Atticus (bear), Anastasia (rabbit doll), Sophie & Sarah
People with multiple personality often have an array of symptoms, many of them belonging to other psychiatric disorders. As we mentioned earlier (post #11 on Jan 19th “Window of Diagnosability” and post #42 on Feb 5th “The Many Faces of Multiple Personality”) the different presentations of the condition can make it difficult for a therapist to diagnose the multiplexity and having symptoms of other disorders makes it even more difficult to see the multiplexity. Also, the person may well have these other disorders and sometimes it’s a specific alter who has them. However, there are many symptoms that are common to multiples. These include depressive, dissociative, anxiety, and phobic symptoms. Substance abuse is a common one for survivors as well as self mutilation. Some multiples have hallucinations and delusions, both symptoms of psychosis. Suicidal urges, gestures and attempts are common as well.
Depression, along with suicidal feelings and attempts, is a very common symptom for survivors of abuse and for multiples. The host personality (see post #5a on Jan 12 “About personalities”) may seek therapy for depression and low self esteem, and possibly might be doing some form of self harm such as cutting, burning or inserting objects into his or her body. He or she may be having difficulty concentrating on school or work, have fatigue, crying spells, and/or sleep problems. What may be different for someone with multiple personality is that the depression isn’t always there, as it would be for someone not multiple. There may be times the person seems quite happy in their life. She may have several mood swings as often as within a day or even within an hour. Of course some of this may be because different alters are surfacing and displaying different emotions.
All multiples have dissociative symptoms such as “spacing out”, and switching from one personality to another. The child needed to dissociate in order to create the other selves. (See post #1 on Jan 8 “Yes We Are. A Beginning” for our definition of dissociation). Forgetfulness is often present as well. Sometimes a multiple may remember something from their past but the person feels distant and detached from it, as if it were only a dream and not a real experience. On the other hand, remembering the past may be a huge problem. Some of the alters, often including the host personality, may not remember their childhood at all or only small parts of it. There may be days, months and years missing.
Survivors of trauma often have Post Traumatic Stress Disorder (PTSD) and other anxiety or phobic symptoms. Panic attacks are very common. The person may have difficulty breathing, heart palpitations, a sensation of choking or being smothered, have faintness or trembling. There may be certain places or objects that cause intense fear for some. These are called triggers because they remind the person of some part of the trauma. Some survivors may not be able to leave their home because their fear of the world is so intense. Danger is right outside their door.
Substance abuse and addiction problems are also very common for survivors. For multiples, it is usually in the form of tranquilizers or alcohol. We took a tranquilizer named Ativan for years and eventually became very addicted to it. The regular recommended dosage is 4 mg per day. Before stopping Ativan we were taking up to 80 mg a day. At another time, some of us began taking Gravol in larger and larger quantities. Again the maximum dosage recommended was no more than 8 times 50 mg a day within a 24 hour period, so a maximum of 400 mg a day. We were taking 20 to 30 pills a day (1000 to 1500 mg).
Multiples hear voices but it doesn’t mean they are crazy. These voices may be different than that of psychosis. The voices are usually that of other alters talking to them. The voices may be threatening, as Razor Man (3) was with Shell (1, 2). Host alters are commonly threatened by other alters. The voices may also be heard crying, screaming or laughing. There may be discussions and arguments heard from within. There may also be voices that calm and soothe, or give advice. We have heard that people with psychosis hear voices as if they were outside their head whereas multiples hear them as inside their head.
It is possible for a person to actually see some of their alters as if they were outside of their body, as if they were another person. Shell saw the three alters called The Bitches (8) (eventually called MEA) as outside of herself and thus did not believe they were alters. It took a long time to convince her they were part of the same system of alters.
He or she may also hallucinate blood, or violent scenes. Both of these may be connected to particular memories of the abuse. Sometimes the person may feel her body change when alters switch. She may be walking down the street and suddenly feel taller and take longer strides. Or the multiple might look in the mirror and see a different face, another alter. After we gave birth to our son Graham, we looked in the mirror and saw a very different face. We even saw freckles that we don’t usually have. It turned out to be Una (4).
There are times that a person may be having “rapid switching” or a “revolving-door crisis” which is when a number of alters are switching from one to another quite quickly, each trying to take control. To a therapist, this may look like psychosis, as the person displays emotions that don’t match the situation. It is usually transient though and indicative of some internal crisis going on.
There is the question whether or not multiples are delusional in their thinking that they are more than one person. We mentioned in post #5a on Jan 12 “About personalities”, that Dr Colin Ross, a Canadian psychiatrist, said a therapist shouldn’t “buy into” the idea that alters are separate people. However, Truddi Chase’s therapist (“When Rabbit Howls”) fully believed Truddi’s alters to be separate people. He had seen all kinds of things such as different brain wave patterns, voices, eye responses to stimuli, and medical conditions that led him to strongly believe that they were separate individuals. As far as any delusion goes, Frank Putnam believed that an alter is delusional when he thinks he can kill off the other alters without killing or harming himself.
Some multiples have displayed catatonia where the person seems to go into a trance and does not move at all. This may be happening because the person, or one specific alter, is overwhelmed by outside stimuli that is causing traumatic memories to surface. It actually may be a healing thing to do as it reduces and filters out the stimuli. We think this is what happens to us when we are in groups. It feels like our brain is screaming for us to shut down because way too much is coming in and we get overwhelmed. Although Julia (1) used to go into catatonic states she no longer does and neither do the rest of us. We just recognize that we need down time and time alone where we can process things and take a break from the stimuli.
Finally, nightmares and flashbacks are also common for survivors of trauma and for people with multiple personality. Flashbacks are intrusive images or feelings of memories of the trauma. The person may also startle easily. Some survivors may be in abusive relationships that mirror the earlier abuse. There also may be physical symptoms and pain that are connected to the past abuse. Headaches are also common.
As you can see there are a myriad of symptoms a multiple can have and display. It is no wonder we become very ill and often, but not always, have trouble functioning normally. We also have many mechanisms to deal with these symptoms. We have ways of making it all manageable. Multiplexity is truly a coping mechanism first and foremost. It is a way to survive the most extreme of situations. Something we should be, and are, proud of.
No comments:
Post a Comment