Dissociative Identity Disorder: The Most Misunderstood Mental Health Issue

Dissociative Identity Disorder

Although clinical cases of patients with alternate personalities were documented and treated by physicians and psychoanalysts in the early 1900s, dissociative identity disorder (DID) was not officially recognized as a distinct psychiatric condition until 1980. By that time, the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) was published and the impact of trauma on brain development and psychological functioning had become more widely recognized. Despite the skeptics who supported unsubstantiated myths about DID as a true diagnosis—including that it was a fad disorder, extremely uncommon, or caused by suggestion—we know today that it is a very real and often misunderstood mental health condition. In an effort to bring more awareness to this condition, actress AnnaLynne McCord chose to speak openly publicly about her own DID diagnosis and allowed her visit to Amen Clinics to be filmed. (You can see the video here.)

DID used to be called multiple personality disorder and is found in approximately 1% of the population. While there are other possible contributing causes of DID, such as war and natural disasters, it is estimated that 90% of cases are brought on by extreme physical, emotional, or childhood sexual abuse.

Dissociative Identity Disorder Evolves as a Coping Mechanism

The human brain isn’t fully developed until approximately age 25. After birth, a child’s brain goes through many stages of growth that are reflected in their beliefs and behaviors and based on the developmental stage in which they are. When children are subjected to abuse or other trauma, they don’t possess the coping skills that an adult would normally have to help manage the emotions and psychological processes of what is happening to them. They will instinctively find ways to cope the best way they can under the circumstances.

When children are subjected to abuse or other trauma, they don’t possess the coping skills that an adult would have to help manage the emotions and psychological processes of what is happening to them. Click To Tweet

For example, a young child who is the target of repeated sexual abuse by a parent may project the experience onto someone else inside her mind as though it isn’t happening to her real self. Dissociating from the experience occurs unconsciously to help her get through the trauma while blocking out the horror of it. Her young brain cannot process nor accept what is happening, yet she must find a way to survive without being overwhelmed by the emotions and shame that threaten to engulf her. In an appropriately developmental way, her brain creates an alternate identity that gives her a way to cope.

Alternate Personalities

In cases of DID, a person will have a core personality and at least one “alter,” although it’s not unusual for someone to have several. The alters have specific personality traits and may be of different ages or genders and have attitudes, behaviors, capabilities, and mannerisms that differ from the core personality. Although there are varying reasons for switching from one personality to another, stress or reminders of the abuse and trauma are common triggers. Again, this is an unconscious process that serves the need to be protected from the past traumatic experiences a person was subjected to.

Common Symptoms of Dissociative Identity Disorder

Although symptoms often begin in childhood, research has found that it can take 6 to 12 years after seeking treatment for DID to be properly diagnosed. Aside from a practitioner’s potential lack of knowledge about the disorder, another reason for this is because people with DID—as with other trauma-based disorders—often have a number of co-occurring conditions, including:

The overt symptoms of these conditions may often be the focus of treatment, while other symptoms that are clinically consistent with the diagnosis of DID may be overlooked or not recognized. These include:

  • Dissociation and switching personalities
  • Gaps in memory about everyday events, including personal information
  • Memory lapses about the traumatic events
  • Feeling disconnected to reality and/or their body

Diagnosis and Treatment of Dissociative Identity Disorder

In cases where DID is suspected but not confirmed, a psychotherapist or psychiatrist can utilize reliable clinical assessment tools, such as the Structured Clinical Interview for Dissociative Disorders (SCID-D) or the Dissociative Disorders Interview Schedule (DDIS) to obtain additional diagnostic information.

Some people with DID may initially be reluctant to talk to their doctor or psychotherapist about their alternate personalities. While embarrassment or shame may inhibit them from disclosing this information, another reason may be that doing so gets too close to the traumatic memories, which by virtue of their alters, they have had some degree of protection. It’s understandable. A very common reaction in therapy for those who have endured trauma is a tendency to try and minimize or skirt around certain issues or feelings, because of the sense of overwhelm they engender.

Healing from Dissociative Identity Disorder is Possible

With an experienced practitioner, a person suffering from DID can begin the healing process, but it must be appropriately paced and not rushed. Helping the patient to develop greater emotional stability and a sense of psychological and physical safety is the first step. Once that has been attained, then the process of working through the painful traumatic experiences can begin. Over time, as those memories are assimilated and better managed, learning how to live and cope in the present—without dissociation and splitting—can be practiced and achieved.

Dissociative identity disorder, emotional trauma, and other mental health problems can be treated. During this time of uncertainty, your mental well-being is more important than ever.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

19 Comments

  1. Thank you for acknowledging this disorder. I am a survivor. I am fully integrated, I think. I had 22 named alters, the first coming when I was 2 1/2. The integration happened too quickly and now I am working on a grieving process. I miss the others when I’m in a stressful situation. I am trying to build new coping mechanisms. I had a SPECT done 9 years ago but never had it explained to me other than to say there was some frontal lobe (?) damage. Anyway, thank you for acknowledging DID.

    Comment by Paula — May 14, 2021 @ 4:07 AM

  2. Narcissism should be on the list in bold red. Talk about a split.

    Comment by Anne — May 14, 2021 @ 4:30 AM

  3. Excellent article! I would add that like autism spectrum disorder that did is also a spectrum disorder. I would also add to the infections checklist herpes 1 and 2 and shingles which are infectious diseases which are also neurological (affecting the neurons). I would also add testing for sleep apnea because a CPAP machine helps with the oxygen problem. While spirituality / God / higher power is essential to recovery, I would also mention the component of spiritual abuse (justifying abuse using the Bible and/or a concept of God or higher power) as a factor in DID. You could ask the client about their earliest spiritual training and whether any ideas about God contributed to a victim justifying, then internalizing, then tolerating abuse, especially the concept of forgiveness when there has been no acknowledgment of the abuse or repentance (ending of the abuse). My mother was murderous and my father was incestuous. I was not able to have safe contact with my father until he was so old he was childlike and didn’t make any sexualized remarks anymore. I couldn’t have physical contact with my mother until she was so old she couldn’t physically assault me anymore, but at 89 she can still throw an emotional punch as good as any abuser. Thank you for the work you are doing with DID, which you can expect to increase geometrically as more and more children are sexually abused, including the explosion of internet porn and human trafficking.

    Comment by Katherine — May 14, 2021 @ 4:33 AM

  4. I was evaluated by AMEN Clinic in Manhattan , NY October 2020 for TBI. After my consult with Dr. Grin; I hired him as my Psychiatrist. This lead to a possible diagnosis of D.I.D.D.O . I found a excellent Dr. whom has me undergoing talk therapy and Nero-Feedback. Nero-Feedback is working for TBI. The Talk Therapy is helping with D.I.D. Nothing is one size fits all. People with TBI and or D.I.D should realize there are excellent treatments available. Mine; is costly; but they should talk with their insurance carrier for coverage; and GET THE RIGHT DR. Prior to Amen; I went through four Psychiatrist; two with PHD’s and over 25 years experience each. I advised them of changes in my voice, manners, Even explained; my family said Dr. Jeckyl and Mr Hyde. You can waste a lot of time with a improper diagnosis

    Comment by Evan Torrey — May 14, 2021 @ 5:26 AM

  5. I heard you have opened a clinic in Fort Lauderdale. Yes?

    Comment by Simone Sanfilipo — May 14, 2021 @ 7:22 AM

  6. Have spect scans been done while different alters are “out” to see if there is a difference in the brain?

    Comment by Ada-Lou — May 14, 2021 @ 7:42 AM

  7. Hello Simone. Thanks for reaching out. We do not have a clinic in Fort Lauderdale. Amen Clinics currently has 9 locations (the closest to Florida would be our Atlanta clinic): https://www.amenclinics.com/locations/. For more information about scheduling, please contact our Care Coordinators: https://www.amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — May 14, 2021 @ 8:59 AM

  8. I have met three people in my life who had DID. The first person actually went into a full dissociative state and changed personalities in front my eyes; it was scary because this “alter” was scary. We actually called the police because we were so frightened. I feel badly because I’m sure he was also frightened. In any case, that was over twenty years ago. Since then I met two other people who had met each other in the hospital where they had been diagnosed with DID. I never saw them change personalities, so I’m assuming they were fully integrated or at least relatively healthy regarding their DID.

    Now I am a neurocounselor, a certified Amen Brain Health Coach, and I do neurofeedback. We do the Othmer Method of neurofeedback; it’s incredibly effective at helping people heal from trauma. I am confident it would be effective at treating DID. I really appreciate this article because of the history of gaslighting people’s experience with this phenomenon/disorder. Thank you!

    Comment by Jen Markovics — May 14, 2021 @ 10:19 AM

  9. Not sure what you mean by website but I read this article on yours. I am glad to see someone talk about DID accurately. I am the survivor of every kind of child abuse imagined. Working with a very skilled therapist has done wonders for me. I know I am a miracle. The thing I think needs to really be brought out is that it is not being “schizo” and the ways that DID is shown in movies and television which really harms our population. I tell people there is a huge difference between being schizophrenic and having DID and we need to stop mixing up the two. In my profession I have seen children who I am sure are DID and it breaks my heart because I know the kind of abuse needed to have it and I know the work it takes to heal. All people need to know that we are not the butt of jokes or having a day where you can’t make a decision easily. Also that DID is a spectrum and that all people do dissociate but not to the extent we have to protect our minds.

    Comment by Jean Sanders — May 14, 2021 @ 11:03 AM

  10. Would welcome treatment but financially suspect prohibitive. On Social Security and Medicare though could use some encouragement. Conceived in violence, birth traumatic. Molested at 4. God has kept me alive. Thank you. God bless you.

    Comment by Judith Grominger — May 14, 2021 @ 1:31 PM

  11. I suffered a high velocity hit to my forehead at age 7 … I’m also a victim of childhood sexual abuse, emotional and physical abuse, and suffered the same as an adult. I have very few memories of my childhood other than bad memories … and people tell me of times spent with me but I have NO memory! Some people have approached me as an adult and seem to know me well … and I don’t have a clue who they are!! It all came together for me while watching The Dr Phil show about DID when Dr Amen was helping Annalynn McCord. It was a lightbulb moment for me and I sobbed. Some other personality has lived a huge portion of my life … and while I have been through years of counseling … I now realize I need much more! The previous counseling was like getting bandaids to cover internal injuries that required much more medical attention!!

    Comment by Valerie — May 14, 2021 @ 2:50 PM

  12. In the late 1980s, I was married to a man for a short time that exhibited multiple personalities. I slowly learned that his father was a sexual abuser, that he suffered PTSD from serving in Vietnam, and that two of his older daughters accused him of long-term sexual abuse. When I tried to talk about it, his personality changed before my eyes. Instead of the docile, almost catatonic, personality that I knew, he became the aggressive and mean person that his daughters had described to me. His eyes burned with anger. His physical appearance changed. He said things that I had never heard before. After the episode, when I described it to our marriage counselor, he was adamant that he did not do it, it never happened, and I was lying to gain an advantage. Later, when I described the experience, people thought I was the one who was crazy.

    Comment by Bonnie — May 15, 2021 @ 3:58 AM

  13. Dear Dr Amen & Staff, Thank You for what you are doing to help others in this area of brain health. These truths and healing are so needed in this world of trauma and addicitions. Just knowing there are reasons and solutions gives such hope and power to our clients, family and friends. I hope to one day soon be a certified Amen specialist. Thank You, Karen Stene Finch CNC. CNHP, Master Herbalist

    Comment by Karen Stene Finch — May 15, 2021 @ 4:10 AM

  14. If you have a newsletter, please put me on the list to receive it. In addition is there a physician in Philadelphia who treats patients.

    Comment by Mary Anne Killian — May 15, 2021 @ 5:09 AM

  15. I am now retired Professional Counselor. I was astounded at how few of my colleagues had a clue about DID. I began treating it early in my career. I started studying it after one of my clients came in dressed in extremely different ways. It was as though this person was many different ages and possibly identified as being a different sex at times. I cannot tell you how many of my peers kept insisting one of my clients was playing me. She did manipulate at times, but once I became fully enlightened about dissociation, I could tell she was not using the personalities solely for manipulation but as a coping mechanism related to stored trauma. When I did case consultations, I was sometimes attacked verbally, and my professional integrity was insulted on more occasions than I care to mention. If you have DID, find someone who tends to specialize in it. Victims of abuse who are not believed by family and friends or by a therapist who doesn’t believe they have coped by creating different personalities to hold and to cope with the trauma are being re-traumatized by the disbelief, and they may never feel safe in therapy. If you have to go to a hospital, be willing to travel to one that regularly treats DID patients at the very least or, preferably, that specializes in threating DID.

    Comment by Candace Dorsey — May 15, 2021 @ 10:26 AM

  16. DID is very real. I know because I was diagnosed with DID years ago. Psychiatrist and psychologist know very little about this mental health diagnosis. It took years for them to find medication that works for me. Today I am stable. I know that trauma and extreme stress will cause me to disassociate and sometimes its hard to tell if I am in a crisis because one of my personalities take over and it’s like someone else is living my life. Sometimes I know if I have disassociated and sometimes I don’t. Thank God for the people who know and support me.

    Comment by vanessa winckler — May 15, 2021 @ 1:25 PM

  17. I am interested to know the answer to question posed by earlier reader: “ Have spect scans been done while different alters are “out” to see if there is a difference in the brain? (Comment by Ada-Lou — May 14, 2021 @ 7:42 AM)”

    Comment by Mariama Ndoye — May 15, 2021 @ 8:09 PM

  18. Thank you for this information. I have an adult child whom I have thought , “split personality.” Not really understanding, but have seen drastic changes through the years. There was a difficult pregnancy, very difficult birth. A lot of emotional trauma in early years. This article and the comments hit home. I am not a doctor, but maybe can get through to her about help. Thank you

    Comment by Patsy Baxter — May 16, 2021 @ 5:33 AM

  19. It’s an outright crime when parents abuse their children. I don’t know the percentage in our society, but it could be as high as 25%. Unfortunately, abused children much too often abuse their own children. The nations of the world spend only 2% of their health budgets on average on mental health. There is no quick fix or easy solution, but until a greater focus is placed on mental health, humanity will suffer much more than is necessary. If we do this, it won’t stop all wars, but it will lessen the violence, both physical and mental in our world.

    Comment by MICHAEL JANKO — May 16, 2021 @ 7:31 PM

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