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Why “Plural” — Ending Multiple-to-Multiple Discrimination

This article is a . It needs more clarity, organization, and dialogue.

Content warning: contains mentions of types of abuse with no details.

Some humans see a need to divide people, and to elevate themselves of the backs of some perceived “lower class”.

For example, even though all African Americans are discriminated against, there are some who discriminate within their community on the basis of skin color, affluence, adopting traits of the external culture of “whiteness”.

Although Latinos are stigmatized and discriminated against, this discrimination within its own culture also happens amongst Puerto Ricans. Or Puerto Ricans versus Dominicans.

As we took American Sign Language and learned about Deaf culture, we found it happens between the Deaf and hard-of-hearing (even the capitalization is part of it, Deaf Pride, Deaf culture) — and now with the encroaching destruction of Deaf culture due to the use of cochlear implants, there are even more divides and stigmatization within their own culture.

In almost every culture, people pick out these traits as desirable, and those as undesirable even amongst others within their culture to elevate some and trash others. It’s a form of stigmatizing one’s own tribe, creating layers and castes, and those who want power distracting the attention of those they want to adore or fear them. Without a common enemy to bind them, their promises and their popularity are vapid and transitory. Trump and immigrants. Hitler and Jews. The power of the common enemy.

There are some of these divides within the plural overarching umbrella. What we all have in common is plurality — being “many” in one body. We have a lot of terminology about what we call these entities: members, alters, parts, people, tulpas, aspects, spirits, souls, minds, family, friends, buddies, headmates, roommates, pieces, introjects, walk-ins, voices, etc. And we have terminology to divide the community into broad bins under the big umbrella: voice-hearers, tulpamancers, endogenic, traumagenic, dissociative identity disorder, other specified dissociative disorder, partial dissociative identity disorder, median, multiple, (plural/multiple) system, etc.

We want to address one particular problem of the exclusion and pushing people away: requiring diagnosis. This is not to say that our community doesn’t need resources to attend to different needs of any of these sub-categories within the broader scope. But that such resources shouldn’t be based on hate, fear, stigmatizing each other, exclusion (i.e. based on “leaving them out”), or bad-mouthing others.

All plurals share centuries if not millennia of stigma about people being more than 1 entity to a body. While some of our needs are different (people with DID and DDs need to handle traumatized entities in their plural system), some of our needs are very much the same (the need not to be stigmatized for being many in a world full of people who are or think they are singular; the need to say “we” and be able to be recognized as individual entities within the group entity).

Regardless of whether someone has a background of trauma or not, group entities have been hunted, killed, exorcised, jailed, institutionalized, hurt, excluded…and for us to live as plural in our life, we need to fight this discrimination and shame, the pain, the suffering, the singling out, the demands for our conformity or masking to suit the public’s perception that the only way it’s OK to be human is to be one. We can’t fight this stigma as separate groups. We can only fight this by showing up as the full spectrum of what it means to be plural.

The Big Problem with Requiring Diagnosis

This is the main thing we wanted to address.

Demanding people have an official diagnosis is blatant (multiple-to-multiple) discrimination.

Known fact: it takes an average of 6-12 years to get an accurate diagnosis. (AVERAGE!)

That number is an average only for those who actually go to therapy. In the meantime, a traumatized multiple is suffering without support and without appropriate help, unable to explain their life. Those in therapy attempting to get better, but mis-diagnosed, may be floundering, shuffled from therapist to therapist with an ever-changing array of diagnosis and medications that are never sufficient to describe or assist with the problems we are experiencing.

Whether in therapy or not, if a person suspects they may have a dissociative disorder, if they think they have others or many or parts that take control of them, there are some circles of multiples who still do not want to support them or hear from them. “Get an accurate diagnosis, then talk to us.”

That’s hurtful. That type of gatekeeping leads to the doorstep of the 70+% who have 1 or more suicide attempts by the time they are diagnosed. It’s unempathic. It’s exclusionary. It’s unsympathetic. “You have to get a diagnosis to join our club” is rude, and painful. It doesn’t give them positive reinforcement or a healthy direction. It makes someone who is confused and feels alone feel more excluded and alone.

But it goes well beyond that. It harms the group as well. It leads to an echo-chamber effect with no diversity.

To demand a diagnosis means a group will definitely be gatekeeping a primarily white privileged perhaps even classist community. Less representations of true abject poverty, less trans, less minorities, less foreigners, less folk without medical coverage, less people with physical disabilities, less psych survivors, less rural folk compared to urban and suburban folk. Also less professionals and less people being trafficked and less sex workers, less people still in danger or living with their abusers.

Let’s break down why.

Who has more access to therapists who are qualified to diagnose for DID or related disorders? (on the whole, white people)

Who has the luxury of taking time from their other responsibilities to go to therapy for 6+ years? (on the whole, white people)

Who has health coverage to pay for visits? Or can afford out-of-pocket for the 6-12 years it takes to even get a diagnosis? (again, usually white people)

Who is less likely to live in a therapy desert and less likely to be unable to take the time, get the transportation, or otherwise be less likely to be unable to afford in any way getting to a therapist capable of diagnosing them, or whose office is 1+ hours away? (white people with resources/access)

Who would be penalized, stigmatized, or hated and reviled by their own community for even seeking out a diagnosis as a multiple? (many multiples within their own system, trans people who want to transition, professionals and students of psychology, many foreigners as their own country may not even recognize DID or have privacy protections for mental health issues)

Who is multiple, but still in danger, and not even allowed to seek out therapy? (trafficked people, sex workers, people still living at “home” with abusers, people in domestic violence situations, S/RA survivors whose own programming may prevent them, and psych survivors who are petrified of being institutionalized and harmed again)

Who would be afraid that their other services would be at risk if they got an accurate diagnosis? (The stigma against being multiple actually affects physical health support for people with disabilities. Some can’t afford being shuffled back-and-forth between mental health and physical health services and have to pick one over the other to focus their money or spoons on — and physical health may win as a life-support issue. Also trans people who are seeking transition, again.)

Other Issues

Here's some other issues we may flesh out later:

  • Instructor/therapist bias. Instructors, supervising clinicians, professors, etc. have bias and do not train people in the field in issues with DID.
    • Therapists may not be trained to recognize it.
    • Therapists may internalize the bias and not believe in DID and refuse to give it as a diagnosis even when clearly indicated.
  • Requiring to know someone's diagnostic status is a blatant violation of medical privacy. This is an issue between an individual, their therapist &/or psychiatrist or treatment team, and insurance company. That's probably already too many people. It should be a choice, and not coerced out of people on pain of exclusion from a community.

So, What to do about it?

We are not advocating to disband any groups.

It’s clear that it’s one thing for a sub-group of plurals to provide support for DID/DD issues only, and have a safe sub-community for people who are diagnosed. This is a positive thing. A good place to go with the big issues that require a completely vetted community setting.

But not a great venue for general socializing. Like if your only social outlet is your therapy group — not so great. For that, a larger more diverse community with new ideas that people can bring back to the smaller group, to ensure that it doesn’t just feed on its own culture, and so everyone gets a good idea of the variety and difference in the world at large.

We find it absurd to demand that all people who are plural must continue to subdivide and exclude within our own community and deny anyone of any subtype of plural support, companionship, recognition, same-ness, inclusion, guidance, resources, and friendship over terminology or pieces of paper.

Larger groups that are inclusive of singular spouses, friends, who allow in respectful questioners or allies, are hypocritical to discriminate within the plural umbrella based solely on taxonomy. There are folk who are seekers of their own truth for whom the taxonomy they use does not quite fit. They may be unsatisfied with groups they fell in with but still felt it described their experience better than anything else before has. When they go seeking a better fit, they may use the familiar and comfortable terminology for them to foster communication while seeking out new words to describe their experiences and internal relationships.

We do not exclude people based on the words they use to describe their experiences. Only on their actions and whether or not they follow the rules. Those who are questioning, who are seekers of truth, may be desperate and we do not want them to become part of the 70% statistic. We can always exclude individual trolls and assholes who are not respectful and violate our groups’ rules — but we won’t generalize that one person’s behavior means everyone with that label or using that terminology is therefore an asshole.

In smaller more selective groups, there will be more specific criteria. In the broadest umbrella of our community we are welcoming to all, whether they can get a piece of paper, can’t get a piece of paper, don’t want a piece of paper, or don’t need a piece of paper.

Whether someone has a piece of paper does not make them better or more important than someone who can’t get the piece of paper for any reason.

Crisses Personal Story (on this topic)

In 1986, we didn’t have a piece of paper.

Because in 1986, even though we were in a mental hospital from May through the following January, our psychiatrist was Freudian-trained, and did not believe in telling their “patient” their diagnosis. We went on to be out of the closet (saying, quite literally: “We have many people in our head.”), write about being plural, support other plurals, and so on. We formed an email list for multiples, we wrote website materials, we started to share self-help information with others, etc. all without having a piece of paper.

In 2005 we found a piece of paper — an invoice dated 2001 that had the ICD code for DID on it. We had finally achieved “official diagnosis”.

And do you have any idea what it changed?

Absolutely nothing.

Though it was the subject of some jokes. It conferred no status other than a little settling of any question. It conferred no prestige. People didn’t flock to us saying, “Finally! now we can listen to you!” No, they listened before, they continued to listen after.

What and Why to Change

The idea that a separate group’s existence somehow devalues your group is stigmatization, discrimination and elitism. To devalue lighter-skinned Puerto Ricans because you’re proud of your darker-skinned heritage. When someone attacks Latinos, they don’t check their target’s skin-tone against some metric for how light or dark it is. People perpetrate this type of bias within their own marginalized group, scrambling over others and elevating themselves by having someone else to shit on.

We think it’s time that plurals stop siloing everything into sub-groups on the bigger organizational level, and we stop bad-mouthing groups based on taxonomy at every level. We have a wealth of language across the plural umbrella, let’s own it, and start using it for what language is meant for: communication and building community. How are we the same? How are we different? How can we work together? What do we need from each other?

The smaller groups with their rules can keep their rules, but we suggest that they review their rules with their group and moderators to banish all hateful and exclusionary statements. It’s one thing to set a bar for entry, another to stigmatize and deliberately exclude, or to censor member’s discussions beyond it being safe and respectful. It leaves new people who read the rules wondering, “Wow, I wonder what these other <mysterious name> people did to deserve being singled out. What makes ALL of them assholes?” And thus continues the stigma between the plural sub-groups. It doesn’t make any of us look better to outsiders, the news media, or new members to have all of this squabbling, either. If it all just was not a thing to begin with — it would free up energy and time with reporters for other important stuff.

Larger public voices should reconsider the continued stigmatization of groups and individuals who never did you harm. If there’s an asshole amongst them, keep distance, block the asshole, and put energy back on the mission. Trolls are there to distract. If they’re not a troll, then why attack them? And if they are a troll — getting a rise out of them is a distraction, too. We all have more important places to spend spoons.

There’s this continuing idea that the mere existence of these labels and taxonomies are damaging to a pet project. Philosophical differences aside, the plural umbrella represents a full spectrum of experience that may be 100% necessary for Mx. Public to finally grasp that this is a normal range of experience within humanity, and that if all of these folk here have always lived amongst them harmoniously, then it’s natural — human nature — that once this other group takes care of some glitches that aren’t their fault they’ll also be able to live amongst everyone harmoniously.

Shouldn’t People Seek Diagnosis?

There’s many “cover your ass” reasons to recommend it. No one wants to risk getting spanked or shut down for “practicing medicine without a license.” And there’s a very simple answer for this issue.

It’s possible to recommend someone seek diagnosis in a stigmatizing and excluding way. Especially in what is essentially an open venue where others can watch the conversation and form opinions about it as well.

A direct instruction or strong suggestion chances guilting the person who does not have access, or making them feel that until they get said diagnosis, they will not be welcomed, their experience will be questioned, they will not have vetted “status” in the group — essentially it guarantees that their experience of the group will be as a tentative member, an outsider intruding into the group.

Here’s our suggestion on wording:

If you have access, and you want confirmation, consider seeking out a diagnosis. Many people have trouble getting an accurate diagnosis. It can take a lot of time and resources. If you have trouble getting access to the resources you need to get an accurate diagnosis, we’re sure the other members of the group will have suggestions for you, so please feel free to ask for more assistance and resources if you want to.

With the first couple phrases, you’re being inclusive of all minorities and abilities, all access and desire. Someone burned by therapists may not be interested in a diagnosis, and that’s their privilege. But you have still done your duty and covered your ass by suggesting it. By saying “other members” you are implying they’re a member of the group now and being inclusive. You’re setting the expectation that this is not as simple as pie, and it will take time, without mentioning numbers or being too intimidating, and telling them that your group may help them shortcut the process.

We don’t need a piece of paper to prove we’re pan, polyam, non-binary, gender-fluid, etc. and get support and recommendations from our peers — this is a problem pretty unique to the plural community because we continue to allow — yes ALLOW — psychology to be our gatekeepers to whom is or is not a “vetted” or in some of the groups “privileged” member of the sub-culture in question. Other similar groups have already fought this battle and decided they did not want to require psychology as a gatekeeper to their culture, or further stigmatize their members by making diagnosis a requirement for inclusion.

With a few small shifts we can take some of our power and self-direction as a community back from the patriarchy and the paternal psychology gatekeepers. More on that another time.

Are we denying the traumatic origin of Dissociative Identity Disorder?

See article: https://www.mentalhealthtoday.co.uk/blog/teach-me-well/denying-the-traumatic-origin-of-dissociative-identity-disorder-denies-those-who-live-with-it-a-recovery

In short, no. DID is a trauma-based diagnosis. If anything, "plural" liberates us from needing a diagnosis or a label that is from the DSM and has its own stigma. People under the larger Plural umbrella are welcome to identify as having DID (we identify as having DID!). The difference is that by identifying plural first, I'm being incredibly inclusive and saying "we are many". Period. The HOW we are many is secondary. "Plural DID system" works. And we're not shutting the door on those who are not yet diagnosed, who will never seek a diagnosis, or whom for any reason do not require a diagnosis — whether now or indefinitely.

Are you many? Yes? Then you are plural. You can identify as a voice-hearer, a tulpamancer, an endogenic or naturally born plural system, etc. We may be DID but we also don't have any evidence of ever being anything but plural either. No original or core, no person named "Christina" no consistent host, etc. As far back as we can remember, we have been plural. We will continue to do so even if we no longer fit the DID criteria of distress and memory issues. Plural works for all of this. And it allows us to address society's misconceptions about DID as well as those who have a diagnosis of DID and their misconceptions about all other plurals.


See Also


Comments:

for us, it took 28 years to get the diagnosis due to how the health care system works. We would wind up with a new job on average of every 13 months, forcing us to change health insurance whiched forced us to change providers, to find a new therapist or health insurance would have a life time max payout for mental health that we would burn in a years time. When you are constantly being forced to find a new provider, a new therapist, it really makes it difficult to get the help you need. Just thought i would share our experience.

Comment by Bear Clan on March 08, 2019, at 01:22 PM

Thanks for your perspective and experience. That's such a great point, we didn't think of. We didn't even have insurance for many years, and didn't keep jobs more than 3 years, so yeah this was an issue for us as well. It may have contributed to our not looking for a therapist and bootstrapping instead. But our first therapist pushing for integration and we said no — so, basically, it was like "Well then why do you need therapy?" :/

Comment by Crisses on March 12, 2019, at 06:12 PM

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