Research on organised abuse emphasises the diversity of organised abuse cases, and the ways in which serious forms of child maltreatment cluster in the lives of children subject to organised victimisation (eg Bibby 1996b, Itziti 1997, Kelly and Regan 2000). Most attempts to examine organised abuse have been undertaken by therapists and social workers who have focused primarily on the role of psychological processes in the organised victimisation of children and adults. Dissociation, amnesia and attachment, in particular, have been identified as important factors that compel victims to obey their abusers whilst inhibiting them from disclosing their abuse or seeking help (see Epstein et al. 2011, Sachs and Galton 2008). Therapists and social workers have surmised that these psychological effects are purposively induced by perpetrators of organised abuse through the use of sadistic and ritualistic abuse. In this literature, perpetrators are characterised either as dissociated automatons mindlessly perpetuating the abuse that they, too, were subjected to as children, or else as cruel and manipulative criminals with expert foreknowledge of the psychological consequences of their abuses. The therapist is positioned in this discourse at the very heart of the solution to organised abuse, wielding their expertise in a struggle against the coercive strategies of the perpetrators. Whilst it cannot be denied that abusive groups undertake calculated strategies designed to terrorise children into silence and obedience, the emphasis of this literature on psychological factors in explaining organised abuse has overlooked the social contexts of such abuse and the significance of abuse and violence as social practices.

~ Michael Salter

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact.But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

~ Cameron West

Of course, I should have known the kids would pop out in the atmosphere of Roberta's office. That's what they do when Alice is under stress. They see a gap in the space-time continuum and slip through like beams of light through a prism changing form and direction. We had got into the habit in recent weeks of starting our sessions with that marble and stick game called Ker-Plunk, which Billy liked. There were times when I caught myself entering the office with a teddy that Samuel had taken from the toy cupboard outside. Roberta told me that on a couple of occasions I had shot her with the plastic gun and once, as Samuel, I had climbed down from the high-tech chairs, rolled into a ball in the corner and just cried. 'This is embarrassing,' I admitted. 'It doesn't have to be.''It doesn't have to be, but it is,' I said.The thing is. I never knew when the 'others' were going to come out. I only discovered that one had been out when I lost time or found myself in the midst of some wacky occupation — finger-painting like a five-year-old, cutting my arms, wandering from shops with unwanted, unpaid-for clutter.In her reserved way, Roberta described the kids as an elaborate defence mechanism. As a child, I had blocked out my memories in order not to dwell on anything painful or uncertain. Even as a teenager, I had allowed the bizarre and terrifying to seem normal because the alternative would have upset the fiction of my loving little nuclear family.I made a mental note to look up defence mechanisms, something we had touched on in psychology.

~ Alice Jamieson

It is necessary to make this point in answer to the `iatrogenic' theory that the unveiling of repressed memories in MPD sufferers, paranoids and schizophrenics can be created in analysis; a fabrication of the doctor—patient relationship. According to Dr Ross, this theory, a sort of psychiatric ping-pong 'has never been stated in print in a complete and clearly argued way'. My case endorses Dr Ross's assertions. My memories were coming back to me in fragments and flashbacks long before I began therapy. Indications of that abuse, ritual or otherwise, can be found in my medical records and in notebooks and poems dating back before Adele Armstrong and Jo Lewin entered my life. There have been a number of cases in recent years where the police have charged groups of people with subjecting children to so-called satanic or ritual abuse in paedophile rings. Few cases result in a conviction. But that is not proof that the abuse didn't take place, and the police must have been very certain of the evidence to have brought the cases to court in the first place. The abuse happens. I know it happens. Girls in psychiatric units don't always talk to the shrinks, but they need to talk and they talk to each other. As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept.(Alice refers to her constant infections as a child, which were never recognised as caused by sexual abuse)

~ Alice Jamieson

SELFHOOD AND DISSOCIATIONThe patient with DID or dissociative disorder not otherwise specified (DDNOS) has used their capacity to psychologically remove themselves from repetitive and inescapable traumas in order to survive that which could easily lead to suicide or psychosis, and in order to eke some growth in what is an unsafe, frequently contradictory and emotionally barren environment.For a child dependent on a caregiver who also abuses her, the only way to maintain the attachment is to block information about the abuse from the mental mechanisms that control attachment and attachment behaviour.10 Thus, childhood abuse is more likely to be forgotten or otherwise made inaccessible if the abuse is perpetuated by a parent or other trusted caregiver.In the dissociative individual, ‘there is no uniting self which can remember to forget’. Rather than use repression to avoid traumatizing memories, he/she resorts to alterations in the self ‘as a central and coherent organization of experience. . . DID involves not just an alteration in content but, crucially, a change in the very structure of consciousness and the self’ (p. 187).29 There may be multiple representations of the self and of others.Middleton, Warwick. Owning the past, claiming the present: perspectives on the treatment of dissociative patients. Australasian Psychiatry 13.1 (2005): 40-49.

~ Warwick Middleton

The return of the voices would end in a migraine that made my whole body throb. I could do nothing except lie in a blacked-out room waiting for the voices to get infected by the pains in my head and clear off. Knowing I was different with my OCD, anorexia and the voices that no one else seemed to hear made me feel isolated, disconnected. I took everything too seriously. I analysed things to death. I turned every word, and the intonation of every word over in my mind trying to decide exactly what it meant, whether there was a subtext or an implied criticism. I tried to recall the expressions on people’s faces, how those expressions changed, what they meant, whether what they said and the look on their faces matched and were therefore genuine or whether it was a sham, the kind word touched by irony or sarcasm, the smile that means pity. When people looked at me closely could they see the little girl in my head, being abused in those pornographic clips projected behind my eyes? That is what I would often be thinking and such thoughts ate away at the façade of self-confidence I was constantly raising and repairing. (describing dissociative identity disorder/mpd symptoms)

~ Alice Jamieson

If I was set an essay on Friday, I’d spend three hours on Saturday morning in the library. Was that normal? I didn’t know. What I did know was that I felt less prone to depression and more normal walking through Venice or staring out over the lake in Zurich. At home I wrestled continually with my moods. The black thing inside me gnawed like a rat at my self-esteem and self-confidence. I felt there was a happy person inside me too, who wanted to enjoy life, to be normal, but my feelings of self-loathing and the deep distrust I had towards my father wouldn’t allow that sunny person to come out. When the black thing had an iron grip on me, I couldn’t even look at my father: Did you do bad things to me when I was little? Like a line from a song stuck in your brain, the words ran through my head and never once came out of my mouth. Not that I needed to say what was in my mind. I was sure Father could read my thoughts in my moods, in the blank, dead stare of my eyes. It was hardly surprising that there was always an atmosphere of strain and awkwardness in the house, and the blame was always mine: Alice and her moods, Alice and her anorexia; Alice and her low self-esteem; Alice and her inescapable feelings of loss and emptiness.

~ Alice Jamieson