By Dr. Perry, PhD
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Dissociative Identity Disorder, previously known as multiple personality disorder is a complex psychological disorder, which is difficult to diagnose and controversial. It is characterized by severe episodes of dissociation. Dissociative behavior can be divided into two categories: detachment and compartmentalization. Detachment is a voluntary or involuntary feeling or emotion that accompanies a sense of separation from normal associations or environment. Compartmentalization is a splitting off of the personality into separate parts where there is a lack of communication and consistency between each part. One key characteristic of dissociative identity disorder is that there have to be at least two distinct personality states. Many healthcare professionals believe dissociative identity disorder is a genuine disorder while other mental health professionals feel it is an offshoot of other mental illnesses and should be removed from the DSM-5 (Diagnostic and Statistical Manual of Mental disorders, fifth edition).
Research suggests that dissociative identity disorder is a reaction to a person’s environment. Interpersonal and environmental stresses particularly during childhood result in a vertical splitting of consciousness. It is believed to originate from severe and persistent periods of childhood trauma or neglect. This differs from a horizontal splitting that results in repression. People who suffer from dissociative identity disorder spend an average of seven years before they get an accurate diagnosis. Signs and symptoms of dissociative identity disorder will vary depending on the individual. However, to be diagnosed with dissociative personality disorder a person must meet these 5 criteria.
1. Disruption of identity caused by the presence of two or more distinct identity states
A person with dissociative identity disorder experiences a splitting of their personality which manifests as one or more distinct personalities. The different personalities may be self reported or reported by others. Each personality has a distinct pattern of perceiving and thinking about the environment and self. A person with dissociative personality disorder will report feelings of being depersonalized. They will report feeling out of their body and having strong impulses that they feel are not their own. One personality will always be present. The alternate personalities are known as alters and exhibit different behaviors, consciousness, memories, perceptions, cognitions and sensory-motor functioning. Alters can have different accents, memories, ages, names, functions, genders and other traits. The alter personality with the most control is called the host, which may or may not be the person’s original personality. There are common alters that exist 1) child and adolescent, 2) protector or rescuer, 3) persecutor, 4) perpetrator and 5) avenger.
2. Recurring periods of amnesia
The individual with dissociative identity disorder has recurrent lapses in memory which goes beyond normal forgetting. This amnesia is caused by the childhood trauma that was suffered at a young age. Many people with dissociative identity disorder do not recall the trauma. There is a blocking of whole chunks of memories. Entire periods of their lives may be forgotten as well as moments of their day. The amnesia can appear in the following ways:
a) There are large gaps in childhood memories
A person may recall some of their childhood and then have blank periods where they recall nothing.
b) Will forget dependable memories
A person will not be able to remember what happened during their entire day and may forget a skill that they have. For instance, they may not be able to recall their ability to play the piano or repair computers.
c) Discovery of everyday actions that they do not recollect
A person with dissociative identity disorder may wake up and find that they have purchased an entirely new wardrobe. The wardrobe may include items they would never wear. Further, they will have no recollection of having purchased the items. Some may experience a dissociative fugue and find they have traveled to a different county, state or even country and have no recollection of how they got there.
3. The person must be distressed by the disorder or have trouble functioning in one or more major life areas as a result of the disorder
This is a common criteria among all serious mental illness diagnoses. The disorder must cause severe distress and impairment in functioning.
4. The disturbance is not part of normal cultural or religious practices
The disorder is not viewed as normal in society. For example, in Western culture an imaginary friend is seen as normal/appropriate and not indicative of a mental illness.
5. The symptoms are not due to the direct physiological effects of a substance
The symptoms that are experienced are not a result of substance abuse. For instance, this does not include blackouts from alcoholism or drug abuse. In the diagnosis of dissociative identity disorder, blood work may be taken to make sure no drugs are in the person’s system.
This article is not meant to diagnose or be a guide for self-diagnosis. The purpose of this article is to educate readers on a serious mental illness. The purpose of this article is not to vilify or shame individuals who suffer from this serious illness. If you feel you or someone you know meet the necessary criteria please know you are not alone and seek the help of a mental health professional.
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