Other Voice Hearers

Organized Extreme Abuse

Although the topic of OEA is listed under Other Voice Hearers, it is important to understand that victims of OEA have a higher prevalence of Dissociative Disorders as a population. This topic is listed separately because there are so many different types of OEA organizations and it is important that individuals with DD understand what happened to them was not their fault regardless of what they have been told by these groups. The other challenge in working to educate about this topic is a societal dissociation of not wanting to believe or accept the existence of this type of abuse in general and the existence of this type of abuse in one’s own community specifically. Meaning even if people can accept that OEA exists, they still perceive that it is happening somewhere else. Out of the different forms of Organized Abuse, the most controversial is regarding Ritual Abuse. There are more and more therapists and resources becoming available to educate the public, professionals, and victims. Below are a few of those resources:

Books Healing the Unimaginable and Becoming Yourself by Alison Miller

https://survivorship.org/what-is-survivorship/

https://www.organisedabuse.com/

https://strengthtoheal.org/understanding-ritual-abuse/

https://www.firstpersonplural.org.uk/ritual-abuse/definition-of-ritual-abuse/

https://endritualabuse.org/

Non Traumagenic Plurality

The term plural was adopted to describe individuals who endorse having multiple personality states sharing a single body. Individuals who do not have this lived experience are referred to as singletons. Plural is used by both individuals who have a diagnosis of DID as well as individuals who did not form self-states based off of traumatic experiences. Within the mental health community and the way the current diagnostic criteria are written, experiencing a traumatic event is not a criteria for the diagnosis of DID. However much of the research into DID has shown that trauma has been part of the process. What is part of the criteria, is for the dissociative symptoms to cause distress in a persons functioning. Many people who endorse non traumagenic DID also share that although they can have other mental health issues like anxiety, depression, ADHD, OCD, their experience of these issues does not come from their dissociation, so a DID diagnosis may not be appropriate because the “disorder” would be attached to their other presenting mental health issue. As stated in the section on DID, research is looking into two factors that might contribute to a DID diagnosis. One is trauma, and the other is high hypnotizability. With that logic, it should be possible for individuals who have this particular aspect and engage in fantasy play around creating inner worlds, it might be possible for non traumagenic systems to be formed. This also can explain why other individuals who can experience a similar degree of trauma as someone with DID not develop dissociative identities. At this time we just don’t really know. What we do know is that the current treatment research as well as recent fMRI scans, and brain pattern recognition research, the evidence to support DID does exist in the body, and the recommended treatment protocols (which are being updated) show that using a trauma informed approach with individuals who have dissociative disorders, can be effective in improving their overall quality of life and reduce the “disorder” that is attached to the diagnosis. We also have to hold space for individuals who have dissociative identities and may still need mental health support for other diagnoses, and not get lost in the weeds of those clients also having internal systems.

Psychosis

Psychosis refers to a collection of symptoms a person experiences that can lead to a loss of touch with or even loss of understanding reality. Behaviors can include isolation, inability to care for oneself like personal hygiene, hallucinations, and some types of delusions. The biggest factor in regards to psychosis is the struggle with reality. Although audio hallucinations like hearing voices is an example of a psychotic symptom, it is not as common as other symptoms that impair a persons functioning. And usually if someone who is experiencing psychosis is hearing voices, many times they believe the voices are coming from outside objects around them. It is important to work with a therapist who can identify if the person they are working with is experiencing dissociative voices more commonly found with DID, and what other possible psychotic symptoms (as usually more than just hearing voices will be present) a person struggling with psychosis might be experiencing. Unfortunately there are too many providers untrained in recognizing and treating dissociative disorders. They automatically assume a person is psychotic because of hearing voices and the person is then subjected to unnecessary medications, invalidating treatments, and at times unnecessary psychiatric holds. It is also important to understand that an individual with DID can also have psychotic symptoms and in that case medication management can be helpful. Individuals with DID who hear voices that are treated with antipsychotics will still report hearing voices, where individuals with true psychosis will report improvement of symptoms with antipsychotics including reduction or complete resolution of voice hearing in some people. This is just another area where once again it is important to work with trained professionals who know how to recognize both dissociative disorder symptoms and psychotic behaviors. If you or someone you know has been diagnosed with a dissociative disorder and it has been recommended to seek medication management for various symptoms, please ask the medication provider if they have ever worked with a patient with dissociative disorders before. If they have not, ask if the would be willing to get consultation. One of the reasons it can take on average 7 to 11 years before someone is properly diagnosed with a dissociative disorder is because they have been treated like they were psychotic, or they are faking symptoms for attention. If this has been your experience then being assessed for a dissociative disorder is strongly recommended.