Perceptions of Mental Illness After Mass Shootings

     I (we) have been watching with growing concern the increase in mass shootings around the country and the ideas it is forming and bringing out in people concerning the mentally ill.  In my own personal studies of humanity in crime (see Supernova posts), I have noticed that whenever atrocious crimes are committed people instantly try to distance their identity from the perpetrator.  Perhaps the incredulity of what one person in their identity group has done leads to a nagging fear in the back of their minds of what they themselves are capable of.  In any case, distancing oneself from the person who has committed immoral, shameful, or misunderstood acts seems to be the first gut reaction when the deed is made public. "They cannot really be human" people exclaim in astonishment.  Or they find reassurance in pointing to a group they do not associate with as the cause for such terrible actions.  I have been alarmed at the reassurance people seem to find in automatically assuming that mass shooters are mentally ill, or in cases of confirmed mental illness, that they believe the mental illness to be the root cause of such extreme violence.

     While some people who believe mental illness to be the cause of mass shootings are pushing for better mental health care in the US, which is desperately needed, I am concerned about the serious detrimental consequences such a belief will have to the community of people living with mental illness.  First off, we share in the shock and grief of the national and universal community we are also a part of when we hear about such crimes.  Secondly it is an unfair affront to automatically lump us together with criminals simply because of a condition which is completely out of our control. Mental illness does not a criminal make.  Being mentally ill does not make a person dangerous.

      Not to mention it is unjust (I won't say unfair) to the perpetrators in assuming they must be mentally deranged to be capable of committing such a violent act.  Or that mental illness is the only reason they would commit such a thing.  Such an act is beyond asking for help, but it is a scream that is MEANT to be heard worldwide.  I ache for them as I do for the victims they have taken.  I can see that some mental illness may make them more predisposed to act on such rage and despair, but rage and despair are things not belonging solely to mental illness, but rather to the human condition.  It is impossible for any human to point to these lost souls and be able to honestly say "They are not one of us!".  The pain and emotion that beat in them is a pain and emotion that beats in all of us; the numbness that blinds them to a sacred reverence for life we have all proven ourselves capable of in lesser degrees.  PAIN is what causes people to kill.  Not guns.  Not mental illness.  Trying to control guns and mental illness may help curb mass destruction but will not address the root cause; ignoring it will only cause that root issue to grow.  I firmly believe that disowning these men will only widen the rift inside ourselves and between each other, and turn a blind eye towards further destruction in the future.

     Another worry about the growing animosity towards mental illness is that most people who live with it will not be in a position to speak out and defend themselves.  Either their mental illness prevents them from organizing and expressing coherent thought, or the stigma against mental health shames them from admitting to anyone that they have a disorder.  The perception of mental illness is already so poorly understood that most people try to deal with it quietly with as few people in their lives knowing about it as possible.  It is easy to pile a stigma on the brand of mental health when no one can speak against it without blowing their cover or making themselves a target.

     I believe the point we are at now in history can be a good turning point if we can learn to truly communicate and listen to each other, not just with our ears and minds, but our whole being.  We need to share ourselves, to express ourselves with each other.  Something needs to be done, not just on a legal level, or a national level, but on a heart level, individually and as a community.

                         

That Question

     Today we had a dentist appointment at 9a.m..  Since for various reasons we have been a night owl for the last few months, we decided the only way to pull this off was to yank our schedule down a bit this week and then pull an all night-er the night before.  Yeah, won't be doing THAT again any time soon. 
     So while we were sitting in the dentist chair (the awesome one that silently glides up and down so I feel like I'm on a mini roller coaster), wearing the sun glasses she gave me to shade against the overhead glare (awesome sun glasses that made me feel like a rock star), two things happened worth mentioning.  First, it occurred to me that while I was happy not to be freaking out at the dentist as I had feared, I was enjoying this way too much.  I nearly shared my glee with the dental hygienist about the rising chair and the rock star shades but rather unsuccessfully covered it up.  I began to ponder that we seriously need to get out more. 
     Then we began that awkward attempt at a two way conversation while one person is holding sharp objects and electric powered tools in the others' mouth.  That's usually the worst part of a dentist trip for many abuse survivors.  I don't have it too bad, but it makes some alters very nervous or frightened.  But the hygienist was very careful and cheerful, giving me plenty of breaks in which I was able to actually reply enough for us to hold a real conversation, which I felt rather proud of.  Good distraction.  The not so good part of the good distraction was my ability as an unemployed person who has suffered severe trauma and is now mentally incapacitated for the time being, to have good answers for the most basic polite conversation starters. 

     "So what do you do?" 

     I live off the goodwill of others while I take an excruciating long time to heal from brainwashing, sexual assault, and torture.       *cricket chirps*
     "Um, I don't work.  I do stuff at home."

     "What are you doing for the rest of the day/weekend?"

     Oh yeah, people actually plan stuff like this.  How would I know what I'll be doing in four hours?
     "I . . .  stay so busy planning for stuff during the week I don't plan for the weekend, I just crash."

     "Oh, that's too bad."

    Nothing like giving a fake answer to avoid eliciting pity only to elicit pity anyway because you're fake answer was just so lame.  So as I learned today, if there are things in your life you can't discuss with strangers and the most basic social questions throw you off guard, you need an alibi.  An alias, if you will.  Prepare for these kinds of questions beforehand and practice them.  You don't have to lie, but know in advance what you are comfortable sharing and what you are not.  Be prepared to share at least something or deflect the question in a way that leaves both you and the other person comfortable.

MPD Frasier Quotes

      I know I have not posted in awhile, here is a bit of Multiple Personality humor from one of my favorite TV shows;



"I really have to go. I'm conducting a seminar on multiple personality disorders, and it takes me forever to fill out the name tags."  -Niles Crane



http://www.popscreen.com/p/MTQwMjI3Mjcx/Free-desktop-backgrounds-with-frasier-october-wallpaper-300882


"Oh, I'm sorry. I meant to, but I had a crisis with a patient. One of my multiples had a new personality emerge - a one-hundred-and-ten-year-old Frenchwoman. It would have been too risky to put off his therapy. Plus I would have missed out on a wonderful recipe for bouillabaisse." - Niles Crane


"Oh yes, I had the same trouble with some of my multiple personality patients; one would always claim that the other one sent the check." Frasier Crane

Tea with Depression

     I've been trying lately to list reasons to be happy about my life in the hopes to inspire me enough to get out of bed when I wake up.  It doesn't work.  I dread getting up to another day, a little paltry list of reasons isn't enough to stave it off.  "My stomach has been feeling really good, I have that yummy jello, I got some new clothes".  It's just not enough.  I know it's about alters needing time out or needing a break, and this comes and goes as part of the process, but I just want to say it sucks.  And I'm OK with that for now.  I want to be able to say to people "I'm depressed" without having them suddenly be uncomfortable like they are sitting with a leper, or make me feel like I should be ashamed or try to hide it.  Sometimes life just sucks, it happens to everyone.  I see no reason to douse it with rainbows and bubbles in an attempt to cover it up so it won't run the risk of making other people uncomfortable.  I can sit with the way I am and just experience it, to be with it instead of dissociating from it.  I stay aware of it, and take precautions, so I know I am letting it go through me instead of becoming something that could be dangerous to me.  No one is yet desperate or harmful, we have an appointment scheduled and we can sit tight until then: meanwhile having a cup of tea next to Depression, Calm, and Acceptance discussing the weather and all our combined observances and hopes for life.

Multiple Personalities and Allergies

     Allergies in a multiple can be complicated.  My therapist told me I didn't need to worry about it right away, but I've found it's good to at least get a handle on or to at least have a general idea of what's going on in allergies with a multiple system.  In a person with multiple personalities, different alters can have different physical conditions.  They may have different ranges of vision, different chronic conditions, or different susceptibilities.  One alter may be allergic to something that the rest are not.  I'm finding this to be true in my system and it is a circus to try and figure out.  Fortunately no one seems to have any immediate life threatening allergies and for that I am gratefully holding my breath at this point.

     The big things that are just in the body and seem to hold true for everyone are lactose intolerance (possibly an actual allergy), wheat intolerance, intolerance to preservatives and other various conditions that require a very strict diet i.e. no sugar, corn, or pork.  Not to mention a lifelong allergy to every pollen that exists.  So I know all about muddling through allergy testing and restricted meal plans. 

     When my therapist first told me she suspected I had DID, otherwise known as multiple personalities, it didn't really sink in right away.  It did make sense though and I was immediately able to name off six- now that we were actually recognizing and discussing the other people inside my head that did apparently, come out to live their own lives from time to time.   During the next week, the dizziness, short blackouts, spinning, and voices clamoring in my head hit the roof.  I constantly had the sensation of being yanked and pushed out of my own body- out of my own brain, out of my own heart and lungs.  The chattering I usually had in my head was constant, and I now realized different voices with different 'tones', like a radio changing stations.  I started to realize how little control I had over my own body.  But where it might have been a slight nuisance before, it was raging out of control now.  Pandora's box had been opened, and there was no going back.

     The day I went back for therapy, the very day, I didn't make it to the appointment because of a sudden allergy reaction to rice and chocolate, after I had just grabbed some chocolate rice protein shake for breakfast on my way out. Well that, and anxiety which just made everything worse.  And switching.  And who knows what all else.  I ended up in the ER that night and a clinic the next morning, getting and EKG and blood draws.  They said it must be a panic attack and sent me home.  Then later I had an appointment with my regular practitioner and it turned out I was indeed suffering from food allergies that caused the shortness of breathe, wheezing, and headaches.  I felt at least mollified that it wasn't all 'in my head' as everyone else I had seen claimed.

     That was two years ago, and the strange symptoms haven't stopped.  After passing everything off as 'just panic attacks' or 'just DID' I realized that there were -at times- a more serious problem.  I now try to record everything and take into account switching and panic attacks.  It seems food allergies can be a trigger for the switching and anxiety just compounds everything.  But there are at times a definite physical reaction immediately after eating a certain food, say cucumber.  I record it and say "Aha!  Gotcha!"  And then for weeks after . . . nothing.  I can eat all the cucumber I want and no reaction, or at times a vague notion of an allergy reaction that I'm not present enough in the body to feel.  It's like trying to catch a grasshopper.  Once I think I've got it, I don't.  The only explanation I can think of is that different alters have allergies that others don't.  All I can say to someone with DID trying to figure out their allergies is, good luck.

Holy crap it's June 18!  How much have I missed, about two weeks?!  Not that all of me was completely gone, just *this* aware part of me was.  I think I did have the vague sense of protesting that I should wake of and DO something only to be overcome by sleepy contentedness before I was out of it.  Not that I don't know that things have been done- new haircut for example- I'm just a bit miffed that it wasn't me.  Because things always need to be done!  We're all in a rat race of urgency . . . oh, maybe not.  There is this annoying sense of missing out on my life though.

Ungrounded- Checking In With Our Inner Selves:)

     I posted earlier from the perspective of my intuitive one, and today we made some discoveries we'd like to add.  Now she is sensitive to the extreme about things like different energies and auras.  So she noticed an effect much more than any of us would when another alter is 'sharing' (co-conscious) but not connected to whoever else is out.  When that happens, she describes it as being extremely ungrounded.  Being "grounded" is lingo from the spiritual people/sensitives/what have you that means being fully present in your body and in tune with tangible reality- "down to earth".   She's written here before about how that can be difficult for people with DID in connection to poor shielding and poor boundaries.  We'd like to add that feeling ungrounded can also come from being disconnected to your other alters.  We simply experience it as being spacey, not really feeling our body except at the top and sometimes even a sensation of floating or feeling far away.  Basically, we're high as a space cadet (might also add that communicating or writing in this state- such as this blog post -might not be clear to others or a great idea for you.  Wheeeee!). 
     We wanted to point out that with DID it might not be that NO one is fully present or in control your body, but that you might not be in touch with the parts of you that are.  Checking in with our alters, having a meeting to see what's going on connects us to the other alters that are out and helps greatly to 'bring us back down to earth' so to speak and fully present in our bodies.  We have been frustrated lately by the limitations on our ability to live our lives when we feel pushed out of our own bodies and unable to think, act, speak clearly etc.  What we are finding now for us personally is that the other alters that are out are also limited in these things when we don't connect.  It can feel a bit weird to ask questions in your mind and wait for someone else to answer, but the ability to communicate with alters can be developed or is there already, though different things may work for different people.  Feeling shut out, spaced out, whatever you call it, is irritating for everyone.  The good news is that it need not happen forever.  Communicating and checking in or having meetings can help bring down the space cadet and have you feeling closer to your normal however-normal-you normally-are self.

SuperNova 4

      "Mankind will stay as it is -in itself a terrible prospect- if the principles of love and justice remain obstinately separated  instead of complementing each other.  Looking on the question from this angle, you will find that in the history of man since  the beginning of Creation, love and justice have opposed each other.  At one period justice was the human ideal, at another, love.  The divine idea of justice in love, love in justice, mankind has magnanimously left to the Creator."  -Hans Habe, The Sunflower

                          ________________________________________________________



     I have ignored this Supernova thread for awhile.  A look into the humanity of criminals causes controversy everywhere including myself, I am sure that's why it is not popular worldwide.  What I am attempting to do with this thread is look at abusers, rapists, people who have done terrible things, with love.  I do this primarily because the people who have hurt me the worst in life were people I loved very much, and still do.  I call it 'Supernova' because when I look at someone energetically at their core every person is blindingly radiant.  What to do then is the constant battle wrestling in me.  The hurt itself- incest, is one of the most unspeakable crimes.  It is one I don't want to look at some days especially from a personal standpoint.   When I connect with other alters and remember the worst I am beyond furious- beyond unforgiving.

     I've studied what cases I could find that somewhat mirrored mine- people who remembered a second life inside the one they knew.  I've tried to understand how men could be dually family men and criminals.  I've read controversies on forgiveness and reconciliation.  I've matched the words good and bad and legal and illegal against each other in an attempt to understand what makes a man what he is or if he can even be defined.  I've tried to understand how my father who I love more than anything could be my torturer, could be my molester, could possibly be my rapist.  I understand that he, and both my parents really, had horrible experiences that have led to the decisions to act in a hurtful way as adults.  It was, however, still their choice and I do not excuse that they constantly chose to use their children as an outlet for their rage and pain so they could avoid confronting it.

      But even though I am hurt and furious over their choices, the more I actually look at them the less I am capable of hating them.  I love.  I cannot stop it, and I would not want to.  I really think the main message of Jesus, Buddha, Gandhi, or any other religious figure or leader of peace boils down to this: I see you.  I see you and I can't help but love you.  To know you is to love you.

     Sexual assault is the most powerful way to tell someone that they don't matter.  The one doing the assaulting believes it for themselves but sends that message in the most devastating way possible to their victim.  For me in incest coming from my dad, the person who I looked to teach me what to think about myself, the effect was even more crippling.  I know my dad believes he is worthless and I see on the faces of every person deliberately hurting another that they believe they themselves are worthless.  Parts of me know -fiercely- that I am not worthless.  My dad is not worthless.  YOU MATTER.  I wish everyone would tell each other that.  Tell your parents, tell your neighbors, tell the people on the street, tell your friends, tell your enemies.  You matter.  You are important.  You make a difference in this world.

With Love, From Me, To You

      Most of us go about day to day focusing on tangible success without much thought to how we are faring beyond a physical level.  The emotions we feel and how we interact with each other is so important and so drastically overlooked.  In therapy I become more and more aware of the emotional body as comparable to a starving dog, a cowering living being fed the occasional scrap with the capacity to be so much more.  And while that's to be expected in a patient with DID as they have usually experienced strong neglect, I think most people today go about quietly and confused with their own inner emotional starvation not knowing what to do about it.

     One of the emotions I learned to block growing up was loneliness- it didn't mesh with the program I was set up with.  According to it I was supposed to stay away from people so loneliness was counterproductive.  Now that we are trying to break the programming we are a bit confused that we should want to be around people or interact and how we should go about doing that.

     Finding a support system, is, of course, invaluable, especially if you have lost a safe support system from your family.  I systematically identify this need and hunt down a solution- I NEED to talk- until someone surprisingly offers to listen- the full package, no strings attached.  Suddenly it's personal and I don't want to talk.  Not running from your support system is apparently the next step after you've found it.

     Friendship can be tricky.  We've agreed not to tell about DID until we know and trust a person very well, but alters switch in and out with everyone, whether we trust them or not.  Most friendships have been broken or distanced suddenly with no explanation, until we've learned to expect everyone to up and walk out at some point without saying a word.  With integrating memories that is being explained somewhat as stories of unknown fights with friends or different alters who broke things off start to emerge.  Finding someone who you can be close to without knowing you have multiple personalities is difficult, just as difficult as finding someone who can handle sticking with you once they know you have multiple personalities.  On the up side it's the perfect litmus test.  If you find someone who will stick with you through all that, they're a keeper. 

     It also applies to dating with DID.  Dating, as I have mentioned before on this blog, is a conundrum with multiple personalities.  Obviously.  The ingrained 'don't get near people' rule seems to apply to all alters- in a weird way that is kind of a good thing here, because I've got alters all over the spectrum in that area, and rules we set for ourselves don't seem to work.   I've wondered if dating an understanding transgender wouldn't be the perfect solution to make everyone happy and content, but even then I doubt it.

     I have also started to recognize a universal pattern, that we seek out people we are comfortable with, usually those we have something in common with.  When we no longer have that thing in common we leave.  Sort of a sad little happenstance in life, that people just drift apart.  If you're trying to change what you have in common with them, especially a bad habit or negative pattern, it can be imperative that you leave.  Similar to addiction, when you are trying to break out of dysfunction, it is difficult to be around people who are dysfunctional.  That doesn't mean you can't or shouldn't love them or necessarily break off from them.  It can mean limit contact to what you are safe with.

     The thing is we love everybody, we are most content when those around us are able to share in it, and dissonance with anyone is painful.  I miss people that I've had to leave.  We are learning the important distinction between keeping in touch with people and expecting them to be able and willing to be our support system.  I have found that everybody is lovable with wonderful things about them, even the ones who hurt others and themselves.  It's an ironic discovery considering one of the main core beliefs programmed into some of my alters was that I am unlovable.  It's not true for me, or any of my alters, or anybody else in the world.

     I think allowing myself to hold onto the good in people and knowing I have the power to limit my contact with the bad in them has made me less bitter.  It hurts less than completely cutting myself off.  Allowing myself to love is the most natural and freeing thing in the world.

Littles Books

I can remember loving books since I was about two.  My mom would pull out a huge bottom drawer by her bed full of children's books and set me in front of it, while she left to do chores around the house.  I browsed through them loving the pictures and the act of turning the pages, and later would pretend to read, something I wanted.

For a while in college I worked in the library.  Learning instructions was difficult but I loved cataloging and putting away books.  Being surrounded by bookshelves has always been comforting to me.  Once while shelving books in the children's section, I recognized a book from when I was little.  Something shifted in my head and things were fuzzy for awhile, and then I blinked to find myself sitting on the floor staring up at the head librarian.  She looked incredulous.  I looked down at a children's book open in my lap, and at the floor around me scattered with children's books.  After a guilty moment I hastily said "I came down here and these were all out of order, I'm trying to organize them."  "Uh huh" she said, thoroughly unconvinced, and walked away still looking a bit dazed.  I scolded myself that I needed to pay better attention on the job, a message I was always telling myself in nearly every area of my life.

It is one of my goals to collect books for my younger alters that they like.  I still prepare myself with a little story whenever I buy one or check one out, 'For my niece' or 'For a little girl I know'.  But so far no one has questioned me buying coloring books or little toys.

Expressing Life in Mental Illness

Angel in the Dark

     I entered a piece in a local collection accepting submissions from those with and around mental health.  Thanks to advocates mental health is now a community not just diseases, imbalances, disorders, or conditions people must bear completely on their own.  I am glad and proud to be a part of this community, and wanted to participate.  I meant to write something for it too, but in the short time I had could not come up with something that felt right.  The theme was about expressing life.  I tried to come up with something optimistic and triumphant, but it felt a bit hollow.  I have seen places and people that only allow happy stories of overcoming trials in the spirit of encouragement.  Depressing stories are banned, as implicitly are those who have not overcome.  I guess I assumed (erroneously I hope) that expressing life was meant to include only encouragement and happiness, to show that people dealing with mental illness could persevere.  I identified "life" with Easter, spring, hope, renewal.  I tried to write about mental illness from that angle.  I couldn't. 

     My experience with DID has certainly had many positive things about it.  I love my alters.  I love my life with them, I love that I have the opportunity to bring new awareness to DID, child abuse, and mental health.  But that is using bad experiences as a tool turned into something good.  DID results from trauma and make no mistake about it, it sucks.  Losing time, always being tired and confused, being out of control of my body, lost and broken friendships, wading through red tape for official recognition and help, that sucks.  That is part of my life.  I am not going to paint it over with daffodils and claim that any kind of mental disorder is a fun little obstacle course that can always be overcome.  I believe that any problem can be overcome with the right amount of time and the proper tools, but that is not today for everyone.  Some people can't, haven't, or didn't overcome, and that's OK.

     Life includes everything, the good and the bad.  With mental illness, there is usually lots of bad.  But that is only one aspect of life.  That doesn't mean that under the bad isn't vibrant life and many different wonderful experiences, the same as anyone else. 

The Rule of Abuse in Dissociative Identity Disorder

 Some Background on DID:
     Dissociative Identity Disorder starts as a way to cope with being helpless, with being unable to change a traumatic situation that occurs repetitively or over a long period of time, typically at a young age.  In persons with DID, the mind has created a way to try and change their reality inside because they could not change unbearable realities on the outside.   Dissociation that has reached it's most severe form as a system of multiple personalities is a form of protection.  Each personality comes out to handle a job that is overwhelming or harmful for the core or "main" personality.  Each personality has their specific job to do, and they only come out to do that job.  This is an efficient solution to cope with a really bad situation as long as the system lasts.  Once an alter system develops it continues indefinitely without anyone the wiser until a significant life change, or additional high stress may cause the system to break down.  When this happens alters are still present, but no longer come out for one specific function or share and block knowledge making their presence unnoticeable.  After a system collapse the presence of alters can become very noticeable as they are no longer able to regulate who comes out for what.  In the core personality of the person who has no knowledge of alters, this often presents as memory loss, extreme confusion, pieces of their life that just don't fit or make sense, reports of them acting out of character, losing control of their body and thoughts, "out of body" experiences.  They may experience headaches, dizziness, and temporary loss of senses such as vision.



 How the Cycle of Abuse Is Present in DID

     -An Inability to React
     Although a protective mechanism from one or many traumatic situations, outside of those situations and later in life, DID can also be seen as a severe inability to react.  This is especially true during the time period between a Multiple System collapse and recovery- whether that recovery be integration or simply awareness and open communication between alters.  In Dissociative Identity Disorder, the ability to react is stifled.  Instead of recognizing a problem, considering their options and taking action to deal with it, a person with DID will either automatically dissociate to numb themselves from any awareness or feeling, or switch alters.  With a switch happens at the first indication of a problem, the core personality is often never even aware that there was a problem to begin with.  If the alter that switched out deals with it, it is possible the core personality will never be aware the problem ever existed.

     -The Connection to Abuse
     Because these coping techniques, dissociation and switching, have been developed out of an inability to change unbearable situations, the core personalities' ability to problem solve is never developed.  Because persons with DID usually come from an abusive background, their being afraid and unable to solve problems is key to remaining part of an abusive cycle.  Cruel, violent, and manipulative people do not encourage their victims to think or pay attention.  They certainly do not encourage them to assess, research, or network their way into a fulfilling life.  DID is the extreme of dissociation, but it also seems to encompass the extreme of an abusive mentality.  People with DID that have may not at one time been "allowed" to respond to problems or fend for themselves are often now not capable of doing so.  Their lives often seem catastrophic because numerous tiny problems have snowballed out of control simply because of their low ability to recognize and respond to problematic situations.  

     -Abuse Encourages the Impediments of DID
     If they are still in the same environment as when the DID developed, sadly the ability of a DID patient to react and respond will probably not be encouraged.  More likely it will be suppressed and thwarted for the purpose of keeping them under the control of someone else.  This is an excessive and dangerous method of control, because it completely stumps a persons' ability to care for and protect themselves- from emotional abuse, from physical violence, for proper nourishment, hygiene, and a number of problems that an inability to react and respond can lead to, from a misunderstanding with a grocery clerk to a collision on the freeway.  The person or persons encouraging this impediment cannot and usually will not even attempt to protect these people who cannot protect themselves.  It is a selfish motive with seriously negative effects on their victim.  

     -Disease and the Link to Abuse in DID
      Disease deserves it's own paragraph writing about the connection of abuse to DID.  So many people with DID come with a ridiculously long list of ailments and diseases rarely seen in a person living in a region with modern medical care.  The extreme level of dissociation in DID can make it extremely difficult to be aware of the body, notice discomfort, or consistently stay with a routine of treatment.  Most DID patients come from an abusive background that caused the long term trauma resulting in DID.  If they grew up with severe neglect, it may not occur to them to seek medical treatment for anything from a burn to a broken leg.  They may not think they are worth helping, or that nothing short of immediate death is worth mentioning to anyone.  This is a continuation of the denial they grew up around.  If they were victims of physical or sexual abuse, the person has likely learned to minimize life threatening situations, and ignores disease just as they were trained to ignore assault.  
     Many alters of DID patients are conditioned to keep secrets.  They may hide medical conditions, or be unable to speak about them or ask for help.  By their nature alternate personalities hide information from other alters, especially the core personality.  Combined with alters "switching" in and out, it is very difficult for a person with DID to notice if something is wrong, make an appointment, keep the appointment, and be able to stay with a treatment program.  Also due to frequent switching and dissociation, it may be difficult for persons with DID to maintain even the most basic hygiene, nourishment, and first aide.  Added to all that is the fact that nearly every System of alters has at least one alter who is self destructive, or destructive of the body.  Self inflicted punishment and mutilation are extremely common.  The overall health picture of someone with DID is one of general neglect, frequent illness and injury, and extreme difficulty getting and maintaining medical care.


     -Communication is Cut
     In every cycle of abuse there is the rule of silence- don't talk about it, don't ask questions, don't tell anyone, don't speak up.  Nowhere is this more true than in Dissociative Identity Disorder.  A core personality who has suffered any degree of mistreatment usually cannot talk about it because their memory of it has been delegated to a different part of the brain- to another personality.  Some alters have complete or partial inability to see or speak, preventing them from observing or telling others what they know.  This includes other people but it may include other alters in their system as well.  Some alters were created as a vault for fear, anger, or knowledge.  They have been specifically designed by the brain to keep what they know and feel locked away from everyone else.  With severe trauma being inflicted on a child, -in this case usually by someone they depend on- there is always a spoken or unspoken message not to talk about it.  A child may at first try to seek help or stop it, but they are always very inherently aware of how vulnerable they are.  Since in these cases there is no help to be had, alternate personalities develop to help the child survive.  

     -In DID, the Rule of Silence is Literally Binding
     Unless they learn differently later in life and recognize the pattern and become aware of what they are doing and the effect it has and make a conscious effort to change, people taught an abusive cycle will take the rule of silence to their graves.  In the case of people with DID, the rules of silence always accompanies a severe inability to function, and unless they can overcome the silence, this too will never change.