You’ve probably heard of Multiple Personality disorder? Well, according to western medicine that no longer exists. Now it’s referred to as DID. Thought of throughout the ages as demon possession, Dissociative Identity Disorder is one of the most stigmatized and misunderstood mental health conditions there is.
Now widely understood as a result of extreme childhood trauma, it occurs in about 1% of the population. The individual displays multiple, dissociative personalities that come out at various times, making them appear to have different people living inside of them.
Although Hollywood portrays this condition as scary and violent, DID people are actually less violent than the general population, often turning their anger in on themselves, causing suicidal thoughts/behaviors and self-harming practices.
What is Dissociative Identity Disorder?
Dissociative Identity Disorder is characterized by the presence of two or more distinct identities or personality states within an individual. These identities, often referred to as alters, often differ in behaviors, attitudes, memories, and even physical characteristics. The transitions between these identities are often accompanied by memory gaps and a sense of detachment from reality.
DID can have a wide range of symptoms that manifest differently from case to case. Folks with it experience amnesia, identity fragmentation, oddly distinct shifts in behavior, voice, or mannerisms, and some experience hearing internal voices or conversations. Individuals with DID often struggle with multiple conditions simultaneously such as depression, anxiety disorders, self-harm, and substance abuse, which can really complicate establishing DID as a diagnosis.
What is Dissociation?
Like most things in health especially mental health, dissociation exists as a spectrum. On the low or non-diagnosable end, we’ve all experienced some form of dissociation…Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity.
I bet you have done things automatically that you’ve done hundreds of times like pumping gas or driving to work. While on autopilot, we often space out and think of other things, and wouldn't be able to recall what we were doing in those moments if we tried. This is a mild form is dissociation. It’s even more likely to happen when we are severely stressed or tired. As our minds become preoccupied with whatever is stressing us out or we “go through the motions” because thinking is hard when exhausted.
But this experience goes to a whole different level in people with DID. A hallmark of someone living with DID is having chunks of time that are just unaccounted for. Blank places in their memory. Often DID people will blank out completely when a different personality takes over, and not be able to recall what happened while this other personality was present. Its almost like each personality has its own separate memory bank. Which makes for a very confusing experience.
Dissociation can also be associated with out-of-body experiences. Feeling detached from their own body or from their emotions, even from the environment they’re in. Some people feel like they are in a vehicle but acting as a passenger, unable to control what happens or what they do.
Why dissociation happens
People who develop DID experience repetitive and often extreme trauma, be it physical and/or emotional, at a very early age, often before age 10. Since as children DID people were unable to get away from the situation physically, their mind created other states of consciousness to allow them to disassociate from the pain of the situation and “be” somewhere else…and eventually someone else.
Each of these personalities or alters were at one point in time created to protect the child who could not protect themselves. Specific situations have specific strategies that work well in them. Repeated exposure to a certain kind of stress launches specific protection mechanisms that eventually personify into alters that are protective in that specific stressful or traumatic situation.
Common manifestations of alters/protectors are:
Host: The part of you that has control of the body most of the time and has no/few traumatic memories. Your brain fragmented these memories into other identities, as follows…
Child: The little version of you (often called littles), stuck at the age of the abuse. Meant to hold the traumatic memory or conversely act as the happy carefree child you wish you could have been.
Protector: They deal with the situation in times of perceived danger. This alter can also harbor fear, anger, and sadness.
Caretaker: Cares for other alters, nurturing the younger and more vulnerable ones.
Gatekeeper: Often appearing emotionless, they've witnessed all the trauma and decide which alter gets to come out and which memories are accessed.
Prosecutors: Anger, self-judgment, and self-hate cause this alter to harm the others.
Non-human: Fairies, animals, ghosts, and inanimate objects like a toaster. Created as a way to feel strong and capable as something else.
Dead alters: Created when the child thinks they have died from the abuse.
Sexual alter: Keeps sexual abuse and rape memories compartmentalized so as to protect the host from them.
Fragments: An undeveloped alter that only holds one memory or emotion.
All Alters are protective.
Do you see how each of the alter types in the above list serve to protect the child in some way? The protector is self-explanatory. The child lives in denial so as to live the life they should have had as a child. The caretaker is a stand in for the mothering one should have had. The gatekeeper chooses the best coping strategy for the situation. Prosecutors prosecute ones self most of the time in a similar way to the “if I hurt me first you can’t hurt me” strategy we see in self-deprecating middle schoolers. The sexual alter keeps sexual trauma locked away into one place/person. A fragment does its protecting by locking away the worst memories into a nearly contextless fragment of the self so they hurt less. The importance of the protective aspects of these alters cannot be overstated and is foundational to integrating alters.
Get to Know Yourselves
Treatment for individuals with DID generally involves long-term therapy aimed at promoting integration and cohesiveness among different identities. Psychotherapy, specifically trauma-focused approaches, such as cognitive-behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), are commonly used. These therapies focus on processing traumatic memories, building coping mechanisms, and fostering internal communication and collaboration among identities.
There is no medication for dissociative disorders. Which is probably the single biggest reason so many medical professionals don't believe it is even real. Some clinicians will treat the depression and anxiety that often comes along with this condition with medication, and this is often the first line of treatment to ensure the safety and stability of the individual if they present with suicidal tendencies. But medication alone will never solve the problem. Upon stabilization, the patient can choose to engage in trauma-based therapy to come to terms with the things that have happened to them. A well-trained DID therapist will help you find coping mechanisms and ways to live in harmony with yourselves. Eventually dropping the last “s”
No Shame
Experiencing and remembering trauma often causes the victim to feel all kinds of things, especially guilt. It's almost as if they feel they deserved what happened to them. Because they felt helpless and couldn’t stop what happened, they often blame themselves and engage in self-destructive behaviors. The truth is, the traumatic events you experienced were NEVER your fault. They were the result of a mentally ill person who took their issues out on the most vulnerable and helpless person in the situation… you.
So If you’re a DID person or know one when the guilt feeling comes and you get down on yourself, remember it was NOT your fault! Seek help from friends and family, and seek treatment. Find a trusted DID experienced therapist that you feel comfortable and genuinely seen with. This person could be your lifeline, so reach out for help now. Consider joining a community of people who have this trauma-based condition so you won't feel alone. DID is real. You deserve help. Don’t let the biases of outdated medical paradigms make you second guess yourself.
*As an emergency mental help number, you can always call 988 any time of the day or night to talk to someone if you’re feeling suicidal or having a mental health crisis.*
Diagnosis and Challenges
Diagnosing DID can be a complex and challenging process. Many individuals with DID experience significant delays in receiving an accurate diagnosis due to the covert and complex nature of their symptoms and the lack of awareness and education among western healthcare professionals. Diagnosis typically involves detailed interviews, psychological tests, and collaboration between mental health professionals. It is crucial for clinicians to distinguish DID from other conditions with overlapping symptoms, such as schizophrenia or borderline personality disorder.
When the book Sybil came out in 1973, there was a flood of people coming forward to get diagnosed with what was called multiple personality disorder at the time. In fact, there were more diagnoses made in the 70s than at any other time in history! Although this book was based on someone who was faking having multiple personalities, there are written records of DID cases throughout history dating back to the 1700s. Cave paintings also gave some indication of this condition. My point is, this is not a new or made-up condition. This is something that’s been around since childhood has been around.
Treatment: Work Together as a Team
Treating DID requires a comprehensive and multifaceted approach that aims to integrate these fragmented identities into a cohesive whole. The following explores some of the main treatment modalities employed in managing and addressing the symptoms of DID.
Psychotherapy:
Psychotherapy, particularly specialized approaches such as Dissociative Disorders Treatment (DDT), is considered the primary treatment for DID. The main goal is to establish a trusting therapeutic relationship and work towards integration and collaboration between different identities. Techniques used may include:
a) Trauma-focused therapy: Addressing the underlying traumatic experiences that led to the development of DID is crucial. Therapists may utilize trauma-focused techniques such as Eye Movement Desensitization and Reprocessing (EMDR) or cognitive restructuring.
b) Integration therapy: The process of integrating dissociated identities into a unified sense of self is a central aspect of DID treatment. This involves promoting communication, cooperation, and understanding between identities, leading to increased cooperation and decreased fragmentation.
c) Grounding techniques: Developing skills to ground oneself in the present moment can help individuals manage dissociative symptoms effectively. Techniques like grounding exercises, meditation, and mindfulness are commonly employed for their effectiveness in regulating the nervous system. A well-regulated nervous system is key to preventing dissociation.
Creative Therapies:
Creative therapies, such as art therapy, music therapy, and dance therapy, can be beneficial in DID treatment. These expressive modalities provide alternative channels for individuals to explore and communicate their thoughts, emotions, and experiences. Creative therapies can help in bridging the gap between different identities and facilitating self-expression and integration.
Hypnotherapy:
Hypnotherapy can be employed cautiously in the treatment of DID. Under the guidance of a trained professional, hypnosis may be used to facilitate communication between identities, access repressed memories, or promote integration. However, it should be approached with care due to the potential for retraumatization or false memories.
Supportive Interventions:
Supportive interventions are crucial in the overall management of individuals with DID. Creating a supportive and validating environment where individuals feel safe to express themselves is essential. This may include involving family members or loved ones in the treatment process, providing psychoeducation about DID, and offering support groups or peer networks where individuals can share their experiences and gain mutual understanding. Its fundamental to remove people who invalidate DID from your support group. Whether that be a friend a family member or a medical provider.
If you or someone you know is struggling with a dissociative disorder, know that there's help available. I hope you choose to embrace yourselves. You deserve to feel whole, no matter how many individual parts you may have. When you get to know the many sides of yourself, you can come to accept the wonderful, different, and unique persons you are. Your alters are all you, were created by your brain to protect you, and all deserve love, acceptance and appreciation.
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