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2. Use a calm, low voice when the child is out of control.

   Traumatized children may have been emotionally and verbally abused by screaming, shouting, and name calling. These emotional scars are hidden scars, which can be more damaging to the child's self worth and identity than physical scars. The verbal abuse has an insidious impact on the child's sense of being as the child feels splintered, insecure, demeaned, and enraged, and may want to retaliate. Given how demanding, provocative, and unrewarding a dissociative child can be periodically, it is a most challenging task for the tired, frustrated, and angry parent to maintain a calm, low voice when the child is screaming or refusing to listen.

   When a child is out of control, it may be best not to try to reason with the child, but to separate the child from the parent. The parent may send the child to his or her room with the instructions that when the child has calmed down, then he or she can come out of the room to discuss what had occurred. Sometimes it may be advisable for the parents to remove themselves from the provocative child who is attempting to incite the parent's anger. This approach would be appropriate if the parent was not worried about the child harming himself/herself or others or destroying property. The parents can go to their bedroom or to the bathroom for privacy until the provocative cycle is broken.

   One parent of a DID child reported that his petite 8-year-old adoptive daughter's alter would scream in his face inches away when he was attempting to deal with her oppositional alter personality. If he yelled back, she would escalate, and the situation would quickly worsen. If he kept his voice low and calm, she was able to calm down sooner. Then, they were able to work out the conflict without a full-blown crisis.

   It is very difficult for parents to separate out angry responses which their child has toward them and see their behavior as symptomatic of the abuse rather than a personal affront to them as parents. One adoptive mother, who was in a helping profession, reported to me that she could deal more effectively with her dissociative teenage daughter's angry outbursts by viewing her as a client rather than as her adoptive daughter who was resistant and fearful of attaching. Maintaining a psychological distance kept the mother from becoming entangled and embroiled with her angry, demanding, and unattached daughter. This "clinical" distance also provided some protection for the mother, who was psychologically hurt by her daughter's rejection.

3. When discussing with the dissociative child consequences, ask the child to have "all your parts (alters, fragments, ego states) watch and listen" so everyone is aware of the undesirable behavior and consequences.

   The parent's goal is to encourage the child to develop co-consciousness by requesting that the child's alters, ego states, or fragments watch and listen when the parent is instructing the dissociative child.

   Parents should not assume that the child and the alters, fragmented personalities, or ego states are aware of the discussion following an inappropriate behavior, even when the child has expressed co-consciousness, because the alters may be "sleeping" or preoccupied with some other activity internally. Several dissociative children whom the author has treated stated that a helpful alter (one who has a positive influence) was "sleeping," even when it was agreed that all alters were to be attentive.

   Another common dilemma with parents is managing the dissociative child's aggressive behaviors, e.g., hitting, swearing, breaking objects, when the child reports that the alter who committed the offense quickly disappeared leaving the host personality "holding the bag." These alters may "go into hiding" to escape from listening to the reprimand. To avoid or minimize this from occurring, the parent needs to make reference to the child and alters, if known, or "to any and all parts" that were involved in the misbehavior to be aware of the consequences decided. For example, the father can say to his dissociative daughter, "I want you and your parts to watch and listen while we talk about what just happened, and decide how it should be handled. Everyone needs to listen so they know the consequences."

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   Due to dissociative features, these children need frequent reminders about the rewards and consequences of unacceptable behaviors. Parents should not assume that the child will remember and learn from one incident to another what is acceptable and unacceptable behaviors. Until the child is further along in treatment in which amnestic barriers have eroded, and there is coconsciousness and cooperation, he or she will require continuous discussion of expectations, rules, and consequences.

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Written: 01/2003. Reviewed 04/2006