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DID resources found on the web
Discussions of abuse, trauma, and mental illness follow.
I read an article about human trafficking in Texas a couple days back when a section on the mental health issues of trafficked sex workers caught my eye. The first condition mentioned was dissociative identity disorder (DID), which makes sense because prostitutes as a group suffer high rates of child sexual abuse and incest (85% and 70% respectively in the study cited). This kind of severe and repeated abuse in childhood is a leading cause of DID, so it makes sense that prostitutes would have high instances of DID. I'm not only talking about pre-prostitution trauma, either. As stated in the linked rapeis.org page the average age of entry into prostitution is 13, meaning many sex workers are still children.
It was particularly good to see the existence of DID discussed in this heavily traumatized group, because as recently as November 2014 I read an article attempting to discredit the whole idea of DID and repressed memories of abuse. And look, obviously some people are malicious or disturbed enough to make false accusations of abuse, and it's not out of the realm of possibility that unscrupulous and biased practitioners manipulated patients into false memories, though I'd like to see better documentation of this assertion. However, if your entire argument boils down to "it's impossible for traumatic memories to be suppressed so no such accusation can ever be true," despite numerous empirical and clinical records of this very thing happening--well, let's just say that's barely a step up from "bitches always lie about rape." Just add an adjective and it becomes "Forgetful bitches always lie about rape."
So, intrigued to find out more about DID in the context of childhood abuse and prostitution, I went searching and found these resources interesting.
Dissociation Among Women in Prostitution - This is a 2003 article summarizing four studies on dissociation done with current and former women sex workers in Canada, Turkey, and the U.S. The studies found higher Dissociative Experience Scale scores among these current and former sex workers than among the general population. And remember how multiple personality disorder is supposed to be a North American disease? Well it turns out the studied sex workers in Istanbul actually had higher rates of DID (18%) than the U.S. sample appeared to (16%).
The "clinical observations and theory" section of the paper had fascinating insights, too. It opens with a quote from W.E.B. DuBois who described the dissociative effect of slavery ("double-consciousness, this sense of always looking at one’s self through the eyes of others, of measuring one’s soul by the tape of a world that looks on in amused contempt and pity. One ever feels this twoness . . ."), which I think would be familiar not just to abuse victims but also to many women, who also maintain this bifurcated view of themselves as both the observer and the observed as a matter of social and even physical survival.
The paper also suggests that dissociation, particularly dissociated identity, is a forced adaptation for sex workers who must be whatever she is desired to be, ("You start changing yourself to fit a fantasy role of what they think a woman should be. In the real world, these women don’t exist. . . . They’re not really looking at you. You’re not you. You’re not even there.") Ultimately, the authors argue, healing won't take place until there is full integration and reckoning with reality. ("That was probably one of the hardest things to get over–re-attaching with feelings and re-attaching with myself and my physical body. . . . The goal . . .is to slowly take every shattered piece of your life and build you back up.")
I liked how the authors cautioned against therapists themselves having bad reactions to their clients' trauma and interfering with their healing. "A range of responses to extreme trauma are common in therapists working with survivors–from minimization, avoidance, denial and under-diagnosis to outrage, overreaction, and over-politicization of the treatment setting." This explains a lot of the therapist horror stories I've heard, come to think of it. Who knew, trained professionals are only human too and have their own defense mechanisms! It seems there needs to be greater recognition of therapists' own limitations and the way they might be retraumatizing their clients.
Overall this was a difficult read for obvious reasons. I had to take a break to compose myself when a survivor was quoted saying, "[A]ll I knew was how to be raped, and how to be attacked, and how to be beaten up, and that’s all I knew." Still, ultimately I found it helpful and hopeful, and there were some awesome parts like the one where it was proposed that the dissociated identities of women are "a small army fighting for the rights of women." It also helped me gain more perspective on DID and gave me a good talking point in case anyone started up with the "It's only been diagnosed in America so nyah" line in my hearing. If anyone needs the text, feel free to hit me up.
Diary of a Multiple Personality - This is a small blog with less than 20 entries and abandoned going on five years, but I still found the glimpses into this woman's life intriguing. Be warned, this blog discusses childhood sexual abuse beginning in infancy, and also the shenanigans of a therapist who appears to be an execrable human being in addition to a strong contender for Worst Therapist Ever outside of ones that committed outright crimes. The blogger as of last report doesn't seem to have worked out good communication between alters, since at least two of them not only engaged in embarrassing and disruptive behavior (sex in highly inappropriate settings) but also put the system in physical danger (unprotected sex with strangers, overdosing on medication). She also discussed painful front-switching and gaps in memory. I hope they've worked that out in the years since, especially seeing how they've left the Therapist From Hell.
The Sum of My Parts: A Survivor's Story of Dissociative Identity Disorder - This one is a memoir by fellow D.C. lawyer Olga Trujillo about her childhood abuse and healing. It seems to be really good, if the reviews are anything to go by. I'm pleased to report that there was not a single person on Goodreads popping out to yell "DID/repressed memory is a racket!" The author was even considerate enough to add a trigger warning for the first six chapters of the book, which everyone agrees are extremely disturbing though not graphic. I bought this one on Kobo and now just need to work up the courage to read it.
I read an article about human trafficking in Texas a couple days back when a section on the mental health issues of trafficked sex workers caught my eye. The first condition mentioned was dissociative identity disorder (DID), which makes sense because prostitutes as a group suffer high rates of child sexual abuse and incest (85% and 70% respectively in the study cited). This kind of severe and repeated abuse in childhood is a leading cause of DID, so it makes sense that prostitutes would have high instances of DID. I'm not only talking about pre-prostitution trauma, either. As stated in the linked rapeis.org page the average age of entry into prostitution is 13, meaning many sex workers are still children.
It was particularly good to see the existence of DID discussed in this heavily traumatized group, because as recently as November 2014 I read an article attempting to discredit the whole idea of DID and repressed memories of abuse. And look, obviously some people are malicious or disturbed enough to make false accusations of abuse, and it's not out of the realm of possibility that unscrupulous and biased practitioners manipulated patients into false memories, though I'd like to see better documentation of this assertion. However, if your entire argument boils down to "it's impossible for traumatic memories to be suppressed so no such accusation can ever be true," despite numerous empirical and clinical records of this very thing happening--well, let's just say that's barely a step up from "bitches always lie about rape." Just add an adjective and it becomes "Forgetful bitches always lie about rape."
So, intrigued to find out more about DID in the context of childhood abuse and prostitution, I went searching and found these resources interesting.
Dissociation Among Women in Prostitution - This is a 2003 article summarizing four studies on dissociation done with current and former women sex workers in Canada, Turkey, and the U.S. The studies found higher Dissociative Experience Scale scores among these current and former sex workers than among the general population. And remember how multiple personality disorder is supposed to be a North American disease? Well it turns out the studied sex workers in Istanbul actually had higher rates of DID (18%) than the U.S. sample appeared to (16%).
The "clinical observations and theory" section of the paper had fascinating insights, too. It opens with a quote from W.E.B. DuBois who described the dissociative effect of slavery ("double-consciousness, this sense of always looking at one’s self through the eyes of others, of measuring one’s soul by the tape of a world that looks on in amused contempt and pity. One ever feels this twoness . . ."), which I think would be familiar not just to abuse victims but also to many women, who also maintain this bifurcated view of themselves as both the observer and the observed as a matter of social and even physical survival.
The paper also suggests that dissociation, particularly dissociated identity, is a forced adaptation for sex workers who must be whatever she is desired to be, ("You start changing yourself to fit a fantasy role of what they think a woman should be. In the real world, these women don’t exist. . . . They’re not really looking at you. You’re not you. You’re not even there.") Ultimately, the authors argue, healing won't take place until there is full integration and reckoning with reality. ("That was probably one of the hardest things to get over–re-attaching with feelings and re-attaching with myself and my physical body. . . . The goal . . .is to slowly take every shattered piece of your life and build you back up.")
I liked how the authors cautioned against therapists themselves having bad reactions to their clients' trauma and interfering with their healing. "A range of responses to extreme trauma are common in therapists working with survivors–from minimization, avoidance, denial and under-diagnosis to outrage, overreaction, and over-politicization of the treatment setting." This explains a lot of the therapist horror stories I've heard, come to think of it. Who knew, trained professionals are only human too and have their own defense mechanisms! It seems there needs to be greater recognition of therapists' own limitations and the way they might be retraumatizing their clients.
Overall this was a difficult read for obvious reasons. I had to take a break to compose myself when a survivor was quoted saying, "[A]ll I knew was how to be raped, and how to be attacked, and how to be beaten up, and that’s all I knew." Still, ultimately I found it helpful and hopeful, and there were some awesome parts like the one where it was proposed that the dissociated identities of women are "a small army fighting for the rights of women." It also helped me gain more perspective on DID and gave me a good talking point in case anyone started up with the "It's only been diagnosed in America so nyah" line in my hearing. If anyone needs the text, feel free to hit me up.
Diary of a Multiple Personality - This is a small blog with less than 20 entries and abandoned going on five years, but I still found the glimpses into this woman's life intriguing. Be warned, this blog discusses childhood sexual abuse beginning in infancy, and also the shenanigans of a therapist who appears to be an execrable human being in addition to a strong contender for Worst Therapist Ever outside of ones that committed outright crimes. The blogger as of last report doesn't seem to have worked out good communication between alters, since at least two of them not only engaged in embarrassing and disruptive behavior (sex in highly inappropriate settings) but also put the system in physical danger (unprotected sex with strangers, overdosing on medication). She also discussed painful front-switching and gaps in memory. I hope they've worked that out in the years since, especially seeing how they've left the Therapist From Hell.
The Sum of My Parts: A Survivor's Story of Dissociative Identity Disorder - This one is a memoir by fellow D.C. lawyer Olga Trujillo about her childhood abuse and healing. It seems to be really good, if the reviews are anything to go by. I'm pleased to report that there was not a single person on Goodreads popping out to yell "DID/repressed memory is a racket!" The author was even considerate enough to add a trigger warning for the first six chapters of the book, which everyone agrees are extremely disturbing though not graphic. I bought this one on Kobo and now just need to work up the courage to read it.
no subject
I highly recommend the debunking of the False Memory Syndrome Foundation, who far as I can tell are largely responsible for the whole, "DID is entirely iatrogenic!" idea.
I've been reading articles for fifteen years about how multi is bullshit and going to vanish any day now, and I've seen articles declaring the same thing dated the past thirty years. Any day now, seriously.
--Rogan
no subject
Ooh yeah! Read that one twice. It also turns out there's an entire issue of a journal called Ethics and Behavior (Vol. 8 Issue 2, 1998) devoted to what lovely people the FMSF are. And by "lovely" I mean "shitty." Misrepresenting research, straight-up lying, harassing opponents, picketing clinics... it seems like there's no end to the FMSF's shenanigans. I'm so mad that I've been swallowing bullshit from these people and their media shills for years.
I've also since read Olga Trujillo's book, and parts of her story reminded me of yours, though others were very different. Trujillo's mother also ignored her daughter's abuse, for instance, even when it was taking place literally before her eyes. Trujillo gave the same explanation for this behavior as you did--that her mother was dissociating because she couldn't come to terms with what was happening. The book was heartbreaking but had a happy ending, and was excellently written all around.
no subject
I might have to check out Trujillo's book then, since you say it's good. I hadn't heard of it till now, and I'm eager to read more about multis who aren't white. (Since it's often portrayed as something white middle-class women get.)
Lately, I find myself revisiting the old DID books, trying to get some clarity. A lot of these books, we first read in our early teens or before, but back then, we were just trying to find a system that cooperated, since we didn't believe we'd been traumatized. Now I'm looking more for answers.
--Rogan
no subject
That's why I was struck by the Turkish sex workers sample. And of course a sizable number of human trafficking victims that the Texas Monthly article talked about are non-white. It's possible that cultural differences play a role in how DID manifests, for instance in less individualistic cultures it's possible that alters don't come as often with names or individual history. (Trujillo's alters have numbers rather than names, for instance, though I'm not saying this has anything to do with culture per se.) But of course, having named alters is not a diagnostic criterion of DID and just because it doesn't take a familiar form doesn't mean it's disqualified from the diagnosis.
Trujillo's book is very good, but it has some absolutely harrowing accounts of rape starting from a very young age and you should pay close attention to the trigger warnings in the foreword. I actually cried more during the therapy part, though. It's not an easy book to read and you might want to have Mac standing by for extra-strength cuddles.
no subject
I'll keep an eye out for Trujillo's book. Because of the recent shit, I've found myself returning to the old DID memoirs again, trying to figure shit out.