Pretty Girl-13

AFTERWORD





ANGIE’S STORY MAY RAISE QUESTIONS OR CONCERNS FOR some readers. If you would like to learn more about trauma and dissociation on behalf of yourself, a friend, or a family member, here is an excellent place to start:

The Sidran Institute

Traumatic Stress Education and Advocacy

www.sidran.org

The Sidran Institute provides general information as well as referrals to people who can help.





AUTHOR’S NOTE





WHAT IS DISSOCIATION? IN THE SIMPLEST TERMS, IT IS WHEN part of our mind “detaches” and does its own thing—drives for fifty miles without realizing it, daydreams and misses an entire class, tunes out all sounds in the room when we’re concentrating on something else. This mild dissociation is quite normal. At the other end of the dissociation spectrum is psychosis—completely losing touch with reality through hallucinations and delusions.

My heroine, Angie, falls into a very special category of mental health patients. When one part of her mind detaches to save her from experiencing traumatic events, a complete, alternate personality takes over. The main theory of dissociative identity disorder (DID) is that it is a defense mechanism; young children, still in the process of understanding and developing their identity, can separate this way under extreme conditions of emotional, physical, or sexual abuse. The fear and pain belong to an alternate personality, sparing the primary person but leaving gaps of hours or days or more in his or her memory. Even when the abuser is gone, the separate personalities remain on call to handle life’s threatening or challenging moments. There’s no accurate estimate of the rate at which this occurs, because reporting is very different across countries and cultures. Certainly, DID has been around for centuries, thought of as possession or hysteria in times past.

The most famous case of DID was Sybil, a real woman whose biography was popularized in book and TV form in the late 1970s. At that time, the phenomenon was called multiple personality disorder and it was considered quite rare, with only one hundred or so cases officially documented. Since 1980, when the American Psychiatric Association officially recognized the disorder, thousands of cases have been found in the United States, for a combination of reasons: more awareness on the part of therapists, recognition of cases that would have been diagnosed as other disorders in the past, and changing public attitudes toward seeking mental health services. Some professionals think it is overdiagnosed, while others think it is under-diagnosed.

When preparing to write this story, I interviewed a friend, “J,” who is a “reintegrated multiple”—someone who has integrated several alternate personalities into one well-functioning person. Everything in J’s story—from the childhood causes of dissociation to what it was like to live as several people to the long process of emotionally dealing with the traumas and recovering as an adult—matched the published accounts of DID that I had read.

Several biographies and autobiographies of people who have experienced DID and reintegrated their personalities or learned to live more comfortably with alters are available. Many tell stories very sad, graphic, and distressing, and having read a few, I wouldn’t necessarily recommend them.

Angie’s fictional experience is told more gently but still accurately represents many of the features of DID. For instance, alters can be different ages, different sexes, different sexualities, and differently handed (right/left). As is true of different people, they will have different tastes, outlooks, memories, voices, facial expressions, and body posture. Angie’s imaginary mental cabin is based on a common experience of multiples who visualize the way alters live together in their minds as people sharing a many-roomed house, a castle, or a space with many compartments.

Angie’s treatment is a mixture of fact and fiction. In real life, psychotherapy takes many years, not a few months. Traditional therapies include talk and hypnosis. People with DID are often very bright, and at the same time, easily hypnotized. Post-traumatic stress disorder (PTSD) is often a part of DID. Dr. Grant’s light bar, an EMDR (Eye Movement Desensitization and Reprocessing) device, is actually now in use for helping PTSD sufferers revisualize bad experiences and reduce their terribly negative emotional reactions. A combination of therapeutic techniques can be very effective in helping a patient with DID break down barriers between the alter personalities, absorb the memories that were too destructive to handle, and work out a plan for bringing the alters into a cooperative relationship.

Angie’s experimental procedure—“optogenetic treatment”—to erase the identities of two alters is currently fiction but theoretically possible in the future. While science hasn’t yet reached the state of pinpointing particular memories to exact locations in the brain, it may be getting closer. In real life, scientists have been able to study which parts of the brain are most active when switching between alters. Optogenetic treatment—that is, putting the genes for light-sensitive proteins into nerve cells—exists today and is being performed in laboratory mice to treat a variety of problems, including paralysis, blindness, Parkinson’s disease, and epilepsy. Neuroscientists are excited about beginning to test optogenetics on humans in the near future. We are on the verge of a new era in treatments for physical and emotional disorders of the brain.

Angie’s story raises a number of questions. If you could simply delete your most awful memories, should you? Would you be the same person? What would you gain? What would you lose?





Acknowledgements

Many thanks are due—to my supportive community of writers, including NaNoWriMo, SCBWI, the SF&F Online Writing Workshop, and Context; to my first readers, Rachel Lentz, Gio Clairval, Jodi Meadows, and Erin Stocks; to my middle readers, Deborah Yeager, Kate Coley, and Gemma Cooper; to all the friends and family who watched and encouraged my growth as an author; to my agents, Joanna Volpe and Nancy Coffey, who believed in the promise; and to my editor, Katherine Tegen, who made it happen.





About the Author


Liz Coley’s short fiction has appeared in Cosmos magazine and speculative fiction anthologies. Her passions beyond reading and writing include singing, photography, and baking. She plays competitive tennis locally in Ohio to keep herself fit and humble.

With a background in science, Liz follows her interest in understanding ‘the way we work’ down many interesting roads. Pretty Girl Thirteen’s journey into the perilous world of dissociative identity disorder is one of them.