A Blast From the Past

DID

"Previously known as multiple personality disorder, dissociative identity disorder (DID) is a condition in which those affected have more than one distinct identity or personality state. At least two of these personalities repeatedly assert themselves to control the behavior of the affected person. Each personality state has a distinct name, past, identity, and self-image.

The primary cause of DID appears to be severe and prolonged trauma experienced during childhood. This trauma can be associated with emotional, physical, or sexual abuse, or some combination. One theory is that young children, faced with a routine of torture, sexual abuse, or neglect, dissociate themselves from their trauma by creating separate identities or personality states [AKA alters]. Manufactured alters may suffer while primary identities "escape" the unbearable experiences. Dissociation, which is easy for young children to achieve, becomes a useful defense. This strategy displaces the suffering onto another identity. Over time, children, who on average are around six years old at the time of the appearance of the first alter, may create many more.

There is considerable controversy about the nature, and even the existence, of DID. The causes are disputed, with some experts identifying extensive trauma in childhood as causative, while others maintain that the cause of the disorder is iatrogenic, or introduced by the news media or therapist. In this latter form, mass media or therapists plant the seeds that patients suppressed memories and dissociation severe enough to have created separate personalities. One cause for the skepticism is the alarming increase in reports of the disorder since the 1980s; more cases of DID were reported between 1981 and 1986 than in the previous 200 years combined. In some cases, people reporting DID and recovered memory became involved in lawsuits related to the recovered memories, only to find that the memories were not, in fact, real. Another disorder, false memory syndrome, then becomes the explanation. Thus, an area of contention is the notion of suppressed memories, a crucial component in DID. Many experts in memory research say that it is almost impossible for anyone to remember things that happened before the age of three, the age when some patients with DID supposedly experience abuse, but the brain's storage, retrieval, and interpretation of childhood memories are still not fully understood. The relationship of dissociative disorders to childhood abuse has led to intense controversy and lawsuits concerning the accuracy of childhood memories. Because childhood trauma is a factor in the development of DID, some doctors think it may be a variation of post-traumatic stress disorder (PTSD). In both DID and PTSD, dissociation is a prominent mechanism

The major dissociative symptoms experienced by patients with DID are amnesia, depersonalization, derealization, and identity disturbances.

1. Amnesia in patients with DID is marked by gaps in their memory for long periods of their past, and, in some cases, their entire childhood. Most patients with DID have amnesia, or "lose time," for periods when another personality is "out." They may report finding items in their house that they cannot remember having purchased, finding notes written in different handwriting, or other evidence of unexplained activity.

2. Depersonalization is a dissociative symptom in which patients feel that their bodies are unreal, are changing, or are dissolving. Some patients with DID experience depersonalization as feeling outside of their bodies, or as watching a movie of themselves.

3. Derealization is a dissociative symptom in which patients perceive the external environment as unreal. Patients may see walls, buildings, or other objects as changing in shape, size, or color. Patients with DID may fail to recognize relatives or close friends.

4. People with DID usually have a main personality that psychiatrists refer to as the "host." This is generally not the person's original personality but is rather one developed in response to childhood trauma. It is usually this personality that seeks psychiatric help. Patients with DID are often frightened by their dissociative experiences, which can include losing awareness of hours or even days, meeting people who claim to know them by another name, or feeling "out of body."

Psychiatrists refer to the phase of transition between alters as the "switch." After a switch, people with DID assume whole new physical postures, voices, and vocabularies. Specific circumstances or stressful situations may bring out particular identities. Some patients have histories of erratic performance in school or in their jobs caused by the emergence of alternate personalities during examinations or other stressful situations. Each alternate identity takes control one at a time, denying control to the others. Patients vary with regard to their alters' awareness of one another. One alter may not acknowledge the existence of others or it may criticize other alters. At times during therapy, one alter may allow another to take control."

Citation-

Frey, Rebecca J., et al. "Dissociative Identity Disorder." The Gale Encyclopedia of Mental Health, edited by Kristin Key, 3rd ed., vol. 1, Gale, 2012, pp. 514-518. Health & Wellness Resource Center, http://link.galegroup.com/apps/doc/CX4013200156/HWRC?u=mtlib_2_906&sid=HWRC&xid=aeb2f2dc. Accessed 14 Dec. 2017.