DISSOCIATIVE IDENTITY DISORDER (DID) | DOES MULTIPLE PERSONALITY DISORDER TRULY EXIST?

DISSOCIATIVE IDENTITY DISORDER (DID) | DOES MULTIPLE PERSONALITY DISORDER TRULY EXIST?

Dissociative Identity Disorder (DID) previously known as Multiple Personality Disorder, is the existence of at least two distinct or split identities otherwise known as personality states. DID is usually a result of severe abuse or trauma. In a sense, it involves experiencing a disconnection between thoughts, memories, surroundings, actions, and identity. This is quite different from a personality disorder in which sufferers have a stiff and unnatural pattern of thinking, functioning and behaving.

Psychologically, Dissociative Identity Disorder (DID) is often mistaken to be a personality disorder. This has since been deemed an inappropriate way to address DID sufferers. It’s considered offensive to use the term Multiple personality disorder (MPD).

DID usually occurs when a child, under the age of 8 (before the brain develops a “whole” sense of self) is subjected to intense trauma over an unrelenting period of time. This trauma is ritualistic in nature. It may take the form of sexual, emotional, physical abuse, or severe childhood illness with protracted pain. Various surgeries can also influence its occurrence.

Living with DID can be likened to being a chameleon, blending seamlessly into various personalities. The sufferer creates a coping mechanism and unconsciously becomes forgetful, allowing the formation of extra “identities” also known as alters (alternate personalities). These alter replace trauma or any grievous disturbances, allowing them to lead a normal life without recalling the traumatic events. According to experts in the field of psychology, there’s a possibility of having alters who are not the same sex as the body.

This comes at a price with side effects such as suicidal thoughts, addiction, etc. Unlike its unfair representation in Hollywood movies, alters are not serial killers. Ironically, they are more likely to hurt themselves instead of others. Experts estimate the prevalence of DID to be from 0.01% to 15% of people[2]. The frequency increases with social unrest,  especially in areas that experience large-scale trauma such as war or natural disasters. Sufferers of this condition are not totally misfits as therapy offers some help.

However, more awareness is necessary as people living with this debatable disorder are often thought to be possessed, liars, or crazy. Worse still, philosophers, scholars, scientists, psychiatrists, and clinicians do not agree on its existence.

Dissociative Identity Disorder

Personal Experience with Dissociative Identity Disorder

My experience borders on the ill-treatment meted out on the sufferers. Years ago, a friend was always accused of stealing food from the store in school. She always denied even when caught in the act. I was embarrassed each time the news filtered in. She was about 18, extremely forgetful, easily distracted, irritable, and irrational at times. She would often bully other students and seize their belongings. Sometimes, she even referred to herself in the third person’s narrative.

Other students labeled her, ‘the possessed’, saying she was controlled by marine spirits or husband (spiritual forces). People tagged her ‘’Ọgbanje’’( a term in Odinani –Igbo: ọ̀dị̀nànị̀ – believed to be an evil spirit that deliberately plagued a family with misfortune).

Years later, we met in a Psychiatric facility where I was undergoing my clinical experience. She could barely recognize me. On one of the consultant rounds, she was to see a psychiatrist. Sadly, she could barely recollect anything. She was always in a confused, forgetful state so much so that she referred to the hospital as a prison ward.

Following assessment, differential diagnoses included schizophrenia, bipolar disorder, antisocial personality disorder, and substance abuse. Personally, I always felt substance abuse was unlikely.

Although not definitive enough, it gave the clinician something to work with. Consequently, she was started on neuroleptics (tranquilizers) which eventually was of little or no benefit.

She was later referred to another psychiatric facility after being diagnosed with dissociative fugue or amnesia. Whenever she tried to recall her early years, she often presented in fragments, lacking clarity.

Dissociative Identity Disorder

It was painful that she couldn’t recall a huge chunk of her childhood. She was usually between the highs and lows of emotions. Though not physically dangerous to put up with but she suddenly became hostile and awkward. According to her significant other, her romantic relations never lasted a year, often breaking up without any explanations.

What is it like to live with dissociative identity disorder?

The root of DID is believed to be severe and prolonged trauma experienced during childhood, including emotional, physical, or sexual abuse.

For Eka, my friend, she had several admissions in the ER due to several suicide attempts. One time she had a deep cut on her left shoulder. It involved a major vein close to the jugular vein. During an assessment, she had told the clerking physician that she slipped and hit her head on the edge of a kitchen sink. As usual, her explanation was incongruent with regard to the nature of the cut. The psychiatrist had to use verbal repetition and mental images to direct her thoughts in an attempt to help her recall how the injury occurred.

Dissociative Identity Disorder

Another alter known as Anthony narrated his experience, after being diagnosed with DID when he was around 22 years. It was after a second suicide attempt, having disassociated, and only remembering a fragment or two before waking up in the hospital.

Now 36, he couldn’t keep a day job or own a business. He talked about how he was arrested several times by the cops and taken to a mental health ward as an “imminent threat to self and others”. He was deemed dangerous. He recalled how he was an abuser of skunk and amphetamine. Tony narrated how many psychologists he met who didn’t believe in his condition, only regarding it as an excuse to be hooked on prescription drugs. For him, life can never be balanced.

Are there triggers to Dissociative Identity Disorder – DID?

The best part for Anthony was identifying his triggers. In his words, “We” thrive on pain: it makes us tougher. However, there are different levels of disassociation. Bestowing to popular belief,  the more trauma, the more alters are likely to disassociate, and with enough trauma, they can disassociate entirely. In some, complete disassociation can lead to ridiculous adrenaline rushes that give them seemingly extraordinary power and/or capabilities.

Those with DID don’t seem to have an established number of “alters”, so, it remains practically impossible to tell how many temperaments they are capable of. Basically, there’s a dominant persona that borrows fragments of other personas around them. This phenomenon goes a long way to affect those around them.

Some alters can perfectly emulate fictitious characters, non-living things, just about anything. Contrarily, this ability doesn’t make them the most talented. Instead, it is accompanied by poor concentration. An alter finds it difficult to finish anything at a stretch. They’re easily distracted or too bored to stick to a routine.

Most take to different psychoactive substances and end up as addicts. Often times, they lose track of time, location, activities, or identity. They may dissociate and find themselves somewhere, not knowing how they got there or where they’ve been.

For Eka, a different component of her identity always had bad intentions for her. This particular alter went by the name, Debi. On one of the many sessions with the therapist, she recounted trying to slice her jugular. Further probe revealed more disturbing things about this hideous ‘alter’ and her mission to self-destruct.

Dissociative Identity Disorder

The alter ‘Debi’ felt like a different age altogether and complained about being too skinny. She detested it, saying it was suffocating and she was claustrophobic.

Is it possible for alters to go away?

Psychologists maintain you cannot kill off a collective part of the conscious mind like you can a person. Thoughts, memories, emotions will lurk around. Some alters may go into hiding, be immobilized briefly, or combined with another part of the mind. They can’t disappear entirely or “be killed’’. This altogether makes DID an enduring disorder. Certain alters are protective in nature, and as such, can go away for long periods of time, especially if they feel they are no longer needed to protect the host. Technically, this can also occur in therapy as soon as the trauma they hold has been told and understood – this process is otherwise known as integration. Importantly though, a certain trigger or extended period of stress can cause an alter resurface.

Eka underwent psychotherapy, which helped her understand fragments of her identity as poorly integrated portions of her overall self, rather than as distinct “personalities”. Thus, she learned to live with her alters in moderation – integrate them, appreciate each alter’s uniqueness, and gain the cooperativeness of conflicting alters.

She was helped to master how to restructure her memory, especially of the abuse meted on her to include her ability to upset it. Some antidepressants were prescribed for her comorbid depression. Lastly, she responded well to the combination of antidepressants and psychotherapy and came to dissociate only rarely. Eka was able to bring into being a new version of herself and develop a more stable and healthy relationship with her family, friends, and co-workers.

Take home nugget

Dissociative Identity Disorder is so complex hence, wrongfully portraying alters in movies –especially the exaggerated outward manifestations– further deludes the unsuspecting population about DID. Other comorbid conditions can make DID homicidal or psychotic.

DID is supposed to go without being seen – like the chameleon of disorders with its entire purpose being to allow the host to lead a normal life by blocking traumatic memories. People are most likely to perceive DID as severe mood swings and memory loss. It is certain that there is a great deal of shame one feels when experiencing switching. It is not enjoyable and is tantamount to sobriety.

If someone seems to enjoy DID, probe further. Lastly, most people with DID are much more likely to hurt or kill themselves than other people.

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