Attachment Theory and Care Giving: The Roadmap for Healing D.I.D.

For nearly 5 years I have been helping my wife, my girls, heal from dissociative identity disorder also known as multiple personality disorder. When I first began this blog I was summarily blacklisted from every d.i.d. group that I tried to join because of my unorthodox ways. And yet, my girls continued to heal rapidly, without experiencing the secondary trauma that so many do from the common therapy process itself. Then I began to read about attachment theory more deeply and found a close similarity to its tenets and my methods, and so I’d like to continue examining how this theory can better inform us when helping someone with d.i.d. heal.

One of the tenets of the modern therapeutic relationship is the “empowerment of the survivor. She must be the author and arbiter of her own recovery. Others may offer advice, support, assistance, affection, and care, but not cure. Many benevolent and well-intentioned attempts to assist the survivor founder because this fundamental principle of empowerment is not observed (p.133)”*. The author then goes on to characterize those who break this tenet as narcissistic, breaking boundaries, counterproductive and having visions of “the role of a rescuer.”

As I read this book, (and I actually do greatly appreciate it), I can understand why so many object to my methods, and yet I believe attachment theory firmly supports what I am doing, and here’s why.

Attachment theory is predicated upon the primary caregiver’s care giving. This care giving is complete and total for an infant and continues throughout childhood. As the child ages the care giving changes and diminishes slowly. As it does, the child forms a complex “internal working model of social relationships” (wiki). This internal model follows the child throughout adulthood and all of life.

Having lived with a woman whose personality was broken and fragmented by the massive trauma she sustained at the time her attachment system was forming, I believe modern psychology does not understand that its tenet of empowerment actually feels strikingly similar to the abandonment the trauma survivor felt as a child. Moreover, the complex nature of this disorder has me attending to so many discordant and often conflicting needs in my girls at the beginning of the journey, that to push “empowerment” from the start is to doom the journey to failure. A healthy attachment model is formed over years. Trauma only serves to complicate that process.

Here are some of the labyrinthine factors that preclude a blind adherence to empowerment:

1)      A childhood-trauma survivor’s attachment model is typically demolished by the trauma. The various girls will likely have varying attachment patterns and thus varying needs to heal and restore those patterns to a “secure” base. Attachment theory assumes being reciprocally “attached” even in the case of the mother and baby. There is no room for the hands-off approach that empowerment assumes. Even with a healthy person, one can expect to get “dirty” at times to fulfill reciprocating attachment needs. With a traumatized person expect to get dirtier, longer…

2)      Though a person with d.i.d. has an adult body, many of the insiders are developmentally and emotionally children. My wife has girls ages 2,3,5,8, and 2 tweens. It would seem the areas of my wife’s brain controlled by the little girls were literally frozen in time by the d.i.d. Thus to “empower” these little girls would feel to them exactly like it would to a normal child: abandonment. Sometimes I think therapists would do well to consult pediatric specialists to help them understand the nature of the needs and desires raging in a d.i.d. patient’s psyche. I always try to treat Karen respectfully, but my wife as a whole is anything but a mature woman. The presence of the little girls demands that I treat them accordingly.

Right now the 2 littlest girls still want me to bathe them and feed them anytime I’m home. And though Alley, my girlfriend, loves to debate adult topics with her many, married friends on-line including politics, religion, sex, parenting and more, she still emotionally feels too little to marry me.

3)      The nature of d.i.d. ought to be self defining: the various girls in my wife’s network were dissociated or unable to communicate with each other at first. At the beginning stage of the journey, they often used me as a middle man; sometimes they still do. To ignore the inherent nature of d.i.d. and insist on “empowerment” only prolongs the time it takes to make progress in the beginning until the communication lines in the brain are literally restored. Yes, it was frustrating when Amy asked me to tell Karen something, especially when I knew they were far along enough that they could talk to each other, but the overlapping and competing needs of the various girls means that I accept at face value their requests for help and assistance.

4)      Attachment theory understands that security is found in proximity to the caregiver. Threats can be faced much better when we know we aren’t alone. Empowerment pushes too much, too soon. To a trauma victim there’s an OVERWHELMING sense of being alone and cutoff. What I found so surprising is that Ms. Herman could accurately assess the problem of the trauma victim feeling alone in the first half of the book, and then completely miss the remedy in the second half. My girls’ overwhelming need, even today, is to know, “YOU ARE NOT ALONE.” Attachment theory understands that our lives are interconnected to each other. Every aspect of our lives is interconnected to those closest to us. For a husband and wife it even includes our bodies. So attachment theory would lead us to naturally assume that I AM a part of my wife’s cure. Not only am I to be her obvious adult attachment figure, but for the little girls I have assumed the role of their primary caregiver. I am literally changing the broken and traumatized “internal working model of social relationships” that they once had.

5)      There’s an old proverb that says, “Death and life are in the power of the tongue” (18:21a). How many of us have destructive words that others have said to us rattling around in our minds? But in a healthy childhood a good parent’s words implant themselves in our brains as well. I take this aspect of my wife’s healing EXTREMELY seriously. I spend all day and night speaking literal, healing, curative words to my girls. Just yesterday I called Tina “precious” and her eyes and face lit up and she said, “You really think I’m precious?” I put my hand to her face and said, “Yes, Honey, I do.”

My positive, uplifting words are part of the cure my girls need. I speak things like “I love you” “You are a good girl.” “I’m proud of you.” “You are precious to me.” “I’m so glad you are a part of my life” etc, etc. As I do I visualize replacing those old, negative words that have haunted my wife throughout life. I’m rewriting her trauma-victim paradigm. It’s like rewriting a PC to accept MacOS. Sometimes I see the replacement of lies with truth like yesterday with Tina. I speak healing words to her. I am literally her cure in this aspect.

6)      To use empowerment as the foundation for the therapeutic relationship with someone who has d.i.d. betrays the corrupting influence of our culture that really doesn’t understand the nature of mental illness. “The body looks fine. Why don’t you act normal?” our culture inherently thinks. If we hear “cancer” or “car accident” we understand, but even mental health professional are swept up in the cultural bias against mentally handicapped people.

At the beginning of the healing journey, my wife was as incapacitated as the proverbial accident victim on a tv sitcom in a full body and head cast with only slits for her eyes and mouth. My girls needed me and my son to do EVERYTHING for them. I worked 55 hours a week, came home and cleaned the house and made food, and still found time to play with the girls and do things to build their co-consciousness. Empowerment is a fantasy for someone with d.i.d. until there have been major strides forward in healing. I have to watch myself carefully that I don’t fall into our cultural trap of looking at my wife’s body and expecting her to act like a normal, healthy woman. I had an uncle who was bedridden for a decade in his 30’s before he died. His devoted wife cared for him while she also held a job and raised 2 children. If she could do so without hope of her husband’s recovery, then I can do it when I do have that hope. And that’s what the girls needed me to do for them to heal.

7)      At times I am a benevolent dictator with my girls. I make no apologies for it. Karen still tells me she doesn’t know what “healing” looks like: but I do. Last week I “declared” no more sex between Karen and me because Tina has become so connected with Karen that Tina feels unsafe when we have intercourse. Karen isn’t happy about this decision. I cried and cried about the decision myself. This is only temporary until either Tina receives more healing in this area or we can figure out a way to do it now that feels safe to Tina. But I have to always look out for the best interests of ALL my girls. Karen and the others still can’t see the big picture because of the residual dissociation among them. I see the big picture, so sometimes I call the shots.

But that doesn’t mean I don’t listen to my girls, lots and lots. Sometimes I make a decision and it’s wrong and the girls are sure to let me know. Then I quickly backtrack, apologize and we go on. I’m a benevolent dictator who always allows the girls to have the final say. My girls have no baseline for “healthy” so empowerment makes them feel overwhelmed and panicky. What they need is a trusted guide on a journey who is still humble enough to tailor things to their individual needs.

Attachment theory recognizes our inherent interconnectedness with our closest relationships. In a healthy relationship each person adds to the relationship. But when only one is healthy the need is even greater for him/her to be able to provide the attachment bonds so necessary for the healing of the other. In the beginning of the healing journey it is fully reasonable and necessary for the person with d.i.d. to be largely dependent on the healthy person. Then as healing continues the care giving is diminished to the interdependent scenario envisioned by attachment theory.


Sam, I Am

*Trauma and Recovery, Judith Lewis Herman, 1992.


7 Comments (+add yours?)

  1. jeffssong
    Feb 02, 2013 @ 09:45:25

    “Attachment theory is predicated upon the primary caregiver’s care giving. This care giving is complete and total for an infant and continues throughout childhood.. . . ”

    It suddenly struck us: this is why we were so hard on ourselves for so long. “We” weren’t good caregivers to our littlest ones; we hated them. We ‘abandoned’ them, or at least one (little Mikie) to the dooms of our inner mind – instead of loving and caring for him.

    So it appears that part of this ‘cure’ is getting some of the adult (and teenage) alters the ‘job’ of being not just caregivers to the other alters, but GOOD caregivers with love in their heart. We weren’t good caregivers for ourselves for so long – and then (of course!) – in an attempt at self-healing, our system gave us one (the Jeffery Thompson alter). That worked, and we worked hard as well, cooperating with this alter in all parts of the system until now our ‘system’ – most of us – have learned caregiving attitudes towards one another – quite a big difference from years ago when we spent most of our time fighting and trying to “kill” or squelch each other’s feelings, thoughts, ways.

    Good post. I’m glad that you and the girls are getting along fine. Given them all our best. 🙂


  2. Bourbon
    Feb 03, 2013 @ 10:06:16

    You speak the same subjective truth as my own therapist does and I love her for it.


  3. Diana LaRose
    Feb 03, 2013 @ 11:30:28

    Hi Sam – I just discovered your blog. My husband has had a couple of diagnoses over the years: bipolar, borderline personality disorder, complex PTSD. I am now wondering about DID.

    His major problem has always been sudden, horrible rages. He is not abusive, but the rages are disturbing and scary. And once they start, nothing “external” can stop them. Eventually, they click off, and he becomes the opposite: teary, guilty, terribly remorseful. The blubbery, passive, depressed personality sometimes lasts for days.

    This type of behavior is typical of a number of common psychologicalk disorders, but a few things have recently made me think DID:

    — the different states are more than just moods. When those personalities take over, the others are not reachable. Hard to describe this in words, but it is extreme.

    –He does not remember things he said/did in each state. It is not a total memory lapse; he knows he was in a different state, but he often doesn’t remember really extreme things he said/did.

    -He can’t stick to projects, plans, etc because what makes sense in one state has no meaning in another.

    — A couple of the states are very childish: completely selfish, illogical, and egocentric.

    The different states are not anything dramatic as one would see in the movies; he doesn’t respond to different names or anything like that. I do not use the term “alters” because I don’t perceive a complete separation between the states. But after living with these states for several years, I can see that they are not phases or moods but pieces of a shattered personality.

    I’m sure I will learn a lot from your blog and am looking forward to reading more of it.



    • Sam Ruck
      Feb 03, 2013 @ 12:48:48

      Hi Diana,

      it’s so good to hear from you. Even though I write this blog for fellow spouses, I infrequently hear from them. Good luck to you and your husband and I hope to hear from you more.



  4. KCSun
    Sep 21, 2013 @ 16:19:45

    This is M. For sake of easiest understanding, I would be equivalent to you Karen although I think I see some huge diferrence. I/we have read most of your blog and each time somethi g else stands out to one of us. In this case I would like to address the sexual aspext you mentioned above. But to explain how we resolved this I need to first explain the ground work that first went into effect.

    Early on when I learned of my D.I.D. I desperately needed time to feel noral and block out the others. This was initially done in two ways. First politely explaining my need, why and asking for privacy. That did a lot for me as the others were sometimes willing to ablidge.

    Also we began learning to mainpulate our inner world. My husband would ask one of the little girls to play a trick on the other by changing something within. At first it was bringing new items in, then that progressed to changing things. Jack is a young teen boy who is maternal to the youngest of our group. He lives in a treehouse. The youg girls got huge kicks out of changing his treehouse to have pink polkadots or giving him a tail. To shorten this, eventually we leaned through help with our ISH (who can often be anything but a help!) To put up a solid wall of privacy. Each of us at times has wanted to share private moments. Obviously this does reinforce our separateness but over the past 6 months that has begun to breakdown as well.

    Over time perfecting the walling ability has become a near universally learned ability but initially it was mine alone. That allowed privacy between our huaband and me. Obviously the wall can never be abused and a heads up to all is given with odjections allowed. Trust and democracy amongst us is paramount.

    I dont know if it helps. Every individual system is different. But asking for the privacy seems like it would be a great start. Leaning to manipulate the inner world is a great way to lessen its realness as well.

    I have a group of once teen girls and now all adults who are with me almost always now. A. Ch. Molly. Jes. N. they each have intimate but not necessarily sexual private time with our husband, so my asking for it is normal. Even the youg girls will have alone times. Oddly enough, we have receny begun to be so constantly cohesively connected of late that we feel odd without the others presence.

    Our husbamd suggested the wall. Once we had the idea it was possible to make happen. I would highly caution against abruptly using it or not being considerate as it can cause chaos!

    Our husband and I went to the best therapist together and learned early on to work all as a team with him included. However we have been doing this without the aid of a therapst for nearly two years now. Sunce we moved half a country away and will not settle for less than ideal for us, we are often doing this trial amd error. So keep that in mind when considering any ideas that come crom us.


    • Sam Ruck
      Sep 22, 2013 @ 10:37:14

      Hi thanks for the comments.

      At this point I don’t think the girls would let us change our method too drastically. And since I seem unable to help them desire to grow up, my focus has been to break down all the walls (target the dissociation). Right now sex seems to be the only wall consistently maintained, though that’s by the little girl’s choice, not by our insistence. Karen knows that if she is ever going to be whole, she needs the others to join her everywhere, including sex. But I don’t push that right now, though I voice that fact.

      Instead, I do everything I can to facilitate co-consciousness, always trying to find activities that the most number of girls will want to participate in. Right now we’re actively involved trying to get Sophia, to WANT to be outside constantly. She’s the only girl that still prefers to be inside at this point, but she is the ONLY girl that can communicated with Tina. So unless she is outside either Tina or the other 5 are disconnected from outside. But Sophia is the littlest girl and for some reason she finds it very tiring to be engaged outside all the time. So I have to reward for being outside more and also caution her to take lots of breaks until she “feels stronger” being outside.

      You are very fortunate to have had a therapist that worked with both of you. I wish we had that. I’ve always been on my own, and sometimes my wife’s counselor has undermined what I was doing, but her positives usually have outweighed the negatives.


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