By Luke Dalfiume, PhD, Licensed Clinical Psychologist, Co-Owner, John R. Day & Associates, Christian Psychological Associates
Dissociation is a common process, something that we all do. When you are daydreaming about your summer trip, or past glory as an athlete, you are dissociating. Dissociation involves splitting away from the current, objective reality and focusing on internal material instead.
Dissociative Identity Disorder, known to many as Multiple Personality Disorder, involves the primary person “going away” dissociatively and another discrete personality taking their place. Often the person with Dissociative Identity Disorder (referred to as DID among professionals) has more than one of these discrete personalities.
There are two types of DID. In the possession form of DID, the alternate personalities are obvious to others. In the non-possession form of DID, the alternate personalities are not obvious most of the time, and the personalities do not stay present for long periods of time.
Below are the formal criteria for diagnosing Dissociative Identity Disorder (from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition—the DSM-5):
A. Disruption of identity characteristics by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
C. The symptoms causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The disturbance is not a normal part of broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play
E. The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).
Sometimes the person with DID may report becoming an observer of “their own” speech and actions, without the ability to control it. They may also report hearing voices different from their own which they cannot control. Strong emotions that do not seem congruent may also be experienced. In addition, as stated in the DSM-5, “Attitudes, outlooks, and personal preferences (e.g., about food, activities, dress) may suddenly shift and then shift back.” In general, there may be an overall sense of experiences that are not consistent with the person’s primary identity.
Dissociative amnesia is characteristic of DID. These may involve a failure to remember chunks of past history (commonly from childhood or adolescence), a failure to remember things that one did or that happened today, or the discovery that one did things that one does not remember doing.
Dissociative Identity Disorder is typically experienced by those who have experienced significant trauma. Dissociation, as noted above, is a common experience (e.g., daydreaming). It is the brain’s way of coping with stress, even stress as minimal as boredom. However, for the person with DID, they often experienced overwhelming stress or stressors, and the more significant DID developed as a result. It is not a conscious process.
DID can be treated, but frequently requires significant time in therapy to build rapport and work toward a greater degree of integration of the secondary personality states into the primary personality.
For more information or to book an appointment, contact John R. Day & Associates, Christian Psychological Associates, located at 3716 West Brighton Ave., Peoria or their additional locations in Normal, Canton, Pekin, Princeton, or Eureka. Call us at 309-692-7755 or visit us online at www.christianpsychological.org.