There are people who fantasize about suicide, and paradoxically, these fantasies can be soothing because they usually involve either fantasizing about others' reactions to one's suicide or imagining how death would be a relief from life's travails. In both cases, an aspect of the fantasy is to exert control, either over others' views or toward life's difficulties. The writer A. Alvarez stated, There people ... for whom the mere idea of suicide is enough; they can continue to function efficiently and even happily provided they know they have their own, specially chosen means of escape always ready... In her riveting 2008 memoir of bipolar disorder, Manic, Terri Cheney opened the book by stating, People... don't understand that when you're seriously depressed, suicidal ideation can be the only thing that keeps you alive. Just knowing there's an out--even if it's bloody, even if it's permanent--makes the pain bearable for one more day.This strategy appears to be effective for some people, but only for a while. Over longer periods, fantasizing about death leaves people more depressed and thus at higher risk for suicide, as Eddie Selby, Mike Amestis, and I recently showed in a study on violent daydreaming. A strategy geared toward increased feelings of self-control (fantasizing about the effects of one's suicide) works momentarily, but ultimately backfires by undermining feelings of genuine self-control in the long run.

~ Thomas E. Joiner

I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices. First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different.The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.

~ Esmay T. Parker

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