Author Archive

Portrait of Anxiety, Avoidant Personality Disorder

Dec 5

Avoidant personality disorder and anxiety limit lives and damage self-image. Change how you think about yourself to reduce anxiety and APD.

Avoidant personality disorder (APD) is like social anxiety on steroids. Someone with avoidant personality disorder lives a severely limited life because he or she is compelled by anxiety to avoid any and all social situations and even simple interactions with others. APD imprisons people in their own mind, holding them captive with fear and anxiety. It traps people in isolated places, such as inside their own home or in a job that involves no contact with other people.

This life-limiting disorder, though, cannot and does not change a person at his or her core. APD can make life difficult, but it doesn’t diminish someone’s humanity and intrinsic value. People with APD have passions, desires, a need for intellectual stimulation, a requirement for companionship, and more.

In My Life in a Nutshell: A Novel, Brian Cunningham lives with extreme anxiety, avoidant personality disorder, and anxiety attacks because of both. His life is limited, and he hates it. He also hates himself for it. When he looks at himself in the mirror, he sees someone who is ridiculous, strange, unworthy of friends, and all sorts of other horrible things. (The book opens with Brian cursing himself, “I’m an idiot.”)

This, sadly, is how many people with APD view themselves. But it really isn’t the case. Brian has many things going for him. If you live with APD, you, too, have many things going for you. I challenge you to explore them. Create a collage, photo story, poem, or written list of all of your passions, values, beliefs, and strengths. The first step to opening your door to the world (just a crack) is to change your thinking about yourself. (Or if you don’t live with APD but know someone who does, help him/her begin to emphasize different things about him/herself.)

This is Brain’s portrait collage. It’s just a small fraction of all that his is.

Avoidant personality disorder and anxiety limit lives and damage self-image. Change how you think about yourself to reduce APD, anxiety.


Peek into Brain’s anxious life:

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What Good is Gratitude?

Nov 21


Gratitude is the mindset of appreciating things in life. Numerous studies have shown, and continue to show, that an attitude of gratitude enhances mental health, wellbeing, and general life satisfaction. Yet sometimes it seems hard to believe. Is being grateful that powerful? And, more bluntly, what is it about gratitude, something that can seem superficial, that has a positive impact on our lives? What good is gratitude?

Gratitude is a way of viewing both your inner and outer worlds as well as living your life.  Here’s an at-a-glance look at what gratitude is as well as what it is not:



With intentional practice, by deliberately pausing to appreciate something about others in our life, our circumstances, a part of our day, beauty around us, and aspects of ourselves, we begin to naturally shift our perspective. Rather than getting bogged down by what is wrong, we start to look more at what’s right. The transformation brings positive life changes. We find that we

  • can better cope with stress
  • might have anxiety or depression but can find reasons to move forward anyway
  • feel lighter, more joyful
  • have more empathy
  • are more determined
  • feel excitement in things
  • are more hopeful

Gratitude works. It does us good because it involves a shift in thinking and in being. Despite focusing only on problems and challenges, we also look for good things on purpose, and we take it a step deeper by being glad, grateful, for the presence of these things.

Some ways to hone the strength of gratitude include

  • journaling
  • reflecting quietly while coloring in a gratitude coloring book
  • Set the alarm on your phone, watch, or fitness band to vibrate hourly to remind you to pause and find something for which to be grateful
  • keep a gratitude jar in a prominent spot so you can write something for which you’re grateful and put it in the jar
  • play I’m Glad Bingo (click the link for a downloadable game board).

Gratitude isn’t a cure-all to make problems disappear. Instead, gratitude is a way of being in life that is positive-oriented rather than negative-oriented. Gratitude is a component of wellbeing and a life worth living.

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5 Ways Reading Enhances Wellbeing

Nov 14

Books are our good buddies, and reading them boosts our wellbeing. Reading lets us escape and de-stress, and it adds positivity and enjoyment to our daily lives, helping us live a quality life, or as positive psychologists call it, a life worth living.

It’s the small things we do every day that add up to big results, such as the ability to reduce stress, anxiety, depression, negative thoughts, and more, and—the key—to replace those things with mental and physical health.

Books are among those small-but-big things. Here are five ways that reading enhances wellbeing:

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Bingo! Play the I’m Glad! Gratitude Game

Nov 6



Happy November! Is November a happy month? In the US, it’s the month of Thanksgiving. It’s a very good thing when countries set aside a national holiday for giving thanks, but can that truly make people happy?

Giving thanks means being grateful. The mindset of being grateful is known as gratitude, and it involves opening our perspective to notice things withing ourselves, in others, and in our lives for which we are glad. Taking moments every day to pause, notice the good, and be grateful for who and what is good, we begin to flourish.

Robert Emmons, a leading researcher and expert on gratitude, has discovered numerous benefits of gratitude and why gratitude is good. Gratitude is an important part of both mental and physical wellbeing, positively influencing how we interact with ourselves and others. Simply put, gratitude lessens the effects of the bad on our minds and bodies and strengthens the effects of the good.

So, again, does that make November, the month of Thanksgiving, a happy month overall? November, after all, signals the onset of the cold months for many people. Branches become bare. The grass in some areas is brown. The holiday season, which begins this month and runs through the end of the year, is stressful for many people–often depressing, anxiety-provoking, or triggering. Does gratitude really do any good at all?

If gratitude is nothing but words expressed out of obligation, spoken on a dedicated day, it won’t have an impact on our wellbeing. However, when gratitude becomes a state of mind, a way of thinking about ourselves, others, and our world, we reap benefits far beyond any Thanksgiving harvest.

Gratitude doesn’t always come naturally. Humans tend to think negatively, to dwell on what is wrong. Sometimes expressing gratitude can make people feel vulnerable, as if doing so is an admission that we can’t do certain things for ourselves or that the good in our lives is there because of circumstances and people other than ourselves.

It’s okay that feeling and expressing gratitude can be difficult. It is definitely not impossible to shift our thoughts to the positive, to look for ways in which to be grateful. This is a decision that you can take charge of, have control over.  Choosing to shift your perspective to one of gratitude can help you feel better mentally and physically.

Because to be fully beneficial, gratitude must become part of our perspective, I offer ideas to help you cultivate that sense of gratitude. Gratitude has more punch when it doesn’t feel like a burden; therefore, I’ve created a bingo game I call I’M GLAD! The Gratitude Game.

I’M GLAD! The Gratitude Game: How it Works

Download the free PDF of the game board (I’M GLAD Bingo). As you seek out and intentionally feel gratitude for the items on the board, mark the space, perhaps with a sticker or a drawing. As you complete rows, treat yourself to something you enjoy. When you have blackout, do something to show gratitude that you’re taking care of yourself. Celebrate! Then create a new board or start over with this one. Gratitude is a never-ending process.

Choosing a grateful outlook can bring a sense of joy and tranquility, of happiness and a love of life. Practicing gratitude can help you create your life worth living and embrace the good even during the bad.

Sign up for my free monthly newsletter, Wellbeing & Words. Each issue is packed with useful tips for enhancing mental health and wellbeing, reading-related tidbits, and updates about my own mental health writing and activities. (I never share e-mail addresses with anyone.) 

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Is Dissociative Identity Disorder (DID) Like a Costume?

Oct 31


First, a note: Dissociative identity disorder (DID) is a real psychological disorder. It’s not artificial like a costume, nor is it scary (well, it can be confusing and frightening to those living with it, but it doesn’t involve terrorizing others). Here, I use costume to paint a picture of what life can be like, in part, for someone living with DID. 

I’m writing this on Halloween because thoughts of costumes created a winding train of thought that ended in thoughts of a friend of mine who lives with DID and then thoughts about the protagonist of my novel Twenty-Four Shadows (a fictitious story based entirely on fact, including information about what DID is like to live with graciously shared with me by my friend).

On Halloween, many people, kids and adults alike, enjoy dressing up in costumes. It can be amusing to disguise yourself to see if others will recognize you. It can also be fun to don a costume to take on a different role for a few hours, to escape and imagine. On Halloween or at other costume parties, people get to take on a different persona. They are someone else, but they never lose sight of who they are. The different identity is merely something external to who they are.

DID is a disorder that forms in young childhood in response to traumas or abuse so extreme that the little child’s psyche escapes from the horror by dissociating, or disconnecting from the moment. Other identities are formed subconsciously in order to help the child “escape” and deal with the abuse. The result is the formation of different identities that develop their own characteristics and consciousnesses and share a body with the original child. DID lasts a lifetime.

Halloween costumes let people change identities. In DID, the person switches between identities. However, unlike a costume, he or she

  • Can’t “put it on” or “take it off” at will
  • Isn’t the driving force behind the switch
  • Doesn’t choose the identity or the the identity’s characteristics and personality
  • Isn’t aware of what’s going on when a different identity takes over
  • Is often confused about what happened during a switch

DID isn’t fabricated, and identities are real in their own right. They’re not costumes. This actually presents a different type of challenge.

Someone with DID undergoes identity switches from the inside. Some external characteristics can be different; for example, some identities might wear glasses while others don’t, and some have different clothing they change into at times, but the essence of the appearance remains the same. The personality, behavior, gender, sexual orientation, age, and more are different. But the look is essentially the same.

Imagine you dressed up as a chef. People interact with you based on your role. People treat you like a chef and some ask you to cater a party. You agree because that’s what you do. You eventually remove your costume. No one truly wants you to cater because you’re not actually a chef and you’re someone who ruins canned soup. It was just fun to pretend.

Now, imagine you’re dressed up and acting like a chef. People interact with you that way because they know you as a chef. Someone asks you to cater a party. You agree because that’s what you do. Your chef identity recedes and you re-emerge. You’ve switched back to yourself. You’re not sure what happened, but you know you lost time. How long was another identity out in the world? A few days later you get a phone call to confirm the details of the party you’ll be catering tomorrow night. What party? You don’t cater. You ruin canned soup. What are you supposed to do now? This is the reality for those living with DID.

Halloween involves the opportunity to don a costume and pretend to be someone different for a few hours. DID isn’t an opportunity. It’s a life-long experience of navigating the world when sometimes you’re not yourself.

Isaac has a similar experience when out with his best friend. People clearly recognize them, but he has no idea who they are:

Isaac looked at the intrusive table companions and tried to determine just who they were. Clearly they knew him. Fairly well, too, or so it seemed. His heart started to pound. Was he supposed to know them? Ugh! He hated it when this happened. There were so many times when he was out in public, in a store or in a restaurant or at the park with Reese and Dominic, for example, that people seemed to know him but he didn’t recognize them at all. More than likely, it was a function of his role with the Conifers. As a marketer and event planner, he was out and about the community year-round as well as frequently present at games in the summer. Still, though, he would think that he would recognize people he came in contact with. Sometimes he did, but they felt like mere acquaintances. Too frequently he had experiences like this one, where people seemed personal and friendly with him but he had absolutely no clue who they were. He faked a happy grin. “Hey! Not much. What about you guys?”

“We just grabbed lunch and are headed to rehearsal. Speaking of which, you plan on joining us again anytime soon? I mean, I know you only play with us occasionally, and not to further inflate your ego or anything, but your trumpet playing adds punch.”

Isaac swallowed hard. He should probably feel relieved by that comment. Clearly these people had the wrong guy. He didn’t feel relieved, though. He felt nauseated. They called him by name. Why? Terrified, he risked a look at Max. Max knew that Isaac didn’t play in a band. Hell, he didn’t even play the trumpet. Or any damn instrument, for that matter. How was Max reacting to these bizarre people? Thankfully, not at all. He continued to toy absentmindedly with his beer.

One of the random chummy strangers followed Isaac’s gaze to Max. “Where are our manners?” she asked jovially. “Isaac, will you introduce us to your friend?” Oh God. How could he introduce these people he supposedly knew but didn’t? He leaned over too far when the woman nudged him. “What’s up with you? You’re acting really weird, and not in a fun way like you usually do. You don’t seem like yourself today.”

Fantastic. He faked another smile. “Sorry. I’m, uh, I’m just having lunch with my friend Max, and, uh, I—”

Mercifully, the woman turned her attention away from Isaac and onto Max. She stuck out her hand enthusiastically. “Max.” She shook his hand heartily when he extended his. “Very nice to meet you. I’m Neptune. This is Adrian and Jet.” She gestured toward each of her companions as she said their names, and each one extended his hand to shake Max’s. The one called Adrian had to lean across the table to do so, and he brushed against Isaac when he did. “We’re part of the band Your Grandma’s ’Hose.”

As the three oddballs talked with each other and drew Max into a conversation, Isaac couldn’t keep up with what they were saying. He felt extremely ill. His hands were sweaty, and he could feel the perspiration bead on the back of his neck and roll down his shirt. He tried to take a drink, but anxious tremors in his hands made the bottle shake when he lifted it. He quickly set it down. He tried once again to tune into the conversation, but the words were drowned out courtesy of the voices that had resumed their commotion in his head. This time, it sounded like a pretty intense argument. About what, though, he hadn’t a clue. The music had started playing, too. The pressure in his head was intensifying and was almost unbearable. He couldn’t show it. With tremendous effort, he focused on Max and what he was saying to the three amigos. Mercifully, he heard Max say, “Yeah. It was nice to meet you, too.”

As the three stood up to leave, the one whom Neptune had called Adrian squeezed Isaac’s shoulder and said, “Don’t be a stranger. You know the schedule.” And just like that, they were gone. Isaac stared at the courtyard door even after it had closed. He was afraid to look at Max. He had to do so, though, when Max spoke.

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Behind Silent Smiles: A Glimpse into the Inspiring New Novel

Oct 24

A journey from childhood to adulthood, across Romania and the world. Behind Silent Smiles takes you into a life of…


First a little girl…

…Then a grown woman








From the Romanian Countryside…

To Bucharest…









To Sacramento, California










Who is she? What happens to her in her life? Find out in 2018. Behind Silent Smiles, the latest novel by Tanya J. Peterson. 


Previous novels by Tanya J. Peterson

Self-help book by Tanya J. Peterson: Break Free: Acceptance and Commitment Therapy in 3 Steps


Sign up for my free monthly newsletter, Wellbeing & Words. Each issue is packed with useful tips for enhancing mental health and wellbeing, reading-related tidbits, and updates about my own mental health writing and activities. (I never share e-mail addresses with anyone.) 

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Who is she? What happens to her in her life?  Find out in 2018. Behind Silent Smiles, the latest novel by Tanya J. Peterson. 


International Day of the Girl: Empowering Girls in Conflict

Oct 11

The 2017 UN International Day of the Girl seeks to empower girls in conflict. The YA novel Losing Elizabeth is a book whose mission is the same.

Today the world comes together to honor girls, our young women who have the potential to bloom and thrive and make a difference in their own lives and in the lives of others. Sometimes, though, a girl’s potential is thwarted. For that reason, the United Nations raises awareness of girls, their lives, and their struggles every October 11.

EmPOWER Girls: Before, During, and After Conflict

This year, the theme for International Day of the Girl is “Empower girls: before, during, and after conflict.” This is a important focal point indeed, for according to the UN, an adolescent girl somewhere in the world loses her live as the result of violence–every 10 minutes.

Sometimes the violence is related to war. Sometimes to some inhumane punishment. Sometimes, it’s abuse by a parent, boyfriend, or other person in the life of a girl.

Losing Elizabeth is a novel for adolescents in middle- and high school to help them see what an abusive relationship is like. It’s a vehicle for discussion to help empower girls to recognize all types of relationship abuse and remove themselves from a toxic, even violent, situation.

The curriculum Find Yourself. Keep Yourself. accompanies Losing Elizabeth. I’ve taken it into schools for a 12-week (once weekly) program and to libraries for a single afternoon program. The goal is to use the story and discussion to empower girls to

  • Know the early warning signs of toxic behavior
  • Recognize control tactics like isolation, manipulation, behaviors, and words
  • Respond and act
  • Know how to help a friend
  • Know how to ask for help

Additionally, and most importantly, girls explore and come to know themselves, their relationship goals, their hopes, dreams, and plans, and more. For it is when girls and teens develop self-awareness that they are empowered to keep themselves rather than losing themselves to others, to abuse, to violence.

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For Mental Illness Awareness Week, What I’ve Learned About Mental Illness

Oct 4


Mental Illness Awareness Week. It’s one of the “ribboned” events, with a dedicated chunk of time (the first week of October each year) during which knowledge and understanding of the issue are brought to light. Mental illness is a wonderful thing to which to dedicate time and attention, for as anyone who has lived with any type of mental illness knows, lack of understanding can lead to prejudice and discrimination. To help end that problem, we observe Mental Illness Awareness Week.

The term mental illness, though, is both vast and vague. Of what should we actually be aware? Of course there’s no single right answer to this, which is one of the things that makes Mental Illness Awareness Week so powerful. Both on- and offline, people and organizations such as the National Alliance on Mental Illness provide facts, statistics, and other information in order to increase awareness of mental illness and those whose lives it touches. I don’t keep it a secret that I have not just professional (I’m credentialed as a National Certified Counselor) but personal experience with mental illness.

After a traumatic brain injury, I was diagnosed with bipolar 1 disorder as well as anxiety disorders. As people don’t live in a vacuum, I had to navigate the worlds of family, friends, coworkers, supervisors, students, parents, clients, and more. It’s from both my personal and professional experience that I offer these insights for Mental Illness Awareness Week:

When it comes to mental illness, I’ve learned that…

  1. “Mental illness” is a fairly meaningless term. We don’t tell someone that we have a physical illness, because that is too broad. More specific: cold, asthma, prostrate cancer, breast cancer, influenza, schizophrenia, depression, dissociative identity disorder, obsessive compulsive disorder. When we know the specific illness, we understand the symptoms and how to manage them.
  2. “Mental illness” refers to a diagnosis rather than to a person. It’s a medical term used to identify what’s going on and how to treat it.
  3. “Mental illness” does not refer to a personal character trait. One isn’t depression, just like one isn’t cancer.
  4. “Mental illness” involves a different way of experiencing oneself and/or the world. It is not a wrong way of being with oneself or in the world.
  5. “Mental illness” doesn’t erase the good in your life and in who you are. To be sure, it adds challenges and difficulties, but it doesn’t not diminish the good within you and around you.
  6. With a diagnosis of a mental illness, someone can still “be,” can still exist and have strengths and weakness and ups and downs and interests and talents and more.
  7. With a diagnosis of a mental illness, someone can still “do,” can make choices and decisions and behave in intentional ways.

To me, the most important thing of which to be aware when it comes to mental illness…

8. With or without mental illness, each and every one of us can find our passions, live with purpose, and create a life worth living.

To be sure, when someone lives with a mental illness, adjustments might have to be made and living with passion and purpose might take extra effort, but passion, purpose, and a life worth living are within reach of everyone. That is important to know during Mental Illness Awareness Week and beyond.

A great way to increase awareness, understanding, and empathy for people living with mental illness as well as their families and friends is through stories. Listening to what someone has to share about their experiences is empowering for the storyteller and the listener. Reading stories, too, can help deepen human understanding. Fiction can convey fact in a way that goes far beyond information and extends to thoughts, feelings, and behaviors. Stories humanize mental illness, which is one of the main goals of Mental Illness Awareness Week.

Others are recognizing, too, that novels can both entertain and inform. In honor of Mental Illness Awareness Week, here’s a peek at what professional critics are saying about Leave of AbsenceMy Life in a Nutshell: A Novel, and Twenty-Four Shadows:

24-shadows-us-review-quote-1   loa-pdx-bk-rev-quote-twitter   nutshell-portland-book-review-quote   24-shadows-us-review-quote-2   loa-us-review-quote   nutshell-kirkus-quote   24-shadows-odonis-person   loa-kirkus-quote   nutshell-kirkus-quote-2-twitter   24-shadows-kirkus-quote   PurchaseLinks circle for website 2
Do you have a question about mental health or mental illness or a topic you’d like to hear about? Use the contact form below to submit it (put Q&A in the subject line), and I’ll address it on the Wellbeing&Words Q&A show on YouTube.

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SOS! What OCD Treatment Will Help Me?

Sep 27

OCD treatment can seem impossible. Yet OCD help and treatment are available. Here, learn about OCD treatments ERP and a new app called nOCD.

Obsessive-compulsive disorder (OCD) is a cruel disorder to live with. It involves obsessions, repeated thoughts that cause sometimes-unbearable anxiety. To tame the fierce anxiety and get the thoughts to stop, or at least slow, someone with OCD often performs patterned behavior, or compulsions.

These obsessions and compulsions alone are cruel, but adding to the pain of OCD is the fact that most people with OCD know that the anxiety and fear are disproportionate to the situation and are even rather irrational. They know it intellectually, but the brain goes into freak-out mode anyway. Physical and emotional responses escalate, even when the intellectual part of the brain tries to reason with the anxiety.

The nature of OCD makes treatment difficult and frustrating. That doesn’t mean, however, that OCD can’t be treated. It can. Successfully.

Treatment & Help for OCD

The two treatments that research has shown to be effective for reducing obsessions and compulsions so people can live a full life are medication and a specific type of cognitive-behavioral therapy (CBT) called exposure response prevention (ERP). According to the International OCD Foundation, about 70 percent of people seeking treatment for OCD benefit from medication and/or ERP.

ERP involves exposure to those things (in both your inner- and outer worlds) that trigger anxiety and fear. You face them, experience them, accept their presence and notice the increasing anxiety you feel. The response prevention component involves making a choice, a commitment, to be with the anxiety without engaging in a compulsive behavior in an attempt to relieve the anxiety.

Does ERP sound just a tad intimidating? That’s because it is. It goes against all human instinct to purposely expose yourself to a trigger then choose to do nothing about it. (Well, you’re not doing “nothing.” You’re learning how to face it and reduce the degree to which it bothers you. You’re just not succumbing to your compulsions.)

ERP is done with support, especially at first. Expecting you to expose yourself to a distressing thought, situation, place, object, etc. with no help through it would be as cruel, if not more so, than OCD itself. Support is as important as the exposure and the response prevention components of ERP. (Maybe it should be called SERP or ERPS.)

Why is Support so Important in OCD treatment?

A little story will illustrate the importance of support during ERP treatment. In the book My Life in a Nutshell: A Novel, Brian Cunningham is a man who, while he doesn’t have OCD, suffers from debilitating anxiety. He begins to see a therapist, who mentions that they’ll eventually engage in exposure therapy. A situation arises that makes him decide to try exposure on his own, at a crowded grocery store.

When I pull into Albertson’s I sit in my car for what feels like a long time and just stare at the building. The doors keep sliding open and shut, like a monster’s maw, sucking shoppers in and spitting them out. There are so many people. Before I can leave my vehicle, I have to breathe into one of my paper bags. I have to keep shoving the bag down when people walk close to my car so they don’t see me lamely hyperventilating into a bag. Finally, my breathing approaches normal and I can enter the store. The moment I step inside, I regret attempting this experiment.

Brian has an extensive panic attack that lands him in his therapist’s office for an emergency session. This is part of their conversation:

“You mentioned last time that we’d do exposure therapy and in vivo therapy, so I was trying it and failed.”

Even though everything is liquid, I can see her smile. “We’ll do those things because they are effective, but it’s far too early. We need to take this one small step at a time.”

Brian went out on his own and purposely exposed himself to triggers. This increased his already intense anxiety, and if he had OCD, it would likely have led him to do the compulsions rather than resisting them.

It would be great if everyone with OCD (or with anxiety disorders like Brian) had a therapist constantly with them. Too bad it’s not possible. But wait! Maybe it is.

Enter nOCD into Effective OCD Treatment

nOCD isn’t a therapist, but it is an excellent support and treatment OCD treatment and help can seem impossible. Yet OCD help and treatment are available. Here, read about OCD treatments ERP and a new app called nOCD.tool for OCD. It’s an app, so it can be with you at all times, whether you use a smartphone or smartwatch.

You create structured, daily ERP plans (this app is yours; OCD is different for everyone, and treatment should be, too). You use proven exposure response prevention therapy to decrease your symptoms, and you use it with your therapist for feedback and support. Your nOCD app also gathers your data so you can see what is working best and what needs adjusting.

nOCD was developed by people with OCD who know what it’s like, who know how obsessive thoughts and anxieties caused by those thoughts as well as by external triggers can severely limit your life. The developers know how the compulsions can be so time-consuming that you miss import things that you really don’t want to miss.

The creators of nOCD know, too, that treatment is possible and that ERP can be successful with the right structure and support. Thus nOCD was born. It’s your mobile treatment and support app to help you live free and well. The cost of the app? Nothing! It’s free in order to give people access to this OCD treatment technology.

OCD treatment can seem impossible. Yet OCD help and treatment are available. Here, learn about ERP and a new app called nOCD.Check it out, and download it. Take charge of your treatment! (If Brian Cunningham had had this, he might have been better able to deal with his grocery shopping experience.)



Filed Under: Wellbeing & Words

What Triggers a DID Switch?

Sep 19



What triggers people with DID to switch to an alternate identity? Learn more about what causes this dissociation?

A DID switch, a dissociation in which a different personality emerges and takes the place of the dominant one, can be painful and bewildering.

Now an excruciating pain spread across his forehead, behind his eyes, and radiated sharp fingers toward the back of his brain. He staggered back against the counter and tried to massage it away. His vision blurred, and he had to close his eyes. He opened them, blinked, and looked around. He began to shake his head. (Excerpt from the novel Twenty-Four Shadows)

The sudden pain, change of vision, and closing and re-opening his eyes signal one of Isaac Bittman’s DID switches.

Dissociative identity disorder (DID) is a confusing, frustrating mental illness. Someone who lives with DID has within him or her a number of alternate personalities, also called alters or parts. The alters are legitimate identities in their own right, with unique interests, abilities, traits, gender, sexual orientation, and more.

The different identities, who can number from two to hundreds, form in the person’s childhood in response to severe abuse. They emerge throughout life, taking over the main personality and causing perplexing problems and situations. Switches originally happen as a defense mechanism to protect the child from horrible abuse; the child dissociates to escape from an unbearable situation, and a different personality emerges in his/her place. Once he or she grows up and the abuse is no longer a threat, why do switches continue to occur?

No. This couldn’t be. They weren’t really firing him. It just didn’t make any sense. He didn’t miss work the way they were accusing. He didn’t. He came to work. He didn’t miss. He was confused. Heavy guilt joined the rest of his thoughts and feelings, stomping from his mind down to his heart and kicking hard against it. What about his family? He couldn’t lose his job. The room was slanting and spinning, nauseating him. He didn’t know how to convince them or change their minds, but he needed to. His stress level was rising rapidly, and he was struck across his entire forehead with one of his searing headaches. He closed his eyes and took a deep breath.

When he opened them, he took off his glasses so he could see better and tucked them carefully into his shirt pocket. To make himself more comfortable, he slid down in the chair a little into a bit of a slouched and crossed his right ankle over his left knee. He studied the two people who sat across from him looking so somber. He extended his arms, palms up, and then shrugged. He grinned broadly. “Hey, c’mon, guys. What the heck? It’s me!” He thumbed himself lightly on the chest. “I ain’t got a clue what y’all are talking about, but surely we can make this right.” (Excerpt from Twenty-Four Shadows)

Isaac had just switched again.

In DID, What Triggers a Switch?

In both of the above passages from the novel Twenty-Four Shadows, Isaac is experiencing a switch. Every single time he switches, he’s going about his life when one of his alters takes over. Isaac recedes and a different part emerges. A big question Isaac has is why?

Isaac to his psychiatrist: I’m really sorry. It’s just that I don’t understand this at all.

Dr. Charlie: It’s okay. The experts don’t fully understand it yet, either, but we’ve figured out a lot and we’re constantly learning more. The human brain is so complex that we’ve only just begun to understand it. We do know that it’s strong and it does what it takes to survive.

It’s true. There is so much yet to be learned about DID, including what triggers a switch. Experts continually seek to answer those questions. So far, they’ve figured out some things about why people switch between alternate identities. Switches can be triggered by

  • Stress When someone is under duress, one of his/her alters often emerges to help, to ease tension or pain, to solve a problem, or give the primary personality a break.
  • Memories For all of us, memories can evoke strong feelings, and for people living with DID, they can trigger switches.
  • Strong emotions A sudden onset of emotion, either positive or negative, can cause alters to take the dominant spot in the personality system.
  • Sensory input Sights, sounds, smells, textures, and tastes can lead to switches between parts.


In looking at things that trigger switches in people who have DID, something important is evident: Every single one of these elements is something that can cause strong reactions in all of us, whether or not we live with DID.

People with DID live with a very difficult challenge that was caused by severe childhood abuse. They are triggered by the same things other people are; the difference is that for them, the trigger leads to dissociation and different identities coming forth to live in the world for a while. Switches are stress reactions that cause different parts of a single human being to emerge.

The movie Split, released in early 2017 features a man living with DID and highlights his switches. While some of this fictitious psychological thriller is quite unrealistic, the talented lead actor does an outstanding job of portraying DID switches. For more on the movie and to help decide whether it’s worth your time, check out these posts:

What the Movie ‘Split’ Got Right (and Wrong)

‘Split’ and Dissociative Identity Disorder: The Good, the Bad, and the Weird

What does it feel like to be Isaac Bittman? Check out this short preview.


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