Dissociative Identity Disorder

Dissociation is a psychological process that often occurs in response to extreme trauma or pain and is an automatic response, based on the type of trauma and the person's coping skills. It allows the person to block negative emotions and experiences from their consciousness and compartmentalize traumatic memories  (Briere et al., 2005; Diseth, 2005). The American Psychiatric Association (2000) describes dissociation as a failure to associate and integrate thoughts, memories, emotions, perceptions of environment, and identity. For example, someone may think about an event that was tremendously upsetting yet have no feelings about it. Clinically, this is termed emotional numbing, a symptom of post-traumatic stress disorder (PTSD). This disturbance in function can be gradual, chronic, or occasional. Symptoms include depersonalization, derealization, dissociative amnesia, fragmented identity, and posttraumatic experiencing.

What is Dissociation:
  • It is psychological numbing. It is used to protect from psychological trauma and is the means to ignoring thoughts or emotion.
  • It includes psychogenic amnesia. This is abnormal memory function that has no organic cause.
  • It also may include depersonalization. The person feels like she is in a dream, watching herself act and having no control over the situation.
  • It may include derealization. The outside world feels strange or unreal.
  • It includes disengagement. The person is not present or consciously engaged.

Dissociation is often used by children experiencing sexual abuse because it removes them from the source of pain, Dissociation can become a persistent coping mechanism. Although a survival skill for a child, continuing to use dissociation as an adult results in emotional dysregulation, reduced self-esteem, relationship problems, and negative health effects. PTSD, dissociation, amnesia, and increased physical illness are common in adult sexual abuse survivors. Dissociation is a predictor of negative consequences (e.g., eating disorders, self-harm behaviors, addictions) in sexual abuse survivors.

Dissociative Identity Disorder (DID) was previously known as Multiple Personality Disorder. It is the most severe and chronic form of dissociation. The person has 2 or more separate and distinct personalities and switches back and forth between these. Each of these dissociated states have characteristics differing from others (e.g., different personal history, self-image, name, and personality characteristics). The individual usually has no memory or awareness of alternative personality states (alters). Stressors or events in the environment often trigger a change from one alter to another. Individuals with DID have frequent gaps in memory, both remote and recent.

Individuals with DID frequently report severe childhood sexual and physical abuse, and these reports have been confirmed by objective evidence. The different personalities sometimes cope with different problem areas in the person's life. Other symptoms common in persons diagnosed with DID include PTSD, self-harm, suicidal behaviors, and mood, substance, sexual, eating, or sexual disorders. Stressors or events in the environment often trigger a change from one alter to another. Diagnostic criteria for DID (DSM-IV-TR, American Psychiatric Association, 2000) include: 

  1. The presence of two or more distinct identities or personality states.
  2. At least 2 of these identities recurrently take control of the person's behavior.
  3. The person is unable to remember important information that is too extensive to be explained by mere forgetfulness.
  4. The disturbance is not an effect of substance abuse or a medical condition.



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