Interview with Author: Catherine Klatzker (from Medium)

PTSD, DID, all those acronyms

First, what is Dissociative Identity Disorder, or DID?

Dissociative disorder used to be known as Multiple Personality Disorder and that’s how many people still think of it. To dissociate means to detach or disconnect. DID generally develops as a result of trauma in very early childhood when dissociated alters, or Parts, split off from their surroundings in order to tolerate the intolerable.

In DID a person’s sense of self is fragmented or distributed among several semi-autonomous sub-selves which may have their own histories — they may not be aware of each other and the central self may not be aware either — and the central self has no control over them. It is not a choice, and it is treatable.

Tell me about your story’s title, You Will Never Be Normal.

A very good friend said recently, “My childhood was so chaotic, with so much abuse, violence, yelling, and screaming, that whenever I hear the children playing with loud yelling I get this adrenal response, totally involuntary — I startle, my heart rate speeds up, and I’m ready to fight. I don’t think it will ever go away.” I thought, and may have said, “You will never be normal,” because his civilian PTSD persists after nearly four decades, and those embodied responses are what I’m primarily referring to with my title. You Will Never Be Normal applies specifically to survivors of traumas, to mental illness, and to so many with histories that set us apart.

A thread of wishing for normalcy runs through my life, of always feeling alien and apart from others, knowing something was wrong with me, of learning how to pass for normal without ever achieving whatever normal is. In 2017, when all the pain and conflict of integrating my Parts was behind me, the enduring presence of my occasional flashbacks and PTSD sank in, and I knew that “even now, I will never be normal.” Hence, my title.

You were an Intensive Care nurse before you started writing?

Yes. For twenty-two years I was a pediatric ICU RN. That work was a calling for me, custom-made in its complexity, intensity, urgency, and mission to help children and families.

When did you know you had a book?

Writing family stories, I hit a wall. I felt I was writing a narrative that had been blank before — in fact, I was unable to come up with any coherent narrative at all. I finally had to acknowledge that I couldn’t tell my story without including my Parts. In fact, my Parts are my story, my only way to a coherent narrative. I soon found that speaking of alternate identities in my writing classes labeled me, and it was a lot to overcome, that I had “outed” my mental illness. As I found the courage to tell my story, I knew I needed considerable skill to get it right. When I finally allowed my conversations with Parts and their conversations with my therapist, Dr. Lew, into my manuscript, I knew I had a book that not only clarified my journey but that potentially demystified dissociative disorders, which are not always, (and maybe not even usually,) as sensational and dramatic as in the movies.

You grew up in a family of thirteen children. How has this affected your ideas about children’s needs, as well as the need for solitude?

Today when I speak of my childhood, I notice I talk about how it was for us. I have to make an effort to speak in first person singular about my childhood. At first glance, this seems to reflect my DID, that I identified as many, not one. It may also indicate how closely connected my sisters and I were in very young childhood. It might be both. I don’t know. The four middle girls in my family were always grouped together. We had extensions to those older and younger than us, but we started out grouped together in that family. As for solitude, books — the summer Bookmobile — were a genuine respite. As a group, with very little articulation of what we understood or cared about, we learned from each other how it felt to be treated by others with almost no supervision: roughly or gently, to be hurt and to be comforted, to make someone laugh or cry. To be mean and to make-up. To listen to a sister. We learned all that from each other. As the oldest of the middle four, I was protective. Our parents were not so available, which affected my ideas of what not to do for children as well. It turns out my sisters remember many things I don’t, so there’s that.

What year were you diagnosed with DID? Did you believe it?

I suspected DID for a number of years with absolute disbelief, maybe six years, before I had the nerve in about 2009, seven years after starting therapy, to pin down a diagnosis from Dr. Lew. By that time, I had been through enough with my Parts that I believed it.

Why don’t you like the term “multiple personalities”?

I agree with the opinion of many prominent researchers that DID patients do not have more than one personality; the so-called different personalities are fragmented components of a single personality, abnormally personified and dissociated from each other.

Do you believe DID was always a part of you?

I believe it became a part of me at times of overwhelming experiences during a critical early developmental period. So it was very early.

Could other people see it in you?

I’ve been told that what other people saw was simply “expressive,” and that everyone appears different when expressing different emotions. My husband and children described this as my “moods.” It’s not unusual for many people to have mood swings without being dissociative.

How did you reconcile your many moods before you knew you had Parts? Are you generally an emotional person?

I am not generally an emotional person. I am introverted, generally quiet, and when highly expressive moods and voices began appearing, I thought I was crazy.

How long did it take you to realize that childhood sexual abuse was the origin of creating alternate identities?

I want to say it took my whole life, but I hope for many more years, so I’ll say a very long time. I held out hope internally that my alternate identities might have been created by witnessing violence, or by childhood neglect. I fought against knowing about the childhood sexual abuse for many years. It fills me with revulsion to realize its truth.

Why did you wait so long to tell someone?

The short answer is that telling someone was not an option without all the strong therapy that preceded it because that level of trauma felt like I would be destroyed.

How does a traumatic flashback feel?

Traumatic flashback is the visceral experience of being present and re-experiencing the trauma here and now, particularly in one’s bodily responses; adrenalin, breathing, heart rate, etc. The message from the back-brain to the body is fight-flight-or freeze. While in a traumatic flashback, one isn’t always aware that’s what it is. The body reacts. I can’t always trace what has set off a flashback, but if I take time with it, I find there is always a precipitating cue — a sound, a phrase, a smell, etc.

How did you deal with the technical difficulties of writing more than one self? Wasn’t that confusing on paper?

Yes! I went through countless rewrites trying to get it right. Possibly the hardest work was slowing down, not avoiding the difficult places in the story, and unpacking my emotional responses. I was generally too clinical in the beginning, committing the easy dissociative error of writing from a detached perspective, complete with footnotes. Other versions identified my Parts long before they actually revealed their names, for instance, and that further fragmented the story. Writing from the identity that embodied them required me to compartmentalize them even more in order to fully express their impact on my life at the time. I was weaving backstory throughout, writing a linear story in a non-linear fashion, and I had to also differentiate between traumatic flashbacks and narrative backstory. A few chapters were published in literary journals and anthologies as I continued to work on the book, so that encouraged me to figure out what was working. I constructed the major organization of the book when I was at Ragdale writing retreat, and even after dozens of reorganizations, the skeleton of that work remains.

What’s something that most people misunderstand about DID?

I think most people think Parts are separate personalities, sort of like “demons” that possess a body: a Dr. Jekyll and Mr. Hyde kind of persona that’s going to change in an instant and be someone else that’s uncontrollable or even violent, and these things are not true. It is not psychosis and it is not schizophrenia.

Some people believe DID is not even a real thing, that we make it up. In truth, most people with DID are ashamed and terrified of their symptoms, at least in the beginning! It is a hidden disorder; we work hard to hide it. DID is real.

People think DID is only about having “a bunch of different personalities,” and far too many don’t know that trauma is the hallmark of the condition, the most destabilizing part.

I’m interested in your therapy. You didn’t have EMDR, hypnosis, DBT, or other therapies often specified for DID.

My therapist always had a wider view than I did, a gestalt approach. There is no one approach or method that is right for everyone, so it’s important to emphasize the individual’s need for a good therapeutic fit. In my case, I didn’t trust anyone. That I agreed in crisis to consult Dr. Lew was based on a two-year relationship as my meditation teacher, to which he also brought a fairly gestalt approach from his vast background. That class was in addition to his clinical psychotherapy practice and his university teaching. I can only speak from my own experience, which is that you are in relationship with your therapist. Ours was often stormy — I considered stopping therapy, just quitting — at least a dozen times as I learned how to even BE in a relationship where Parts of me openly distrusted him and sometimes hated him. An important theme developed of repeated damage-connected-to-repair, as I learned to tolerate our conflicts and all my Parts gradually opened to my therapist.

There are certain qualities each person will want to look for in a therapist and a therapeutic relationship, probably different for each person. Even from a position of profound psychological distress, I knew I needed a therapist who practiced mindfulness in its fullness, whose age reflected his/her experience, whose depth of listening was steadfast, committed, and honest. I always thought Dr. Lew was a step ahead of me intellectually, too, and I needed that as well: a very bright person. People ask why I wouldn’t choose a female rather than a male therapist, and I can only answer that as Dr. Lew was the right person for me, gender wasn’t as high a consideration as all the rest of it. There were times I told him it would be easier to speak to a woman, and we both just acknowledged that truth and carried on.

Are your Parts still with you now?

Not as separate fragmented bundles of raw emotion. No. They are as integrated as your emotions.

Can you beckon Parts to come to the forefront?

No. My Parts, before integration, were disconnected bunches of chaotic emotions swirling around me. Each Part carried different traumatic emotions, raw and unattached to anything I could find or name. Usually, when I encountered the terror, it engulfed me. When I encounter those terrors now, I am not engulfed. I connect and contain them. So, no — I cannot beckon Parts to come to the forefront. They are no longer separate.

Are there still triggers that make you dissociate or “go away”?

No. Dissociation itself is on a spectrum. The low end of the spectrum where every human dissociates, is where I also am. Daydreaming while driving and missing my exit. That sort of thing.

Since writing the book, has your relationship changed with any of your siblings?

A few of my siblings are more distant. There is not just one answer to how to connect and communicate within these relationships when you are healing. You may encounter a lot of denial in the family, for good reason, if there’s been abuse in a family that no one speaks of.

What will people take away from this book?

There are actually three stories here. The primary story is the fracturing into Parts as a result of childhood sexual abuse and the long road to integration. The secondary story is about making sense of the life I assembled moving from place to place and relationship to relationship to understand my true strength. The third is the social commentary in part of the book about the struggle underneath the primary narrative of a single mother in the United States. I think people connect emotionally to hope, and to the search for balance in their lives.

In your book you say, and repeat, that “it’s not trauma alone that traumatizes — it’s having no one who is interested or cares about you afterward, that’s what’s especially traumatizing.” Can you talk a little about this?

There is a lot of discussion about resilience and why is it that many people can suffer the same overwhelming childhood trauma and only a few have post trauma sequela of PTSD and DID. So that’s a big question, and some people may disagree with me. It is my opinion that lacking a secure early childhood attachment, and having no one to model safety, contributed enormously to the trauma that created my dissociated identities. Many trauma-informed researchers share this opinion, such as Martin J. Dorahy, Karlen Lyons-Ruth, and Bessel van der Kolk. My opinion is based on my lived experience.

Was helping others a motivation for sharing this story?

That’s what kept me going. I have received unexpected emails from strangers that found my website and said how much it helped them, how important it is to know we’re not alone, that there is hope. All I have is my story. I didn’t know it might be that important to others, but it is.

Was writing this book cathartic for you?

The healing work was the work of therapy. Writing helped me reflect more on what had happened, the sequence of events, how grateful I am for the grace and kindness I’ve found in my life. Writing gave me a creative space to look deeply at humiliating and disturbing aspects of my life without knowing if I’d just end up labeled crazy.

I found myself with more empathy than when I started — why was that? A mental shift had happened. I wanted to try to make sense of it. I wrote the memoir in order to understand what had happened. I think the writing, the creation of art, gave me the space to find those moments of kindness and grace that I’d missed as I went through the shifts.

How do you remain hopeful?

I remind myself that I do know what to do, how to be grounded, how to breathe. I recall the compassion, the tenderness that awakens in me when I think of what I learned from my child Parts, when I wanted to take their burdens as my own. This is a microcosm of the world, I see that, expanding out so far beyond ourselves. This is how I remain hopeful.