Reflection of woman walking with an umbrella in a puddleDissociation can be described as feeling disconnected from the self, the world, or reality. Someone experiencing dissociation may not remember what happens during the episode. They might also feel as if they are observing themselves from an outside perspective.

Many people begin dissociating while experiencing abuse or another traumatic event. Dissociation can help people cope with what’s happening, but if it continues after the trauma stops, it can negatively affect a person’s life.

There are several types of dissociation, though they share some common features. According to Mental Health America, about a third of people experience dissociation on occasion. About 4% of people have more frequent or severe dissociation.

People who dissociate might:

Dissociative identity (DID) is perhaps the most well-known dissociative condition. It occurs in about 1.5% of the population, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

People with DID have more than one identity state. These different identities, often called alters, can take control of the person’s thoughts and behavior, often during times of trauma or stress. The person may not remember what happens when an alter is in control.

As with other types of dissociation, DID can develop in response to trauma. It’s often linked to ongoing trauma in childhood.

What Does Dissociation Feel Like?

Mild dissociation is common. Most people daydream or lose track of time on occasion. Even briefly seeing familiar surroundings as strange or unrecognizable isn’t unusual. If these feelings happen often, last for a long time, or cause distress, it may be a good idea to talk to a counselor.

How dissociation feels may vary based on the type of dissociation and the person who has it. There are three main types of dissociation: dissociative identity, dissociative amnesia, and depersonalization-derealization. The DSM also lists other specified dissociative disorder and unspecified dissociative disorder.

People with dissociative identity might:

DID can cause distress and emotional strain. People with DID also have an increased risk for self-harm and suicidal thoughts. They may feel powerless to maintain their identity, afraid of what their alter states might do while in control, and frustrated with their inability to remember events.

Dissociative amnesia is memory loss associated with trauma. People may:

Dissociative fugue, a rare form of dissociative amnesia, can indicate DID. It occurs when a person has a period of memory loss and takes on a new identity away from home. The person may not regain memories and identity for some time.

Depersonalization-derealization disorder (DDD) is characterized by a sense of detachment from reality. People with this condition may:

People often seem unconcerned, detached, or disoriented during episodes. But because people with DDD remain aware of reality while feeling disconnected from it, the condition often causes significant distress.

5 Triggers for Dissociation

Dissociation typically develops in response to trauma. Research has linked dissociation and several mental health conditions, including borderline personality, ADHD, and depression.

Dissociative depression

Dissociative depression, a type of chronic depression, tends to develop earlier than other types of depression, sometimes as early as childhood. It’s been linked to trauma and post-traumatic anger. People may have more somatic symptoms, like pain, and are at increased risk for suicidal thoughts. They may experience mood swings, difficulty concentrating, and weight fluctuation more frequently than people with other types of depression.

Research suggests this type of depression is most common in women who experienced childhood sexual abuse. It’s often treatment-resistant—until dissociative symptoms are treated. Then the depression typically improves.

Borderline personality (BPD)

Some characteristics of dissociation are similar to those of borderline personality. For example, an alter identity may be seen as an unstable sense of self. Self-harm, suicidal ideation, and difficulty managing emotions when stressed are associated with both dissociative issues and BPD. People with BPD also often struggle in relationships and avoid difficult experiences, and many hear voices. BPD is also commonly linked to childhood trauma and neglect.

Seventy-five to eighty percent of people with BPD may experience dissociation during stress. In fact, dissociation is one of nine diagnostic criteria for BPD (five are needed for diagnosis). According to a 2016 analysis of 10 studies, dissociation occurs more often with BPD than with other mental health issues.

Recent research suggests dissociation may affect memory and emotional learning, which may be one reason why BPD is often difficult to treat.

Addiction

Research has linked addictive behaviors and dissociation. A 2005 study found that more than 17% of people getting help for substance abuse had a form of dissociation. Addiction, which can be seen as a type of dissociative behavior, has further been linked to trauma and alexithymia, a condition where people can’t identify their emotions. A study published in 2014 suggested trauma, alexithymia, and dissociation could often predict alcohol dependence. Like dissociation, addiction to alcohol may develop in response to trauma.

A 2015 study looking at 68 people who were substance-free for at least six months found that almost 25% had severe depersonalization symptoms, while over 40% experienced mild depersonalization. The study did not determine a cause of the symptoms, but the findings suggest a further link between addiction and dissociative symptoms.

Obsessive-compulsive disorder (OCD)

Multiple studies have found links between dissociation and OCD. Dissociative symptoms occur often with OCD. People with OCD might have dissociative episodes without having a specific dissociative condition. OCD symptoms can resemble dissociative symptoms, especially when the person experiences distress related to their thoughts or compulsions. People trying to resist intrusive thoughts, for example, may push them away by making themselves experience memory loss (forcible amnesia).

When people have both conditions, dissociative symptoms tend to be more severe. The risk for depression also increases, as does the risk for a co-occuring personality disorder.

Attention-deficit hyperactivity (ADHD)

ADHD is often misdiagnosed. Research suggests some children thought to have ADHD may in fact be showing signs of trauma. Telling the two conditions apart can be difficult. Blanking out while remembering something frightening, having difficulty focusing, and acting out are all signs of both posttraumatic stress and ADHD. A small 2006 study found that children who experienced abuse were more likely to show apparent symptoms of ADHD but actually have a dissociative condition.

Many children exposed to repeated trauma or abuse go on to develop a dissociative condition.
Though they may still have ADHD, it’s often not be the primary cause of symptoms. Mental health professionals may find it helpful to evaluate for posttraumatic stress as well as ADHD and ask the children they work with about home and school.

A study published in 2017 further linked ADHD and dissociation. According to the study, people with BPD are more likely to have a history of childhood trauma, dissociation, and ADHD symptoms.

Does the Cause of Dissociation Influence How It’s Treated?

Therapy is the primary treatment for dissociation. Medication might be recommended when severe symptoms of depression or anxiety accompany dissociation, but there is no medication that treats dissociation itself. If another mental health issue occurs with dissociation, effective treatment should consider both concerns.

People with borderline personality, ADHD, depression, substance abuse issues, or OCD can also benefit from therapy, but the most helpful types of therapy vary.

Dialectical behavior therapy is considered the most effective therapy for BPD, but some research suggests dissociation may negatively impact the success of DBT. People who have both conditions may respond better to treatment that focuses on dissociative symptoms. Treatment that focuses on managing BPD symptoms may not help dissociative symptoms. Research shows it’s important to address the underlying trauma as well.

Dissociative depression is often resistant to treatment when dissociation symptoms aren’t addressed, so it’s important for mental health professionals to be able to recognize dissociative issues in therapy. If chronic depression is treated with antidepressants, people with dissociative depression may see little improvement. But treating the dissociation often helps improve depression.

One study suggested screening people with substance abuse issues for dissociative symptoms, in order to treat both issues. Dissociation symptoms in people with addiction could persist if only addiction is treated.

Dissociative symptoms often go unrecognized in therapy, especially when the person seeking support has another mental health condition. Dissociation is treatable, but it’s important for therapists to recognize and address symptoms when they occur with other mental health conditions. Treatment may have less benefit when the person seeking help is dissociating, as they may not be as “present” in therapy.

When seeking help, tell a therapist about all symptoms, even if they don’t seem connected. Therapy is most effective if you can discuss all symptoms and begin to work through underlying trauma.

Remember you are not alone! Help is available. Begin your search for a counselor today.

References:

  1. American Psychiatric Association. (2018). What are dissociative disorders? Retrieved from https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders
  2. Craparo, G., Ardino, V., Gori, A., & Caretti, V. (2014). The relationships between early trauma, dissociation, and alexithymia in alcohol addiction. Psychiatry Investigation, 11(3), 330-335. doi: 10.4306/pi.2014.11.3.330
  3. Dissociative disorders. (2017, November 17). Retrieved from https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/diagnosis-treatment/drc-20355221
  4. Endo, T. (2006). Attention-deficit/hyperactivity disorder and dissociative disorder among abused children. Psychiatry and Clinical Neurosciences, 60(4), 434-438. doi: 10.1111/j.1440-1819.2006.01528.x
  5. Foster, C. (2016). Understanding dissociative disorders. Retrieved from https://www.mind.org.uk/media/4778451/understanding-dissociative-disorders-2016.pdf
  6. Goff, D. C., Olin, J. A., Jenike, M. A., Baer, L., & Buttolph, M. L. (1992). Dissociative symptoms in patients with obsessive-compulsive disorder. The Journal of Nervous and Mental Disease, 180(5), 332-337. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1583477
  7. Kleindienst, N., Limberger, M. F., Ebner-Priemer, U. W., Keibel-Mauchnik. J., Dyer, A., Berger, M., Schmahl, C., & Bohus, M. (2011). Dissociation predicts poor response to dialectical behavior therapy in female patients with borderline personality disorder. Journal of Personality Disorders, 25(3), 432-447. doi: 10.1521/pedi.2011.25.4.432
  8. Krause-Utz, A., & Elzinga, B. (2018). Current understanding of the neural mechanisms of dissociation in borderline personality disorder. Current Behavioral Neuroscience Reports, 5(1), 113-123. Retrieved from https://link.springer.com/article/10.1007%2Fs40473-018-0146-9
  9. Kulacaogu, F., Solmaz, M., Ardic, F. C., Akin, E., & Kose, S. (2017, September 30). The relationship between childhood traumas, dissociation, and impulsivity in patients with borderline personality disorder comorbid with ADHD. Psychiatry and Clinical Psychopharmacology, 27(4), 393-402. Retrieved from https://www.tandfonline.com/doi/full/10.1080/24750573.2017.1380347
  10. Mosquera, D., & Steele, K. (2017). Complex trauma, dissociation and borderline personality disorder: Working with integration failures. European Journal of Trauma and Dissociation, 1(1), 63-71. Retrieved from https://www.sciencedirect.com/science/article/pii/S2468749917300145
  11. Ruiz, R. (2014, July 7). How childhood trauma could be mistaken for ADHD. The Atlantic. Retrieved from https://www.theatlantic.com/health/archive/2014/07/how-childhood-trauma-could-be-mistaken-for-adhd/373328
  12. Saddichha, S., Pradhan, N., Gupta, H. (2011). A case of obsessive-compulsive disorder presenting as dissociative disorder: The role of sodium thiopental interview. The Primary Care Companion for CNS Disorders, 13(3). doi: 10.4088/PCC.10l01134
  13. Sar, V. (2015). Dissociative depression is resistant to treatment-as-usual. Journal of Psychology and Clinical Psychiatry, 3(2). Retrieved from https://pdfs.semanticscholar.org/2e1f/54678c76ed2071655c9378ce60c56d4abfc1.pdf
  14. Sar, V. (2014). The many faces of dissociation: Opportunities for innovative research in psychiatry. Clinical Psychopharmacology and Neuroscience, 12(3), 171-179. doi: 10.9758/cpn.2014.12.3.171
  15. Scalabrini, A., Cavicchiolo, M., Fossati, A., & Maffei, C. (2016, November 21). The extent of dissociation in borderline personality disorder: A meta-analytic review. Journal of Trauma and Dissociation, 18(4), 522-543. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/15299732.2016.1240738
  16. Schafer, I., Langeland, W., Hissbach, J., Luedecke, C., Ohlmeier, M. D., Chodzinski, C. … Driessen, M. (2010, June 1). Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both-A multi-center study. Drug and Alcohol Dependence, 109(1-3), 84-89. doi: 10.1016/j.drugalcdep.2009.12.012
  17. Sirvent, C., & Fernandez, L. (2015, May 11). Depersonalization disorder in former addicts (Prevalence of depersonalization-derealization disorder in former addicts). Journal of Addiction Research & Therapy, 6. Retrieved from https://www.omicsonline.org/open-access/depersonalization-disorder-in-former-addicts-prevalence-of-depersonalizationderealization-disorder-in-former-addicts-2155-6105-1000225.php?aid=52845
  18. Spiegel, D. (2017). Dissociative amnesia. Retrieved from https://www.merckmanuals.com/home/mental-health-disorders/dissociative-disorders/dissociative-amnesia

2017 Best Resources for DissociationDissociation describes a detachment from reality during which a person might hallucinate, daydream, or experience changes in their behavior or identity for a period of time. Individuals who dissociate may have memory loss or an “out-of-body” feeling during these episodes. Extreme dissociation can negatively impact a person’s life and daily function, and those who have dissociative experiences are urged to seek help to better understand their symptoms and learn about what is causing the dissociation.

Though dissociation may co-occur with other mental health conditions, it has no single predictor. Because it is common for individuals with dissociation to have experienced trauma or posttraumatic stress (PTSD) at some point in their lives, it can often be associated with trauma. Others may experience anxiety, panic, or obsessions and compulsions (OCD) alongside dissociation.

As dissociation is often a method of coping with stress or trauma, therapists who treat dissociation aim to help people find alternative coping mechanisms that can help them feel empowered rather than removed in their personal lives. Seeking help from a trained mental health professional is strongly encouraged, but in the meantime, or even if you or a loved one are already pursuing therapy, GoodTherapy.org’s favorite dissociation websites and organizations of 2017 may also help provide guidance and support.

Double exposure image shows silhouette of person's head looking out among clouds with second exposure of cloudsThe condition that used to be known as “multiple personality disorder” is perhaps one of the most complex types of mental health condition. Though frequently depicted in movies and the media, since the 1994 publication of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, multiple personality has not been recognized as a clinical diagnosis by the American Psychological Association. In its place is the more enigmatic-sounding, lesser known “dissociative identity disorder” (DID).

Though it’s been more than twenty years since this change, a Google search of “multiple personality disorder” still produces many times the results as a search of “dissociative identity disorder.”

What, then, is the difference between the two concepts, and why hasn’t DID gained more cultural traction?

The Rise and Fall of an Idea

The idea of multiple personalities inhabiting the same body, which appears to be a constant source of fascination to the public, has long been explored in fiction, poetry, and film. Robert Louis Stevenson’s famous novel Dr. Jekyll and Mr Hyde, first published in 1886, permanently imprinted the idea of the dual personality in the collective mind long before the popularization of psychological ideas.

By 1980, when multiple personality was first identified as a separate condition, the concept of multiple personalities was already well known. Seven years previous, the book Sybil: The Story of a Woman with 16 Different Personalities, which described a woman who had 16 personalities, sold hundreds of thousands of copies and was even turned into a movie. The book’s title illustrates the way the concept of multiple personalities plays on deeply rooted concepts of possession. From 1980 to 1994, the year multiple personality was replaced with DID in the DSM, annual diagnoses went up from the low hundreds to the mid-thousands.

When psychology and popular culture intersect so neatly, there is often a danger of the latter leading the former astray, as with this case. Increasingly, professionals came to recognize that the popularized concept of multiple personalities substantially distorted the real experience of those who had been diagnosed. Thus, in the DSM-4, the diagnosis of MPD was replaced with DID to emphasize it was dissociation, rather than multiple personalities, per se, that was particularly significant.

What is different about people who have DID is the dissociation they experience when they transition between these personality states, dissociation that often leads to lapses of memory and a sense of discontinuity. In other words, what is unique is that their personality states are not integrated into a greater whole.

Increasing awareness of dissociation involves more than simply changing the name of the condition, however. To do so, I believe it is essential to consider these two key points.

First, having different personae is not what is unusual about dissociative identity. All of us are likely to behave and even think in substantially different ways depending on whether we are at work, at a party, with an old friend, a new partner, our children, and so on. What is different about people who have DID is the dissociation they experience when they transition between these personality states, dissociation that often leads to lapses of memory and a sense of discontinuity. In other words, what is unique is that their personality states are not integrated into a greater whole. As some people put it, rather than having more than one personality, they have less than one.

Another key point is that the dissociation between personality states is part of a spectrum of dissociative phenomena experienced by people who have DID. Dissociation can occur in the way the individual experiences the passage of time (i.e. flashbacks), consciousness (thinking about themselves as if they were a third or second party), their body (feeling that they are “out of body” or looking at themselves from the outside), and emotion (not experiencing normal emotions in response to stimulus or experiencing them only vicariously). In more extreme cases, dissociation might present as different personality states that may be startlingly dissimilar, but this does not mean there are actually two or more identities within the same body. Instead, DID can perhaps best be understood as a cluster of severe dissociative symptoms.

The Link Between DID and C-PTSD

As I discussed in an earlier article, dissociation is one of the most frequent and characteristic symptoms of complex posttraumatic stress (C-PTSD). Children who experience multiple incidents of abuse, neglect, or other forms of ill treatment at the hands of a caregiver may respond by detaching in some way from their situation as a coping or survival mechanism. This detachment, or pattern of dissociative thoughts, becomes a fixed part of their personality and persists into adulthood in radically changed circumstances. The stimuli triggering dissociative episodes is beyond the individual’s control and often also beyond their understanding. A central part of therapy for C-PTSD is the identification of these triggers and the development of responses that can help the individual avoid or manage dissociation.

It’s not surprising, then, that DID often co-occurs with C-PTSD. Indeed, one might go further and wonder whether the two should really be considered separate categories. Many people have criticized the “dynamic nominalism” of the DSM—in other words, the distillation of complex arrays of symptoms into concrete syndromes … until they are changed ten years later. Nothing illustrates this better than the history of DID. In the first two editions of the DSM, the phenomenon of split personalities was included as a category of what was referred to as hysterical neurosis. In the DSM-3, the terms ‘hysteria’ and ‘neurosis’ were omitted entirely and multiple personality emerged as a separate diagnosis, only until it was replaced in the DSM-4 with DID.

In this, I am reminded of the words of John Briere:

“If we could somehow end child abuse and neglect, the eight hundred pages of the Diagnostic and Statistical Manual (and the need for the easier explanations such as DSM-IV Made Easy: The Clinician’s Guide to Diagnosis) would be shrunk to a pamphlet in two generations.”

References:

  1. Gillig, P. M. (2009). Dissociative identity disorder: A controversial diagnosis. Psychiatry (Edgmont), 6(3), 24–29.
  2. Lanius, R. A. (2015). Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research. European Journal of Psychotraumatology, 6, 10.3402/ejpt.v6.27905. http://doi.org/10.3402/ejpt.v6.27905
  3. Lawson, D.M. (2017). Treating adults with complex trauma: An evidence-based case study. Journal of Counseling and Development, 95(3), 288-298. http://doi.org/10.1002/jcad.12143
  4. Najavits, L., & Walsh, M. (2012). Dissociation, PTSD, and substance abuse: An empirical study. Journal of Trauma & Dissociation : The Official Journal of the International Society for the Study of Dissociation (ISSD), 13(1), 115–126. http://doi.org/10.1080/15299732.2011.608781
  5. Spitzer, C., Barnow, S., Freyberger, H. J., & Grabe, H. J. (2006). Recent developments in the theory of dissociation. World Psychiatry, 5(2), 82–86.
  6. Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. (2013). Therapeutic assessment of complex trauma: A single-case time-series study. Clinical Case Studies, 12(3), 228–245. http://doi.org/10.1177/1534650113479442

Double exposure image of woman on street in two places at once with long blonde hair, looking outHollywood often does a disservice to people with mental health conditions. Consider the number of feature films and television shows depicting people experiencing mental health issues as being dangerous, low functioning, and undesirable. Not only are people with mental health challenges not accurately represented, these inaccurate depictions can also do damage by generating prejudice and creating additional stigma and related stress for those trying to function. The burden of stigma is likely to make the world even more difficult to navigate for individuals living and coping with mental health concerns.

In recent years, efforts to increase mental health awareness and reduce stigma have led to some changes, including more accurate portrayals of mental health issues and those who experience them, but much work still needs to be done. One particular portrayal that fell flat appeared in the movie Split, released in early 2017. In this movie, which was roundly criticized for its portrayal of mental health conditions, a character with dissociative identity disorder (DID) had a dangerous alternate personality. As a counselor who treats dissociative conditions such as DID, the majority of which are not characterized by violent behavior toward others, this was particularly disturbing to me.

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It is imperative we, as a society, receive accurate information about not only DID but all mental health conditions, instead of relying on the distorted information, provided by Hollywood and other unreliable sources, that so often leads to fear and discrimination.

Prevalence of DID

When I was in graduate school, dissociation wasn’t really highlighted. It was only briefly mentioned before we quickly moved onto “more common” mental health concerns. Based on this, I assumed dissociative conditions, DID in particular, were such a rare phenomenon I was highly unlikely to encounter them in practice.

As it turns out, this couldn’t have been further from the truth. DID and other forms of dissociation are far more common than many think. In fact, according to the Institute for the Study of Trauma and Dissociation, it is estimated the prevalence of DID in the general population is between 1 and 3%. In inpatient psychiatric units (including those for adolescents, eating disorder treatment, and substance abuse programs) the prevalence is estimated to be between 1 and 5%.

Factors in the Development of DID

There are varying theories about why a person might develop DID. One theory, based on the work of pioneers in the diagnosis and treatment of dissociative disorders—Pierre Janet, Francine Shapiro, Onno van der Hart, Frank Putnam, Colin Ross, Stephen Porges, and Bessel van der Kolk, among others—is that DID is a way the brain learns to organize itself in order to survive traumatic experiences. This theory, incidentally, describes my own belief about DID’s origins. In my work with people who have developed DID, I have found 100% of them to have experienced some kind of trauma in childhood, including ritual abuse; neglect; sexual, physical, or emotional abuse; and medical trauma, among others.

To better understand DID, we must consider the nervous system and information processing system in the brain. When a person has normal, healthy experiences, the brain is able to take in this information, decide what is important and what is not, and then file it away in the area designed to hold memory. When the person recalls the experience, there likely won’t be much of an emotional charge when bringing up the (non-traumatic) incident.

However, when a person, particularly a very young person, experiences trauma, the nervous system immediately experiences a heightened sympathetic nervous system response (also known as “fight or flight“). When the child—DID typically begins in childhood—goes into this sympathetic nervous system arousal but cannot fight off the pain, perpetrator, or trauma, the next best thing they can do is to shut down into a hypoaroused, numb, disconnected state. The nervous system is in survival mode, and the integrative capacity of the brain is compromised and therefore unable to properly integrate the information. Thus, the traumatic memory stays frozen in time.

As the child grows up, these parts/alternate memory may become more distinct, and subsequent traumatic events may cause the brain to divide further into various parts to hold on to the aspects of trauma. These parts take on distinct personalities and identities.

For people with DID, pain and abuse are experienced again and again. Because these experiences are pervasive and so overwhelming to the nervous system, the person’s brain has to split off the experience(s) so they can continue to survive and function in life. One or more alternate memory networks, or parts, are created in the brain to hold the various components of memory to allow the person to continue to function. In a child who has experienced or is experiencing abuse, this process is particularly helpful as they attempt to survive in an environment where they are being hurt by their caregivers but must depend on those who are abusing them at the same time. Essentially, the process of dissociation allows a person to survive what might otherwise not be survivable.

As the child grows up, these parts/alternate memory may become more distinct, and subsequent traumatic events may cause the brain to divide further into various parts to hold on to the aspects of trauma. These parts take on distinct personalities and identities. This internal dynamic, if not treated, continues into adulthood. Some parts are responsible for helping the person to function in daily life. Other parts continue to hold any unresolved traumatic memories, feelings, sensations, images, thoughts, and beliefs the person experienced at the time of trauma.

A person with DID may or may not be fully aware of the dynamic inside. Often they believe they are “crazy,” but the reality is they are incredibly resilient. They are intelligent and creative. They are generally not at all like the dangerous, unstable characters often depicted in films and television—though viewing these portrayals could lead them to believe they are in fact similar, or at least appear to others as such. In my experience, people who have DID are often high-functioning and highly adaptive. In fact, you have likely met someone with DID and not known—people with this condition are generally adept at skillfully navigating social situations because they have clever parts who learned how to adapt to various challenges.

Treatment for DID

Although they navigate the world skillfully, people with DID experience real suffering. The parts or alternative memory networks holding the trauma may become activated and bring about various challenges:

These parts are not malicious in their intentions. They are merely operating with the information they hold, which is not complete. Often, these parts do not know the trauma is over. They are not aware the person got out of the situation and became able to act on their own and do things to keep themselves safe. Essentially, the whole system wants to feel better, but sometimes parts are not on the same page. This is where therapy helps.

The great news for those who have DID is that the condition is treatable. Good therapy treats DID (as well as the underlying trauma) not by attempting to “get rid” of parts. Instead, a well-trained therapist will help the system orient to the present, work with the person seeking treatment to explore each part and help them learn to together, and help the system work through the memories that could not be integrated at the time of trauma.

If you want more information on the realities of dissociation, a good resource for research-based, accurate information is the Institute for the Study of Trauma and Dissociation.

The next time you see an example of any mental health issue (not just DID) in the media, suggesting people with that condition are unstable, dangerous, or undesirable, remember to consider the reliability of the source and seek out the truth from experts and reliable organizations.

References: 

  1. Chu, J. A., Dell, P. F., Van der Hart, O., Cardeña, E., Barach, P. M., Somer, E., … & Twombly, J. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12, 115–187. Retrieved from http://www.isst-d.org/downloads/guidelines_revised2011.pdf
  2. Nedelman, M. (2017, January 23). What Shyamalan’s Split gets wrong about dissociative identity disorder. CNN. Retrieved from http://www.cnn.com/2017/01/23/health/shyamalan-split-movie-dissociative-identity-disorder/index.html
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