Information on Sexual Abuse & MPD/DID

For Your Information

Well, I was going to try to give y'all some helpful information about Sexual/Ritual Abuse and MPD/DID (Multiple Personality Disorder/Dissociative Disorder) without it being all "text booky" ... but, I'm not too good at explaining things ... so, sorry for the "schoolish" way that this is done ... but this information is very good and crucial for anyone that has anything to do with abuse and MPD/DID ... ;o)

What is MPD?

One of the significant mental health issues of the 1990's concerns the
recognition of trauma as the root cause of some psychiatric conditions.

Until recently, Multiple Personality Disorder (MPD) and other Dissociative Disorders (DDs) have been considered to be rare and extraordinary phenomena. It is now understood that these conditions can be common effects of severe trauma in early childhood, most typically extreme, repeated physical, sexual, and/or emotional abuse. In 1994, with the publication of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders--IV, the name and some of the diagnostic criteria for Multiple Personality Disorder (MPD) were changed to Dissociative Identity Disorder (DID), reflecting changes in professional understanding of the disorder. To make this article easier to read, I will use the acronym DID(MPD) throughout; the points made, however, may apply to a variety of dissociative conditions.

People who chronically dissociate often refer to the experience as "spacing out" or "trancing." Technically, dissociation is a mental process which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. When a person is dissociating, certain information is not associated with other information as it normally would be.

For example, during a traumatic experience, a person may dissociate the memory of the place and circumstances of the trauma from his ongoing memory, resulting in a temporary mental escape from the fear and pain of the trauma and, in some cases, a memory gap surrounding the experience.

Because this process can produce changes in memory, people who frequently dissociate often find their senses of personal history and identity are affected.

Most clinicians believe that dissociation exists on a continuum of severity. This continuum reflects a wide range of experiences and/or symptoms. At one end are mild dissociative experiences common to most people, such as daydreaming, highway hypnosis, or "getting lost" in a book or movie, all of which involve "losing touch" with conscious awareness of one's immediate surroundings. At the other extreme is complex, chronic dissociation, which may result in serious impairment or inability to function.

Dissociative disorders develop under fairly consistent circumstances. When faced with overwhelmingly traumatic situations from which there is no physical escape, a child may resort to "going away" in his or her head. This ability is typically used by children as an extremely effective defense against acute physical and emotional pain, or anxious anticipation of that pain. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the child to function as if the trauma had not occurred.

Dissociation is often referred to as a highly creative survival technique because it allows individuals enduring "hopeless" circumstances to preserve some areas of healthy functioning. Over time, however, for a child who has been repeatedly physically and sexually assaulted, defensive dissociation becomes reinforced and conditioned. Because the dissociative escape is so effective, children who are very practiced at it may automatically use it whenever they feel threatened or anxious -- even if the anxiety-producing situation is not abusive. Often, even after the traumatic circumstances are long past, the left-over pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, family, social, and daily activities.

Repeated dissociation may result in a series of separate entities, or mental states, which the trauma survivor may perceive as having identities of their own. These entities may become the internal "personality states," of a DID(MPD) system. Changing between these states of consciousness is described as "switching."

People with dissociative disorders may experience any of the following:

depression, mood swings, suicidal tendencies, sleep disorders (insomnia, night terrors, and sleep walking), panic attacks and phobias (flashbacks, reactions to stimuli or "triggers"), alcohol and drug abuse, compulsions and rituals, psychotic-like symptoms (including auditory and visual hallucinations), and eating disorders. In addition, individuals with DID(MPD) can experience headaches, amnesias, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed).

By Esther Giller, Director
Sidran Foundation
Reprinted by permission

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What is child sexual abuse?

Child sexual abuse is any sexual behavior directed toward a child by a person who has power over that child. Such behavior always involves abetrayal of the child's trust.Some forms of sexual abuse involve physical contact. These include masturbation, intercourse, fondling, oral sex, and anal or vaginal penetration with objects. Other types of sexual abuse, such as exhibitionism, leering, and sexual suggestiveness, do not involve physical contact. People who sexually abuse children do so in order to meet their own needs. Abusers do not have the child's best interest in mind. Abusers need not be strangers. They can be anyone in a position of power or trust: fathers, uncles, cousins, stepfathers, siblings, mothers, teachers, babysitters, neighbors, grandparents, peers, clergy, or doctors.

How prevalent is child sexual abuse?

It has been estimated that 20-40% of girls and 2-9% of boys are sexuallyabused by the time they reach eighteen. These are probably conservative estimates since many incidents of sexual abuse are never reported.

How can I know if I was sexually abused?

If you remember being sexually violated as a child, trust your memories, even if what you're remembering seems too awful to be true. Children simply do not make things up. It is common, however, for individuals who have been abused not to have clear memories. One way of coping with sexual abuse is to repress or for-get that it ever happened. Even in the absence of conscious memories certain experiences can trigger intense feelings of fear, nausea, and despair. Some of these "triggers" include specific sounds, smells, tastes, words, and facial expressions.Whether or not you have specific memories, if you suspect that you were sexually abused, then you probably were. Often the first step in remembering involves having a hunch or a suspicion that some type of violation occured. Pay attention to these feelings, for people who suspect that they were sexually abused generally discover that this has been the case.

If it happened back then, why do I have to deal with it now?

There are many factors that make it impossible for children to receive the help that they need at the time of the abuse. Unfortunately, many children who do seek support are met with reactions such as disbelief, lack of concern, and even blame. Despite efforts to seek help, the abuse may continue or even get worse. There are many understandable reasons why children do not seek help at the time of the abuse. Abusers often scare children by threatening to retaliateor by insinuating that the child will not be believed. The abuser may alsoconfuse the child by implying that the abuse is the child's fault. Comments such as "You asked for it," "You were all over me," and "I know you enjoyed it" are often used to blame and to silence the child. Sexual abuse of a child can never be the child's fault. For whatever reason, if the abuse is not dealt with at the time, its damaging effects will still be present years later.

What are the effects of child sexual abuse?

There are many ways that people experience the harm that results from having been sexually abused. Consider the following questions (Bass and Davis, 1988):

Self-Esteem
* Do you often feel that you are not a worthwhile person?
* Do you feel bad, dirty, or ashamed of yourself?
* Do you have a hard time nurturing yourself?
* Do you feel that you have to be perfect?

Feelings
* Do you have trouble knowing how you feel?
* Have you ever worried about going crazy?
* Is it hard for you to differentiate between various feelings?
* Do you experience a very narrow range of feelings?
* Are you afraid of your feelings? Do they seem out of control?

Your Body
* Do you feel present in your body most of the time? Are there times when you feel as if you've left your body?
* Do you have a restricted range of feelings in your body? Do you find it difficult to be aware of what your body is telling you?
* Do you have a hard time loving and accepting your body?
* Do you have any physical illnesses that you think might be related to past sexual abuse?
* Have you ever intentionally hurt yourself or abused your body?

Intimacy
* Do you find it difficult to trust others?
* Are you afraid of people? Do you feel alienated or lonely?
* Do you have trouble making a commitment? Do you panic when people get too close?
* Do you expect people to leave you?
* Have you ever been involved with someone who reminds you of your abuser or someone you know is not good for you?

Sexuality
* Do you try to use sex to meet needs that aren't sexual?
* Do you ever feel exploited sexually or use your sexuality in a way that exploits others?
* Are you able to "stay present" when making love? Do you go through sex feeling numb or in a panic?
* Do you find yourself avoiding sex or pursuing sex you really don't want.
* Do you experience flashbacks during sex?

Will I Ever Feel Better?

The devastating effects of sexual abuse do not need to be permanent. You can heal! You have already survived the worst part, the abuse itself. You have choices now that you didn't have then. If you choose to commit to your own healing process, have patience with yourself, and let others support you along the way, you can learn that it is possible not only to "survive," but to experience what it means to be truly alive.

Where Do I Begin

If you think that you may have been sexually abused, speaking with a trained professional can be extremely helpful. You don't need to be alone in your pain. In fact, "breaking the silence" is one of the most important components of the healing process. Make an appointment with a professional who will understand what you have been through.

SOURCE:

The Counseling Center for Mental Health
Divison of McKinley Health Center
University of Illinois Campaign/Urbana
Reprinted by permission

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When a Child Tells.

When a child tells an adult that he or she has been sexually abused, the adult may feel uncomfortable and may not know what to say or do. The following guidelines are for responding to children who have been sexually abused:

What to Say

* If a child even hints in a vague way that sexual abuse has occurred, encourage him or her to talk freely. Don't make judgmental comments.
* Show that you understand and take seriously what the child is saying. Child and adolescent psychiatrists have found that children who are listened to and understood fare much better than those who are not. The response to the disclosure of sexual abuse is critical to the child's ability to resolve the trauma of sexual abuse.
* Assure the child that he or she did the right thing in telling. A child who is close to the abuser may feel guilty about revealing the secret. The child may feel frightened if the abuser has threatened to harm the child or other family members as punishment for telling the secret.
* Tell the child that he or she is not to blame for the sexual abuse. Most children in attempting to make sense out of the abuse will believe that somehow they caused it or may even view it as a form of punishment for imagined or real wrong doings.
* Finally, offer the child protection, and promise that you will promptly take steps to see that the abuse stops.

What to Do

Report any suspicion of child abuse. If the abuse is within the family, report it to the local Child Protection Agency. If the abuse is outside of the family, report it to the police or district attorney's office. Individuals reporting in good faith are immune from prosecution. The agency receiving the report will conduct an evaluation and will take action to protect the child.

Parents should consult with their pediatrician or family physician, who may refer them to a physician who specializes in evaluating and treating sexual abuse. The examining doctor will evaluate the child's condition and treat any physical problem related to the abuse, gather evidence to help protect the child, and reassure the child that he or she is all right. Usually, the child should also have a psychiatric evaluation to find out how the sexual abuse has affected him or her, and to determine whether ongoing professional help is necessary for the child to deal with the trauma of the abuse. The child and adolescent psychiatrist can also provide support to other family members who may be upset by the abuse.

While most allegations of sexual abuse made by children are true, some false accusations may arise in custody disputes and in other situations. Occasionally, the court will ask a child and adolescent psychiatrist to help determine whether the child is telling the truth, or whether it wil lhurt the child to speak in court about the abuse. When a child is asked as to testify, special considerations--such as videotaping, frequent breaks, exclusion of spectators, and the option not to look at the accused--make the experience much less stressful. Adults, because of their maturity and knowledge, are always the ones to blame when they abuse children. The abused children should never be blamed. When a child tells someone about sexual abuse, a supportive, caring response is the first step towards getting help for the child, reestablishing his or her trust in adults.

SOURCE:

Facts For Families: the American Academy of Child and Adolescent Psychiatry

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