Chapter 15. Dissociation and the “Volcanic Model” (6)

It appears that what we can do is very limited as far as dormant volcanoes are concerned (and so are dormant identities of DID patients). However, if a dormant volcano can still erupt in the future with resultant grave disaster, we might have to take some measure to prevent it from happening. So far, our technology is very limited, but some time in the future, we might be able to reduce a pressure inside the volcano in order to delay or abort its eruption. Being aware of the total lack of any specialized knowledge about volcanology, I would venture to imagine: What if some very measured tectonic movements are administered in order to “let off steam” of magmatic pressure little by little ? However, I am also aware that that type manoeuvre should be done with most caution, as it might backfire and trigger larger and unexpected eruption. This tactic of "letting off steam" might be applied more realistically to our treatment of DID patients. We might be able to call out emotional identity sometimes in order to avoid future unexpected appearance and disorderly conducts. However, it might end up stimulating the emotional personality unnecessary.
More concretely, let us imagine a DID patient who has a violent identity who can suddenly pop out and disrupt the social life of the main identity. Fortunately he has been gone for a while, and he might stay dormant indefinitely if undisturbed. However, if the patient has some stressful events on his/her job, it is expected that that violent personality might get stirred up and emerge again. In this case, is it therapeutic and ethical to take preventive measure and deal with him while he is still dormant? It is a very touchy, but important question. There is a Japanese saying “Don't wake a sleeping baby”. If we apply this to the treatment of DID, calling out the violent identity might end up triggering another disruption in the patient's life unnecessarily. However, if experiences of traumatic stress is imminent and the violent identity is most likely activated, or if there is some hint that he is already half-awake, we might need to follow another proverb: “Crying baby should be picked up and cuddled”.
Of course there is no single answer to this question. Clinicians should rely on their experiences and their gut feeling to find the answer at an each juncture of their clinical experiences. Volcanic metaphor (or"baby metaphor"?) does not indicate us any correct answer, except to help us have an image about what might be going on in the patients. The metaphor might also help us refrain from having a following heroic idea: “in order to really treat the patient, we need to get to the bottom of the patient's problem at all cost."

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