DID clients were under the impression, that once the diagnosis was made, their therapist would know how to help them more effectively. It provided them with a sense of possible progress and instilled hope.
"The diagnosis is important… But I think, if you actually know what you've got, what you are dealing with, you know where to go with it. Or your therapist knows where she is going.” (Carol 1/27).
Receiving a diagnosis of having a dissociative identity disorder (DID) is not always a relief for clients. One woman in my research felt that once she was diagnosed with DID that therapists' focus was predominantly on the DID symptoms than on her as a person.
It was his ability to connect with me on some really deep unconscious level… I believe my therapeutic journey began before I was diagnosed DID, and in fact the best work for me was done before that diagnosis confused everything with people looking at the DID, wanting to learn about the processes of DID, rather than engaging with ME (Mona 3/1).
Mona's report showed again, that it is important to look at the client as an individual that can not be put into a certain box. Not all sizes fit all. Important for therapy is in every case to come to an understanding of treatment necessities together with the client.
Making a connection with a therapist had to be followed by making a connection through being diagnosed with dissociative identity disorder (DID). It signaled for the DID clients I interviewed a break through in this first stage of their therapy that I have called 'Connecting'.
We finally seem to have got something so that I can say, we have got something to work with (Sharon, 1/6).
The concept of the ‘good therapist’ is widely debated amongst professionals and clients. Whereas professionals value training, qualification, experience, and membership in a professional organisation as the trademark of a good therapist, clients have quite a different perspective.
Intersubjectivity, the ability to emphatically feel with the client, to see the world through her eyes, and to acknowledge that this world might look different than one's own eyes (Rahm et al., 1993), seems to have made the connection between therapist and client possible.
Once a connection has been made, the therapist had to prove her trustworthiness. Making a connection with the therapist is a process that has to be repeated over and over again until such a time when the client is putting all her negative expectations aside and starts trusting the therapist. Only then is progress in therapy possible. DID clients go to some length to test their therapist. Putnam (1989) believes that it is with certainty that they will carry out various tests one way or the other.
The completion of 'reaching out', the first stage of connecting, is achieved once DID clients are able to make a connection with a suitable and competent therapist. The establishment of the therapeutic alliance is impossible without such a connection and successful treatment and progress in recover is unlikely. For some DID clients it took sometimes several trials with therapists until they found the one that they were able to connect with.
When trust between DID client and therapist has not been established yet or has broken down, then clients reported that control techniques turned out to create a hindrance to recovery. These techniques impacted negatively on the therapeutic relationship, which is the cornerstone of successful therapy and recovery.
When therapy did not provide the DID client with good enough experiences, or when for example transferential issues were not satisfactorily resolved, some clients attempted to salvage control by terminating with their therapist and looking for another one.
The most striking feature of this first stage of therapy is that clients cannot exit this stage until they have been able to connect with a suitable therapist. It is this particular circumstance that puts great responsibility on therapists’ shoulders.
CONNECTING: DID Clients Main Concern in Therapy |
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1. Stage Reaching out for therapy |
2. Stage Coming together |
3.Stage Making human contact |
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Cause Context Condition Interactions Consequence |
Losing It No Understanding Keeping Going Grappling For Control Making A Connection |
There must be more to life Being Alone And In Crisis Having Faith Grouping Together Integration |
Behind Block Walls Don’t Know How To Relate Repairing Broken Trust Learning To Relate Homecoming |
Multiple Voices 