Measuring ourselves against societal norms can be a frustration filled venture. Most of society generally relishes traits like reliability, follow through, perseverance and, perhaps most of all, consistency. Arguably, these traits are profoundly helpful at work, in school or some other endeavor that requires predictability and results. These characteristics also tend to be key in maintaining most relationships. They’re also pretty elusive when you’re a system.
Consistency in Daily Life
Medications & Supplements
Let’s just take regular old daily life. Nothing extravagant, just really simple aspects of daily life that most people might take for granted can often be exceptionally challenging for systems. For example, something as mundane as taking medications as prescribed can be a whole feat in itself. The “Normies,” (a term a system friend uses to refer to singlets) might simply remember their medication schedule in their heads, they may use weekly pill organizers, or perhaps they set an alarm as a reminder to take their medication on time. For systems? It’s a whole crapshoot.
Systems can use weekly pill organizers only to discover it was never touched all week. We can set alarms and reminders, and maybe whoever is out will follow through and take the medication. Or maybe they’ll simply find the alarm annoying, silence it, and carry on with whatever it was that they were doing. Co-fronting can also present a curve ball. One part may try to take the medication while the other part resists, which leaves them frozen in inaction. Then, of course, there can be the opposite problem: days when medications are taken but a conscientious, health-oriented part shows up and takes the medication without knowing it was already taken, effectively double dosing the body. In the grand scheme of life, you wouldn’t think simply taking a pill should be quite so challenging. Oh, but it can be!
Attempting to explain all of the above to the prescriber who’s inquiring about your “medication compliance” can feel too overwhelming or embarrassing to delve into. “Why aren’t you taking your medication?” “I forget sometimes.” “Just set an alarm on your phone to remind you.” “Umm…okay…” After all, how do you explain these idiosyncrasies to providers who don’t understand DID and not end up feeling completely shamed?
Nutrition & Hydration
Eating is another common area of struggle for systems. Never mind the complex fact that different parts can have different iterations of eating disorders and those parts may or may not be getting treatment for them, there’s also just the very basic fact of knowing to eat at all. To a “Normie” that might sound bewildering: after all, how could someone legitimately not know that they need food? Well, buckle up, Buttercup, because that is exactly what can happen in systems. There are parts that don’t even know that they live in a body, which means they don’t recognize the body’s needs, which means…you guessed it…they don’t know how to take care of a body. They legitimately don’t know that they need to nourish and hydrate it on a regular basis. They do not experience body cues to respond to, and even if they did, they might not know what they mean. Even parts that do recognize the body may not be able to sense or translate hunger cues, which leaves the body without adequate nutrition. As with the medication scenario above, alarms can be set, but that does not guarantee they will be responded to…Swipe up. Noise gone. Problem solved— at least in that particular part’s opinion.
There are also parts that enjoy eating food, but who are not able to discern when the body has had not only enough, but way more than enough. So, they eat without regard to whether or not the body has recently had food and may be even extremely full.1 Once they finish eating, those particular parts often exit, leaving the next part who ends up in front in extreme physical discomfort, which in turn tends to exacerbate negative emotions and frustration as well as discord amongst parts.
There are also safety issues inherent in eating problems. Some parts may be intolerant of or even allergic to certain foods while other parts can consume those same foods without issue. (No, really. It’s a thing! We’ve experienced it.) If the part that is not intolerant or allergic eats the food and switches out, and a part that is intolerant or allergic switches in too soon, they can experience the reaction, which, if it is a bona fide allergy, can be extremely dangerous. As you might imagine, this scenario may be challenging to explain to staff in the ER. So, while Intuitive Eating might seem like the perfect solution for many people today, for all the aforementioned reasons, it is not always a particularly good option for systems.
Sleep
By now you might be thinking, “Okay, I can see where medication and food might be challenging, but sleep is pretty basic, right? Everyone gets tired and sleeps, right?” Not necessarily. Some parts simply disappear into the headspace when they’re tired, leaving other parts out to front. The parts fronting might not be tired, despite the fact that the body has been up for 16+ hours already. Or perhaps the part fronting is a protector part whose specific job is to keep the system safe at night. Because they are frozen in trauma time, they remain up, on guard, watching, waiting…or distracting on Instagram, TikTok or Substack as that may be. Still other parts may be up doing their preferred activities that they were unable to do earlier in the day due to work, school or family obligations or some other pressing need of whichever parts happened to be out during the day.
Regardless of the reasons for lack of sleep, a physical body does need rest and sleep to be able to function. It also needs rest in order to heal physically and emotionally-a process most systems are actively engaged in at any given time.
Alternatively, some systems have parts that want to rest all the time, spending endless hours if not whole days on end in bed. These parts may be profoundly depressed or hiding from the world in an attempt to feel safe enough. When this happens, other obligations go unmet and consequences can be quite negative.
Either extreme- too little or too much sleep cause problems for systems and their physical vessels. Attending to the problems encountered in daily life is an integral part of the stabilization phase of trauma treatment. Ensuring the system has the foundation of Maslow’s hierarchy of needs down with some consistency is important. It is also challenging when inconsistency and confusion are the norm in systems’ lives, especially at the onset of care and sometimes at other challenging times as well.
A Glimpse into A Therapy Session
Part: I’m so tired. I’m pretty sure we only got about 2 1/2 hours of sleep last night.
Therapist: Okay, in the last five minutes I’ve learned that you haven’t taken needed medication in over a week and are having symptoms. You can’t remember if you’ve eaten today at all and it’s almost 6pm and now I’m learning that you haven’t slept. You all need to start working together. You all share a body, whether you like it or not, and nobody can do anything that they want to do if you don’t take care of your body because you won’t have a body. Whether you all like it or not you do have a body that you share and it needs care. What time did you go to bed?
Part: About midnight and we had to get up at 550am. But we didn’t fall asleep until after 330am.
Therapist: So in a best case scenario, the most you could have gotten was almost 6 hours. Most people need more than that, but it’s not horrible. So, why couldn’t you sleep, what was going on?
Part: It was really loud in the headspace. I think some parts were looking forward to seeing you today. There were also flashbacks and hard memories playing… I don’t really know. It’s really loud right now and I can’t think.
Therapist: Okay. You all have to start realizing that you’re on the same team and you have to start acting like it or nothing is going to work. Medication definitely needs to be taken as prescribed, so we can start with you setting alarms to…
Part interrupting: We actually run our life by alarms, but parts just shut off alarms and don’t do anything about what’s on the alarms. I can see it happen, but I can’t do anything about it because I’m in the back or off to the side watching.
Therapist: We need to have some ground rules that you all are going to need to talk about together before we meet next week. You’re going to need to explain to everyone what the medication is for and why it needs to be taken on time. The part that needs the medication needs to be the part taking it. You need to do the same thing when it comes to food and sleep. Explain to everyone why you need food and why sleep is important. There needs to be a rule that if an alarm goes off whoever is out is not allowed to ignore it. If they can’t do what the alarm is saying to do, they need to get another part that can. Ignoring things like eating and drinking water isn’t okay. You all don’t ignore when you need to use the bathroom, right? You use that regularly.
Part Blankly stares back at the therapist, blinking occasionally.
Therapist: chuckles at herself Oh, right, I forgot, most of my clients with DID don’t so it makes sense that you probably don’t…
Part: shrugs sheepishly. You’d be surprised how long you can hold it…even if you recognize it, it’s not like I don’t want to get up, I just can’t. It’s like that with going to bed sometimes. I know we need to go to bed, but I’m stuck there in place in the headspace, I don’t have control of the body and I can’t move even though inside I’m saying come on we need to go to bed.
Therapist: nodding That’s actually not unusual for systems. We can work on that. But for this week, let’s start with you educating everyone inside about what the body needs. Talk with them about what medication you need to take, why and when you need to take it and what happens if you don’t. Do the same thing for eating, hydrating and sleep. At some point there needs to be a bedtime for everyone, but we’ll get there in a bit. Start with medication, sleeping and eating at least 3 times a day.
Part notices internal commotion. Some parts calling the therapist a hardass, some saying they don’t want to take care of a body, some parts asking, “what body?? “ some parts realizing how true this statement is and another Little part saying “ooooh let’s have brownies for dinner!”
Therapist noticing a shift in the client: What did you just hear?
Part: So many things… But I definitely heard one of the littles just say “We can have brownies for dinner!!!”
Education and Negotiation
In the above scenario, the therapist is assisting the client to get on track with meeting basic needs. Without this in place, it’s pretty challenging for anything to move forward. How the communication and education happens will be trial and error for a new system or one in which communication is inconsistent or there has been a communication breakdown. Some strategies that tend to work are:
Using a journal to write explanations and ask for help and feedback
Talking out loud when ‘alone,’ or talking within the headspace, or through an app like Antar or Otter.ai.
Antar is an app that lets you create profiles and assign colors so parts can talk to each other. It can end up looking like a color coded text conversation.
Otter.ai is an app that can pretty accurately transcribe voice messages. It’s designed to transcribe meetings, which makes it perfect for a system meeting for parts who can’t write and/or are speaking out loud. You can record for 30 minutes at a time under the free version, and the app allows you to keep both the transcripts and voice messages. Voice memo or voice to text Apps can be particularly helpful when you are conversing with each other and don’t have the ability to write notes. We’ve had some really eye opening things come up in meetings only to not be able to remember it even an hour later. These apps, when used, can be a game changer that way. Be sure to pin it to your desktop.
Use a whiteboard to communicate. The whiteboard can be in your home…or in the headspace if you have good access to it- you can look into the headspace to see what’s written on it (note: this does not work for all systems)
Leave sticky notes around the house with information and instructions on them.
If you do not live alone things like whiteboards and sticky notes may not feel safe, so using the notes section of your phone and setting reminders throughout the day to check the notes section can help the parts who are fronting.
Taking time to educate everyone inside about why we need food, medicine and sleep helps with the negotiations that also need to happen between parts. Educating at the onset can circumvent some questions. Be prepared for parts to have questions, thoughts, objections or opinions that you’ll need to respond to. Keep track of the ones that you get stuck on so your therapist or mentor can help you complete the negotiations. Putting in the work upfront, while time consuming, ultimately helps life flow more fluidly.
Inconsistency in Relationships
Relationships are complicated and a lot of work for “Normies.” Negotiating to make sure both parties needs are met, working on problematic behaviors and beliefs takes time and effort. For systems with multiple parts that front, it’s even more complex and multilayered. Not only is it true that multiple parts can engage in different relationships with different people…different parts can also engage in different relationships with the same people. Not to mention that if someone doesn’t know that you are a system, your presentation, viewpoints, and emotionality may seem to vary wildly as they incorrectly perceive your switches or different parts as simply you being inconsistent across the board.
Depending on your level of co-consciousness, you may or may not be privy to some of the relationships your parts have with others. Even if you are privy, how you present in the relationship will depend on which part is out or which part is passively influencing you. It will also be determined by how those parts feel, what they need and what their roles may be. Extroverted parts are great at entertaining others. They’re fun, spontaneous, wise, and chatty. Other people tend to love spending time with them. But, there are also introverted parts. They don’t love spending as much time with people. They might enjoy one on one conversations or a quiet date that doesn’t involve much interaction, for example a movie. There are Littles who tend to be playful, innocent or outright rambunctious. They may be experienced as fun or completely annoying by others. There are the middles and moody, rebellious teen parts who can be interesting or about as cuddly as a cactus. But remember that the body looks the same to outsiders, and if those outsiders don’t know that they’ve befriended a system, and that they are interacting with radically different parts…those outside friends are likely to feel very confused. To “Normies” being with a system can feel like they have the world’s moodiest friend whose disposition and preferences change more often than most people change their clothes.
Take this hypothetical scenario as an example: An extroverted part makes plans with a friend, but on the day of the event, an introverted part is fronting. That part may decide to cancel or begrudgingly follow through feeling (and looking!) completely miserable, sulking the entire time. The friend feels confused because when they made plans, they were speaking with a super social, communicative part and now it feels to them like that seemingly same person wants absolutely nothing to do with them. The introverted part that is fronting in turn feels stressed by the friend’s confusion and responds by disappearing into the headspace. A part that typically trauma dumps and overshares appears, takes over and begins explaining how triggered they feel and why. The friend, still unaware that they’re dealing with a system of parts, finds themselves overwhelmed and confused. They think back over the friendship and realize that this happens often. Their friend will have contradictory points of view, sometimes arguing over points they’ve even previously agreed upon. Over time, the inconsistency in demeanor, presentation and ability to be present in the relationship feels so chaotic and unpredictable that the friend cannot tolerate it any longer and the relationship either ends or becomes distant and irregular.
Some people may be quick to suggest that you, “just tell them you’re a system!” But it’s important to remember that DID/OSDD carry great stigma and it is not always safe to disclose, nor does everyone deserve that information. Therefore, for many systems, until internal communication and cooperation become regular, scenarios like the one above will not be uncommon. It can compound feelings of inadequacy, shame and brokenness, as well as exacerbate discord amongst parts of the system.
Inconsistency in Responsibility
In addition to relationship problems, there are often work or school performance issues. There are multiple factors that contribute to this. Some parts are workhorses, highly adept at getting things done. They receive awards, get straight A’s, excel at seemingly everything they do…when they’re present, that is. When they’re not present, other parts may lock into doom scrolling for hours as a socially acceptable way of dissociating. Or you might find yourself hijacked by a Little or Middle who leaves work or school to play. You may be conscious of it, but powerless to move or do anything beyond worry about all of the things that aren’t getting done while you’re stuck scrolling or out making sand castles at the beach. If you aren’t co-conscious, you might find yourself suddenly looking at a mountain of unfinished work, not understanding what just happened. You may feel like you’ve been busy all day, yet have nothing to show for it. Or, you might not even remember the day at all. You may have a part that can compensate by overworking, staying up all hours of the night or working weekends to catch up…or…you may not catch up which leaves you to face the repercussions of failing grades or job loss. To people outside of you, you appear erratic and perhaps frustrating. When this sort of dynamic happens in therapy and the therapist is unfamiliar with complex dissociation and systems, it can lead to misdiagnoses. To the system itself it all feels confusing, frustrating and at times outright embarrassing if not scary.
Acceptance & Moving Forward
As much as most of us would like some semblance of consistency and predictability, it does take time to get there. They don’t call it a healing “journey” for nothing, after all. We have the option of emotionally pushing back and focusing on how unfair it is that we have to deal with the unpredictability and chaos after having already survived unspeakable horrors. And while that is all true, that viewpoint often keeps us even more stuck as we spin in the unfairness of it all. Sometimes, the best thing we can do is recognize that it “just is what it is” for the time being, while working diligently to make changes. Accepting that change takes effort and time is the path to freedom.
For most systems (ours included) forward movement comes through consistently working on communication with all parts. Using external methods like sticky notes, journals, whiteboards and apps until internal conversations that stay in conscious memory occur. It is always important to be listening to and acknowledging parts. Taking time to converse and negotiate ultimately leads to cooperation and collaboration…and when that happens, magic happens. It’s a long road, but it’s a worthwhile road, and you are worth all the effort.
Important note: there is absolutely nothing wrong with singlets eating past fullness or eating more than is wanted. For more information check out information from Intuitive Eating and the Association for Size Diversity and Health. This blog is addressing the issues in a system that stem from amnestic barriers and lack of communication amongst parts that lead to extreme discomfort and impairment.