Disclaimer: The content of this article is for informational purposes only and should not be considered as financial, medical, or psychological advice. It is important to consult with qualified professionals for personalized guidance and recommendations in these respective areas.
Dissociative Identity Disorder (DID) is a complex mental health disorder that can be ranked among the most misunderstood and wildly misrepresented psychological conditions in mass media and pop culture today. Characterized by the presence of two or more distinct states of consciousness (or identities) within a single individual, DID is theorized to arise as a response to chronic severe trauma induced upon an individual during his or her early childhood development. This article aims to help demystify DID, clarify common misconceptions, explore treatment options, and underscore the importance of mental health care.
What is Dissociative Identity Disorder?
DID is a disorder that can be described as reflecting a person's complex psychological response to overwhelming and repeated trauma experienced during the formative years of childhood. When the developing mind encounters insurmountable stress, at any stage in life, it may employ dissociation as a defense mechanism—partitioning off parts of the self that experienced trauma.
For example, a warfighter can experience combat-induced trauma, and respond to such trauma by segregating the memories of the harmful experience (the emotional part or EP) from the sense of self (the apparently normal part or ANP). After combat, the veteran may experience intense memories of the violent encounter, sometimes as if it was actually occurring again. Theorists suggest, to help the mind cope, the brain dissociates from harm or perceived harm to help the person function and cope in daily life.
Some theorists suggest that when a child is still developing their core sense of identity, this identity-construction phase can be maladaptively disrupted by repeated instances of severe trauma. Thus, in such cases, the surviving child constructs a multiplicity of senses of identity, instead of building a single core identity (even without realizing these symptoms until later in life).
These distinct identities as created by maladaptive dissociation during childhood are now called alternate states of consciousness, or "alters," each possessing to some extent their own perceptions of life, memories of lived experiences, and even different ages, sexes, and ethnicities. These alters may serve various roles, sometimes aiding the individual in coping with situations that the person would otherwise find intolerable.
Of Branching Trees and Shattered Glass
Up until recently, the mainstream way of articulating DID is that it is a condition in which a "primary personality" is dissociated from personalities that are not that person's "true self." However, another, more emergent model has been suggested that appears to shed more light on the issue - a model that can be referred to as "functional multiplicity."
Instead of "primary/secondary" identities, functional multiplicity is rather like a growing tree that bifurcates to form new branches, or a shattered mirror that's broken into multiple pieces. Which one is the "original," and which one is the "alter"? This metaphor arguably offers a more accurate representation of how DID manifests within an individual. In this emergent model, each alter is not an imposter or a fragment that is fundamentally different from the "original" piece but is, instead, a vital piece of the whole, carrying its unique perspective, memories, experiences, and reasons for coming into existence.
This metaphor-hunting gets into the questions of "What is real?" and "What is not real?" However, current understanding of the illness suggests that all of these identities are real. They are simply aspects of that person that are so pronounced, that they come off as "different" or "other" personalities. One goal in psychotherapy for people with DID is reintegration of the real "selves" into one cohesive "self" - or, at the very least, functional harmony between these "selves."
The Emergent Model of DID
This model suggests that, rather than having one "true" self and multiple "false" selves, individuals with DID possess a mosaic of equally valid identities that have emerged in response to severe trauma. The trauma, acting like the cut that splinters the tree or the impact that shatters the mirror, necessitates the development of these alters as a survival mechanism. Each alter serves a purpose, whether it's to handle specific types of stress, to carry memories too painful for the others, or to manage particular aspects of daily life.
Therapeutic Approaches in the Light of the Emergent Model
Modern therapy for DID, aligned with this emergent model, focuses on fostering communication, cooperation, and possibly integration among the alters. The goal is not necessarily to merge all identities into a single one but to ensure they can function cohesively, much like piecing together a mirror to reflect a unified image, albeit with the understanding that the lines of division may still be visible.
Integration, in this context, is about achieving a harmonious internal system where all parts are acknowledged and respected for their contributions to the individual's survival and well-being. It involves therapeutic strategies that encourage alters to share their experiences and work together to navigate life's challenges. For some, complete integration may be the goal, while for others, the objective might be to reach a state of functional multiplicity where distinct identities coexist in a cooperative and mutually supportive manner.
Navigating DID with Compassion and Understanding
This emergent perspective on DID underscores the importance of approaching the disorder with compassion, recognizing the resilience behind the formation of each alter, and the collective effort towards healing. Therapy becomes a space where individuals can explore the depths of their internal worlds, learn from each alter, and gradually create a sense of wholeness from their collective experiences.
Understanding DID through the lens of the emergent model dispels myths of "fakeness" or hierarchy within the system of alters. It emphasizes that healing and managing DID involves embracing all parts of oneself as integral to the fabric of their being. This approach not only fosters self-acceptance but also encourages societal acceptance of DID as a legitimate and complex response to trauma.
One prevalent misconception about DID is its confusion with schizophrenia. While both are serious mental health conditions, they are distinctly different in symptoms, causes, and treatments. Schizophrenia is primarily characterized by delusions, hallucinations, and disorganized thinking. In contrast, DID involves the presence of multiple identities within a single individual, with switches between these identities often triggered by stress.
Another common misunderstanding is the portrayal of DID as inherently dangerous or monstrous. Media representations have often sensationalized DID, depicting individuals with the disorder as volatile or linked to criminality. In reality, those with DID are far more likely to be victims of violence than perpetrators. Understanding DID requires compassion and recognition of the disorder as a sophisticated coping mechanism developed in response to extreme trauma.
Treatment and Coping Strategies
Treatment for DID typically involves psychotherapy, with the goal of integrating the various alters into a cohesive identity or achieving harmonious coexistence among them. Therapy may focus on addressing the trauma at the root of the disorder, improving communication between alters, and developing coping strategies for managing dissociation and trauma-related symptoms. No one-size-fits-all treatment exists for DID; therapeutic approaches are tailored to each individual's unique experiences and needs.
Many individuals with DID utilize the concept of an "inner world"—a mental space where they can interact with their alters. This can occur through visualization, meditation, or recurring dreams. The inner world serves as a therapeutic tool, allowing individuals to engage with their alters, understand their perspectives, and work collaboratively towards healing. By fostering internal dialogue and cooperation, individuals with DID can gain insights into their own minds and develop strategies for navigating daily life.
The Path to Healing
Understanding and treating DID is an intricate process that underscores the importance of mental health care. It's crucial for individuals experiencing symptoms of DID, or any mental health condition, to seek professional help. A trained therapist can provide the support, strategies, and understanding needed to navigate the complexities of DID.
Your Mental Health Matters
Living with DID is a journey of self-discovery, resilience, and healing. By fostering a deeper understanding of DID and dispelling myths and misconceptions, we can create a more compassionate and supportive environment for those affected by the disorder. Mental health is an integral part of our overall well-being, and taking steps to care for our psychological health is a responsibility we all share. In doing so, we affirm the value of each individual and the importance of nurturing a healthy, integrated sense of self.
International Society for the Study of Trauma and Dissociation. (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. This document offers comprehensive guidelines for the treatment of DID, based on the latest research and clinical expertise.
Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. Guilford Press. A seminal work on DID, offering insights into the diagnosis, clinical features, and treatment approaches for the disorder.
Van der Hart, O., Nijenhuis, E., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. W. W. Norton & Company. This book explores the concept of structural dissociation and its application in treating complex trauma-related disorders, including DID.