Dissociative Identity Disorder and the Process of Couple Therapy

I find little on the Internet addressing individuals living and loving a spouse believing who suffers multiple personalities/Dissociative Identity Disorder (DID). Only a few spouses have come to this blog to share their difficulties, frustrations, and triumphs.
      A home with a spouse, usually the wife/mother identifying as a multiple who experiences alter selves, by nature creates a home in chronic chaos. The woman believed to suffer from alter personalities is often a financial drain on family financial resources as well as emotional resources. Treatment for DID is known to be long and arduous – sometimes lasting decades. The depths of despair the wife/mother experiences during therapy makes it extremely difficult for her to function making home responsibilities and employment outside the home overwhelming or impossible. Marriages suffer from the weight of long-term psychotherapy that usually disassembles the patient rather than bolstering their functioning and overall mental health.
      For example, multiples present themselves as little children, therefore, demanding guidance and assistance from someone else (usually the husband or psychotherapist) to keep them safe and to carry out spousal and parental duties. At other times, the multiple may present as an angry or suicidal alter who needs emergency medical intervention; or someone of the opposite sex; or other personalities they are not – in reality.
      The unpredictability and chronically unstable mental-state of one spouse creates unique needs for the other spouse.
      A spouse and parent who brings this type of chaos to the family brings challenges to the marriage and family unit. Although I think the psychiatric condition of multiple personalities is contrived (not to mean faked), I support the mental health care profession addressing marital difficulties stemming from the diagnosis and treatment for multiple personalities clinically called Dissociative Identity Disorder.

Heather B. MacIntosh PhDCPsych
Accepted author version posted online: 10 Sep 2012


Couple therapy in the context of Dissociative Identity Disorder (DID) has been neglected as an area of exploration and development in the couple therapy and trauma literature. What little discussion exists primarily focuses on couple therapy as an adjunct to individual therapy rather than as a primary treatment for couple distress and trauma. Couple therapy researchers have begun to develop adaptations to provide effective support to couples dealing with the impact of childhood trauma in their relationships but little attention has been paid to the specific and complex needs of DID patients in couple therapy (MacIntosh & Johnson, 2008). This review and case presentation explored the case of “Lisa”, a woman diagnosed with DID and “Don”, her partner and illustrated the themes of learning to communicate, handling conflicting needs, responding to child alters, sexuality and education through their therapy process. It is the hope of the author that this discussion will renew interest in the field of couple therapy in the context of DID with the eventual goal of developing an empirically testable model of treatment for couples.

Retrieved 12-05-12.

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  1. The Improper Adoptee

     /  12/08/2012

    I am the owner of the blog The Improper Adoptee,
    and I just wanted to tell you that I love the post you did on Candace-I have written quite a few entries about her myself. and will continue to do so. I agree with a lot you say on your blog and I am also Anti-Psychiatry like you are. Thanks for the great info you have provided.and for speaking out against this abusive “profession”. which just isn’t done enough.


    • Hello The Improper Adoptee,

      Thank you for sharing your thoughts and for keeping the memory of Candace Tiarra (murdered during rebirthing therapy) alive.

      I can understand why you would get the impression that I am anti-psychiatry, but I am not. I am against pseudoscience parading around as science and misleading mental health consumers otherwise.


  2. Hey Jeanette,

    I know you and I have discussed this before, but for the benefit of any of your new readers, I thought I’d leave a comment again. My blog and Ben’s (Loving Someone with DID) are the only 2 blogs I know of from the supporting spouse’s perspective.

    As for what my wife’s disorder does to our marriage: I really don’t view it as any different (substantively) than if she had had a massive car wreck and was either temporarily or permanently an invalid. At least now that I know “why” she is the way she has always been for our 24-year marriage, we are making progress toward her complete healing.

    Consider having a spouse in which “something” is wrong physically but you spend years going to doctors and trying to help her and NOTHING helps her get better. That’s how it was for me and the first 20 years of our marriage. My wife was an AWESOME mother and homeschool teacher (son got academic scholarship and will graduate next spring with almost a 4.0, having won multiple academic awards while in college), but she was a TERRIBLE housekeeper (doesn’t work outside) and wife, though she and I were great platonic friends. So I did everything and anything I could to try to help her those first 20 years with NO effect. Once we got the d.i.d. verdict it finally gave me the understanding I needed to REALLY help her heal.

    Now, yes, the healing journey is exhausting for me as I help the little girls heal, but at least now I feel like we are moving forward and I really have hope that some day I will have a healthy marriage. But because we are NOT doing it the ISSTD way, we don’t have all the negative side effects that are so common with most d.i.d. sufferers. No suicide issues. No need for anti-depressives or anti-psychotics. Few S.I. issues. No in-hospital stays. Mostly it’s just a lot of loving and family bonding activities that are giving the little girls time to heal.

    As for your corollary issue about “couple therapy.” As nice as that would be, from my perspective of d.i.d. being “real”, couple therapy is a waste of time because the little girls control traits and abilites of my wife that Karen (the adult) does not have access to yet. And so, until the little girls heal and grow up sufficiently to want to marry me (a stated goal I’ve told all of them), “couple therapy” would be like trying to help a person without legs run the marathon. Karen literally does NOT have all the traits and abilities a healthy woman has so she has NO ability to function as a healthy wife.

    Anyways, that’s my perspective, in case you or your readers care.




    • Hello, Sam, always a pleasure.

      I understand your point about couple’s therapy not working for the reasons stated. I realize that, yet would like the husband to have a place to express his needs and to have the wife/multiple understand.

      I cannot imagine having a spouse who acted like a little girl in need of care and attention. You mentioned that you are helping the girls grow up which I think is different from what others seek. People sometimes express the desire to integrate the alters so the person will be one; others prefer to keep their alters; and you are helping little alters grow up. The differences may be due to the ISSTD model being the predominant treatment modality i.e. integration.

      Although I once lived my life believing I had multiple personalities, that ended nearly 20 years ago when I came to the conclusion that the multiplicity I experienced was a result of therapy. That said, I understand the mechanisms, belief systems, and thought processes. I am not multiple, nor do I have a spouse that is multiple, so I will default to your experiences in these matters.

      I understand your analogy to a spouse having a seriously debilitating physical-illness and find that scenario extremely different than having a spouse with multiple personalities. When I thought I had multiple personalities my life was chaotic, fraught with fear, flashbacks of trauma, periods of being a little child, and an overall inability to function and take care of myself without lots of help. I cannot imagine a marriage that must incorporate one partner regressing to a child and having all the need and care that requires from the spouse. I mean no disrespect, Sam, but think asking someone to be a caretaker in this fashion is selfish. But your marriage works for you – otherwise I suspect you may have left decades ago, I don’t know.

      I think of Karen’s DID “verdict” as you put it as a life sentence. DID therapy is not known for its success rate. You have already put in 20 years of trying to heal your wife with what seems to be years and years more of the same in the future. Again, I don’t know.

      What happens if Karen’s child alters grow up and don’t want to marry you and have no interest in being with you? Just askin’

      Thanks again, Sam, for stopping by. Best. JB


      • Jeanette,

        I don’t see this as a life sentence. It felt like that before we knew about the d.i.d. but since then (4 1/2 years ago), we have made steady progress forward. I’m working with the last insider that we have any evidence of and ALL of them deeply love me and emphatically state they NEVER want to be with anyone else because I have taken the time to win each of their hearts. The teens are girlfriends and have stated when they are ready to marry, I WILL be the one.

        I know the success rate stinks for the ISSTD model and the people never are quite right even when they are deemed “healed”. But I’m not willing to accept their standard for my wife. She WILL be completely healed when we are done…I think.

        As far as my analogy, someone who is confined to bed, a complete invalid, is no less exhausting than my wife. I had an uncle who died of ms in his late 30’s and his wife had to be as completely self-sacrificing as I do with the little girls for almost a decade, maybe even more, because most of my self-sacrificing has to do with sexual needs, but I find the little girls HIGHLY delightful companions to be with because they really are “super” children. Again it’s not like you see on most blogs where the littles can barely function. Since I have brought the littles out and adopted them completely into the family their talents and abilities quickly became “adult” in abilities. It’s the emotional orientation that is slowest at maturing, though even that has progressed significantly in each girl.



        • I didn’t mean to suggest that your situation is less exhaustive, for sure is is highly exhaustive.


          • Jeanette,

            I didn’t take offense, but I actually meant that my aunt’s situation was in some ways worse than mine. She had a terminally ill, bedridden spouse, little children in the house and she had to work a fulltime job.

            The chaos you experienced, I believe, is because you were subjected to the faulty ISSTD model and healing method. That chaos is NOT part of our experience! I’m not saying it’s not hard on me, but it’s hard on my wife (all the girls and Karen) as well. I guess to me it’s part of the “for better or for worse” clause. I’m not saying this was my dream. It hurts like hell, but I love my wife. She didn’t ask for this and I’m going to help get her thru this so we can BOTH be happy in the end.



          • Oh Sam, your Aunt’s situation sounds dreadfully sad.

            I think you are right about me getting the ISSTD model of recovery. Had I remained in treatment, I would likely still be there. Hopefully with your methods, Karen will find her way out soon. Glad to know you do not have that chaos – it was horrible and the stress was through the roof. I believe that stress and chaos left me with permanent physical issues.


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