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On the last track we discussed meeting the alter personalities of a client with dissociative identity disorder. Three ways of meeting the alter personalities are the alter personalities "come out" voluntarily , indirect inquiry, and direct inquiry.
On this track we will discuss personality histories. Would you agree that working with a client with dissociative identity disorder means working directly with that client’s alter personalities? Therefore, this track will give a brief description of some things to look for in compiling a brief history for your client’s personality system. Four basic lines of questioning can provide you with enough psychopathology to begin to foster internal communications within your client’s personality system. Putnam uses four basic lines of questioning that are outlined on this track.
#1 Naming Each Personality
For example, do you remember Alan from the last track? When Alan’s angry alter refused to give a name, I simply referred to him as ‘the Angry one.’ Later I learned his name was Vaughn. I kept a list of alters’ names with a brief biography and description of each alters’ role in Alan’s personality system.
#2 Determining Physical Aspects of the Alter
Alan’s age when his alter personality first came out became relevant later when I began to explore for past trauma. As you know, alter personalities are usually created during times of extreme stress for the client. For example, if your client’s alter first appeared at the age of 6 years, then you might suspect specific traumas associated with that period of your client’s life.
#3 Determining Perceived Function
This question serves several purposes. First, I could find out if Vaughn was aware of Alan and, second, I wanted to know about Vaughn’s control mechanisms. Vaughn answered, "I’m always in control of Alan, but sometimes I just let him do what he wants." I then asked, "Do you ever influence Alan without coming out?" Vaughn stated that he did.
Another question I asked was whether or not Alan knew of Vaughn’s existence. Vaughn stated, "No and it’s better that way." I made note of Vaughn’s answers. However, I did not assume that they where the whole truth. Even so, would you agree that there is usually at least some useful information in each of an alter personality’s answers?
The process of identifying awareness of other personalities is often referred to as ‘chaining.’ I have found that ‘chaining’ allows the therapist to acquire an overlapping list of names or descriptions of the alters who compose the personality system. Each time I hear of a new personality who has not yet appeared, I ask to meet him or her. This technique helps to fill in the gaps in the personality system.
Regarding Alan, I was able to acquire a great deal of valuable information about the size, composition, and structure of the overall personality system. To summarize, my list provided an idea about the minimum number of alters. It appeared Alan had at least two, which included Vaughn and a child of unknown age. Vaughn appeared to be in his early or mid twenties even though Alan was in his late thirties.
In addition, the list indicated something about the perceived role of Vaughn. At one point Vaughn stated, "I’m basically the brawn and guts for that spineless old man!" Clearly, this information also led to an idea of which of Alan’s alters were likely responsible for specific pathological or dangerous behaviors. And finally, the list provided an idea of the awareness each alter had of one another. The psychopathology obtained by taking a brief history of each personality became useful to foster internal communications within Alan’s personality system. Internal communications will be discussed more later in this course.
First, however, think of your Alan. How could taking a brief history of each of your client’s personalities be useful in your treatment approaches? What questions could you ask that might pertain more to the specifics in your client’s case?
On this track we discussed personality histories. The four basic lines of questioning outlined on this track to obtain a personality history are naming each personality, determining physical aspects of the alter, determining perceived function, and chaining.
On the next track we will discuss behavioral contracts. We’ll describe three steps to writing a contract. These three steps are specificity as to what is required from each personality, determining the consequences for contract violations, and length and termination of contracts.
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