Dissociative Identity Disorder

Dissociative identity disorder, more commonly known as multiple personality disorder, is one of the most intriguing and least understood of mental disorders. "Dissociative identity disorder is characterized by the presence of "...at least two separate ego states, or alters, different modes of being and feeling and acting that exist independently of each other, coming forth and being in control at different times" (Davison and Neale, pg180). "Each personality is fully integrated and a complex unit with unique memories, behavior patterns, and social relationships that determine the nature of the individual's acts when that personality is dominant" (Breiner, pg 149).

While psychologists now recognize childhood abuse as a precipitant of DID, the general public is, for the most part, unaware of the strong, almost universal connection. "The vast majority (as many as 98 to 99%) of DID individuals have documented histories of repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood." (DID (MPD) pg2). The two main types of abuse that occur are sexual, involving incest, rape, molestation, and sodomy, and physical, involving beating, burning, cutting, and hanging. Neglect and verbal abuse are also contributing factors. DID is more common among women, probably because females are more frequently subjected to sexual abuse than males.

This disorder is often referred to by professionals as; "Emergency defense system. As a child dissociates, or breaks the connection between his/her thoughts, feelings, and his/her very identity, he/she becomes like a 'hidden observer who does not have to deal with the pain or fear of the attack. (Alexander, pg 94) All thoughts and memories of the abuse are psychologically separated from the child. After repeated abuse, this dissociation becomes reinforced. If the child is good at it, he/she will use it as a defense mechanism in any situation that he/she perceives as threatening, and different personalities begin to develop. "Trance-like behavior in children has been found to be the single best predictor of childhood dissociative identity disorder." (Carlson, pg118) It has been documented that dissociative identity disorder can only develop during childhood, usually between the ages of 3 and 9. There is no "adult onset" dissociative identity disorder, due to the fact that "Only children have sufficient flexibility (and vulnerability) to respond to trauma by breaking their self into different, dissociated parts." (Rainbow House, pg 2) It has also been found that only children who are highly susceptible to hypnosis are able to accomplish dissociative behavior. This is because a hypnotic state is very similar to the trance-like states that the children enter into, so if the children can be easily hypnotized, they can also easily go into trances. Others respond to their abuse in a more typical fashion. Children with dissociative identity disorder may have several different alters or personalities, each with its own distinct characteristics and strengths. These alters become dominant at different times according to the outside stressors, but "...there are usually only 3 to 6 alters who are particularly active...on any given day." (Rainbow House, pg3) "When active, this alters May or may not be apparent to observers, in fact, the personality differences in children with dissociative identity disorder tend to be subtle and less in number than seen in adults suffering from this disorder." (Kluft, pg55) When alters are of different ages, talents, or temperaments, the distinctions between them become more obvious. It is also interesting to note that the same may be true for the dissociative identity disorder sufferer him/herself; that is, one personality may or may not be aware of the existence of another personality. In some cases, there may be an awareness of only one or two of many alter, in others, an awareness of all. Dissociative identity disorder individuals are usually not diagnosed until they approach or reach adulthood, and even then, not until having undergone years of misdiagnoses. There are many reasons for this. A person with DID often presents symptoms that are common to many other mental disorders. Depression, panic disorders, sleep disorders, and suicidal tendencies are, but a few of the reasons, these people seek help. Furthermore, their host personality may be amnesiac with regard to their alters and/or the experiences of those alters. Their personality changes may be passed off as mood swings, or, they may have gone for a long time without experiencing a dissociative episode. These are compounded by reluctance on the part of professionals to diagnose DID, and the DID individual to be able or willing to provide necessary information. Many are hesitant to believe that the bizarre abuse to which their patients were subjected as children actually occurred. This is particularly true when incest was a part of the abuse, as it frequently is. Also, because DID was long thought to be extremely rare, it simply was not a considered diagnoses for many clinicians. The great majority of DID individuals know they have a problem: they may fear that they are crazy, but do not realize they have multiple personalities. Once diagnosed, they may themselves be strongly resistant to the idea, spending months of therapy denying what their therapist has found. This is unfortunate, because of all the severe mental disorders, DID has one the best prognoses. However, in order to successfully help the patient, the therapist must first gain his/her trust and willingness to assist in the treatment. An acceptance of the diagnosis is the first step, and it may be many months in coming. "Once contact and trust are accomplished, the therapist must establish communication with all of the alter personalities in order to learn their names, origins, functions, problems, and relationships to the other personalities" (Coons, pg6). The amount of time required to do this, is dependent upon the degree of trust the patient places in the therapist. The host personality and his/her alter personalities must then be helped to begin coping with their traumatic experiences. Only after this has been done can the "...fusion of integration of the personalities begin." (Coons, pg 10) As each alter exposes its trauma, it can "...yield its separateness and re-integrate (because that alter is no longer needed to contain undigested trauma)" (Rainbow House, pg 5).

Recovery from DID and the childhood trauma which perpetuates it can take years. It involves a painful re-examination of one's past and a long "...process of mourning." (Rainbow House, pg 5) It is particularly difficult because the individual must come to terms with the fact that (in many cases) the beatings, sexual abuse,