For many caregivers who assist their loved ones, the journey involves navigating the medical system and its many challenges. This time, the journey takes a different course, avoiding the usual psychiatric treatment model entirely as a husband helps his wife through her experiences with “alters” (usually classified as Dissociative Identity Disorder, or DID). Together, attachment theory and his own supportive approach have proved instrumental in helping her on her ongoing path to healing.
Sam Ruck (his pen name) has been part of the Mad in America community for a few years, providing supportive material for others caring for loved ones living with DID. The story of Sam and his wife, Ka’ryn Marie, thrive on the tenets of love, commitment and healing, each of equal footing. Sam has also written a book—he’s looking for a publisher—about his transformation as a good healing companion to his wife.
Married for 35 years, they come from a devout Evangelical faith that has evolved over time. While they attended different churches in the same denomination, they met while Ka’ryn Marie (also not her real name) was dating a friend of his. Later, they got to know one another at the small bible college Sam attended. Sam knew that she was the one for him. Eventually, her “alters” joined them at church, where they worked to hide them to prevent judgment and stigma. They attended a few different churches to continue their faith traditions and eventually departed altogether to protect her, and to avoid conflict within the community during the shift of viewpoints during the pandemic. While their involvement in being part of the traditional church community has dissolved, their faith remains strong.
Ka’ryn Marie’s DID appeared after they were married, when intimacy exposed her deepest childhood traumas of sexual abuse at the young age of 2. Ka’ryn’s trauma was unbeknownst to both of them prior to their marriage, as a switch was ignited in Ka’ryn when they began to be physically intimate. Avoiding this intimacy and her sense of being uncomfortable opened up old wounds of her sexual abuse by a neighborhood boy. Little girls, or “alters,” began to appear in various forms—and included voice changes, mannerisms, and expressional feelings, which held different parts of her trauma. Other alters appeared as wounded girls from the verbal and emotional abuse of Ka’ryn’s mother, which showed up in other ways and also needed healing. Sam has worked to identify these little girls and alters, recognizing their varying personalities who have needed consistent care, patience, understanding, and healing.
As these girls have begun to heal, they interconnect with one another, merging with one another to the point that they appear as his “greater wife,” as Sam refers to Ka’ryn. In other words, the ultimate goal is the amalgamation of all the girls, merged into one woman as if the trauma never occurred.
The early experiences with them prompted Sam to dive into their spiritual teachings for answers and ultimately change, hoping to heal himself through his own therapy and deeper understanding of his reactions and responses to his wife’s challenges. People who live with DID often feel very detached from experiences, or even forget doing something that others have witnessed. There are gaps in memory, and the confusion and stress of living with day-to-day experiences that do not feel like themselves. While people who live with DID have strong internal personality fragmentation, they do not display “multiple personalities,” and the condition is typically hidden from the outside observer. Combining spiritual faith and the practices of Attachment Theory throughout the years, Sam and Ka’ryn Marie have worked diligently to figure out what works for their creative lives outside of the societal norm.
Attachment Theory is a psychological method created by John Bowlby, a psychoanalyst who researched the effects of the parental bond on infants and children. Attachment behaviors are instinctive responses to the perceived threat of losing the safety and care provided by the primary caregivers. These behaviors and habits determine what type of relationships people have as they grow in life. Children are inherently intuitive to the care they are receiving, even if they do not have the verbal communication skills. Depending upon what trauma may be experienced, children learn to adopt survival-mode behaviors.
Below are Sam’s answers to questions about his wife, their life together, and their journey toward healing.
How did you figure out how to help your wife, who lives with DID?
As I deeply studied the holy writings with which I was familiar, I realized that my highest calling was to nourish and cherish my wife just like I would myself. And our tradition has a belief that “what we are called to do, we will be equipped for that task.” And so as my wife and I began to encounter “alters” and extreme dissociation and all the extreme states which go with it, I had a confident belief that no matter how different, how stretching, how stressful these experiences were, that I would somehow find the wisdom I needed to walk through each experience with her.
As the other little girls or “alters” began to come out and join our marriage and family, they mostly fronted as little girls under the age of 8. They were so helpless, so desperate for love and attention and for someone to simply take care of them, and so scared and traumatized from the original abuse. I simply knew I couldn’t abandon them no matter how hard it was for all of us. This experience has given me time to work through my own issues while I learned from each of them how to best help my wife and all her alters.
Because my wife’s alters initially fronted as scared and hurt girls, I became a parent to them, comforting each of them. I held each of them and whispered, “It’s ok now, honey. I’ve got you now. I’m so sorry no one heard you crying before. But I hear you. I see you. You are important to me, and I’ll take care of you because I love you and you are one of my special girls.” And eventually, as I simply comforted them as any child wants to be comforted by her parents, the healing which my wife had never gotten originally began to take root in her heart.
Later we found out these techniques would best be called attachment-theory concepts. And so I studied up on them and began to implement them more thoroughly and purposefully.
How have you applied attachment theory to your relationship with your wife?
Attachment theory recognizes that four basic attachment patterns arise in children up to age 18 months based upon the primary caregiver’s behavior. A securely attached child’s caregiver responds appropriately, promptly, and consistently to the child’s needs and cries for help. An avoidant pattern arises from a caregiver who gives little or no response to the child’s needs and cries for help, discouraging crying and pushing independence. The ambivalent/resistant pattern comes from a caregiver who is inconsistent in his/her responses to the child, swinging from appropriate to neglectful. And the disorganized child often is subjected to an abusive caregiver who frightens the child or is frightened herself. (Wikipedia.)
I had unknowingly been following the key factors of attachment theory as I connected with each girl to heal from their past trauma and integrate with the other “alters.” We worked on strengthening the existing relationships between the girls and shifting their inner working model. I patiently worked to bring them to the outside world, to share their thoughts and feelings, so I could help them heal. I provided a way for them to associate with each other and their inner and outer worlds for comfort. It has been a long road to help the little girls progress along in their “stuck” youthful child-like behaviors chained by the trauma induced upon them.
I know that attachment theorists are not nearly as strident in their proclamations about the clear-cut categories of attachment in their lives. My progress shifted from an unhealthy attachment to a secure one, and then my girls began to mirror their own patterns as well.
While my own needs are rarely met by my wife despite my cries for help, I’ve worked through it to become more accepting. I have become my own witness, jumping from various unhealthy attachment styles as she was unable to respond to me. I have also endured my own trauma from this very experience—and the weight of responsibility to care and love her as she is without my needs being met can be an ongoing challenge. I am grateful and lucky to have had a mostly healthy childhood to carry me through to my wife’s healing. The key for me is to continuously work through my unhealthy attachment patterns within myself until my wife heals and can reciprocate.
Are there any doctors (or other clinicians) who have been helpful?
At the start of our healing journey 16 years ago, I found a woman about an hour from where we lived who practiced an alternative form of therapy called theophostics as well as other modalities.
According to Ed Smith, the Baptist minister who developed it, “Theophostic is a ministry of helping emotionally wounded people to acknowledge and to identify the true source of their inner emotional pain and find lasting peace through receiving personalized truth directly from the Lord.” Through a series of sessions, the facilitator prays with the participant, then guides them through emotions and memory recollections from the events and experiences—which is then questioned to get to the core belief. Once the core belief is identified, the facilitator guides the participant through a reframing process with the support of Jesus.
The theophostic therapist provided it as a free service as a ministry. My wife and I saw her together for a brief amount of time while I was trying to deal with a personal trigger of mine. Once I got healing from that, my wife agreed to continue to see the lady for the trauma she had suffered as a toddler. One week, early on, my wife got lost while driving to her appointment. She was totally lost and had no idea where she was. Her counselor suggested she might have DID like another woman she had helped, and that started us on our healing journey.
My wife spent more than five years seeing this counselor. It was never a relationship from expert to patient, but more like one friend helping another. At times my wife would help her counselor with her own personal issues and struggles. During those years my wife visited this woman, it gave me a chance to deal with my own personal issues, and eventually, as I began to take more and more of a role in our healing journey, my wife moved past her friend’s ability to help.
Why have you decided not to hospitalize or treat her at a residential center? Has she ever been medicated? Was that ever an option?
It never really even crossed my mind. And I want to be clear to all the family and spouses who went that route that I have absolutely no judgment toward them. I know that’s what our culture dictates, and I would never demand someone do what I have done when it has literally almost driven me to the brink of mental, emotional, and physical exhaustion—repeatedly. I honestly don’t know if we chose the correct route at times, and yet when I read the heartbreaking stories on Mad in America, I know that I kept my wife’s agency and dignity intact while we also grew closer together in many ways.
According to my faith tradition, walking with my wife on this healing journey was my responsibility and privilege, not someone else’s. I was commanded to “nourish and cherish” her like I would myself. My faith tradition is very big on unconditional and sacrificial love for those in our lives. And besides, who else would really do what she needed and walk with her through all the fear and pain from four decades before? Even if we could afford [it], no paid ‘expert’ would ever have the time, ability, or access that I have 24/7 to walk with my wife through every part of life as we heal and integrate those trauma memories from the past into her everyday narrative. From time to time I did consider looking for help after my wife moved past her original counselor, but she was always so insistent on keeping her privacy that I never ended up finding a replacement.
It’s hard. There are no easy or ‘perfect’ solutions, including the one we’ve chosen. My wife and I are still stuck, after 10 years, to break an impasse with the last “alter” to join our relationship. But we keep trying. We struggle and fight together, and we keep hoping to find the healing that she, and we, need. I hope I’ve become a better, more empathetic and caring man for taking this journey with her because of the manner in which we’ve done it: respecting her agency, validating her pain, fears, and emotions, and engaging her in every aspect of what others call “madness.” We’ve witnessed a lot of amazing things together which most people never get to experience when they take the traditional route, and I hope someday she’ll be in a better place so we can share those with more people.
I would love to see a greater collaboration between therapists, sufferers, and the primary attachment figures of the sufferers, which would be the spouses, significant others, and families. We are the only ones who can be there 24/7 when our loved ones need us. And, if we cultivate a relationship with our loved ones that is based on respecting their agency, humanity, and how they are experiencing their trauma and its effects, we will have access to help them in a way that no one else can possibly replicate.
Sam and Ka’ryn are hopeful she will recover from her trauma, and all her alters will be merged into one woman. In the meantime, they consistently continue to work on patiently progressing and working together in sickness and in health. To read more about Sam and his journey, you can find his blog, with parts of his book, here.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.