Anyone have information about DID? (Disassociative Identity Disorder)

[Spectralist]

I’m not by any means an expert on the subject but i’ve read the book Dissociative Identity Disorder Sourcebook by Deborah Haddock as well as the portions of more general psych textbooks, abnormal psych textbooks, & case studies that deal with DID and related disorders. I’m not an expert on psychology either i hasten to point out, just very interested in the subject. Especially abnormal psychology.

It’s been too long since i read enough on it to write anything particularly coherent on the subject so i’ll just jot down some bullet points of interest on what i recall.

The disorder is very closely related to Post Traumatic Stress disorder. And not all that related to Schizophrenia despite them often being considered similar(or even the same thing) by the laymen and the media. The disorder always or almost always follows from an exceptionally traumatic event.

There’s often not a complete division on the states and it’s rarely the case where there is only two states. Switching between states is rarely as dramatic as seen on TV & the like. And is often seen by friends and family as normal, or extreme, mood swings. An undiagnosed individual suffering from DID may just be seen as an eccentric or moody person.

Some psychologists don’t consider it to be necessarily maladaptive. The treatment goal is not always to integrate the personalities. Sometimes the treatment goal is to… well i couldn’t think of how to put it so i went and grabbed the book i mentioned: “Some people, however, feel that an equally viable goal is that of co-consciousness, with each part working in cooperation with the others, much like members of a family might operate if they hope to live in any kind of harmony.”

DID is often(well not often it’s extremely rare, but often among cases of DID) discovered when a patient comes in complaining of depression. The patient may not even be aware that they are coping with the disorder.

In some cases one state will black out or not remember the events that happen while a different state is in control. In other cases states are aware of what’s happening(or at least have memory of what happened) even if they are not necessarily aware of the fact that multiple states exist. In all cases, however, there is some form of memory loss too extensive to be attributed to normal forgetfulness.

There is an unusually high prevalence amongst very heavy drug users. I do not believe it’s known whether the drugs cause the disorder, cause the disorder to be more likely to be misdiagnosed, or are examples of people self medicating.

@olivesmarch4th

However, the formation of ‘‘alter’’ personalities doesn’t make a whole lot of sense from a clinical perspective and is, at best, extremely rare. I think a lot of people who claim to have DID are most likely grappling with borderline personality disorder, complex PTSD or some other serious mental instability resulting from trauma that creates a conflicting or schizmed sense of self.

I don’t necessarily see the distinction. You could easily call DID a subtype of PTSD and that wouldn’t mean it doesn’t exist. Or perhaps a type of cyclical fugue brought on by a traumatic event. Any two individuals suffering from any psychological disorder are very unlikely to exhibit the same symptoms in exactly the same way. Psychology, unfortunately, is simply not capable of being that divisive. And so we need to make, perhaps arbitrary, distinctions of where one disorder ends and another begins. It’s like looking at a spectrum and asking “where does blue end and green begin?” you have to draw the line somewhere or make increasingly more distinct subdivisions. But then you have to draw the line for those subdivisions anyway.

DID is simply a specific set of symptoms.

From the DSM-IV:
A. The presence 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).
B. At least two of these identities or personality states recurrently take control of the person’s behaviour.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (e.g., complex partial seizures).

@olivesmarch4th

The different paradigms of identity might be interpreted as alters, but are not completely different personalities.

They aren’t considered completely different personalities by mainstream psychology:

@Dissociative Identity Disorder Sourcebook

Therapists are more likely to operate from a framework that defines alters as ego states, or parts of the self, so as to reinforce that they are actually various aspects of one self.

Nor is the creation of a new identity unique to DID. For example bullet #2 from Fugue State:

@Wikipedia

* sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past,
* confusion about personal identity, or the assumption of a new identity, or
* significant distress or impairment.

And the creation of a new personality is done by writers and story tellers on a routine bases. So i don’t see why someone would be sceptical that such a thing is possible. In DID, however, it is more internalized and taken to an extreme.

I can understand the scepticism. All of psychology is extremely subjective though, not just DID, and i don’t agree that DID is necessarily more subjective than more accepted areas of psychology.

I’m sure there’s a degree of over diagnosis though. But I’m of that opinion on most of psychiatry. According to wikipedia 1 in 100 Canadians suffer from DID. Which seems to me to be ridiculously high and screams of over diagnosis. Though i can’t be bothered to follow their cite at the moment as i’ve spent too much time composing this post as is.

[Spice_Weasel]

@Spectralist

There is an unusually high prevalence amongst very heavy drug users. I do not believe it’s known whether the drugs cause the disorder, cause the disorder to be more likely to be misdiagnosed, or are examples of people self medicating.

Interesting.

I don’t necessarily see the distinction. You could easily call DID a subtype of PTSD and that wouldn’t mean it doesn’t exist. Or perhaps a type of cyclical fugue brought on by a traumatic event. Any two individuals suffering from any psychological disorder are very unlikely to exhibit the same symptoms in exactly the same way. Psychology, unfortunately, is simply not capable of being that divisive. And so we need to make, perhaps arbitrary, distinctions of where one disorder ends and another begins. It’s like looking at a spectrum and asking “where does blue end and green begin?” you have to draw the line somewhere or make increasingly more distinct subdivisions. But then you have to draw the line for those subdivisions anyway.

Obviously you are more knowledgeable about this disorder than I am. I have read the book Sybil (and that book, for better or worse, influenced my understanding of DID for a looooong time) and I’ve encountered people who supposedly have this disorder. What you are describing as the mainstream understanding within the psychological community is absolutely nothing close to its common portrayal. What you describe seems more realistic to me.

Nevertheless, your comment about the spectrum of disorder basically underscores my point. DID is not considered a subset of PTSD in the DSM-IV, it is classified as a separate disorder, presumably because the dissociative component is so strong. But there are diagnoses like Acute Stress Disorder which also emphasize the dissociative component, and the distinction between Acute Stress Disorder and PTSD is based on faulty evidence that imbues dissociation with special significance. It seems just as likely to me that the distinction between DID and Complex PTSD, or DID and borderline personality disorder, is also completely arbitrary.

And the creation of a new personality is done by writers and story tellers on a routine bases. So i don’t see why someone would be sceptical that such a thing is possible. In DID, however, it is more internalized and taken to an extreme.

As a writer I find this comparison a little farfetched. There is a huuuuuuuge difference between creating a work of fiction and fictionalized characters and dealing with a shattered sense of self as a result of trauma. It’s worth noting that I didn’t say I thought it was impossible, I said I thought it didn’t make sense. Now, though, it looks like my assessment of DID is pretty close to that of mainstream psychology, with the exception that they classify it as a separate disorder.

I can understand the scepticism. All of psychology is extremely subjective though, not just DID, and i don’t agree that DID is necessarily more subjective than more accepted areas of psychology.

This is the fundamental issue – the fact that most (not all) psychology is extremely subjective. From the treatment of anxiety to the treatment of schizophrenia, the field is rife with B.S. treatments that don’t work, inconsistent self-reporting, confirmation bias, and doctors looking to stroke their own egos. Some of this is just inherent in addressing the complexities of human psychology, but a lot of it is willful ignorance. DID, at least originally, stemmed from a psychoanalytic understanding of human psychology. That right there is a big red flag, and seems to be complicated by the controversy of memory loss, memory repression, and spontaneous memory recovery. I’m not saying it can’t overcome that handicap or that there’s not something of significance going on, I’m just saying we need to tread carefully.

For starters, we might examine why the vast majority of DID cases seem to be concentrated in North America.

ETA: Spectralist I do appreciate your contribution here.

[Maggie_the_Ocelot]

My stepdad is a counselor that specializes in abuse victims with PTSD and DID. He’s on the board at the ISSTD mentioned above.

As I recall him telling me, DID is a very specialized response to severe trauma. It generally requires the person to have:

1. Suffered REALLY severe abuse (verbal, physical, sexual, most likely all three)
2. on an ongoing basis, which
3. started at a very young age (under 5)
4. on an unusually imaginative child who
5. happened to hit upon the solution of “splitting” the personality as a way to cope with the abuse.

He says the popular idea of having “two personalities” is completely inaccurate - if the abuse is severe enough to require one split, it’s always going to require more than one split. He rarely sees DID patients with fewer than ten alternate personalities. Though of course, some personalities are more dominant than others, and some only come out for specific situations, so it might seem that there are fewer than there are.

I actually had an ex-roommate that had DID. I wouldn’t have known it except that I knew about the syndrome from my dad, and I happened upon a long note she had written, venting after a fight with her boyfriend…the handwriting changed majorly like 6 times over the course of the page, and it flipped back and forth between the first and third person when referring to herself. I had already known that her father was an abusive asshole, and that she was a little “spacey” sometimes, losing the thread of a conversation in the middle and stuff, but it’d never occured to me that it might have been DID until then. I asked her about it, and my dad was able to hook her up with a good therapist.

So yeah. It’s real. Not common - but real.