Multiple personality disorder: ‘Creating personas was my way of coping with....

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http://www.timesonline.co.uk/tol/life_a ... 250768.ece

From The Times
May 11, 2009

Multiple personality disorder: ‘Creating personas was my way of coping with abuse’
After years of abuse by her father, Alice Jamieson developed multiple personality disorder. She tells how trauma has shaped her life

Meeting new people is stressful for Alice Jamieson — not her real name — and it is at times of stress that her alternative personality is inclined to appear. So perhaps I should not be surprised that when Alice first walks towards me at her home, there is no sign of a 40-year-old woman who is about to begin a PhD. In her place is a ten-year-old boy called JJ who hangs his head, dangles his arms and talks in a slow, high-pitched voice.

Would I like to see his new light? I follow him to another room, where a spectacular aeroplane light fitting hangs from the ceiling. He whizzes the propeller round and shows me a set of wooden letters that are to be attached to the door. They spell “JJ’S DEN”. “I can come here and be on my own,” he explains.

We sit down in the kitchen and I tell JJ that I think Alice’s book is really good. I’m trying to use words appropriate for a conversation with a ten-year-old boy when his legs stop swinging and he raises his head and looks at me keenly. Alice is back. She shakes my hand to introduce herself; she has no knowledge of the conversation we have just had.

When Alice Jamieson was 24 she was told that she had multiple personality disorder, or dissociative identity disorder (DID), a condition that is associated with abuse in childhood. At one point she had about 15 alternative personalities, many of them children with specific memories of the abuse that she suffered, largely at the hands of her father, although at times he sanctioned the involvement of other adults, too.

DID is an elaborate defence mechanism that enables victims of abuse to cope with what has happened to them. If a bad experience is dealt with by a separate person, then good experiences — perhaps with the same adult to whom attachment is imperative — can be preserved.

Alice’s book, Today I’m Alice, is a compelling account of the strategies she has used to survive more than two decades of grotesque sexual, physical and emotional harm. It is not comfortable reading but it does offer insight into a form of mental illness that is more pervasive than we may realise. This is pertinent as health and social care professionals debate how best to identify the abuse of children. It is estimated that nine out of ten abused children remain silent about their damaged past, even as adults.

Alice grew up with her parents in a big house in suburbia. Her father was a respected professional who enjoyed golf, and she had an older brother, though this was a family in which there was little communication. When she was six months old her father started to abuse her. Throughout her childhood, adolescence and young adulthood he raped her hundreds of times. “There was no perversion my father didn’t inflict on me,” she writes.

To Alice the child, this was all she knew and therefore it was normal. She told no one because her father said that no one would believe her, and as “Daddy’s little girl” she craved his attention. Yet by the time she was a teenager she was anorexic, numbing herself with alcohol, a compulsive runner, and had obsessive complusive disorder. She also began to hear the voices of various characters who told her that she was useless and urged her to kill herself. She has since overdosed more than 100 times and the forearms she has cut repeatedly are patched up with 600 stitches. She has also suffered from drug addiction.

Her book tells this story in the manner of a curtain being drawn back. As a child Alice was aware of disturbing dreams; slowly she came to understand that these were repressed memories of real events, and that she endured her abuse by dissociating from it, by becoming another person who would hold that memory. This meant that she lost the time when she functioned as another person. With professional help, some of her “alters” have become integrated, though she chooses to keep JJ.

“Creating personas in my head was my way of coping,” Alice says. “They would take on board the abuse and I’d not remember what had happened. JJ is the main person who comes out. I think he represents the childhood that I lost. It’s important to have that ability to sit and play.”

JJ reappears a minute later. He giggles, asks my name again, then says: “I’m getting in the way. You’ve got questions to ask.” I will meet him five times.

The big question that Alice’s history raises is why her abuse was not picked up. Her mother and brother knew nothing about it until she told them as an adult, though at the age of 2 she had an anal fissure and as a small child she was repeatedly treated for cystitis in hospital. Part of her mission now is to ensure that all professionals who work with children recognise the signs.

“Why it didn’t ring alarm bells with somebody at school, I don’t know. I was depressed at 14, 15. I’d fall asleep in lessons, yet nobody asked questions. When I was a teenager a child psychiatrist asked me outright: ‘Have you been abused?’ What are you meant to say when you’re living at home with your parents? You’re not going to say yes because the fear of God is put into you — no one will believe you.”

Certainly sexual abuse was not widely debated in the Seventies and Eighties, and even now it is more commonly associated with sink estates than with the middle classes. That has been her father’s protection. When, at the age of 21, she confronted him with the knowledge that he had abused her, he raped her at knifepoint and beat her up so badly that she needed hospital treatment.

In 1999 she did eventually report the abuse to the police, who investigated — but her father, who denies the allegations, was not prosecuted, largely because Alice’s mental health was poor at the time. The abuse has, however, been validated by the Criminal Injuries Compensation Authority, which carried out a two-and-a-half-year investigation and awarded her more than £400,000. She also has a letter from her local police force confirming its belief that she has told the truth.

Much of her life has been lonely. Not knowing how to have a loving relationship, she avoided them. Her recovery has a lot to do with Alec, whom she met three years ago when he was a churchwarden. A jovial man in his sixties, he spends hours playing with JJ. “He was unconditional,” says Alice, “never judgmental. He didn’t say anything about belief or disbelief, he wasn’t fazed by what I said. If I hadn’t made that bond I’d be dead now.” The book has also been cathartic: “Almost more so than any therapy I’ve had, because I described what happened.”

It is hard to put across the experience of meeting Alice without describing her voice, her manner, the way she looks at you, all of which could identify her and consequently her father, which legal considerations prevent. But I can say that when we said goodbye she kissed me enthusiastically on both cheeks. For a woman who has experienced such trauma that only a few years ago she could not bear to be touched, that is a positive sign.

Today I’m Alice, by Alice Jamieson, is published by Sidgwick & Jackson, £12.99

How alter egos aid survival

A child survives by forming an attachment to one or more adults. If that attachment is threatened, the child has to find a way to cope. Multiple personality disorder, or dissociative identity disorder, is a survival mechanism.

“When a child’s neurological system can’t cope with what’s going on, they have to find some way of dealing with it as if it hasn’t happened,” says Remy Aquarone, secretary of the European Society for Trauma and Dissociation and director of the Pottergate Centre for Dissociation and Trauma. “Perhaps a father looked after his daughter most of the time but would occasionally abuse her. Then the two experiences are separated to preserve the attachment to the good father, which is paramount. So the child finds herself split into one person who deals with the abuse, and another who deals with the attachment. Adults who were abused as children will say that they could tell immediately from the way their abuser talked and their body movement whether abuse was about to happen. If it was, they would immediately switch personality to minimise the impact.”

This is a primitive mechanism linked to animal responses, Aquarone says. “An animal that is about to be attacked increases its chances of survival if it plays dead and is passive. With a child, a threat comes along, the child freezes, then something takes its place. It’s a psychological coma of forgetting and not knowing.”

Alice Jamieson’s sense that she loses time is typical of people who are abused over many years, Aquarone adds. “People carry on for maybe 20 years having no memory of the abuse, then it starts leaking through and they have a breakdown, which is the beginning of trying to process what couldn’t be processed before.

“The more that went wrong in childhood, the more different situations have to be coped with by another part of them — by an ‘alter’. In adulthood this is no longer necessary as a survival mechanism but it is templated, so it carries on.”

Many people with dissociative conditions do not seek treatment; Aquarone estimates that 0.5 per cent of the population may be affected. Treatment began 20 years ago in the US and focused on integrating the personalities. Today the emphasis is to reduce the symptoms, which often include self-harm, and to facilitate communication between the outside personality — in this case Alice — and her alters. The outside personality is encouraged to talk about her history and to understand that her alters use up some of her conscious time. “You make sure that the outside personality is the one in charge,” says Aquarone.