2016 November 17

Keys to attachment and relationships in Dissociative Identity Disorder:

How can we understand how we got where we are? Why are relationships so hard? Here’s what we’ll talk about in this post:

Dissociation as a result of relational conflicts

Bonding – NOT

Who am I and who are you?

Irreconcilable conflicts

Disorganized attachment

Reactive Attachment Disorder

Are my relationships safe?

You CAN have good relationships

Identifying problems in relationships

The most important relationship of all

What is the path to allowing God to love me and heal me?

God’s will in all this

What does knowing God’s love have to do with attachment disorders and relationships?

A simple way to find God’s love

Ask for help

Dissociation as a result of relational conflicts

A fundamental, and indeed foundational, aspect of human life is relationships with other people. We all are who we are as we relate to others. A unique aspect to living as a multiple is that relationships are distorted by the very fact that each Alter may have his/her own self-image and relational strategies. Both self-image and relational strategies are developed in a person very early in life and are a consequence of the integrity of caregiver emotional investment and response to physical needs. In nearly all cases of DID, the foundations of relational living are distorted by abandonment, inconsistent care, and/or mistreatment. The formation of a dissociative system is the result of irreconcilable conflicts between self and caregiver or other individuals in early childhood. These conflicts are the consequence of the child’s inability to process abandonment and/ or severe abuse. In the extreme children may even despair of life itself. It’s important for those of us who are trying to recover our lives to understand how our experiences very early in life have affected our capacities to be social and form relationships in the now. Our experience in our own journey and that of many others we know is that self-esteem and relational capacities are greatly diminished in most people with DID. Thus, the ability to form lasting, satisfying relationships is minimal. Here we’d like to explore some the important interpersonal dynamics in early life and examine how they influence capacities in social living.

Bonding – NOT

Theories about how humans learn to form interactive bonds and relationships suggest that the very earliest interactions with caregivers set the stage for the life-long understanding of who we are and who other people are in relationship to us. Note identity is a combination of the realization of self and others in relation to self. This realization normally starts with bonding to the mother. Most moms know that bonding with an infant immediately after delivery is important for the health and well-being of both mom and child. (See here for some information on bonding.) This early interaction is physical, emotional, mental, and psychological. Although bonding normally occurs at or before birth, some 20% of moms find that it takes weeks to months to form strong relational bonds with their newborn. Optimally a child receives care for all physical needs, as well as comfort and security. However, there is more to bonding than just having diapers changed and food given. Eye contact, skin contact, interactive talking or singing, and smiling all are tools used by infants to establish attachment. This early time of life begins the process of forming attachments that will serve as a guide to all subsequent relationships. If all goes well the baby forms a secure attachment to her/his earliest caregivers, preferably a mom and a dad.

Who am I and who are you?

But sometimes these early days and weeks of life are not optimal. Obviously, prematurity and NICU environments can play havoc with the infant’s idea of security. Nonetheless, bonding and emotional security is possible even in these difficult circumstances. Studies have shown that the emotional state of the mother is critical. Major crises in a mother’s life within two years before or after delivery lead to a substantial risk of attachment problems. So when Mom is traumatized or abused, babies sense a lack of security. When the interaction between child and caregiver is unpredictable or negative, disorganized attachment can occur. (I’ll talk more on disorganized attachment below.) Mistreatment, inconsistent care, emotional volatility, and unrealistic expectations can all lead a child to confusion about security, whether they are good or bad, or whether the caregiver is safe or a threat. In these situations the child lacks the necessary elements to determine who they are and who other people are in relationship. This leads to an incoherent sense of self.

Irreconcilable conflicts

Early in life dissociation is a tool infants and young children use to escape irreconcilable conflicts (eg. Mom is dangerous/ I depend on Mom for safety). Therefore, some have suggested that disordered attachment may be a risk factor for later attachment disorders and/or dissociative disorders. In cases of severe, recurrent trauma, esp. from caregivers, dissociation is one of the few mechanism available to a young child for escape. Trauma in the context of lack of attachment to a safe, comforting caregiver, is particularly damaging.  Dissociation allows the child to live in this unpredictable or dangerous environment by putting the fear and pain out of current memory. Despite this escape mechanism abused children may exhibit a variety of social problems such as: developmental delays, eating disorders, unusual soothing behaviors, depression/anxiety/indiscriminate attachment, inappropriate modeling of adult behavior, and aggression/cruelty often with a complete lack of empathy. Thus the consequences of abuse and abandonment are often serious and life-long.

Disorganized attachment

Does disorganized attachment as a child lead to attachment disorders later in life? A huge amount has been written on this. We found Liotti to be a good review. Much of the work on attachment disorders is based on the Adult Attachment Interview (AAI). Without going into any of the details, essentially one of three outcomes of the AAI are expected: Autonomous (secure attachment – I remember and value good relationships), Dismissing (insecure-avoidant attachment – I don’t really remember childhood relationships but it doesn’t matter), or Preoccupied (insecure-ambivalent attachment – I think about my parents a lot but it makes me feel bad or angry). When there is incoherence between thinking and feelings regarding attachment memories, the result is another classification called Unresolved. This form of attachment is often related to parents who have unresolved memories of traumas and losses. Clinically there are great similarities between dissociation, unresolved Adult Attachment Interviews, and disorganized attachment. Again see Liotti for details. Children with disorganized attachment are very vulnerable to dissociation as a coping mechanism. Furthermore, dissociative and borderline disorders, as well as complex PTSD, are all associated with disorganized attachments. [Note that many people with DID also have co-morbid diagnoses of Borderline Personality Disorder and complex PTSD.]

Reactive Attachment Disorder

Probably in the most severe cases, a survivor may have Reactive Attachment Disorder (RAD). In this case there is a craving for love and affection, but there is little to no capacity to expose that need due to sadness and fear. There is usually an inability to “feel” the emotions of attachment (love, security, peace). Some of the signs of RAD are distrust; need to control all aspects of life; anger; impulsivity; negative behaviors; lack of empathy, love, and affection; refusal to take advice; irresponsibility; addictions; helplessness; confusion; and a fake positive persona. Such survivors tend to be very self-reliant, work alone, be critical of others, exhibit passive-aggressive behavior, shun social life, exhibit jealousy and emotional overindulgence in relationships, and usually don’t maintain long-term relationships. (Sadly, we relate to most of this.) Obviously, therapy can be difficult because of fear of relationship with a therapist and lack of positive experience in relationships. If this sounds like you, be encouraged; there is help, below.

What does this mean to trauma survivors? In the case of DID, there are internal relationships among Alters and Primaries,  and there are relationships with other individuals. Both are important, and both can be affected by early trauma. Here we will focus on external relationships.

Are my relationships safe? 

Probably an almost immediate need among survivors is learning to evaluate the safety of current relationships. Safety is the primary concern for the individual, but also knowing what safe relationships look like is one step toward learning how to develop good relational skills. We found an interesting article that examines how one can determine whether the people with whom one is in relationship are trustworthy. Here the authors define trust as “consistency; relationships are not intertwined with control, fear, betrayal, punishment, rumors, banishing, and abuse; people are free to choose where they go and who they see based on their sense of self-worth”. We recommend reading the entire article. However, it’s instructional to look at the questions proposed to determine the trustworthiness of others in relationship, esp. with Littles. In the exercise, below, there are a series of “yes” and “no” questions with regard to a hypothetical relationship with Person X. In a completely trustworthy relationship all the “yes” questions will be answered “yes,” and all the “no” questions will be answered “no”. Obviously, the more questions answered incorrectly, the more one should be concerned about the relationship’s safety. For more information on this, please see the original article.

“No Questions:

1. Does Person X encourage Littles to interact with them?
2. Does Person X expect unwarranted loyalty from you or your Littles?
3. Does Person X create an environment where you feel an assumed threat of being left out or banished if you do not please?
4. Does Person X set unattainable expectations that you must follow?
5. Do you feel afraid to tell Person X ‘No’?
6. Have you witnessed Person X playing favorite to other people or comparing you to someone?
7. Have you witnessed Person X saying one thing and doing another?
8. Do you feel uncomfortably drawn to Person X?
9. Have you witnessed Person X attempting to turn you or others against someone who may be a safe person or isolating you from others?
10. Have you witnessed Person X making excuses for their inappropriate behavior?
11. Have you witnessed others making excuses for Person X’s behavior?
12. Is Person X in anyway exploiting you by this relationship?
13. Does Person X give you or others gifts or money in return for your friendship and/or loyalty?
14. Do you feel afraid to answer this quiz honestly?
15. Does Person X make you feel ‘special’ as you did in an abusive relationship?

Yes Questions:

1. Does Person X have a documented or witnessed history of being honorable and dependable?
2. Does Person X most often follow through with what he/she plans?
3. When Person X tells you something, do you witness it to be true most of the time?
4. Does Person X’s truthful statements reflect reality?
5. Is Person X more interested in others’ well-being than personal gain?
6. Do you feel comfortable and safe in the presence of Person X?
7. In your experience has Person X ever purposefully let you down when you needed help?
8. Do you always remember all discussions and interactions with Person X?”

Identifying problems in relationships

Survivors with dissociative disorders will usually need help with interpersonal relationships. In an article by Kathleen Young there is a good review of the interpersonal problems that often face survivors: Isolation and loneliness because it’s too risky to attempt connections; The bad parts will destroy others; Attachment to strangers that are too close/ personal ; Not able to evaluate others because needed information is sequestered by dissociation; Finding safe, kind relationships undesirable or frightening; Sabotaging relationships when they get too close; Extreme people pleasing; Other adult abusive relationships are present. This complex milieu can lead to complicated needs in adulthood. Therapists and survivors must be aware that all of these relational issues stem from the same traumas and lies learned early in childhood. Survivors often deal with issues of helplessness or lack of control. Unfortunately, early coping mechanism may still be utilized to relieve the pain. This may include violence, self-condemnation, and soothing behaviors to numb the pain (as in drugs, isolation, or self-harm).

You CAN have good relationships

Learning to develop healthy relationships is possible, but it’s hard work. Obviously, in therapy the relationship to one’s therapist must be of the utmost security and safety, regardless of whether that is immediately apparent to all of one’s Alters. If the survivor has RAD (see above), learning attachment strategies is part and parcel to examining old patterns of abuse and survival. It seems like there are as many treatment plans out there for RAD as there are types of therapy. It can be overwhelming, but the critical element must be at least one uncompromising relationship – usually with the therapist. The worst thing that can happen is to be abandoned/rejected in therapy. The internet is filled with self-help guides for building relationships. Innumerable books have been written on the subject, indicating that this is a societal problem as well as a survivor problem. Knowing that attachment issues are at the base of relational issues can be empowering. If you have DID don’t condemn yourself because you have problems with relationships. After all, it’s not just one of you who is trying to relate to another outside person. Our advice is to never give up seeking the honest receipt and expression of love and affection. At times it may seem impossible, but it’s not. Perseverance and objective help are key.

Kathleen Young suggests the following guidelines:

1. “1. Avoid going to extremes. Neither isolation or premature, instant attachment are healthy for you. Learn to share of yourself with people in your life gradually, over time.
2. Learn to hear and pay attention to your “inner voice”. This could be your intuition, or your gut sense of something feeling not quite right with another person. This could also be the voices of other parts of you. Do not discount what they have to say without exploring it. Yes, some parts may have the job of warning you away from anyone, but there may be valid reason for concerns about an individual in your life.
3. Get to know yourselves. Develop relationships with other parts of yourself. Learn to communicate with each other. Share information about people you are meeting, developing friendships or intimate relationships with.
4. Do you already have someone in your life you trust? A friend? A therapist? Use them as a sounding board or reality check. Share what concerns you. Listen to feedback, especially if you tend to “forget” things that concerned you regarding the new person’s behavior.
5. Remember that trust is something that is earned. Trust is built in relationships by experiencing each other over time. Pay attention to whether what others say and do matches up (or does not); look for consistency over time. Let yourself evaluate whether the relationship is mutual or one sided: do you each get a chance to talk, receive support and attention or does it seem to flow in one direction mostly?
6. Learn how to sort out whether your reactions are present- or past-based.  Are you angry because someone has violated your boundaries now or are you reminded of past experiences?  Sometimes it is both!”

The most important relationship of all

Unfortunately, all of the above ignores the most powerful and pertinent relationship of all, that between a person and Jesus Christ. Whether one meets Jesus as a child or as an adult, fully accepting Jesus into your life IS allowing the most powerful, transforming nature in the universe to act inside you and to heal you. Yes, there are numerous issues that may prevent anyone with DID from having a full relationship with Jesus, but opening the door is enough. It’s helpful to name the issues that can block relationship with God: anger at God for what happened to you, self-hatred that makes one believe you can’t be loved or even affirmed by anyone (even God), fear of God as a man, distrust of God as an extension of mistrust of anyone, belief that God wants and caused all this pain, belief that God hates women, belief that the church (which may have seriously hurt you) and God are the same, belief that God can never forgive you for all the things that you did or that have happened to you, rejection of God as the evil one taught to you in a cult, belief that you’re not good enough for God to care about you…………..  Well, we identify with all of these, and it didn’t impact God one little bit. It doesn’t offend God one little bit. No one knows you, loves you, cares for you, and wants you to be in relationship more than God. That can be extremely difficult to believe. But it’s true.

What is the path to allowing God to love me and heal me?

So what is the path to allowing God to love you and heal you? The first step is to give God a chance. That may seem extremely scary, and God knows that. He knows more about you, your system, what you went through, and what you believe than you do. For those with no Christian education, probably the safest way to learn a little bit about God is to either talk to a Christian who is knowledgeable about DID or to just look at the Bible. The Bible is God’s very words. In the table of contents you can find a book called John. It was written by someone who was Jesus’ very good friend. In that book John is writing about all the things he saw while Jesus was on earth 2000 years ago. When you read it, ask God to speak to you while you’re reading. He will. I promise. Read it and ask God to show you who He really is. At some point take the chance and just ask God to help you. You want healing. You want to have relationships. Ask Jesus to show you how.

God’s will in all this

The abuse you experienced is not God’s will. In fact, He is grieved and angry about it. That was all Satan’s plan. But God DOES have a plan for you. It’s a perfect plan for your healing. The foundation of all healing, anywhere of any type, is a relationship with Jesus. All of the issues listed above about God are LIES. About a decade ago we believed all of those lies. Asking Jesus to show us about Himself and to heal us wasn’t an instant miracle. It’s been a long hard struggle of pressing in to know God and to give Him carte blanche access to every aspect of our history and our belief system (to the extent we were able at any given time). We asked Holy Spirit/ Father God/ Jesus Christ to be our guide. We studied the Bible. Actually there came a couple years when we were so angry with God, we couldn’t read the Bible at all. Still God never gave up. The best of all worlds is to find a Christian pastor or counselor who has a proven track record of dealing with DID. But even without such help, God can heal you. He never, ever gives up. In one of the books of the Bible called Ephesians, the author, Paul, writes “For this reason I kneel before God the Father from whom every family in heaven and on the earth is named. I pray that according to the wealth of His glory He may grant you to be strengthened with power through His spirit (Holy Spirit) in the inner person, that Jesus Christ may dwell in your hearts through faith (knowing that Christ is God and He died for you on a cross so that your sins can be forgiven), so that, because you have been rooted and grounded in love, you may be able to comprehend with all Christians what is the breadth and length and height and depth, and thus to know the LOVE OF CHRIST JESUS that SURPASSES KNOWLEDGE, so that you may be filled up to all the fullness of God.” Eph 3:14-19. So what does that mean? God Himself will give you the capacity to understand and experience the love of God that is so endless, one can hardly express it.

What does knowing God’s love have to do with attachment disorders and relationships?

God created humans, and in that He made humans to naturally live in relationship. Many understand that God made Eve so that Adam would not be alone. He made families. He made tribes. His perfect will for us is that we love others as we love Him. In fact, God says that all of the Bible can be summed up in “Love God with all our heart, soul, mind, and strength, and love your neighbor as yourself.” That’s hard to understand when you hate yourself and you believe God hates you. So the first lie to address is that God hates you. It’s a lie. There are books and books and books written about how much God loves us. A new one just came out, which I’d recommend. It’s a love letter from God. You can find it here. Nothing speaks of God’s love more than His allowing Jesus to die for us on the cross. Jesus rose from the dead and is forever interceding on our behalf before God.

A simple way to find God’s love

Many people who have been abused seem to lack the capacity to feel love or affirmation at all. We were certainly that way. But slowly as we gave God the chance to change us, He did. If you’ve accepted God into your life (see how here), and you don’t feel His love, more than likely someone in your system is blocking that emotion. Probably one of the most important questions you can ask yourself about God is, “What would it mean to me if I let God love me?” Then be honest with yourself. There are innumerable answers: He’ll hurt me; I can’t trust Him; I’ll lose control; He can’t love me because I’m so bad; on and on and on…. Then ask what would it mean if (whatever you said). Answer these questions from your gut, not your mind. You may have to do several levels of “what would it mean if” questions, but sooner or later you’ll know when you hit on the real lie. An example of such a “what would it mean” chain is: What would it mean if I let God love me: God will hurt me if I let Him love me, What would it mean if God hurts me: God hates me, What would it mean if God hates me: God will kill me, What would it mean if God kills me: I’ll never ever be loved by anyone ever in my life. All of the chain is a lie, but the fundamental lie is the hidden belief that no one will ever love me. At that point God will speak. You will KNOW that it’s a lie and that God really loves you. Anything that’s not 100% Truth, (which is that God loves you unconditionally, more than you could ever think or imagine, no matter what you even believe about Him now), is a lie. Give Him the lie. Ask Him to speak His Truth into your life. He will.

Ask for help

Having the security of God’s love, no matter how minimal that might be at the beginning, is central to forming a solid sense of identity and worth. Without that, forming safe, positive relationships is extremely difficult. If you’re having trouble feeling God’s love, I’d really like to help you. Contact me from the Contact Page or just write a comment below. Knowing that you have the most foundational attachment in the universe, between you and God, is the start of a life with good, solid relationships. It will happen. God is faithful. He’ll never let you down. Get hold of me, and we can talk. I went through this journey. It really helps to have someone to walk with you. Let me know.

If you have any questions about what was talked about above, please contact me. I’d love to hear from you.