DID: Myths and Facts

 

DID is a myth

There's much controversy surrounding the classification of DID: it used to be listed under Hysteria, then under Amnesia, now there's debates on whether it should be under Post-Traumatic Stress Disorder. Mental health community has disagreements on the cause of DID and the appropriate treatment modalities for it, but nobody disputes the fact that there are patients presenting with DID symptoms, that these symptoms can cause them significant impairment in functioning, and, if so, require treatment.

DID is rare

Statistics range between 0.01% and 7% of population, depending on how you count. For comparison, depression affects 6.7% of americans, diabetes - 8%, asthma - 7.4%, alcoholism - 30%, autism - 0.01%, OCD - 2%, PTSD - 7.8%, bipolar disorder - 2.6%. So DID is somewhere between autism and depression.

DID is a form of insanity

Some people believe that DID, schizophrenia, and bipolar are essentially the same, and that anyone who has either of these conditions is a danger to society This myth has more to do with misconceptions surrounding mental illness overall than DID in particular. In reality, mental illness and insanity are two separate concepts. According to World Health Record, 25% of people worldwide are affected by mental or neurological disorders at some point in their lives. According to the National Institute of Mental Health, insanity defense is used in less than 1% of cases, and isn't always successful. As for all mental health problems being the same - the current DSM (Diagnostic and Statistical Manual of Mental Disorders) lists approximately 279 different disorders. Schizophrenia is a thought disorder. Bipolar is a mood disorder. DID is a dissociative disorder. The three have very little in common, and neither of them automatically makes you insane. It's kind of like saying that asthma, diabetes, and osteoporosis are the same thing because whoever has either of these is a cripple: insulting, and not true.

DID is a healthy norm

Dissociation is a spectrum and all people dissociate to one extent or another. However, DID stands for "Dissociative Identity Disorder", i.e. the extent of dissociation experienced by the person with this condition is beyond normal healthy fluctuations, and causes them significant impairment in functioning. This impairment is one of the required diagnostic criteria, i.e. you can't be diagnosed with DID if you aren't experiencing it. Some people with DID don't don't feel their condition is causing them any inconvenience and don't like to be labeled mentally ill. However, arguing that something called "Dissociative Identity Disorder" is not a disorder makes for very confusing conversations, especially since many people do in fact feel that their condition disrupts their life, and want help with it. If you're talking of something other than DID, i.e. the disorder listed in DSM under code 300.14, it would make sense to use a different term, for the sake of clarity. For example, "multiplicity" might be a good alternative.

DID is caused by severe abuse

Many mental health professionals believe that DID is caused by early childhood trauma. The type of trauma can vary: abuse, natural disaster, war, hospital stay, etc. Whether a child develops DID or not depends on the impact of the trauma and on the child's resilience: a healthy and happy child with a great support network will be able to withstand more than a less fortunate one. Many children experience severe trauma but don't develop DID. Having DID doesn't prove that you suffered "worse" abuse than others, just like committing suicide doesn't prove that your life is harder than lives of other people - it only proves that it's more than you can cope with.

DID is iatrogenic

Some mental health professionals believe that DID could be iatrogenic, i.e. caused by therapy in adulthood rather than trauma in childhood. There was a boom of dissociative disorders around 1980s-1990s because back then therapists used modalities which encouraged dissociation rather than curing it (e.g. hypnosis or Internal Family Systems). Psychology is a young science, and mistakes do happen sometimes. Most therapists use different modalities now, but the people who were harmed in 80s-90s are still in therapy, battling a condition that was worsened (if not outright caused) by previous therapy. However, DID also exists in clients who were never exposed to those modalities; the first documented case was that of Jeanne Fery, 1584. Thus, while some cases of DID might be iatrogenic, others must be caused by something else. Whatever the cause, someone who has DID deserves help and support, and should not be blamed, shamed, or ridiculed for their condition.

DID is a form of attention-seeking

Some people attempt to gain attention by malingering various disorders, e.g. gluten intolerance, cancer, or DID. There are no blood tests to confirm or deny mental illness, but faking it isn't any easier than faking fluent Mongolian. Mental health professionals successfully sort through these issues and provide appropriate treatment for whatever condition the client presents with, be it DID, one of the cluster B personality disorders, factitious disorder, or anything else. Outside of therapy, the diagnosis rarely matters because it doesn't create any special entitlements. Some people with DID are shy and considerate, others are annoyingly dramatic - we come in all shapes and forms. Those who are needy, manipulative, or otherwise intolerable, face social rejection regardless of their diagnosis, and claiming DID (real or imagined) doesn't make them any more likeable.

DID is a form of creative self-expression

DID receives a lot of media attention due to its controversy, so it's understandable that some of the younger folks find it fascinating and want to explore the concept. Most people can recognise different aspects of their personality, and it can be fun to name them, draw their portraits, write fiction stories about their adventures, etc. Split personality anime is particularly popular: elves, kittehs, cute toddlers wearing oversized mary jane shoes, etc. There's nothing wrong with creativity, but it's crucial to differentiate between a hobby and a mental health condition. The young artist engages in these activities because it's fun; they can create as many characters as they like, edit them, scrap them and create new ones, or abandon the project and take guitar lessons instead. Someone with DID, on the contrary, is not choosing to have it; it's causing them serious impairments, and they can't make it stop at will.

DID is a demonic possession

People who never heard of DID sometimes describe it as demonic possession: some external force took over you and made you do things you later cannot explain and have no recollection of doing. Such experiences can indeed be confusing or even frightening, but they aren't caused by anything external, and have a logical explanation. Dissociation involves detaching from some of your experiences, thoughts, and feelings because they are too painful to deal with. They stay bottled up inside, and occasionally burst out. There's nothing sinister in there, it's simply old pain that needs to be healed. Psychotherapy can help you become aware of it and process it, so that such incidents would stop. It takes time, but is doable.

Alters are people

In legal and physical sense a person is a sum of their alters: they share the same body, passport, and responsibility for each other's actions. It's similar in psychological sense too. The purpose of dissociation is avoiding intolerable situations by spacing out and letting another alter take over and handle the problem. As a result, neither alter develops the skills to handle the full spectrum of life. One can have great assertiveness, but fear friendships. Another can be good at bonding with people, but unable to handle conflicts. They complement each other, and the system overall can be functioning well, but each separate alter wouldn't function as well on their own.

Alters can have individual physical characteristics

Alters are psychological entities, so they can't have physical characteristics by definition. Physical characteristics apply to the physical body. However, some people speak of their alters having unique physical conditions, e.g. one of their alters is allergic to cats while others aren't. It can be quite confusing, but has two explanations. First, it's possible for alters to be unaware of the fact that their body is allergic to cats: whenever they get close to one, the alter who is aware of the allergy takes over and deals with the allergic reaction, so other alters can remain blissfully unaware. Second, it's possible for DID to be comorbid with somatic symptom disorder, where you experience symptoms of a physical illness without actually having it. The body is not allergic to cats, but one alter believes they are, and actually starts sneezing. Somatic symptom disorder can be resolved with therapy.

DID is easy to spot in others

If illnesses were easy to diagnose, there would be no need for doctors. Even a common cold can present differently: it might start with a runny nose and develop fever later, or it might start with fever and progress to sore throat, skipping runny nose entirely. DID is a more complex condition than a common cold, and each person with DID can present differently at each point in time. Some experience time loss on daily basis and admit it to their friends - others experience it rarely, are unaware of it, or simply keep it to themselves. Additionally, people can be moody and absent-minded for a multitude of reasons besides DID. If you feel your friend needs professional help, you can suggest it, or wait till they decide to seek it on their own terms. They might be seeing someone already, and simply not wanting to update you on it. Playing therapist with your friends damages the relationship and doesn't help them any.

All people with DID have to integrate

Memory loss that comes with DID can negatively affect relationships, employment, time and money management, etc. It's inconvenient, and most people with DID want to do something about it. Some wish to get rid of their alters; that's impossible, just like it's impossible to get rid of your anger or sadness. Others hope to merge all alters into one. Yet others want to keep who they are, but establish co-consciousness and cooperation, so that there's no memory loss and all alters work as a team rather than pulling in opposite directions. Both of these choices take time and effort, but eventually result in improvement of quality of life.


WHAT IS DISSOCIATION?

Dissociation means the separation of things that were, or usually are, together (e.g., associated.) In their minds, people usually remember a whole event, including sights, sounds, feelings, and meaning. When dissociation occurs, the remembered event may be devoid of meaning or feelings, which are separated and stored in another part of the mind. In other words, the different parts of the memory are stored and recalled separately, not as a congruent whole. Strictly speaking, dissociation is a mental process, a way of recording and storing information. It is one of the mind’s ways of operating. Some information may be dissociated, while other information is stored as a whole. Sometimes you hear “So-and-so is dissociated.” This is shorthand for saying that their mind uses dissociation. A person is always a whole person, regardless of how their mind works. Nobody stores their feet in one place, their nose in another, and their mind someplace else, even though some days it may feel that way.

WHAT CAUSES DISSOCIATION?

Dissociation occurs when a person experiences extreme stress or stimulation. Under these conditions, life is experienced differently and the memory of an event is stored differently in the mind. Research suggests that the brain operates differently when experiencing or recalling stressful and non-stressful events. Here is a personal example that many people may be able to relate to. I remember skidding badly on an icy street. As the car skidded, colors seemed brighter and time passed very slowly, I was enveloped in total silence even though the radio was on and I experienced no thoughts or feelings whatsoever. I was aware of only the visual part of this experience as it happened. Later, the emotions hit. I was so frightened that my heart pounded and my legs shook, but I could no longer clearly remember the visual memory. When a child is severely abused, extreme stress occurs repeatedly. Many events are experienced in a state of shock, stored in a dissociative state, and recalled in fragments. If a child dissociates extensively, even memories of less stressful events can be dissociated. Perhaps the child is still in shock, perhaps the child’s sensitivity to stress is raised, perhaps the mind comes to store all material in a familiar way. There are innate temperamental differences between people. Some people probably dissociate more easily than others or require less stress to change over into dissociative mode.

WHAT IS A FLASHBACK?

A flashback is a dissociated memory that returns to consciousness. It can be a smell, a taste, a sound, an image, an emotion, or all these things together. It can last a moment or linger on for weeks. People describe smelling alcohol or perfume when none is present, hearing a phrase over and over again in their heads, feeling panic or dread for no logical reason, or seeing images, like snapshots or movies behind their eyes. All these are fragmented memories rising up into consciousness. They can be extremely vivid and can appear to be happening in the present. The more fragments come together at the same time, the more intense the flashback. Flashbacks are terrifying if you don’t know what they are and if you don’t realize they will eventually stop. Experiencing flashbacks doesn’t mean you are going crazy - it means that you are at a point in your life when you are able to deal with things that you couldn’t cope with earlier. They tend to lose their intensity when you have assembled the fragments into a coherent memory, talked about it, cried about it, and absorbed the memory into your life.

WHAT IS MULTIPLICITY?

In some children, the mental fragments are organized or arranged into “personalities” which seem to have a history and a life of their own. Often the personalities are so separated that they are not aware of each other’s existence. This is called an amnesic barrier.

Imagine a child with a mother who is loving one moment and cruel and sadistic the next. The child will obviously react differently, depending on the mother’s mood. The child will learn different ways of responding to the “good” mother and the “bad” mother. All children do this to some extent because no adult is perfectly consistent. Now imagine that the child is so stressed out that memories of interactions with the “bad” mother are dissociated. When the “good” mother is around, the child has no knowledge of the “bad” mother, or of the “bad” child. But as soon as the mother turns nasty, the child switches, and knows exactly how to react. That’s multiplicity.

WHAT IS AN ALTER?

An alter is one personality of a person with multiplicity. The personality who is “out” most of the time is often called the host personality, and personalities seen less frequently are called alternative personalities, or alters. Some people have only one or two alters, others have hundreds or even thousands. Some people with multiplicity experience each alter as a separate person. Others experience them as different from their usual self, but not as different people. Multiplicity is not exactly the same from person to person and each person’s experience of their inner reality is unique. Often alters have names, have a distinct age, and have specific jobs to do. One may be in charge of feeling anger, another of going to school or work, another may be the one who decides which alter gets to be in control of the body at any given time. Alters may have a different gender from the body or a different sexual orientation from the host. There may even be alters who are animals, objects, or abstract ideas. Sometimes people have alters who are experienced as being dead or immortal. The formation of alters is a natural psychological process, given extreme early childhood stress. Abusive adults who are aware of the process can manipulate and train the emerging personalities to their own ends. Some survivors of ritual abuse have alters trained by their abusers to do certain tasks and to behave in ways desired by the abusers. And some survivors have alters organized in elaborate patterns designed by the perpetrators, with strict rules about how the alters communicate with each other.

WHAT IS CO-CONSCIOUSNESS?

When two or more alters are aware of what is happening in the present, they are said to be co-conscious. When two or more alters share control over the body’s actions, they are said to be co-present. A person may have alters who are unaware of each other, alters who are always mutually aware of each other, and alters who are aware at some times but not others. Alters who are aware of the presence of other personalities know they are multiple, while alters who aren’t in contact with other personalities firmly believe they are “the only one there.” An alter may even be multiple.

WHAT IS INTEGRATION?

Integration is used to describe two different processes. One is the process of alters learning to communicate and cooperate and sharing their memories with each other. The other sense of the word is the actual merging (or fusion) of two or more alters to become one. Nothing is lost: all memories, talents, and personality traits are preserved, but organized in a different way.  One survivor described integration as “falling in love with myself” rather than as the death of part of herself, as she had feared. Some people do not fuse and find that their lives are perfectly satisfactory as long as their alters are communicating well. Others fuse partially, reducing the number of alters. Most people with many alters do this in stages, allowing for time for the system to stabilize and get used to the new internal organization. Some people “become one” for a period of time and then either new alters are formed to deal with new life circumstances or the former alters split off and become themselves again. Living with being multiple is an on-going process, just like living with not being multiple is. There are choices to be made, decisions that make life easier or harder. There is no hard and fast rule about what the “best” way is - each person’s path in life is unique

DSM-IV (Diagnostic and Statistic Manual of Psychiatric Disorders version IV) Criteria of DID:

  1. The presence of two or more distinct identities or personality states; each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
  2. At least two of these identities or personality states recurrently take control of the person's behavior.
  3. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
  4. Please browse our resources library and particularly this page for more information and support.


All a man's affairs become diseased when he wishes to cure evils by evils.
~ Sophocles
This page was last updated on February 16th, 2017
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