role playing? Did I miss a major cue? Usually I’m not the type of therapist to get rattled, thinking, “I’ve seen it all”. But I had not see it all. Not even close.
By the end of this session I knew that this was Dissociative Identity Disorder, a mental health condition usually precipitated by trauma and where a person splits into many personalities or “alters”. My first thought, as an experienced therapist was, “Oh shit!”. Never having worked with a multiple, the term I’ll use, I was at a loss. But I was also trained as a family therapist and knew “systems”. Systems theory recognizes the interplay between members of a family and its effect on the individual. Murray Bowen (1978), the father of this model, laid out a theoretical approach that helps an individual separate within the context of a family system. It is a method of liberating oneself from their family of origin, and achieving a different and healthier definition of self. It allows one to regulate their own anxieties and to learn how to not react to the anxiety in others. In addition to systems theory, my training as a regression therapist was also invaluable and would assist both Zara and I to co-discover the underlying dissociated traumas, parts and patterns (Lucas, 1992). I knew that the manifestation of one’s personality and circumstances is but a layer of the whole self, and that I had the experience to help Zara if I proceeded cautiously.
As I expected, other alters followed “George’s” lead, and outed themselves during our sessions. Or I should say, flooded me with their presence. I had to keep a flow chart to keep track of them. I also had to redefine who the patient actually was. Alters have as much claim to the therapist as the host, in fact maybe even more. They represent the whole personality system, and carry memories and perceptions that comprise the constellation of selves.
Twenty five personalities and sub–personalities emerged; some very young and some adults, some at war with each other, others there to help, and others there to cause pain. I will note the primary ones, first the young ones. Suzi was the terrified one. She was only 4 years old and couldn’t make eye contact with me for fear of being hit and punished. She was afraid that “No one would love me”. Tom was another younger part of Zara; he was angry. He held Zara’s memory and said about her mother, “The female bitch never wanted me around.” He was angry at Zara because she did nothing to protect herself. “We are all Zara’s victims”, he said. Tom insisted that Zara “Tell her parents to F themselves”. Jane was a little girl who held Zara’s pain and wanted to help her with her guilt. She was also “Daddy’s little girl” who was special to him. She felt alone among the alters, believing they all hated her. She was the alter I spent the most time with until she hid for quite a while.
The adult alters possessed a similar range of feelings and memories. There was George, who like Tom, was angry, bitter and hostile. Margaret was the rational one, who was calm and assured. Alex was the “Free spirit”, the artsy photographer who recognized the beauty in the world. Abby was the seriously depressed alter. She wanted to die and wanted to kill her parents, who she saw as her torturers. She was shocked when I told her that I’d like to try to help her as she felt utterly hopeless. She cried at the thought of being cared for. Josephine saw herself as a worthless “Dirty little whore” beyond help. She said “I am a slut and what is there to be loved about me?” Acting out what Zara had been told by her mother – that she almost killed her during the birth process – she claimed to have tried to kill Zara’s mother when she was born. Then there was the nameless male adult, the “evil” one, who wanted to kill the incestuous father. He was feared by the other alters, who also do not let him emerge, hence the lack of a name.
Sarah was the enlightened personality. One of the many remarkable aspects of multiples is the Internal Self Helper (ISH), who attempts to watch over all the other alters. Putnam (1989) notes that the ISH can “Provide information and insights into the inner workings of the system” (p.110) and once identified prove to offer often invaluable guidance to the therapist. Sarah was the ISH in this case. As I sat with her I felt that I was in the presence of a prophetic being. She was the embodiment of a self-reliant, self-assured, confident individual. She explained that “I am the behind the scenes person. I pick up the pieces and put them back.” She acted at times as my supervisor, co-therapist, and occasionally, a mystic. Possessing a great sense of humor, and in reply to my comment that she is a great co-therapist, she said wryly, “So I get part of the fee”.
Altered States and Therapeutic Challenges
I even had an alternate role in the drama. There were times during the “transition”, defined as the switching between alters and host, that Zara slipped into other realms of consciousness. These I believed were past life sojourns that included me in the narrative. It appears that I was an older brother or friend/relative who took good care of her. Those moments, few and far between, were the most peaceful and serene times in the therapy.
The therapeutic challenge, as described by Dr Putnam in his book ‘Diagnosis and Treatment of Multiple Personality Disorder’, “Is the recovery of dissociated traumatic material and the integration of this material into a larger memory and sense of identity” (1989, p.191). Not all that dissimilar to past lives, which requires a similar integration. Those of us who practice past life therapy know that it is dirty work. We see the rawness of human emotions. The brutality that history can dish out. We know that we have to be enormously grounded and secure in ourselves to allow a patient to go through the experience without the need to rescue them; thus potentially depriving them of a cathartic therapeutic experience and missing the possibility to reach even deeper levels of trauma for the sake of healing. My experience with PLT was indeed a helpful grounding for working with Zara.
The therapeutic work was intensive, in both content and time. To integrate all the personalities each alter had to have their turn with psychotherapy. Typically we’d have two double sessions per week. On rare occasions we’d do a third session. Some alters also required more therapy than others. Jane was one such example. Not only was she in a deep state of despair, but she acted it out by physically beating Zara, who would come to a session all bruised, with no memory of the attack. She was reacting to Zara’s continued attempts to reach out to her mother, seeking kernels of acceptance that seldom manifested. Zara’s rare moments of connection with her mother were fleeting and would be quickly followed by another rejection. Jane would then punish Zara for subjecting her “selves” to continuous torment by physically hitting her.
Jane was so primitive that she had to be socialized to express her feelings in words rather than acting out. I had to validate Jane’s desire to hit Zara while at the same time helping her to channel her rightful rage in a more acceptable way. This required forging a strong relationship between myself and Jane. I’d say to Jane that she had every right to want to hit Zara but that was not going to stop Zara from pursuing her mother. Jane would then ask me what she could do to express herself. I’d say, “Try to save your anger for our sessions and express it with me. Tell me how you hate it when Zara demeans herself in pursuit of her mother’s love”. During rare light moments, as she processed my advice, she even giggled a few times like a typical child of her age.
Survival, Integration and Completion
Eventually Zara came to understand the roles the alters played in her survival; they were the repository of all her trauma induced memories and feelings, each crying out in their own way to be heard. As disturbing as the presence of alters can be, it is also an exquisite example of the sub–conscious mind at work to protect the self against obliteration. In the same way that the immune system attacks invaders to the body, the mind employs its own defenses in response to trauma. To say that Zara is a survivor of childhood trauma does not do justice to the miracle of adaptability, and the power of the individual to survive.Once integration was accomplished, Zara and I moved onto more traditional supportive psychotherapy. Zara asked me if I thought she had the right stuff to go back to graduate school and become a therapist. Without hesitation I unequivocally said yes. Like everything else, we looked at all angles of this plan. Sure, she knew there might be triggers but she had the coping skills to adapt and even extricate herself if necessary from situations that might be too challenging for her. It might be curious for some to think that I’d sanction a person to work in the mental health field when years before she was cowering in fear under a table in my office for fear of getting attacked. Well I say, “Who better than Zara? Who has been to the depths of oblivion and slowly emerged intact, strong, capable, resilient and wise”.
Zara was placed in her second year (internship) setting at an organization doing crisis intervention, intakes, and mostly short term therapy treatment. This agency hired her upon completing her degree and she works there to this day doing excellent work, having earned the respect of her peers. No-one at work knows about her past and her recovery. She’d like to eventually fill them in. I hope that she does. It might give them an education – the likes of which grad school could never come close to. They do in fact need more education. The topic of multiples arose a few times in her supervision as well as in ‘rounds’. She was incredulous that some clinicians did not see this as a real problem. They tended to see it as an offshoot of a psychotic condition or a manipulation representing a secondary gain. In my own experience I have come across psychiatrists who did not even think such a diagnosis was real. I can only imagine how many people have been misdiagnosed and mistreated over the years. I’m sure that many anti-psychotic medications were used to quell the inner desire for internal voices to be given a platform to express themselves.
Conclusion
‘Talking About Myself Behind My Back’ was going to be the title of the book that Zara was thinking about writing but never did. One of the primary reasons, not surprisingly, is that it could not be written until both her parents passed. Zara did not want to be disinherited under any circumstances. She earned that money and now it is rightfully hers. I hope that the alters were able to understand this to a degree. Maybe they do get it, because as Zara would quip. “The natives have not been restless for quite some time”.
Postscript by Zara
I look at my arms… They are cut… I don’t know how or why… I told people I played with a cat. A moment in and out of time. I survived because I do not hold the memories of my traumatic past. I can counsel others because I do not hold the memories. The thought that alters saved my sanity is surreal. But it is the truth. Growing up there were so many memory gaps that I did not understand.
I talked to some of my parents’ friends as an adult… They implied that they knew something was happening in my house… They didn’t know what to do… Time halts but continues, freeze arrives for many in moments, but in and out of time life flows. I do not know who “adulted” for me, I think they did a good job.
I was sent away to my grandparents for many summers so I was not a problem for her… At least those moments of summer sojourn showed me what love truly is… I was in the position of my father’s wife… A loveless marriage… Both parents put me there… Perpetrator parent and colluding abuser… I would be woken up early on weekends to make him coffee so that she could sleep… I made dinner reservations for them every weekend… Why was that?… I don’t or can’t know… But somebody knows… What I do know is that at times my husband and kids would look at me strangely wondering why I did not remember things that I had done or said. I had no explanation. That bothered me. Now I know I was not crazy, someone else was doing my work and living my life so my core could survive until integration.
Integration happened over the last few years; I no longer jump in terror by triggers I cannot understand. It is a strange feeling to know I was traumatized and have few memories, but I am grateful that my soul (personality) split in order to handle the traumas. At times, and being an older adult now, I feel that I have lost part of my life (amnesia). But I am so happy to be whole and want to thank all the alters who handled what I could not, got angry for me, and loved me enough to help me become the person I am today.
I am also grateful to Danny for believing me and believing in me. He was a safe and protective friend as well as my therapist. He journeyed with as a guide through the dark, and a companion towards the light. I will never forget him and all the help and support he offered me.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Bowen, M. (1978). Family therapy in clinical practice. NY and London: Aronson.
Lucas, W.B. (1992). Regression therapy a handbook for professionals: Volume II – Special instances of altered state work. USA: Transpersonal Publishing.
Putnam, F. (1989) Diagnosis & treatment of multiple personality disorder. New York: The Guilford Press.
Ricker, A. (2006). The ultimate betrayal: The enabling mother,incest and sexual abuse. Arizona: See Sharp Press.
Shaw, D. (2014). Traumatic narcissism: Relational systems of subjugation. New York: Routledge
Sinason, V. & Conway, A. (2021). Trauma and memory: The science and the silenced. New York: Routledge.
Woolger, R.J. (1988). Other lives, other selves: A jungian psychotherapist discovers past lives. New York: Bantam Books
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