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US Tara - Season 1

 Episode 1: Pilot
Episode 2: Aftermath
 Episode 3: Work
 Episode 4: School Spirit
 Episode 5: Revolution
 Episode 6: Transition
 Episode 7: Alterations
Episode 8: Abundance
 Episode 9: Possibility
 Episode 10: Betrayal
 Episode 11: Snow

 Episode 12: Miracle

Episode 1: Pilot

Tara is a wife and mother with DID. She manifests four alters, thus far. Tara is a working mother who paints nursery room murals. She is the one that her children call “Mom.” T is a dramatic, pot-smoking, sexualized teenager. Buck is a hypermasculine ‘good old boy’ who claims to be a Vietnam veteran. Finally, Alice is a 1950s ‘Betty Crocker’-style, perfect housewife. Alice does not appear in the first episode. Each alter has its own distinctive behavior, attitudes, and manner of dress. Tara has no awareness or memory of what her alters do or say when they ‘come out.’ Tara has a female therapist, Dr. Ocean, who is alluded to, but not seen in this episode.

The family consists of Tara, her husband Max, gay son Marshall, and daughter Kate. Tara’s sister, Charmaine, puts in an appearance; she does not believe that Tara has DID and is jealous of the attention and acceptance that the family give to Tara (and her alters). Charmaine tells Max that he deserves better than Tara; she appears to be clearly ‘hitting’ on him. Unlike Charmaine, Tara’s wife and teenage children know, accept, and interact freely with her alters. Not only do they know that Mom has DID, but some friends and neighbors seem to be aware of this as well. Kate tells her boyfriend about Mom’s disruptive DID behavior, but becomes defensive when he pronounces Tara to be weird. When Tara later sees this boyfriend being physically rough with Kate, she confronts him. Later, Tara’s alter Buck gets into a fistfight with him—and Marshall angrily attacks and repeatedly kicks Kate’s boyfriend after the boyfriend punches Buck in the face.

Commentary:
Is this what DID really looks like? Almost everything about Tara and her alters is ‘over the top.’ DID looks like this in only about 5% of cases, and even then is rarely paraded this openly. In the vast majority of cases, switching from one alter to another is covert or hidden, appearing as abrupt, but often subtle changes of mood, behavior, or attitude. Alters usually do not call attention to themselves. Why? As we search for an answer, it helps to understand the ‘purpose’ of DID. DID is developed in early childhood as a means of coping with repeated trauma, usually abuse that far too often occurs at the hands of a trusted and needed caretaker. In short, DID is usually a survival strategy for coping with one or more chronically dangerous caretakers. The alters help the child to cope with this situation. That is their purpose. And this purpose is usually best-served by the alters not calling public attention to themselves (quite the opposite of Tara). This covert style of functioning usually continues into adulthood. That is why Tara’s public style of switching among various alters with wildly different clothes, beliefs, feelings, and desires is uncommon.

How realistic is the portrayal of Tara’s interaction with her family (and vice versa)? Although the portrayal of Tara’s alters is ‘over the top,’ (Remember, this is entertainment!), the portrayal of the family is often remarkably realistic. This is a loving family, but a dysfunctional one because the kids are having to deal with Mom’s psychiatric condition far too much. All experienced DID therapists have encountered families like this (albeit usually with less dramatic alters). The love and acceptance in this family is very important and very healing. Tara’s alters trust the family. On the other hand, although this arrangement may be supportive for Tara, and to some extent for Max, it is unfair to burden children, even teenage children, with these kinds of interactions with the alters. Tara’s children should not have to deal with T’s sexualized behavior and her immature acting out (pot smoking, shopping sprees for racy clothes, and secretly obtaining a birth control prescription for daughter, Kate). No wonder Kate tells T, “I love you best out of all the alters.” Similarly, Marshall should not have to endure Buck’s macho insults and anti-gay put-downs (loving though they may be). This pattern of family interaction turns the children into caretakers for their mother. The technical term for this is parentification. This kind of family interaction is a recipe that guarantees recurrent problems and occasional chaos. In the long run, the kind of love that this family shows tends to win out. With good dissociative disorder therapy, Tara will probably be able to heal. Nonetheless, her children may be found to have paid a terrible price in the process.

In many cases, a person with DID keeps the alters entirely hidden from the family (and everyone else). This hiddenness has at least two different causes: (1) caution and lifelong habit, and (2) avoidance of current danger. We have already discussed lifelong hiding (of alters) as a habit that is acquired in childhood. Current danger is another matter. Women and men with DID usually grew up in an abusive home. Not surprisingly, as adults, persons with DID often pair-off with an abusive mate. Continued abuse in adulthood gives them new reasons to hide their alters. The frequency of abusive marriages or partnerships in adults with DID explains why assessing the supportiveness/abusiveness of current relationships is so important for therapists who treat DID.

How realistic is Charmaine’s attitude toward Tara? Very realistic. It is quite common for siblings who grew up in the same abusive family to manifest a variety of different styles of coping with their childhoods. Some siblings may also have DID, but, in many cases, siblings cope with the abuse in their childhood via denial (or even frank amnesia) or some other means of distracting themselves from what is taking place around them. When this happens, the siblings tend to have a variety of interrelated adult reactions to their own childhood abuse or their vicarious experience of a sibling’s mistreatment (e.g., chronic avoidance of difficult subjects, difficulty with relationships, substance abuse, sexual promiscuity/addiction, etc.). Thus, Charmaine may not believe that her sister has DID, but subsequent episodes are likely to show that she has symptoms of her own that may ultimately prove to be related to having experienced or witnessed childhood mistreatment.

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Episode 2: Aftermath

Tara resents the messes that her alters leave behind—both the dirty dishes and the emotional havoc. Following Buck and T’s recent actions, Tara returns and convenes a family meeting. She relies on the family to tell her what her alters did while they were ‘out.’ Tara has no memory of their actions; she has amnesia. In contrast to Episode 1, it is now clear that both children are, indeed, discomforted and distressed by Mom’s highly visible alters. Kate is rebellious and angry. Fourteen-year-old Marshall is suddenly wetting the bed. Both are now somewhat ostracized at school—labeled as members of a “weird” family. It is apparent that Kate and Marshall are ashamed of their mother’s behavior and long to interact with their ‘real’ mother. Tara is increasingly tense and dispirited as she sees the impact on the family of her switching and chaotic behavior.

It is now becoming evident that Tara often ‘switches’ to another alter when she is stressed. Max her husband notes that her switching has become more frequent since Tara stopped taking her medication. During this episode, Tara is again stressed and switches to yet another alter—Alice, a 1950s-style, perfect homemaker who claims to be a graduate of Radcliffe. Alice announces, “Tara isn’t equipped to handle this family right now. We’ve reached a consensus and I need to be here now.” Alice’s long-term goal is to take over and be ‘out’ all the time. She is efficient, super-competent, and tries to make everything beautiful and happy, very much like the mother (June Cleaver) in Leave It To Beaver. Alice also has a cruel and sharp side to her. When Kate berates Alice with a sexually-graphic tirade, Alice attempts to jam soap into Kate’s mouth. They nearly come to blows. Max hears the uproar and rushes in to quiet them down. Max subsequently insists to Alice that he will be the one to enforce any discipline. In spite of her outburst, Alice is cheery and confident; she makes a personal photo album for each family member. Kate is visibly sad as she looks longingly at the photos of herself and her mom from happier days.

Commentary:
How realistic is the show’s explanation that T, Buck, and Alice are ‘coming out’ because Tara went off her medication? No medication directly affects whether switching will occur more or less frequently. Many persons with DID do take medication, but their medications are aimed at other coexisting mental disorders or symptoms, such as anxiety and depression. When other mental disorders are controlled with medication, and when the symptoms of anxiety and depression are decreased, a person with DID is often better able to cope with daily life. Stress in one’s life, and/or the stress of having other mental disorders or disruptive symptoms does increase the likelihood of ‘switching’ in DID patients. Accordingly, any medication that reduces stress may reduce the person’s ‘need’ or impulse to ‘go away’ and switch to another alter. Tara and her family are not sophisticated mental health professionals. From their perspectives, reducing the medicine is directly, rather than indirectly, related to the alters coming out more and more.

Do people with DID really have amnesia for what some or all of their alters do and say? This is an extremely important question. In fact, this question requires a comprehensive technical answer because amnesia in DID is neither simple nor straightforward. Let’s begin with the stereotyped view of DID, which portrays the person as having total amnesia for everything that the alters do or say. Some cases of DID are, indeed, like this—apparently including Tara. On the other hand, many DID individuals are not like this. That is, many persons with DID do have some awareness of at least some of what their alters do and say. This means that awareness of what (some) alters say or do should never be considered as proof that the person does not have DID. Moreover, as a person with DID moves toward recovery, the person becomes more and more aware of what alters are doing. In other words, decreasing amnesia is a routine accompaniment and a trustworthy indicator of effective therapy. Yet, despite decreasing amnesia, the person still has DID until the day that he or she ‘integrates’ all of the alters. Finally, to further complicate the matter, individuals with DID often do their best to hide their amnesias and memory lapses from others (because they know very well that their memory problems are abnormal and they don’t want others to think they are weird or crazy).

Alice hopes to completely ‘take over’; she wants to be ‘out’ all the time. Is this possible? No. Alters that want to totally ‘take over’ occasionally seize control for a period of time (usually hours to days, but occasionally for much longer periods), but they never succeed in remaining in control. Once they ‘come out,’ these alters usually begin to tire and rapidly become exhausted. They simply do not have the energy to stay ‘out’ indefinitely (but they are loathe to ever admit this).

How realistic or typical is Tara’s way of dealing with her alters? The most common way that persons with DID deal with their alters is to avoid thinking or talking about them (or the possibility that they exist). In short, most people with DID ‘deal’ with their alters by not dealing with them at all. This is called avoidance and denial. It is helpful for the layperson to understand that both the occurrence of amnesias and the very existence of alters constitute ways of avoiding and denying some extremely uncomfortable truths (i.e., that the person has suffered unacceptable/intolerable events, and that the person now ‘has’ alters). DID is thus a collection of coping strategies that postpone dealing with some profoundly uncomfortable realities.

Unlike many persons with DID, Tara seems to admit that she has DID. Although she continues to have amnesia for her alters’ actions, she is willing to deal with their existence by seeking information about the alters from her family. This is a common pattern of coping in persons with DID, especially once they have been diagnosed with DID. Therapeutically, however, this is a phase of coping that the therapist steadily seeks to reduce as it places undue burdens on the family, especially the children. They are stressed by being repeatedly exposed to the alters. Moreover, the children are even more burdened, and quite inappropriately so, when they become a routine link in how Mom ‘deals’ with her alters. Episode 2 bears witness to the price paid by the children placed in such a situation. No matter how bravely Tara’s son tries to grin and bear it, he is clearly in pain. Similarly, the behavior of Tara’s daughter speaks more loudly than do her words. In this essentially loving family, many well-intentioned efforts and attitudes bring with them all sorts of collateral damage. Far better for Dad to be in this position than the children, without delegating caretaking roles to the children. And better still is the therapeutic future wherein Tara deals directly with her alters and does not routinely interpose family and friends as intermediaries in that process.

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Episode 3: Work

In the beginning of this episode, Tara returns and discovers that Alice has made some provocative sexual overtures to Max. After some uncomfortable sexual discussion, Max begins to make love with Tara, but is unable to become aroused. Tara attends a therapy session with Dr. Ocean, and discusses her sexual concerns. Tara is hired to paint a mural by a friend of her sister, Charmaine. Later, Max sexually approaches Tara again, but she puts him off because she is preparing her plans for the mural. They make a date to have sex the next evening. The next day, when she presents her plan for the mural to the client, Tara discovers that the client knows she suffers DID. She feels betrayed that Charmaine told the client this personal information. Charmaine arrives unexpectedly while Tara is making her business presentation to her client. Tara tries to confront her sister privately, but the client barges into the kitchen, interrupts Tara and Charmaine, and tries to minimize Charmaine’s betrayal by asking Tara, ”Don’t we all have multiple personalities in some way?” She also claims to have been molested. That evening, Max comes home for his planned sexual get-together with Tara, but she is gone. Instead, Buck is ‘out,’ watching a porn DVD. Buck tells Max that Tara couldn’t deal with sex that night. After some discussion, Max and Buck decide which of Buck’s porn DVDs to watch.

Commentary:
Doesn’t everyone have different parts? The answer to this question is yes, and no. We all have different aspects of our personality that we show in different situations (e.g. a work self, a parent self, a friend self, a sexual self, a playful self, etc.). In this way, we all have multiple selves. However, the normality of having multiples selves or states of mind (often called “ego states”) differs significantly from what is found in individuals with DID. In DID, the different selves or states, or alters, take over or intrude abruptly often without the individual having a conscious choice (like Tara, who is overtaken by her alters), and act in ways that the individual as a whole does not control. And as we can see from Tara’s experience, individuals are often completely unaware of what happens when alters are in control. Thus they are experienced by the individual as “not me,” at least to some degree. Alters have their own relatively separate identities; that is, they have different ideas about who they are and what they look like (self-representations). They even have different memories and experiences from each other (e.g., Buck experiences himself as a man and a Vietnam vet, while Alice experiences herself as a sophisticated, organized graduate of Radcliffe who has no children). People without DID experience their ego states as “me”; their ego states are part of a relatively seamless experience of self and memory.

Is Tara ‘crazy?’ Tara is offhandedly characterized as “crazy” by her new client, which raises the question of whether Tara is truly the most dysfunctional adult character in this show. Obviously, DID is strikingly different from how most people exist in the world. However, DID has a purpose (i.e., coping with the intolerable) and persons with DID are not necessarily more maladjusted than others in the world around them. This particular episode of Tara seems to make that point rather clearly. We see that some of her family and acquaintances may be more dysfunctional than she is. For example, Charmaine and her friend have a superficial way of interacting that, at moments, is both ridiculous and amazingly insensitive. Charmaine compares Tara to someone that has “ass cancer.” Max’s ways of interacting with Tara are almost as inconsistent as her alters’ ways of interacting with him. Because he knows it upsets Tara, he refuses to have sex with her alters. However, he then agrees to watch pornography with Buck. Although Max and Tara have this agreement around sex, both are clearly conflicted about it, and we are sensitized to appreciate that even people who do not dissociate must struggle with internal inconsistencies and conflicts.

Is Tara’s sexual behavior typical of someone with DID? In the beginning of the show, Tara and her alters both appear open to sexual encounters with Max. Later, however, Tara becomes so anxious about their planned sexual get-together that she ‘goes away’ and Buck ‘comes out.’ This is not uncommon in DID. Many persons with DID (but not all) avoid sex and are glad have an alter ‘handle’ it for them. Thus, Tara’s openness to sex in Episodes 1 and 2 is more atypical, whereas her avoidance of sex in this episode is more typical. Buck makes it clear to Max that he (Buck) understands that Tara is not ‘up’ for sex that night. Buck’s ‘coming out,’ (as opposed to T or Alice who have both tried to seduce Max) can be seen as Buck ‘protecting’ Tara from the behavior of her sexual (female) alters.

How typical is Tara’s denial of her alters? Tara tells Dr. Ocean that her alters “aren’t me.” At the beginning of therapy, and often for a remarkably long time, many DID clients deny their diagnosis and are resistant to considering their alters to be part of them. As therapy progresses, persons with DID tend to accept some alters as “me,” but continue to insist that certain other alters are ”absolutely not me.” The reasons for this denial are many: shame, avoidance/disowning of painful memories, disowning of alters’ current behavior, and so on. Clients are reluctant to accept their alters because the alters feel the need to do things that are “not like me,” and thus cause shame and embarrassment. Denial also serves to disown certain emotions and reactions to trauma and abuse (as well as the realization that their caretakers or parent-figures were not who the client has tried to believe they were). The long-term goal of therapy is for persons with DID to slowly accept and own their alters and to develop a unified and consistent sense of self and personal history.

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Episode 4: School Spirit

The episode begins with Tara addressing her video diary, saying that she doesn’t believe in God (but Alice does). For Tara, “heaven” is when her love of art and her job come together. Thereafter, Tara discovers her husband, Max, masturbating in the shower. The context for this is Tara’s failure to ‘show up’ for their date for sex in Episode 3 (see above). Kate is hiding a black eye behind dark glasses, the result of her tussle with Alice in Episode 3. Both Kate and Marshall continue along complicated paths involving difficult relationships, Kate in a mutually seductive relationship with her boss at Barnabee’s, and Marshall having a crush on another boy. Max needs help on a landscaping job and talks Marshall into skipping some classes to help him. Marshall loses control of a riding mower and runs it into a bee hive, which sends Max scrambling desperately to find an ‘epi pen’ to stop Marshall (who is profoundly allergic to bee stings) from plunging into a fatal anaphylactic shock. Tara is quite angry with Max about this, and Max shouts back at her that she is not free of mistakes. Tara continues to paint a mural for her new client, Tiffany St. John, Charmaine’s friend and franchise sales coach. Tara tells Tiffany about her marital sex life and her alters. Tiffany tells Tara that the two of them are ‘the same.’ “When I blow Roger,” she says, “I pretend to be Michelle,” a streetwalker in a television show. “That’s the only way I can get through it.” Tara, optimistic about Tiffany’s apparent efforts to relate, tells Dr. Ocean that she may have found a friend.

In a painful scene, Tara talks with Max about her extensive memory problems (i.e., amnesia). She can’t remember whole chunks of her childhood, does not remember her first date with Max, and has no memory of many events in their marital life. She poignantly declares, “I want our sex life back!” Then, in a particularly wrenching scene, (for the viewer as well as Tara), Tara goes out to dinner with Tiffany and Charmaine. Tiffany overenthusiastically talks about Tara’s alters and says, “I want to meet one!” Tiffany reminds Tara that she, too, was molested, although it is said in a dismissive way, as if it means nothing. Charmaine drunkenly expresses extensive and graphic doubts about Tara’s DID, and mocks her claims of sexual abuse, as well as her development of alters. Charmaine rambles on about the many times that she herself has had sex that she didn’t want when she was drunk, but notes that she didn’t develop any alters. Tara stiffly smiles throughout the dinner, saying little. She later tells Max that she did not enjoy dinner. She and Max make love.

The next morning Tara goes to Tiffany’s to work on the mural. Tiffany is in a rage. During the night, the mural had been crudely defaced with red paint that says, “Die yuppie (obscenity).” Tara knows nothing about what happened, but only she had a key to Tiffany’s home. Tiffany throws Tara out and Tara is later served with a restraining order requiring her to stay away from Tiffany. Charmaine shows up, tells Tara that she has been banned from selling the franchise products, and declares, “You always ruin everything!” Tara is stricken, but comes to life when she and Charmaine mock Tiffany’s bowl of stones engraved with trite affirmations (e.g., “Believe”). At Tara’s repeated urging, the two sisters play a childhood patty cake game from their childhood.

Commentary:
How realistic are the events of this episode? We have phrased this question broadly (instead of focusing narrowly on the shocking defacing of the mural) because this episode provides what is too often missing in accounts of ‘crazy’ DID behavior—the interpersonal ‘reasons’ for that behavior. After 4 episodes of this show, it is increasingly clear that although she suffers from DID, Tara is a genuinely good-hearted woman who loves her family. She treats others well and does her best to be a good wife, sexual partner, mother, and commercial artist. But she has at least two ongoing sets of difficulties in her life, only one of which centers on the actions of her alters. Her second set of difficulties results from the behavior of those around her. Max loves her, but four episodes have shown him to be sporadically undependable as a spouse and a co-parent. In particular, this episode displays Tiffany’s repeated comments about Tara’s alters and her excitement about them (“I want to meet one!”). The dinner with Tiffany and Charmaine turns into a profoundly selfish and insensitive ‘ambush’ of Tara by Tiffany and Charmaine, which is a more overt and concentrated expression of the disrespect that both have shown her in the previous episodes.

The most shocking incident in Episode 4 is not the defacing of the mural; it is Charmaine’s drunken, sarcastic, and stunningly dismissive rant about the unbelievability of Tara’s sexual abuse and DID. Probably to the viewer’s surprise, Tara deals with this intensely unpleasant situation by exhibiting a forced smile and not switching to another alter. She avoids any confrontation in the situation. Given a little understanding of DID, however, the ensuing destruction of Tiffany’s mural ‘makes sense.’ The original purpose of Tara’s alters is to protect her from abuse—and there is little doubt about the abusiveness of the dinner ‘ambush.’ Because Tara did not defend herself during dinner, an alter takes action and retaliates against Tiffany. On the other hand, in light of Charmaine’s harsh words during dinner, it is notable that Tara does not confront Charmaine. Instead, Tara makes a sustained effort to restore their sisterly relationship. This is both loving and revealing; it reveals that Tara’s ability to stand up for herself remains limited, and her desperate need for family and connection prevents her from being angry at Charmaine. Tara is less invested in Tiffany, and is very vulnerable in her wish to have a friend, so Tiffany makes the easier target. She may also be protecting herself against being eventually rejected by Tiffany.

Once again, in this series we see that one need not have DID in order to struggle with conflicting perspectives and behave very differently over a very short period of time. Charmaine clearly demonstrates both an affectionate closeness and a hostile, depreciating, and rejecting anger toward her sister.

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Episode 5: Revolution

Max and Tara have an appointment with Dr. Ocean to try to understand if and/or why one of Tara’s alters defaced the mural she had been painting for Tiffany (see Episode 4 above). Dr. Ocean suggests that an alter may have been jealous of Tara’s friendship with Tiffany and wanted to interfere. Meanwhile, Kate and Marshall watch Tara’s video diary, hoping to find clues about ‘who’ (which alter) defaced the mural. In one entry, Buck hints that people don’t really know him and boasts that they “are going to talk about this for a long time.” Tara tells Max that she sometimes senses that information about her alters is true, even though she doesn’t remember what happened. She says she doesn’t think she (i.e. her alters) ruined the mural. She is hurt that Max does not believe her.

Immediately after the therapy session, Tara switches to T. T takes off in Tara’s car, preventing Tara from attending a mock trial at Marshall’s school, in which he has a prominent role. When Max shows up at the school without Tara, Marshall tells him to go and find her instead of staying for his performance. Max and Charmaine set out to find T. While they are driving, Max asks about a roommate Tara had in boarding school around the time of some sort of traumatic incident, which has not yet been revealed. Charmaine remembers the roommate as a tall girl, and gives Max part of her name. She mentions that while Tara was sent away to boarding school, she (Charmaine) remained in public school, but doesn’t know why. [From episode to episode, viewers are getting small hints about Tara’s history that may explain why she has DID.]

Eventually Max and Charmaine find T at one of her favorites haunts (a video arcade where teens hang out) in a town 150 miles away. T dances provocatively in front of an audience in the arcade. Max clearly enjoys T’s behavior and appears to join in the fun, but his real agenda is to get more information about the mural incident. He calls Marshall and says he is staying overnight with T and will be home the next day. T begins flirting with and kissing a younger man (she says she is 16), but Max interrupts and tries to stop her. Finally, he literally picks her up over his shoulder and carries her away, telling the man that he is her father (since T refuses to acknowledge that Max is her husband). When they get to their hotel room, Max presses T to admit that she defaced the mural. She says she can’t tell him what happened, and then says she will, if he has sex with her. When Max readily agrees to have sex, she becomes uncomfortable, asking if the contract with Tara has changed. Max continues to angrily confront T with ruining Tara’s opportunity for work and to have a friend, but he does not have sex with her. T insists she didn’t do it and Max believes her.

In the meantime, Charmaine has discovered that Marshall and Kate are having a big house-party in their parents’ absence, primarily because Marshall wants to invite Jason, the boy on whom he has a crush. During the party, Kate drives off with Gene, her strange boss who seems infatuated with her. Jason comes to the party with a girl, which devastates Marshall. Nevertheless, Marshall works up the courage to broach the subject of whether Jason is interested in him, but just then T walks in and immediately (and very rudely) asks Jason if he is gay. This humiliates Marshall. Afterward, Marshall erupts at T, telling her that she is irresponsible, that she ruined his mom’s mural, and that she has made both his parents miss numerous school functions. He shouts, “I want my real mother and only her, and none of you other freaks!” T blows him off, denying she is Marshall’s mother. Marshall asks her in anguish, “Then why are you in my mother?” T responds flippantly that she doesn’t know. Max informs Marshall that T did not deface the mural. Later, T awkwardly apologizes to Marshall.

While Dr. Ocean is trying to help Tara and Max sort out why an alter felt the need to destroy the mural, she notes that it has been helpful for the alters to come out and express themselves, saying “this is what we wanted.”

Commentary:
How important is it for alters to ‘come out’ in everyday life? Initially, it has been helpful for Tara and her family to begin to know the alters by having them come out, but now their behaviors may be taking a destructive turn. It is true that it is important to understand and know previously hidden alters. In fact, all of us (not just individuals with DID) do best when we understand and accept all aspects of our selves (i.e., feelings, experiences, memories, etc.). However, an actual therapist would never encourage or condone destructive behaviors as a necessary part of therapy. Alters can certainly be out and understood without behaving in ways that disrupt or destroy the patient’s life. The individual may be encouraged in any number of ways to develop communication, cooperation, and caring among alters. Note, however, that the person can do this without ‘switches’ that interfere with daily life. Nevertheless, unhelpful switches are common, and are often not very controllable in the beginning stages of treatment, and often continue for a prolonged period of time. Therapy should help the individual to gradually gain control over impulses to enact disruptive behaviors, no matter which alters are engaging in unacceptable actions.

Tara switched to T after a therapy session when she realized that Max is convinced that she (Tara and/or her alters) defaced the mural. Why does Tara switch at that moment? Why does she switch to T instead of a different alter? As a total human being, Tara protects herself from major stress by switching. Tara is in a very serious predicament: the destruction of the mural has ruined a chance to work and be creative, lost her a friend, created distrust with Max, upset her sister and children, and humiliated her. It is dawning on Tara that she is out of control, and sometimes in very destructive ways. Tara and everyone else in the family is experiencing a variety of confusing emotions, but no one know knows how to deal with them.

Tara probably switches to T because T’s style of ‘coping’ is to avoid thinking about or dealing with problems by engaging in frantic play, doing drugs, and pursuing sexual preoccupations. T literally runs away to her favorite place: an arcade, where lots of people come to escape reality for a while. T seems to be protective of some important, highly vulnerable information. She says she can’t tell Max about what happened to the mural, and then quickly tries to seduce Max to change the subject. We see a moment of vulnerability and confusion in T when Max agrees to have sex with her. As much as it appears that she wants to seduce him, when it comes down to it, she doesn’t really want that, and is relying on Tara’s contract with Max.

As we witness this interaction, it’s not completely clear what T is protecting. However, T may be serving a common function of some alters: to distract and avoid having Tara or anyone else get close to intolerable traumatic experiences or painful emotion. This task is often taken on by alters that act out in destructive ways. By being “bad,” they provoke chaos, anger, criticism and punishment from others, so that hidden and genuine emotions and experiences won’t have to come to the surface. This behavior is not limited to individuals with DID; it also occurs in “integrated” individuals. For example, we see Kate acting out as the “bad” child in order to avoid her own pain. In the end, T creates more havoc in Tara’s life and with her family by trying to hook up with a strange man, hurting Marshall by not showing up at his school functions, and then utterly humiliating him in front of his male crush. This situation highlights a major and painful reality of living with DID: alters are developed to reduce stress, but end up creating more stress as they continue to handle problems in their own dysfunctional ways.

An additional psychological mechanism often underlies the acting out of persons with DID. Many persons with DID were repeatedly betrayed by an abusive parent or caretaker. This abusive betrayal is so intolerable that the child tries to convince herself that the mistreatment was ‘deserved’ because she was ‘bad.’ She ‘proves’ this to herself repeatedly by acting out and being bad. This allows her to continue to tell herself that she is the bad one—not her parent or caretaker. Thus, by being ‘bad,’ she can avoid grieving that she was terribly hurt by people who were supposed to love her.

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Episode 6: Transition

Episode 6 begins with Buck making an entry into the video diary, explaining and acting out how he survived in Vietnam. Buck executes some pseudo-martial arts moves and punches. Max is told by his neighbor that Tara is asleep in his backyard. He goes over to find her (in the form of Buck) passed out on a lawn chair. It is Tara herself that wakes up, not understanding how she got an injury on her hand (which she got when Buck punched the camera). Max tells Tara that Buck was at the Chiefs’ football game, went to the bathroom after a fireworks display, and never came back to where he was sitting. [By implication, Buck became caught up in some PTSD-related symptoms when triggered by the fireworks.]

We see Tara’s parents for the first time when they come to visit for Charmaine’s birthday. Their arrival sets off a series of dysfunctional and troubling interactions. The parents are critical of each other, and immediately critical of both Tara and Charmaine (Tara, for not having a new couch and Charmaine for being thin and causing Tara so much trouble in preparing for her party). They show differential attention to Tara and are dismissive of Charmaine. Alternatively, they are overly pleasant at moments, acting as if they are two happy parents enjoying food and games. During a brief outing, Tara’s father tells Max he thinks that the children should come live with them. Angered, Max accuses Tara’s father of not watching after his own children (Tara and Charmaine). Max doesn’t tell Tara, knowing it will upset her. Tara’s mother makes reference to Tara “depriving” the children, and suggests that the children should come live with them. Tara is upset by this and doesn’t understand why her mother wants to take the kids. When her father makes reference to Buck’s behavior, Tara learns that Charmaine has told her parents about the problems the alters have caused recently. Tara becomes upset with both Charmaine for her betrayal, and Max for not telling her what her father said earlier. The crisis comes to a head when Charmaine erupts at the entire family for being “overlooked” for many years. She laments her declining dating life, which she attributes to her botched “boob job.” At this point she exposes her malformed breasts to the group. Tara leaves the room and is coaxed upstairs by Max, where they laugh together about the outrageous nature of the situation.

The visit by Tara’s parents is extremely stressful for all the characters, and they attempt to cope in different ways. Max initially discourages Tara from taking Xanax (which she decides not to do), but he ends up taking it himself because he is frustrated with Tara’s father. Marshall tries to appease everyone, especially Charmaine, by making her a thoughtful birthday present with a photo of them on a trip together. Max forces Kate to hang out with her grandparents. Kate “smarts off,” briefly socializes after Max confronts her, and is encouraged to leave before she gets nasty again. She goes to her boss’s house to escape the situation. Kate ends up making out with Gene (her weird boss), and possibly having intercourse with him. After erupting at the family, Charmaine goes to Neil’s home. (Neil is a coworker and friend of Max’s with whom Charmaine was intimate a year ago). Tara is determined not to switch to another alter; she is fairly quiet and non-confrontational (as she was at dinner with Tiffany and Charmaine in Episode 4). Max helps to keep her from switching by running around in the yard with her and by laughing with her upstairs. However, it is implied that Tara (perhaps in an alter) acts out her anger by making it appear that her father has wet the bed. Even though Max knows this, he sarcastically tells Tara’s father that he is sorry about his problem with bedwetting. The parents leave to everyone’s relief. Tara sighs that she “made it” through their visit.

Commentary:
What dysfunctional patterns of interaction do we see in Tara’s family of origin? We’ve only seen a small sample of interactions between Tara’s parents and the other characters at this point, but some notable dysfunctional family dynamics become apparent. Tara’s mother and father oscillate between being nice and placating and being critical and harsh. We don’t know yet if Tara’s parents were like this when she was a small child, but this kind of inconsistency is certainly problematic for a child’s development. Children who are very young are dependent on their attachment with their parents for stability and the formation of their own personality. Experiencing such conflicting patterns of behavior from one’s parents can be confusing and distressing to a child.

Another apparent dysfunctional family dynamic is discomfort with a direct expression of anger towards the parents. Max implicitly voices what Tara cannot allow herself to say directly. Charmaine, although her outburst is at the whole family, seems to direct her anger more towards Marshall, who was actually attempting to be kind to Charmaine. She shifts quickly to blaming her ex-boyfriend who pushed her toward the botched “boob job,” and away from her parents. Tara never expresses anger directly towards her family; instead, she acts out by making it look like her father wet the bed.

Still another dynamic is the conflicted favoritism shown to Tara by her parents. She is clearly both favored and praised, but also depreciated and undermined. Charmaine is rightfully jealous of being relatively neglected. We are unaware at this point in the show if there was a downside to Tara’s “specialness” (e.g. sexual abuse), but if there was, Charmaine clearly doesn’t know about it.

Given the stress of having her parents in her home, why doesn’t Tara switch? Previous episodes have correctly shown that Tara tends to switch when she is under stress. In this episode, Tara tries very hard to stay present and not “transition” to another alter; she fears that Alice will come out and try to do everything perfectly. Why doesn’t Tara switch? There are two different explanations for this. On the one hand, (as was the case during Episode 4’s highly stressful dinner with Charmaine and Tiffany), it is self- protective for Tara to remain “herself” and not give her parents any more reasons to criticize her. If Tara were to switch and be more assertive and/or provocative, her problematic relationship with her parents might be worsened. From this perspective, we might conclude that Tara’s need to preserve her relationship with her parents is more important than defending herself.

Max also does his best to prevent Tara from switching. Although Tara is mostly quiet, she and Max are a united front against the crazy parents. Max steadfastly supports Tara; he interrupts many of her parents’ dismissive and critical stances toward her, stands up to Tara’s father, and does his best to make Tara feel loved and supported. Max takes Tara outside and helps her to dash around the back yard, both of them being silly and giddy. Max says he doesn’t know why he is doing this, but the viewer understands that he is helping her blow off steam, laugh at the craziness of it all, and is reaffirming their bond against ‘the loonies’ that have invaded their home. All of this is a sustained declaration of his love for her and their ability to stand together against her parents’ outrageous behavior. Together they triumph; Tara’s parents never see her switch.

On the other hand, it seems possible that Tara did switch, at least twice, and that Tara doesn’t know it and neither do her parents. Max discovered a hooded figure in a red poncho crouched over her sleeping father’s groin. It could be that Tara never switched to T, Buck, or Alice because a part of her was coming out at night and acting out by soaking her parents bed. As with Tiffany’s defaced mural, the mystery is now, “Who did that?”

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Episode 7: Alterations

The theme of the episode is authenticity and identity, being one’s self vs. not being oneself, or presenting one’s self as a false self. Tara says to her video diary, “A lot of people just want to be rescued from themselves. They wish they could be airlifted from their skin and dropped into someone else’s. Me, I just wish I could stay the same for a whole week.” In contrast to Tara’s often heart-breaking pursuit of continuity and stability, her sister Charmaine hopes to effect dramatic changes in herself by having “corrective surgery” on her disfigured breasts. Tara agrees to be her postsurgery “boobie buddy.” Max drives Charmaine to the hospital. En route, Charmaine again denies the reality of DID: “It’s not a disorder; it’s a weakness. She does it to herself.” She calls herself the best sister in the world for trying to help Tara face reality as she (Charmaine) sees it. Later, to Charmaine’s dismay, Buck, not Tara, is at her side when she awakens after surgery. Buck takes Charmaine home. At first, Buck refuses to soften his quasi-obnoxious, macho persona. He turns his back on Charmaine to watch extreme fighting on TV, cleans a large revolver, and denies that Marshall is “his son,” proclaiming that if Marshall were his son, he would be a real “pussy hound.” As Charmaine berates Tara, Buck says, with crude but telling sympathy, “That lady’s got problems. The rest of us got to hold it down as long as we can.” Finally, Buck agrees to wash Charmaine’s hair while Charmaine sits in the tub (which Tara used to do for her). Charmaine recalls that the two of them used to play a beauty shop game outside when they were kids and that one time they got in trouble for their use of the hose. For the first time, Charmaine witnesses Tara switch. Buck transitions to Tara, who is instantly disgusted by the taste of cigarettes in her mouth. Tara clearly has no recall of what had happened while Buck was out. Tara asks apprehensively if Buck was “horrible.” “No,” says Charmaine, “He was a pretty good boobie buddy.”

Marshall consults his ‘wise,’ older sister about his crush on Jason. He tells her, “Jason’s ignoring me.” Kate reflexively says to “ignore him right back.” After further such coaching by Kate, Marshall ‘plays hard to get’ and successfully attracts a phone call from Jason. When Marshall bemoans the apparent need for game-playing and misrepresenting his true feelings, Kate tells Marshall, “Don’t ever be yourself; it’s the kiss of death.”

Meanwhile, Max is making secret efforts to understand his wife. After Dr. Ocean refuses to answer his repeated phone calls, Max rushes into her office between appointments and tells her that there is “a new alter.” “It wasn’t Tara,” he insists, it was “a weird poncho goblin, like an animal.” Dr. Ocean indirectly reveals an important fact that has only been peripherally apparent until now—she is quite inexperienced with regard to treating DID. Max is startled when she says, “I’ve really been educating myself a lot about this stuff lately.” She then naively reassures Max that “whimsical” child parts may be active at night. Max will have none of it. “Tinkerbell is whimsical” he says, “This little f***er pisses on people!” Nevertheless, Max succumbs to his wish to be reassured when Dr. Ocean asks him to come to Tara’s next therapy session, and says that he trusts her. Dr. Ocean closes by saying, “I think having a professional and a loved one working together in tandem can be very productive.” That night, while Tara is sleeping over at Charmaine’s, Max meets with Heidi Sawyer, Tara’s boarding school roommate. Heidi tells Max that she thinks her former boyfriend (Trip Johanssen) raped Tara. This idea is a belated realization for Heidi. At the time, she had heard from her friends that Tara slept with Trip, but both Trip and Tara denied it. Heidi never spoke to Tara again. Since then, however, Heidi has realized that rape is a better explanation of what she remembers from that night, given that Tara came home that night looking like she had been “knocked around,” and had no memory of what had happened.

The next morning, Tara comes home to shower and change. She listens attentively to each family member as they catch her up on what they did the day before. Max claims that he got together with a friend and went to the gym. Tara tells Max about Buck and Charmaine, but she does not tell Kate or Marshall: “I never lied to the kids about a transition before. I told Max though; I know he’d never keep anything from me.” Max remains silent about the “poncho goblin,” his visit to Dr. Ocean, and his investigations into Heidi Sawyer and Trip Johanssen.

Commentary:
Do therapists with little or no previous experience with DID attempt the treatment of a person with DID? Because few therapists have the requisite training and experience to treat DID, it is extremely common for persons with DID to be treated by a ‘rookie’ DID therapist. Although this is often a necessity (due to the small number of experienced DID therapists), this is far from an optimum treatment situation. In fact, professional organizations routinely urge that therapists seek immediate consultation and get training as soon as reasonably possible if they undertake the treatment of a case that is outside their area of expertise. In the absence of such immediate consultation and training, it is recommended that the therapist transfer the case to a therapist who is competent to treat that particular disorder. Thus, as a ‘rookie’ DID therapist, Dr. Ocean should have immediately obtained consultation about DID and sought out training with regard to treating the disorder. There is a strong possibility that no matter how well intentioned and intelligent Dr. Ocean is, her lack of knowledge about DID will lead to misunderstandings, missteps, and misadventures in the therapy. As usually occurs in these situations, Dr. Ocean clearly cares about Tara and has formed a strong and supportive therapeutic relationship with Tara (and Max). However, Dr. Ocean’s lack of training about DID may seriously hinder Tara’s therapeutic progress.

How common is the behavior of Tara’s husband—that is, investigating what is going on with the alters and what really happened in the past? The partner of a person with DID inevitably has strong urges to try to discover what happened in his loved one’s childhood and to learn what is going on with the alters in the here and now. That said, it is far better for these urges to be resisted and, perhaps, discussed with the partner’s therapist. Such ‘investigations’ can easily generate unexpected and unfortunate consequences. Additionally, when these investigations are conducted in secret, they involve deception that inevitably undermines the marital relationship. The secrets of a person with DID (usually hidden away in alters) protect him or her from intolerable and painful information. The disclosure or unearthing of those secrets is always inherently destabilizing for the patient—sometimes disastrously so. DID patients often suffer so much guilt and shame about what has befallen them that they react to the outing of their secrets in self-destructive ways, including self-injury and suicide attempts. For these reasons, it is best that the patient’s family members not try to ‘dig up’ the patient’s secrets.

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Episode 8: Abundance

Several characters deal with soaring anxiety. Max is anxious and agitated about “the new alter.” Over the weekend, he besieges Dr. Ocean with phone messages asking for an expedited therapy session with him and Tara. In one message, Max promises Dr. Ocean not to tell Tara about the new alter—and then promptly does so a few minutes later when Tara asks what is bothering him. Tara is very distressed to hear that she has a “new alter.” She becomes even more upset when she realizes that Max and Dr. Ocean have talked about this behind her back (see Episode 7 above). She insists that Max tell her everything. Max tells her that the new alter is different from the others. “It’s animalistic, pure id [Freud’s term for the part of the unconscious mind that is motivated purely by basic urges and instincts], I guess.” Tara is horrified, “You’re making me sound like an evil rabid squirrel!” Unable to contain his anxiety, Max bluntly tell Tara, “Yeah, well it’s kind of like that—but the size of you.” Tara rushes to the bathroom, vomits in the toilet, and immediately switches to Alice.

Shortly thereafter, Alice dramatically enters the kitchen and tells the family, “Somebody’s got puppies in the oven! I…am with child!” After the kids leave for school, Max confidently tells Alice that she can’t be pregnant because Tara has an IUD. Alice says she doesn’t believe in IUDs and that God helped her get pregnant. Later, Charmaine monitors Alice while she takes a home pregnancy test. Alice promptly interprets the negative result (i.e., unchanged pink screen; no plus sign) as evidence that she is going to have a girl.

Alice and Charmaine comfortably hang out together while Alice paints. Alice comments that she wishes Tara had taught her to paint (indicating there may be communications among the alters about which we have no knowledge). Kate comes in, announcing that she has just been fired from her job. Kate had confronted her boss about his making sexually-charged comments to her in front of the entire wait staff of Barnaby’s. Kate told her boss that his generation is “too serious,” that his text message about her Latin test was “funky,” and that they should end their relationship—whereupon he fired her. Unfazed when Kate tells her about it, Alice asks Kate when she last had her hair done. Alice then takes over as hair dresser and cosmetician for Kate and Charmaine. She refers to Charmaine by various endearing nicknames (e.g., “Trixie,” “Baby Bird”). Alice teaches Kate about men’s underlying emotionality and neediness. “Never humiliate them,” she says. Instead, women “should use vocal tones that are a half-note higher” because that “makes men feel safer and stronger.” Later, Kate follows Alice’s advice and convinces her boss to give her back her job.

Alice and Max go to therapy together. This is the first time in eight episodes that an alter other than Tara has come to therapy. Alice is unrelentingly upbeat. Dr. Ocean is friendly, but is beginning to seem more and more ineffectual. After the therapy session, Max asks Alice to wait in the hall and he charges back into the therapy room and declaims angrily, “Nothing got done today. Nothing!” Dr. Ocean replies with equal irritability, “You told her about the new alter and she transitioned immediately. She’s afraid there’s no way you could love something that far out.” Max explodes, “She’s got that f***ing right!” Dr. Ocean tells Max that Tara’s insecurity about him has caused Alice to become pregnant. “Alice made a baby to keep you.” Alice comes back in, retrieves Max, and they leave. Dr. Ocean collapses into her chair, muttering: “S**t!”

Alice and Max attend the evangelical Hell House performance (which includes Marshall as one of the “homos”). Max gets into an argument with Alice. She tells him that he has been “relentless” with his pursuit of information about Tara and her alters: “You’ve gone and brought Gimme out!” Max asks who Gimme is, and Alice says, “You don’t know. You have no idea what you’re playing with.” That night, Max awakens and finds Alice sobbing on the bathroom floor. Her period has come and Alice is devastated because she thinks she has had a miscarriage. Max holds her, saying “I love you, Alice.”

Commentary:
In earlier episodes, Charmaine was rejecting and contemptuous toward her sister’s diagnosis of DID. Why does she now seem to be so accepting of Alice? This is an important point. When skeptics or rejectors of the diagnosis of DID are recurrently exposed to DID phenomena, they often mellow (admittedly, some skeptics remain unyielding in their rejection of the diagnosis—and are too often contemptuous and even abusive toward persons with DID). Here, however, we see a more benign outcome. The origins of Charmaine’s mellowing outlook were evident in the preceding episode (see Episode 7 above) when Buck took on the role of “boobie buddy” after Charmaine’s breast surgery. Initially, Charmaine and Buck’s interactions were bumpy and difficult, but they increasingly got along together, with Buck becoming less reactive to Charmaine’s skepticism, and Charmaine, in turn, becoming a bit less skeptical of DID. Buck even nurtured Charmaine by washing her hair (just like Tara used to do). During that event, Charmaine witnesses, for the first time, a highly visible switch from Buck to Tara. Now, in Episode 8, Charmaine and Alice interact comfortably for several hours. Several things appear to be happening. First, Charmaine’s anxiety about DID appears to be decreasing. Second, she finds herself less and less able (and, perhaps, less and less wanting) to deny the reality of Tara’s DID. Third, Charmaine (and Kate) are exposed to an alter’s positive aspects. Alice is quite loving and helpful to both of them. We might even say that the three of them are bonding.

Why does Alice develop a fantasized pregnancy? What is going on here? The heart of the matter is that DID is a collection of strategies for denying and avoiding extremely uncomfortable realities and providing alternatives that are more tolerable, at least for the moment. Fantasy is a major DID coping strategy; alters are each built upon a greater or lesser degree of fantasy. The basic fantasy that underlies alters is that “terrible things did not happen to me.” We also know that Alice believes she went to Radcliffe. Buck believes he is a Vietnam veteran. T believes she is 16. Earlier episodes have shown that switching often serves to avoid anxiety. Here, Alice becomes ‘pregnant’ when Max is dumping his anxiety about Gimmee on Tara—leaving to feel like “an evil, rabid squirrel.” Dr. Ocean tells Max that, “Alice made a baby to keep you.” This is a reasonable interpretation given the vehemence of Max’s reactions to Gimmee (and the danger that Max might reject Tara). Aside from her fantasized pregnancy, however, it is notable that Alice is helpful and very loving toward Charmaine and Kate. Thus, amidst the apparent ‘weirdness’ of DID, positive things are happening—Alice is nurturing both Charmaine and Kate. Alice’s healthy interpersonal behavior can be contrasted with that of Max and Dr. Ocean—both of whom, like Tara and Alice, are dealing with their own anxieties about Gimmee. Max dumps his anxiety on Tara and Dr. Ocean. Dr. Ocean, in turn, avoids dealing with the issue of “the new alter,” and then tears into Max when he berates her (“Nothing got done today! Nothing!”) for avoiding the matter. After one more blast of anger and anxiety from Max (about his not being able to love someone as extreme as Gimmee), Dr. Ocean deals with her own anxiety and discomfort by rejecting Max (i.e., she tells him that he needs his own therapist). It seems clear that Dr. Ocean’s anxiety and discomfort are rooted in her shame over her therapeutic inadequacies, failures, and her continuing uncertainty about what to do in her treatment of Tara. We are left to wonder whether all this may foreshadow some disruption in her work with Tara.

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Episode 9: Possibility

In a therapy session, Dr. Ocean discusses “Gimmee,” the “new alter” with Tara and Max. Tara is upset that Max and Dr. Ocean have been speaking without her knowledge; she feels betrayed and “sold out.” Dr. Ocean suggests that “Gimmee” may serve to keep painful truths away from Tara. Max suddenly blurts out that he has discovered the name of the boy who is thought to have raped Tara when she was at boarding school. Tara becomes angry and storms out of her therapy session saying, “I can’t deal with this.” Dr. Ocean is left talking to herself (and probably feeling inept). On the street, Tara explains to Max that her secrets must be hidden from her for a reason. She tells Max that he needs to stop being John Wayne; i.e., the brave “cowboy” who rides into town and brings law and order. “I am not your town,” Tara protests.

Kate again fakes illness to get out of work and confides in Tara, “I wish I could get away like you do.” Tara, completely fed up, resonates with Kate and proposes that she and Kate leave town for a girls’ “get-away.” En route, Tara tells Kate that she drives “like an old lady” and Kate reminisces about learning to drive. Tara says, “I took you out driving,” but Kate corrects her, “No, Buck took me out driving. Remember?” Tara begins to share her marital concerns with Kate; Kate says, “Let’s not stress!” and proposes that they check into a close-by hotel and spa. Upon their arrival, Kate notices a tattoo parlor on the premises, and proposes she be allowed to “get a tattoo in honor of girls’ night.” “Absolutely not!” says Tara, “You’re 15.” Meanwhile, back at home, Marshall and Charmaine are chatting. Charmaine is trying to be appropriate but characteristically slips into overdisclosing her sexual behavior. 

At the spa, Tara and Kate crash a party for Pharmaceutical reps. They meet two men and are momentarily intoxicated by the male attention. Tara soon realizes that Kate has disappeared, and goes searching for her. She finds Kate making out with an older guy in a hot tub. Kate rapidly pulls Tara away from the hot tub. When the two women are alone, Tara quietly and appropriately confronts her daughter: “What are you doing? You don’t even like this guy.”  Kate becomes angry and accuses her mother of similar indiscretions: “You do the same thing all the time. Charmaine told me that you were all over this skinhead at the Sugar Shack.” Subdued, Tara replies, “That was T.” Kate confronts her immediately: “Mom, I hate to break it to you. The same person that is here right now is the same person that was at that Sugar Shack.” Kate then runs back to her pharmaceutical rep in the hot tub. Tara wilts, and there is an immediate switch. T comes out and changes into a swimsuit, jumps into the hot tub between Kate and the man, puts her arm around the man, and starts flirting with him.  Kate is upset, and T leaves quickly.  Kate’s upset soon transforms into concern. She goes looking for T and finds her in the tattoo parlor, about to have the word “SLUT” tattooed on her hip. Knowing that her mother would be mortified by this tattoo, Kate tries to intervene. As her intensity and concern escalate, Kate says, “Hey, that’s Mom’s body, Mom’s blood, Mom’s teeth, Mom’s hair… That’s Mom’s DNA. You’re a visitor and you know it.” The moment the tattoo artist begins, Tara “comes to,” saying “Owww!” Kate quickly sees she is no longer dealing with “T”, and asks, “Mommy?” In the end, mother and daughter get matching tattoos on their hips. They return to their hotel room where they watch movies in bed and bond. Tara reveals that Kate’s father has a tattoo, too, but won’t say where it is.  

Meanwhile, Max continues to dig for information about Trip Johanssen (whom he was told raped Tara while she was at boarding school). At the Johanssen offices, Max meets Trip’s brother, who informs him that Trip works in the companys Chicago office. Max repeatedly tries to call Tara (who does not answer) and eventually leaves her a voicemail, saying that he is sorry and that he will stop digging for information. 

The relationship between Marshall and Jason continues to develop. Marshall is becoming increasingly obsessed with his appearance and naively begins a workout regimen (e.g., push ups, running). Charmaine and Marshall discuss this pursuit briefly as Charmaine comes over to borrow a shirt from Tara’s closet for her big date. Later, Jason comes over; he and Marshall drink liquor together and watch a movie on Marshall’s bed. Noticing the pirate ship that Tara has painted on Marshall’s ceiling, Jason marvels about how Marshall’s mother is “there” for him (unlike his own “terrible mother”). Jason falls asleep and Marshall kisses him; Jason wakes up and reciprocates. Jason leaves later. The viewer is left unsure as to what happened between the boys, but when Max comes home, Marshall is quiet, dreamy, and given to little smiles. Max empathizes with him, saying, “You’ve got it bad… There’s nothing like love.” 

Overall, the episode shows an increasing level of compassion between the characters: Max understands Tara’s desire for him to leave her secrets alone. Kate seems to understand Tara’s disorder with increasing sensitivity. Max clearly empathizes with Marshall’s lovesick state. The only character who does not exhibit genuine compassion is Gene (Kate’s creepy boss), who delivers food for Kate (who is supposedly sick) and steals a picture of Kate from the family’s refrigerator. We are unclear what this means, but his actions suggest that his boundaries are poor, he is preoccupied with his own gratification, his judgment is clouded by his obsession with Kate, and he is “up to no good.”

Commentary:
In this episode, Kate and Tara have two poignant confrontations.  In their argument at the hot tub, Kate confronts her mother about T’s behavior at the Sugar Shack as coming from “the same body that is here right now” (i.e., “Mom’s body”).  Later, Kate becomes upset after Tara walks away and goes to find her.  She discovers that her mother (as T) is about to have the word “SLUT” tattooed on her hip.  She protests to T and tries to call out Tara.  What is the significance of the comments/interventions that Kate makes in these two incidents?  In both, Kate is sending the message to her mother that what she does in other alters is the “same person”, and that what her alters do to the body is being done to her mother’s body. Over these two episodes Kate is growing up a little (maybe a lot), and moving from self-absorbed pseudo-sophistication to a more compassionate and caring stance toward her mother.

Kate appears to be moving from almost total self-centeredness (similar to T’s superficiality and manipulativeness) to a more mature stance that is modeled on Tara when she is functioning at her best. Kate becomes increasingly aware of both Ts and her own self-destructiveness and leaves her irresponsible momentary fling in order to track down her mother. This is an impressive maturational leap for someone who recently has been giving advice to Marshall on how to be successfully fake, and who had assimilated Alices recommendations about manipulating others, but could barely take a step on her own behalf without shooting herself in the foot. In a period of minutes, Kate breaks out of her usual ‘false self’ adaptation to become a risk-taking and intimate ‘true self’ who reaches out to her mother.
           
Kate begins to step up to the plate at the hot tub when she calls her mother out, insisting that the person who is with her at the spa now (i.e., Tara) is the same person who was at the Sugar Shack making out with the skinhead (i.e., T).  She is essentially saying, “You are ultimately responsible for the behavior of your alters” (in this case, T.). On the other hand, Kate’s hot-tub confrontation of her mother is also a manipulative adolescent counterattack to end her mother’s loving, correct, and quite well-delivered confrontation of Kate’s inappropriate behavior. Note that upon delivering her counterattack, Kate wheels away from her mother and returns to her inappropriate behavior (i.e., she climbs back into the hot tub with her older man). One is left to wonder just who it is that is not taking responsibility for her own behavior in this instance, Tara or Kate or both?

In the later incident at the tattoo parlor, Kate tells T (who is grandiosely flaunting her “SLUT” tattoo template), “you are tattooing mother’s body.” Clearly, Kate recognizes something more fully than either T or Tara can grasp, that there is only one body here. Kate is clearly demonstrating a growing sophistication in her understanding of her mother’s DID. Although she does not acknowledge that Tara’s body is also T’s body, her words are undoubtedly impactful. Kate has sent an important message to Tara: T resides in the body of her mother. Kate is the first person to take the stance toward Tara which contemporary therapists find most effective: compassionate confrontation of the DID patient with an often unwelcome fact: what the alters do affects the person as a whole, or, as therapists often insist, “You are all in this together.”

Urging Tara to accept responsibility for her alters and their behavior is good therapy, an intervention which should be administered repeatedly by Dr. Ocean, rather than by Kate. Why isn’t Dr. Ocean making this type of intervention? Although Dr. Ocean’s interpretations about the different functions of the alters’ behavior have merit, we continue to see that Dr. Ocean is somewhat disoriented in her approach to Tara and her mental disorder. Dr. Ocean lacks training and expertise in working with DID. She is seeing Tara without having learned how to treat DID, which is considered ethically questionable by many mental health professions. Dr. Ocean has made no direct interventions that ‘tell’ Tara she is just one person (who is responsible for the behavior of ALL of her).  In any successful therapy of DID, the therapist communicates (to whichever alter or alters are currently ‘out’ and/or listening ‘from inside’) that all aspects of the person belong to each and every alter. An effective DID therapist teaches the client to develop a respectful awareness of what other alters are thinking and feeling. One essential therapeutic goal is to promote increased communication among all of the alters. This fosters mutual collaboration which allows the client to gain increasing control over her parts and more control over ALL of her behavior.

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Episode 10: Betrayal

The episode begins with Tara making a video diary entry. She says that at the tattoo parlor (see Episode 9), for the first time, she noticed that “I wasn’t there, but I could actually hear what T was hearing before I transitioned.” In addition, she had seen Alice in the kitchen with her, offering her ingredients to improve a dish that she was cooking. Tara describes these experiences of awareness as “incredible.” Later, in Tara’s therapy session, Dr. Ocean explains Tara’s experience as “co-consciousness” (simultaneous awareness of parts for each other), and says it is “quite a breakthrough.” Tara had previously been without any awareness of what transpired when other alters were out. Tara seems genuinely pleased and excited. Then, without any warning, Dr. Ocean says that since Tara has made progress, this might be a good time for her to see another therapist who specializes in DID. At first Tara thinks she means adding an additional therapist, but Dr. Ocean tells Tara she would actually be “seeing another therapist instead of me.” She tells Tara that they will have four more sessions “to help with the transition.” Tara looks stunned and says, “You’re breaking up with me. You’re just giving up on me.” Dr. Ocean denies this and tries to reframe it as “not the end of our relationship, but a graduation.” Tara, clearly not ready for a graduation, sarcastically says, “OK, just what I need—more transitions.” Her passive resignation to decisions and circumstances not to her liking, seen in other episodes, is striking in this instance.
           
Afterwards, Tara drops off trash bags to Max, who is preparing a wealthy woman’s garden for a social event. Tara tells Max about Dr. Ocean’s abrupt termination. Devastated, Tara expresses confusion. She wonders why Dr. Ocean felt the need to end her therapy just when she was making progress. Max is furious with Dr. Ocean. He curses angrily and exclaims, “We need her. Why’d she do that? What are we going to do now?”

Kate continues to feel uncomfortable with her creepy boss, Gene. While talking with him in his office at Barnabee’s, she spots a photograph of her in his desk drawer (the very photograph that Gene had stolen from the Gregson’s refrigerator in Episode 9). He tells her it is for when they are apart; he then offers her a photo of himself for the times when they cannot be together. Kate barely contains her disgust, and says that she does not want the picture back.  She quickly leaves his office. Later, Kate talks with another co-worker about Gene’s bizarre behavior. The co-worker tells Kate that Gene routinely makes advances or takes liberties with new employees, and that perhaps Kate could file a sexual harassment suit. Kate sees Gene flirting with a new employee, which further deepens her disgust with Gene.

Meanwhile, Charmaine has persuaded Tara to meet her at a spa to have massages together. Charmaine looks forward to the massages as a treat, but, foreshadowing events to come, Tara is hesitant and states that she doesn’t like to be touched by strangers. She also tells Charmaine about Dr. Ocean’s termination. Tara is clearly very upset, hurt, and preoccupied with this clumsy and painful rejection. Charmaine brushes off Tara’s concerns, and remarks that if people who went to therapy would get a massage every week instead, the world would be a better place. Charmaine remains predictably unpredictable in her support of Tara. But Tara will not be distracted from her immediate concerns. She persists and asks why Dr. Ocean “dumped” her: “She was the first therapist I could trust and now I have to start all over again with someone else.” Charmaine retorts that maybe Tara was “too much” for Dr. Ocean, “I mean you are a handful, Tara. There are four of you, plus Ocean. That’s not a relationship. It’s an orgy.”  

Tara lies down on the table for her massage, and is nonplussed that she has to put her face into a confined area, a towel-padded hole in the table surface. Within seconds of being touched by her masseuse, Tara abruptly sits up, gasping for breath. Alarmed, her massage therapist rushes off to find Charmaine. When they return, they find Tara, who has switched into Gimmee, crouching on the floor, huddled under a sheet that covers her head and body like a hood and poncho. She is moaning and growling. When Charmaine tries to calm her, Gimmee screams, runs through the spa, pulling down the drapes that divide the masseuses’ cubicles and knocking over a table. When “cornered,” she abruptly switches to T, who angrily pushes away both Charmaine and the massage therapist and tries to intimidate the others who just witnessed what had occurred. Charmaine is genuinely scared and shaken. She offers the spa staff a lame excuse for Tara’s behavior, explaining that her sister has a phobia of touch. Charmaine tells T to leave Tara alone for awhile.

In the meantime Kate attempts to call the human resources office at Barnabee’s corporate headquarters to file a complaint about Gene. She gets lost in a frustrating automated voice loop, pressing one button after the other without reaching anyone successfully. Charmaine arrives home and tells Max and Kate about what happened at the spa and about Dr. Ocean’s “breaking up” with Tara. Max says that it sounds like Gimmee came out at the spa, but T insists, once again, that she knows nothing about Gimmee. Max responds to T’s obnoxious behavior by suggesting that she go out to the shed and “chill out for a bit.” Charmaine wants to leave for a date, but Max asks her to stay until Tara “comes back.” She agrees.

As this is happening, Jason and Marshall return home from riding bikes together. They are just beginning to talk about what happened in the bedroom between them last time. T walks up to them at this awkward and important moment. After a bit of T’s outrageous banter, Marshall suggests that she “go hang out in the shed.” T responds by teasing the boys about “wanting some alone time” with each other. Jason says that he likes T: “I think she’s funny.” Marshall again talks about their recent time in his bedroom. Jason says that he could “do that again,” but as Marshall invites him up to his bedroom, Max interrupts and asks Marshall to come inside for something “important” (to tell him about Tara’s episode at the spa and what is going on with T). T returns and persuades Jason to put Marshall’s bike away in the shed. Once they are in the shed, T provocatively starts coming on to Jason . She asks seductively if he likes girls and suggests that “maybe, you’re bisexual.”  Jason backs up a bit and says, “Maybe, I’m 16.” T retorts that she, too, is 16.

In the house, Max is explaining Gimmee to Kate, Marshall, and Charmaine. He says that Gimmee is preverbal and has no social skills—“the kind of alter that defaces murals and pees in people’s beds.” Charmaine makes a lame joke, “Well, this is fantastic. Tara thinks she’s a Rottweiler or something.” Kate asks to have a lock put on her bedroom door (so Gimmee can’t get in). Marshall decides to go out to the shed to check on T. He walks into the shed and finds Jason kissing T, who is holding Jason’s hand firmly cupped to her breast. Marshall is shocked and outraged and he kicks the door of the shed. T’s head drops as Tara seems to struggle to return and is clearly upset, apparently aware enough of what has happened to understand, but not so much that she can own the behavior of T as hers. Tara follows Marshall up to his bedroom. She says, “That wasn’t me, I would never… I wish I could protect you.” Devastated and enraged, Marshall says that he can protect himself. He makes Tara leave his room. Tara goes to Max and cries, understanding that she has done something truly terrible. Tara is even more distressed when Max tells her that Gimmee came out at the spa and that, now, Charmaine knows about Gimmee. Kate is overwhelmed and says she is going to stay overnight with a friend. Tara goes downstairs and apologizes to Charmaine.

Charmaine misses her date because of the chaos, but is kind to Tara, in stark contrast to her cruel joke earlier. Marshall returns to the shed and deliberately sets it on fire. As Charmaine prepares to leave, they all discover the shed in flames. They also find Marshall reclining in a lawn chair, watching the shed burn. He does not assist the others in fighting the fire.

Commentary:
Dr. Ocean told Tara that it is best that Tara transfer to a therapist more familiar with DID and that she, Dr. Ocean, will no longer see her. This is a huge surprise and a very painful shock for Tara. Max is angry that Dr. Ocean is abandoning them in their struggle with this difficult illness and the havoc it wreaks on Tara and their family. Charmaine says that Tara was probably “too much” for Dr. Ocean. Why would a therapist terminate with someone with DID? Is the way Dr. Ocean announced their ending typical?

Previous episodes have shown that Dr. Ocean has little, if any, experience in treating DID. Recent therapy sessions have shown her to be increasingly frustrated and overwhelmed by both Tara and Max. Dr. Ocean is caring and well-intentioned, but she is unskilled in dealing with the complexities of DID (and its accompanying interpersonal complications). Sadly, Dr. Ocean’s good intentions did not cause her to undertake training in the treatment of DID and/or consultation from an expert in DID treatment. Clearly, Dr. Ocean has been overwhelmed by clinical complexities that are beyond her current competence or skill-set.  We are not shown how she arrived at her decision to terminate treatment with Tara and transfer her to a specialist, but she comments that her clinical supervisor concurs with this decision. In itself, such a transfer of care is appropriate and therapeutic because it makes it more likely that the patient will receive a higher level of care. The problem, however, is not the decision, but how Dr.Ocean carries it out (i.e., via a sudden announcement that she will terminate her care of Tara in four sessions, and refer her to a specialist). 

Individuals with DID usually have serious difficulties trusting others. And yet, Tara had come to trust Dr. Ocean. She believed that she had finally found someone who understood and could help her. In addition, Tara had rendered herself vulnerable by allowing Dr. Ocean access to her alters—an enormous leap of faith for someone who had been terribly hurt by others. Dr. Ocean does not appear to appreciate the fragility of Tara’s trust and how important it is for a therapist to be slow and delicate when effecting the transfer of a long-standing DID patient. In addition, Dr. Ocean does not seem to realize that Tara is at a critical (and very vulnerable) juncture in her recovery process. She has started to develop some co-consciousness with her alters. This is an inherently scary process for Tara because it increases her contact with alters who hold so many feared memories and feelings. This is precisely the wrong moment for Dr. Ocean to announce that she is terminating Tara’s therapy and sending her to another therapist. Dr. Ocean also appears insensitive to the profound bond that Tara (and some of her alters) have developed with her. Rejection and abandonment are two of the most feared and overwhelming experiences for individuals with DID. Even the hint or suspicion of rejection or abandonment can precipitate some acting out at best (and severe psychological decompensation at worst).

Tara’s emotional and psychological equilibrium was completely undone by Dr. Ocean’s insensitive and abrupt announcement that she plans to terminate Tara’s therapy. Tara frantically tries to make sense of this rejection; she asks Max and Charmaine to help her understand what is happening. By the time that she arrives at the spa for a massage, Tara is in a precarious state (that is not helped by Charmaine’s suggestion that she was “too much” for her therapist.) Tara’s massage promptly sends her over the edge. Gimme, the young, wounded, animal-like part of Tara emerges, expressing absolutely raw, intense, and wordless emotion that was probably evoked as much by Dr. Ocean’s abandonment as by the massage itself. Of course, this is much too vulnerable a state for Tara to maintain while in a public setting. T comes out to protect Tara with all the anger she can muster. We have to imagine that T is enraged at Dr. Ocean as well. Later, T does the unthinkable: she betrays Marshall by making out with his boyfriend (thus causing Marshall to feel as betrayed by Jason and T as Tara feels betrayed by Dr. Ocean). Only after the fact, when terrible harm has already been done, does Tara manage to regain control from T.

If there is a need to end therapy with an individual with DID, the therapist should carefully (1) plan how to bring up the topic; (2) decide the best timing for proposing the termination; (3) conduct a series of respectful conversations about it; (4) thoroughly explore the meanings of the termination to the individual; (5) discuss and process the individual’s reactions over time; and (6) make a plan with the individual, not for him or her. Dr. Ocean violates these principles. Worse, she does not even give an adequate reason for why the termination must happen so abruptly.

T betrays Marshall by trying to seduce his boyfriend. How often do alters engage in such willfully destructive and hurtful behavior, particularly toward a child? It is important to remember that the United States of Tara is entertainment, not reality. Although such events are known and possible, they most certainly are uncommon. Parenting skills in individuals with DID vary widely, just as they do among all parents. About a third of persons with DID are excellent parents, but one-sixth of DID parents are abusive at least on some occasions. The parenting behavior of the remaining half of DID parents is well-intentioned but compromised (by their dissociation and/or depression, or other problematic issues), and not malevolent.  While it is true that abused individuals have an increased risk for becoming abusers themselves, this outcome is by no means universal. In fact, most abused mothers with DID (83%) never perpetrate abuse. Although we don’t know with certainty the full range of Tara’s difficulties and problem behaviors, in the 10 episodes already aired, Tara has shown herself to be a reasonably good and emotionally-available mother (notwithstanding some outrageous behaviors from her alters). Tara herself presents as a generally good and intermittently excellent parent whose main failings are passivity and failures to set appropriate limits. She tries to be permissive and loving, and wants to be loved in return. Her ability to exert parental authority and to perceive when its use would be appropriate are compromised. Confronted with her passivity and abdication, her children are often forced into parental roles. T, Alice, and Buck, on the other hand, have been periodically inappropriate with Kate and Marshall. The children have had to accommodate to behaviors that may make the audience laugh, but which are at times psychologically abusive (even if said with some degree of affection). Still, T’s highly sexualized behavior with Jason (and concomitant betrayal of her son) is such an extreme enactment that it far exceeds any other outrageous alter-related behavior shown or referred to in previous episodes. The vast majority of families with a DID family member will not encounter such extreme behavior

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Episode 11: Snow

Speaking to her video diary, Tara reminisces, “We had a priest. He used to give us gumballs in the confessional at St. Anne’s. If you were really penitent and Father Roger could feel sorrow in your heart, he’d hit you with some Hail Marys and put a little gumball in the slot.”  Tara looks sad and wistful. She realizes that she has wounded her son very deeply. She has no Father Roger to help her deal with T’s betrayal of Marshall (see Episode 10), or to offer her compassionate forgiveness. In the meantime, Marshall has begun to take Xanax, an anti-anxiety medication, and wanders around the house in his pajamas. Max insists that Marshall goes to school. When Tara walks up and asks him what is wrong, Marshall dismissively says “Nothing!” and walks away. Tara says, “Everybody’s mad at me. To tell the truth, I’d even be mad at me right now, too.” Tara stands in the shower fully dressed, staring blankly, her clothes soiled by the fire. We understand that what she wishes to cleanse herself of has nothing to do with the fire. She feels she is filthy, and is profoundly ashamed of herself.

Afterwards, Tara overhears Kate and Marshall talking in the bathroom. Marshall says, “She should be put away.” Kate tells him, “Shut your gob!” Max walks in and tries to calm Marshall, but Marshall’s rage will not be silenced. “She’s insane.” Kate is hesitant, but says maybe Marshall is right. She asks, “Do we need a plan or something? Maybe she should go back on her meds.” Max says, “I know it’s messed up right now, but we’re not gonna bail on her like Dr. Ocean and all those other useless doctors we’ve dealt with. She made a commitment to stay off meds until she got better.” Marshall firmly replies that she is not getting better, and quotes Chief Brody from the movie Jaws: “We need a bigger boat.” Tara finally comes in and just stands there, staring at Marshall with an expression of unutterable sadness on her face. Marshall walks away.

Apprehensive but determined, Tara checks herself in to an inpatient unit that specializes in the short-term treatment of dissociative disorders. She meets her therapist, Dr. Holden, purportedly an expert in DID. He interviews Tara and Max and reviews her treatment history. We learn that Tara was hospitalized in 1989 after driving into the back of an ice cream truck. Tara says that for a long time, none of her doctors could figure out what was wrong with her. Until her DID was diagnosed, she says, “We were just drowning.” This is the first time in 11 episodes that it is made apparent that Tara has been having serious problems for a long time. We appreciate how hard Max and Tara have worked to convince themselves that their approach to Tara’s illness has more rhyme and reason than has been apparent to the viewer.

Foreshadowing that he is not as skilled as we would wish him to be, Dr. Holden promptly mispronounces the word dissociation. “Disassociation,” he says, “is so tough. I commend you for making your way here.” Max asks what Tara can expect.  Dr. Holden explains, “Look, it’s pretty straightforward. You can’t get better until you know what happened to you. My program provides a two-week protected environment where patients can really dig in. Once we start breaking down walls between you and your alters, you’ll be able to get out of survival mode and really start to live.” He tells her she will have individual therapy, group therapy, and long term recovery planning. Dr. Holden then shocks Max by saying that he (Max) will have to participate in group and couples therapy to deal with his own issues.

We next see Tara and Max in group therapy with other couples. An annoyingly chipper woman begins joking about how she copes with her husband Marty, a combat veteran who started losing time and having fugue episodes after he came home from Iraq. The dissociative patients in the group share poignant experiences about not being able to account for time, not knowing what they did earlier in the day, not being able to remember their lives or their childhood, and so on. Tara describes how she “got really good at hiding it.” She says that her trauma happened at 16, “so I didn’t start switching until after that. But, whenever I would come back from a transition, I knew exactly how to cover and get by.” She tells the group that in the month at boarding school before summer, she wore her bathing suit every day under her clothes. She says she just sat in her dorm window, waiting for summer to come. “The next thing I remember…snow. Everywhere. I was at my parents and six months had gone by in an instant.  And it was just…white.” Asked about her reaction to the snow, Tara says, “It was not what I expected, but it was… beautiful.”
                                                                                                               
Marshall takes yet more Xanax at the water fountain in the school hall. Jason comes up to him and profusely apologizes. Marshall immediately says “It’s not your fault. My mom’s a total freak show. She’s actually at a hospital for the criminally insane now.” Jason said, “I feel really bad about what happened. I even talked to my dad about it. Listen, I think you are the most awesome kid in the school. Remember me when you win your Oscar, OK?” Earnest, determined, and ashamed, Jason walks away.

Tara has an individual session with Dr. Holden. She asks, “So… you really think you can get them to come out?” He replies that “some patients find it easier with hypnosis or sodium pentothal, but you’ve been experiencing co-consciousness which indicates permeability within your system.” Tara reflexively says, “I’ve never experienced co-consciousness with Gimmee.” Dr. Holden encourages her. “Look, you can do this, Tara. Once we can access the trauma by probing your alters…even if it’s hard to watch, you’ll finally know.” Tara says, “OK,” and Dr. Holden turns on a camera to videotape her session.

Meanwhile Kate goes to the corporate headquarters of Barnabeez to file a sexual harassment complaint against her boss, Gene. The woman who interviews Kate is stunningly unsympathetic. She tells Kate, “The food industry is a hotbed of sexual improprieties, it’s basically institutionalized. That’s why people work at restaurants. It’s not uncommon for young waitresses to develop feelings for their managers. It’s OK if you blew him. Did you blow him?” In this vignette, the viewer observes the might of a large corporation that is determined to conceal rather than address its employees’ indiscretions in order to protect its public image, something that seems to blindside Kate, who has never experienced it before.

In her session with Dr. Holden, Tara is acutely frustrated: “What is wrong with me? I was able to be co-conscious before I came here. It’s been four days! Why doesn’t hypnosis work?” Dr. Holden explains that therapy is a process and that “the alters are not ready.” “They just met me,” he says. Tara insists that she likes him and trusts him. Tara has yet to grasp the ongoing impact of her alters on her life and therapy, even when they are not in executive control.

Meanwhile, Max is having an even tougher time in group therapy. He oscillates between barely-contained impatience and contempt on the one hand, and continually talking about Tara’s problems on the other hand. One woman patient takes it upon herself to confront Max about Dr. Holden’s rules, asking, “Aren’t we supposed to keep our sharing focused on ourselves?” To which the group therapist says, “That’s right.” The group member then says, “Yeah, like what’s really going on deep down inside of you.”  The viewer is unclear whether this woman is trying to be helpful, buttering up the therapist, or putting Max down. Max folds his arms, looking frustrated and disgusted, and says, “I don’t know how that could help.” Like the intimate other of most DID patients, he sees the entire problem within Tara. Max is usually oblivious, as he is in group, to his own role in maintaining and at times reinforcing Tara’s DID.

At lunch in the cafeteria with Tara, Max describes group therapy as “a lot of useless yammering.” A patient, Jenny, stops at their table and starts a conversation. Jenny says that she is “integrated.” When asked how she accomplished that, she says, it took “a lot of time and hard work…like Tara is doing.” The exchange is puzzling to the viewer. Should we believe Jenny? Is Tara actually doing a lot of hard work? Or is Tara working hard while some other alters are blocking her and Dr. Holden’s efforts?

Kate finds Marshall taking more Xanax; she confronts him. “What is this, Anna Nicole Smith time? …this is really dumb.” Marshall frowns and says, “It makes everything better.” It is painful to see this sensitive, thoughtful young man reduced to stifling the anguish caused by his mother’s outrageous behavior with sedatives. Kate tells him that if he takes a pill whenever things are going wrong that he won’t know when things are really going wrong and won’t be able to fix them. Marshall angrily tells her that he knows exactly what is wrong. With focused intensity, Kate asks, “Do you even get what Mom’s alters do? They do stuff for Mom. She was protecting you!…He’s going to marry a girl. And he’s never going to love you the way that you love him.…So T came out to try to put a stop to it!”  The viewer may note that Kate and Marshall have reversed their usual roles. Here Kate is attempting to look beneath the surface of her mother’s behavior and understand what drives her, while Marshall, usually his mother’s staunchest defender, has completely withdrawn from his usual empathic stance.

Meanwhile, Max calls Charmaine to check on things at home. Max has slept in his truck to avoid the other patients and spouses who just want to talk and share. Charmaine tells him that he has a lot of issues and doesn’t want to deal with them because he’s afraid of falling apart if he does.  We are left unclear about why Max sleeps in his truck instead of going to a hotel room.

Dr. Holden, unable to access Tara’s alters and/or her hidden traumas with conversational therapy or hypnosis, resorts to a drug-facilitated interview, using sodium amytal. Sodium amytal is a sedative medication, administered intravenously. It induces a “twilight” state in which people may be more suggestible and less resistant to questions. When Tara is “under,” Dr. Holden asks, “I’m wondering if anybody inside Tara has a memory of a night when something happened with Tara and a boy named Tripp?” This question provokes visible signs of internal distress. Buck suddenly comes out and asks, “What’s in it for me?”

Later, Dr. Holden plays darts with Buck on the unit. Dr. Holden says that since Buck doesn’t want to have therapy in the office, “I’ll just hang with you.” Buck replies, “You can hang all you want, but nobody wants to talk to you. That’s why I’m here.” Buck then makes an extremely crude and hostile sexual comment to Dr. Holden to further distance him.

Buck continues to be loud and aggressive on the unit. Max and Dr. Holden are observing through a window. Max asks, “How are we doing?” and Dr. Holden claims, “This kind of regression tells me I’m on the right track.”  Max impatiently disagrees. “You cost $6,000 a week; I can see this shit for free in my living room.” Dr. Holden asks Max to try and trust the program. The viewer may be confused by this exchange. From Dr. Holden’s perspective, he has broken through to an alter, and considers this to be progress. From Max’s perspective, Buck’s emergence represents “the same old same old,” and he is desperate to see something he can recognize as progress.

Back in group therapy, the woman who had confronted Max about talking about Tara rather than himself has collapsed into despair. “They say that God never gives you more than you can handle. That’s not true. Marty’s never getting better. And I can’t eff-ing handle it.” Max gives her a stiff and awkward pat on the back. No matter how different Max feels from this woman, and despite his previously unflagging optimism about Tara,  his often profound denial, and his dismissive stance toward the hospital’s program for significant others, his behavior now suggests that Max is beginning to slide toward this woman’s pessimistic point of view. This terrifies and demoralizes him.

In couples therapy, Buck tells a whopper about sliding his Harley under an 18-wheeler and popping out the other side without a scratch. Max loses it, pointing out that Buck stole this story from a Burt Reynolds movie (Convoy). “What the f*** are we doing here?” Buck angrily tells Dr. Holden that Max is impossible to communicate with. This pushes Max over the edge. “You want to know what’s f***ing hard, Tara? Waking up in the middle of the night, not knowing where you are. Yeah, that’s hard. Trying to piece together some kind of normal life. But down inside, you’re losing all hope that the sucker’s ever going to end. This is not what I had in mind for my life. This is a waste of time. I’m getting out of here.” He walks out. Buck angrily pursues Max into the hall, calling him a “pussy” for walking away. Max turns back. “Hey, Buck, do me a favor. If you see Tara, tell her I’m through. I’m not doing this anymore.” Max leaves; the feelings he had been trying to deny and stifle finally having broken through.

When Tara finally has come back out, she walks in to a party on the unit. Jenny, the integrated DID patient, wistfully tells Tara that she hopes her integration sticks. “I’ve been integrated before and it turns out some of the alters were just hiding.” Tara looks a bit shocked, but tries to reassure Jenny. Tara notices a photo of two small girls and asks who they are. Jenny says that they are her children, that they must be 10 and 12 now, and that she hasn’t seen them in a while. Her ex has full custody. Tara looks stricken, probably realizing that this could happen to her.

Tara gets in line at the unit telephone. For the first time, Tara imitates Buck in order to intimidate the person who is using the phone (who promptly ends his call). Tara calls Max, who is driving [home?], and says, “I want to find Tripp Johanssen. If my alters won’t tell me what happened, then I want to find him myself.” Max says he will help her and that he misses her. Tara looks out the window and sees snow coming down. “I miss you, too,” she says softly.  She watches the snow fall outside in wonder and hope.
                                                    
Commentary:
Early in this episode, the Gregsons revisit the issue of medications for Tara. Kate and Marshall wonder if medications are necessary, and Max reminds them that
Tara is determined to stay off medication until she recovers. What would trained mental health professionals have to say about this issue?
Mental health professionals would respect Tara’s determination and her appreciation that, on medication, her alters felt controlled and were less accessible, but most would consider this brave experiment to be a failure (and, indeed, conceptually flawed from the outset). Medications do not control dissociation. Sometimes alters believe that they are controlled by medication, but this is a matter of expectation rather than a genuine effect of the medication itself.  Medications diminish the discomforts that are likely to promote dissociation, so while patients are on medication, their threshold for dissociating and switching alters may be higher. In view of the escalating frequency and seriousness of inappropriate alter behavior that has characterized Tara over the course of this series, it would be preferable to protect both Tara and her family from the impact of her alters’ out-of-control behaviors. Moreover, Dr. Ocean’s ongoing tolerance of these misadventures is yet another indicator of her less than optimal treatment of Tara. Similarly, Max and Tara’s ongoing tolerance of the alters’ problematic behaviors is another sign of their often questionable judgment as parents when it comes to Tara’s DID. That is, Max and Tara have been prioritizing their own profoundly deep and intense relationship over the well-being of their children.

Dr. Holden tells Tara that she cannot get better until she gets to know her alters and learns what happened to her. Is it true that people with DID don’t get better unless they remember and learn about their alters? This is actually a complicated question. The answer is yes and no. Yes, individuals with DID should have communication with their alters. But that communication must embrace negotiation and an inner cooperation that ensures smooth functioning in daily life. Dr. Holden is either (1) oversimplifying a very complicated situation in order to define therapeutic goals for Tara, (2) speaking only of the mission of this hospital stay, or (3) he is making a serious error (if he in fact assumes that just knowing about alters and traumatic memories is curative in itself). The viewer has no way of knowing which is the case. Dr. Holden is a minor character and there is no time for, or dramatic value in, clarifying his treatment philosophy in depth. We need to remember that a person develops alters and the other phenomena of DID for one fundamental reason: their early traumatic experiences were overwhelming and those experiences simply could not be accepted as ongoing aspects of their identities and memories. Persons with DID often can only get to know their alters and learn about their traumatic memories when they have sufficient strength and coping skills to tolerate, and ultimately accept, what has happened to them. Most individuals with DID continue to be extremely avoidant of their alters and the memories and feelings that the alters hold. As we have seen, Tara has had considerable difficulty just coping with the stresses of her daily life. This indicates that she is likely to have difficulty coping with the additional stress of delving into the traumatic events that made her dissociation necessary in the first place.

During this brief, two-week hospitalization, Dr. Holden must consider the risks and benefits associated with either (a) leaving Tara’s other alters and trauma history unexplored or (b) going forward with exploration and counting on the structure and support of the hospital setting and program (and the increased frequency of psychotherapy appointments) to safeguard Tara’s potential destabilization during that process.

On the one hand, Tara wants to know her alters. On the other hand, she does not. The fact that Tara has so little awareness of her alters (and continues to experience them as “not me”) shows that she is very avoidant of them. When such avoidance is challenged, persons with DID will usually increase their efforts to fortify their avoidance. Hence, Tara responds to Dr. Holden’s therapy sessions and hypnosis by being unable to remember her trauma and by her alters’ refusing to come out. When a DID person’s avoidance is confronted too strongly (i.e., before the individual is ready to face what is still being avoided), he or she is at risk for decompensating in some significant way. For example, Tara lost control and T behaved terribly toward Marshall after Tara had been overwhelmed by Dr. Ocean’s abrupt and intolerable termination. This brought about Tara’s psychiatric hospitalization.
                          
Once in the hospital, the apparent therapeutic objective initially is to access the alters and hidden memories that drive Tara’s dysfunctional behaviors. From this perspective, the attempts to use hypnosis and drug-facilitated interviews are reasonable steps to consider, but neither Tara nor the other alters are willing or able to cooperate with these objectives. When Buck emerges under amytal, he sneers at Dr. Holden, “Nobody wants to talk to you. That’s why I’m here.” Dr. Holden’s subsequent assertion to Max, that Tara’s regression “tells me I’m on the right track,” is difficult to understand. It suggests that Dr. Holden has not acknowledged Tara’s ongoing demonstrations that she and her alters are too defended to be accessed and worked with in the format of a two-week hospital stay. We have to wonder if Jenny’s series of integrations that fell apart reflect a treatment approach on Dr. Holden’s part that too greatly prioritizes uncovering over the need to strengthen and support his patients until they are capable of confronting traumatic material. Hospital treatment is usually only a very small aspect of an ongoing psychotherapy. However, the viewer knows that Tara does not have a strong ongoing outpatient psychotherapy to which she can return. In fact, it is not clear whether Tara has any treatment to which to return. The viewer may assume that Dr. Ocean meant to refer Tara to Dr. Holden, but Dr. Holden runs a unit and cannot be assumed to have a large outpatient practice. Even if he did, Tara would have a 400 mile commute to see him! We wonder how safe and/or feasible such an arrangement would be for an out-of-control DID patient.

A typical DID expert who is experienced with short-term hospital care would have been more likely to focus initially on the patient’s immediate crises and their consequences; namely, (1) Tara’s rejection by Dr. Ocean; (2) her need to become reestablished in a competent therapy; (3) the need to establish communication and cooperation among her alters; and (4) Tara and her alters’ need for expert help in coming to grips with the effect of their actions on her son, Marshall.  In all likelihood, a focus on Marshall would have brought the alters to the surface quite rapidly because they are all quite dedicated to him (however differently they may express their commitment and concern).

Max struggles with treatment for himself. He is also not pleased with Tara’s treatment. What is going on? Previous episodes have suggested that Max is too focused on Tara’s problems. Now we can see that Max is every bit as avoidant of his own problems as is Tara of her problems. In fact, Max may be even more avoidant than Tara. She, at least, is attempting to deal with her problems. We do not know what Max is avoiding, but it is clear that he is very defensive and not able to get help for himself. He has difficulty accepting that he cannot fix Tara’s problems. He pins his hopes on Dr. Holden’s intensive interventions, in the hope that everything will rapidly improve. Max is irritated with Dr. Holden when things do not progress in the first 4 days of treatment, yet we learn that Tara has had problems for decades. Max has pursued the notion that confronting Tara’s past would prove curative; hence his seeking out Tara’s prep school roommate and Tripp. Max’s notion of recovery is not realistic, and might prove to be traumatizing. However, in so doing he is following up Tara’s implicit theory of why she is mentally ill. Thus, Max’s efforts to dig up Tara’s past trauma are not as completely his own as Tara tends to protest.
Max clearly needs support and help, but is still unwilling, unable, or at least too conflicted to receive it. Partners, friends, and families of individuals with DID generally benefit from some kind of support and education. They should actively seek out this type of help.

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Episode 12: Miracle

In the final episode of Season 1, much is resolved (at least for the moment) and loving reconnection is restored in the Gregson family. Tara and Max meet with Dr. Holden to prepare for meeting with Tripp Johanssen the following day. The affectionate banter, eye contact, and touch between Tara and Max makes clear that they are very much back together, the angry/hurt rupture in their relationship healed. Dr. Holden checks to see whether Tara genuinely wants to meet Tripp Johanssen. He yields to her preference about how to proceed despite his own misgivings about the proposed meeting. [Note: Confronting one’s alleged abuser is a very controversial and often unsettling experience, especially at a stage of treatment when the DID (or any other) patient remains quite unstable. See below.] When Tara reconfirms her commitment to go ahead, Dr. Holden says that he will do everything he can to facilitate the meeting and to keep her safe. After some additional cautions from Dr. Holden, Tara says that she is ready and that she is “not looking for a miracle.” Naively and hopefully she says, “Not knowing has got to be worse than anything that could happen in that room, right?” This wistful hope will not survive the encounter with Mr. Johanssen.

At home, Marshall and Kate are eating “miracle fruit” (which makes everything they eat subsequently taste sweet). We must wonder if this is a bittersweet metaphor for how the Gregson family, especially Tara and Max, try to sugar-coat and minimize the negative in their approach to Tara’s DID and dysfunction. With her cell phone in her hands, Charmaine asks if they have any messages for Tara. Kate says, “Yeah, tell her I said hi.” Marshall says, “Nope,” and receives a dark stare from Kate: “You’re never going to talk to Mom?”

Kate meets with two executives at the Barnabeez corporate headquarters. She is sure that they will give her money to “compensate” for her experiences with her boss at work. To her shock, they advise her to drop her case. Kate tries to stand up to them, but they turn her words against her and steamroll her.

At home afterwards, Kate starts to tell Marshall about her experience with the Barnabeez executives. As they talk, Marshall receives a text message that informs him that Jason is out with a girl at Starbucks.  Marshall is thunderstruck. “Just like what you said would happen… You were right about everything—that Mom was just trying to protect me.” Kate gently replies, “Why are you telling me?” We know that Kate’s being right about Jason does not prove she has infallible insight. In fact, for all we know, her ideas about Jason may not have been on target – perhaps Jason’s talk with his father, who is unlikely to have been as permissive and non-judgmental as Max, has abruptly redirected his expression of his sexual behavior. However, both children desperately want to restore their relationship with their mother, and Marshall seizes upon Kate’s words. They are what he wants to hear. In fact, they are what he needs to hear.

In the hall at the hospital, Max tries to help Tara with her strong pre-meeting jitters. She sinks down against the wall and sits on her haunches. Max tells her he will get Dr. Holden. A moment later, she hears a voice saying, “Mom?” She looks up and finds a smiling Marshall standing in front of her. He kids with her about the hospital not providing enough chairs, and says she should write a letter of complaint. He offers to help her, saying that he is “an excellent scathing letter writer.” Tara is almost transformed as she melts with relief and love. Marshall pulls her to her feet, hugs her, and says, “I forgive you, Mom…and I love you.”

Tripp and Tara, accompanied by their spouses, are introduced to each other by Dr. Holden.  The two women facilitate the initial ice-breaking.  Tara says that she doesn’t remember what happened. Both she and Tripp admit to having been very drunk. Subdued and looking guilty, Tripp expresses what appears to be genuine willingness to “tell you anything I can remember.”

In the hall, Marshall and Charmaine chat. She asks which of her two recent boyfriends, Nick and Neil, he likes best. Charmaine smiles as she receives a text message from Neil, telling her to “hang in there.” Marshall defends Tara’s alter, Alice, to Charmaine. Charmaine is amazed at how “normal” Marshall is despite the craziness in his family.

Back at the Gregson home, Kate walks downstairs and finds her former boss, Gene, sitting in her living room, drinking a Sierra Mist that he has taken from the Gregson’s refrigerator. Kate is ‘creeped out’ and angry. Gene tells her that he has been fired, but “it was worth it. I’d lose anything to be with you. I’m in love with you, Kitty… You’re the one.” “No I’m not,” says Kate. Unfazed, Gene says, “I knew you only went to HR [Human Resources] to get my attention… So what’s next for us? Do we tell everyone?” Or run away together?” Faced with Kate’s growing confusion, Gene says, “Being apart is not an option, am I right? I know I can’t live without you.” Kate goes out to the kitchen “to get a glass of water.” She grabs her mother’s car keys and drives off in her mother’s car. This interaction finally reveals that Gene is not just creepy, he is a full-blown stalker (whose obsession with Kate verges on erotomania—the delusion that Kate secretly loves him).

Tara and Tripp talk awkwardly about what happened between them when they were in prep school. Max gets quite angry at Tripp and walks out. Tara follows Max into the hall, calms him down, and brings him back into the room. Tripp is remorseful. He admits that he “took advantage” of Tara. With sincerity, he says, “If I could go back, it sure as hell wouldn’t have happened.” As they are ending their meeting, Tripp says goodbye to Tara, calling her “T.” Tara, Max, and Dr. Holden are silenced by this; they all stare at Tripp. Was this the name Tara had gone by when she was with Tripp? The implications of this possibility start to sink in. Suddenly, T comes out and boasts about her sexual encounters with both Tripp and his buddy, Mike. Buck comes out and says, “This is BS. T is just trying to act all cool. If all the girls and Tara had let me out that night, I would have pulled your balls out your butt hole.” T immediately comes back out and continues to be obnoxious to Tripp and his wife. She taunts Tripp, accusing Tripp and Mike of having had a homosexual encounter after their sex with T. Shocked and flustered, the Johanssens make for the nearest exit.

After the Johanssens leave, Dr. Holden explains to Max that Tara was “already a multiple” before that night with Tripp. He points out that what happened at boarding school didn’t make Tara split, “It was a retraumatization.” T tries to disrupt this discussion by grabbing the photo of Dr. Holden’s wife, from her desk, pronouncing her “hot,” and saying, “I’m not a lezzo, but I’d suck her box!”  Max tells her, “Enough!” and Alice comes out and apologizes for T’s behavior. Alice refuses to let T come out back out (T apparently has more to say). Alice does her best to block Dr. Holden from talking to Tara, who he hopes may be listening from inside (i.e., co-consciousness).  Dr. Holden tells Alice that Tara is strong. “No, she isn’t. She’s weak and she needs me,” retorts Alice. “That you would dare to suggest that you know her better than I do, is just…” Her head drops and Tara comes back out, and softly says, “I want to go home.” When Tara and Max rejoin Marshall and Charmaine in the waiting area, Marshall, with, visibly concerned, asks,  “How’d it go?” Tara says, “It was a lot of things.”

Discharged from the hospital, Tara returns home. In the truck on the way home, Tara and Marshall are deep asleep, Marshall with his head on Mom’s shoulder, and Tara with her head leaning against Marshall’s head. Back home, their first family dinner at home is awkward and difficult. Max finally says, “What are we doing?  …Get your coats.” He takes the family bowling, an event that, as Max probably intended, turns out to a perfectly normal family outing. They tease one another, boast, are silly, and have a great time together. Tara notes with wonder that the kids’ bowling has improved. Max tells her, “They learned from Buck.” Tara waits a bit and then says, “You know, it could get worse before it gets better.”  Apparently untroubled, Max says, “I know.’ They both seem to be lost in thought as the camera pulls back to reveal Alice, T, and Buck gathered around them, with Gimmee crouched behind them, between the chairs.

Commentary:
Tara meets with the man who raped her. This seems risky. How common is this in the treatment of persons with DID? It is risky, especially early in the recovery process. And, despite’s Tara’s and Max’s enthusiasm for this encounter, and their high hopes that this meeting will advance Tara’s treatment, most experts would have discouraged the meeting with Tripp. Such meetings (with a person who has abused the DID patient) have at least two major sources of risk: the behavior of the abuser and the emotional unpreparedness of the DID patient to handle the encounter. There is no guarantee that the abuser will be contrite and admit what he or she did. Tripp Johanssen’s ready cooperation is uncommon. In many (most?) cases, the abuser is uncooperative, denies having mistreated the patient, and implicitly or explicitly calls the patient a crazy liar. Needless to say, most DID patients do very poorly when that happens; acute suicidality and hospitalization are not unlikely consequences. In short, because of the risk of denial, uncooperativeness, and name-calling, it is inadvisable for DID patients to hazard such a meeting until they are very far along in their recovery process. Otherwise, they are simply not able to deal with a denying and unrepentant abuser. Another source of risk is that even if the abuser is well-motivated and cooperative, and the patient well-prepared, there is often a layer of depersonalization that has remained as a persistent shield against experiencing the full impact and implication of accepting the mistreatment as real, a layer which may be abruptly shattered, flooding the patient with pain and painful realizations.

The previous 11 episodes have consistently stated that Tara’s DID originated at age 16 when she was raped. Now, it appears that Tara was “already a multiple” at the time of that rape. What is going on? Several things. To begin with, DID-savvy viewers have known all along that DID originates in early childhood—not at age 16. Accordingly, these savvy viewers have been waiting for an explanation of the supposed age 16 onset of Tara’s DID. When Tripp innocently referred to Tara as “T,” he let two cats out of the bag. Not only do Tara, Dr. Holden, and Max now know that Tara was “already a multiple” at the time of her rape, but, more importantly, Tara’s alters and their protection and defensive deception of Tara have been “outed.” That is, Tara now realizes that T, Buck and Alice knew all along that Tara’s DID did not start at age 16; they have deliberately hidden this secret from Tara. They let Tara falsely believe that it all began at age 16 at boarding school. The disclosure of this long-protected secret is a major disruption to the system as a whole. The disclosure is immediately followed by rapid switches among T, Buck, and Alice. Despite their different public reactions to the disclosure, none of them are happy about this powerful revelation. For the first time (in the viewer’s, and perhaps in Tara’s experience), things have gotten beyond the alters’ control. T tries to distract Dr. Holden and Alice tries to block Dr. Holden’s (and Max’s) access to Tara. Both are unsuccessful. Tara, her family, and Dr. Holden now know that the answer to Tara’s DID lies further in the past. Tara’s alters had worked hard to keep that fact hidden.

Tara is discharged to go home with her family. Is this because Tara made therapeutic progress in her meeting with her rapist?
We can approach this question two ways, first from the perspective of experts in the treatment of DID and second from the perspective of the development of the drama of the Gregson family within “The United States of Tara.”

Expert perspective: While the premise in the question is accepted by the Gregsons, and perhaps by Dr. Holden, most experts in the treatment of DID would not support such a course of action. Tara has just gone through a major confrontation with an alleged rapist. Her personality system may still be in disequilibrium. One cannot rule out the risk of some form of psychological aftershock. The main goals of this hospitalization from the perspective of a dissociative disorders specialist (see commentary on Episode 11) remain unresolved. The focus on the meeting with Tripp might be seen by experts as a diversion from the more important central issues of the treatment. As the episode ends, Tara has not been established in a new therapy, there is no reason to think T’s disruptiveness has been reduced, and although there are some nascent hints of increased awareness and connection among the alters, it is preliminary and has not been harnessed for therapeutic purposes. From this perspective, the press to hit a psychotherapeutic home run by confronting Tripp and implicitly eradicating the reason for being of Tara’s DID demonstrates that wishful fantasies, perhaps subscribed to by both the Gregsons and Dr. Holden, have hijacked the course of Tara’s hospital stay and diverted it from attaining its most important objectives.

Dramatic perspective: From the perspective of the drama of “Tara,” perhaps, in part the premise in the question is valid, but the major reasons that Tara was ready for a pass may have been that two major crises had been resolved. First, Max and Tara had fought and had a major disruption of their relationship; Max had erupted, saying that he had “had it’” with Tara and her alters. He had left the hospital, and headed for home. Nevertheless, Tara and Max managed to resolve this crisis on their own. The re-established strength of their bond is very visible during their meeting with Dr. Holden prior to the session with the Johanssens. Second, and of at least equal importance, was the resolution of the crisis that had precipitated Tara’s hospitalization—T’s sexual approach to Jason (which devastated Marshall and severely ruptured his relationship with his mother). Marshall’s ability to resolve his hurt and sense of betrayal in favor of forgiveness and love was transformative for Tara (and for the rest of the Gregson family—perhaps even including Charmaine). We can understand Marshall’s forgiveness as more a statement of his yearning to reestablish his close and loving relationship with his mother, despite the preferred rationale of Kate’s interpretation. Our commentary for Episode 11 (above) expressed our disquiet about Dr. Holden’s focus on uncovering the past (and his concomitant foregoing of crisis management). By the end of Episode 11, Tara was reeling from the impact of 3 crises: (1) being terminated by Dr. Ocean, (2) Marshall’s rage at his mother for what T did, and (3) the rupture in the relationship between Tara and Max. By the time Tara met with the Johannsens, the Gregsons had resolved the two family-based crises on their own. These, we think, are the therapeutic achievements that may have rendered Tara ready for discharge home. However, even this more sympathetic reading leaves Tara without meaningful treatment, lurching toward the further crises and complications that will both shock, educate, and entertain us in season 2 of “The United States of Tara.”

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