The therapist's experience of disbelief in working with dissociative identity disorder
Disbelief of patients with Dissociative Identity Disorder remains a common, yet relatively unexplored phenomenon within psychotherapeutic literature. In treating DID, therapists and healthcare professionals alike are subject to strong unconscious forces that make both diagnosis and treatment of DID difficult for the practitioner. In this dissertation the writer’s own process with both clinical literature and patient work is explored, as part of a hermeneutic literature review into the nature of disbelief of DID. The therapist's countertransference is seen as pivotal to conceptualising disbelief, as a 'to be expected' part of treatment. Disbelief is examined through the lenses of the imperative to not-know and the difficulty with the multilateral self. The imperative to not-know is explored as a defensive process, that acts to prevent knowing, though an investment in -K, resulting from the patient's need for early life survival (Bion,1962). The therapist’s difficulty with the multilateral self is then examined as a protective response based on the degree of dissociation that occurs in DID, as well as the reliance on a unitary model of self. Qualities that enhance the practitioner's ability to treat DID with such difficult, evasive, and overwhelming dynamics are explored, including the development of negative capability and an ability to maintain the complexities, by entering into uncertainty and not-knowing. The therapist’s ability to 'stand in these spaces' is seen as central to restoring linking and K in effective DID treatment (Bromberg, 1996; Bion, 1962). An interdisciplinary cross pollination of ideas is sought, in order that an ongoing fruitful engagement regarding countertransference, disbelief, and DID can be of benefit to the patient.