Dissociative Identity Disorder is defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as “a dissociative disorder characterized by the existence in an individual of two or more distinct personalities, each having unique memories, characteristic behaviour, and social relationships. At least two of the personalities control the patient’s behaviour in turns, the transition often being abrupt. The host personality usually is totally unaware of the alternate personalities, experiencing only inexplicable gaps of time and inability to recall important personal information.”
- Nine times more women than men are diagnosed with DID.
- 97% of those diagnosed have a history of physical of sexual abuse, a huge majority being objectively verified even when the patient didn’t recall the abuse.
- Most people start to show signs in their 20s or 30s.
- “Alters” will have distinct histories, behaviour, even physical characteristics. (For example, only some of Hilary’s personalities wear glasses; one is colour-blind.)
- Generally, there will be gaps in the memory of different alters and in the memory of the executive personality. That is, they aren’t conscious of each other.
- There is sometimes “co-consciousness” – awareness of another alter. This happens frequently during the years of therapy (5 years or so on average) needed to integrate the alters into one personality which is controlled at all times by the executive personality.
- Alters serve different functions. Passive alters have limited memories; controlling or protective identities have more memory.
- People with DID are prone to self-mutilation, suicidal thoughts, anxiety, depression, visual and/or auditory hallucinations.
- 80 % of DID people who team up with a specialist do improve. Many remain multiple but still decrease their self-destructive and other negative behaviours and symptoms.
How does it happen?
Children are just learning to sort the world, its occupants, and their experiences into an integrated life story. A child overwhelmed by ongoing trauma – commonly abuse at the hands of a trusted adult – may manage that experience by compartmentalizing it, maintaining different personality fragments (alters) to cope with terrible events. Growing up, the child remains psychologically compartmentalized with different personality fragments (alters) holding traumatic memories and keeping them separate from the core, executive personality. The alter’s memories will be stored subconsciously, often for years. Most people with DID initially seek therapy for other things – commonly amnesia, confusion, depression, anxiety.