The door suddenly jerks open. A wideeyedteenager bursts out. She stares at me in dazed horror. In a strangeway, I both know and don’t know what has just happened. As the fragmentsbegin to converge, they convey a horrible reality: I must havebeen hit by this car as I entered the crosswalk. In confused disbelief, I sinkback into a hazy twilight. I find that I am unable to think clearly or towill myself awake from this nightmare.A man rushes to my side and drops to his knees. He announces himselfas an off-duty paramedic. When I try to see where the voice is comingfrom, he sternly orders, “Don’t move your head.” The contradictionbetween his sharp command and what my body naturally wants—toturn toward his voice—frightens and stuns me into a sort of paralysis.My awareness strangely splits, and I experience an uncanny “dislocation.”It’s as if I’m floating above my body, looking down on the unfoldingscene.I am snapped back when he roughly grabs my wrist and takes mypulse. He then shifts his position, directly above me. Awkwardly, hegrasps my head with both of his hands, trapping it and keeping it frommoving. His abrupt actions and the stinging ring of his command panicme; they immobilize me further. Dread seeps into my dazed, foggy consciousness:Maybe I have a broken neck, I think. I have a compellingimpulse to find someone else to focus on. Simply, I need to have someone’scomforting gaze, a lifeline to hold onto. But I’m too terrified tomove and feel helplessly frozen.
During this hour in the waking streets I felt at ease, at peace; my body, which I despised, operated like a machine. I was spaced out, the catchphrase my friends at school used to describe their first experiments with marijuana and booze. This buzzword perfectly described a picture in my mind of me, Alice, hovering just below the ceiling like a balloon and looking down at my own small bed where a big man lay heavily on a little girl I couldn’t quite see or recognize. It wasn’t me. I was spaced out on the ceiling. I had that same spacey feeling when I cooked for my father, which I still did, though less often. I made omelettes, of course. I cracked a couple of eggs into a bowl, and as I reached for the butter dish, I always had an odd sensation in my hands and arms. My fingers prickled; it didn’t feel like me but someone else cutting off a great chunk of greasy butter and putting it into the pan. I’d add a large amount of salt — I knew what it did to your blood pressure, and I mumbled curses as I whisked the brew. When I poured the slop into the hot butter and shuffled the frying pan over the burner, it didn’t look like my hand holding the frying-pan handle and I am sure it was someone else’s eyes that watched the eggs bubble and brown. As I dropped two slices of wholemeal bread in the toaster, I would observe myself as if from across the room and, with tingling hands gripping the spatula, folded the omelette so it looked like an apple envelope. My alien hands would flip the omelette on to a plate and I’d spread the remainder of the butter on the toast when the two slices of bread leapt from the toaster. ‘Delicious,’ he’d say, commenting on the food before even trying it.
Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters.Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.