Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health
This answer was rated:

I am a therapist (LPC)for 19 years... I'm working with a

woman who has DID....
I am a therapist (LPC)for 19 years... I'm working with a woman who has DID. She has been through years of therapy in the past, her alters have integrated quite well. I have been seeing her for weight loss using hypnosis. She has felt very safe with me. One of her three known alters has made herself known to me. She has talked to me twice. Her "little girl" alter told me there are others that no one knows about. Only she knows of them, she gave me one of their names. I asked to speak to one and she said they did not want to and went deep, deep inside. So, my question is can an alter have her own alters which the other alters don't know about? My client said she did not know of any others. I only know about DID by what I have read. I feel I need to continue to work with this client because she feels so safe. However, I need to talk to an expert and or do a lot more reading. Any suggestions on reading material?
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 7 hours by:
1/30/2011
Selah R, M.S. LPC
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Verified
Selah R, M.S. LPC :

Thank you for trusting JustAnswer with your important question.

Selah R, M.S. LPC :

Yes it is possible for there to be alters that the main alters do not know about. They can either be alters that split from the little girl alter, and now seem to live inside her; or they can be cut off from the other two alters you've talk to through dissociative barriers. It could be that the rest of the system decided the body would be safer and more functional if those two alters didn't know about the others and the information/memories/emotions they may be holding.

Selah R, M.S. LPC :

I'm not sure what you've read on the subject, so please feel free to tell me what some of the books are you've already got. I can help point you in the direction of a few more.

Selah R, M.S. LPC :

But I've talked with many systems that had strong divisions. Some systems are set up in levels like a house, there they talk about alters being in different areas of awareness based on how high or low they are. Some systems talk about the division being more of a good versus evil, light versus dark side, or safe versus unsafe type terminology. Many times the alters that hold most of the traumatic abuse, and the most volatile emotions, are the ones lumped into the less desirable place/group.

Selah R, M.S. LPC :

I've also seen systems that appear to integrate online to then find the next layer of alters. In that case it's usually reaching a certain level of stability and mental health that allows the internal self helpers to decide that the alters most commonly out are now ready to deal with more information/trauma history/alters. It's a safety mechanism to try to keep from overwhelming or disintegrating/splitting the newly combined alters. It can also be a safety measure to try to prevent overwhelming the counselor and other supportive people whom they might fear would leave if they "knew everything at once."

Selah R, M.S. LPC :

The biggest thing you can do for her right now is to reassure her that you're going to be part of her treatment team as long as possible, and that you will help her find more treatment team members if needed. Some DID clients have so many issues that they really do benefit from having more than one therapist to work on separate issues. Especially when one therapist may need to work on the DID and trauma, while the other may need to stay focused on one particular issues like an eating disorder or substance abuse issue, or another major life skill focus.

Selah R, M.S. LPC :

The main two need to know that the little girl believes there are more alters, and they need to be reassured that their internal landscape and system was created to keep the body and everyone inside safe. No matter how chaotic it might feel for them to face that there might be "others", they need to remember they can survive the process of meeting, hearing/knowing, and merging with those alters too. The journey to recovery never lets us see the entire road at one time. We take each twist and turn in the road with limited information and an obstructed view... but we keep moving forward through the peaks and valleys.

Selah R, M.S. LPC :

Encourage the little girl to create a system map with you. What does the internal "family tree" look like? What does the internal landscape look like? Are there houses or other buildings inside? Is she aware of internal self helpers, historians, or other care takers inside? These alters often seem to be the older (as in created early on in the DID process), and are invaluable in the recovery process. They also tend to be the ones with the most knowledge about what all is really going on inside.

Selah R, M.S. LPC :

You also can start trying to listen to see if these others appear to be fully developed alters, or are they more one-dimensional and temporary, what would be called fragments. Fragments can seem like alters to other insiders, but they are easier to integrate because they don't have as much experience being autonomous as more developed alters.

Selah R, M.S. LPC :

You may want to contact other professionals in your area who have more experience treating DID for a consult. Sidran.org and ISST-D.org both offer directories of professionals who work with complex trauma, dissociation, and DID. Both sites usually also offer education, books, and treatment guidelines to help professionals learn about treating DID and related issues.

Selah R, M.S. LPC :

When using tools like hypnosis or EMDR, it's always critical to get a signed informed consent form from your client. They need to understand the psychological risks of these tools, and that these risks are higher for DID clients. They also need to understand that what they remember while using these tools is often considered "tainted" if they intend to pursue legal action based upon the memory/trauma work. Not many are worried by these risks, but it's still legally and ethically wise for you to get this type of information in a written form they can sign.

Selah R, M.S. LPC :

Sincerely

Selah R, M.S. LPC :

Selah

Customer:

Selah, Thank you so much, you gave me excellent information. The books I just ordered are "Clinical Perspectives on MPD", Kluft; "Treating DID:Power of Collective Heart", Krakauer; and "DID Sourcebook", Haddock; I also thought about getting "Trauma Model Therapy" by Colin Ross. I live in Dallas so I can also go to the Ross Institute for help. Any other suggestions for reading material or comments on the Ross institute. I see you are offline now so I can wait or have another person answer.

Selah R, M.S. LPC
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Verified
Selah R, M.S. LPC and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Those are great books. Also sign up for a visiting professional day at Timberlawn's Trauma program if you're interested. They also offer free CEU Brownbags that are sometimes trauma and dissociation specific. Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders - Paperback (Apr. 16, 1998) by James A. Chu is another one I recommend, but only if you feel like you need additional information on treatment and containment tips after you've read the others (especially the Trauma Model). Some EMDR CEU classes also focus on grounding techniques to use with trauma or DID clients, and these tools can be useful even if you don't do EMDR.

Best wishes,
Selah
Selah R, M.S. LPC
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Verified
Selah R, M.S. LPC and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 6 years ago
Thank you again. You have been very helpful.
Ask Selah R, M.S. LPC Your Own Question
Selah R, M.S. LPC
Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
582 Satisfied Customers
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.

Selah R, M.S. LPC is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

4,021 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
My ex did gay porn but swears he's not gay.. he's so back
My ex did gay porn but swears he's not gay.. he's so back and forth with me.. he was addicted to oxy I love him but he's so closed off… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
I keep thinking about what I did when I was younger, when I
I keep thinking about what I did when I was younger, when I was about 6 I remeber like kissing almost making out with my two sisters, they were 5 and 4 then later when I was about 14-15 I developed la… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
I am having terrible guilt and shame about things I did in
I am having terrible guilt and shame about things I did in my past which have suddenly come to my consciousness - when I was about 16 I was extremely sexual and ended up sniffing knickers on a number … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
In 2004 when I was 17 years old I voluntary committed myself
In 2004 when I was 17 years old I voluntary committed myself to an inpatient rehab for substance abuse. I stayed there for 4 days. I recently had to sign a waiver allowing a 3rd party to access/view m… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
How do I find the right Dr, not even sure what questions to
how do I find the right Dr , not even sure what questions to ask . I am a 56 yr old male , I've struggled with self esteem issues , substance abuse and many aspects connected to ADD … read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
Leah,I had a question I did get to mention yesterday..the
Hi Leah,I had a question I did get to mention yesterday..the thread was getting a bit to long anyway lol… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
I did ask a male professional earlier about my problem, but
I did ask a male professional earlier about my problem, but it would be great to get a female psychologists view also. My husband and I have not had sex in 6 years. He had a mild stroke 5 years ago, b… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
My husband call me a, he did it today. I told him under no
My husband call me a bitch, he did it today. I told him under no circumstances do you have the right to call a woman a bitch. He also tells me that I am miserable. Everytime he starts a fight. … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
Its kind of imbarrising.. I did realize I could chat to some
its kind of imbarrising.. I did realize I could chat to some one on here … read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
My doctor switched me from sertraline to viibryd. I did one
My doctor switched me from sertraline to viibryd. I did one week of 10 mg, then 2 weeks of 20 mg, now back to 10mg so I can switch back to sertraline. I don't like viibryd. How can I safely switch bac… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
Dear Dr. Keane, just a quick message to say that I did not
Dear Dr. Keane, just a quick message to say that I did not get that job, enough time has passed by to now know this. I've plenty to say, but not plenty of time this week as my gran is now visiting, so… read more
Dr. Keane
Dr. Keane
Therapist
Doctoral Degree
1,379 satisfied customers
I have a friend who says she has DID but she doesn't meet
I have a friend who says she has DID but she doesn't meet the criteria. Her alters are dead people. Mostly characters from Movies or Musicals like Phantom of the Opera. Would this behavior be a sympto… read more
llw26
llw26
Private Practice
Doctoral Degree
11 satisfied customers
Why some people get angry if other people point out they did
Why some people get angry if other people point out they did wrong things? I would think when people know they did wrong things they should feel sorry and try to correct. Thanks.… read more
llw26
llw26
Private Practice
Doctoral Degree
11 satisfied customers
Dear Dr. Keane, I did what you suggested about my dad.
Dear Dr. Keane,I did what you suggested about my dad. Actually, I spoke to my mum too and she's right, it just is not his kind of thing, to get support. You were right, when I initially brought up the… read more
Dr. Keane
Dr. Keane
Therapist
Doctoral Degree
1,379 satisfied customers
Thank you. I did download a book about a little boy with
Thank you. I did download a book about a little boy with autism, from the perspective of an autistic child, but it turned out to be 64 pages long and just a little too grown up -- even though it menti… read more
Dr. Mark
Dr. Mark
Doctoral Degree
129 satisfied customers
My husband lied to me about his. He did cheat on his ex-wife
My husband lied to me about his. He did cheat on his ex-wife after all. Now he says I am sticking my nose into his business. … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
My wife and I did some role reversal consisting of her being
My wife and I did some role reversal consisting of her being dominant. Domestic discipline and domination. SometiMrs she makes me wear panties. I find embarrassing but arousing too. The whole mentalk … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
Have DID. totally dissociated for the first time the other
have DID. totally dissociated for the first time the other day in therapy and embarrassed self. now terrified to face therapist again. any ideas how to calm anxiety and face therapist?… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
4,021 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x