Are there souls, so to speak, for whom the prognosis is better than for others? And when I consider all my patients, over all the years, the answer is yes: there is in fact an astonishingly robust correlation between an individual's successful recovery on the one hand, and on the other hand, a person's preexisting conviction that she and she alone is responsible for something. This something could be an endeavor or a specific person, or is quite likely to be the conduct of her life in general. People who are compelled and organized by a sense of responsibility for their actions tend to recover.
And conversely, sadly, people whose directive meaning systems do not include such a conviction tend not to recover, tend to remain dissociatively fragmented and lost.
This distinction is other than that of perceived locus of control-Who has the power, I or the universe?-which is an understandably double-edged issue for nearly all survivors of trauma. Rather, the difference is that of tenaciously assuming personal responsibility for one's own actions, and therefore taking on personal risk, versus placing the highest valuation upon personal safety, both physical and emotional, which often precludes the acknowledgment of responsibility. (If I acknowledge responsibility toward my child-or my friend or my ideas or my community-then I may be compelled to stick my neck out. I may have to do or feel something that will make me more vulnerable.) Here, the psychology of trauma comes full circle, in that the original function of dissociation is to buffer and protect; and so by rights, patients who value self-protection above all else should be candidates for treatment failure, even though they may experience, in addition, an ambivalent wish to be rid of their devitalizing dissociative reactions.
A self-protective system of mind may express itself behaviorally in many ways. Three of the most common ways can be characterized as action-avoidant dependency upon another person or upon a confining set of rules, a preoccupation with reassigning blame, and actions and complaints that indicate a lack of perspective on one's own problems relative to the problems of others. In dissociative identity disorder, such behaviors-just like their "responsible" opposites in a very different "soul"-may be observed, along with some distracting variations in style; across all of the various personalities.
The third behavioral expression of a self-protective soul-acting upon a lack of perspective on one's own problems relative to those of others-is reflected in our society at large by the popular phenomenon of victim identification. Victim identification presupposes the belief that there is a finite group of victims within the larger population, and that one is either a member of this group or not. Membership is (paradoxically) attractive because it affords, first and foremost, a sense of belonging, and after that, all the special status, sympathy, and considerations typically given to those who have been preyed upon and hurt. Also, as an identity, as something to be, it may fill up the terrifying sense of emptiness that often follows trauma.
Unfortunately, forever holding on to an identity as victim bodes ill for the person's recovery from that very trauma. Holding fast to this way of seeing oneself and the world can keep an individual endlessly beguiled by his own misery. Also, victim identification blinds its subscribers to the leveling fact that we have all-yes, granted, some more so than others-but we have all been hurt at one time or another. We are in this together: patients, non¬patients, therapists, everyone.
For these reasons, it is crucial that a fine balance be struck by therapists, and by anyone wishing to help those with DID, or any other dissociative disorder-in the session room, in the home, in survivors groups, and even in the newly developed context of mental health Web sites and chat rooms. A survivor of trauma is a victim, certainly; but "victim" does not comprise the totality of her, or anyone else's, identity. Helpers must support the healing process in both of its phases: the survivor must endure the discovery that she is a victim, and then she must take responsibility for being that no longer. Both parts are equally important, and in neither phase can self-protection be the primary goal. Enabling someone's long-term identity as a victim robs her of an important human right, that of being responsible for her own life.
Also, whether or not a particular person is willing, after a time, to relinquish the status of victim is important information for a helper, because it tends to predict who will and who will not recover. In this regard, I sometimes gently point out to a patient that if she will reflect for a moment, she will probably realize that extreme victim identification and self-pity were, truth to tell, prominent characteristics of her abuser. And is this really how she wants to live her whole life, too?