PICT and Dissociative Identity Disorder (DID)
What is Dissociative Identity Disorder (DID)

There are seven positions on the dissociation continuum:

  • Everyday Dissociation - driving a familiar route and arriving at our destination with no memory of the journey. It is also a natural important ability we all use in order to function safely or usefully when sudden trauma occurs (almost watching ourselves help someone injured instead of allowing distress to overtake us). We can also use it to achieve a feeling of calm, sometimes used in spiritual or cultural practices. It also includes out-of-body experiences. We can use it to imagine ourselves achieving something (seeing yourself as if watching from a distance).
  • Depersonalisation Disorder - a feeling that your body is unreal, changing or dissolving. Strong feelings that you are detached from your body.
  • Dissociative Amnesia - not being able to remember important personal information or incidents and experiences that happened at a particular time, which can't be explained by ordinary forgetfulness.
  • Dissociative Fugue - there is severe amnesia, with moderate to severe identity confusion and often identity alteration. For instance, a person travels to a new location during a temporary loss of identity. He or she may assume a different identity and a new life.
  • Post-traumatic Stress Disorder (PTSD) - this person may experience flashbacks, reliving the trauma repeatedly, which causes extreme distress. This, in turn, triggers a dissociative, numbing reaction.
  • Dissociative Disorder Not Otherwise Specified (DDNOS) - different types of dissociation may occur, but the pattern of mix and severity does not fit any specific dissociative disorder.
  • Dissociative Identity Disorder (DID) - sometimes called Multi-Personality Disorder (MPD). Someone with DID experiences shifts of identity as separate personalities. Each identity may assume control of behaviour and thoughts at different times. Each has a distinctive pattern of thinking and relating to the world. Severe amnesia means that one identity may have no awareness of what happens when another identity is in control.

People fragment their personality in an effort to find safety and escape trauma. It is like a filing system, one aspect of their personality will hold the bulk of the 'bad', another will take a lead role and be essentially the 'good' one, there may be different personalities at different ages, or some of a different gender. All will have some role to play in keeping the 'whole' safe - 'divide and conquer'. Some clients may not have conscious knowledge of that process. It is important to remember that anyone who has DID is someone who is highly intelligent and resourceful - those same attributes will be of help when the person is ready to engage in resolution of their problems.

It is important here to mention that there is a movement within the 'Multiple' community to remain fragmented and if those individuals come as clients to a PICT therapist, they will be offered only as much assistance as they desire. Although integration is the general goal, PICT does not push anyone towards integration they are not ready for or do not want.

However, as stated, generally speaking, a PICT therapist is aiming to integrate all the personalities into one again, but NEVER to engage in getting rid of or destroying any personality aspect. Even if a personality aspect manifests in a very destructive manner, resolution is always about integration, not destruction. Everyone has destructive parts within and if they were not blended with the whole they could be disruptive or dangerous to us. For example, if determination (an aspect that is usually admired) were not blended it would be very strong and unruly ‘stubbornness’, which could cause a lot of problems for work, social or relationships. It is useful for clients to remember that the aspect/personality part is not 'bad', it is just undiluted and needs integration with the whole to follow its safe and useful purpose.

It is important to first establish how many personality aspects there are and what their 'role' is. Clients may be asked to draw a representation of their inner 'family' on a flip chart as a starting point. During therapy clients may unconsciously switch to another alter whenever they feel the therapist is getting near to something scary or unknown. In fact, it may be the job of some aspect to stop therapy from happening. That is the single most difficult aspect in dealing with clients who have Multi-personalities because the more 'switching' happens the longer it takes to resolve their issues. If possible, it is useful to ask the most adult or responsible personality to come forward to facilitate therapy and important to get that aspect's problems resolved first so there is a stronger ally to help comfort and assist the others.

It is often the case that specific resolution work will be done with every personality because often there are 'fire walls' between personalities and not a lot of information seeps through - sort of like having several clients at once. Each part/personality will be complimented for the hard work it does trying to bring a sense of safety. Clients will also be complimented on the resourcefulness and intelligence it took to create several, separate and different personalities as a coping strategy. It will be confirmed that it was a great strategy and served an important and life saving purpose for many years, but now it is no longer the most useful strategy to use and may have gone past its sell-by date. The same resourcefulness and intelligence will be utilised to recreate the 'whole' so that the client can reach his or her full potential and experience genuine safety rather than the illusion of safety the multi-personality strategy offers.

Further Information

Some of the information on the seven positions on the dissociation continuum above was adapted from MIND Publications: Understanding Dissociative Disorders. For more information on the Dissociative Disorder continuum you can contact Mind Mail Order, 15 - 19 Broadway, London, E15 4BQ. T: 020 8221 9666 E: publications@mind.org.uk

Further Reading

Two excellent books to give you further information on the experience of DID are:

  • “Amongst Ourselves - A Self-Help Guide to Living with Dissociative Identity Disorder” - by Tracy Alderman and Karen Marshall (1998 New Harbinger Publications)
  • “Today I am Alice” - by Alice Jamieson (2009 - Sidgwick & Jackson)