BOOK REVIEW: switching time by richard baer

my rating:
1 out of 5 birdies. not the most egregious thing i've read, but this unfortunately falls into many of the same pitfalls as most books written by non-specialty clinicians who encounter their first DID patient. more suited for entertainment purposes rather than an informational piece.

content warnings for the book: child abuse, domestic abuse, CSA, incest, human trafficking, organized abuse, cults, pregnancy loss, suicide, self harm, fatphobia, disordered eating

content warnings for this review: fatphobia

My first book review is going to be more half-assed than I'd like, on account of the fact that I started writing this halfway through the book. I'd started reading it in October of last year, where I made it about 45% of the way without being very impressed. At one point, my interest drifted towards other things, and Switching Time was forgotten. This has only changed as of recent. In the span of 2 days, I've finished ripping through The Secret Diary of Laura Palmer by Jennifer Lynch and Memory Slips by Linda Cutting. I figure that, while I'm here, I might as well clean up my reading list and finish this once and for all.

Switching Time follows Baer's clinical experiences with Karen, a mother presenting to his psychiatric practice complaining of depression and chronic pain. Through hypnosis, Baer discovers that Karen is a system of 17 alters who formed as a result of organized abuse. The book details his near decade of work with Karen, ending with her system fully integrating.

When looking up preliminary information on this book for my write-up, I was surprised to find it was published in 2007. This is not a very good thing. The writing style and clinical practices remind me most of books on DID from the 80s, particularly my beloathed Prism: Andrea's World by Jonathan Bliss. Similarly to Prism, Baer, Karen's therapist, has what seems to be loose boundaries between himself and Karen (more on that later), and his work with her is done almost exclusively through hypnosis. Also similarly to Prism, Switching Time tends towards self-aggrandizing comments and an apparent disdain for the subject. The deja vu this causes makes Switching Time feel like an improved version of Prism, which is impressive because Switching Time was published 20 years later by a completely different author.

I'm always so amazed at clinicians who write entire books about patients they don't even seem to like. Karen is interesting enough to be the subject of a 360 page long book, but is still comes off as so resented by Baer that his attempts at neutral descriptors of her end up coming off as subtle digs. Most often, these comments are about how she is fat, annoying, and miserable to be around. I would not want my healthcare provider portraying me this way in a published book. It comes off as cruel and reflects more poorly on the author than it does Karen. Many of the comments about Karen's weight are directed towards Sandy, the alter responsible for most of the system's weight gain. She is described as "slouching with her belly stuck out, and, somehow, completely un-self conscious." I will admit that these sorts of descriptors arouse a hefty side-eye in me.

The section I reached that made me take a break to start writing this was the following passage:

Which I just found amazing. There's the one-two punch of "it's the first time I have found Karen personally interesting," followed by him casually bragging about his own social skills. Like, I get it, he's a therapist, that's part of his job, but what? What? Had this been the only comment, I would have skipped right by this. Yes, it makes sense. Psychiatrists are not choosing patients based on who they would like to go out drinking with. It only becomes noticeable as a repeated phenomenon. There is a subtle tone here that is not normal compared to most of the other books I've read by clinicians. I'm also picking up on the fact that Baer only finds her interesting on a personal level after she begins reflecting his own mannerisms. Hmmmm.

Another part of the book that catches my attention is that, eventually, much of the therapeutic process seems to be lead by Karen's own system after Baer begins admitting in sessions that he doesn't know what to do. One of Karen's alters, named Holdon, ends up writing a letter to Baer including a step-by-step guide on how to lead the next therapy sessions:

This ends up being the roadmap that is used for the rest of Baer and Karen's time together. I have conflicting feelings about this. I do believe that therapy is a collaborative effort, and patients should have as much of a say in treatment as their providers. On the other hand... is there a therapy equivalent of parentification?

Ultimately, a decision is made: Karen's system needs to integrate now because none of the alters are getting along and it's leading to nonstop crises.

Now, I'm no psychologist. I've no background in the subject. I am but a humble person with DID who reads everything I can get my little hands on. But this seems like the opposite of how it usually works? Without revealing too much of my hand, my own therapist (a specialist in CDDs) has been working to bridge the gap between my alters in order to make integration possible. My own understanding is that the goal is that eventually, alters will be able to form a stable relationship with one another through empathy and trauma processing, and this will lead to either integration or functional multiplicity. So I just don't really get how this other plan works. The alters are more differentiated than ever. The system is rapid-switching multiple times per day, every day. Everything is devolving. I'm struggling to really wrap my head around how the solution to that is "if I hypnotize you, I can just force your alters together anyways. Let's start with the most unstable and differentiated ones." Then I can't tell if my confusion is because I'm stupid, or if something is wrong here. C'est la vie.

Regardless, the other alters work this plan out without informing Karen 3, the "host" alter that everyone is going to be integrated into. Karen 3 only learns of the plan the day the first integration is set to happen. It's done with her consent, of course, but waiting until the last minute leaves a weird taste in my mouth.

This is not helping my confidence.

This is not helping my confidence.

Despite everything, this approach works? It's also super overwhelming and puts Karen out of commission for two weeks. Her own description of the experience doesn't sound great:

But it works, at least, according to the book. I find myself wondering, like... is this how integration actually feels? It sounds much more unpleasant than in other books I've read. It's certainly much worse than my own experience. I'm left mostly with the feeling of "I dunno," like I don't know enough to make a judgement call either way. Shrug.

The next integration goes much smoother. Karen includes details on her own perspective on it in a letter to Baer. I wanted to include her description in here because I genuinely really enjoyed it:

(The part I'm leaving out after this is a descriptor of the abuse suffered by this alter. I'm not including it in part because it feels personally wrong for me to post the details of other peoples' trauma, and in part because I don't want this review to consist of nothing but passages from the book. I want to write my own thoughts, too!)

...But I also know it's bad form to make an argument without including the supporting text. One thing I'd like to point out that has been an undercurrent through the book is that Karen calls her therapist all hours of the day. This is done to the extent that the constant late-night calls are a factor in Baer separating from his wife. On one hand, I sympathize with Karen. She has no other support system. On the other hand, I find myself thinking back to my various therapists. They have always had firm boundaries about not being contacted after-hours. This makes sense to me - they are people who exist outside of their relation to me, with their own families, friends, partners, and other clients. I'd imagine that essentially being on-call 24/7 would result in some crazy burnout. As if being a therapist isn't stressful enough! With this in mind, I wonder how much of Baer's exasperation with Karen is a result of him not putting up the same boundary. I don't know, maybe things were different back then.

Comforting.

Okay, okay, I don't only have bad things to say. I think this insight on the integrative capacities of systems is really cool:

Because it genuinely is really cool how smoothly systems can integrate new ideas and characteristics into themselves. I think it speaks to the adaptive nature of complex dissociative disorders. The sort of plasticity described here is a genius way for a mind to handle a world that is terrifying and unpredictable. It's one of those things that makes me sit back and think about how it's kind of cool that brains are able to do this. It's sad, but it's also neat!