I see things in windows and I say to myself that I want them. I want them because I want to belong. I want to be liked by more people, I want to be held in higher regard than others. I want to feel valued, so I say to myself to watch certain shows. I watch certain shows on the television so I can participate in dialogues and conversations and debates with people who want the same things I want. I want to dress a certain way so certain groups of people are forced to be attracted to me. I want to do my hair a certain way with certain styling products and particular combs and methods so that I can fit in with the In-Crowd. I want to spend hours upon hours at the gym, stuffing my body with what scientists are calling 'superfoods', so that I can be loved and envied by everyone around me. I want to become an icon on someone's mantle. I want to work meaningless jobs so that I can fill my wallet and parentally-advised bank accounts with monetary potential. I want to believe what's on the news so that I can feel normal along with the rest of forever. I want to listen to the Top Ten on Q102, and roll my windows down so others can hear it and see that I am listening to it, and enjoying it. I want to go to church every Sunday, and pray every other day. I want to believe that what I do is for the promise of a peaceful afterlife. I want rewards for my 'good' deeds. I want acknowledgment and praise. And I want people to know that I put out that fire. I want people to know that I support the war effort. I want people to know that I volunteer to save lives. I want to be seen and heard and pointed at with love. I want to read my name in the history books during a future full of clones exactly like me. The mirror, I've noticed, is almost always positioned above the sink. Though the sink offers more depth than a mirror, and mirror is only able to reflect, the sink is held in lower regard. Lower still is the toilet, and thought it offers even more depth than the sink, we piss and shit in it. I want these kind of architectural details to be paralleled in my every day life. I want to care more about my reflection, and less about my cleanliness. I want to be seen as someone who lives externally, and never internally, unless I am able to lock the door behind me. I want these things, because if I didn't, I would be dead in the mirrors of those around me. I would be nothing. I would be an example. Sunken, and easily washed away.

They will hate you if you are beautiful. They will hate you if you are successful. They will hate you if you are right. They will hate you if you are popular. They will hate you when you get attention. They will hate you when people in their life like you. They will hate you if you worship a different version of their God. They will hate you if you are spiritual. They will hate you if you have courage. They will hate you if you have an opinion. They will hate you when people support you. They will hate you when they see you happy. Heck, they will hate you while they post prayers and religious quotes on Pinterest and Facebook. They just hate. However, remember this: They hate you because you represent something they feel they don’t have. It really isn’t about you. It is about the hatred they have for themselves. So smile today because there is something you are doing right that has a lot of people thinking about you.

I dial her mum's number, then sit down cross-legged, facing the wall. When she comes on the line, she sounds uncertain, hesitant. 'Hey! Guess where I am?' I ask, my voice loud with false cheer. 'Rami told me. The Wellesly Hospital in Worthing. What's it like?' 'For a loony-bin it's actually quite decent,' I reply. 'I don't have Sky or an en-suite, and the menu isn't exactly à la carte, but you know...' I tail off. There is a silence. 'Do you have your own room?' Jenna asks, 'Oh yeah, yeah. I have a lovely view of the sea between the bars of my window.' She doesn't laugh. 'Have you started' -there is a pause as she searches for the right word -'threatment?''Yeah, yeah. We had group therapy today. Tomorrow we'll probably have art therapy - maybe I'll draw you a hourse and a garden. I know, perhaps they'll teach us to make baskets! Isn't that why they call us basket cases?''Flynn, stop,' Jennah softly implores.'And we'll probably have music therapy the day after. Maybe I'll get to play the tambourine. Or the triangle. I've always wanted to play the triangle!''Flynn-''No, I'm serious! I'll ask for some manuscript paper and see if I can write a composition for tambourine and triangle. Then I can post if off to you to hand in for my next composition assignment.''Flynn, listen-''Hold on, hold on! I'm making a note to myself now: Find fellow insane musician and start composing the Flynn Laukonen Sonata for Tambourine and Triangle.''Flynn-''And then, when they let me out, if they ever let me out, perhaps you could pull a few strigns and organize for me and my tambourine buddy to give a recital. I'm not sure where though -how about the subway at Marble Arch tube? Nice and central, good acoustics-''What are the other people like?' Jennah cuts in, an edge to her voice. I notice she doesn't use the word patients. Clever Jennah. For a moment there you almost made me forget I was locked up in a mental institution.'Round the bend, just like me,' I reply. 'I'm in excellent company. We'll be swapping suicide tips in no time at all!' I give a harsh laugh.

Some of the most evil human beings in the world are psychiatrists. Not all psychiatrists. Some psychiatrists are selfless, caring people who really want to help. But the sad truth is that in today's society, mental health isn't a science. It's an industry. Ritalin, Zoloft, Prozac, Lexapro, Resperidone, happy pills that are supposed to "normalize" the behavior of our families, our colleagues, our friends - tell me that doesn't sound the least bit creepy! Mental health is subjective. To us, a little girl talking to her pretend friends instead of other children might just be harmless playing around. To a psychiatrist, it's a financial opportunity. Automatically, the kid could be swept up in a sea of labels. "not talking to other kids? Okay, she's asocial!" or "imaginary friends? Bingo, she has schizophrenia!" I'm not saying in any way that schizophrenia and social disorders aren't real. But the alarming number of people, especially children, who seem to have these "illnesses" and need to be medicated or locked up... it's horrifying. The psychiatrists get their prestigious reputation and their money to burn. The drug companies get fast cash and a chance to claim that they've discovered a wonder-drug, capable of "curing" anyone who might be a burden on society... that's what it's all about. It's not about really talking to these troubled people and finding out what they need. It's about giving them a pill that fits a pattern, a weapon to normalize people who might make society uncomfortable. The psychiatrists get their weapon. Today's generations get cheated out of their childhoods. The mental health industry takes the world's most vulnerable people and messes with their heads, giving them controlled substances just because they don't fit the normal puzzle. And sadly, it's more or less going to get worse in this rapidly advancing century.

For three days and three nights, Phædrus stares at the wall of the bedroom, his thoughts moving neither forward nor backward, staying only at the instant. His wife asks if he is sick, and he does not answer. His wife becomes angry, but Phædrus listens without responding. He is aware of what she says but is no longer able to feel any urgency about it. Not only are his thoughts slowing down, but his desires too. And they slow and slow, as if gaining an imponderable mass. So heavy, so tired, but no sleep comes. He feels like a giant, a million miles tall. He feels himself extending into the universe with no limit. He begins to discard things, encumbrances that he has carried with him all his life. He tells his wife to leave with the children, to consider themselves separated. Fear of loathsomeness and shame disappear when his urine flows not deliberately but naturally on the floor of the room. Fear of pain, the pain of the martyrs is overcome when cigarettes burn not deliberately but naturally down into his fingers until they are extinguished by blisters formed by their own heat. His wife sees his injured hands and the urine on the floor and calls for help. But before help comes, slowly, imperceptibly at first, the entire consciousness of Phædrus begins to come apart — to dissolve and fade away. Then gradually he no longer wonders what will happen next. He knows what will happen next, and tears flow for his family and for himself and for this world.

In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma.The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.

Dr. Talbon was struck by another very important thing. It all hung together. The stories Cheryl told — even though it was upsetting to think people could do stuff like that — they were not disjointed They were not repetitive in terms of "I've heard this before". It was not just she'd someone trying consciously or unconsciously to get attention. really processed them out and was done with them. She didn't come up with them again [after telling the story once and dealing with it]. Once it was done, it was done. And I think that was probably the biggest factor for me in her believability. I got no sense that she was using these stories to make herself a really interesting person to me so I'd really want to work with her, or something. Or that she was just living in this stuff like it was her life. Once she dealt with it and processed it, it was gone. We just went on to other things. 'Throughout the whole thing, emotionally Cheryl was getting her life together. Parts of her were integrating where she could say,"I have a sense that some particular alter has folded in with some basic alter", and she didn't bring it up again. She didn't say that this alter has reappeared to cause more problems. That just didn't happen. The therapist had learned from training and experience that when real integration occurs, it is permanent and the patient moves on.

At cocktail parties, I played the part of a successful businessman's wife to perfection. I smiled, I made polite chit-chat, and I dressed the part. Denial and rationalization were two of my most effective tools in working my way through our social obligations. I believed that playing the roles of wife and mother were the least I could do to help support Tom's career.During the day, I was a puzzle with innumerable pieces. One piece made my family a nourishing breakfast. Another piece ferried the kids to school and to soccer practice. A third piece managed to trip to the grocery store. There was also a piece that wanted to sleep for eighteen hours a day and the piece that woke up shaking from yet another nightmare. And there was the piece that attended business functions and actually fooled people into thinking I might have something constructive to offer.I was a circus performer traversing the tightwire, and I could fall off into a vortex devoid of reality at any moment. There was, and had been for a very long time, an intense sense of despair. A self-deprecating voice inside told me I had no chance of getting better. I lived in an emotional black hole.p20-21, talking about dissociative identity disorder (formerly multiple personality disorder).

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact.But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

Of course, I should have known the kids would pop out in the atmosphere of Roberta's office. That's what they do when Alice is under stress. They see a gap in the space-time continuum and slip through like beams of light through a prism changing form and direction. We had got into the habit in recent weeks of starting our sessions with that marble and stick game called Ker-Plunk, which Billy liked. There were times when I caught myself entering the office with a teddy that Samuel had taken from the toy cupboard outside. Roberta told me that on a couple of occasions I had shot her with the plastic gun and once, as Samuel, I had climbed down from the high-tech chairs, rolled into a ball in the corner and just cried. 'This is embarrassing,' I admitted. 'It doesn't have to be.''It doesn't have to be, but it is,' I said.The thing is. I never knew when the 'others' were going to come out. I only discovered that one had been out when I lost time or found myself in the midst of some wacky occupation — finger-painting like a five-year-old, cutting my arms, wandering from shops with unwanted, unpaid-for clutter.In her reserved way, Roberta described the kids as an elaborate defence mechanism. As a child, I had blocked out my memories in order not to dwell on anything painful or uncertain. Even as a teenager, I had allowed the bizarre and terrifying to seem normal because the alternative would have upset the fiction of my loving little nuclear family.I made a mental note to look up defence mechanisms, something we had touched on in psychology.

It is necessary to make this point in answer to the `iatrogenic' theory that the unveiling of repressed memories in MPD sufferers, paranoids and schizophrenics can be created in analysis; a fabrication of the doctor—patient relationship. According to Dr Ross, this theory, a sort of psychiatric ping-pong 'has never been stated in print in a complete and clearly argued way'. My case endorses Dr Ross's assertions. My memories were coming back to me in fragments and flashbacks long before I began therapy. Indications of that abuse, ritual or otherwise, can be found in my medical records and in notebooks and poems dating back before Adele Armstrong and Jo Lewin entered my life. There have been a number of cases in recent years where the police have charged groups of people with subjecting children to so-called satanic or ritual abuse in paedophile rings. Few cases result in a conviction. But that is not proof that the abuse didn't take place, and the police must have been very certain of the evidence to have brought the cases to court in the first place. The abuse happens. I know it happens. Girls in psychiatric units don't always talk to the shrinks, but they need to talk and they talk to each other. As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept.(Alice refers to her constant infections as a child, which were never recognised as caused by sexual abuse)

I resolved to come right to the point. "Hello," I said as coldly as possible, "we've got to talk.""Yes, Bob," he said quietly, "what's on your mind?" I shut my eyes for a moment, letting the raging frustration well up inside, then stared angrily at the psychiatrist."Look, I've been religious about this recovery business. I go to AA meetings daily and to your sessions twice a week. I know it's good that I've stopped drinking. But every other aspect of my life feels the same as it did before. No, it's worse. I hate my life. I hate myself."Suddenly I felt a slight warmth in my face, blinked my eyes a bit, and then stared at him."Bob, I'm afraid our time's up," Smith said in a matter-of-fact style."Time's up?" I exclaimed. "I just got here.""No." He shook his head, glancing at his clock. "It's been fifty minutes. You don't remember anything?""I remember everything. I was just telling you that these sessions don't seem to be working for me."Smith paused to choose his words very carefully. "Do you know a very angry boy named 'Tommy'?""No," I said in bewilderment, "except for my cousin Tommy whom I haven't seen in twenty years...""No." He stopped me short. "This Tommy's not your cousin. I spent this last fifty minutes talking with another Tommy. He's full of anger. And he's inside of you.""You're kidding?""No, I'm not. Look. I want to take a little time to think over what happened today. And don't worry about this. I'll set up an emergency session with you tomorrow. We'll deal with it then."RobertThis is Robert speaking. Today I'm the only personality who is strongly visible inside and outside. My own term for such an MPD role is dominant personality. Fifteen years ago, I rarely appeared on the outside, though I had considerable influence on the inside; back then, I was what one might call a "recessive personality." My passage from "recessive" to "dominant" is a key part of our story; be patient, you'll learn lots more about me later on. Indeed, since you will meet all eleven personalities who once roamed about, it gets a bit complex in the first half of this book; but don't worry, you don't have to remember them all, and it gets sorted out in the last half of the book. You may be wondering -- if not "Robert," who, then, was the dominant MPD personality back in the 1980s and earlier? His name was "Bob," and his dominance amounted to a long reign, from the early 1960s to the early 1990s. Since "Robert B. Oxnam" was born in 1942, you can see that "Bob" was in command from early to middle adulthood.Although he was the dominant MPD personality for thirty years, Bob did not have a clue that he was afflicted by multiple personality disorder until 1990, the very last year of his dominance. That was the fateful moment when Bob first heard that he had an "angry boy named Tommy" inside of him. How, you might ask, can someone have MPD for half a lifetime without knowing it? And even if he didn't know it, didn't others around him spot it?To outsiders, this is one of the most perplexing aspects of MPD. Multiple personality is an extreme disorder, and yet it can go undetected for decades, by the patient, by family and close friends, even by trained therapists. Part of the explanation is the very nature of the disorder itself: MPD thrives on secrecy because the dissociative individual is repressing a terrible inner secret. The MPD individual becomes so skilled in hiding from himself that he becomes a specialist, often unknowingly, in hiding from others. Part of the explanation is rooted in outside observers: MPD often manifests itself in other behaviors, frequently addiction and emotional outbursts, which are wrongly seen as the "real problem."The fact of the matter is that Bob did not see himself as the dominant personality inside Robert B. Oxnam. Instead, he saw himself as a whole person. In his mind, Bob was merely a nickname for Bob Oxnam, Robert Oxnam, Dr. Robert B. Oxnam, PhD.

Pierre Janet, a French professor of psychology who became prominent in the early twentieth century, attempted to fully chronicle late- Victorian hysteria in his landmark work The Major Symptoms of Hysteria. His catalogue of symptoms was staggering, and included somnambulism (not sleepwalking as we think of it today, but a sort of amnesiac condition in which the patient functioned in a trance state, or "second state," and later remembered nothing); trances or fits of sleep that could last for days, and in which the patient sometimes appeared to be dead; contractures or other disturbances in the motor functions of the limbs; paralysis of various parts of the body; unexplained loss of the use of a sense such as sight or hearing; loss of speech; and disruptions in eating that could entail eventual refusal of food altogether. Janet's profile was sufficiently descriptive of Mollie Fancher that he mentioned her by name as someone who "seems to have had all possible hysterical accidents and attacks." In the face of such strange and often intractable "attacks," many doctors who treated cases of hysteria in the 1800s developed an ill-concealed exasperation.

The physical shape of Mollies paralyses and contortions fit the pattern of late-nineteenth-century hysteria as well — in particular the phases of "grand hysteria" described by Jean-Martin Charcot, a French physician who became world-famous in the 1870s and 1880s for his studies of hysterics...""The hooplike spasm Mollie experienced sounds uncannily like what Charcot considered the ultimate grand movement, the arc de de cercle (also called arc-en-ciel), in which the patient arched her back, balancing on her heels and the top of her head...""One of his star patients, known to her audiences only as Louise, was a specialist in the arc de cercle — and had a background and hysterical manifestations quite similar to Mollie's. A small-town girl who made her way to Paris in her teens, Louise had had a disrupted childhood, replete with abandonment and sexual abuse.She entered Salpetriere in 1875, where while under Charcot's care she experienced partial paralysis and complete loss of sensation over the right side of her body, as well as a decrease in hearing, smell, taste, and vision. She had frequent violent, dramatic hysterical fits, alternating with hallucinations and trancelike phases during which she would "see" her mother and other people she knew standing before her (this symptom would manifest itself in Mollie). Although critics, at the time and since, have decried the sometime circus atmosphere of Charcot's lectures, and claimed that he, inadvertently or not, trained his patients how to be hysterical, he remains a key figure in understanding nineteenth-century hysteria.

You see, people in the depressive position are often stigmatised as ‘failures' or ‘losers'. Of course, nothing could be further from the truth. If these people are in the depressive position, it is most probably because they have tried too hard or taken on too much, so hard and so much that they have made themselves ‘ill with depression'. In other words, if these people are in the depressive position, it is because their world was simply not good enough for them. They wanted more, they wanted better, and they wanted different, not just for themselves, but for all those around them. So if they are failures or losers, this is only because they set the bar far too high. They could have swept everything under the carpet and pretended, as many people do, that all is for the best in the best of possible worlds. But unlike many people, they had the honesty and the strength to admit that something was amiss, that something was not quite right. So rather than being failures or losers, they are just the opposite: they are ambitious, they are truthful, and they are courageous. And that is precisely why they got ‘ill'. To make them believe that they are suffering from some chemical imbalance in the brain and that their recovery depends solely or even mostly on popping pills is to do them a great disfavour: it is to deny them the precious opportunity not only to identify and address important life problems, but also to develop a deeper and more refined appreciation of themselves and of the world around them—and therefore to deny them the opportunity to fulfil their highest potential as human beings.

Our “increasing mental sickness” may find expression in neurotic symptoms. These symptoms are conspicuous and extremely distressing. But “let us beware,” says Dr. Fromm, “of defining mental hygiene as the prevention of symptoms. Symptoms as such are not our enemy, but our friend; where there are symptoms there is conflict, and conflict always indicates that the forces of life which strive for integration and happiness are still fighting.” The really hopeless victims of mental illness are to be found among those who appear to be most normal. “Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does.” They are normal not in what may be called the absolute sense of the word; they are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness. These millions of abnormally normal people, living without fuss in a society to which, if they were fully human beings, they ought not to be adjusted, still cherish “the illusion of individuality,” but in fact they have been to a great extent deindividualized. Their conformity is developing into something like uniformity. But “uniformity and freedom are incompatible. Uniformity and mental health are incompatible too. . . . Man is not made to be an automaton, and if he becomes one, the basis for mental health is destroyed.

In the deep, wet tangled, wild jungle where even natives won't go is a mystical, dangerous river. The river's got no name because naming it would make it real, and no one wanted to believe that river be real. They say you get there only inside a dream-but don't you think of it at bedtime, now, 'cause not everyone who goes there be able to leave! That jungle canopy, it so leafy true daylight can never break in the riverbank, it be wet muck thick with creatures that eat you alive if you stay still too long. To miss that fate, you gots to go into the black water. But the water be heavy as hot tar; once you in, it bind you and pull you along, bit by bit, 'til you come to the end of the land, and then over the water goes in a dark, slow cascade, the highest falls in the history of the world ever. There be demons in that cascading water, and snakes, and wraiths that whisper in your ears. They love you, they say. You should give yourself to them, stay with them, become one of them, they say. 'Isn't it good here?' they say. 'No pain, no trouble.' But also no light and no love and no joy and no ground. You tumble and tumble as you fall, and you try and choose, but your mind be topsy-turvy and maybe you can't think so well, and maybe you can't choose right, and maybe you never wake up. "It felt like that," I tell Tootsie, "even after you got me out and Scott moved me to Highland. I couldn't choose. I couldn't shut out the wraiths...But you would say, 'Hang on, sweetie,' and Scottie would say, 'I miss you, Mama,' and Scott would hold me, just hold me and say nothing at all." Tootsie snorts. "Scott was useless the whole while." "Scott was in the river, too.

Capitalist realism insists on treating mental health as if it were a natural fact, like weather (but, then again, weather is no longer a natural fact so much as a political-economic effect). In the 1960s and 1970s, radical theory and politics (Laing, Foucault, Deleuze and Guattari, etc.) coalesced around extreme mental conditions such as schizophrenia, arguing, for instance, that madness was not a natural, but a political, category. But what is needed now is a politicization of much more common disorders. Indeed, it is their very commonness which is the issue: in Britain, depression is now the condition that is most treated by the NHS. In his book The Selfish Capitalist, Oliver James has convincingly posited a correlation between rising rates of mental distress and the neoliberal mode of capitalism practiced in countries like Britain, the USA and Australia. In line with James’s claims, I want to argue that it is necessary to reframe the growing problem of stress (and distress) in capitalist societies. Instead of treating it as incumbent on individuals to resolve their own psychological distress, instead, that is, of accepting the vast privatization of stress that has taken place over the last thirty years, we need to ask: how has it become acceptable that so many people, and especially so many young people, are ill?

You’re innocent until proven guilty,” Mandy exclaimed, unable to hide her gleeful smile. She missed the way people used to have normal conversations, used to be more caring for each other than themselves, back in the Seventies and Eighties. These days, she realized, neighbors kept to themselves, their kids kept to themselves, nobody talked to each other anymore. They went to work, went shopping and shut themselves up at home in front of glowing computer screens and cellphones… but maybe the nostalgic, better times in her life would stay buried, maybe the world would never be what it was. In the 21st century music was bad, movies were bad, society was failing and there were very few intelligent people left who missed the way things used to be… maybe though, Mandy could change things. Thinking back to the old home movies in her basement, she recalled what Alecto had told her. “We wanted more than anything else in the world to be normal, but we failed.” The 1960’s and 1970’s were very strange times, but Mandy missed it all, she missed the days when Super-8 was the popular film type, when music had lyrics that made you think, when movies had powerful meanings instead of bad comedy and when people would just walk to a friend’s house for the afternoon instead of texting in bed all day. She missed soda fountains and department stores and non-biodegradable plastic grocery bags, she wished cellphones, bad pop music and LED lights didn’t exist… she hated how everything had a diagnosis or pill now, how people who didn’t fit in with modern, lazy society were just prescribed medications without a second thought… she hated how old, reliable cars were replaced with cheap hybrid vehicles… she hated how everything could be done online, so that people could just ignore each other… the world was becoming much more convenient, but at the same time, less human, and her teenage life was considered nostalgic history now.Hanging her head low, avoiding the slightly confused stare of the cab driver through the rear view mirror, she started crying uncontrollably, her tears soaking the collar of her coat as the sun blared through the windows in a warm light.

Haymitch isn't thinking of arenas, but something else. "Johanna's back in the hospital."I assumed Johanna was fine, had passed her exam, but simply wasn't assigned to a sharp shooters' unit. She's wicked with a throwing axe but about average with a gun. "Is she hurt? What happened?""It was while she was on the Block. They try to ferret out a soldier's potential weakness. So they flooded the street, " says Haymitch.This doesn't help. Johanna can swim. At least, I seem to remember her swimming around some in the Quarter Quell. Not like Finnick, of course, but none of us are like Finnick. "So?""That's how they tortured her in the Capitol. Soaked her then used electric shocks," says Haymitch. "In the Block, she had some kind of flashback. Panicked, didn't know where she was. She's back under sedation." Finnick and I just stand there as if we've lost the ability to respond.I think of the way Johanna never showers. How she forced herself into the rain like it was acid that day. I had attributed her misery to morphling withdrawal. "You two should go see her. You're as close to friends as she's got," says Haymitch.That makes the whole thing worse. I don't really know what's between Johanna and Finnick, but I hardly know her. No family. No friends.Not so much as a token from District 7 to set beside her regulation clothes in her anonymous drawer.Nothing.

I remembered during puberty, through the anorexic mists of intermittent menstrual cycles, that man, my father, lifting Shirley's nightdress over her head and asking her in his mocking way to choose what colour condom she wanted. 'Red or yellow?' Which did she choose? I can't remember. Perhaps she alternated. Perhaps there were other colours. It didn't happen once. It happened again and again. I had no power to stop it. That man, my father, had some control over me. I was drugged by the black silence in that big house, the vile whiff of aftershave, the crushing torment of inevitability. My father fucked Shirley using red or yellow condoms and it was those condoms that brought it all to an end. It was my last realization of the day; any more would have been too much to contemplate. That time when my mother had found used condoms in bedroom, he had admitted, after a pointless burst my father's of denial, that he had been going to prostitutes. That was no doubt true but I can't imagine clients take used condoms away with them; prostitutes would surely get rid of the things. No. My father kept those used condoms as a prize. He was fucking his fourteen-year-old-daughter. He was proud of it. Rebecca welled up with tears. Poor thing, she kept saying. Poor thing.

In this chapter I restrict myself to exploring the nature of the amnesia which is reported between personality states in most people who are diagnosed with DID. Note that this is not an explicit diagnostic criterion, although such amnesia features strongly in the public view of DID, particularly in the form of the fugue-like conditions depicted in films of the condition, such as The Three Faces of Eve (1957). Typically, when one personality state, or ‘alter’, takes over from another, they have no idea what happened just before. They report having lost time, and often will have no idea where they are or how they got there. However, this is not a universal feature of DID. It happens that with certain individuals with DID, one personality state can retrieve what happened when another was in control. In other cases we have what is described as ‘co-consciousness’ where one personality state can apparently monitor what is happening when another personality state is in control and, in certain circumstances, can take over the conversation.

Cheryl was aided in her search by the Internet. Each time she remembered a name that seemed to be important in her life, she tried to look up that person on the World Wide Web. The names and pictures Cheryl found were at once familiar and yet not part of her conscious memory: Dr. Sidney Gottlieb, Dr. Louis 'Jolly' West, Dr. Ewen Cameron, Dr. Martin Orne and others had information by and about them on the Web. Soon, she began looking up sites related to childhood incest and found that some of the survivor sites mentioned the same names, though in the context of experiments performed on small children. Again, some names were familiar. Then Cheryl began remembering what turned out to be triggers from old programmes. 'The song, "The Green, Green Grass of home" kept running through my mind. I remembered that my father sang it as well. It all made no sense until I remembered that the last line of the song tells of being buried six feet under that green, green grass. Suddenly, it came to me that this was a suicide programme of the government. 'I went crazy. I felt that my body would explode unless I released some of the pressure I felt within, so I grabbed a [pair ofl scissors and cut myself with the blade so I bled. In my distracted state, I was certain that the bleeding would let the pressure out. I didn't know Lynn had felt the same way years earlier. I just knew I had to do it Cheryl says. She had some barbiturates and other medicine in the house. 'One particularly despondent night, I took several pills. It wasn't exactly a suicide try, though the pills could have killed me. Instead, I kept thinking that I would give myself a fifty-fifty chance of waking up the next morning. Maybe the pills would kill me. Maybe the dose would not be lethal. It was all up to God. I began taking pills each night. Each-morning I kept awakening.

Why do I take a blade and slash my arms? Why do I drink myself into a stupor? Why do I swallow bottles of pills and end up in A&E having my stomach pumped? Am I seeking attention? Showing off? The pain of the cuts releases the mental pain of the memories, but the pain of healing lasts weeks. After every self-harming or overdosing incident I run the risk of being sectioned and returned to a psychiatric institution, a harrowing prospect I would not recommend to anyone.So, why do I do it? I don't. If I had power over the alters, I'd stop them. I don't have that power. When they are out, they're out. I experience blank spells and lose time, consciousness, dignity. If I, Alice Jamieson, wanted attention, I would have completed my PhD and started to climb the academic career ladder. Flaunting the label 'doctor' is more attention-grabbing that lying drained of hope in hospital with steri-strips up your arms and the vile taste of liquid charcoal absorbing the chemicals in your stomach. In most things we do, we anticipate some reward or payment. We study for status and to get better jobs; we work for money; our children are little mirrors of our social standing; the charity donation and trip to Oxfam make us feel good. Every kindness carries the potential gift of a responding kindness: you reap what you sow. There is no advantage in my harming myself; no reason for me to invent delusional memories of incest and ritual abuse. There is nothing to be gained in an A&E department.

Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing. So they fragment the memories into hundreds of shards, leaving only acceptable traces in their conscious minds. Rationalizations like "my childhood was rough," "he only did it to me once or twice," and "it wasn't so bad" are common, masking the fact that the abuse was devastating and chronic. But while the knowledge, body sensations, and feelings are shattered, they are not forgotten. They intrude in unexpected ways: through panic attacks and insomnia, through dreams and artwork, through seemingly inexplicable compulsions, and through the shadowy dread of the abusive parent. They live just outside of consciousness like noisy neighbors who bang on the pipes and occasionally show up at the door.

Well,' said Can o' Beans, a bit hesitantly,' imprecise speech is one of the major causes of mental illness in human beings.'Huh?'Quite so. The inability to correctly perceive reality is often responsible for humans' insane behavior. And every time they substitute an all-purpose, sloppy slang word for the words that would accurately describe an emotion or a situation, it lowers their reality orientations, pushes them farther from shore, out onto the foggy waters of alienation and confusion.'The manner in which the other were regarding him/her made Can O' Beans feel compelled to continue. 'The word neat, for example, has precise connotations. Neat means tidy, orderly, well-groomed. It's a valuable tool for describing the appearance of a room, a hairdo, or a manuscript. When it's generically and inappropriately applied, though, as it is in the slang aspect, it only obscures the true nature of the thing or feeling that it's supposed to be representing. It's turned into a sponge word. You can wring meanings out of it by the bucketful--and never know which one is right. When a person says a movie is 'neat,' does he mean that it's funny or tragic or thrilling or romantic, does he mean that the cinematography is beautiful, the acting heartfelt, the script intelligent, the direction deft, or the leading lady has cleavage to die for? Slang possesses an economy, an immediacy that's attractive, all right, but it devalues experience by standardizing and fuzzing it. It hangs between humanity and the real world like a . . . a veil. Slang just makes people more stupid, that's all, and stupidity eventually makes them crazy. I'd hate to ever see that kind of craziness rub off onto objects.

Blame is a Defense Against PowerlessnessBetrayal trauma changes you. You have endured a life-altering shock, and are likely living with PTSD symptoms— hypervigilance, flashbacks and bewilderment—with broken trust, with the inability to cope with many situations, and with the complete shut down of parts of your mind, including your ability to focus and regulate your emotions.Nevertheless, if you are unable to recognize the higher purpose in your pain, to forgive and forget and move on, you clearly have chosen to be addicted to your pain and must enjoy playing the victim.And the worst is, we are only too ready to agree with this assessment! Trauma victims commonly blame themselves. Blaming oneself for the shame of being a victim is recognized by trauma specialists as a defense against the extreme powerlessness we feel in the wake of a traumatic event. Self-blame continues the illusion of control shock destroys, but prevents us from the necessary working through of the traumatic feelings and memories to heal and recover.

Other personalities are created to handle new traumas, their existence usually occurring one at a time. Each has a singular purpose and is totally focused on that task. The important aspect of the mind's extreme dissociation is that each ego state is totally without knowledge of the other. Because of this, the researchers for the CIA and the Department of Defense believed they could take a personality, train him or her to be a killer and no other ego stares would be aware of the violence that was taking place. The personality running the body would be genuinely unaware of the deaths another personality was causing. Even torture could not expose the with, because the personality experiencing the torture would have no awareness of the information being sought. Earlier, such knowledge was gained from therapists working with adults who had multiple personalities. The earliest pioneers in the field, such as Dr. Ralph Alison, a psychiatrist then living in Santa Cruz, California, were helping victims of severe early childhood trauma. Because there were no protocols for treatment, the pioneers made careful notes, publishing their discoveries so other therapists would understand how to help these rare cases. By 1965, the information was fairly extensive, including the knowledge that only unusually intelligent children become multiple personalities and that sexual trauma endured by a restrained child under the age of seven is the most common way to induce hysteric dissociation.

Working simultaneously, though seemingly without a conscience, was Dr. Ewen Cameron, whose base was a laboratory in Canada's McGill University, in Montreal. Since his death in 1967, the history of his work for both himself and the CIA has become known. He was interested in 'terminal' experiments and regularly received relatively small stipends (never more than $20,000) from the American CIA order to conduct his work. He explored electroshock in ways that offered such high risk of permanent brain damage that other researchers would not try them. He immersed subjects in sensory deprivation tanks for weeks at a time, though often claiming that they were immersed for only a matter of hours. He seemed to fancy himself a pure scientist, a man who would do anything to learn the outcome. The fact that some people died as a result of his research, while others went insane and still others, including the wife of a member of Canada's Parliament, had psychological problems for many years afterwards, was not a concern to the doctor or those who employed him. What mattered was that by the time Cheryl and Lynn Hersha were placed in the programme, the intelligence community had learned how to use electroshock techniques to control the mind. And so, like her sister, Lynn was strapped to a chair and wired for electric shock. The experience was different for Lynn, though the sexual component remained present to lesser degree...

As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept.Child abuse will always re-emerge, no matter how many years go by. We read of cases of people who have come forward after thirty or forty years to say they were abused as children in care homes by wardens, schoolteachers, neighbours, fathers, priests. The Catholic Church in the United States in the last decade has paid out hundreds of millions of dollars in compensation for 'acts of sodomy and depravity towards children', to quote one information-exchange web-site. Why do these ageing people make the abuse public so late in their lives? To seek attention? No, it's because deep down there is a wound they need to bring out into the clean air before it can heal. Many clinicians miss signs of abuse in children because they, as decent people, do not want to find evidence of what Dr Ross suggests is 'a sick society that has grown sicker, and the abuse of children more bizarre'. (Note: this was written in the UK many years before the revelations of Jimmy Savile's widespread abuse, which included some ritual abuse)

There were other strange signals and signs. Another day, suddenly felt an almost overwhelming urge to travel to Balitmore. I wanted to 'kidnap' a helicoper fly it there if I didn't drive the there', she explains. 'I had no idea where I was to go, only that I was certain I would know my destination as I encountered signs and certain landmarks along the way. I was not even certain who I was to meet, or what my mission was, but I felt I must go.' Beginning to heal by this time with Talbon's help, she resisted that urge. Yet she sensed she would be summoned for three more Cat Woman missions: two in 1999 and one in 2000.As for the code words for activating her, those had been erased from Cheryl's conscious memory. Buried deep in her unconscious mind, however, the words, when called up, cause her to react as her programmers want her to. Though she can't remember the activation codes, Cheryl knows her handlers said the same things every time. 'I'm working on unblocking the words in therapy. Once I know what the words are, I can learn how to stop their effect on me. I did it already when I learned the control code. Standing in front of a mirror, I said the control code words over and over until I was completely desensitised to them. That's what I have to do for the activation code words... but I have not been able to recall all of them as yet.' Dr. Talbon was struck by another very important thing. 'It all hung together. The stories Cheryl told - even though it was upsetting to think people could do stuff like that - they were not disjointed. They were not repetitive in terms of "I've heard this before". It was not just trying consciously or unconsciously to get attention. She'd really processed them out and was done with them. She didn't come up with it again [after telling the story once and dealing with it]. Once it was done, it was done. And I think that was probably the biggest factor for me in her believability. I got no sense that she was using these stories to make herself a really interesting person to me so I'd really want to work with her, or something.

Because now mental health disorders have gone “mainstream”. And for all the good it’s brought people like me who have been given therapy and stuff, there’s a lot of bad it’s brought too.Because now people use the phrase OCD to describe minor personality quirks. “Oooh, I like my pens in a line, I’m so OCD.”NO YOU’RE FUCKING NOT.“Oh my God, I was so nervous about that presentation, I literally had a panic attack.”NO YOU FUCKING DIDN’T.“I’m so hormonal today. I just feel totally bipolar.”SHUT UP, YOU IGNORANT BUMFACE.Told you I got angry.These words – words like OCD and bipolar – are not words to use lightly. And yet now they’re everywhere. There are TV programmes that actually pun on them. People smile and use them, proud of themselves for learning them, like they should get a sticker or something. Not realizing that if those words are said to you by a medical health professional, as a diagnosis of something you’ll probably have for ever, they’re words you don’t appreciate being misused every single day by someone who likes to keep their house quite clean.People actually die of bipolar, you know? They jump in front of trains and tip down bottles of paracetamol and leave letters behind to their devastated families because their bullying brains just won’t let them be for five minutes and they can’t bear to live with that any more.People also die of cancer.You don’t hear people going around saying: “Oh my God, my headache is so, like, tumoury today.”Yet it’s apparently okay to make light of the language of people’s internal hell

There is always a man eager to explain my mental illness to me. They all do it so confidently, motioning to their Hemingway and Bukowski bookshelf as they compare my depression to their late-night loneliness. There is always someone that rejected them that they equate their sadness to and a bottle of gin (or a song playing, or a movie) close by that they refer to as their cure. Somehow, every soft confession of my Crazy that I hand to them turns into them pulling out pieces of themselves to prove how it really is in my head.So many dudes I’ve dated have faces like doctors ready to institutionalize and love my crazy (but only on Friday nights.)They tell their friends about my impulsive decision making and how I “get them” more than anyone they’ve ever met but leave out my staring off in silence for hours and the self-inflicted bruises on my cheeks.None of them want to acknowledge a crazy they can’t cure.They want a crazy that fits well into a trope and gives them a chance to play Hero. And they always love a Crazy that provides them material to write about.Truth is they love me best as a cigarette cloud of impossibility, with my lipstick applied perfectly and my Crazy only being pulled out when their life needs a little spice.They don’t want me dirty, having not left my bed for days. Not diseased. Not real.So they invite me over when they’re going through writer’s block but don’t answer my calls during breakdowns. They tell me I look beautiful when I’m crying then stick their hands in-between my thighs. They mistake my silence for listening to them attentively and say my quiet mouth understands them like no one else has.These men love my good dead hollowness. Because it means less of a fighting personality for them to force out. And is so much easier to fill someone who has already given up with themselves.

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.

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.

The word is dissociate. There is no 'a' before the 'ss'. People invariably say dis-a-ssociate, which, if you're suffering Disso-ciative Identity Disorder/Multiple Personality Disorder, can be irritating. People then want to know how many personalities I have and the answer is: I don't know. The first book about Multiple Personality Disorder to make an impact was Flora Rheta Schreiber's Sybil, published in 1973, which carries the subtitle: The True and Extraordinary Story of a Woman Possessed by Sixteen Separate Personalities. Corbett H. Thigpen and Hervey M. Cleckley published the controversial The Three Faces of Eve much earlier in 1957, and Pete Townshend from The Who wrote the song 'Four Faces'. People seem to feel safe with numbers. The truth is more complicated. The kids emerged over time. Billy, the boisterous five-year-old, was at first the most dominant. But he slowly stood aside for JJ, the self-confident ten-year-old who appears when Alice is under stress and handles complicated situations like travelling on the Underground and meeting new people. The first entity to visit was the external voice of the Professor. But he had a choir of accomplices without names. So, how many actual alter personalities are there? I would say more than fifteen and less than thirty, a combination of protectors, persecutors and friends - my own family tree.

Once I had found the courage to tell Rebecca about the children in my head, it wasn't so hard in the coming months to tell Roberta. On the train from Huddersfield one day in May I made a roll call of the usual suspects: Baby Alice; Alice 2, who was two years old and liked to suck sticky lollipops; Billy; Samuel; Shirley; Kato; and the enigmatic Eliza. There was boy I would grow particularly fond of named limbo, who was ten, but like Eliza he was still forming. There were others without names or specific behaviour traits. I didn't want to confuse the issue with this crowd of 'others' and just counted off the major players with their names, ages and personalities, which Roberta scribbled down on a pad. Then she looked slightly embarrassed. 'You know, I've met Billy on a few occasions, and Samuel once too,' she said. 'You're joking.' I felt betrayed. 'Why didn't you tell me?' 'I wanted it to come from you, Alice, when you were ready.' For some reason I pulled up my sleeves and showed he my arms. 'That's Kato,' I said, 'or Shirley.' She looked a bit pale as she studied the scars. I had feeling she didn't know what to say. The problem with counsellors is that they are trained to listen, not to give advice or diagnosis. We sat there with my arms extended over the void between us like evidence in court, then I pushed down my sleeves again. 'I'm so sorry, Alice,' she said finally and I shrugged. 'It's not your fault, is it?' Now she shrugged, and we were quiet once more.

The case of a patient with dissociative identity disorder follows:Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.

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.