It’s scary to think you’ve ‘gone mad’. It’s scary to think you have some serious, incurable ‘mental illness’. It’s scary to not understand what on earth is going on in your brain. And perhaps what’s even scarier is finding out that what is ‘wrong’ with you has a name: dissociative identity disorder.
‘I don’t feel real. All the time—literally all the time—I feel like I’m living life from behind a glass screen, or that I’m watching life as it’s happening on TV but it’s not real. I’m always ten yards removed from it. I don’t cry. I don’t feel things. I feel like I’m in a dream. I feel like I’m going mad. Even now, talking to you, I’m not sure if this is really happening or not or if I’m just imagining it. The GP says I’m just depressed, but I’m not.’
I was abused by my dad, and also my grandad. And in many ways, I want to just leave it there and not say any more, because every time I say it a huge cloud of fear comes up and a voice screams in my ear that none of it really happened.
It’s like, for a moment, my heart falls into my feet and I’m overcome by this terror that I really am just making it up, and that there’s something terribly wrong with me that I would do such a thing.
Once we understand dissociation as a logical response to overwhelming trauma, it stops being so dramatic and different, and the person suffering dissociation stops being ‘complex’ and ‘bizarre’ too. There is nothing bizarre about dissociative disorders—what is bizarre is how some people can be so badly mistreated that they end up with a dissociative disorder.
Someone who has dissociative identity disorder may have distinct, coherent identities that are able to assume control of their behaviour and thought.
What medications should be used in the treatment of dissociative identity disorder? This fact sheet takes guidance from the ISSTD’s Treatment Guidelines for DID.
How should dissociative identity disorder be treated? What do the guidelines say, and who produces them?
There are many ways to describe dissociation, and we look here at dissociation as it pertains to dissociative identity disorder and trauma.
Dissociative identity disorder is a creative survival mechanism for coping with overwhelming and chronic childhood trauma.
For dissociative identity disorder (DID) to develop, there is usually chronic trauma in early childhood along with significant problems in the child-parent relationship.
Diagnosis of dissociative disorders is by no means straightforward, mainly due to a lack of training and knowledge. The main diagnostic criteria can be found in the DSM-5 and this article explains how diagnosis is made.
There are a number of diagnostic tools available for assessing dissociative disorders. This article lists the principle ones.
Dissociative disorders appear as diagnostic categorisations in both the American-based DSM-5 produced by the American Psychological Association (APA, 2013), and the other ‘diagnostic’ bible used more widely in Europe, the World Health Organisation’s ICD-10.
DDNOS is seen by many people as a ‘not yet’ or ‘a not quite’ version of dissociative identity disorder and although it is supposed to be a ‘residual category’ and only given to a few people, in fact the vast majority of people diagnosed with a dissociative disorder fall into this category.
I have dissociative identity disorder. I have many separate, distinct and unique ‘parts’ of my personality. My ‘parts’ or ‘alters’ collectively add up to the total person that is me. I am the sum of all my parts. They are each a letter, and I am a sentence.
So I’m curious. On what do you base your belief in dissociative identity disorder? This was a tweet I received from a fellow twit based in the US a few months ago. The more I use social media, the more I realise how controversial dissociative identity disorder is. For me, after the last 5 or 6 years, it is ‘normal’.
I look up and I am in my therapist’s room. I look up and I am in the cafe area of the shopping mall. I look up and I am in bed in the dark. I look up and I don’t know if I am I. There is no thread of continuity between these places, these experiences. Who am I now, writing this, re-reading this, re-writing this?
A brief guide to dissociative identity disorder, a post-traumatic condition, by Carolyn Spring.
What is it like to be me? What is it like to be the me that is me-not-you, different, alone, DID?
You – in my minds you are you-not-us, but who am I to you? Can you know me?