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
- 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,
- 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
- 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
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
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.
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: firstname.lastname@example.org