Dissociative Identity Disorder

Dissociative Identity Disorder (DID), formerly called Multiple Personality Disorder until 1994, is a mental illness that is characterized by having at least two clear, distinct identities or personality states. These personality states are referred to as “alters”, which essentially control the individual’s behavior and may have different reactions, emotions, and body functioning. An alter often has a sense of its own identity and the capacity to process actions. They also often have different characteristics such as – name, age, gender, vocabulary, general knowledge, predominant mood, taste preferences, and handedness. Common types of alters include – inner self-helpers, introspects, protectors, managers, persecutors, gatekeepers, and caretakers. Each alters has a “job” that they perform (a needed job, rather than a preferred job). The various identities may or may not deny knowledge of one another, be critical or appear to be in open conflict. There can be as little as 2 alters or as many as 100+.

Research indicates that a combination of environmental and biological factors work together to cause this fragmentation or splitting of identity. The disorder generally occurs because the affected individual is unable to integrate various aspects of identity, memory, and consciousness in a single multidimensional self. Usually, a primary identity carries – the individuals given name, is submissive, helpless, dependent, and depressed. This is thought to stem from trauma experienced by the person with the disorder. This dissociative aspect is thought to be a coping mechanism to combat abuse, shame, and fear from a situation or experience that is too violent or painful to assimilate with their conscious self, such as insistent neglect, or emotional, physical, and sexual abuse. 98-99% of individuals who develop Dissociative Identity Disorder have recognized personal histories of recurring, overpowering, and unbearable disturbances at a sensitive developmental stage of childhood. Research has shown that the average age for the initial development of alters is 5.9 years of age.

How does Dissociative Identity Disorder change the way an individual experiences life?

• Depersonalization (the sense of being detached from one’s body – “out of body” experience)
• Derealization (the feeling that the world is not real)
• Amnesia/Time Loss (failure to recall personal information that is so extensive it cannot be blamed on forgetfulness)
• Identity Alteration/Confusion (sense of confusion about who a person is that can lead to distortions in time, place and situation)

Treatment for Dissociative Identity Disorder consists of psychotherapy with hypnosis with the goal of being to make contact with as many alters as possible and to understand their roles and functions in the patient’s life. The therapist usually will seek to form a relationship with the identities that are responsible for violent or self-destructive behavior in an attempt to control the behavior. The therapist also seeks to establish communication among the identities to find out which ones have memories of the distressing events in the individual’s past. The ultimate goal, being the ability to enable the individual to achieve a breakdown of their separate identities and unify into a single identity.

The Diagnostic Statistic Manual (DSM) V identifies the following criteria to diagnose Dissociative Identity Disorder:

1. Two or more distinct identities or personality states are present, 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. The person had an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
4. The disturbance is not due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).