If we treat the patient A this way, theoretically there are two possible outcomes. One is that B’s sense that he or she is an independent being and different from A is reduced, according to their opinions. The other is that B feels that his or her own individuality is ignored or belittled. B might feel helpless and distrustful to the clinician. Unfortunately, the latter seems to happen in most of the time, based on my DID patients’ statement. Probably I have never heard of any cases where the former actually happened, but my experiences can be biased. One of the multiple identities of a DID patient said “my former therapist never recognized me as an individual different from him/her [host personality] and I was very upset. I asked him repeatedly to change that attitude, but he never did.” I hear similar complaints from many other patients.
Even among those clinicians who agree to treat each identity as an independent individual, calling them by their name (such as “B” of the individual A that we mentioned above) can be still controversial. Some clinicians are concerned about consolidating each identity iatrogenically by using names of different identities.
Theoretically, it is possible that in the course of the treatment of DID patients, new identities can be generated or emerge, where clinicians play some part. That itself is not surprising, as DID’s identities have developed in response to various stimuli from the environment, and therapist’s influence may well be one of them. I consider, however, that that new identity generated under the influence of clinicians should not be taken so seriously, and here is why I think so.
Suppose that a DID patient A has different identities named B, C and D. A clinician gives him a suggestion that there can be another identity called E, and the patient takes it in. Now A has different identities B, C, D and E, although some patient might not respond to this suggestion fully and create a slightly different identity that can be called F. (By the way, this kind of process occurs often in the sessions of mediums or spiritual healers where new identity is taken in through auto-suggestion). The point that I would like to make is that usually these new identities E, or F do not become one of the major players in A, in terms of their emotional conspicuousness. Usually new identities reflect nature of the relationship in which new identities are formed, and unless the relationship with a therapist is traumatic, violent or abusive, no reason for E or F to carry any heavy emotional charge. Typically E, or F plays a role of a temporary guest or an extra besides major players such as A,B,C, and D, and they are destine to be forgotten or disappear sooner or later unless special attention is directed to them.
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