By Sara Lambert

I have met with many people now who are new to their diagnosis of MPD and one of their main concerns - which I also shared in my early stages of therapy - is that their multiplicity is obvious to anyone who meets them. TV and the movies have left us with the idea that switching between alter selves is a dramatic affair, with marked changes in voice, appearance, and behaviour. When most people think of multiplicity, they recall the "classic" cases of The Three Faces of Eve and Sybil, where switching was overt and noticeable, usually between a small number of selves who were dramatically different from each other. However, these cases are now considered representative of the minority. Perhaps one reason why they were the hallmarks of MPD for so long is because of their overt nature. The multiplicity of Eve and Sybil was impossible to avoid. More subtle manifestations of multiplicity were missed. Because few multiples have the Sybil-variety MPD, and because only those who did were diagnosed, the condition was considered rare for many decades.

These days, therapists understand that multiplicity is a condition of great secrecy, and most switching between alter selves is difficult to detect, at least initially. Therefore they have become more alert, and so better able to diagnose MPD even when it is covert. Unfortunately, though, the popular perception of personality switches as being dramatic and cliched continues. This may be because Sybil-variety MPD is better television! But it has left multiples with two concerns. One is that, if they're not like Sybil, they're not really multiple. The second is that their swit-ching is as blatant as that which they see portrayed on tv. This is a real problem because it keeps multiples embarrassed about their multiplicity, isolated from other people, and feeling out-of-control and over-exposed. Without exception, I have been able to assure people that even I, a multiple myself, can not necessarily tell when they switch selves. The difficulty is that, unless we are standing infront of a mirror at the time and able to hold on to our own perceptions, we don't know what we look like when we switch. It feels such a dramatic change that, especially in the early days of our diagnosis, we are sure everyone around us must have noticed.

There are two factors which influence whether someone will be able to recognise multiples' switching. The first, most obviously, is who we switch between. A change from one adult female self to another is generally not going to be so extreme, depending on their similarities in character and presentation. On the other hand, a change from adult to child self is going to create a number of considerable differences that will be apparent to most people - although this is hinges on how long the switch lasts for, whether the child self speaks in her own voice or at all, and also whether the observer believes in multiplicity and wants to accept what s/he is seeing. The second factor is how well the observer knows you or other multiples. It is usual for multiples to spend a number of years in therapy and other health care systems and have no one notice their multiplicity, until they meet a therapist who knows what to look for. It is also usual for a therapist, friend, or partner to become more adept over time at recognising switching and knowing who is "out" without having to be told.

Sometimes, therapists and friends may have an inexplicable sense that you have switched, even if there are no apparent changes, even during a pause in a phone conversation. People talk about feeling a tingling at the back of their neck, a shift in the air, or an instinct in their minds or bodies, that alert them to a multiple's switching. What happens is that the switching process affects energy levels and the subconscious alignments between people. Most people, especially those who don't know you are multiple, will not be aware of these subtleties of existence, nor have any understanding why they suddenly feel "the atmosphere change slightly" as you covertly switch. But people who are familiar with multiples learn to pick up on these changes. Animals are especially attuned to them, as any multiple with a pet will be aware. (It seems uncanny sometimes to me how well my cats and dog know when I switch, and how they change their own attitudes to accommodate the newly arrived person!)

So what does a multiple look like when she switches selves? There are a number of characteristics that are affected by switching. However, it is important to remember, as you read further, everyone is unique. If your switching style is not accounted for, that does not mean you are abnormal, non-multiple, or somehow "doing it wrong". There is no wrong way!

Facial Changes:
The eyes are the windows of the soul, and more than one MPD psychologist has lectured in lyrical depth about the eye changes that occur with switching. They are generally insubstantial and indescribable changes, yet, at the same time, very apparent. Just "something" in the eyes conveys the new person behind them. Sometimes, a multiple's eyes will change colour when she switches, from dark blue to light grey, for example - certainly, this was well-noticed in me long before anyone knew I was multiple.

Other facial changes include a rearrangement of wrinkles and creases, a shift of the jaw from underbite to overbite, and muscle tension/relaxation. Skin may become flushed or pale. Even bone structure can seem to alter, although in fact it is the mobile features (muscles, jaw, etc) being rearranged that make it look like the bones themselves have moved.

Sometimes these changes can be very dramatic, and the multiple may end up looking like quite a different person. In other cases, a subtle shift in expression is all that indicates switching. It is also not uncommon for multiples to keep their faces as still as possible during switching, in an effort (conscious or not) to hide the change in selves.

Body Changes:
Switching is often accompanied by changes in posture, body language, and physical gestures. This is especially the case if the alter self is locked within memories of abuse, and holds their body as if the abuse is still happening to them. For example, they may curl up, rock, pace, jam themselves into a corner or under furniture, or go very stiff, experiencing themselves as still living in the past time. But the re-enactments of abuse can also be very subtle, such as massaging an arm that was broken in the past or digging fingernails into skin to distract from painful thoughts.

Different selves also have mannerisms unique to them. One may be restless, another languid, another physically expressive, another uptight with a nervous tic - various traits of individual personality. Although the body does not actually change in a real sense, different selves may arrange it in a way that can really make it look like they have somehow shrunk or increased in size. Child selves may appear to have difficulty getting their feet to reach the floor. Angry ones may sit with such confidence and force of presence that they seem to be six feet tall. There is also often a change in selves' abilities to managed physical movement. Some are incredibly strong and can lift things the body does not seem capable of lifting. Some have a deftness not seen in any of the other selves. And some limp, suffer paralysis in parts or all of the body, and have tremors. A number suffer physical disabilities like mutism, deafness, blindness, and being crippled. When tested, they maintain these disabilities - in other words, they are not pretending, they genuinely can not see or walk, even if their body is capable to doing so. In other cases, physical changes are very subtle or non-existant. A number of multiples do not have a close association with their bodies, and so do not really "wear" it to any great extent; others have a specific alter whose job it is to hold the body at all times, therefore maintaining a smoothness of physical characteristics.

Voice and Speech Changes:
You would think that, since all selves inhabit one body, all would be limited to the same vocal range. But there can be alterations in pitch, volume, rate, manner of speaking, accent, language use, and vocabulary. Child selves may use "baby talk" and the idiosyncratic grammar of children who have not learned the proper use of tenses. Some selves may have speech problems, such as stuttering or lisping. These changes have been investigated with voice spectral analysis and it has been proven that they can't be duplicated by actors. However, it is also true that voice/speech changes are generally subtle enough that an observer who was unaware of your multiplicity may not even pick them up.

Emotional Changes:
This is where switching is at its most obvious. Sudden changes in emotion, especially when "inappropriate", often get multiples slapped with the labels "moody" or "manic-depressive". Tears that come and go in seconds, flashes of anger, and other abrupt changes make it apparent to everyone that some kind of switch has occurred, even if they do not know to call it MPD. However, multiples are not constantly bouncing off the walls or flicking in and out of different emotional states, and most changes blend in to the spectrum of "normal" behaviour.

The Switching Process:
Switching can take place instantaneously or over a few minutes. Usually it begins with one slow blink, a number of rapid blinks, or an upward roll of the eyes. Sometimes there is a muscular reaction, such as facial grimacing, twitching, shuddering, or an abrupt shift in posture. In the case of extended switches, a multiple may go into an unresponsive trance. More rarely, switches may be violent and extreme, and look like seizures. Both the trance episodes and the seizures mean that a false diagnosis of epilepsy is given to a significant number of multiples.

Even before they know they have MPD, multiples can be very clever at hiding their switching. They look away, lower their head, rub their hand across their forehead or through their hair so their face is hidden for a moment, and/or wait until no one is looking at them.

Typically following switching, the newly arrived self will orient him/herself to place and time with small behaviours known as "grounding". For example, she may clasp her hands, touch her temples, look around the room, rearrange her posture, cough discreetly. Panic is rare since, after all, multiples have been switching all their lives. If she meets a pregnant silence which obviously indicates to her that the previous self was in the middle of a conversation, she will make a casual comment such as, "I'm sorry, could you say that again?" or "Where were we?" to get the conversation back on track with minimum suspicion on the part of the other person. It is easier than singletons would think to continue talking eloquently about a subject you find yourself suddenly dropped into!

Multiplicity is a highly adaptive mechanism, designed to allow the survivor the best possible level of functioning. Thus switching generally happens in a logical way and for good reasons. An alter comes out because s/he is the most ideal one to handle what is going on at the time. It may be because she is an expert in the circumstances (eg, a quick-witted alter confronting a snarky shop assistant) or because she holds essential information (eg, an alter who knows how to drive operating the car) or because her inability to handle the situation is the best way to get out of said sit-uation (eg, a scared child coming out, crying inconsolably, when everyone else in the system wants to avoid a thorny question their therapist has just asked). It is usually when the internal system is stressed or in some kind of trouble that switching becomes problematic, with the wrong people coming out uninvited, and the changes showing up more clearly as less care is taken to hide the multiplicity.

Not Switching:
Most of the time, multiples actually do not switch overtly. Rather, we commonly experience internal switches where selves influence our feelings and actions rather than coming "out" to take full control of the body. This creates sensations like hearing words coming out of your mouth that don't belong to you, seeing the world as if you are taller or shorter, having someone else's feelings and thoughts overlapping your own, and so on. This covert, behind-the-scenes action is usually hard for anyone on the outside to notice (although experienced therapists will often say things like "Is there someone behind you right now?", sensing the hidden influence). For this reason, multiples can realistically go for decades with no one, including themselves, being aware of their MPD.

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If you are going to work with ritual abuse survivors, you must also get educated if you want to be effective. And you must learn to be humble. Trauma survivors do not need to be around ignorant, modern-day Pharisees. Survivors in pain need people who will connect with them on an emotional level, get right down in there where they are, and listen. --Kathleen Sullivan