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2019 PPWC Survey Results · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to long time listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 0:59
  This episode is about the results of the twenty nineteen Plural Positivity World Conference survey results about common survivor and plural experiences. The trigger warning for this episode is that it is very monotonous in that it is a reporting of percentages and numbers given over and over as we share the survey results. And while nothing is discussed at all, there are mentions to specific kinds of abuse because the ACEs questionnaire was included in the survey. So if this information is not interesting to you or at all concerns you as far as triggering content, you can skip this episode. Otherwise, you're welcome to listen, or if it's easier for you to read or follow along, you can read this on the blog at systemspeak.org.
• 1:48
  As always, please care for yourself during and after listening to this podcast. Thank you. As part of the February last year, we helped with a survey with results to be shared in 2020 at this year's conference. This plural positivity experience survey was not associated with any research project nor did the survey go through any review panel process. There was input from the plural community itself, including deciding which contextual questions to include, such as the ACES questionnaire, as well as verbiage options to be as inclusive as possible for the plural experience.
• 2:38
  Again, this was not a research project, but was an expression of the plural experience both individually and as a community. Participants were informed that the survey results would be shared during the twenty twenty PPWC conference. To continue the survey, participants had to agree that they understood this and that they were over age 18. Any participant who did not agree to have their results shared or who were 18 were excluded from the survey results published below. It was explicitly stated and participants agreed to understanding that the questions were only for information about their experience and not at all diagnostic in nature.
• 3:21
  Participants were also warned that due to the nature of trauma specific questions, they could be triggered during the survey. Resources and referrals for support were offered and system wide self care was encouraged before, during, and after participating in the survey. This survey was designed by plurals themselves as a community, following online discussions in support groups, peer mentoring groups, and a variety of social platforms. The common threads of interest were narrowed down and presented in polls on the social platforms. While obviously vast and covering a multiplicity of areas that would be too many variables for a research project, this was again just the general areas of experience that plurals themselves wanted to know more about and were interested in learning in regards to shared experiences.
• 4:13
  This particular survey was in English. The survey took an average of twenty six minutes to complete. The first page of the survey was simply exclusionary material clarifying the purpose, concerns, and limitations of the survey. Any no responses exited the participant from the survey. Questions included, I am over the age of 18.
• 4:38
  I understand the screening tools used in this survey are for data gathering only and not meant to be diagnostic in nature. I understand that due to the nature of the survey in regards to trauma and dissociation, some of the questions may be triggering. I am safe and able to care for myself during and after this survey and know where and how to seek support if I need help. I understand I can quit this survey at any time. I understand the data gathered from this survey is nonidentifiable and that the survey is done with SSL encryption.
• 5:13
  I understand that the data results will be combined and that the overall results will be shared in the Plural Positivity World Conference for plurals by plurals. I understand that the data results will be shared with the conference via the System Speak podcast, which is a public podcast already on air. I understand that the podcast may be linked to from other blogs, YouTube channels, and support groups online. I understand that while this is not an official research project, the clinical community as a whole may have access to these results generally and the related nonidentifiable data. I understand these things and consent to this survey.
• 5:52
  The second page of the survey were demographics, including country, identified gender, body age, levels of education for self and each parent. It also included context questions regarding perception of trauma impact on education, frequented online resources, government assistance, housing stability, and patterns of sleeping, eating, and exercise. The third page of the survey were the questions from the dissociative experiences scale, again, clarified that this was for appropriateness of the survey and not for diagnostic purposes. The fourth page of the survey were the adverse childhood experiences or ACEs, questions. The fifth page of the survey was about therapeutic experiences, including number of therapists prior to diagnosis, number of therapists since diagnosis, reasons for changing therapists, current reported diagnoses, ritual abuse identification, how therapy is paid for, positive and negative experiences with therapists, what does and does not feel safe in therapy, misdiagnosis experiences, treatment goals, and integration perspectives.
• 7:05
  The final page of the survey was cultural, about the personal experiences and identification of or with the integration process and views on functional multiplicity. There were no research analyses done with the data beyond the collective per question results shared below or any correlation conclusions drawn from this survey due to this not being an actual research project and other obvious limitations to the survey. That said, we do believe it to be informational about the common experiences of the pleural community as a whole and that the survey could be informational upon reflection when considering future clinical studies. The PPWC organizers had an initial goal of 100 responses from different people diagnosed with DID or otherwise identifying as multiple or plural. The link to the survey was shared in all known dissociative disorder and plural community support groups on Facebook, posted and shared on Twitter, and then also explained and shared on other communities, including Discord, Reddit, and Tumblr.
• 8:09
  The link was also left live on this website, and we did discuss it on the podcast. The link was left live for six months so that as many could participate in the survey as possible. Ultimately, the survey received eight sixty three responses from different IP addresses, which were not tracked or recorded, but filtered only for non repetition of the survey. These responses came from 61 different countries, including Canada, United States, Mexico, Panama, Colombia, Peru, Brazil, Uruguay, Argentina, Chile, Iceland, Ireland, UK, France, Germany, Belgium, Netherlands, Denmark, Norway, Sweden, Finland, Poland, Spain, Portugal, Italy, Slovenia, Austria, Czech Republic, Slovakia, Hungary, Serbia, Romania, Greece, Morocco, Ghana, Egypt, Uganda, Kenya, South Africa, Turkey, Lebanon, Israel, Iran, Pakistan, India, Nepal, China, Thailand, Cambodia, Indonesia, Philippines, Russia, South Korea, Japan, Australia, and New Zealand. The survey had a 92% completion rate.
• 9:37
  An additional 6% completed more than 75% of the survey, but needed to stop due to length of the survey. 1% had to stop the survey because of triggers. The final 1% did not complete the survey and did not explain why. The results of the survey are as follows, and all of this information can be found on our blog at systemspeak.org. The first page of this survey resulted in only participants who answered yes to the first seven questions that we've mentioned above already were to be included in the results below.
• 10:13
  The second page about demographics listed the countries as I shared. The second page was about demographics. I have already listed the countries represented. In regards to identified gender, 54% identified as female, nine percent identified as male, nine percent identified as non binary, eight percent identified as trans male, four percent identified as gender queer, three percent identified as trans female, two percent identified as gender fluid, 2% identified as nonconforming, 1% identified as gender variant, and 1% identified as questioning. 4% listed other as their identified gender and reported that they did not want to answer.
• 11:08
  Please note, female and transfemale, as well as male and transmale were included separately not to divide the genders female and transfemale being the same gender and male and transmale being the same gender, but simply to clarify experiences in everyone's request for their journey to be included and reflected specifically. The remaining percent were decimals in the above percents and also will be in the case with the remaining results below. In regards to the actual body age, people reported forty three percent were ages 25 to 34, 20 percent were ages 18 to 24, 16 percent were ages 35 to 44, 13 percent were 45 to 54, two percent were 55 to 64, and one percent was 65. We would suggest that the online platforms provided access to younger populations not usually included in research studies. We would also suggest that the online platforms were more accessible to those who are in rural areas and in other geographic locations not usually available to participate in research studies.
• 12:20
  In regards to their father's education, twenty six percent reported that their father had high school education only, Twenty one percent had graduate level education. Twenty percent had bachelor's level education. Seventeen percent had some college but no degree. Seven percent had an associate's degree. Six percent did not complete high school.
• 12:43
  In regards to the participant's mother's education, twenty five percent had high school degree only. Eighteen percent had some college but no degree. Eighteen percent had a bachelor's degree. Fourteen percent had graduate level education, eleven percent had an associate's degree, and eleven percent did not complete high school. For participants themselves, thirty five percent have some college but no degree, twenty two percent have a bachelor degree, sixteen percent have a high school degree only, eleven percent have a graduate degree, nine percent have an associate's degree, and four percent have not finished high school.
• 13:24
  For context, remember that twenty percent of the participants were in the age group of 18 to 24. However, that said, more participants have finished high school than their parents. More have some college even if they have not finished a degree. More have associate's degrees than their fathers. More have bachelor's degrees.
• 13:44
  Of these, in regards to how their trauma histories impacted their educational efforts, participants reported thirty four percent felt their trauma impacted impacted their education a great deal. Twenty five percent felt their trauma impacted their education a lot, but I struggle through. Thirteen percent felt that their trauma impacted their education a great deal. Seven percent felt they were able to complete their education as far as they wanted. Six percent felt their trauma moderately impacted their education.
• 14:16
  Five percent felt their education was impacted by trauma some, but they were able to deal with it. Four percent felt their trauma impacted their education only a little, and one percent felt their trauma did not impact their education. As for online platforms survivors frequently use for support, seventy eight percent use Facebook, seventy seven percent use YouTube, 70% use Facebook support groups, 36% use professional and or clinical research sites, 32% use Twitter, 28% use podcasts, 24% use Reddit, 22% use Tumblr, and 20% use organizational sites. As for level of functioning and assistance needed, 59% of participants reported they are not on any Social Security, housing assistance, or food stamps. 27% of participants reported they are on social benefits of some sort.
• 15:17
  8% of participants reported they use social benefits as do others in their household. Three percent of participants reported that they do not use them themselves, but someone in their household does. As for housing stability, participants reported that in the last five years, twenty four percent have not moved, twenty percent have moved once, fifteen percent have moved three times, thirteen percent have moved twice, seven percent have moved five times, seven percent have moved more than 10 times, four percent have moved six times, two percent have moved seven times, two percent have moved four times, one percent have moved eight times, and one percent have moved nine times. The survey included questions about sleep, eating, exercise. In regards to sleep, participants reported that fifty four percent do not exercise at all, either due to preference or medical condition.
• 16:17
  Twenty one percent exercise twice a week. Thirteen percent exercise once a week. Ten percent exercise five times a week or more. No other responses were reported on that question. In regards to eating, participants reported that thirty six percent eat twice a day, twenty four percent eat three times a day, fifteen percent eat smaller amounts four times a day, 11% eat just once a day, and six percent reported that eating is difficult, and so they leave food out when whoever is inside just grazes throughout the day.
• 16:54
  In addition, thirty four percent reported they struggle to eat five to six days a week. Twenty percent reported struggles to eat one to two days a week. Twenty percent do not struggle to eat at all. Eighteen percent struggle to eat three to four days a week. Six percent do not miss meals no matter what, nor do they find it difficult to eat.
• 17:16
  In regards to sleeping, participants reported that twenty eight percent sleep eight hours or more because they have help with medication. Twenty two percent sleep six to eight hours without medication. Twenty four percent sleep four to five hours without medication. Twenty one percent sleep three to four hours without the use of medication. Four percent sleep one to three hours without medication.
• 17:42
  In addition, twenty four percent rarely have nightmares, but sometimes, twenty two percent have nightmares one to two nights a week. Eighteen percent have nightmares, but not so much since starting therapy. Fifteen percent feel like they have nightmares still every night. Eleven percent have nightmares three to four nights a week, and seven percent have nightmares five to six nights a week. The DES was included for context of what issues participants struggle with and which populations were completing the survey.
• 18:13
  It was not used for diagnostic purposes, nor were the results saved in any way according to specific participants. Rather, the algorithm of responses scored this page per participant, but only reported in the results of the page in the percentage of participants who scored each range. So, are not informed of which DES score goes with which participant. We only know what percentage of each possible DSE score. That was intentional as an additional buffer for privacy since this is not a clinical research study or diagnosis in any way.
• 18:46
  Participants were not informed of their individual score nor was this reported to us in any way. Individual DES two scores were not reported or disclosed to anyone in any way. Of the participants in this survey, eighty nine percent scored above 30 on the DES two. Six percent scored between twenty seven and thirty. Four percent scored between twenty four and twenty six, one percent of participants scored 23 or below.
• 19:15
  The high scores were expected due to the population receiving notice and participating in this survey, especially as they were primarily those already in treatment for or aware of their own issues of trauma and dissociation. Please note that the higher scores, 30 and above, only indicate high levels of dissociation and are not indicative of a specific diagnosis in and of themselves. Again, the inclusion of the DES-two was only as a measurement of experience in the context of this survey. No clinical interview, structured or otherwise, was part of this survey and no diagnoses were given to any participant. Links for more information about the DES2, which you can learn about on the ISSTD website are included on the blog.
• 20:01
  We included the ACE questions by request of the community due to increasing discussion within the community physiological impact of trauma long term on our bodies. The ACE study questions were broken down into the questions listed below to which participants could answer yes or no. Again, a specific participant's answers were not saved per participant, but rather as a poll for how many participants answered yes to each question. This was both in protection of people's privacy and because the survey was not being given in a clinical setting. Four percent of participants opted out of this page due to the nature of the triggering questions regarding their own trauma.
• 20:41
  Another one percent declined to participate for unspecified reasons. The positive results endorsed by those participants who completed this set of questions are given as follows. Did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? Eighty percent of participants answered yes. Did a parent or other adult in the household often or very often act in a way that made you afraid that you may be physically hurt?
• 21:13
  Seventy eight percent of the participants answered yes. Did an adult or person at least five years older than you ever touch or fondle you or have you touched their body in a sexual way? Sixty six percent of participants answered yes. Did an adult or a person at least five years older than you ever attempt or actually have oral, anal, or vaginal intercourse with you? Fifty two percent of participants said yes.
• 21:40
  Did you often or very often feel that no one in your family loved you or thought you were important or special? Seventy one percent of participants said yes. Did you often or very often feel that your family didn't look out for each other, feel close to each other, or support each other? Seventy percent of participants said yes. Did you often or very often feel that you don't have enough to eat, had to wear dirty clothes, and had no one to protect you?
• 22:09
  Forty four percent of participants said yes. Did you often or very often feel that your parents were too drunk or high to take care of you or take you to the doctor if you needed it or didn't for some other reason. Thirty six percent of participants said yes. Did a parent or other adult in your household often or very often push, grab, slap, or throw something at you? Fifty three percent of participants said yes.
• 22:38
  Did a parent or other adult in the household often or very often ever hit you so hard that you had marks or were injured? Forty five percent of participants said yes. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? Twenty three percent of participants said yes. Was your mother or stepmother sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?
• 23:06
  Fifteen percent of participants said yes. Was your mother or stepmother sometimes, often, or very often threatened with a gun or knife or other weapon? Four percent of participants said yes. Were your parents separated or divorced? Forty nine percent of participants said yes.
• 23:25
  Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? Forty seven percent of participants said yes. Was a household member depressed or mentally ill, or did a household member attempt suicide? Seventy two percent of participants said yes. Did a household member go to prison?
• 23:46
  Fifteen percent of participants said yes. It is interesting to note that seven percent of participants reported that they wish the ACE questions included similar specific questions for their father or stepfather the way it does about the mother or stepmother, as this group of people reported their mothers as the or one of the primary abusers, even against their father or stepfather. Page five addressed common therapeutic experiences for survivors. This section of the survey addressed issues regarding therapeutic experiences that the plural community had brought up in discussion about what to include in the survey. In asking about who was in therapy, their participants responded as follows.
• 24:31
  Fifty eight percent were currently in therapy at the time. Ten percent had been in therapy, but had to quit because their therapist didn't believe in dissociation. Ten percent wanted to meet, but have been unable to find therapist who works with dissociation. Eight percent had been, but had to stop when their funding was cut or insurance stopped paying for it. Four percent were, but their therapist moved.
• 24:55
  Four percent were not currently, but were actively looking for a therapist. Three percent were, but had to stop because of schedule conflicts. One percent were, but not because they chose to be in therapy. Not one person responded that they were in therapy and it was entirely covered by insurance. When asked about how many therapists they had had thus far, participants responded that twenty one percent had been referred more than six times, eighteen percent had been referred more than seven times, eighteen percent had been referred more than twice, sixteen percent had been referred more than three times, eleven percent had more than eight therapists already, ten percent had more than 10 therapists already, and only four percent had been with one therapist for the entirety of their treatment.
• 25:47
  The remainder participants had not yet found a therapist. Of these, when asked why they had seen so many therapists, participants responded as follows. And please note, due to multiple experiences with different therapists, participants could report more than one reason, so these percentages do not add up to 100. 40 eight percent couldn't make a positive connection with good rapport. Thirty nine percent could tell their therapist didn't know what to do with them.
• 26:15
  Thirty one percent had to move because of related instability. Twenty six percent felt their therapist didn't listen to them. Twenty five percent had a therapist tell them they didn't know how to treat them. Twenty two percent felt their therapist did not believe them. Seventeen percent had a therapist who moved or left an insurance panel.
• 26:37
  Nine percent were abused by a therapist. Eight percent had a therapist who retired. Eight percent had schedule conflicts, seven percent didn't believe their therapist when they did get diagnosed or got scared and so quit therapy, and six percent left a therapist who was trying to force integration. Other comments included experiences of aging out of a particular school or program, the therapist not being able to handle gender identity or sexual orientation issues, being too anxious to keep appointments, finances, or being forced to report abusers. When asked how many therapists it took before getting an accurate diagnosis, the participants responded that forty two percent had seen two therapists, 30 nine still had gotten a proper diagnosis with just one therapist, 16 percent had to see four therapists before they were diagnosed properly, five percent saw six therapists, three percent saw more than eight therapists, one percent saw more than 15 therapists prior to getting an accurate diagnosis.
• 27:44
  When asked to share their diagnosis, if they felt safe doing so, the participant percentage were. Fifty three percent were diagnosed with DID, fifteen percent were still not sure, twelve percent were waiting on results of testing for diagnostic appointments, eight percent were diagnosed with complex PTSD, five percent were diagnosed with PTSD, four percent were diagnosed with DDNOS, three percent were diagnosed with OSDD. When asked who did the diagnosing, participants replied that fifty four percent were diagnosed by a therapist, twenty four percent were diagnosed by a psychiatrist, twenty three percent were diagnosed by case manager or social worker, five percent were diagnosed by a doctor, and four percent were peer diagnosed by a friend who referred them to a clinical professional. When asked how they identified any experiences of SRA, participants shared that fifty six percent did not know what the terms were and did not think they'd apply to them. Twenty three percent knew what the terms were, but also knew it did not apply to them.
• 28:55
  Seven percent preferred the term RAMC, ritual abuse mind control. 5% preferred the term SRA, satanic ritual abuse. 4% preferred just the general term of trafficking. 3% preferred the term RA, ritual abuse, and 1% preferred the term SRA MC, satanic ritual abuse, mind control. It is interesting to note that not any single participant chose the more general term of organizational abuse and no single participant endorsed mind control only.
• 29:30
  When asked about other non trauma diagnoses, seventy seven percent also have anxiety, sixty seven percent also have depression, sixty seven percent have both a dissociative disorder and PTSD, twenty five percent have a panic disorder, nineteen percent also have OCD, thirteen percent have also been diagnosed with borderline personality disorder, eleven percent have also been diagnosed with bipolar disorder, six percent have another mood disorder diagnoses, three percent have another personality disorder diagnosis. When asked about their best therapeutic experiences, participants shared, and again, they could endorse more than one. 80 percent said the best therapy was when the therapist was good at listening to them. Fifty seven percent said it was good therapy when they felt safe. Fifty six percent said they knew it was good therapy when they got good advice.
• 30:28
  Fifty two percent said it was good therapy when they feel connected. Forty nine percent said the best therapeutic experience is when the therapist responds to others inside alters or parts or personalities. Forty eight percent said good therapy needs a safe feeling setting. Forty five percent said it is good therapy when they receive comfort. Forty percent said it is good therapy when they gain coping skills.
• 30:55
  Thirty eight percent said it's best when they are educated about their mental health issues. Thirty eight percent said the best therapeutic experience is having access to contact outside sessions when policies make those boundaries clear upfront. Thirty eight percent said the best experience happens when the scheduling is consistent. Twenty seven percent said the best experience is when they are held accountable for their progress. Twenty seven percent said the best experience is being able to relax and practice relaxation strategies.
• 31:28
  Eighteen percent said it is good therapy when they also get safe hugs with permission. Thirteen percent said it is only a good therapy experience when the office staff also feels safe, both on the phone and for check-in or check out. And twelve percent said it is good therapy when the therapist plays with littles or intentionally includes them when appropriate. When asked about the most helpful techniques the therapists use, participants responded, eighty seven percent listening, 72% reassurance, sixty four percent playing together, 62% art, 26% guided imagery, twenty six % psychoeducation, twenty four % EMDR, twenty one % music, nineteen % DBT, eighteen % meditation, sixteen % CBT, thirteen % sensory therapy, eleven % san tray therapy, ten % horse or pet therapy, eight % progressive muscle relaxation, five % yoga, three % hypnotherapy. Please note that the above list is not an efficacy rating of which techniques are the most effective or produce the best results.
• 32:47
  These were simply the comfortable techniques experienced by the participant population of this survey. It does not mean any one of those is better or more helpful than another, and it may reflect more frequency of use or access than quality of treatment. When asked what made them feel not safe in therapy, the participants endorsed the following: sixty five percent not knowing how to help me, fifty six percent not listening to me, thirty nine percent therapists saying my stories were too hard or too much or too intense for them, thirty seven percent, therapists refusing to talk to others inside, alters, or parts. Thirty two percent, discounting my stories. Thirty percent, therapists talking too much about their own stuff during sessions.
• 33:35
  Twenty five percent not feeling safe with office staff or an office setting. 21% not available outside of session. 21% not knowing about vacations or time off ahead of time for scheduling. 20% concerns about confidentiality. 19% boundary violations.
• 33:55
  18% therapists being afraid of my insiders. 16% sudden movements. 15% rejection of littles. 13% touch without permission even if it was safe or appropriate, 13% lack of eye contact, 12% texting or taking calls from other people during sessions, 8% not closing the office door during sessions. 3% deliberately triggering to prove a point, access a particular altar, or test progress.
• 34:31
  Two percent inappropriate or unwanted religious discussion, and two percent falling asleep during sessions. Of participants asked, eighteen percent had been abused by a therapist at some point in their treatment. Of these, only four percent reported it. Of those in therapy, eighty two percent agree with their therapist on treatment goals. Some of these goals include seventy five percent decrease in anxiety or panic, seventy two percent have the goal of improved functioning, sixty seven percent are working on memory work or specific trauma processing, sixty seven percent are working on improved internal communication, Sixty six percent are working on compassion for myself.
• 35:17
  Sixty two percent are working on improved mood. Fifty eight percent are working on improved cooperation. Forty one percent are working on decreasing the amount of lost time. Forty percent are working on maintaining functioning. 34% are working on remembering.
• 35:36
  22% are working on stabilization and reducing self harm behaviors. 15% are working on reducing interpersonal drama with outside relationships, and 14% are working to accept the diagnosis. When asked their therapist's goal for therapy, participants reported fifty percent of them have a therapist with the goal of functional multiplicity. Only five percent reported their therapist has a goal of integration. Another twenty percent did not know what their therapist's goal was or what they thought about integration as opposed functional multiplicity.
• 36:14
  Twelve percent did not think their therapist has ever heard of functional multiplicity. When asked about their own goal for therapy, participants reported seventy eight percent of participants reported functional multiplicity as their goal for therapy. Only three percent reported their goal for therapy was integration, and eleven percent had not yet heard the term functional multiplicity. When asked directly if participants ultimately had some goal or vision for final or complete integration, seventy eight percent of participants said no. Ninety two percent said they were interested in some level of functional multiplicity.
• 36:55
  The final questions regarding plural perspectives became more specific in regards to identifying with or despite trauma, levels of dissociation, and functional multiplicity or ultimate integration. These questions arose from the efforts at uniting the plural community as a resource for itself for plurals, by plurals, while also respecting individual experiences and understanding the perspectives of the clinical community. The options for these responses to these questions came from the plural community themselves in exploring options for self expression as a community culture and not just a clinical diagnosis. The questions will be listed with the participant percentage responses following. In regards to my trauma and dissociation, I identify as thirty five percent reported DID, twenty seven percent reported plural, twenty two percent reported multiple, five percent reported dissociative, three percent reported traumatized, and two percent dismissed it as baggage.
• 38:01
  In regards to my trauma and dissociation, I am thirty percent reported they are in the closet publicly, but have found a support group online. Nineteen percent report they have told friends, but not their family. Twelve percent report that everyone knows and they consider themselves an advocate. Ten percent report that they have told their friends and family but carefully with good boundaries. Four percent report that everyone knows, they are not safe enough to be an advocate culturally.
• 38:31
  Three percent are still in the closet, but they get it and are trying to deal with it. Two percent are still unsure what's going on. In regards to my trauma and dissociation coming out to myself, sixty four percent reported it was a huge relief because everything finally made sense. Forty two percent reported it brutally hard, but at least I knew what was going on. Thirty two percent reported that it was positive because they found others like them.
• 39:01
  Eighteen percent reported that it was so hard and terrifying and confusing that they still can't think about it. Fourteen percent reported that it was a good thing because they finally got help. And seven percent reported it was not a big deal. In regards to my trauma and dissociation, coming out to others was, thirty seven percent reported that this was mostly with others online who know what it's like. Twenty nine percent reported it was not as big of a deal as they thought it would be.
• 39:30
  Twenty seven percent report that it was disappointing because they lost a family or friend because of it. Twenty five percent reported that it was okay and their friends were supportive. Twenty four percent reported it was easier with their friends than their family. Sixteen percent reported it was terrible because of the repercussions that followed. Fourteen percent reported it was dangerous and caused safety problems.
• 39:57
  And thirteen percent reported it as terrifying and totally backfired. I believe my dissociation is thirty eight percent chose traumagenic adaptive, meaning I am this way because of trauma and I still use dissociation adaptively to deal with life, but not necessarily intentionally and not as part of my intentional cultural expression. Thirty four percent chose traumagenic, I am this way because of trauma. Thirteen percent chose traumagenic cultural, I am this way because of trauma, feel mostly in control of my symptoms, and have intentionally adapted to it as a cultural lifestyle. Two percent chose endogenic.
• 40:43
  I was this way before I was born, but not because of trauma. One percent chose exogenic. I was this way since I was born or grew up this way, but not because of trauma that I know of yet. There were no people, zero participants endorsed that they were plural because of iatrogenic, because of the therapist making them this way, because of iatrogenic sociocognitive, because of internalized or copied symptoms seen in friends or online, or iatrogenic cultural because of internalized symptoms applied as a lifestyle. No one reported those three.
• 41:24
  Other responses including mixed origin, endogenic but heavily and negatively impacted by trauma, Traumagenic neonatal developed this way because of our maternal unit was being abused and traumatized in the womb. We are born ready for plurality, traumagenic sociocognitive. When I was young, I tended to identify with 65% books, 31% teachers, thirty one % movies, 24% video games, 23 science fiction anything, 21% comics, 20% role playing games, 17% caregivers, seventeen % role models. We included those categories in that question because of the common experience reported by survivors of fictives being rejected by therapists. However, what we would like to point out for therapists to consider and for the clinical world to become more inclusive in their responses, as we pointed out in the history of DID lecture at last year's PPWC conference, which we will link to in the blog.
• 42:33
  We hope that is helpful both to survivors feeling familiar and comfortable that there are others like them and help in giving clinicians a taste of some of the cultural experience as far as the perspective of lived experience. While this was not a specific research project, we do believe it could be very useful in changing some of the language that clinicians use as well as a starting place for future clinical research. Thank you. Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before, not like this.
• 43:42
  Connection brings healing, and you can join us on the community at www.systemsspeak.com. We'll see you there.