An Introduction To Dissociative Identity Disorder
Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder (MPD), is one of the five dissociative disorders identified by the American Psychiatric Association (DSM-IV, 1994).
Dissociation occurs when there is a disruption of the normal processes of consciousness, perception, memory, and identity that define a person's individual self. These individuals have the ability to mentally isolate and separate themselves from painful memories and traumas they have experienced. While minor forms of dissociation, such as daydreaming, are common and considered normal for all of us to some degree, DID is a severe form of dissociation. Those with DID tend to compartmentalize their memories, emotions, and coping responses into separate personality states, referred to as alter personalities. Dissociation produces a lack of connection in the individual's thoughts, feelings, memories, and even identity. During a traumatic experience, dissociating from whatever circumstances the person (usually a child) might be in provides a temporary mental escape from the pain of the trauma, which often results in a memory gap, as well (Sidran Foundation, 1994). The number of alters within an individual with this disorder often correlates to the severity of the abuse. Alter personalities may or may not be aware of each other. They may be of different ages, genders, faiths, professions, or even have different IQs, brain waves, or cognitive and physical abilities. Each may hold banks of different memories, have different beliefs, ambitions and outlooks, and present entirely different physical and psychological aspects from the "host" personality (Mayer, 1988). Many of those with DID are able, at least outwardly, to function in a way that few would suspect what is happening within them internally. Most "multiples" are so cut off from their own past memories and emotions that even they are often unable to connect or make sense of their responses and reactions to everyday situations. Often this is because of the dissociative barriers that remain in place, which serve as protective devices from their past experiences. Traumatic memories have been sealed off so that they are unable to invade the consciousness of the person who functions as the presenting personality. Often, however, troubling dreams, depression, anxiety, time loss, and other vague feelings of something not being "right" remain and are a source of distress to the person with DID. These seemingly unrelated "symptoms" are what usually prompts the individual to seek help from a doctor or therapist. Unfortunately, coming to a clear diagnosis can be a long-term and difficult process, but until this occurs, treatment for the underlying symptoms usually proves to be unsuccessful or only provide temporary relief, at best.
What causes such a level of trauma that an individual, a child in particular, would have to go to such extremes as to need to dissociate from all memory of it? According to Psychologist Diane Langberg (1994), it is currently thought that this disorder results from "severe physical and sexual trauma, accompanied by psychological trauma." She further states that "DID clients report the highest rates of childhood physical, sexual, and other forms of abuse and trauma among those suffering from any known psychiatric disorder." Most of these victims of abuse describe abuse that was "profound, relentless, and intolerable," usually occurring before they were five years old, in an environment void of nurturance. Dissociation serves as a protective measure when other sources of protection and safety are not available to the victim of such traumas. Kubetin & Mallory (1992) explain that when a person is "overwhelmed with severe abuse, torture, or terror, particularly during childhood, the protective mechanism of dissociation may come into play." Combined with certain other environmental conditions, such as repeated trauma and extreme abuse, the likelihood of dissociation being the chosen as the (and often only) method of 'escape' from these intolerable conditions becomes even higher. DID is being identified and studied more than ever before. Though researchers who accept "multiplicity" (referring to Multiple Personality Disorder or, as the more modern terms describing a child's ability to dissociate and split off, DID), they are not entirely agreed on how the syndrome develops, only that early childhood trauma is a factor (Mayer, 1988). Individuals with Dissociative Identity Disorder most frequently report having experienced severe physical and sexual abuse as children. Treatment of Dissociative Identity Disorder for those attempting to recover from the devastating effects of child abuse and severe trauma, and the resulting years of pain and loss that it causes them, is a long and difficult process. And yet there is hope of a positive outcome if disorders such as DID are brought to treatment, and healing can indeed take place. It cannot be done alone, however, and much help and support is needed for the abuse survivor in order for healing to occur. According to the Sidran Foundation, dissociative disorders are highly responsive to individual psychotherapy, along with other adjunctive therapies, and the prognosis is good when proper treatment is undertaken and completed.
While some aspects of Dissociative Identity Disorder, not unlike Post Traumatic Stress Disorder, can be controversial in some areas, those suffering from this condition deserve to be heard, to be believed, to be helped, and to be able to receive whatever resources we have available in order for them to reach wholeness and healing.
References: American Psychological Association (1999). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, TR; Washington; p. 519-529.
Kubetin, C. A. & Mallory, J. (1992). Beyond the Darkness; Houston; Rapha; p. 16-17, 33.
Langberg, D. M. (1997). Counseling Survivors of Sexual Abuse; Wheaton; Tyndale House; p. 208.
Mayer, R. (1988). Through Divided Minds; New York; Doubleday; p. 28.
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