So that's it. That's the big secret. I tried to kill myself on New Year's eve. Just like Sadie did last night. Only she really did it. I don't know all the detatils, just the basics. She took a bunch of pills. I don't know what they were or where she got them. I'd like to think they were Wonder Drug. Then at least she could have gone thinking she was flying.
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.
Ninety-six per cent of juvenile prostitutes are fugitives from abusive domestic situations; 66 per cent began working before they turned 16. (Prostitution is their only perceived means of survival.) Millions of children work as prostitutes around the world. A third are male. One study revealed that over 50 per cent of prostitutes are the children of alcoholics or substance abusers, and 90 per cent are deflowered through incest or rape. Ninety-one per cent of prostitutes do not speak of the abuse. (The truth of life is told through the language of behavior.) Abused children suffer Post-Traumatic Stress Disorder, guilt, self-destructive impulses, suspicion, fear. Seventy-five per cent of prostitutes attempt suicide. (Imagine their scrapbook of memories.)