Lemire/Smallwood # 10, Death and Birth: Part One

Hello fellow Loonies, it’s Leyna again, here with another exploration of the representation of DID in Moon Knight comics. In this article, we will explore such topics as the difference between imaginary friends and alters, the importance of internal worlds, the portrayal of mental health professionals in comics, and the definition and explanation of introject alters.

This issue begins “some years ago” in Chicago (although we can pinpoint it to probably mid to late 80’s, due to the items in Marc’s room). A young Marc Spector is drawing with sidewalk chalk outside his apartment building, when he meets another young boy, about the same age, who introduces himself as Steven Grant. Marc takes Steven up to his apartment to show him his bedroom, as they chat about their dads, plans for the future, and toys. It seems like a normal interaction between two boys that are becoming fast friends…until Marc’s father walks in the room, and we see from his perspective that Marc is the only young boy in the room.

This initial scene, in pages 1-4, exhibits two common misconceptions about DID. The first is that the types of “imaginary friends” that many young kids create for themselves are similar to DID, or can develop into DID. If anyone listening to this has that fear for their own children, I can reassure you that imaginary friends and alters are two entirely separate things. Imaginary friends are basically fictional playmates that a child invents in order to help them work out difficult thoughts or emotions, such as fears, anxieties, or goals for the future. They are not classified as a mental disorder, and are generally seen as a normal childhood phenomenon that children will usually grow out of. Alters, on the other hand, are a literal divergence of the child’s sense of identity into two or more identities, which happens on a subconscious level due to intense trauma. Once a pattern of creating alters has been established, they can also be created from stressful situations or a general emotional need that the system has that cannot be met by any of the current alters, but these types of alters are still created on a subconscious level, not invented consciously.

Having said all of that, it is possible for DID systems to mistake actual alters for imaginary friends. I have talked to several other DID systems online who have said that after they were diagnosed as DID and started to meet their alters, they realized that they had talked to some of them when they were a child, but later dismissed it as imaginary friends that they grew out of. It’s also possible for a DID system to also have imaginary friends in addition to alters. When we were younger, we had an imaginary friend, and many years later found out that it was invented by one of our alters named Denise D. It was her role in our system to keep the secret of our multiplicity from ourselves by keeping our internal and external worlds separate, and she must have thought we were getting too close to discovering our internal world, and needed to be distracted. However, it seems that Lemire was trying to imply that Steven Grant was an imaginary friend of Marc’s that later evolved into an actual alter, and that’s not the way DID works.

But if we go with the assumption that Steven was already an actual alter that only seemed like an imaginary friend at the time, that brings us to the other common misconception about DID that is displayed in this opening scene. Many fictional stories about DID systems show one of the identities “seeing” one or more of the others in the external world, i.e., as a hallucination. I’ve heard that this can sometimes happen, but it’s nowhere near as common as movies and TV would have you believe. It’s far more common for us to only “see” and “hear” each other in the internal world of our own mind, not as hallucinations coming from outside ourselves. It’s probably portrayed that way for the sake of clarity for the audience, but it leads to perpetuating the confusion between DID and schizophrenia, in which hallucinations are more common.

In the next scene, on pages 5-8, we see a present-day Mr. Knight visiting Gena at her diner, in a “New Egypt” version of New York City. When he tells Gena that he needs to go back to the mental hospital (from which he escaped in a previous issue of this run), she asks why on Earth he would want to go back there. He tells her that he thinks that all of this, or at least some of it, might be in his head. When Gena protests that she feels real, Marc tells her “You’re real. Or at least you’re my memory of you. And that’s real. It’s really hard to explain. I don’t fully understand it myself.” I can definitely empathize with this type of confusion. While it’s unlikely that Marc is literally hallucinating pyramids and sand on top of the actual skyline of New York City, it’s not all that uncommon for people with DID to have some confusion between the internal and external worlds. It’s possible that all of this is occurring within Marc’s mind, but it seems so real to him that he thinks it might be the external world. Then again, with this being the Marvel universe, this could also be some literal spiritual realm to which Marc has been transported by Khonshu (or possibly Anubis).

Marc tells Gena that he has to save Crawley’s soul from Anubis, which may seem like it shouldn’t be all that important if he thinks that it’s not real anyway. It could be that Marc thinks that he can’t afford to take that chance, if there’s even a slight possibility that it might be the actual Crawley’s soul. Or maybe he realizes that even if it is within his own mind, it might still be important to see it all through to the end. Sometimes it’s necessary for alters to explore our internal world, to learn more about ourselves and how our own mind works. The understanding of ourselves that can be gained from these types of internal quests can often help us to function better in the external world. We have gone on several of these quests over the years, and it has helped us to understand our own mind, and how we can work together better as a system.

After this scene, we flash back again to Marc’s childhood, when Marc and his father are meeting with a child psychiatrist. It’s not specifically stated whether this is their very first appointment with the doctor, but it seems like it’s at least in the fairly early stages of treatment. After a brief conversation, the doctor tells Marc to wait out in the hall so he can talk with Marc’s father privately. Marc obeys the doctor, but of course, since he knows the conversation will be about him, he tries to listen through the door. He only catches pieces of the discussion, but what he does hear speaks volumes. I would like to compliment the letterer of this issue, VC’s Cory Petit, for the interesting way in which he portrayed the letters fading in and out to show the limited audibility.

I want to explore each piece of what Marc hears in depth, because even though it may seem plausible enough, it actually portrays several misunderstandings about the way the mental health profession works, at least from my own experience as someone who has been through a lot of therapy for many years.

“Very worried about…serious disorder”: It’s very unlikely, based on what Marc and his father told the psychiatrist, that he would immediately diagnose Marc as DID. Even in adults, statistics have shown that people with DID are usually misdiagnosed for about the first 5-7 years of their therapeutic treatment. Getting a DID diagnosis as a child is extremely rare, almost unheard of. It’s far more likely that the psychiatrist would have told Rabbi Spector that his son has created some imaginary friends, and that this is not unusual for children, but that Marc should probably have some therapy to help him work through whatever issues are leading him to feel the need for imaginary friends.

“Dissociative spectrum…distinct identities”: Even if Marc were diagnosed as DID, this terminology probably would not have been used back in the mid to late eighties. Back then, it would have been known as multiple personality disorder, it didn’t get changed to dissociative identity disorder until 1994. It was still classified under the category of dissociative disorders back then, and there are other dissociative disorders, such as dissociative amnesia, depersonalization, derealization, and fugue. But it is highly unlikely that a psychiatrist in that time period would have used the terminology “dissociative spectrum” to describe Marc’s condition. My guess is that Lemire was trying to equate it with the terminology that people use for the “autism spectrum” today, but as far as I’m aware, I don’t think that type of terminology is often used when discussing dissociative disorders even in current times.

“But he needs treatment immediately…therapy is not enough…medication”: It’s very unlikely that the psychiatrist would be that harsh with his language toward Marc’s father. Talk therapy is actually the most effective method for treating DID, so I’m not sure why the therapist would immediately dismiss it as being not enough. Also, there is no medication that is specifically made to treat DID. However, there are medications that can help with symptoms that often go along with DID, such as depression, anxiety, and confusion. But these types of medications can often have harsher side effects on children than they do on adults, so it probably wouldn’t be the first treatment recommended for young Marc.

“Possibly time away from home…more aggressive methods of treatment”: Here the psychiatrist seems to be referring to institutionalizing Marc, and possibly things like shock therapy. Options like this would almost certainly not be discussed with the father of a child as soon as they were diagnosed. First of all, the days of people with mental illnesses being locked away for years simply because they have a diagnosis have been over for decades. There are still behavioral health facilities, but they are not anything like what you see in movies like One Flew Over The Cuckoo’s Nest. In modern times, people are usually only institutionalized if they are a danger to their self or others, if they have committed a crime while not in a coherent state of mind, or if they decide they need help to overcome an addiction or other issue. It would probably not be recommended for a child as young as Marc unless he was actively harming himself, and several other options to help him had been tried and failed. The simple fact of being diagnosed with DID would definitely not be enough to warrant such an extreme response.

As for shock therapy, that is sometimes still used, but again, only in extreme cases, and I don’t think it would ever be used on a child as young as Marc. Shock therapy is a very controversial treatment nowadays. There are some who swear by it, such as the late Carrie Fisher, who claimed that it helped tremendously with her bipolar disorder, even though she admitted that it caused her to lose a lot of her memories of her past. Our system has never had to have shock therapy, and personally, we are grateful for that. We have talked to some other DID systems who have had it done, and it seemed to do more harm than good for them, often causing the creation of more alters who have intense phobias of electricity.

Marc’s attempted eavesdropping is interrupted by a voice behind him, asking what he is doing. When he says that he is listening to the doctor talk to his dad, the voice tells him “That man in there is not your true father…I am.” Marc turns to see Khonshu, in his bird-skulled appearance from the Ellis and Shalvey run of Moon Knight. Khonshu then tells Marc, “Soon, you will come to me. And you will be complete.” (I’m getting some serious Darth Vader vibes here…) When Marc’s father comes out of the psychiatrist’s office to tell Marc that he is very sick, and they will have to send him to a place where they can help him get better, he apparently doesn’t see Khonshu. It seems that only Marc sees Khonshu, as he tells Marc “I’m waiting…”

Throughout this story arc, it seems that Lemire is leaving it up to the interpretation of the reader as to whether Khonshu is an actual Egyptian god, or an aspect of Marc’s mental health issues. There has been a lot of debate about this over the years, but personally, I think it’s entirely possible that it could be both. It’s not all that uncommon among DID systems to have a certain type of alter called an “introject.” These are alters that are based on either fictional characters or real people that exist in the external world. They are basically the DID system’s “head canon” version of that person, based on their perception of what that person is like. Sometimes this can be a person who is one of their perpetrators, because they feel like they need to keep the abuse going, because it’s all they know. Or, it could be someone, whether real or fictional, that makes the system feel comfortable, as a way of alleviating the pain of the trauma.

Often, when these introject alters first come into existence, they will believe that they literally are that person. It is important for them to learn to come to terms with the fact that although they may be a version of that person, they are actually an alter in a DID system. This can be very difficult for them, because it feels like an invalidation of who they think they are. But they need to accept it, because if they don’t, it can create a lot of internal, and potentially external, conflicts. It could even be lethal, like for instance if they believed that they were bulletproof or had the ability to fly or heal from any injury. But it’s important to also keep in mind that although they are not really the person or character that they thought they were, they are no less real than any of the other alters. Once they have accepted the reality of their situation, they can start forming their own sense of identity as an alter, which will of course be influenced by their own experiences as part of their DID system. So as time goes by, they will become less of a carbon copy of the person or character that they were originally based on.

In our system, we have a few alters that are either introjects or introject-adjacent. We have a pair of identical twin sisters that were based on fictional characters from a story that Doug (yes, our Doug) wrote. But since Doug never really got around to finishing that story, the fictional character versions of them weren’t fully fleshed out, so the alter versions of them didn’t have a lot to pattern themselves after besides their names and appearances. It’s important to note here that even though these introject alters were based on characters that someone from our own system created, that does not mean that we invented these alters on purpose. The creation of these alters still happened on a subconscious level because of a traumatic event, our subconscious mind just chose to base them on these characters from Doug’s memories of the story that he wrote. The other introject-adjacent alters that we have are very loosely based on two characters from Marvel Comics, Rachel Summers of the X-Men and Danielle Moonstar, a.k.a. Mirage, of the New Mutants. But in the case of these two, it’s pretty much just their physical appearance, and in the case of Rachel, her first name, that are based on these characters. They don’t have superhero costumes or mutant powers in the internal world, and they don’t really identify as those characters. So it’s more like a case of “inspired by” rather than “based on” in their cases. It’s also possible for buildings and other locales in the internal world to be based on real life or fictional places, and we used to have a mansion in our internal world that was loosely inspired by Xavier’s School For Gifted Youngsters. (Gee, can you tell that we’re big X-Men fans?)

Getting back to the Marvel character that this article is supposed to be about, my interpretation of the issue of whether Khonshu is real is this: Marc really was chosen by the actual being known as Khonshu (whether he was a literal Egyptian god or an alien being or whatever the case may be,) and this is probably the first time that Khonshu reached out to contact Marc. But sometime in the intervening years, Marc’s mind may have created an introject alter based on Khonshu, because of the trauma of having the actual Khonshu messing with his head. This, of course, makes things more ambiguous, because Marc would have a difficult time determining which Khonshu is talking to him.

As the scene transitions again to the present, we see Mr. Knight once again hearing the call of Khonshu, and going down into the sewer to confront Anubis, who still holds Crawley captive. Mr. Knight tries to renegotiate to free Crawley, and Anubis at first refuses, saying their deal is finished. But when Mr. Knight presses the matter, Anubis finally admits that there is something he has lost in the Overvoid, and if Mr. Knight can retrieve it, he will release Crawley. However, Anubis won’t tell Mr. Knight what it is, saying only, “You will know it when you see it.” Crawley tries to tell Mr. Knight not to accept this new deal, just to let him go, but Mr. Knight says he can’t do that, and dives into the empty space around the ferry that carries Anubis and Crawley.

As he free falls through space on the next page, he hears voices saying things like “Not working. Increase the dosage,” and “Might need to try more aggressive methods.” This seems to indicate that he might be still in the mental hospital, and all of this might be happening within the internal world of his mind. But he seems to not care about that, because he needs to see his quest through to the end. As I said earlier in this article, sometimes it’s important to see these things through, because even if it is “all in Marc’s head,” it is a very real part of the structure of Marc’s mind, and learning more about that can help Marc and his alters to understand themselves better. As he lands in an upside-down world, he sees people in ancient-Egyptian-peasant-looking garb fleeing from something. He starts to ask what’s going on, but then turns around to see a very mean-looking man dressed in ancient Egyptian finery, riding a giant insect, with a pyramid floating in the sky behind him. “Oh, expletive deleted” indeed, Mr. Knight.

As we end on this upside-down cliffhanger (cliffclimber?), Khonshu decrees that it’s time for ratings. As a comic book story, I really liked this one a lot. Smallwood’s art was superb, especially the extremely realistic facial expressions. There were several bits of really creative visual storytelling, like the words fading in and out when Marc was eavesdropping, and the upside-down pages at the end. The plot was very compelling, the way it wove together the past and present, with interesting revelations in both. From a purely story and art perspective, I’m going to give this one a nearly full moon, at 9.5 out of 10.

However, I don’t think I can be quite as generous when it comes to the representation of mental health. The depiction of the DID itself wasn’t too horrible. It was somewhat inaccurate, but not necessarily stigmatizing. But the depiction of the mental health profession left a lot to be desired. I’m not going to go over every point of it again, since I already explained it in depth earlier in this article, but Lemire showed the psychiatrist as being a lot harsher in his treatment recommendations than what would likely have happened in real life. This is a common problem in fictional stories about mental health professionals, and can unfortunately lead people to be more afraid than they should be to take their children to therapy, or to seek help for themselves. I don’t think Lemire was necessarily trying to paint the psychiatrist as a villain, but I think that writers of fiction need to be more careful with how they portray mental health professionals, because many people already have a lot of fears about seeking treatment for mental health issues. And after all, avoiding treatment for mental health can be just as dangerous and potentially deadly as avoiding treatment for physical health.

However, I will admit that the portrayal of the psychiatrist could have been worse. At this point, he was just talking to Marc’s father about treatments. It wasn’t specified how long Marc was going to have to stay in the mental health facility, and the shock therapy was only hinted at, not explicitly stated or shown. So, with that, and the fact that Marc and his alters weren’t shown in a negative light, it gains a few points, but I think I do need to take off several points due to the importance of showing a more positive representation of mental health professionals. So I will rate this one at a waning gibbous, 6 out of 10, for the mental health aspect, for an overall average of a barely waxing gibbous, 7.75 out of 10.

That’s all I have for now, but I’ll be back with another article next month. Until then, may Khonshu watch over the denizens of the night.