eiseEducation

The presence and activities of diverse organized centers of experience, identity, initiative, and executive control characterize the mental functioning and lives of individuals diagnosed with Dissociative Identity Disorder and allied complex, chronic dissociative conditions. Working with these dissociated self-states (i.e., alters, identities) is a central concern in their psychotherapeutic treatments. This presentation reviews the emergence of the current “new classical” picture of these disorders, a model that superseded earlier depictions and stereotypes, and explores the implications of this revised understanding. It  discusses alters, alter systems and system “rules,” and how the inner worlds of dissociative patients impact overt behaviors from behind the scenes, expressing the thoughts and initiatives of alters ostensibly not exerting executive control. It describes “invitational inclusionism,” a therapeutic stance that embraces all alters and invites them to become stakeholders in the success of the treatment, and outlines the types of interventions (applicable within most psychotherapeutic paradigms) that follow naturally from its premises. It discusses and demonstrates how phenomena long thought to indicate psychosis can be understood as markers of the activities of alters not currently in executive control, and become powerful tools for working across dissociative barriers, often even when these barriers have been powerful and deeply entrenched. Finally, it explores the concept and process of integration.