August, you are most welcome here and your ideas are of great interest. Thank you for taking so much time to share them with us. We also believe that people will do what ever is necessary to survive. I agree with you that it is possible to use dissociative processes to deal with unknowable trauma. It also makes sense to me to link their creation to one's attempt at the management of intense emotions. I like your reframing of the mpd patient's behavior as a testing mechanisms and attempts at adaptation from within a traumatized person's pathogenic system.
I am interested in learning more about your mentor -Frank Richardson. What is his theory and where is he? Your experiences at the mpd ward sound reminiscent of a recent novel about a psychiatry residency- Mount Misery by Shem. It is possible that patients do induce their disorder, but they have genuine issues and problems however they express them. They are asking for our help. I have not found it useful to encourage or invite my patients to separate their different feelings or experiences into alters or personalities but I know many colleagues have found it helpful. I like your concept of mpd as a construction. In Control Mastery theory symptoms are usually treated as constructions, created by the patient in compliance to their pathogenic beliefs. They serve to keep the patient out of some fore told danger. We find symptoms abate when the patient feels safe enough to test and understand the previous function the symptom served.
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