Today I stumbled across an excellent article by UK psychotherapist Valerie Sinason about Dissociative Identity Disorder and the difficulties in both diagnosis and treatment which exist within the very traditional British public health care system.
Without early specialist training on the consequences of abuse, professionals are attacking each other’s contradictory diagnoses without realising the aptness of Walt Whitman’s words “I am large. I contain multitudes”.
Compared with Freud’s ability to recognise the traumatic aetiology of hysteria one hundred years ago (Freud, 1896), contemporary clinicians have found it extremely hard to bear the horrors of patients’ objective lives. Sometimes (Hale & Sinason 1994) psychotherapists’focus on the internal narrative is a defence against the historic external reality.
However, as de Zulueta (1995) comments: “a refusal on the part of psychiatrists and therapists to validate the horrors of their patients’ tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable.
Both quotes come from the revised edition of Attachment, Trauma and Multiplicity by Valerie Sinason (Editor), which contains contributions by both survivors of trauma with Dissociative Identity Disorder and professionals working with psychological trauma.
Does the NHS have (undiagnosed) Dissociative Identity Disorder?
Recently I heard a therapist who does a great deal of trauma work in the UK refer humourusly to the British NHS health care as having a so many separate states that do not communicate with each other, and typically have different and opposing ideas, that it felt as if the NHS system itself was in fact suffering from dissociative identity disorder… Sinason writes about “Fragmentation within professional teams” as well as between them:
“the psychiatrist who meets a frozen DID patient who shows only one state (as a result of correctly assessing their psychiatrist’s inability to deal with the subject) then attacks the other psychiatrist/social worker/psychologist/psychotherapist who points out the fragmentation into states. We are then witnessing the trauma-organised systems… that systemically mirror the DID experience.”
Read more (Details may trigger.)
- Dissociative Identity Disorder
- Other Specified Dissociative Disorder (DDNOS)
- Living with Trauma
- Breaking the silence of stigma – not what you would expect
- What Would Make You Believe a Survivor of Childhood Sexual Abuse? by Andrea Grimes (via traumaanddissociation.wordpress.com)
- Valerie Sinuson Interview (nathanieljharris.wordpress.com)
- Its time to learn about Dissociative Identity Disorder (diddispatches.wordpress.com)
- 50 Treatment Issues for Dissociative Identity Disorder (discussingdissociation.com)
- PTSD A set of survival responses (traumadissociation.wordpress.com)