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Holistic Therapy for People with Dissociative Identity Disorder

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This book puts forward a model of therapy and support for people with DID that provides individual therapy, staff support, and a safe place to live. It relies upon the ideas of Bowlby by providing a secure base and this recognises the attachment needs. It also includes staff who are trained to provide a therapeutic environment and also receive support to do their work.The fourth element after the base, the staff, and the training, is the individual therapy. Together it has been possible to adopt a holistic approach which leads to a significant improvement in quality of life for individuals with DID, and confidence for commissioners and teams in the approach. By including the perspective of all the players and presenting a practical model for successful working, the book will be invaluable to anyone looking to commission or provide services for this client group.

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9 Chapters

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Chapter One: Starting Out


We need your help, we need your aid
Because we are so much afraid
The bad ones talk and hurt us so
We have no safe place to be and go
We're wanted dead we're wanted gone
The road is wearisome and long
We need to find a strengthened place
An open and a friendly space.

We need you to hear what we say
And help us find a better way
The dark ones always in a crowd
Follow us and they are proud
To hurt and maim and poison too
Like we're the dog dirt off their shoe
They never care about us so
Do you know somewhere safe to go?


The information in this chapter is relevant to a number of people with DID and will be presented in such a composite way as to enable the maintenance of confidentiality for the individuals concerned. Safety is always an issue for people with DID, who have survived abuse and trauma, often in a family context, and usually with some continued threat. The stories and the information informing the plans are those found most often with the client group.


Chapter Two: A Usual Bumpy Road to Treatment


What did I do wrong to deserve such abuse
Sometimes I wonder what is the use
In trying to understand people and world
Evil is the only plan that is unfurled
People are cruel and hurt and dismay
People are just there to ruin your day
I don't understand this world oh so cruel
Everyone tried to maim and to rule.

Life should not competitive be
It should be good and of abuse free
So I don't understand where this abounds
Just like I do not understand sound
People can hurt with words and not heal
People can be unjust and not real
And when you cant talk it just is not fair
To have dictatorial people there.

Lots of loud sound gets right in my face
Just like the making of life like a race
Be kind instead of horrid and wrong
Tune your mind into a different song
Do not be clipped but open your door
Be receptive and then you will soar
No abuse, no shouting, you frighten my world
And then a planet of peace can be unfurled.


Chapter Three: Life—What's That?


How do we even prepare to begin
To tell of a life that is without sin
The child not at fault and yet so abused
Treated liked dog dirt and totally used
Hurt and controlled and tortured and pained
Rituals glory the bad people gained
So the child broke in pieces with lots of new names
Because of torturer's spiteful evil games.

The battle to live began at our birth
The child constantly fighting to even have worth
The horrors that happened splitting her mind
Into children and adults, animals of all kinds
The fight for their freedom constantly aflame
Until one day they were rescued and their freedom came
Many years came and many years went
Until one day a new life was sent…


To most people in the world, I exist as one person—that is what society sees and thinks I actually am. But to those who know me, we are much more than one person—we are many inside one body. This is because we have Dissociative Identity Disorder (DID), and have many alternate personalities (alters). As a collection of alters we switch in and out of the body, and are many different ages, both male and female, and animals who keep our body safe, all with different abilities and roles. Within the following writing by ourselves, you will notice changes between the words I and we. This signifies switching between alters, which we felt was important to happen for chronological continuity and for everyone inside our body to have their say who wants to. Also, direct quotes by any alter are indented in a different font. Everyone within our system has been silenced for too long, and now it is time for our truths to be known.


Chapter Four: Setting Up a Service


Chapter One describes what is required to set up a service for someone with DID and complex needs. This chapter will explore in more depth what is required to manage a service of this kind. The service provider's main experience has been in providing specialist twenty-four-hour support for those with a learning disability. They have used the same principles but have needed to adjust the thinking and behaviour when supporting someone with multiple alters. This chapter is going to explore further the four components of providing a trauma-informed package and how the provider developed services in this way.

Initial thoughts of supporting someone with many alters within the community are “Can it be done? Will it be safe for the individual and also staff? What rules/laws will govern this type of project? How will it be funded? What do we need to do?” The service provider was able to overcome many such issues through knowing that they had the support of commissioners of the service.


Chapter Five: Making Progress


How do I keep them all in line?

They do what they want and do it with ease

Without a thank you a yes or a please.

I lose lots of time and I have lots of fear

I wonder what happens when I am not here

Will you please tell me how I should cope

Because what they are doing has too much scope.

This was the most horrid thing she had seen

She did not understand the alters that came

She felt oh so lost and like she was lame

She needed the healing therapy gave

It felt like conducting a musical stave

She needed the help and she needed it so

She would know more of what each did know.

What are they showing me and how do I let

Them come out with me knowing and finally have joy?

Are they a girl an animal or boy?

I am confused and I need to know


Chapter Six: Being Support Staff


Will you listen, will you hear,
We come to you with heightened fear,
We want to talk, we need to play
We need a better brightened day
We need you to fight for us
And to never make a fuss
Will you listen, will you care,
We so need you to just be there.

We cannot walk this path alone,
There's so much dark, and so much stone
Bad people are at every turn
And we need you to help us learn
Will you be the one that sees
Hear our cries and hear our pleas
If you are then all we need
Is to take the gauntlet and proceed.


This chapter has been woven together to give a flavour of what it is like to support someone with DID living in an ordinary house in the community. We work one to one, so there is always one of us there, but when there, we have to be the one who manages and keeps everything and everyone safe. None of us had worked with someone so complex before but we had worked for the employer so felt supported to do the work.


Chapter Seven: A Client's Voice


Do you get why we need help
Do you really care
Do you understand our need
And can you be there
Do you see that we aren't safe
Do you understand
Why we need to get away
They are underhand.

So many may not get abuse
Accessing and the like
But we know you do and need your aid
And ask for your hand to strike
Please make us safe and hear our cry
We know that you are able
And thank you in advance of this
For making us all stable.


“Creating meaningful lives”. This is the motto of the company that took over our care. Holistic and trauma-informed care are at the heart of our supporters, and therapeutic attachments are very important to them all. They took us as we are, and accepted us, right from day one. They became involved in every aspect of our lives, no matter how trivial it seemed. Staff were trained in the principles of disability psychotherapy, which made them easier to talk to. This is the basis for the title of this chapter.


Chapter Eight: A New Therapist


A new life starts, the old one ends
Its time for staff and real new friends
A spot to be, a safe new space
A private and a quietened place
Somewhere where we can be us
Without folks making a real fuss
A place where whatever happens we
Are unquestionably safe and free.

A place where care and support abounds
No more evil sights and sounds
We have a freedom never had
A real reason to be glad
No more sadness, no more fear
Just happiness forever here
A place to work on issues and
Walk the path both hand in hand.



A feature of long-term holistic therapy is that when, for whatever reason, a therapist leaves, Amara Care has to find a new therapist. This is very complex and we thought it would be helpful to provide a sample of the early stages of a new therapist relationship, using an amalgam again. This is written in the therapist's words.

Before I begin describing a short, but hopefully to be a long and successful, journey, I will provide a brief explanation of the terms I will be using in this chapter. Carly is currently the host and so predominantly present; the other alters are referred to by Carly as the “system”, and this is how I will refer to them in this chapter. Because Carly and her system are many, I will often refer to the collective as “them” unless I am describing a specific alter, in which case I will refer to them as him/her as appropriate. The system are supported in a 24-hour specialist support service that ensures they have a member of staff with them at all times; in this chapter I will refer to the staff collectively as “the team”.


Chapter Nine: Conclusion


There are voices in the brain
Making us feel quite insane
They try to trick, they try to boast
And make us look like fools the most
We need you to help us try make sense
We feel like we're behind a fence
So tall we cant get over it
We feel like we're not worth their spit.

We fight and tell them we're the truth
But think they might be in their youth
Is a programme in the frame
Or do these people have a name
They do not listen, do not care
Just make us know that they are there
We want to sleep but cannot too
Because they are not in our crew.

We want to tell them they are wrong
That they are like a pied pipers song
Following others in the dark
Without the light, no divine spark
Please help us know just how to work
With them until they cannot shirk
Their responsibilities
And work with us in total ease.


Will you listen, will you hear?” writes an alter. It is a crucial question. We all need some level of dissociation to survive the ups and downs of ordinary life. Taking account of extreme cumulative trauma in another or oneself requires an extra openness that can lead to secondary traumatisation if we do not have adequate filters and support. Not everyone can listen let alone hear. Clients tell us very clearly the difference between listening and hearing. Yet even to try to listen is sometimes an achievement. “You will only hear half of it and you won't believe it,” said one woman with a mild intellectual disability (Morris, 1994) to her psychotherapist who clearly showed the highest level of emotional intelligence.



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