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I was much crazier than I had imagined. Or maybe it was a bad idea to read DSM-IV when you're not a trained professional. Or maybe the American Psychiatric Association had a crazy desire to label all life a mental disorder.
Jon Ronson
Every time you feel like mocking a person you disagree with politically by implying that they are mentally ill, I want you to instead imagine you are talking to every single person who actually is mentally ill and telling them they are worthless. That's how it makes mentally ill people feel. Doesn't seem very progressive now does it?
Ariel Howland
My own studies on the natural history of DID indicate only 20% of DID patients have an overt DID adaption on a chronic basis, and 14% of them deliberately disguise their manifestations of DID. Only 6% make their DID obvious on an ongoing basis. Eighty percent have windows of diagnosability when stressed or triggered by some significant event, interaction, situation or date. Therefore, 94% of DID patients show only mild or suggestive evidence of their conditions most of the time. Yet DID patients often will acknowledge that their personality systems are actively switching and/or far more active than it would appear on the surface (Loewenstein et al., 1987).R.P. Kluft (2009) A clinician's understanding of dissociation. pp 599-623.
Paul F. Dell
Do You Have DID?Determining if you have DID isn’t as easy as it sounds. In fact, many clinicians and psychotherapists have such difficulty figuring out whether or not people have DID that it typically takes them several years to provide an accurate diagnosis. Because many of the symptoms of DID overlap with other psychological diagnoses, as well as normal occurrences such as forgetfulness or talking to yourself, there is a great deal of confusion in making the diagnosis of DID. Although this section will provide you with information which may help you determine if you have DID, it is a good idea to consult with a professional in the mental health field so that you can have further confirmation of your findings.
Karen Marshall
In this paper I propose the existence of two distinct presentations of DID, a Stable and an Active one. While people with Stable DID struggle with their traumatic past, with triggers that re-evoke that past and with the problems of daily functioning with severe dissociation, people with Active DID are, in addition, also engaged in a life of current, on-going involvement in abusive relationships, and do not respond to treatment in the same way as other DID patients. The paper observes these two proposed DID presentations in the context of other trauma-based disorders, through the lens of their attachment relationship. It proposes that the type, intensity and frequency of relational trauma shape—and can thus predict—the resulting mental disorder. - Through the lens of attachment relationship: Stable DID, Active DID and other trauma-based mental disorders
Adah Sachs
The DID patient is a single person who experiences himself or herself as having separate alternate identities that have relative psychological autonomy from one another. At various times, these subjective identities may take executive control of the person’s body and behavior and/or influence his or her experience and behavior from “within.” Taken together, all of the alternate identities make up the identity or personality of the human being with DID.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p7
James A. Chu
Dissociative parts of the personality are not actually separate identities or personalities in one body, but rather parts of a single individual that are not yet functioning together in a smooth, coordinated, flexible way. P14
Suzette Boon
The source for any mental trauma is never the other person, but its your own MIND psyching YOU into believing that you're vulnerable at first, thereby gradually increasing the intensity of suffering as it justifies through illusionary reasons as falsity forms its very foundation with fabrication as prime element - all thanks to the unconscious recess, thus driving one into a life-negative state with violent mood swings followed by depression and onset of suicidal tendencies! Beware of your MIND, for it's not YOU!
Ramana Pemmaraju
The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR.While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false.Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia.
Richard P. Kluft
The thesis that DID is merely a North American phenomenon has been refuted in the past decade by research reports based on standardized assessment from diverse countries, such as from The Netherlands, Turkey, and Germany (Boon & Draijer, 1993; Gast, Rodewald, Nickel, & Emrich, 2001; S ̧ar et al, 1996). Clinicians and researchers should be careful to avoid categorizing a universal human condition as culture-bound.
Paul F. Dell
Several themes describe misconceptions about mental illness and corresponding stigmatizing attitudes. Media analyses of film and print have identified three: people with mental illness are homicidal maniacs who need to be feared; they have childlike perceptions of the world that should be marveled; or they are responsible for their illness because they have weak character (29-32). Results of two independent factor analyses of the survey responses of more than 2000 English and American citizens parallel these findings (19,33):- fear and exclusion: persons with severe mental illness should be feared and, therefore, be kept out of most communities;- authoritarianism: persons with severe mental illness are irresponsible, so life decisions should be made by others;- benevolence: persons with severe mental illness are childlike and need to be cared for.- Although stigmatizing attitudes are not limited to mental illness, the public seems to disapprove persons with psychiatric disabilities significantly more than persons with related conditions such as physical illness (34-36).
Matthew W. Corrigan
According to Hoge and colleagues (2007), the key to reducing stigma is to present mental health care as a routine aspect of health care, similar to getting a check up or an X-ray. Soldiers need to understand that stress reactions-difficulty sleeping, reliving incidents in your mind, and emotional detachment-are common and expected after combat... The soldier should be told that wherever they go, they should remember that what they're feeling is "normal and it's nothing to be ashamed of.
Joan Beder
Stigmas speak to the idea of difference and how difference shames us and those we know.
Michael Lewis
Pathological dissociation is characterized by profound, functional amnesias and significant alterations in identity; normal dissociation is expressed primarily in the form of intense absorption with internal stimuli (e.g., daydreams) or external stimuli (e.g., a fascinating book or television program).
Frank W. Putnam
the stigma of severe mental illness leads to prejudice and discrimination. Stigmas are negative and erroneous attitudes about these persons. Unfortunately, stigma's impact on a person's life may be as harmful as the direct effects of the disease.Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765–776.
Patrick W. Corrigan
The unique stigma of PTSD. The stigma of PTSD remains one of the most formidable barriers to effective care.
Michael A. Cucciare
People who live with mental illnesses are among the most stigmatized groups in society.Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World Psychiatry. Oct 2008; 7(3): 185–188. PMCID: PMC2559930
Heather Stuart
Public stigmatStereotypetNegative belief about a group (e.g., dangerousness, incompetence, character weakness)PrejudicetAgreement with belief and/or negative emotional reaction (e.g., anger, fear)DiscriminationtBehavior response to prejudice (e.g., avoidance, withhold employment and housing opportunities, withhold help)Self-stigmatStereotypetNegative belief about the self (e.g., character weakness, incompetence)PrejudicetAgreement with belief, negative emotional reaction (e.g., low self-esteem, low self-efficacy)DiscriminationtBehavior response to prejudice (e.g., fails to pursue work and housing opportunities)Understanding the impact of stigma on people with mental illness. World Psychiatry. Feb 2002; 1(1): 16–20.PMCID: PMC1489832
Matthew W. Corrigan
I had people saying 'it's all in your head'. Do you honestly think I want to feel this way?
Sonia Estrada
Denial and minimizing is often seen in genuine PTSD and, hence, should be a target of detection and measurement.
Harold V. Hall
The central mechanism of the avoidance mechanism of PTSD is the ego defense of denial
Frank M. Ochberg
There is clear evidence from internal investigations in the past that some raters actually see themselves as adversaries to veterans. If a claim can be minimized, then the government has saved money, regardless of the need of the veteran. Just recently, the press exposed an official e-mail from a high-level staff person who stated in essence that PTSD diagnosis was becoming too prevalent and offered ways to delay and deflect ratings in order to save the government money.
Taylor Armstrong
Advances in biological knowledge have highlighted the potential chronicity of effects of childhood maltreatment, demonstrating particular life challenges in managing emotions, forming and maintaining healthy relationships, healthy coping, and holding a positive outlook of oneself.
Christine Wekerle
Mental illness is nothing to be ashamed of, but stigma and bias shame us all.
Bill Clinton
I'm not the kind of person who likes to shout out my personal issues from the rooftops, but with my bipolar becoming public, I hope fellow sufferers will know it's completely controllable. I hope I can help remove any stigma attached to it, and that those who don't have it under control will seek help with all that is available to treat it.
Catherine Zeta-Jones
Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. ... In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas.
David J. Morris
Results of two independent factor analyses of the survey responses of more than 2000 English and American citizens parallel these findings (19,33):- fear and exclusion: persons with severe mental illness should be feared and, therefore, be kept out of most communities;- authoritarianism: persons with severe mental illness are irresponsible, so life decisions should be made by others;- benevolence: persons with severe mental illness are childlike and need to be cared for."World Psychiatry. 2002 Feb; 1(1): 16–20.PMCID: PMC1489832Understanding the impact of stigma on people with mental illnessPATRICK W CORRIGAN and AMY C WATSON
Patrick W. Corrigan
Several themes describe misconceptions about mental illness and corresponding stigmatizing attitudes. Media analyses of film and print have identified three: people with mental illness are homicidal maniacs who need to be feared; they have childlike perceptions of the world that should be marveled; or they are responsible for their illness because they have weak character (29-32)."World Psychiatry. 2002 Feb; 1(1): 16–20.PMCID: PMC1489832Understanding the impact of stigma on people with mental illnessPATRICK W CORRIGAN and AMY C WATSON
Patrick W. Corrigan
No one would ever say that someone with a broken arm or a broken leg is less than a whole person, but people say that or imply that all the time about people with mental illness.
Elyn R. Saks
Many people with Dissociative Disorders are very creative and used their creative capacities to help them cope with childhood trauma.p55
Marlene Steinberg
The SCID-D may be used to assess the nature and severity of dissociative symptoms in a variety of Axis I and II psychiatric disorders, including the Anxiety Disorders (such as Posttraumatic Stress Disorder [PTSD] and Acute Stress Disorder), Affective Disorders, Psychotic Disorders, Eating Disorders, and Personality Disorders.The SCID-D was developed to reduce variability in clinical diagnostic procedures and was designed for use with psychiatric patients as well as with nonpatients (community subjects or research subjects in primary care).
Marlene Steinberg
When preparing for Book One, I talked to a couple of psychiatrists about psychosomatic phenomena, neuroses and dissociative conditions, for example the so—called hysterical blindness suffered by many who saw the Killing Fields in Pol Pot’s Cambodia: their eyes objectively see, but they are not aware of it and are blind because they believe they can’t see. One specialist told me that among modern Western people, ’metaphorical’ symptoms such as Fredy or those Cambodians evince are much rarer now than earlier in the twentieth century or before. Nowadays most people are better equipped by education to verbalise their neuroses, and have lots of jargon in which to do so. For most of the dissociative dimension, I could draw on things I knew from within myself.
Les Murray
The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn’t even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, “I know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It’s the only thing that works.” For her. Lord knows, I’m not a doctor, and I don’t understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her…. well then, it works for her. Which is not to say that it will work for you, for me or for others.
Stephen Fry
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.
David Yeung
Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good.
Marlene Steinberg
My client who has only three alter personalities besides the ANP was unaware of her multiplicity until she encountered a work-related trauma at age sixty. She became symptomatic as the hidden parts emerged to deal with the recent trauma.
Alison Miller
It is not unusual for subjects diagnosed with a Dissociative Disorder on the SCID-D to be surprised at having their symptoms validated by a clinician who understands the nature of their disorder.
Marlene Steinberg
She fails to see who I am, even, for her eyes do not, will not, take me in. Instead they transmit a powerful message. She is like a billboard flashing, starkly: 'Keep Out'.
Carol Lee
Interestingly, the patients who presented to me self-diagnosed [with Dissociative Identity Disorder had tried to tell previous therapists of their plight, but had been disbelieved. These therapists had used fallacious "capricious criteria" (KIuft, 1988) to discredit the diagnosis; e.g., that the patient could not possibly have MPD because she was aware of the other alters [sic!].
Richard P. Kluft
Schizo. It didn't matter how many times Dr. Gill compared it to a disease or physical disability, it wasn't the same thing. It just wasn't. I had schizophrenia. If I saw two guys on the sidewalk, one in a wheelchair and one talking talking to himself, which would I rush to open a door for, and which would I cross the road to avoid?
Kelley Armstrong
The country is not growing because the mental state of the people are retarded
Sunday Adelaja
They called me mad, and I called them mad, and damn them, they outvoted me.
Nathaniel Lee
Stigma against mental illness is a scourge with many faces, and the medical community wears a number of those faces.
Elyn R. Saks
I couldn’t trust my own emotions. Which emotional reactions were justified, if any? And which ones were tainted by the mental illness of BPD? I found myself fiercely guarding and limiting my emotional reactions, chastising myself for possible distortions and motivations. People who had known me years ago would barely recognize me now. I had become quiet and withdrawn in social settings, no longer the life of the party. After all, how could I know if my boisterous humor were spontaneous or just a borderline desire to be the center of attention? I could no longer trust any of my heart felt beliefs and opinions on politics, religion, or life. The debate queen had withered. I found myself looking at every single side of an issue unable to come to any conclusions for fear they might be tainted. My lifelong ability to be assertive had turned into a constant state of passivity.
Rachel Reiland
Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning.… Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.… They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe.
Judith Lewis Herman
those glasses aren't for the sun they're for darkness, exclaims Rue. Sometimes when we harvest through the night, they'll pass out a few pairs to those of us highest in the trees. Where the torchlight doesn't reach. One time, this boy Martin, he tried to keep his pair. Hid it in his pants. They killed him on the spot. They killed a boy for taking these/ I say Yes. and everyone knew he was no danger. Martin wasn't right in the head. I mean he still acted like a three year old. He just wanted the glasses to play with, says Rue. Hearing this makes me feel like District 12 is some sort of safe haven. Of course, people keel over from starvation all the time, but I can't imagine the peacekeepers murdering a simpleminded child. There's a little girl, one of greasy sae's gradkids, who wanders around the Hob. She's not quite right but she's treated as a sort of pet. People toss her scraps and things.
Suzanne Collins
Police intentionally murdering a mentally unstable person will always be unacceptable when there are numerous other non-lethal options available to them.
Steven Magee
Patients with complex trauma may at times develop extreme reactions to something the therapist has said or not said, done or not done. It is wise to anticipate this in advance, and perhaps to note this anticipation in initial communications with the patient. For example, one may say something like, "It is likely in our work together, there will be a time or times when you will feel angry with me, disappointed with me, or that I have failed you. We should except this and not be surprised if and when it happens, which it probably will." It is also vital to emphasize to the patient that despite the diagnosis and experience of dividedness, the whole person is responsible and will be held responsible for the acts of any part. p174
Elizabeth F. Howell
Holding one's self responsible is a critical feature in stigma and in the generation of shame since violation of standards, rules, and goals are insufficient in its elicitation unless responsibility can be placed on the self. Stigma may differ from other elicitors of shame and guilt, in part because it is a social appearance factor. The degree to which the stigma is socially apparent is the degree to which one must negotiate the issue of blame, not only for one's self but between one's self and the other who is witness to the stigma. Stigmatization is a much more powerful elicitor of shame and guilt in that it requires a negotiation not only between one's self and one's attributions, but between one's self and the attributions of others.
Michael Lewis
Solomon had good days and he had bad days, but the good had far outnumbered the bad since Lisa and Clark had started coming around. Sometimes, though, they'd show up and he's look completely exhausted, drained of all his charm and moving in slow motion. They could do that to him—the attacks. Something about the physical response to panic can drain all the energy out of a person, and it doesn't matter what causes it or how long it lasts. What Solomon had was unforgiving and sneaky and as smart as any other illness. It was like a virus or cancer that would hide just long enough to fool him into thinking it was gone. And because it showed up when it damn well pleased, he'd learned to be honest about it, knowing that embarrassment only made it worse.
John Corey Whaley
There are men who wants only the woman; such are tagged, 'real men', and there are ones who want only their bodies; such are tagged, 'fake men', and there are others who wants neither the woman, nor the body; such are tagged, 'GAY MEN
Michael Bassey Johnson
Jail has become the biggest mental health hospital.
Steven Magee
She was so shattered about what kind of man he was -- brutal, tender, passionate. There was little doubt he had some mental disorder.
Margaret Way
It is growing up different. It is extreme hypersensitivity. It is a bottomless pit of feeling you're failing, but three days later, you feel you can do anything, only to end the week where you began. It is not learning from your mistakes. It is distrusting people because you have been hurt enough. It is moments of knowing your pain is self inflicted, followed by blaming the world. It is wanting to listen, but you just can’t anymore because your life has been to full of people that have judged you. It is fighting to be right; so for once in your life someone will respect and hear you for a change. It is a tiring life of endless games with people, in order to seek stimulus. It is a hyper focus, so intense about what bothers you, that you can’t pay attention to anything else, for very long. It is a never-ending routine of forgetting things. It is a boredom and lack of contentment that keeps you running into the arms of anyone that has enough patience to stick around. It wears you out. It wears everyone out. It makes you question God’s plan. You misinterpret everything, and you allow your creative mind to fill the gaps with the same old chains that bind you. It narrows your vision of who you let into your life. It is speaking and acting without thinking. It is disconnecting from the ones you love because your mind has taken you back to what you can’t let go of. It is risk taking, thrill seeking and moodiness that never ends. You hang your hope on “signs” and abandon reason for remedy. It is devotion to the gifts and talents you have been given, that provide temporary relief. It is the latching onto the acceptance of others---like a scared child abandoned on a sidewalk. It is a drive that has no end, and without “focus” it takes you nowhere. It is the deepest anger when someone you love hurts you, and the greatest love when they don't. It is beauty when it has purpose. It is agony when it doesn’t. It is called Attention Deficit Disorder.
Shannon L. Alder
With DID patients, if they feel hostility or aggression they take it out on themselves with self-harm... They’re self-destructive and repeatedly suicidal, more so than any other psychological disorder. So that's what's typical – not this wild aggression, or stalking women [or robbery].- Dr Bethany Brand, on Billy Milligan and Multiple Personality Disorder (DID)
Bethany L. Brand
Self Hate: The deadliest 'dis-ease' experienced by wounded souls.
T.F. Hodge
A more fundamental problem with labelling human distress and deviance as mental disorder is that it reduces a complex, important, and distinct part of human life to nothing more than a biological illness or defect, not to be processed or understood, or in some cases even embraced, but to be ‘treated’ and ‘cured’ by any means possible—often with drugs that may be doing much more harm than good. This biological reductiveness, along with the stigma that it attracts, shapes the person’s interpretation and experience of his distress or deviance, and, ultimately, his relation to himself, to others, and to the world. Moreover, to call out every difference and deviance as mental disorder is also to circumscribe normality and define sanity, not as tranquillity or possibility, which are the products of the wisdom that is being denied, but as conformity, placidity, and a kind of mediocrity.
Neel Burton
Her parents, she said, has put a pinball machine inside her head when she was five years old. The red balls told her when she should laugh, the blue ones when she should be silent and keep away from other people; the green balls told her that she should start multiplying by three. Every few days a silver ball would make its way through the pins of the machine. At this point her head turned and she stared at me; I assumed she was checking to see if I was still listening. I was, of course. How could one not? The whole thing was bizarre but riveting. I asked her, What does the silver ball mean? She looked at me intently, and then everything went dead in her eyes. She stared off into space, caught up in some internal world. I never found out what the silver ball meant.
Kay Redfield Jamison
When you’ve had a psychotic breakdown it’s always so difficult making that decision. You meet someone new and you wonder how much you should tell them? You wonder what that person’s threshold of ‘strange’ is, and at what point in my story would I end up driving them away. That fear it’s always there in the back of your mind. Those details you never really even admitted to yourself, but that somehow have to be told just as much as they have to be buried deep down.
Cyma Rizwaan Khan
What daily life is like for “a multiple” Imagine that you have periods of “lost time.” You may find writings or drawings which you must have done, but do not remember producing. Perhaps you find child-sized clothing or toys in your home but have no children. You might also hear voices or babies crying in your head. Imagine that you can never predict when you will be able to have certain knowledge or social skills, and your emotions and your energy level seem to change at the drop of a hat, and for no apparent reason. You cannot understand why you feel what you feel, and, if you are in therapy, you cannot explore those feelings when asked. Your life feels disjointed and often confusing. It is a frightening experience. It feels out of control, and you probably think you are going crazy. That is what it is like to be multiple, and all of it is experienced by the ANPs. A multiple may also experience very concrete problems, even life-threatening ones.
Alison Miller
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