[Disclaimer: I have used aliases to protect the confidentiality and identity of clients or patients. No other names have been changed.]

I did get a few new clients because of what they read in the newspaper. Two individuals said they saw the article and they wanted to see if I could work with them. Their names were Patricia and Sadie who said they believed they had DID – Dissociative Identity Disorder – meaning they had different personalities and other dissociative experiences.

It was brave of them to approach me knowing that they had little means to pay for therapy. I mean, speaking from personal experience, I am very hesitant to ask for help for myself when I cannot pay for something.

I then met with Patricia and Sadie who were to become my clients. I agreed to see them pro-bono (for free). Neither of them had insurance that I could bill nor did they have a decent income.

I had explained to the best of my ability the extent of my experience and expertise in the field. I didn't want anyone to think that I was an expert with years of experience in the field.

Just like I had felt when I noticed that I could help people with schizophrenia without having been an expert in that area. The fact that people with certain disorders might have trouble getting psychotherapy was a key motivator for me.

I couldn't help but want to donate some of my time to be there for those individuals who had been harmed so profoundly early in life. After I met with them, it was clear that they had been abused, betrayed, and hurt by people who should have provided for them and protected them.

My dedication to providing the best possible services and availability to them was not diminished by their inability to pay for services.

I spent a great deal of time learning from them. Asking open-ended questions. Listening.

I cannot remember the exact questions that I asked them but they would have been the standard questions that relate to dissociative experiences, which I describe in more detail below.

Patricia and Sadie had said that they already knew that they had different personalities and that that they could relate to the description of DID from the newspaper article. As mental health professionals, we have to start where the client is. So, if they say that there are other personalities that are "out" at different times and go by different names, one would accept and respect their "experience" or their "reality."

Another referral that I received was a bit unusual. I was at the office when the receptionist called me and said that a John Freifeld was on the phone.

I picked up and John began to speak to me. He said he found the article online about Dissociative Identity Disorder (DID) and had found my website where I announced my private practice.

He said that he had been meeting online with a woman named Jessica who might have DID and she lives in my area, but he is not local.

He said that he has a chat room that he operates.

Okay. He explained that he wasn't a therapist just a "support person" who runs a recovery forum and chatroom online for alcoholics and people with other addictions.

The fact that there is no relationship between alcoholism/addictions and dissociative disorders didn't register as important to me at that moment. How would a layperson know this?

John asked if I could see Jessica for therapy. I agreed. I was eager to see if I could help. At the time it seemed like a great opportunity to help someone who seemed confused.

I then waited for her phone call.

John sent me transcripts of the chat sessions he had with Jessica. It was clear, as I read, that he not only thought she might have DID but he had been interacting with different personalities that had different names.

Jessica called me and we agreed to meet at my office the next day.

She was in her late thirties, slightly heavy, with dark hair.

I said that I read the transcripts from John and noted that she had been talking to him as if she was a different person at different times.

"Have you been diagnosed with Dissociative Identity Disorder?" I asked.

"No, my doctor has me on medication for depression and anxiety," she answered.

"How did you discover that you have different personalities?" I asked.

She said, "John has helped me to understand different things about myself," she said.

I started to get some information about her experiences. "Do you lose track of time... do you have amnesia? " I asked.

"Yes," she answered.

"How often?"

"A lot."

"Okay," I began holding the transcripts that I had. "There are these other personalities that spoke to John, can you describe what that is like? Do they come out on their own and do you lose track of time when that happens?"

"Usually, John asks to talk to some of my alters," she answered, adding, "sometimes I don't know what happened when someone else is out."

I was trying to find out when and how she first figured out that she had different personalities but she couldn't seem to remember.

"I understand that this can be confusing." I said, "or hard to talk about. Do you talk to your husband about this?"

"He knows that I have different parts," she answered, "and that I have been talking to John about this."

"Okay." I then asked, "so, other than your doctor, have you seen another therapist or psychiatrist about these problems?"

"No, we weren't sure if anyone will believe us."

"We?" I asked.

"Yes, there are others... inside."

"What's that like?" I asked.

"Sometimes the others are talking, and I can hear them or see them... but it's not me."

"Where are they now? Or where do they go?" I asked.

"There are rooms inside," she answered adding "and places."

"Rooms?" I asked.

I had heard of this technique being used by therapists to talk about or to think about different ego states, as parts of us and how different rooms or locations where they might exist or live could be used as a metaphor. I had hypnotic scripts from the "Handbook of Hypnotic Suggestions and Metaphors" which is published by the American Society of Clinical Hypnosis (ASCH).

I have heard about this in other settings as well. I did not expect a layperson to be using techniques like this nor did I know how John had learned to do these things.

Jessica continued by saying, "It's like a big house with different bedrooms where different people live," she explained.

"Did you create the house on your own?" I asked.

"I don't know," she said.

I was thinking that while a formal diagnosis had not been made, we have to meet the client where they are. If Jessica related to the world as if she was a different person at different times, that is how I would have to proceed.

So, I asked, "Is there someone else that might want to talk and might have more information to share?"

"Do you want to talk to them?" she asked.

"Sure," I said.

After a brief pause, she said "Hi, Bruce." Her voice sounded younger and the "u" in Bruce sounded longer and accentuated like "oo".

"Hi," I answered.

"I'm Cindy. I'm six."

"Hi, Cindy. Are there others?" I asked since I had read the transcripts of chat conversations with John.

"Yes, there are other girls like me. There's Amanda, she's eight."

"How long have you been with Jessica?" I asked.

"A long time, but she didn't know us for a long time."

She had seemed like a child, indeed. While I was concerned that a proper diagnosis had not been made, I had to keep relating to Jessica through the others that would come out.