Subtle Ways Psychiatry Has Harmed Us

Often without reason, psychiatrists will forcibly institutionalize people, shock them, and medicate them against their will; these are extreme and unnecessary methods that the system employs against a significant number of people it deems dangerous. But there are other, more subtle ways in which psychiatry degrades and harms those it sees as “mentally ill,” and encourages us to degrade ourselves as well.

Though the two of us have never been in a psych hospital, we have suffered many of these subtle forms of oppression by psychiatry. It was essential for us to find new frameworks to understand ourselves that didn’t depend on what psychiatry thought of us. Before we get into that, though, we should introduce ourselves.

Who we are (and why that matters)

You may be wondering why we’re writing this together, since this is a personal story. We’re writing this together because we do everything together—literally, everything. We exist as what’s called a multiple system, or just system for short, which means that we’re multiple people (two, at the time of writing) sharing one body. We use the name Violent Trans Empire to refer to ourselves as a group.

There are many explanations for how there can be multiple people in one body, and many ways to experience it—some systems were born as multiple people, some used spiritual techniques to “call in” others from what they see as different realms to share a body with them, and some, like us, had our brain create multiple people to help deal with trauma and abuse.

This last idea is probably the most familiar in pop culture. Psychiatry calls it Dissociative Identity Disorder (DID), but it’s often still known as Multiple Personality Disorder or just “split personalities.” The idea of several “alternate identities” in one body, fighting for control of their body and suffering from amnesia, has been held up as a classic plot twist in movies like Split, Fight Club, and Sybil. Multiple systems are regarded as either dangerous killers who ought to be controlled by the psychiatric system, or helpless victims who must rely on psychiatry to heal our “broken” minds.

Neither of these ideas are true for us, and encountering them early in our process of understanding ourselves was deeply harmful. While the first was easy to dismiss as just pop culture nonsense, the second was much harder to overcome.

How the psychiatric model misled us

We first discovered the idea of multiple systems online, and through reading about others’ experiences, we began to realize how much we could relate. I (Skylar) have been in this body since birth and had always assumed that Missy and previous others were just fancy imaginary friends who had stayed around past the usual age. Upon realizing that there were other people who had similar experiences, I started clinging to the model that the psych system laid out, trying to force both of us into diagnostic criteria and terms that would give me some feeling of belonging and a way to make sense of this. However, many of the ideas simply didn’t fit.

One of the hallmarks of Dissociative Identity “Disorder” is amnesia between system members, so that when one takes control of the body (called “switching” or “fronting”), the others don’t remember what happened during that time. We don’t experience amnesia at all. Another major problem DID systems face is not being able to control when they switch; they may switch due to a trauma-related trigger and have to quickly adjust. We’ve never had that problem either, and in fact originally had serious problems switching. I quickly became so focused on the DID model as the “one true way” to be a multiple system that I could not let Missy switch in at all. I was terrified that if she did, she would say or do something “too similar” to me, or I wouldn’t feel any different—something that would somehow reveal that I was faking everything and that she was just a figment of my imagination.

The standards we were trying to meet were a little different from the way the psychiatric system understands DID: most of the literature only sees system members as “alternate personalities” or “alters” that are in fact not people. “Alters” are thought of as just fragments of an original person who split apart due to trauma. While some of the DID systems we encountered did believe this, we and many others dismissed it as far too dehumanizing, as it completely ignores most system members’ experiences and perceptions of self.

However, among the systems we encountered who agreed that this was wrong, many of them still insisted that the only way to be a multiple system was to meet DSM criteria for DID (or its subsets, OSDD1-a and 1-b, which are similar). Even though they disagreed with the standard psych model in one sense, they still tried to force others to adhere to the general idea according to the psychiatric system. All the systems we mentioned in our introduction—those who exist that way by birth, or by spiritual means—were considered “fakers” and “roleplayers” by the groups we met online. Essentially, we felt like we had to meet at least some of the psych system’s standards to be allowed to exist.

This caused a lot of tension between Missy and me, to put it mildly. I would try to let Missy front, only to force her out a few seconds later out of fear, or if she stayed in, I’d nitpick everything she did to see whether it was “really” her or if I was still somehow faking it. Missy and I got into fights over this, where I would demand that she front and “prove” that she was real, but then wouldn’t or couldn’t let her.

Missy’s perspective

I’m interjecting here, because I want credit for having been anti-psychiatry from the start. I didn’t have the option of subscribing to the psychiatric model of multiple systems, since doing that would mean forfeiting my existence as a separate person. Skylar could, perhaps, find ways to fit into that model while still being allowed to express himself and be taken seriously. He might have to be considered more disordered than he is, but he’d still be seen as real.

My very existence is anti-psych: as a system member, as someone whose personality is not just separate from Skylar’s but would be considered “disordered,” as someone who refuses to be seen as part of him, and especially as someone who refuses to be integrated—that is, I refuse to undergo “treatment” in which psychiatrists force all the system members who aren’t the designated original to fuse with each other into the original, to try to “put back together” what they see as a fragmented single mind. But we’re not a single mind; we’re two people who share a body. Integrating me would mean that I cease to exist as a person.

So, I have my own issues with the psychiatric model and have never wanted anything to do with it. Unfortunately, for a time, while that was not the only model we had, those that supported it were certainly the loudest and the most insistent.

Problems with seeking treatment

I (Skylar) was still insistent that we try to get diagnosed with at least a subtype of DID so that I could feel like we had some validation for our existence. I knew that this was likely to be dangerous—we ran the risk of being seen as delusional and forced into an institution. We worried about being seen as unfit to care for ourselves or possibly dangerous to ourselves or others (as per the Split stereotype of murderous DID systems). So, we treaded very carefully in telling a therapist about how we existed, being careful to emphasize that we could still function and we weren’t distressed by being multiple. And we were lucky enough that our primary therapist believed us.

But in order to keep from being seen as disordered, we had to point out explicitly how we didn’t meet the DSM criteria for “distress and/or dysfunction.” We couldn’t exist as per the DSM description and also identify as healthy or non-disordered; either we had DID and thus allowed ourselves to be seen as disordered for existing, or we had to let go of this model.

I clung to the dysfunction criteria for a while, trying to play up the post-traumatic emotional and memory issues that we do have to make it seem like we were disordered enough to “count” but not enough to need hospitalization. By focusing heavily on our post-traumatic issues, I believe I made them worse. I would write down every trigger, flashback, and emotional problem we experienced, getting anxious if we didn’t have what I thought was enough or severe enough during a given week. I set up this dilemma in my head where either we fit the DID criteria exactly or our system wasn’t real, which meant that the trauma and abuse we had endured must not be real or bad enough either.

Finding a diagnosis didn’t help

I eventually went against Missy’s feelings and my own better judgement and took us to a psychiatrist to try and get diagnosed. I was actually aiming to get several other “disorders” that I thought I had confirmed, but as long as we were there I thought I’d try for DID too. I brought up our experiences but was too anxious to talk about how Missy could physically take over our body—I was worried that our psych would ask for proof, try to “treat” us by putting us through a program of integration therapy, or just outright lock us up.

As it turned out, none of those happened. We got diagnosed with PTSD instead, and any mention of Missy was dismissed as me having “complex internal relationships,” by which our psychiatrist basically meant imaginary friends. She also slapped us with a diagnosis of “schizotypal traits,” meaning that we weren’t obviously delusional or paranoid enough to be fully schizotypal, and didn’t hallucinate—or at least I had another explanation for the “voice” I was hearing—so we couldn’t be schizophrenic. She noted that we talked to ourselves and looked odd, but in spite of this she didn’t prescribe any antipsychotics or therapy. But this was obviously not due to any acceptance or understanding of our existence; instead, we just got extremely lucky that she overlooked these things.

In hindsight, it probably helped that we didn’t go into much detail about Missy or the nature of our relationship; it sounded in her report like our psychiatrist just thought I had an overactive imagination or at most some kind of weird spiritual beliefs that she didn’t care enough to interfere with. It helped that I didn’t mention that Missy sometimes took over part or all of my body; that would likely not have been received well. We had originally gone in to get diagnosed with several “personality disorders” as well, so it’s likely that our psychiatrist may also have thought that this was a complicated form of “attention-seeking” and largely ignored it so as not to encourage me. We ended up with the right combination of an inattentive psychiatrist and certain personality traits that made her not take us seriously enough to be worth a trip to a psych hospital.

The solution: anti-psychiatry

Again, Missy deserves credit for having arrived at the solution long before I did. She, along with open-minded systems we met online and a few offline friends, talked me around to being anti-psychiatry, and to understanding ourselves in a way that didn’t require us to meet DSM criteria. I realized that those criteria were made up by people who are just one person per body (and so don’t have a full understanding of what it’s like) and used to cast those with more than one person per body as dangerous or incompetent. Most of all, these criteria are used to force us, and to make us force ourselves, into ways of existence that are harmful to us.

We’re not dysfunctional or bad just because there are two of us in here. What’s more important than being a socially acceptable single person is that we know how to get along and manage our trauma and our life together. Knowing this, we now strive to advocate for other systems and reach out to those that may not understand systems, to show that existing as we do is okay and that we can learn to navigate the world by cooperating. We don’t need the psychiatric system or its labels to allow us to exist, or to try to fix us. We just need to be accepted as we are.

Part of how we try to get people to accept our existence is through articles like this, but we also try to reach out on a personal level to people we know. We’ve come out to several friends with good results, and those that don’t understand well at first have been willing to learn more. We’ve also written a paper and given a presentation for a class unrelated to psychology, to give people who would not otherwise have known about multiple systems a chance to learn what we are and how we should be seen, as opposed to what psychiatry currently thinks of us. So, we take small steps in our daily life to spread awareness and acceptance.

How we function and cooperate

Now, if we refuse to let psychiatric labels define us, what is our life like? I’d mentioned how difficult it was before to coexist while trying to force ourselves into a framework that didn’t have room for us; has it gotten easier since then?

Yes, it has absolutely gotten easier and we get along much better now. Missy is able to front when she wants and I’m getting better at stepping back and generally being less anxious about everything. I usually still front most of the time, because I’m the one who takes care of most coursework and housework, but now she can finally come out in therapy, to help when I’m anxious or low on energy, and to just spend time with our friends and get to feel like a normal person. Our daily life is actually pretty normal—we go to class, the grocery store, hang out with friends—except that whoever isn’t fronting is often hanging around close by to make sassy commentary.

It’s not perfect, since we still do have post-traumatic emotional issues and bad memories to deal with, but now that we’ve accepted that being multiple is okay, we’re better equipped to handle that as well. We’re also in a relationship with each other, which is great, though it can be difficult trying to figure out how to explain to people how that’s even possible—we’ve gotten reactions like, “But how do you have sex?!?” which is way too intrusive, or, “Oh, so you’re dating yourself,” which is at least accepting, kind of, but still wrong. Often, we just don’t bother to explain things like that because it takes too much emotional energy. In general, though, we’ve found accepting and understanding friends who we can be ourselves around.

I wish we had figured out years ago that we don’t have to fit any psychiatric paradigm or be acceptably “normal” in order to be happy. All we need is understanding.