Bayridge Family Center
Burlington, Ontario, Canada

by David Cosier

Dissociative Identity Disorder
A Creative Survival Technique

Dissociative Identity Disorder (DID), formerly called Multiple Personality Disorder (MPD), is the name given by the American Psychiatric Association's Diagnostic and Statistical Manual (DSM IV). This name change came into effect in 1994 to better reflect the ongoing understanding of what can occur from severely traumatic events, experienced by children, during their early developmental years.

DID is a defence mechanism that protects a child from the physical and emotional pain associated with abuse, by separating a part of the child's mind or consciousness to deal with severe trauma. Over the time of repeated abuse, separate parts can develop to establish their own identities. This condition involves the existence of at least two or more distinct personalities or personality states, each with its own way of relating to itself and to the outside world, which frequently exchange executive control of a person's behavior. These distinct personalities operate within one person, normally referred to as the "host". The "host" is the one who makes the primary daily decisions, and is in control of the human mind and body, most of the time. When an alternate part of a person comes forward, the host is temporarily no longer in control. During these times, the host may experience a loss of time, with little or no recollection of what has transpired during their absence. There may also be episodes when different degrees of co-consciousness exists, i.e. the host becomes more fully aware that they are sharing their body with different parts within herself. This usually happens when a part comes forward to express themselves, and the host may at times recognize the identity of the individual part, even though they may not always be aware of the dialogue or the actions taken by the alternate part within themselves.

Judy Castelli, an artist and a survivor with DID, provides a good understanding of what happens as a child experiences the nightmare of ongoing, repeated abuse. The mind splits into many personalities if the abuse is prolonged, so that no one part of the mind has to experience the entire trauma. Castelli also mentions that the mind of a child can separate itself from physical, sexual, and emotional abuse that is simply a miracle. Faced with repeated assault, the child's mind can send out more resilient parts to cope with the horror, and the splitting of their mind will continue until the abuse stops. The different personalities will often remain hidden while the mind grows, and finds its strength, until a point in time when the memories can come to the conscious mind, and the secrets of the abuse can be revealed.

DID needs to be seen as a creative survival tool, rather than a disease or stigma. It allows a child to escape from situations where there is no physical escape by going away inside and allowing someone else, another alternate personality, to take over their place. It is often used by children who have grown up in severely abusive environments, and it can continue to be the preferred way of coping well into an individual's adult life. It is in the adult life of a severely abused person that many of these coping mechanisms break down, and the appropriate treatment is necessary for personal healing and growth.

The symptoms of DID can include: depression, mood swings, suicidal tendencies, episodes of amnesia or loss of time, panic attacks, phobias, self-mutilation, headaches, out of body experiences, conduct problems, and the inability to focus in school. Those who develop these symptoms have documented histories of repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood (usually before the age of nine).

Identifying and properly diagnosing DID can be the most difficult obstacle in receiving appropriate treatment. It is common for people to be treated for secondary symptoms like depression and anxiety, before a proper diagnosis is made. However, once a specialist does confirm the condition, then he can guide the process along by helping the individual to integrate all of their memories into their central consciousness. As the individual is able to recall and deal with their past, there is no longer the need for alternate personalities. The process of therapy for adults is often long and arduous, and can take anywhere from 3 - 5 years to resolve.

Therapy usually involves some form of treatment, to help stabilize the person, lessen the degree of dissociation, increase cooperation and co-consciousness within the system, and often ultimately merge the different personalities (or alters) into one personality, a process called integration. Stabilizing the individual can include implementing contracts to ensure their own physical and emotional safety, referring to physicians for drug treatment needs, and developing a cognitive framework to help the abused person acknowledge how they think and feel, and to discuss what they consider to be "normal".

Dr. Colin Ross, one of the leading experts in this field, identifies areas of support that can be offered to those diagnosed with DID:
1. Help each alter personality to understand that he or she is one part of a whole person,
2 . Use the alters' names as convenient labels, not licenses for irresponsible autonomy,
3 . Treat all alters fairly and empathically,
4 . Encourage empathy and cooperation between personalities,
5 . Be gentle and supportive. Remember the severity of the trauma, and
6 . Do not dramatize symptoms such as amnesia.

Colin Ross also mentions that the "host" may have a lot of denial of the diagnosis of DID, and may at times believe that they have made up the stories of their own trauma. Friends and relatives of the survivor with DID may also find that they have different types of emotional reactions in trying to be supportive. There may not always be a sense of who they are speaking to, and sometimes even the survivor themselves may not always know what alternate personality is coming forward.

As the survivor goes through the healing process, they may at times feel like quitting the therapy, as it can be a frightening experience to surrender their coping mechanisms which have been a survival tool for enduring trauma. Being able to trust other adults can help them to stay focused and centered within them, so that they do not have to revert to former methods of coping, and therefore, be open to new ways of relating.  

Frank Putnam, another leading researcher of DID, expresses the benefit of reparenting of a survivor, and for that need to be fulfilled from within the survivor's own context. Since the child has not grown up with a healthy sense of who they are, and probably not had supportive role models, reparenting becomes a necessary part of their own growth and maturity. Other means of support include: 1) treating with exceptional discretion and care the diagnosis of someone you know who has is living with DID. Relationships and careers can be seriously affected by careless gossip, and by the intrusion of those who neither really wants to care for, or support, the individual in need. 2) Encouraging survivors to find support groups, like Survivors of Incest Anonymous, which supports individuals with DID, including a collection of literature to help them through their own recovery. 3) spending time with others who have gone through traumatic experiences in their early and late childhood can also be helpful, as they know the difference between understanding the concepts and experiencing it personally, and 4) building healthy boundaries to respect the needs of both support people and the survivor, and to model different methods of coping, to ensure the survivor can move beyond previous patterns of disruptive or destructive behavior.  

DID is a condition that is very treatable, both through managing any chemical imbalance in mood swings, and working through patterns of abuse in early childhood. The professional staff at Bayridge Family Center are capable of assisting you, or a loved one, to find the personal and professional help you need, in a most discrete and confidential manner. This condition is something that you need not face alone, whether you are a survivor of abuse who is trying to cope as an adult, or if you are a support person, helping someone in need. Our contact information is provided through our web-site: www.bayridgefamilycenter.com, or you may request an appointment through reception at 905-319-1488.

Outside Sources:
1) Mental-Health-Matters.com,
2) Colin A. Ross, 1989, M.D. Multiple Personality Disorder, Diagnosis, Clinical Features, and Treatment , 1989,
3) Frank W. Putnam, M.D., Diagnosis and Treatment of Multiple Personality Disorder , 1989
4) CMHA web-site,
5) The Sidran Foundation and
6) Fact Sheet by Cameron West

---

Need Help? Searching? We can help!

Give us a call 905-319-1488

For more information www.bayridgefamilycenter.com