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US Tara - Season 3

 Episode 1: Youwillnotwin
Episode 2: Crackerjack
 Episode 3: The Full F... You Finger
 Episode 4: Wheels
 Episode 5: Dr Hatteras Miracle Elixir
 Episode 6: The Road to Hell is Paved with Breast Intentions
 Episode 7: The Electrifying and Magnanimous Return of Beaverlamp
Episode 8: Chicken n Corn
 Episode 9: Bryce Will Pay
 Episode 10: Train Wreck
 Episode 11: Crunchy Ice

 Episode 12: The Good Parts

 

Episode 1:  …youwillnotwin…

All of the characters are struggling with identity issues. Charmaine maintains that she wants to be an independent woman who can stand alone as a single parent, but she has to come to accept that in reality she is in a relationship with Neil, who confronts her denial. Marshall, who is negotiating the complexity of the gay world, wants his partner to acknowledge their relationship by using the word "boyfriend." Kate wants a new job, and tries to present herself as an assertive, take charge woman, but her previous internet escapades have affected her reputation and her prospects. Tara herself is internally conflicted. As Buck she wants to get revenge against her previous abuser, but as Tara she wants to move on with her life and return to school. Another alter, of uncertain identity, clearly doesn’t want her to move forward with school and tries to interfere with her first homework assignment by acting out against her, creating a prolonged writing block. Max wants to support Tara’s academic aspirations, but he is afraid of her attending classes because she had a suicide attempt when previously enrolled in school. Completely frustrated, Tara indeed feels driven to self-injury or worse. Finally the alters come to the rescue and take over and her psychologist alter begins to dictate the problematic paper for her.

Commentary:
Is it common for a persons with DID to scare their perpetrators with threats of violence towards them? No. Although many individuals with DID have fantasies of harming people who harmed them when they were children, it is uncommon for clients to seek out and frighten their perpetrators in the way Buck has done in this episode. It is more common that individuals with DID act out violently towards themselves in the form of self-harm or suicide attempts. (Note: in this episode, the man Buck has found is NOT the right person, but he initiallly THINKS he is, so the question here is posed as a general question about DID despite Buck’s mistake).

Tara wants to return to school. Given what is going on in her life, and her history of a suicide attempt when she was previously enrolled in school, is this a good idea right now? Tara’s desire to do something with her life beyond being a DID patient is healthy. However, Tara seems to be pursuing this goal without having made a preliminary assessment of how this decision would affect her internal system. She continues to make decisions that reflect her wish to deny her dissociative disorder, and its implications for her life. Tara also seems to be pushing aside the implications of the disclosure by her parents that she was abused by her foster brother. She is trying to move on, seemingly without allowing aspects of her mind to process this information. Tara has made what appears to be an internal “unilateral decision” to move on with her life. If Tara were in therapy, her therapist would encourage her to work to make sure that either all parts of her were on board with returning to school (or at least would refrain from messing things up), before taking steps to enroll.

While writing her first school assignment, Tara suddenly “transitions” and writes profanity on her screen, as well as the words “you will not win” before impulsively stabbing her wrist with a letter opener. Why does this happen? Other parts of her system intervene to stop this action – is this possible in DID? We can’t be exactly sure why these hostile acts occur, but it seems likely that a part of Tara (one that she may not be aware of yet), feels ignored by her return to school or her avoidance of her abuse, and is trying to stop her. It also may be trying to interfere with "learning" of any kind, which might lead to learning things still kept secret, a possibility reinforced by the threatening words which were written when Tara first sat down to do her paper. That other parts of her intervened to protect Tara from harming herself is quite common in DID. Often protective parts will intervene in ways that lead to clients calling their therapists or other support systems for assistance. This incident dramatically illustrates the way emotional conflict in DID patients is often expressed by one alter or group of alters acting one way, only to be countered by another alter or group of alters acting in a different manner.

Trivial Point of Ironic Interest (For Hard Core Psychology Geeks Only!) The topic of Taras paper, one of several possible topics she could have chosen from, is Somatoform Disorder or somatization. Everywhere in the world except in the United States, Somatoform Disorder is considered a Dissociative Disorder, in the same category as Dissociative Identity Disorder. Is the upset surrounding a paper about somatoform dissociation a subtle and ironic foreshadowing of plot elements that will bring DID into the relationship of Tara and her professor? Tune in next week!

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Episode 2: Crackerjack

Things are stormy for Tara. She embarrasses herself at her first day of school by switching to her psychologist alter and assuming the role of teacher in her psychology lecture. Mortified, she later decides that she must explain herself and takes the risk of disclosing her condition to the Dr. Hatteras, whose class her psychologist alter had impulsively taken over. However, when she tells Dr. Hatteras that she has DID, he ridicules and denies it is a real diagnosis, and shames her by challenging its legitimacy in front of the class. After class, Tara becomes angry with Dr. Hatteras. She makes a transition to “T,” switching right in front of him, and then kicks his lunch across the quad. Having switched to “T,” she gets in a fight with Kate at the end of the episode and hits her outside of Tara’s awareness. Meanwhile, Max is losing business and is offered a job by a larger company. Taking it requires him to fire his best friend Neil, who depends on him for the job, especially because he has just become a father and has his own family to support. This causes terrible discord between Max and Neil, and creates a rift between Max and Charmaine just when things had appeared to become calm and stable in their relationship. Kate is excited about the idea of teaching in Japan, and decides she wants to teach abroad. She becomes outraged with Tara when her mother does not support her. Marshall, alone in a crowd in his family of individuals perpetually distracted by their own preoccupations, continues to question what being gay will mean for his life path.

Commentary:
Tara’s psychologist alter switches and teaches the class, which ends up being embarrassing for her when she is caught by her teacher. Is this something someone with DID would really do? Unlikely. Most persons with DID are avoidant of this type of attention, and do not want to be seen for fear of being hurt or shamed. It would be more typical for an individual with DID to sit in the class and try to keep a low profile. It is not uncommon for DID patients to develop therapist alters, but this usually is in the service of self-soothing. In one frequent pattern, a personality is developed based on the DID patient’s own therapist, and serves to reassure them in between sessions. Less frequently, such alters try to steer the other alters away from areas the real therapist hopes to explore, but which the patient fears approaching.

Dr. Hatteras denies the existence of DID, referring to it as “an excuse, a crutch that severely damaged people hide behind to avoid pain” or as a “performance to get attention.” Are there people that think this way about DID, and is there any validity to these statements? The research on DID shows that individuals with DID are much more likely to be avoidant in their interpersonal style than attention seeking. DID clients ARE indeed severely damaged individuals (seeing as most DID clients have endured multiple episodes of interpersonal violence). However, most are extremely frightened of the diagnosis and have trouble accepting it. The non-acceptance of the diagnosis is actually a way that DID clients avoid pain, because accepting it would mean to admit that they have been extremely affected by traumatic events. Although there are individuals who “fake” the diagnosis of DID or exaggerate their symptoms, they are reasonably uncommon. Research shows that only about 6% of DID patients are overt, dramatic, and potentially attention-seeking.

At the end of the episode, Kate is chasing Tara to prevent Tara, in her alter “T,” from driving while drunk. Tara ends up hitting her daughter in the face and then switches back to “Tara.” Kate is more relieved to see her “Mommy” is back than she is angry about being hit. Is this mother daughter interaction typical of mothers who have DID? This is a tough question. Only one out of six DID mothers ever inflicts anything upon one or more of her children that would be considered severe abuse. Of these, only a minority are hurtful to their children knowingly and intentionally. It is more common for an alter to strike out in fear or desperation, in a state of disorientation and not knowing who is in his or her environment. It is unfortunately typical that children of DID parents, (especially before the diagnosis or early in the treatment of the DID patient), are often in the role of having to take care of their DID parents and help them to avert crisis situations. Kate, like her brother Marshall, is a veteran “parental child,” forced to be responsible over and over again when their mother, Tara, is failing in parental responsibility. Kate’s strong desire for her “Mommy” expresses the pain she experiences when she witnesses her mother’s switching into alters who are clearly not willing or able to function as the mother she loves, depriving her of a secure and consistent attachment with her mother. Kate’s chaotic behavior actually demonstrates her multiple and contradictory identifications with her fragmented mother. Her relationship to her mother is ambivalent – Kate loves “Tara” very much, but is resentful, angry, and even enraged with the other alters, and with Tara for being unable to control their problematic behaviors.

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Episode 3: The Full F… You Finger

Kate’s first attempt to leave for a job teaching in Japan is thwarted by an earthquake. Rebounding from her disappointment, she asserts herself to get reassigned to another city. After hearing from a flight attendant that the new city is potentially undesirable, she gets cold feet. As Kate’s adventure continues, Max takes steps to acquire his mother’s signature to sell his landscaping business. Max has always known that she is mentally unwell. He hasn’t seen her in two years (because he has avoided her) and discovers (or can finally admit to himself) that her hoarding problem is out of control. Marshall, who has come with Max, learns from his grandmother that her husband left her because of her problems. Marshall begins to question Max about whether he is considering leaving Tara. Meanwhile, Tara is juggling multiple stressors, including coping with Kate’s leaving for Japan, planning Charmaine’s baby shower, and continuing with her return to college. Tara is switching frequently. This affects her interactions with Charmaine, who is on the verge of going into labor throughout the episode. Charmaine is already upset that only a few people are attending her baby shower. The sisters go shopping together for some last minute things for the shower. After consoling Charmaine in the grocery store, Tara switches to “T” and generates chaos. Charmaine becomes furious. She feels abandoned by Tara, and chases T out of the store, trying to prevent her sister from driving off in the car. T’s antics behind the wheel stress and terrify Charmaine, who runs about trying to get T/Tara to stop tearing around and complete their errands. As the episode draw to an end, Charmaine has been left behind in the parking lot of the store. Exhausted, terrified, stressed, and standing alone in the lot, her water breaks.

Commentary:
In this episode, we learn that Max’s mother is psychiatrically disturbed. She chats on incessantly, obsessively, irrelevantly’ and occasionally even childishly; and she has a severe hoarding problem). Could Max have been attracted to Tara because she resembles his mother in some way? This is possible. We have learned enough about Max so far to understand that he is nowhere near as together as he seems, and often lacks even basic awareness about why he reacts as he does. It is likely the case that at some level of his mind, not necessarily at a conscious level, he was attracted to Tara because he has unresolved feelings about his relationship with his mother. In psychology this phenomenon is referred to as a repetition compulsion. In his relationship with Tara, Max is engaging in a relationship with another impaired and needy person, potentially so he can “master” the situation and handle it with competence, repairing his helplessness in contending with his mother when he was child. He was unable to make his mother well despite his best efforts. His mother indulges herself in her symptoms and is unmotivated to change them.

Similarly he tries to make Tara well, another effort doomed to failure. Tara, across her many alters, is simply not taking adequate responsibility for her/their behavior. She is not showing motivation to move either toward integration (the unification of her alters) or a resolution (a stable situation in which there may or may not be a degree of integration, but the patient has learned how to handle him or herself across various situations such that life moves on smoothly and seamlessly). She is not pursuing meaningful treatment (and has not done so over three TV seasons), and her efforts at self-curing are wishful and fragile, doomed in advance to self-destruct. It is not only the simplistic notion that Max “wants a gal just like the gal who married dear old Dad.” Men in general are often drawn to partners who share some features of a close and familiar family member. Beyond that, in this instance it is more that Max has such a high tolerance for abnormal behavior, and such a well-developed skill at stitching together the good moments between himself and another person and acting as if that were the whole relationship, that he is able to take a relationship with someone like Tara in stride. Max rebounds from disaster after disaster in his relationship with Tara, refocusing so intensely on what draws him to her that he usually succeeds for the moment in diverting his attention away from the unresolved issues that surround them. In earlier commentaries, we have commented on how being the child of an inadequate parent often forces the child toward becoming a caretaker to that parent. We can infer Max was a parental child to his mother, and recapitulates much of this in his relationship with Tara. From this perspective, Max, Marshall, and to some degree Kate function as parental children to Tara! Having been a parental child socializes the child to adapt to the needs of an impaired adult. However, it does not prepare one well to understand and undertake the burdens and responsibilities of actual parenthood. Max often is oblivious to what would be in the best interests of Kate and Marshall, and his management of the situation with Neal, his best friend and employee, toward whom he often takes a paternal stance, was also inept.

Tara’s switching seems to be occurring more frequently, and Tara seems to be losing more and more time. Why is this happening? What needs to happen to either permit or help Tara’s symptoms to improve? Tara is under a lot of stress, and stress can increase the frequency dissociative switching. She is stressed by her complex, demanding, and triggering involvement in school; the demands that Charmaine is putting on her to create an ideal and highly attended baby shower; and most importantly, her complicated and intense emotions about Kate’s plans to depart from home and launch a life of her own. The histories of individuals with DID often are characterized by experiences of emotional and physical abandonments in times of need. It is likely that Tara’s unresolved issues are being painfully activated by Kate’s anticipated departure, flooding her with painful emotions, emotions capable of pushing her, in combination with other factors, toward decompensation. Interestingly, Tara repeatedly abandons her sister Charmaine when Tara’s switching interrupts their connection and their efforts to do things together. Although this does not appear to be conscious and purposeful on Tara’s part, it is not uncommon for individuals with DID to project the feelings that they are having onto another person in order to try to get distance from the intensity of the feelings. In this case, perhaps Tara is projecting her neediness and fears of abandonment onto Charmaine, a dynamic encouraged by Charmaine’s preoccupation with how people see her and whether they care about her. She unconsciously escapes from Charmaine’s neediness, and, perhaps for the moment, from her own, as she switches into alters who act as if they are without such needs.

In addition, Tara is also not dealing with learning the identity of her abuser, even though this concern is occurring through Buck’s efforts trying to find him (efforts which are outside of Tara’s awareness). Tara needs to reengage in therapy to explore and understand why she is losing so much time, and so that the underlying issues that are causing her symptoms can be identified and worked through. This is especially the case because her support system is changing. Max is becoming less consistent in supporting Tara. Kate is intent on leaving the scene. Marshall is moving beyond his self-sacrifice on his mother’s behalf to develop his own identity. Charmaine is not only exhausted and disgusted by her sister’s antics, but she is about to turn a great deal of her emotional energy toward mothering her child, whose birth is imminent. Tara’s stress and stressors are increasing, and she has exhausted or disenchanted much of her support system. This opens the door for a much more overt expression of her dissociative disorder.

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Episode 4: Wheels

Tara’s family members are becoming more and more aware of the consequences of her behavior on their well being as individuals and as a family. Marshall has been deeply affected by his interactions with his grandmother. He questions Tara directly if she thinks “dad would ever leave?” He asks her whether they are “screwed up as a family.” Tara assures Marshall of what she wants to believe in spite of everything - that :everything is fine.” Kate discloses to Tara that her sexual education came from various different alters with different perspectives. Tara does not remember, and asks her mother “Why am I not confident and secure?” Tara reassures Kate, again letting what she wants to believe over-ride a multitude of concerns. Meanwhile, Max has become increasingly frustrated with Tara’s denial of the problems generated by her return to school. He becomes so angry that he throws her books out of the house. Tara insists that school has been a stabilizing force in her life. The most striking confrontation Tara has to contend with comes from Charmaine. Charmaine refuses to allow Tara to be around her newborn baby, insisting that Tara’s behavior is too unpredictable to assure the safety of her child. Tara is heartbroken at being kept at a distance from Charmaine’s baby, and tries to convince her that there is nothing she should be concerned about. Tara is also under fire at school. On the one hand, she tries to keep up, but she begs her psychology professor to give her an extension to prepare for a test because her alters have been giving her trouble. Dr. Hatteras is far from sympathetic. He responds, “Stop blaming things that don’t exist.” Tara responds to the situation by holding an internal meeting with her alters. Her attempt to take control of her situation is confrontational. She declares she is “dissolving the United States of Tara" and is now a “benevolent dictator.” She claims the right to be in control of the others’ behavior. She asks the alters to write about what they need. She “comes to” from this internal meeting in the middle of her exam. All the other students have left and she finds herself sitting, covered in ink with writing (presumably from her alters writing on her), with her professor, Dr. Hatteras, watching her intently. This is too much for even Tara to deny. Feeling, humiliated, pathetic and defeated, she looks at Hatteras and simply says, “I’m crazy.”

Commentary:
Charmaine tells Tara she does not want her around her child. Is this limit too harsh or unreasonable? No. Recently Charmaine has witnessed Tara switch on multiple occasions, and engage in behavior that is both erratic and dangerous. Given that “T” almost ran Charmaine over with her car (causing stress so significant that her water broke) and that Tara overall is unable to remain in any stable self, it does not seem unreasonable that Charmaine would set this limit. Charmaine, in one of her first demonstrations of healthy assertiveness, sets firm boundaries. She is putting the physical and emotional health of her newborn baby above her sister’s needs to deny the extent of her mental illness. She accepts the fact that protecting her infant and that this may cause turmoil in her relationship with her sister. Charmaine understands that being a caring and protective mother to her child leaves no room for colluding with Tara’s denial, and that supporting Tara’s self-esteem cannot be allowed because it would place her infant at risk. With surprising maturity and self-assurance, Charmaine sets appropriate limits with her sister.

Tara’s teacher tells her to “stop blaming things that don’t exist.” Is this feedback good feedback for Tara to hear? Yes, and no. Tara has been running wild, and confrontation is in order. However, her teacher is coming from a skeptical position based on the theory DID is not a legitimate mental disorder. It certainly is not helpful for Tara to be told that her alters do not exist. Increased self-hatred, determination by the alters to prove they are “real,” and perpetuation of denial are possible and potentially destructive consequences. However, Tara does need to be confronted about taking responsibility for her behavior. Ideally, such confrontation would be empathic and compassionate, which Hatteras’ confrontation is not. A therapist in this situation would encourage Tara to take responsibility for ALL of her alters, and to work with them to establish enough internal collaboration to decrease the level of chaos that is occurring in her life.

Tara holds an internal meeting in which she tells her alters she is taking control as a “benevolent dictator” and that they will “bend to [her] will.” She asks them to write down what is important to them so she can begin her leadership while keeping some of their needs in consideration. Is this a good strategy for Tara to take in managing her system? “Internal meetings” are an integral part of the early stages of DID treatment. Tara’s is well intentioned in terms of her wish to contain her problem behavior, however, her hostility to the alters is dismissive of their important role in her mind, survival, and functioning (after all, they are she, and she is they). Her approach to this internal meeting is not ideal, and provokes the episode in which her alters do what she asked them to do, but do it in the middle of an exam, sabotaging the very goal she had in mind in trying to suppress them. The alters have been an important part of Tara’s surviving her childhood abuse. However problematic, their efforts are generated by protective and caring motives, however they have gone awry. The best approach for an internal meeting would have been for Tara to try to establish collaboration with her alters, viewing all as important and worthy of respect. She should recognize how they have helped her to cope and survive past circumstances, and confer with them about how to work with them on how they can help one another in the present, in ways that do not cause her additional problems. An experienced DID therapist could help Tara approach internal meetings with her alters in a way that would facilitate increased cooperation among alters, which would decrease time loss and increase her overall functioning. A skilled therapist would insist that Tara show respect for each and every alter, and that each and every alter should show respect for Tara, working together to improve the quality of life that they all will share in some way.

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Episode 5:  Dr. Hatteras’ Miracle Elixir

Tara wants to drop her abnormal psychology class, but Dr. Hatteras has other ideas – he wants to write a paper on Tara’s disorder (even though he doesn’t believe in DID), claiming he can help her.  He tries to blackmail her by telling her he will give her an A in the class if she joins him in this endeavor. Max initially is against the idea, but he changes his mind. He decides that he wants Tara to work with Dr. Hatteras because he sees her working with Hatteras as a better option than her getting no help at all. Dr. Hatteras brings his initial write up and treatment ideas to Tara at her home. It is based on what she wrote during her exam. After seeing Dr. Hatteras’ manuscript, she reluctantly agrees to work with him. Tara’s relationship with Charmaine remains conflicted.  Tara’s alters try to help Charmaine with the baby.  Charmaine continues to set boundaries with Tara, but as she becomes increasingly frustrated with the burdens of being a new mother, she reluctantly accepts Tara’s assistance.  Meanwhile, Max is learning the difficulties of working for a company that is more concerned with money than with getting jobs done correctly.  At the same time, Kate is in training as a flight attendant. She “hangs in there” with determination and, despite the sadism of her brutal instructor and attempts by competitive classmates to undermine her, she prevails. Marshall and Lionel have a falling out around whether to submit a film to their school film festival, and Marshall develops feelings for another boy in their project group, Noah.

Commentary:
Dr. Hatteras has decided he thinks he can help Tara, and Tara has reluctantly agreed.  Is this a good idea?  No, for a variety of reasons.  First of all, Dr. Hatteras has made it clear that he does not believe in DID.  Even though it is possible that he could learn otherwise via his experiences with Tara, his stance sends message of rejection and dismissiveness to her alters. This builds a power-struggle into the foundation of the psychotherapy, compromising the beginning of the relationship and setting the stage for things to become chaotic at time goes on. More importantly, Dr. Hatteras is exploiting Tara in a number of ways.  As her teacher, his role should be ONLY to be her teacher, not to be her counselor.  If he were to be her counselor, he should give the highest priority to her therapeutic needs rather than to his hopes that he can use the papers he will write about Tara to attain a more prestigious academic appointment.  His using his authority as her teacher to get her to engage with him so he can write a paper about her is a breach of his fiduciary responsibility as a professor, and a major ethical failure.  He is making it blatantly clear that his agenda is to write one or more papers about her condition.  His primary concern is conducting the successful blackmailing of one of his students  (Tara) to promote the advancement of an agenda that is not primarily designed to help or educate Tara.  Hatteras’ relationship with Tara is wildly inappropriate and exploitive of Tara’s vulnerabilities. His unethical behavior positions Tara to be manipulated and used, (a clear re-enactment of the  trauma dynamics within Tara’s family of origin).  A healthy, helpful therapy for DID has good boundaries. Within the protective safety provided by those boundaries and the caring of the therapist (a combination often referred to as the “holding environment”), the first goal of the therapist is to help the client develop skills to manage his or her symptoms and to function better in society.  The therapist’s only agenda should be to establish a therapeutic environment within which the client can learn new skills for living as a less fragmented person.

In this episode, we see Tara give in to Dr. Hatteras’ demands, and Charmaine give in to having Tara help her with the baby.  Why are these sisters giving into things that are against their better judgment? We know already that Tara has a trauma history, having been abused by foster brother and betrayed by both of her parents, who tolerated that situation.  We do not know if Charmaine experienced similar abuse, but we suspect as much, and we do know that they both grew up in a dysfunctional family with poor boundaries and mixed messages.  Tara and Charmaine are both very vulnerable right now, and both need help (although in different ways).  Unfortunately, neither appears to have the ability to set up reasonable boundaries and stick to them.  Their needs for nurturance and assistance in areas in which their own capacities fail them are over-riding their better judgment.  Unfortunately, this is not an uncommon occurrence for individuals who have grown up in dysfunctional environments. Tara desperately wants to graduate. Rather than follow through with her initial plan to drop Hatteras’ course, she accepts his statement that it is too late to drop his course (which is probably true without mitigating circumstances, but could be possible with a proper medical excuse), and is swayed by the promise of course credit and a good grade, which would bring her to the very cusp of graduation. Charmaine’s determination to keep Tara at a distance from own her child is completely undermined by her increasingly humiliating appreciation of her own failings, ignorance, and incompetence in her role as a new mother. Tara has and can teach many of the mothering skills Charmaine lacks. In some alters Tara is a very competent mother of infants, but in most becomes progressively more deskilled as a parent as her children grow beyond the stage of passive dependency and face developmental and social challenges which she herself failed to master. She has exactly the knowledge and skills Charmaine needs to acquire, but at any moment might switch into an alter that lacks these strengths, and leave Charmaine completely unsupported.

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Episode 6: The Road to Hell is Paved with Breast Intentions

Kate seems to be doing well at her job as a flight attendant. She has developed feelings for a frequent passenger on her route, a man who flirts with her but turns down her hints, and even her directly asking him for a date.  Neil invites Charmaine and Tara’s mother for a visit under the pretense of her seeing her granddaughter, but he really is counting on her for some money to help their cash-strapped new family.  Their mother knows this. She pretends to be bountiful and generous, and uses the lure of money  (i.e., purchasing what they need for their child) to get to see her granddaughter. However, she has no money to give them, because she has just had to place her husband (Charmaine and Tara’s father) in a nursing home because of his progressive dementia.  Neil ends up having to take a job he was offered by his brother. Tara’s mother is critical to Neil and Charmaine throughout her visit, but when she speaks to Tara, she apologizes for failing Tara in the past and claims that she is trying to change. Tara herself seems to be changing to some extent.  Per her contract with the alters, there is more purposeful switching, as alters come out to take care of certain stressors that Tara has to deal with, but then Tara “comes back.”  Dr. Hatteras does not see this as progress, and confronts Tara that she is one person who needs to take responsibility for her the difficult situations in her life.  As he transcribes their last session, he hears an unfamiliar voice tell him “You will not win.”  Marshall and Noah begin to make a movie for the film festival based on Marshall’s family.  Originally the movie was going to be based on the family’s dysfunction, but they dig up old home movies and Marshall is struck by how his parents seemed so in love at the beginning of their relationship, and decides his movie is actually love story.  Max and Tara seem more connected to this theme as well, as Marshall’s inquiries remind them of their love for one another.

Commentary:
Dr. Hatteras is confronting Tara that she is “one person” and that she needs to take responsibility for her difficulties and deal with them without deferring to the other ways she refers to herself and conducts herself.  Is Dr. Hatteras doing good therapy?  Yes, and no.  A good DID therapist would indeed tell a client that all her alters are part of him/her, and that the alters are not “different people.”  An informed and skilled DID therapist would help a client understand that the alters are different ways of being that once served different purposes useful for surviving in an abusive environment. A DID therapist would acknowledge the existence of the alters and help the client understand what the function of the alters has been in supporting his/her survival, and how the alters can best work together now to help him/her cope.  After symptoms have stabilized, the therapist would then work with different aspects of the alter system to permit them to share and process information about traumatic events (in a very slow paced manner), paving the way for the client to become truly integrated into one way of being.  Dr. Hatteras is encouraging Tara to get more involved in challenging aspects in life (which could be good), but is doing so without any awareness of resistance that could occur from other aspects of her system.  This approach is almost guaranteed to backfire. There are strong hints that problems are on the horizon. We hear an alter tell him, “You will not win!”

Tara and Charmaine’s mother acts as if she is a “good mother,” but is ultimately out to benefit her own interests and concerns.  Is this typical of parents of children who develop DID?  Although it is virtually impossible to develop a “typical picture” of the parents of individuals who come to have DID, many DID clients have reported that one of both of their parents show many of the self-centered traits we associate with the psychological term, “narcissism.” Narcissism is the tendency to focus on the needs of the self as opposed to the needs of others, combined with a lack of empathy for what other people are feeling.  Narcissism can contribute to emotional abuse, emotional neglect, physical abuse, physical neglect, or sexual abuse, as parents put their own needs first and act in certain ways that are detrimental to their children’s needs.  Tara’s mother’s agenda is to see “MY grandbaby” regardless of the effects it has on Charmaine, Neil, or Tara.  Tara and Charmaine also display traits of narcissism, although not to the extent shown by their mother.  Tara’s self-centered focus has certainly affected her children negatively, and it remains to be seen how Charmaine’s narcissistic tendencies will affect her parenting.

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Episode 7: The Electrifying and Magnanimous Return of Beaverlamp

Kate’s new career as a flight attendant seems to be going well. She confronts Evan about why he turned down her invitation for a date. He reveals that he is recently divorced and has a child. Kate persuades him to spend some time with her. He gives in, and they appear to have a good time in each other’s company. The family as a whole is planning and preparing for a big party: Their plan is to hold a baby shower for Charmaine that seques into the reunion of Max’s old band, Beaverlamp. Max is furiously practicing throughout this episode, seemingly reconnecting with his youth and with the early days of his relationship with Tara. Marshall interviews Max for the movie he is making. He confronts his father about why he and Tara chose to have more children after Kate if Tara was already displaying signs of mental illness. Max makes a powerful response, assuring Marshall that deciding to have him was the best decision he and Tara ever made. However, despite his forceful words, his tone is angry and defensive, and he abruptly walks away from his son as he finishes. Marshall is understandably confused and upset by this conversation. His father’s words, his tone, and his turning away from him are disconcerting. Marshall rejects Noah’s attempts to comfort him. He turns to his ex, Lionel, for emotional support, and has a breakdown about all that has happened. Marshall later apologizes to Noah. Meanwhile, Dr. Hatteras has learned that “Kite Boy,” the patient he bragged about (and about whom he wrote a book about his success in convincing him he was not a kite), has killed himself by trying to fly as if he were, in fact, a kite. His ego shattered, Dr. Hatteras turns Tara away, refusing to help or treat her any longer. He harshly rejects attempts on the part of Tara (and her alter Buck) to beg or demand that he preserve and continue the relationship. Max confronts Dr. Hatteras about Tara’s need for help only to be told that Tara is “never going to get any better.” To all outward appearances, Tara’s interactions with her family members suggest that she is coping well with Hatteras’ rejection. However, as the episode nears its end, her solitary behavior and inner life suggests otherwise. She “accidentally” cuts herself cooking, and at the conclusion of the episode, she transitions quickly, walks away from the party, goes outside, breaks a beer bottle, and proceeds to cut her arm.

Commentary:
Dr. Hatteras decides abruptly to stop treating Tara because he learns that a previous patient has taken his life. Is this remotely ethical? No. If Dr. Hatteras is so unsettled by this news (which would be difficult for any therapist to deal with) and thinks that his ability to work with Tara might be compromised, he should tell Tara he needs some brief time off to regain his equilibrium. If Tara could not tolerate even a brief break in her treatment, Dr. Hatteras should arrange for Tara to see another therapist until he can resume her treatment, or transfer her care completely to another therapist. Dr. Hatteras’ self-absorption, driven more by the impact of “Kite Boy’s” suicide upon his career than by grief or concern over “Kite Boy” himself, compels him to abandon any pretense of caring for anyone else. He abruptly abandons Tara without arranging any other source of support and help for her. This is unethical behavior. When it is necessary to end or interrupt an ongoing psychotherapy therapy for ANY reason (other than the abrupt incapacity or death of the therapist), the situation should be explained and explored with the client in a supportive and compassionate manner, and sessions should be encouraged to allow the client the opportunity to process any feelings that were brought about by the reality of having to say goodbye and ending the treatment.

Tara is engaging in increasing levels of self-destructive behavior in this episode. Why? Although we cannot be completely sure why Tara is engaging in cutting herself, it is reasonable to assume that her rejection by Dr. Hatteras and his withdrawing the support and help he had promised her has dealt her a painful and heartbreaking blow. Clients with histories of childhood trauma usually have also experienced profound neglect. They often have significant abandonment issues, and respond to rejection or the withdrawal of attention and care with a catastrophic reaction; i.e., they may “fall apart.” In their lives, the very people that were supposed to have protected them often have exploited them or failed to protect and/or rescue them from dangerous people and dangerous situations. Tara (or parts of Tara) are likely to have interpreted Dr. Hatteras’ behavior as confirmation that there is something inherently wrong with her, or that she actually deserves such mistreatments. Thoughts of self-injury or actual self-injury are common reactions to such situations. Self-blame and suppression of anger at those who have been hurtful are also common cognitive distortions in the traumatized. Therapy must help traumatized clients see that their mistreatment was not due to some inherent fault and “badness” within them, but rather was due to the illnesses and out of control behavior of those who have hurt them.

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Episode 8: Chicken n’ Corn

Kate’s idealistic view of Evan crashes when she meets his son Monty, who is completely out of control and expresses his hatred for Kate (“You’re not my Mommy!”). Max and Marshall get to meet Evan, but Monty is so distracting that they hardly get to know each other. Marshall is thrilled that his film has been accepted to a festival in New York, and asks his father to go on the trip. He hopes it will be a time when they can bond. Marshall is disappointed and angry when he discovers that Max is terrified of flying and becomes hysterical. The son is forced to parent his own father throughout the flight. During the height of his panic, Max tells Marshall that he “shouldn’t get his hopes up” about the film festival, crushing Marshall’s spirits. As Max continues to fail his son, Marshall is becoming more and more disenchanted and angry with his father. Meanwhile, Charmaine feels like she is losing her self in the trials of motherhood obligations and breaks the boundary she had set with Tara. She leaves her baby, “Wheels,” with Tara and sets out for a day of self-care at a spa. Despite Charmaine’s new willingness to leave her child with Tara, Tara has been becoming increasingly decompensated. She cut herself at the end of last episode. At the beginning of this episode, Tara is volatile, and easily triggered into displaying severe symptoms. As the Gregson family walks through a corn maze, Tara becomes frightened by one of the actors costumed as “monsters,” hired to frighten the people who walk through the maze. Tara immediately regresses to become her alter “Chicken,” runs away in terror, and ends up huddled in the corner of a shack. She appears to be reliving some kind of traumatic event as she whimpers, “It hurts.” Tara is unaware when her alter, Alice, pays a visit to Dr. Hatteras. Alice confronts Dr. Hatteras; she tells him that Chicken is missing and that Dr. Hatteras has to help her. Dr. Hatteras tries to get her to leave the office, but Alice shows him the cut on her arm to demonstrate that things are dangerously out of control. Dr. Hatteras speaks as if he knows what alter may have done the cutting. In response to this, Alice says she has already said too much, and disappears. Later that day Dr. Hatteras shows up at Tara’s house to try to help her. He confronts her about the cut on her arm and her visit (as Alice) to his office. Tara knows nothing about these matters. Abruptly, she disappears with Charmaine’s baby, and travels by bus to a location some miles away. Unaware of how she got to where she is, and unaware of where she is, she calls Dr. Hatteras to ask for help to find her way home. Hatteras confronts her again, asking Tara what happened to Chicken. Later, they go to the corn field to try to reconstruct and understand what had happened. Tara starts to hear Chicken’s voice, and then finds herself back in the shack again, crying that Chicken has been killed. When Dr. Hatteras asks who killed her, Tara fades away and is replaced by a scary appearing alter who reports “I killed her,” and reveals that his name is Bryce Crane. (Bryce Crane is the name of Tara’s half brother from her father’s first marriage, the perpetrator who abused Tara). Bryce is menacing, and states that he is going to kill Tara.

Commentary:
Are the symptoms that Tara displays in this episode typical of DID?
In this episode Tara demonstrates a number of symptoms that people with DID can experience and enact when they become overwhelmed and begin to decompensate psychologically. Tara’s switching to a child alter when she is scared by the “monster” in the field is not atypical. A frightening event in the present may trigger not only recollections of similar frights in the past, but it may also precipitate a switch into a childlike state associated with how things were in the past. What viewers are witnessing in the episode in the shack is Tara’s being in a child-like self state lost in a flashback or a reliving of a traumatic event. In a flashback a client re-experiences a traumatic event of the past (or an anticipated or feared traumatic event) in a stressful manner that may involve some or all sensory modalities. It may involve a fragmentary aspect of a past event, an entire scenario, or any degree of complexity in between. It may become so vivid and real that a person can become completely overtaken by the re-experiencing of the past, engulfed by the feelings and sensations associated with that memory, and actually become disoriented to present reality, instead believing he or she is actually reliving the past.

Tara is experiencing and showing many signs of amnesia. She loses a lot of time in this episode. She engages in a variety of behaviors outside of her “Tara” awareness, including visiting Dr. Hatteras as Alice, and taking Charmaine’s baby out of town with her on a bus trip. This trip out of town, travel without awareness, is called a fugue by mental health professionals: unexpected sudden travel with no recollection of why the travel has occurred. Although Dr. Hatteras is trying to understand why these things are happening to Tara, understanding why is not a complete treatment. Competent DID therapists would not only be very interested in why – they would be working to help Tara acquire coping skills to manage the stresses that lead to her flashbacks and time loss, and to curtail those flashbacks and amnesias before they take her over completely.

Tara reports that Chicken is missing, and later we learn that an alter says he “killed” Chicken and is going to try to kill Tara. Can this really happen? What is the nature of these threats? This is a complicated issue. Under certain circumstances the mind can accept ideas and perception which are actually incompatible with one another and could not really be true at the same time. The mind’s ability to tolerate these incongruous matters is often referred to as “trance logic.” Bryce Crane is an alter that is based on Tara’s abusive half-brother. This alter seems to have an extreme dislike for Chicken, and some other alters as well. In some individuals with DID the alters can actually think they are completely separate from other alters, and that they can “kill” off parts of themselves. That a part believes he or she can kill another part of the mind by destroying the body occupied by the other part and survive unharmed is a classic illustration of trance logic. To think that the body can be destroyed but one can survive because the body belongs to another alter and not one’s self makes the DID patient very prone to consider suicide, and makes this condition potentially lethal. What can be imagined may be given equal standing with what is actually the case. Thus, Bryce hasn’t actually killed Chicken, but he thinks he has because either she is temporarily in accessible, her toy is destroyed, or both. However, Chicken is not “dead,” but she is currently inaccessible to any of the other alters. Bryce’s threat to kill Tara is VERY concerning, because we already know Bryce has cut Tara, and it is apparent he thinks he can hurt or kill other alters and remain intact himself. This is a common problem in DID, and it must be addressed immediately. In a competent therapy, the alter Bryce would be gently confronted to understand that he and other alters share the same body and mind, and that killing an alter would mean killing the entire body. Therapists who work with DID regularly challenge trance logic to decrease dissociative barriers and ensure the safety of the client. Ironically, Dr. Hatteras’ ideas are grossly inept because even when he tries his best, he is so egotistical that he looks at Tara’s situation as one that he can manage utilizing only his own ideas. A normal person would welcome as much information as he or she could gather in order to solve a problem, but a DID patient is so afraid of some of the contents of his or her mind that several alters may hatch problem-solving plans based on incomplete information: hence Gimmee and Chicken run, Shoshonnah pontificates, Alice preaches, T sexualizes, and Buck becomes aggressive. None of them is capable of “playing with a full deck.” In a similar manner, Dr. Hatteras is afraid to face his own inadequacies of character and knowledge. Where he should be humble about his shortcomings and learn how to handle the situation with which he is confronted, he blusters and remains stuck in his old ideas, which have little to do with how to treat DID. Instead of studying the professional literature, getting a consultation, or doing something else to improve his expertise in treating DID, he carries on in a way that resembles the thinking limitations of Tara’s alters. He tries to confront the treatment of DID from a position of relative ignorance. Even when he genuinely tries to be helpful, and extends himself generously, his limitations and his fear of facing the realities with which he must contend in order to help Tara undermine his best efforts. Like Tara, what remains excluded from his mind, in his case excluded by egotism rather than dissociation, leaves him weakened and compromises his chances of success in what he tries to achieve.

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Episode 9: Bryce Will Play

Kate is still quite enamored with Evan, but the out of control misbehavior of his son, Monty, tests her affection and her endurance.  Charmaine is stressed by the new demands of motherhood, and joins a “book club” for the mothers of infants. Her fellow moms seem to have more interest in drinking than literature.  Marshall and Max attend the debut of Marshall’s short film. Max is surprised to learn that the film, entitled “Max Makes Good,” is about him.  The theme of Marshall’s film is that his father is “living one life, dreaming another,” essentially in denial of the extent of Tara’s mental illness. Max reacts negatively. He is offended. He says he is glad Tara didn’t see “Max Makes Good” because it would upset her. He holds fast to his denial, insisting that Tara “doesn’t put [him] through anything.”  Meanwhile, Tara’s over the top behavior continues to escalate.  More and more she switches into Bryce, a terrifying identification with her abusive half-brother. In the inner world of the mind, Bryce is on the attack, acting with brutality, claiming that he is killing other alters (e.g., symbolically burning Shoshanna’s books, stabbing Gimme’s coat).  Bryce declares that his goal is to kill all the alters, including Tara. Dr. Hatteras confronts Bryce. Rising to the occasion and making a thoughtful clinical intervention, Hatteras tries to explain to Bryce that if he kills other alters, he will kill himself.  Bryce tolerates no opposition. Adding Dr. Hatteras to his list of enemies, and knowing he is profoundly allergic to crab, Bryce attempts to kill Dr. Hatteras by serving him a dish made with crab meat, endangering his life.  Over the days prior to the events of this episode, Dr. Hatteras had become completely absorbed in trying to help Tara, to the extent of spending long evenings at her home while Max is out of town.  Ironically, Dr. Hatteras’ out-of-control behavior has exhausted the patience and tolerance of colleagues in the department of psychology, moving them to act just as he seems to be beginning to understand Tara’s DID. Dr. Swallow, the department’s co-chair, feels compelled to intervene. He acknowledges the stress Hatteras had been under after the suicide of kite boy, whose successful treatment had been the cornerstone of Hatteras’ professional career, and appreciates that this may fuel the intensity of his current work with Tara. Nonetheless, he insists that strong and definitive steps must be taken. He insists that Hatteras terminate his involvement with Tara. He tries to both minimize any damage to Tara’s pursuit of her degree and protect the reputation of his department by offering to give Tara with an A in her psychology course, stipulating that she attend no further classes in the course and never discuss her complicated relationship with Dr. Hatteras. He tells Tara she needs treatment by an expert, and gives Tara the names of two therapists skilled in treating DID. Dr. Hatteras will complete teaching the current semester, but will be retained on the faculty. As he makes, his exit, Dr. Hatteras sarcastically depreciates one expert, recommending the other, and finally tells Tara he has been “converted.” He now believes in DID.

Commentary:
Tara’s alter Bryce is acting out violently. He tries to kill the other alters, destroying objects identified with them, and attacking them in the inner world of the alters. When Dr. Hatteras confronts Bryce, Bryce tries to kill, or at least scare off, Dr. Hatteras. Are these actions typical of an alter that is an introject of an abuser?  Alters that are introjects of abusers are typically mean to other alters verbally and behaviorally, but for specific purposes. Within the DID patient’s alter system, the job of alters based on abusers alters is typically to protect the individual from more severe pain by imposing authoritarian rules and demands which would keep the patient obedient to the abuser, and safe from incurring the abuser’s displeasure or wrath, or by inflicting a degree of pain to discourage attitudes and actions which would bring still more pain upon that individual.  Abuser alters often express a desire to kill other alters, believing that this could serve as a way to reduce internal emotional pain, to pave the way for their assuming complete control, or to facilitate some other agenda.  Once the therapist challenges the trance logic of the DID patient (as Hatteras challenged Bryce’s assumption he could survive the destruction of Tara, and instance of the toleration of mutually incompatible ideas and perceptions without being troubled by their incompatibility), alters typically find ways to keep the trance logic intact by dismissing the implications of what they have been told, or by rationalizing their way around the confrontation. Although abuser alters can be challenging, hostile, threatening, dismissive, or aggressive towards therapists, they typically work to undermine or sabotage treatment from behind the scenes, or threaten to harm other alters or the body if the therapist does not agree to their demands. They are more likely to attack the therapist by undermining his or her credibility to the other alters or by making a threatening gesture than they are likely to take steps to physically harm the therapist, especially if the therapist can align with the goals of the alter is motivated to pursue (e.g. pain reduction), and work with the alter on developing healthier strategies to achieve those goals that do not endanger the client’s well being. However, serious and potentially lethal attacks on therapists are not unheard of.
Dr. Hatteras is so invested in Tara’s “treatment” that he is spending a great deal of time at her home.  Are there therapists that go to such lengths? If so, is that considered good treatment?  Some therapists perceive a DID client to be so distressed and helpless that they become much too involved in their care. Such therapists may see DID clients outside of professional settings, involve their clients in their personal lives, and take active steps to “rescue” their clients from dangerous circumstances.  Although these efforts may be completely well intentioned, many, and perhaps virtually all of these efforts are problematic for a variety of reasons. Here are a few of them. First, such interventions ultimately convey to the client the message that he or she does not have and/or is unable to develop the skills and abilities to control his/her symptoms and function autonomously. Second, while the therapist can be extremely helpful in fostering recovery, the therapist can never “undo” the damage that was done to a client in childhood by providing literal reparative experiences (e.g., “reparenting”). Endeavors to achieve such objectives, no matter how well-intended, are attempts to reverse years of overwhelming and unfortunate childhood experiences. Inevitably, they are too little, too late, and entail a tremendous number of boundary crossings, the next factor to be discussed. Even though some aspects of the therapist’s role are somewhat parental, the therapist is not a parent. It is not possible to love a client into health. If it were, Max would have cured Tara. Third, in making such efforts, the therapist’s behavior conveys to the client the messages that professional boundaries (the rules of professional conduct designed to protect the safety of the patient and preserve the quality of the treatment) are not firm and meaningful, that it is permissible to bend, bypass, and overlook them. The client initially is often pleased with his or her “special” treatment, but in the long term this pleasure often fades, replaced by feelings of mistrust, vulnerability, and unsafety in the therapeutic relationship. Such specialness too often re-enacts the “special” treatment a victim of childhood receives and later appreciates to have been abusive exploitation. Successful DID therapies are characterized by thoughtful and compassionate approaches to matters of structure and boundaries, resulting in approaches flexible enough to embrace the uniqueness of the individual patient and firm enough to preserve the conditions necessary for optimal and safe treatment

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Episode 10: Train Wreck

The Gregson family has been in crisis and  teetering on the brink of disaster for some weeks now. Matters come to a head with the sudden death of Lionel, Marshall’s ex-boyfriend.  Tara does her best to be there for Marshall, who is shocked and stunned by to learn that Lionel has been killed in a car accident. Despite her efforts, she is losing control. Bryce, the alter based on her abusive half-brother, pushes forward relentlessly, gaining control more and more frequently, and wreaking havoc when he is present.  Tara believes her medication can control Bryce. She tries to suppress him by sniffing her medication, hoping that Bryce cannot make himself throw it up, but her efforts are futile.  Just when Marshall needs Tara’s support the most, for Lionel’s funeral, Bryce takes over, flippantly “blows off” the funeral and proceeds to trash Marshall’s room. Meanwhile, Kate rushes home. She has taken a break from her duties as a flight attendant to support Marshall. She tells Marshall that he needs to get out of the house, but admits that even though she is attempting to leave, she, like Marshall, is too involved to break away. In her own personal life, she and Evan have been trying to define their relationship. She decides she wants him to be her “problem” instead of her mother, and hopes to take their relationship to a more serious level. Home from New York, Max learns about Bryce’s attempt to harm Dr. Hatteras by feeding him crabmeat, to which he is allergic. Max also learns that Dr. Hatteras is no longer involved in Tara’s care. Max feels alone as things are falling apart around him. He turns to Marshall for help.  Instead, Marshall tells Max that he needs to leave. Surprisingly, Max gives him permission to go his own way.  His expression acknowledges that he knows Marshall has endured too much, that the family has exploited and exhausted his resources, and given too little in return. Max attempts to set boundaries with Tara’s alter Bryce, but Bryce is openly defiant. Bryce’s response to Max’s efforts is “Fuck you, old man!” He says will not allow Tara to return, and taunts Max that Tara is not coming back.  Bryce tortures Max, symbolically destroying Tara in front of him by cutting off her long hair. Returning from his out of town work with his brother, Neil learns that when Charmaine allowed Tara to take care of their daughter, “Wheels,” Tara, in an altered state, took her out of town on a bus. Neil tells Charmaine that she needs to limit her contact with Tara, because Tara is not a safe person.  Charmaine struggles with his demands. Struggling with their implications, she wonders how she will know when Tara is OK. Neil pushes these concerns aside. He insists that the safety of his wife and his daughter is the most important consideration. Everything else must be secondary.

Commentary:
Tara’s alter Bryce Crane acts out at the time of Lionel’s funeral by destroying Marshall’s room.  Why would this happen?  Is this behavior that one would expect from an individual with DID? It is unclear why Tara’s alter Bryce feels the need to destroy belongings in Marshall’s room, but we can venture one hypothesis.  The hypothesis is based on our knowledge that alters that are introjects of previous abusers were formed to engage in protective functions for the client. (See commentary for last episode.) The night before Lionel’s funeral, Tara mentions to Max that she realizes that Marshall could have died.  She is very vulnerable in that moment.  It is possible that Bryce came forward because Tara could not handle that level of vulnerability (the realization that she could lose her own son), and that he destroys Marshall’s room to anger Marshall and drive him away.  Although this level of aggression is not common in DID, the dynamic is.  Individuals with DID have had so much abandonment and loss in their lives that they have great difficulty tolerating the idea that further loss of loved ones could occur.  One way protective alters (such as Bryce) deal with this fear is to push loved ones away. By distancing themselves from the intimacy, they hope to decrease the amount of pain they would feel if they lost the person. This process may not be carried out at a conscious level.  One goal of therapy is to teach the DID client how to tolerate interpersonal closeness without sabotaging it, and to accept the inevitable experiences of separation and loss.

In this episode, Tara attempts to suppress switching to Bryce Crane by taking medications.  Is this something that would be effective for someone with DID?
No.  Although taking certain medications (e.g., sedatives) might prevent an individual with DID from acting out as much when in a destructive self state, this solution is temporary and will not ultimately solve any problem.  In fact, it could make the problem worse.  Destructive alters who are acting out usually have a good reason for doing so, despite the fact that their behavior is incredibly disruptive and the good reason may be far from apparent.  To try to suppress an alter that is acting out will likely result in more acting out behavior, because the alter wants to be heard and understood.  Competent DID therapists reach out to these potentially disruptive alters to encourage them to express themselves in a therapeutic dialog rather than in problematic behavior. They work with destructive alters to try to determine the motives for their behavior, and to teach them more adaptive ways to protect the client from whatever they fear.

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Episode 11: Crunchy Ice

After weeks of increasing chaos, the Gregson home is clearly in a state of crisis. Bryce Craine, Tara’s sadistic alter based on her abusive half-brother, dominates this episode. In executive control most of the time, Bryce wreaks havoc in Tara’s life, “killing” other alters in her internal system, and inciting conflicts with different family members. During this episode, Bryce manages to break a prized Christmas decoration that belongs to Max’s mother; comes on to Kate in an aggressively sexualized manner; and taunts Marshall about Lionel. The members of the Gregson family hold different opinions about what should be done to help Tara. Max tries to fix the problem with well-worn Gregson strategies that have worked in the past (though only for short periods of time!); for example, taking Tara to her favorite places. Desperate, and hopeless, they fail to make things right. Kate and Charmaine think that Tara should be institutionalized. Max’s mother encourages Max to leave Tara because “crazy is crazy.” She says she agrees with the decision that her husband made to leave her, and that his only mistake was leaving Max behind with her. Neil finds the obituary of the real Bryce Craine among some of Buck’s pornography kept at Neil’s home for “safe-keeping.” The family determines to take Bryce (the alter) to the grave of the historical Bryce to prove to the alter Bryce that he is not the real Bryce. At the gravesite Charmaine loses control of her emotion, expressing her rage over what had been done to her Tara. The stark reality of the grave has no power to shift Bryce’s perspective. Reveling in his grandiosity, Bryce, like many confronted abusers, blames his victim, Tara. He insists “I did it, I’m the one. She deserves it. She wanted it to happen, that is why she never told.” The episode comes to a head as Bryce taunts Marshall, who refuses to back down, and confronts Bryce, announcing “I’m not scared of you.” At this point, Bryce fakes a transition to the alter, Alice, comes closer to Marshall, and slaps him. Marshall counter-attacks, and Tara, as Bryce, ends up on top of Marshall, hitting him in the face. As Max breaks up the fight, Tara returns. She is devastated to see what she, as Bryce, has done. Max finally sees that Tara needs hospital care, and Marshall understands that he must leave the home, as he cannot live in this in this masochistic way. Although Max has told Marshal that he needs his help, he sees the damage that Marshall has endured. He realizes that he must let Marshall go, and gives him permission to do so. As the episode comes to an end, Max is driving Tara to a treatment facility. As they cross a bridge, Tara demands that Max pull over to the side of the road. Tara tells Max that she loves him, springs out of the car, and jumps off the bridge.

Commentary:
What would experts on DID say about the behavior of the alter Bryce Craine?
Is Bryce’s behavior is typical of individuals with DID? Yes and no. Previous commentaries noted that Bryce sees “his” body as separate from the bodies of other alters. This tolerance and endorsement of mutually incompatible perceptions is referred to by scholars of hypnosis and dissociation as “trance logic.” Trance logic is common in the thinking DID clients. It can result in situations in which suicide attempts are made outside the awareness of some parts of the mind , and are experienced by other parts of the mind as their attempts to kill a body that belongs to other parts.

When Bryce speaks about the abuse in a way that suggests Tara is at fault for its occurrence (“she wanted it to happen”), he demonstrates a typical rationalization and set of defense mechanism common in alters that are based up abusers. This nonsense is often found in the testimonies of child abusers and rapists in the legal system. At a deeper level, Bryce’s blaming other alters for the abuse, which is actually self blame, distances himself from participating in the painful feelings of having been unable to protect one’s self in the face of terrible events the total human being Tara could not control. This has a survival value that may not be immediately apparent. Bryce preserved an island of mastery (however twisted and perverse) in the stormy sea of Tara’s childhood helplessness. Bryce’s persistence preserves in Tara’s mind the illusion of having some control over a course of her life’s events. Being left with nothing but the sense of one’s own helplessness is intolerably painful. Some similar dynamics are found in the Stockholm syndrome.

While the sort of nasty behavior Bryce shows towards other members of the Gregson family is not unknown, it is not typical. It is not the norm for alters based on abusers to behave seductively toward their children, destroy the possessions of family members, or to attack them physically. When such behaviors due occur, they usually are isolated and infrequent, and do not encompass such a wide range of negative behaviors.

As a consequence of Tara’s behavior in this episode, her family decides to have her hospitalized. Is this the right decision? Yes. At this point in time, Tara is a threat to her own safety and to the safety of her family members, and is unable to exercise sufficient control over her own behavior. Tara would best be served by being treated in an inpatient facility that specializes in treating DID patients, because treatment professionals at a specialized facility would know to work specifically with the major target symptoms associated with Tara’s decompensation. The alter Bryce Craine must be assisted to decrease “his” acting out behaviors. Imposing a “chemical straightjacket” and strict external controls may cause Bryce and these behaviors to be suppressed for the moment, temporarily appearing to reduce Tara’s presenting problems, but would be unlikely to contribute to the long-term resolution of Tara’s condition. Such “successes” may not persist long beyond the discharge date. Although a hospital stay may be urgent at this point in Tara’s narrative, the single MOST important thing that Tara needs is to commit herself to intense work with a therapist who is trained and competent in working with DID clients. Good outpatient therapy with a skilled and knowledgeable therapist can help clients with DID avert hospitalizations by accessing and working with alters on a regular basis. If Tara is hospitalized, the most important part of her hospital care will be the arrangements made for aftercare with such a therapist. She should be seen for at least two sessions per week, either as two sessions of regular length or a single session of double length.

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Episode 12: The Good Parts

The episode begins with a dramatic scene, a fantasized dungeon of torments, in which Tara water-boards and tries to kill her alter Bryce, because she wants to be free of him, ironically repeating the sort of inner murder Bryce had been trying to perpetrate against other alters in recent episodes. Just as she believes she has succeeded, Max finds her. This proves to be the inner world experience of Tara’s having jumped from the bridge into a body of water, and Max’s jumping in to save her. Tara and Max offer clumsy lies to the police investigating why she jumped off the bridge. Tara talks Max into taking her to Boston for treatment (i.e., to the expert Dr. Hatteras recommended) instead of to the nearby inpatient facility to which they had been driving. When Tara and Max return home, the family is distressed by this change of plans. Tara tries to reassure them that going to Boston is the right thing. She begs everyone to come together for one last final family supper before her departure. Marshall, exasperated far beyond his capacity for tolerance, responds with bitter, angry sarcasm. He feels Tara keeps trying to make things better with empty superficial gestures. Neil tells Max that he and Charmaine are going to move to Texas. They offer Marshall a chance to live with them. Charmaine doesn’t want to move, but eventually gives in when Tara confronts her, urging her to deal with her issues about allowing Neil to take care of her. Charmaine asks Neil to marry her. As the family dinner approaches, Max has fantasies of acting out in anger towards those around him who are denying the gravity of the current situation. The irony of his rage at others for not taking the stance he has taken for years is glaringly apparent. Max finally loses it at dinner and explodes. The family, including Tara, seems to understand, and they carry on. Within seconds, things are back to “Gregson normal.” It is as if Max’s outburst had never occurred. Marshall, who has been angry at his mother throughout the episode, confesses to Evan that he has not gone to Lionel’s memorial site. Later Marshall finds Tara in his room, cleaning up the mess her alter Bryce had made. She succeeds in coaxing Marshall to go to the site. Marshall tells her that he regrets he didn’t say everything he needed to say to Lionel before he died, and that he will not repeat the same pattern with her. Kate tells Evan that although she really wants to move to St. Louis with him as he has requested, she feels she should stay home with her Marshall while her parents are in Boston, where Tara can receive specialized treatment. Evan supports Kate’s decision, and tells her he loves her. As the episode nears its end, the family says their goodbyes to Tara and Max. Marshall tells his mother that he does not want treatment to eliminate her “good parts,” and she tells Marshall and Kate that they are her “good parts.” As Max and Tara drive toward Boston, Tara seems to be experiencing some kind of freedom and hope. Tara puts down her window and sticks her head through the open window, appearing to relish being cleansed by the fresh air.

Commentary:
Has Tara really killed her alter Bryce? Although Tara may have momentarily succeeded in getting Bryce to step back from being front and center, it is not possible for one alter to kill another alter in this manner. Alters can only become more integrated with each other through the paced processing of traumatic memories. Even then, it would not be the case that an alter was “killed,” but rather that alters become less separate from each other over time as they share memories, emotions, and sensations that have been fragmented from each other. Although alters cannot kill each other, trance logic, discussed earlier, allows the death of alters to be experienced as if real, although they persist. Such alters may remain hidden or inactive for protracted periods of time, making the DID patient more certain that such illusory deaths are “real.”

Is Max’s anger outburst at the dinner table a healthy response to what is going on in the family? Although it is completely reasonable that Max would be upset about his wife’s behavior being out of control for such a prolonged period of time, his suppression of anger has not been healthy and has led to this violent outburst. Max needs to learn more healthy strategies for modulating his feelings, as opposed to denying them and then allowing them to explode, and then reconstituting his denial. (Such patterns, ironically, are quite characteristic of clients with PTSD.) Max seemingly remains largely unaware of how he has contributed and how he continues to contribute to Tara’s problematic situation by supporting Tara’s irrational preference to continue to try to work out her problems without specialized help. Among mental health professionals, a person who makes it possible for a person with addiction issues/mental disorders to continue his or her dysfunctional behavior is called an enabler.

What should Tara expect from specialized inpatient treatment for her DID? Tara has a lot to learn. A good specialized treatment facility for DID would help Tara learn skills to manage her switching so she stays present and does not continue to enact behaviors outside of her awareness. She should expect that her treatment team will want to work with Bryce on understanding his adaptive functions, how he is trying to protect Tara (and from what), and on teaching Bryce and other alters skills to protect Tara and one another in more adaptive ways. Much of treatment will focus on helping Tara’s system of alters to develop better internal communication and collaboration with each other, so that internal conflicts and life issues can be resolved internally with greater ease. Tara will also be encouraged to have a solid treatment team lined up prior to discharge, including specialists who will follow up and expand upon the work she has done in the hospital. Tara should NOT expect to be processing much of her past trauma during this hospitalization. Detailed discussion and processing of traumatic events can occur in therapy only after the client has demonstrated a prolonged period of stability, and has mastered the tasks of the beginning stages of treatment.

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