Dissociative Identity Disorder (DID), the new-ish name for an old label, multiple personality disorder, still has its armies of detractors. Despite reams of controversy littered through the pages of the upcoming revision of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders slated for May of 2013, DID is still likely to be one of the most misunderstood diagnoses in the book. For some time, many in the media and even members of the mental health profession have contended that DID is not a legitimate mental illness-that it is, in essence, a fake.
What is DID?
DID most commonly develops as a result of severe and sustained childhood trauma. The theory is that a child’s fragile psyche dissociates in order to cope with stressors with which no child can possibly contend. Dissociation is a mental process, which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity (PsychCentral.com). Dissociating from traumatic experiences allows those experiences to become repressed, so that memory of them does not begin to emerge until later in life-sometime during adulthood-when the individual is more able to emotionally cope with memories of traumatic experiences. In instances of DID, the experiences are too severe, or the psychology or genetic makeup of a particular child is too fragile to later integrate the traumatic memories in a healthy way. Instead, the individual’s psyche fractures, splitting off from the core self so that independent identities emerge, each with separate characteristics.
The DSM criteria for DID is as follows:
- The presences 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).
- At least two of these identities or personality states recurrently take control of the person’s behavior.
- Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
- The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.
What are the Controversies?
One component that makes DID difficult for some mental health professionals to swallow is a theory of its causality which pertains to repressed memories. These professionals are dubious of repressed memories and the potential for “remembering” childhood abuse that may never have actually occurred. With the 1980s childhood abuse claims tied to Satanic cult practices, it’s no wonder for these fears. Those claims-largely overblown and sensationalized in the media-turned out to be overwhelmingly unsubstantiated. But Bethany Brand, PhD, a professor of psychology at Townsend University and an expert in the research and treatment of dissociative disorders explains that most people with DID do not forget their childhood abuse, particularly when it was chronic or severe. “[S]ufferers may forget episodes or aspects of some of their trauma,” Brand has said, but it’s “fairly rare not to remember any trauma at all and suddenly recover memories of chronic childhood abuse.” Those individuals who experience recovery of repressed memories often do so around events or experiences they had maintained some memory of, but which they had dissociated chunks of in order to cope. Skepticism over false memories and the many myths surrounding DID persist in the mental health field because of a lack of awareness, education, and adequate and updated training on the subject. Brand has explained that one of the beliefs which persists about DID is that there are “different people” inside someone who has DID. This only adds to the notion that the disorder itself and the people who suffer it are unusual or bizarre. Another complicating factor are those mental health professionals outside the mainstream who choose to treat DID patients with strange and unproven methods. The treatment that dissociative experts use for DID patients is similar to the standard methods for treating complex trauma, and these are the treatments with the highest efficacy in helping DID patients recover from their past traumas and to integrate the split “self-states” they perceive and which trouble them even while they have served as a method of coping with insurmountable pain for a time.
Prevailing Myths of DID
The myths surrounding DID and its sufferers are many, and so it’s important to set right at least a couple of facts. Despite media sensationalizing and Hollywood portrayals, DID is a subtle disease; it takes many years for anyone-family, sufferers themselves, and even therapists-to determine what is happening, if they ever do. The “self-states” are generally not so distinct as to be easily spotted, even if they can be. Efficacious treatments for DID do not involve hypnosis in order to “retrieve” past memories. While hypnosis has been proven beneficial in aiding patients in finding a calm, secure state in order to work through anxiety and other emotions, the use of hypnosis to explore repressed memories has been negated by the mental health field as it can produce clients who are too susceptible to producing “memories” which never occurred. DID sufferers typically share a common childhood history of repeated and severe emotional, physical, or sexual abuse or a combination of these. When their disease strikes, they are confused and uncertain, and many report a lack of awareness or understanding of self. Another feature DIDs often share in common is a new fracturing of self-a new seemingly independent identity emerging-each time a new traumatic experience took place. In this way their central identity (who they truly are) could slip away through dissociation in order to bear the terrible event they were forced to suffer as a child. The mind is the most complex organ in the known universe, and the human the most adaptable animal. If we can live successfully in the arctic as well as on the equator, can walk on the moon and live months in space, it is no wonder that one mind can trick itself into believing it is many so that it can endure a more hostile terrain than any of these.