Treating Child Alters like real Children....

What do you think of this http://tinyurl.com/childalters?

Wow, I read that whole article. I'm sure there are child alters who are beguiling and can side-track therapy. I'm have no doubt that children alters can be as endearing as real children for a therapist. My Little John alter isn't "child-like," he's exactly like a three-year-old. He went inside at age two and he hasn't come out to anyone else but me ever. For brief periods I've gone walking with him for a couple decades now and he's only aged a year. I have been around plenty of three-year-olds (not alters) and this little guy moves, thinks and talks like a three-year-old. He's not needing anything, he's not throwing tantrums, he's just a curious little kid. So treating him as something else doesn't quite gel for me. When he's nearby, he can sometimes see and gets upset at bad images I think of, so yes, that's not an average kid. Admittedly I am completely at a loss as to what to do with him other than answer his questions, reassure him I'm safe, and stay close by so he doesn't hurt himself.

I just wanted to say that is very sweet Johnny-Jack . I think this issue could go either way for some children alters. It might all depend on the severity of their state of mind to treat them with more compassion like you would a real child, or to treat them like a small alter who needs to eventually develop like the others.

Emily is very shy and she doesn't really come across like a true 9 year old, she does change ages (sometimes) though so that may be why. There are times that when she comes out she is "out", but I'm present with her, so it makes things hard to handle because I'm juggling her and myself at one time.

Interesting..
The article was relatively easy to read and understand although rather long.\
IDK how I feel about it as a whole... other then I think it's just an extreme view of dealing with Child alters. I think there is a huge need for nurture and love and comfort for them. And I think that her views are of the ideology of integration which we dont really feel is OUR goal.
It's worth a read thought

I do empathize with the chronic dis-empowerment and extreme neurotic suffering....

sigh.... what is the end goal of treatment...?? what is success in terms of DID??? getting along or becoming one... who knows...

I don't like "Easter egg" surprise links, so here is a direct link:

http://citeseerx.ist.psu.edu/viewdoc/do ... 1&type=pdf
Therapeutic Hazards of Treating Child Alters as Real Children in Dissociative Identity Disorder
Shielagh R. Shusta-Hochberg, PhD

ABSTRACT. “Dissociative identity disorder (DID), with its typical etiology of extreme, repetitive childhood trauma, usually includes manifestations of childlike ego-states, among others. For many patients, these ego-states, originating with the initial traumatic insults to the psyche in childhood, have been called forth again and again as new situations evoke the earlier trauma. When clinicians, family and friends react to them with warmth, nurturing, and empathy, this may exacerbate the illusion that such ego-states are indeed actual children. This can result in a patient becoming increasingly resistant to working through the issues and experiences by which these ego-states have become fixed, with the risk of therapy reaching an impasse. Attitudes, interventions, and approaches to move past such impasses are addressed.”

This paper was originally presented as “Fixed Illusions: Treating the Reification of Child Alters in Dissociative Identity Disorder,” at the 18th Annual Conference of the International Society for the Study of Dissociation, November 2002, Baltimore, MD. Journal of Trauma & Dissociation, Vol. 5(1) 2004.

I think i have ready every page of your PDF before reply , let me ready once....

First of all, thank you so much to tylas for sharing this link!

i agree with everyone here, I dont think i agree or like that paper at all... Its too rigid and kinda oppressive...Well, for us it is, i mean, some of the issues the examples bring up might be very relevant for someone else, but they dont resonate at all for us...And it seems that DID is such a diverse disorder and that no therapeutic interventions are a '1 size fits all" kind of thing. This paper leads one to believe that ALL child alters are demanding, time- consuming, manipulative and generally only there until they can be 'grown up' and integrated!-- this overall theme is something we, as a system have taken offense to. But only because it does not relate to us in any way. It may have great meaning and be a very helpful paper for some therapists or DID'ians with many child alters or overly demanding ones.

We have a system of individuals consisting of: 7 little's (below the age of 10) and 6 teenagers (between 15 and 19) and i can assure you that they all know their place and role within the system. And like Johnny-Jack said, they are not 'acting' like children, they ARE children! They cannot process of understand the 'adult' issues within the system an as such are shielded from those topics. By doing this they do not act out, they do not throw tantrums or come out at unexpected or unsuitable times. They come out when they are best suited for a task- as is their true function! Our children do not demand attention of toys (though they do ask at times) they are well aware of their internal and external worlds and what is acceptable in both. They DO need love, attention and understanding just as any child would, but they do not need or seek that from our current T and do not deserve to be treated as simply "child-like ego states". There is a BIG difference between 'ego states' and fully developed alters. This is something i think gets confused here.

The very notion of "child alters are not packets of childness retained in a surrounding sea of adult psyche. They are stylized packets of adult psyche." -- this implies that DID is formed in adulthood and that the core chooses to 'style' these alters as they see fit. This definition is entirely offensive! Child alters ARE small packets of childhood cut off and protected from the world and yes they are in a surrounding sea of the adult mind!! No matter how much i try to find the appropriate words to describe just how incorrect those 2 sentences are i struggle over my anger and disappointment that a person of such academic and professional standing could say that. The very point of DID is to cut off pieces of ones self for the protection of the whole!
We as a system are really resenting of the last few paragraphs of the paper in the bits where they say that the system needs to be told that integration does not mean the death of the alters but that they will simply no longer be so separate. While we understand that integration is most T's primary objective, this paper leads one to perceive that it is the ONLY way to help the little's heal... (we could be over reacting there with that because e are so hypersensitive to the notion of integration for our system.) But we truly believe it is the clients decision and that 'reparenting' a child alter with "the love and affection that they never received cannot do any harm to the alter.-IF it is from a safe source and can be relied upon for a foreseeable amount of time. In our case, the bodies SO, helps to provide this for the little's. I do agree with the paper in that providing this support and nurturing should NOT be the primary goal of therapy and that it does need to come from within the system.

I must stop talking in an effort to restrain myself and leave my thoughts there. I trust that everyone understands that these are simply the thoughts of a DID system's alter and that we fully understand that our way is not the only way of viewing this paper. It does include many good points, but i feel its is let down by the poor choice of wording and bias of the author.

I took the paper differently. I took it as ...


It's so easy for us and other to spend our time with the children. They are adorable and lovable as children are. Because of this we ignore or don't even find alters that are not as endearing. It's hard to compete with a cute little kid.

I love when my littles come out, but I am glad I read this and will make sure and not favor them and make time and space for the others.

i agree with you a bit too Tylas, but i guess it comes back to how your system is set up. We have a very strong little who comes out just about every day with the SO, but none of the 'bigs' are ever ignored or forgotten about either, i guess because they're all such strong personalities in their own right. They certainly make their presences known! haha

But yeah i can see how in some systems, if one were to favour the little's too much, the bigs would get somewhat ignored. I guess we just don't have that problem within our system because its the bigs who talk at T and basically 'run the show'.


Thanks again for posting! it was an interesting read. I've never seen my ISH react like she did! never- ever! lol

How did you find that paper anyways? Did u just google search for DID or did someone put you onto that particular piece?

I took it as interacting with child alters can cause therapy to lose focus on dealing with trauma as the patient and therapist can forget the children they are dealing with are part of a system who inhabit an adult body, and who are adult.

i think it makes some potentially valid points... and i also think it makes some misconceptions. in my own experience with dissociated parts/ego states, "child alters" are ego states that are split off from childhood due to trauma, not childlike creations made later on.

i have found there is no gradual letting down walls between ego states, (only denial that there is any separation.) for me, integration of dissociated parts is relatively sudden. treating those parts of me as children who need help internally has worked positively. internal help in resolution of trauma is part of this, but agreed not losing sight of healing as the goal...

there has never been any death fear for any part of me, as far as i know, all parts of me see it as merging an already existing symbiosis, (don't have separate personalities with separate lives, more like lots of different separate pieces interacting through one person, if that makes sense?) but my therapist suggested other parts of me might see it that way (being killed off), which upset me, but i didn't know why i was upset. it turned out part of me was upset that she might say things that could make me feel uncomforable, guilty or afraid. i agree its important to treat each person/system as individual.

but paying excessive attention to child alters in therapy without trauma resolution isn't necessarily helping with treatment. in the sense that alters are separate for a reason, and that no amount of love will cure trauma unless that love is part of addressing that trauma. my dissociated child parts get a lot of attention from me, because so far that seems to be where the trauma is held. that's allowed parts of me that were protecting other parts to eventually step aside so those underneath can come out.

it was interesting to read what was written about denial too. lol.