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Abstract
This paper is a brief overview of Dissociative Identity Disorder, or DID. It explores what the disorder is,
why it is no longer referred to as Multiple Personality Disorder (MPD), the symptoms of the disorder, the
role of the ―alters‖ or other individuals present within the host, diagnosis of the disorder, and treatment of
the disorder. It also explores some of the basic reasons why some professionals do not ―believe‖ in this
disorder that is becoming more and more prevalent and researched.
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Dissociative Identity Disorder
What is Dissociative Identity Disorder?
Dissociative Identity Disorder is, according to an article on Psychology Today, ―a severe
condition in which two or more distinct identities, or personality states, are present in—and alternately
take control of—an individual.‖ Individuals who have this disorder also have bouts of extreme
forgetfulness and memory loss (Psychology Today). There are many degrees of severity of the disorder.
Many people might actually experience disassociation without realizing it. In an article on
PsychCentral.com, there are many ―dissociative experiences common to most people, such as
daydreaming, highway hypnosis, or ‗getting lost‘ in a book or movie, all of which involve ‗losing touch‘
with conscious awareness of one's immediate surroundings.‖ However, these are mild. On the other end
of the spectrum is chronic disassociation which may not allow people to function normally
(PsychCentral.com) DID usually manifests itself due to some traumatic experience in the individual‘s
past.According to the author who writes under the pseudonym ―Quiet Storm‖ whose work is published in
the textbook by Sattler (1998), ―MPD [Multiple Personality Disorder] is not a disease. It is not a sickness.
It is a highly developed coping mechanism that allows the young mind to compartmentalize, or dissociate,
repeated and traumatic abuse‖ (p. 41). The author adds that for her, ―being able to create Alter
personalities to cope with the abuse is the only thing that allowed us to survive our childhood alive. MPD
was never a disease – it was a gift, the gift of life we gave to ourselves‖ (p. 41).
“Dissociative Identity Disorder” vs. “Multiple Personality Disorder”
Dissociative Identity Disorder (DID) is often referred to as ―Multiple Personality Disorder.‖
However, ―Multiple Personality Disorder‖ is no longer the official name of the disorder. It was changed
in 1994 when the disorder became more common and was more widely studied (Psychology Today).Most
often, people diagnosed with DID do not feel like they are overcome by different personalities. The
―personalities‖ that possess them are more like alternate people or different parts of a person. According
to an article on PsychCentral.com (2010), ―A person diagnosed with DID feels as if she has within her
two or more entities, or personality states, each with its own independent way of relating, perceiving,
4. DISSOCIATIVE IDENTITY DISORDER 4
thinking, and remembering about herself and her life.‖ PsychCentral.com also advises that although these
identities or ―alternate states‖ are all very different, they are all ―manifestations of a single person.‖
According to an article on Psychology Today, DID is not made up of different personalities, but instead it
―is characterized by a fragmentation, or splintering, of identity rather than by a proliferation, or growth, of
separate identities.‖ According to Psychology Today, ―the various identities may deny knowledge of one
another, be critical of one another or appear to be in open conflict.‖ It makes a little more sense for
different fractions of an individual, or different identities, to be in conflict with one another rather than
just personalities.
Symptoms
The most prominent symptom is what gives the disorder its name: having other identities. There
must be at least two identities or ―alters‖ that periodically take over a person and his or her behavior and
actions. Psychology Today states that ―half of the reported cases include individuals with 10 or fewer‖
identities. Another major symptom of DID is memory loss. Those suffering from DID have an ―Inability
to recall important personal information that is too extensive to be explained by ordinary forgetfulness‖
(PsychCentral.com). The ―alters‖ of a person suffering from DID may appear when the individual is
stressed or in an uncomfortable situation.Certain alters may appear when particular stressors appear
(Psychology Today). Other symptoms include depression, guilt, and anxiety. There may be behavioral
problems in childhood, and as a student the individual may be unable to focus. Self-destructive or
aggressive behavior may appear along with audio or visual hallucinations (Psychology Today). Because
DID is usually brought about by severe trauma, people may experience ―post-traumatic symptoms
(nightmares, flashbacks, and startle responses) or Post-Traumatic Stress Disorder‖ (Psychology Today).
The Alters
The ―alters‖ are the different ―personalities‖ or identities of the person who experiences DID. A
person can have over a hundred alters, but generally a person has ten or fewer (Psychology Today). All of
the individual‘s alters have distinct personalities and identities, and ―Each may exhibit its own distinct
history, self-image, behaviors, and, physical characteristics, as well as possess a separate name‖
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(Psychology Today).J.L. Ringrose (2011) uses the ―analogy of the body representing a house and the
alters representing the rooms. Some may have the door open, where there is communication, and some
may have the door firmly closed, where there is no communication oronly muttering can be heard. This
can be extended to include how some alters can reach each other, through interconnecting doors, whilst
others cannot‖ (p. 298). Different alters appear at different times, usually due to stressors the individual is
experiencing. Different alters may show up to take control of different situations depending on which one
might handle the present situation the best. Psychology Today says that ―Alternative identities are
experienced as taking control in sequence, one at the expense of the other, and may deny knowledge of
one another, be critical of one another or appear to be in open conflict.‖ Alters can remember different
things that the individual may have forgotten or blocked. Pieces of information the individual cannot
remember may be stored in the memory of a different alter. According to an article on Psychology Today,
―passive identities tend to have more limited memories whereas hostile, controlling or protective
identities have more complete memories.‖ Quiet Storm from Sattler‘s textbook explains that ―Many of
our Alter personalities were born of abuse. Some came because they were needed, others came to protect‖
(p. 41). A person can develop alters with each new trauma, or they can develop to protect, defend,
comfort, or heal the host after the trauma has already occurred.
Diagnosis
DID is rather rare, but as more research is being done on the disorder it is becoming more easily
diagnosed. As Spring (2011) explains in an article, ―DID is a well-researched, valid and cross-
cultural diagnosis which despite widespread opinion is not rare: research indicates that it affects between
one and three per cent of the general population.‖DID is oftentimes confused or misdiagnosed as
schizophrenia or other psychotic disorders, and sufferers of the disorder often spend many years in
therapy before they are properly diagnosed (Spring). According to Psychology Today, ―the average time
that elapses from the first symptom to diagnosis is six to seven years.‖ It is sometimes hard to diagnose
children because of their vivid imaginations. PsychCentral.com states that ―In children, the symptoms are
not attributable to imaginary playmates or other fantasy play.‖ Despite all the references and research
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available on the disorder, ―perhaps the majority of people with DID will fail to receive a
correct diagnosis as some mental health professionals, despite the extensive literature, refuse to believe
that it 'exists‘‖ (Spring.)
Treatment
Psychotherapy is the treatment of choice for most professionals who have clients experiencing
DID (PsychCentral.com).The goal of this long-term psychotherapy isto deconstruct ―the different
personalities and [unite] them into one‖ (Psychology Today). Quiet Storm shares that her ―therapist tells
us that when we have remembered everything and worked through the pain associated with these
memories, we will no longer need Alter personalities to protect us, and then and only then we can begin
the process of integration into a single, cohesive personality‖ (p. 43). In her journal published in 2011,
J.L. Ringrose describes psychotherapy with a DID patient as resembling ― family therapy where all the
family need to be heard and considered‖ because ―the host and each alter may have different beliefs,
feelings and actions to the same event. Where the host and one or more alters believe it is safe to talk
about ‗x‘, other alters may disagree‖ (p. 297). Medication is usually not recommended for people who
suffer from DID. If medication is used, it must be monitored extremely closely (PsychCentral.com).Some
acceptable medications that may help with DID include ―antidepressants, anti-anxiety drugs or
tranquilizers [that] may be prescribed to help control the mental health symptoms associated with [DID]‖
(Psychology Today). In recent years, many people who experience DID have formed or joined self-help
groups. According to PsychCentral.com, ―There is no overt reason why a support group for this disorder
would not be beneficial to individuals.‖ Hypnosis is another option for treatment of the disorder. In his
journal article published in 2012, R. P.Kluft explains that ―Hypnosis was used in the first successful
treatment of DID/DDNOS and has been associated with most successful treatments to date‖ (p. 146).
Dispute
There are many people who do not believe that DID is an actual disorder. They believe that the
individual is simply role-playing or looking for attention.In a study by A. Reinders (2012) and others, the
authors state that ―despite its inclusion in the Diagnostic Manual for Mental Disorders, the genuineness
7. DISSOCIATIVE IDENTITY DISORDER 7
ofdissociative identity disorder (DID) continues to be disputed‖ (p. 1). Those who do not view the
disorder, or ―The non-trauma-related position, also referred to as the sociocognitive model of DID, holds
that DID is a simulation caused by high suggestibility and/or fantasy proneness, suggestive psychotherapy
and other suggestive sociocultural influences (e.g., the media and/or the church)‖ (p.1). Those who hold
this position simply believe that the individual simply adopts different ways of speaking and acting, and
he or she claims memory loss all due to his or her proneness to high fantasy suggestions or actions.
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References
Kluft, R. P. (2012). Hypnosis in the treatment of Dissociative Identity Disorder and Allied States: an
overview and case study. South African Journal Of Psychology, 4(2), 146-155.
PsychCentral.com. 26 August 2010. What is Disassociation?. Retrieved from
http://psychcentral.com/library/dissociation_intro.htm
Psychology Today. Dissociative Identity Disorder (Multiple Personality Disorder). Retrieved from
http://www.psychologytoday.com/conditions/dissociative-identity-disorder-multiple-personality-
disorder
Reinders, A., Willemsen, A. M., Vos, H.J., Boer, J., & Nijenhuis, E.S. (2012). Fact or Factitious? A
Psychobiological Study of Authentic and Simulated Dissociative Identity States. Plos ONE, 7(6),
1-17). Doi:10.1371/journal.pone.0039279
Ringrose, J.L. (2011). Meeting the needs of clients with dissociative identity disorder: considerations for
psychotherapy. British Journal of Guidance & Counseling, 39(4), 293-305).
Doi:10.1080/03069885.2011.564606
Sattler, D. N., Shabatay, V., Kramer, G. P. (1998). Abnormal Psychology in Context: Voices and
Perspectives. Boston, MA: Houghton Mifflin Company.
Spring, C. (2011). A guide to … working with dissociative identity disorder. Healthcare Counselling &
Psychotherapy Journal, 11(4), 44-46.