​​​​​​​Substantial numbers of patients with Dissociative Identity Disorder at the time of presentation as adults report incestuous abuse continuing into the adult years and for many, the abuse is current and ongoing. Data relating to a series of 10 such incestuously abused women is presented. Such patients usually have been sexually abused from a very early age (typically from under age 3), with the manipulation of their sexual response a key component in conditioning an enduring sexualized attachment, at the same time shame and fear are used as key components in maintaining compliance and silence.

​​​​​​​In the wake of traumatic experience, survivors tend to be overwhelmed by intense emotions and body sensations, loss of faith in the universe, and unrelenting punitive introspection. Addictive craving and behavior seem to offer an ‘out,’ the promise of blessed relief from both the emotional and somatic overwhelm. The result is the frequent co-occurrence of addictive disorders that ultimately poses an equal or even greater threat to the patient as do the trauma symptoms.

It is well known, and documented, that clients with complex PTSD and Dissociation have a high level of suicide risk. The presence of non-suicidal self-injury (NSSI), suicide attempts (SA), and suicidal ideation (SI) in these clients is a constant challenge to both clients and therapists.