What is Dissociative Identity Disorder?
The single best go-to resource on DID is probably the International Society for the Study of Trauma and Dissociation (ISSTD) found at http://www.isst-d.org . There are a vast number of articles there for victims as well as professionals. Their page on Dissociation: Frequently asked Questions will probably answer most questions of people who are new to this field: http://www.isst-d.org/default.asp?contentID=76. Another website to explore might be http://www.net-burst.net/. However………………..
Simply Put:
DID used to be called Multiple Personality Disorder (MPD), which I still prefer because that’s how it seems to me/us. After all we all live together in one body. And that’s basically the definition of DID. In DID there are at least 2 distinct identities or personalities who can take executive control of the body. Many of us refer to that as “being out”. There can be two personalities, a dozen or so, or even thousands in cases of polyfragmented DID.
How does someone become DID?
DID is the result of chronic severe neglect, physical or sexual abuse, and/or other forms of trauma in children before the age of 7 or 8. Dissociation occurs when children cannot deal with the trauma and need a psychological escape. Dissociation is a coping mechanism for surviving the unsurvivable. However, there is actually an entire spectrum of dissociative disorders of which DID is the most severe.
What does dissociation look like to the world?
Clinicians looking for dissociative disorders sometimes use an instrument called Structured Clinical Interview for Dissociative Disorders (SCID-D); http://www.scid4.org/faq/scidfaq.html . This set of questions highlights the 5 expressions of dissociation: depersonalization, derealization, amnesia, identity confusion, and identity alteration. Depersonalization is like an out-of-body experience. It feels like you don’t belong in “that body”. Derealization is the sense that the world is not real. It could look odd, distorted, blurred… all sorts of things. Amnesia is just what you think, you can’t remember. Often there is no memory of commonly known personal information (like your address or phone number). But it can even be as severe as having no memory of years of your life. Identity confusion is the observation of different personalities. Along with that can be a sudden distortion of time (even year), where you are, what’s happening, etc. Finally, identity alteration is a bit more subtle in that there may be a sudden change in emotion, facial expression, and confusion about what just happened. So how does this manifest on the outside? DID is rarely dramatically noticeable with abrupt extreme changes in personality. More commonly you have to be really looking for it to notice that the person in front of you is not the person you were talking to a few minutes ago. One must remember that the person has had a lifetime to find coping mechanisms to be “normal”. (Note: there are a variety of tests that can be used to diagnose DID, and some of them are discussed here: http://www.net-burst.net/counselor-therapist/psychological-test-DID.htm. )
What does DID look like to the multiple?
That’s all over the map. Some multiples, like us, went most of our lives never having any idea anyone else was “in there”; that’s called being non-coconscious. On the other extreme, some people remember growing up with voices, friends, other parts inside. They could watch what the other one was doing all the while knowing it wasn’t “them”. That’s coconscious. Of course, there is everything in between. Many people refer to the sum of all the personalities to be a system. In some multiples there are systems within the system, or subsystems. It can get extremely complicated, and every multiple is different. It’s believed that some multiples never know they are multiple. Most multiples over time eventually have enough problems with life that they seek help, although the average time in clinical therapy is somewhere around 7 years before anyone figures it out; http://patient.info/health/an-introduction-to-dissociative-identity-disorder. The reason for that is that multiplicity is an adaptive behavior since childhood. Everyone has spent their life trying to look normal, no matter how abnormal it may look to others. More importantly, multiples typically seek help for other things such as physical pain, anxiety, PTSD, depression, etc., not having a clue they are multiple. In some cases only one personality goes to therapy. The others never present in that venue and so are missed.
Are all personalities/ identities the same?
Each personality will generally have his or her own world view, memories, and capacities. Furthermore, probably all people with DID would tell you that not all personalities are equal. Some researchers divide personalities into Emotional Personalities (EP) that deal primarily with traumatic memories and Apparently Normal Personalities (ANP) that tend to deal more with normal life. We have found the designation of Primary Identities vs. Alters to be helpful http://www.rcm-usa.org/PDF%20Files/Primary%20Identity%20Approach%20Overview.pdf . In this paradigm alters are the heroes, taking on various aspects of the trauma in order to save the Primary Identities. Alters can be well-formed or highly fragmented, but they rarely have a strong sense of “I”. On the other hand Primary Identities are more like the original person prior to trauma. There can be many of them, but they each have a very strong sense of “I”. In many cases the original or core person is hidden. Within this overview of alter types there are many, many defined jobs, which is beyond our discussion here, but can be reviewed at http://svalispeaks.com/?p=208.
What makes a personality go inside and another one come out?
No one really knows how the complexity of all of that works. Different environmental triggers, natural and purposed, usually cause a switch. Changes in internal state, such as stress or needing to access a specific bit of memory, can cause a switch. Many multiples can change who is out on purpose with comprehension of what they are doing. Going back to the discussion on types of personalities, some suggest the alters have the most dramatic switches because of dissociation. On the other hand Primary Identities are more related and so the change from one primary to another may be less dramatic. We’re not sure if that is true, but it’s something to contemplate if you are a multiple.
If you have questions, please connect with me here: Contact Me