Chapter 12. Various Therapeutic Techniques (3)

However, not every DID patient has uncontrollable violent identity. Or, identity deemed violent often turns out to be not so “violent”, but rather agitated, fearful or scared, based on the observations of my DID case load. They might occasionally show apparently harmful or self-destructive behaviors, but they seem to know when and how to stop themselves before they really follow through with their act. One of my young female patients has an identity that occasionally comes out and threatens to choke her male partner. However, its behavior was always limited to choking gesture without really squeezing her fingers into his throat. Another female patient had an identity that once appears impulsively goes up to the rooftop of a building in order to throw herself away, but she always manages to switch into a safer identity before she reaches the top floor. One of the features of DID patients is their high sensitiveness to other’s pain, and if they happen to hurt other people, other personality would usually stop the risky behavior. I call this a “safety mechanism” of DID patients. However, it is my impression that safety mechanism is less efficient for male DID patients whose violent identity tend to be much more likely to act out compared to female DID patients.

A part of the violent identity of a DID patient might be the images taken in of a person who was abusive and violent toward the patient in the past, but the main part could be from the patient’s fearful and frantic emotional reaction to the past abusive and violent events. A fearful and frantic identity might suddenly shows up in a context of flashbacks, having cutter knife in her hand for the purpose of self-defense or in order to cut on her wrist to relieve her emotional pain. Although that identity can be recognized as a violent identity, it is doubtful if it is really harmful to others, but rather is defensive, desperate and scared.
Purely aggressive violence is often confused with so called resistive violence (Treiman, 1986). It is a kind of violence which is exerted in a reflex and unconscious manner when an action is stopped by someone else. It has essentially a self-protective nature and is often elicited among general population. Some minor pushing and shoving in the subway might develop into a harmful serious fight, as a series of resistive violence tends to feed into each other and escalate rapidly. (When a man is stepped on his foot by another man, he pushes this another man away to avoid this intrusive act. The other man, without noticing his own act, feels pushed by the original man without reason and push him back rather harshly. The original man feels offended by this action and push back more forcefully…. and so on.)
Treiman DM (1986) Epilepsy and violence: medical and legal issues. Epilepsia. 27(suppl 2):S77-S104