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S3 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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S3 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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S3 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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S3 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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